title: Association of subcutaneous and visceral adiposity with albuminuria: the Framingham Heart Study.
abstract: Microalbuminuria is a common condition associated with increased incidence of cardiovascular events and mortality. Abdominal obesity is associated with microalbuminuria, but studies linking visceral adipose tissue (VAT) and microalbuminuria are limited. Our objective was to determine the associations of albuminuria with VAT and subcutaneous adipose tissue (SAT). We performed a cross-sectional study in the Framingham Multi-Detector Computed Tomography (MDCT) cohort (n = 3099, 48.2% women, mean age 53 years). VAT and SAT volumes were measured using computed tomography. Urinary albumin-to-creatinine ratio (UACR) was calculated from spot urine samples. Microalbuminuria was defined as a UACR >25 mg/g in women or >17 mg/g in men. Overall, 7.9% (n = 244) of the sample had microalbuminuria. Among men, VAT (odds ratio (OR) 1.48 per s.d., P < 0.0001) and SAT (OR 1.37 per s.d., P = 0.0002) were associated with microalbuminuria in minimally adjusted models, which remained significant after multivariable adjustment (VAT OR 1.34 per s.d., P = 0.001; SAT OR 1.28 per s.d., P = 0.005). Additionally, when considered jointly, VAT (P = 0.002) but not SAT (P = 0.2) was associated with microalbuminuria. In women, VAT was associated with microalbuminuria after minimal adjustment (OR 1.28, P = 0.01), but not after multivariable adjustment (OR 1.03, P = 0.8). In multivariable models in women, SAT was associated with a decreased odds of having microalbuminuria (OR 0.75 per s.d., P = 0.03). In conclusion, VAT is associated with microalbuminuria in men but not women. Albuminuria may be a manifestation of visceral adiposity.
authors.affiliation: National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, USA.
authors.forename: Meredith C
authors.initials: MC
authors.lastname: Foster
authors.forename: Shih-Jen
authors.initials: SJ
authors.lastname: Hwang
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Massaro
authors.forename: Udo
authors.initials: U
authors.lastname: Hoffmann
authors.forename: Ian H
authors.initials: IH
authors.lastname: DeBoer
authors.forename: Sander J
authors.initials: SJ
authors.lastname: Robins
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Fox
mesh_terms: D050154:Adiposity; D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000209:etiology* / Q000652:urine; D000465:Algorithms; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000503:physiopathology*; D012720:Severity of Illness Index; D012727:Sex Characteristics; D050507:Subcutaneous Fat, Abdominal / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D055105:Waist Circumference