title: Abdominal and gynoid adipose distribution and incident myocardial infarction in women and men.
abstract: OBJECTIVE
  The relationships between objectively measured abdominal and gynoid adipose mass with the prospective risk of myocardial infarction (MI) has been scarcely investigated. We aimed to investigate the associations between fat distribution and the risk of MI.
  
  
  METHODS
  Total and regional fat mass was measured using dual-energy X-ray absorptiometry (DEXA) in 2336 women and 922 men, of whom 104 subsequently experienced an MI during a mean follow-up time of 7.8 years.
  
  
  RESULTS
  In women, the strongest independent predictor of MI was the ratio of abdominal to gynoid adipose mass (hazard ratio (HR)=2.44, 95% confidence interval (CI) 1.79-3.32 per s.d. increase in adipose mass), after adjustment for age and smoking. This ratio also showed a strong association with hypertension, impaired glucose tolerance and hypertriglyceridemia (P<0.01 for all). In contrast, the ratio of gynoid to total adipose mass was associated with a reduced risk of MI (HR= 0.57, 95% CI 0.43-0.77), and reduced risk of hypertension, impaired glucose tolerance and hypertriglyceridemia (P<0.001 for all). In men, gynoid fat mass was associated with a decreased risk of MI (HR=0.69, 95% CI 0.48-0.98), and abdominal fat mass was associated with hypertriglyceridemia (P for trend 0.02).
  
  
  CONCLUSIONS
  In summary, fat distribution was a strong predictor of the risk of MI in women, but not in men. These different results may be explained by the associations found between fat distribution and hypertension, impaired glucose tolerance and hypertriglyceridemia.
authors.affiliation: Department of Surgical and Perioperative Sciences, Sports Medicine Unit, Umeå University, Umeå, Sweden.
authors.forename: P
authors.initials: P
authors.lastname: Wiklund
authors.forename: F
authors.initials: F
authors.lastname: Toss
authors.forename: J-H
authors.initials: JH
authors.lastname: Jansson
authors.forename: M
authors.initials: M
authors.lastname: Eliasson
authors.forename: G
authors.initials: G
authors.lastname: Hallmans
authors.forename: A
authors.initials: A
authors.lastname: Nordström
authors.forename: P W
authors.initials: PW
authors.lastname: Franks
authors.forename: P
authors.initials: P
authors.lastname: Nordström
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D001786:Blood Glucose / Q000502:physiology; D001823:Body Composition; D015992:Body Mass Index; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D015228:Hypertriglyceridemia / Q000150:complications; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology*; D009765:Obesity / Q000150:complications*; D011446:Prospective Studies; D011877:Radionuclide Imaging; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D013548:Sweden
chemical_list: D001786:Blood Glucose