Abdominal Visceral and Subcutaneous Adipose Tissue Compartments. Association With Metabolic Risk Factors in the Framingham Heart Study
- From: MarilynMann <mannm@xxxxxxxxxxx>
- Date: Sun, 24 Jun 2007 14:53:59 -0000
Fox, et al., Abdominal Visceral and Subcutaneous Adipose Tissue
Compartments. Association With Metabolic Risk Factors in the
Framingham Heart Study
Published online before print June 18, 2007
(Circulation 2007, doi:10.1161/CIRCULATIONAHA.106.675355)
Background--Visceral adipose tissue (VAT) compartments may confer
increased metabolic risk. The incremental utility of measuring both
visceral and subcutaneous abdominal adipose tissue (SAT) in
association with metabolic risk factors and underlying heritability
has not been well described in a population-based setting.
Methods and Results--Participants (n=3001) were drawn from the
Framingham Heart Study (48% women; mean age, 50 years), were free of
clinical cardiovascular disease, and underwent multidetector computed
tomography assessment of SAT and VAT volumes between 2002 and 2005.
Metabolic risk factors were examined in relation to increments of SAT
and VAT after multivariable adjustment. Heritability was calculated
using variance-components analysis. Among both women and men, SAT and
VAT were significantly associated with blood pressure, fasting plasma
glucose, triglycerides, and high-density lipoprotein cholesterol and
with increased odds of hypertension, impaired fasting glucose,
diabetes mellitus, and metabolic syndrome (P range <0.01). In women,
relations between VAT and risk factors were consistently stronger than
in men. However, VAT was more strongly correlated with most metabolic
risk factors than was SAT. For example, among women and men, both SAT
and VAT were associated with increased odds of metabolic syndrome. In
women, the odds ratio (OR) of metabolic syndrome per 1-standard
deviation increase in VAT (OR, 4.7) was stronger than that for SAT
(OR, 3.0; P for difference between SAT and VAT <0.0001); similar
differences were noted for men (OR for VAT, 4.2; OR for SAT, 2.5).
Furthermore, VAT but not SAT contributed significantly to risk factor
variation after adjustment for body mass index and waist circumference
(P 0.01). Among overweight and obese individuals, the prevalence of
hypertension, impaired fasting glucose, and metabolic syndrome
increased linearly and significantly across increasing VAT quartiles.
Heritability values for SAT and VAT were 57% and 36%, respectively.
Conclusions--Although both SAT and VAT are correlated with metabolic
risk factors, VAT remains more strongly associated with an adverse
metabolic risk profile even after accounting for standard
anthropometric indexes. Our findings are consistent with the
hypothesized role of visceral fat as a unique, pathogenic fat depot.
Measurement of VAT may provide a more complete understanding of
metabolic risk associated with variation in fat distribution.
* * *
So how does one know how much VAT one has? Does one have to have a
multidetector computed tomography scan to find out?
Marilyn
.
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