title: Intra-abdominal fat and metabolic syndrome are associated with larger infrarenal aortic diameters in patients with clinically evident arterial disease.
abstract: OBJECTIVE
  Abdominal obesity and its associated metabolic consequences are major determinants for the development of vascular disease. Fat tissue close to arteries may also directly affect atherogenesis. The study examined whether intra-abdominal fat accumulation is an independent determinant of infrarenal aortic diameter in patients with clinically evident arterial disease. The relationship between metabolic syndrome and infrarenal aortic diameter was also assessed in this patient group.
  
  
  METHODS
  Cross-sectional study was done of 2726 patients with clinically evident arterial disease enrolled in the Second Manifestations of ARTerial Disease (SMART) study. Intra-abdominal fat was measured with ultrasonography and by measuring waist circumference. Metabolic syndrome was defined according to the Adult Treatment Panel III. The maximal anteroposterior diameter of the infrarenal aorta was measured using ultrasonography. The relation between intra-abdominal fat, metabolic syndrome, and infrarenal aortic diameter was determined with linear regression analyses and adjusted for age, sex, height, and smoking.
  
  
  RESULTS
  Infrarenal aortic diameters (mm) increased across quartiles of intra-abdominal fat derived by ultrasonography (quartile 4, 19 +/- 7 mm vs quartile 1, 17 +/- 5 mm; adjusted beta, 1.34; 95% confidence interval [CI], 0.73-1.94) and across quartiles of waist circumference (quartile 4, 19 +/- 7 mm vs quartile 1, 17 +/- 5 mm; adjusted beta, 1.43; 95% CI, 0.82-2.04). Patients with metabolic syndrome had slightly larger infrarenal aortic diameters (18 +/- 7 mm vs 17 +/- 6 mm; adjusted beta, 0.70; 95% CI, 0.27-1.13) compared with those without metabolic syndrome.
  
  
  CONCLUSIONS
  Intra-abdominal fat accumulation and metabolic syndrome are associated with larger infrarenal aortic diameters in patients with clinically evident arterial disease. These data may indicate a role for intra-abdominal fat in the development of larger aortic diameters.
authors.affiliation: Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Petra M
authors.initials: PM
authors.lastname: Gorter
authors.forename: Frank L J
authors.initials: FL
authors.lastname: Visseren
authors.forename: Frans L
authors.initials: FL
authors.lastname: Moll
authors.forename: Yolanda
authors.initials: Y
authors.lastname: van der Graaf
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000473:pathology*; D003430:Cross-Sectional Studies; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000473:pathology*; D008875:Middle Aged; D014463:Ultrasonography; D014652:Vascular Diseases / Q000453:epidemiology / Q000473:pathology*