title: Abdominal fat radiodensity, quantity and cardiometabolic risk: The Multi-Ethnic Study of Atherosclerosis.
abstract: OBJECTIVE
  Fat radiodensity, as measured by fat attenuation on computed tomography (CT), has emerged as a potential biomarker of "fat quality." We sought to characterize the relationship between fat radiodensity and quantity in subcutaneous, visceral, and intermuscular fat depots, and its role in inflammation, insulin resistance, and metabolic syndrome (MetS).
  
  
  RESULTS
  We studied 1511 individuals from the Multi-Ethnic Study of Atherosclerosis who underwent CT for measurement of regional fat distribution and radiodensity, along with biomarker assessments and adjudication of incident metabolic syndrome (MetS). Linear, logistic and Cox regression analyses were used to measure association between fat radiodensity and (1) fat quantity, (2) biomarkers of cardiometabolic dysfunction, and (3) both prevalent and incident MetS. In each fat depot, radiodensity was strongly and inversely associated with quantity (e.g., visceral fat radiodensity vs. quantity: ρ = -0.82, P < 0.01). After adjustment for age, sex and race, lower visceral fat radiodensity was associated with greater C-reactive protein, leptin and insulin, but lower adiponectin (P < 0.01 for all). After full adjustment for cardiovascular disease risk factors, visceral (but not subcutaneous or intermuscular) fat radiodensity was associated with prevalent MetS (OR = 0.96, 95% CI = 0.93-0.99, P = 0.01). Moreover, lower visceral fat radiodensity was associated with incident MetS after the same adjustment (HR = 0.95, 95% CI 0.93-0.98, P < 0.01). However, this association became non-significant after further adjustment for visceral fat quantity.
  
  
  CONCLUSIONS
  Fat radiodensity is strongly correlated with fat quantity and relevant inflammatory biomarkers. Fat radiodensity (especially for visceral fat) may be a complementary, easily assessed marker of cardiometabolic risk.
authors.affiliation: Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center, Boston, MA, USA. Electronic address: rshah1@bidmc.harvard.edu.
authors.forename: Ravi V
authors.initials: RV
authors.lastname: Shah
authors.affiliation: Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Allison
authors.affiliation: Department of Cardiology, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: J A C
authors.initials: JA
authors.lastname: Lima
authors.affiliation: Department of Cardiology, Brown University, Providence, RI, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Abbasi
authors.affiliation: Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Eisman
authors.affiliation: Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors.forename: C
authors.initials: C
authors.lastname: Lai
authors.affiliation: Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department of Medicine and Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Jerosch-Herold
authors.affiliation: Department of Cardiology and Medicine, University of California-Los Angeles, Los Angeles, CA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Budoff
authors.affiliation: Department of Medicine (Cardiovascular Medicine Division) and Department of Radiology (Nuclear Medicine Division), University of Michigan, Ann Arbor, MI, USA. Electronic address: vlmurthy@med.umich.edu.
authors.forename: V L
authors.initials: VL
authors.lastname: Murthy
mesh_terms: D050153:Abdominal Fat / Q000000981:diagnostic imaging* / Q000378:metabolism; D052242:Adiponectin / Q000097:blood; D050154:Adiposity / Q000208:ethnology; D000368:Aged; D050197:Atherosclerosis / Q000208:ethnology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006801:Humans; D015994:Incidence; D007328:Insulin / Q000097:blood; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging; D020738:Leptin / Q000097:blood; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000000981:diagnostic imaging* / Q000208:ethnology; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D016016:Proportional Hazards Models; D012307:Risk Factors; D050507:Subcutaneous Fat, Abdominal / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014481:United States / Q000453:epidemiology
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; D007328:Insulin; D020738:Leptin; D002097:C-Reactive Protein
keywords: Adiponectin; Adiposity; C-reactive protein; Insulin; Metabolic syndrome; Obesity
references.citation: J Am Coll Cardiol. 2011 Jun 21;57(25):2461-73
references.pmid: 21679848
references.citation: Nat Commun. 2014;5:4982
references.pmid: 25236782
references.citation: Adipocyte. 2012 Apr 1;1(2):89-95
references.pmid: 23700517
references.citation: Obesity (Silver Spring). 2010 May;18(5):884-9
references.pmid: 20019678
references.citation: J Clin Endocrinol Metab. 2015 Aug;100(8):E1056-64
references.pmid: 26062015
references.citation: Circulation. 2004 Jan 27;109(3):433-8
references.pmid: 14744958
references.citation: J Clin Endocrinol Metab. 2015 Jan;100(1):227-34
references.pmid: 25226289
references.citation: Am J Cardiol. 2013 Sep 1;112(5):726-30
references.pmid: 23711806
references.citation: JAMA. 2013 Jan 23;309(4):340
references.pmid: 23340626
references.citation: Obes Surg. 2015 Feb;25(2):381-5
references.pmid: 25381117
references.citation: Diabetes. 2009 Mar;58(3):718-25
references.pmid: 19074987
references.citation: Obesity (Silver Spring). 2015 Feb;23(2):286-9
references.pmid: 25522219
references.citation: Cell Rep. 2014 May 22;7(4):1116-29
references.pmid: 24794440
references.citation: J Clin Invest. 2003 Dec;112(12):1821-30
references.pmid: 14679177
references.citation: Am J Epidemiol. 2002 Nov 1;156(9):871-81
references.pmid: 12397006
references.citation: JAMA. 2012 Sep 19;308(11):1150-9
references.pmid: 22990274
references.citation: JACC Cardiovasc Imaging. 2014 Dec;7(12):1221-35
references.pmid: 25440591
references.citation: PLoS One. 2011;6(7):e22112
references.pmid: 21829446
references.citation: J Clin Invest. 2003 Dec;112(12):1796-808
references.pmid: 14679176
references.citation: Nature. 2015 Mar 12;519(7542):242-6
references.pmid: 25533952
references.citation: J Am Heart Assoc. 2014 Aug;3(4). pii: e000788. doi: 10.1161/JAHA.114.000788
references.pmid: 25169793
references.citation: J Am Coll Cardiol. 2013 Apr 23;61(16):1698-706
references.pmid: 23500236
references.citation: Ann Intern Med. 2013 Dec 3;159(11):758-69
references.pmid: 24297192
references.citation: Obesity (Silver Spring). 2011 Nov;19(11):2121-9
references.pmid: 21836643
references.citation: JACC Cardiovasc Imaging. 2013 Jul;6(7):762-71
references.pmid: 23664720
references.citation: J Nucl Med. 2010 Feb;51(2):246-50
references.pmid: 20124047
references.citation: J Am Coll Cardiol. 2011 Jul 5;58(2):140-6
references.pmid: 21718910
references.citation: J Clin Invest. 1995 May;95(5):2409-15
references.pmid: 7738205