title: Cross-Sectional Associations of Computed Tomography (CT)-Derived Adipose Tissue Density and Adipokines: The Framingham Heart Study.
abstract: BACKGROUND
  Excess accumulation of abdominal subcutaneous (SAT) and visceral adipose tissue (VAT) is associated with adverse levels of adipokines and cardiovascular disease risk. Whether fat quality is associated with adipokines has not been firmly established. This study examined the association between abdominal SAT and VAT density, an indirect measure of fat quality, with a panel of metabolic regulatory biomarkers secreted by adipose tissue or the liver independently of absolute fat volumes.
  
  
  RESULTS
  We evaluated 1829 Framingham Heart Study participants (44.9% women). Abdominal SAT and VAT density was estimated indirectly by adipose tissue attenuation using computed tomography. Adipokines included adiponectin, leptin receptor, leptin, fatty acid-binding protein 4 (FABP-4), retinol-binding protein 4 (RBP-4), and fetuin-A. Fat density was associated with all the biomarkers evaluated, except fetuin-A. Lower fat density (ie, more-negative fat attenuation) was associated with lower adiponectin and leptin receptor, but higher leptin and FABP-4 levels (all P<0.0001). SAT density was inversely associated with RPB-4 in both sexes, whereas the association between VAT density and RPB-4 was only observed in men (P<0.0001). In women, after additional adjustment for respective fat volume, SAT density retained the significant associations with adiponectin, leptin, FABP-4, and RBP-4; and VAT density with adiponectin only (all P<0.0001). In men, significant associations were maintained upon additional adjustment for respective fat volume (P<0.005).
  
  
  CONCLUSIONS
  Lower abdominal fat density was associated with a profile of biomarkers suggestive of greater cardiometabolic risk. These observations support that fat density may be a valid biomarker of cardiometabolic risk.
authors.affiliation: National Heart, Lung, and Blood Institute's Division of Intramural Research, The Framingham Heart Study, and the Population Studies Branch, Framingham, MA.
authors.forename: Jane J
authors.initials: JJ
authors.lastname: Lee
authors.affiliation: National Heart, Lung, and Blood Institute's Division of Intramural Research, The Framingham Heart Study, and the Population Studies Branch, Framingham, MA.
authors.forename: Alison
authors.initials: A
authors.lastname: Pedley
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, MA.
authors.forename: Udo
authors.initials: U
authors.lastname: Hoffmann
authors.affiliation: Department of Biostatistics, Boston University, Boston, MA.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Massaro
authors.affiliation: Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, MA.
authors.forename: John F
authors.initials: JF
authors.lastname: Keaney
authors.affiliation: National Heart, Lung, and Blood Institute's Division of Intramural Research, The Framingham Heart Study, and the Population Studies Branch, Framingham, MA Evans Department of Medicine, Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA Sections of Cardiology and Preventive Medicine, Boston University School of Medicine, Boston, MA Department of Epidemiology, Boston University School of Public Health, Boston, MA.
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
authors.affiliation: National Heart, Lung, and Blood Institute's Division of Intramural Research, The Framingham Heart Study, and the Population Studies Branch, Framingham, MA Division of Endocrinology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA foxca@nhlbi.nih.gov.
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Fox
mesh_terms: D054392:Adipokines / Q000097:blood*; D050154:Adiposity; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging* / Q000378:metabolism*; D016014:Linear Models; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging* / Q000378:metabolism*
chemical_list: D054392:Adipokines; D015415:Biomarkers
keywords: adipokine; adipose tissue; computed tomography; epidemiology