Abdominal Visceral Adipose Tissue is Associated with Myocardial Infarction in Patients with COPD.
BACKGROUND
Cardiovascular diseases are frequent and a major cause of death in patients with chronic obstructive pulmonary disease (COPD). In the general population, various fat depots including abdominal visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and liver fat have been linked to increased risk of cardiovascular diseases. We hypothesize that these adipose tissue compartments are associated with myocardial infarction (MI) in patients with COPD.


METHODS
We collected measures of VAT and SAT areas and liver attenuation on the computed tomography scan of the chest from 1267 patients with COPD. MI was a self-reported physician-diagnosed outcome. The association between fat depots and self-reported history of MI was assessed by logistic regression analysis in which the patients within the 2 lowest tertiles of VAT and SAT areas were the reference group.


RESULTS
Eighty three patients (6.6%) reported a history of MI at the time of enrollment. Compared to patients who did not have an MI episode, those who had a prior MI had a higher VAT area (mean ± SD, 303.4 ± 208.5 vs. 226.8 ± 172.6 cm2; P=0.002) with no differences in SAT area and liver fat. After adjustment for age, gender, obesity, pack years of smoking, hypertension, high cholesterol, and diabetes, patients within the upper tertile (vs. those in the lower tertiles) of VAT area had increased odds of MI (odds ratio [OR] 1.86, 95% confidence interval [CI] 1.02 - 3.41).


CONCLUSIONS
Increased abdominal visceral fat is independently associated with a history of MI in individuals with COPD.
Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Alejandro A
AA
Diaz
Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Tom P
TP
Young
Surgical Planning Laboratory, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Sila
S
Kurugol
Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Erick
E
Eckbo
Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Nina
N
Muralidhar
Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Joshua K
JK
Chapman
Department of Epidemiology, Colorado School of Public Health, University of Colorado- Denver, Aurora, Colorado.
Gregory L
GL
Kinney
Surgical Planning Laboratory, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
James C
JC
Ross
Surgical Planning Laboratory, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Raul
R
San Jose Estepar
Surgical Planning Laboratory, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Rola
R
Harmouche
Department of Epidemiology, Colorado School of Public Health, University of Colorado- Denver, Aurora, Colorado.
Jennifer L
JL
Black-Shinn
Los Angeles Biomedical Research Institute, Torrance, California.
Matthew
M
Budoff
Department of Medicine, University of Colorado School of Medicine, Aurora.
Russell P
RP
Bowler
Department of Epidemiology, Colorado School of Public Health, University of Colorado- Denver, Aurora, Colorado.
John
J
Hokanson
Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
George R
GR
Washko
COPD; CT; myocardial infarction; visceral adipose tissue