title: Change in Intra-Abdominal Fat Predicts the Risk of Hypertension in Japanese Americans.
abstract: In Japanese Americans, intra-abdominal fat area measured by computed tomography is positively associated with the prevalence and incidence of hypertension. Evidence in other populations suggests that other fat areas may be protective. We sought to determine whether a change in specific fat depots predicts the development of hypertension. We prospectively followed up 286 subjects (mean age, 49.5 years; 50.4% men) from the Japanese American Community Diabetes Study for 10 years. At baseline, subjects did not have hypertension (defined as blood pressure ≥140/90 mm Hg) and were not taking blood pressure or glucose-lowering medications. Mid-thigh subcutaneous fat area, abdominal subcutaneous fat area, and intra-abdominal fat area were directly measured by computed tomography at baseline and 5 years. Logistic regression was used to estimate odds of incident hypertension over 10 years in relation to a 5-year change in fat area. The relative odds of developing hypertension for a 5-year increase in intra-abdominal fat was 1.74 (95% confidence interval, 1.28-2.37), after adjusting for age, sex, body mass index, baseline intra-abdominal fat, alcohol use, smoking status, and weekly exercise energy expenditure. This relationship remained significant when adjusted for baseline fasting insulin and 2-hour glucose levels or for diabetes mellitus and pre-diabetes mellitus classification. There were no significant associations between baseline and change in thigh or abdominal subcutaneous fat areas and incident hypertension. In conclusion, in this cohort of Japanese Americans, the risk of developing hypertension is related to the accumulation of intra-abdominal fat rather than the accrual of subcutaneous fat in either the thigh or the abdominal areas.
authors.affiliation: From the General Medicine and Hospital and Specialty Medicine Services, Veterans Affairs Puget Sound Health Care System, Seattle, WA (S.E.K., E.J.B.); Division of Endocrinology, Metabolism and Nutrition, Department of Medicine (C.A.S., S.E.K.) and Department of Anthropology (D.L.L.), University of Washington, Seattle; Department of Preventive Medicine and Environmental Health, Graduate School of Medicine, Osaka City University, Osaka, Japan (T.H.); and the Seattle Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington (E.J.B.).
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Sullivan
authors.affiliation: From the General Medicine and Hospital and Specialty Medicine Services, Veterans Affairs Puget Sound Health Care System, Seattle, WA (S.E.K., E.J.B.); Division of Endocrinology, Metabolism and Nutrition, Department of Medicine (C.A.S., S.E.K.) and Department of Anthropology (D.L.L.), University of Washington, Seattle; Department of Preventive Medicine and Environmental Health, Graduate School of Medicine, Osaka City University, Osaka, Japan (T.H.); and the Seattle Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington (E.J.B.).
authors.forename: Steven E
authors.initials: SE
authors.lastname: Kahn
authors.affiliation: From the General Medicine and Hospital and Specialty Medicine Services, Veterans Affairs Puget Sound Health Care System, Seattle, WA (S.E.K., E.J.B.); Division of Endocrinology, Metabolism and Nutrition, Department of Medicine (C.A.S., S.E.K.) and Department of Anthropology (D.L.L.), University of Washington, Seattle; Department of Preventive Medicine and Environmental Health, Graduate School of Medicine, Osaka City University, Osaka, Japan (T.H.); and the Seattle Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington (E.J.B.).
authors.forename: Wilfred Y
authors.initials: WY
authors.lastname: Fujimoto
authors.affiliation: From the General Medicine and Hospital and Specialty Medicine Services, Veterans Affairs Puget Sound Health Care System, Seattle, WA (S.E.K., E.J.B.); Division of Endocrinology, Metabolism and Nutrition, Department of Medicine (C.A.S., S.E.K.) and Department of Anthropology (D.L.L.), University of Washington, Seattle; Department of Preventive Medicine and Environmental Health, Graduate School of Medicine, Osaka City University, Osaka, Japan (T.H.); and the Seattle Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington (E.J.B.).
authors.forename: Tomoshige
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: From the General Medicine and Hospital and Specialty Medicine Services, Veterans Affairs Puget Sound Health Care System, Seattle, WA (S.E.K., E.J.B.); Division of Endocrinology, Metabolism and Nutrition, Department of Medicine (C.A.S., S.E.K.) and Department of Anthropology (D.L.L.), University of Washington, Seattle; Department of Preventive Medicine and Environmental Health, Graduate School of Medicine, Osaka City University, Osaka, Japan (T.H.); and the Seattle Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington (E.J.B.).
authors.forename: Donna L
authors.initials: DL
authors.lastname: Leonetti
authors.affiliation: From the General Medicine and Hospital and Specialty Medicine Services, Veterans Affairs Puget Sound Health Care System, Seattle, WA (S.E.K., E.J.B.); Division of Endocrinology, Metabolism and Nutrition, Department of Medicine (C.A.S., S.E.K.) and Department of Anthropology (D.L.L.), University of Washington, Seattle; Department of Preventive Medicine and Environmental Health, Graduate School of Medicine, Osaka City University, Osaka, Japan (T.H.); and the Seattle Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington (E.J.B.). eboyko@uw.edu.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Boyko
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology; D001213:Asian / Q000706:statistics & numerical data*; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D015444:Exercise; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D007328:Insulin / Q000097:blood; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000473:pathology*; D007564:Japan / Q000208:ethnology; D008297:Male; D009929:Organ Size; D011236:Prediabetic State / Q000453:epidemiology; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D050151:Subcutaneous Fat / Q000473:pathology; D013848:Thigh; D014057:Tomography, X-Ray Computed
chemical_list: D001786:Blood Glucose; D007328:Insulin
keywords: Asian Americans; adiposity; hypertension; intra-abdominal fat