title: Relationship Between Measures of Adiposity, Arterial Inflammation, and Subsequent Cardiovascular Events.
abstract: BACKGROUND
  The objective of this study was to evaluate how different measures of adiposity are related to both arterial inflammation and the risk of subsequent cardiovascular events.
  
  
  RESULTS
  We included individuals who underwent (18)F-fluorodeoxyglucose positron emission tomography/computed tomography imaging for oncological evaluation. Subcutaneous adipose tissue (SAT) volume, visceral adipose tissue (VAT) volume, and VAT/SAT ratio were determined. Additionally, body mass index, metabolic syndrome, and aortic (18)F-fluorodeoxyglucose uptake (a measure of arterial inflammation) were determined. Subsequent development of cardiovascular disease (CVD) events was adjudicated. The analysis included 415 patients with a median age of 55 (P25-P75: 45-65) and a median body mass index of 26.4 (P25-P75: 23.4-30.9) kg/m(2). VAT and SAT volume were significantly higher in obese individuals. VAT volume (r=0.290; P<0.001) and VAT/SAT ratio (r=0.208; P<0.001) were positively correlated with arterial inflammation. Thirty-two subjects experienced a CVD event during a median follow-up of 4 years. Cox proportional hazard models showed that VAT volume and VAT/SAT ratio were associated with CVD events (hazard ratio [95% confidence interval]: 1.15 [1.06-1.25]; P<0.001; 3.60 [1.88-6.92]; P<0.001, respectively). Body mass index, metabolic syndrome, and SAT were not predictive of CVD events.
  
  
  CONCLUSIONS
  Measures of visceral fat are positively related to arterial inflammation and are independent predictors of subsequent CVD events. Individuals with higher measures of visceral fat as well as elevated arterial inflammation are at highest risk for subsequent CVD events. The findings suggest that arterial inflammation may explain some of the CVD risk associated with adiposity.
authors.affiliation: From the Cardiac MR PET CT Program, Department of Imaging and Division of Cardiology (A.L.F., R.A.P.T., M.H.M., A.A., Z.R.L., R.S.K., B.B.G., U.H., A.T.), Program in Nutritional Metabolism (J.L., S.K.G.), and Division of Cardiology, Department of Medicine (A.T.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.); and Department of Radiology, Weill Cornell College of Medicine, New York, NY (Q.A.T.).
authors.forename: Amparo L
authors.initials: AL
authors.lastname: Figueroa
authors.affiliation: From the Cardiac MR PET CT Program, Department of Imaging and Division of Cardiology (A.L.F., R.A.P.T., M.H.M., A.A., Z.R.L., R.S.K., B.B.G., U.H., A.T.), Program in Nutritional Metabolism (J.L., S.K.G.), and Division of Cardiology, Department of Medicine (A.T.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.); and Department of Radiology, Weill Cornell College of Medicine, New York, NY (Q.A.T.).
authors.forename: Richard A P
authors.initials: RA
authors.lastname: Takx
authors.affiliation: From the Cardiac MR PET CT Program, Department of Imaging and Division of Cardiology (A.L.F., R.A.P.T., M.H.M., A.A., Z.R.L., R.S.K., B.B.G., U.H., A.T.), Program in Nutritional Metabolism (J.L., S.K.G.), and Division of Cardiology, Department of Medicine (A.T.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.); and Department of Radiology, Weill Cornell College of Medicine, New York, NY (Q.A.T.).
authors.forename: Megan H
authors.initials: MH
authors.lastname: MacNabb
authors.affiliation: From the Cardiac MR PET CT Program, Department of Imaging and Division of Cardiology (A.L.F., R.A.P.T., M.H.M., A.A., Z.R.L., R.S.K., B.B.G., U.H., A.T.), Program in Nutritional Metabolism (J.L., S.K.G.), and Division of Cardiology, Department of Medicine (A.T.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.); and Department of Radiology, Weill Cornell College of Medicine, New York, NY (Q.A.T.).
authors.forename: Amr
authors.initials: A
authors.lastname: Abdelbaky
authors.affiliation: From the Cardiac MR PET CT Program, Department of Imaging and Division of Cardiology (A.L.F., R.A.P.T., M.H.M., A.A., Z.R.L., R.S.K., B.B.G., U.H., A.T.), Program in Nutritional Metabolism (J.L., S.K.G.), and Division of Cardiology, Department of Medicine (A.T.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.); and Department of Radiology, Weill Cornell College of Medicine, New York, NY (Q.A.T.).
authors.forename: Zachary R
authors.initials: ZR
authors.lastname: Lavender
authors.affiliation: From the Cardiac MR PET CT Program, Department of Imaging and Division of Cardiology (A.L.F., R.A.P.T., M.H.M., A.A., Z.R.L., R.S.K., B.B.G., U.H., A.T.), Program in Nutritional Metabolism (J.L., S.K.G.), and Division of Cardiology, Department of Medicine (A.T.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.); and Department of Radiology, Weill Cornell College of Medicine, New York, NY (Q.A.T.).
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Kaplan
authors.affiliation: From the Cardiac MR PET CT Program, Department of Imaging and Division of Cardiology (A.L.F., R.A.P.T., M.H.M., A.A., Z.R.L., R.S.K., B.B.G., U.H., A.T.), Program in Nutritional Metabolism (J.L., S.K.G.), and Division of Cardiology, Department of Medicine (A.T.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.); and Department of Radiology, Weill Cornell College of Medicine, New York, NY (Q.A.T.).
authors.forename: Quynh A
authors.initials: QA
authors.lastname: Truong
authors.affiliation: From the Cardiac MR PET CT Program, Department of Imaging and Division of Cardiology (A.L.F., R.A.P.T., M.H.M., A.A., Z.R.L., R.S.K., B.B.G., U.H., A.T.), Program in Nutritional Metabolism (J.L., S.K.G.), and Division of Cardiology, Department of Medicine (A.T.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.); and Department of Radiology, Weill Cornell College of Medicine, New York, NY (Q.A.T.).
authors.forename: Janet
authors.initials: J
authors.lastname: Lo
authors.affiliation: From the Cardiac MR PET CT Program, Department of Imaging and Division of Cardiology (A.L.F., R.A.P.T., M.H.M., A.A., Z.R.L., R.S.K., B.B.G., U.H., A.T.), Program in Nutritional Metabolism (J.L., S.K.G.), and Division of Cardiology, Department of Medicine (A.T.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.); and Department of Radiology, Weill Cornell College of Medicine, New York, NY (Q.A.T.).
authors.forename: Brian B
authors.initials: BB
authors.lastname: Ghoshhajra
authors.affiliation: From the Cardiac MR PET CT Program, Department of Imaging and Division of Cardiology (A.L.F., R.A.P.T., M.H.M., A.A., Z.R.L., R.S.K., B.B.G., U.H., A.T.), Program in Nutritional Metabolism (J.L., S.K.G.), and Division of Cardiology, Department of Medicine (A.T.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.); and Department of Radiology, Weill Cornell College of Medicine, New York, NY (Q.A.T.).
authors.forename: Steven K
authors.initials: SK
authors.lastname: Grinspoon
authors.affiliation: From the Cardiac MR PET CT Program, Department of Imaging and Division of Cardiology (A.L.F., R.A.P.T., M.H.M., A.A., Z.R.L., R.S.K., B.B.G., U.H., A.T.), Program in Nutritional Metabolism (J.L., S.K.G.), and Division of Cardiology, Department of Medicine (A.T.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.); and Department of Radiology, Weill Cornell College of Medicine, New York, NY (Q.A.T.).
authors.forename: Udo
authors.initials: U
authors.lastname: Hoffmann
authors.affiliation: From the Cardiac MR PET CT Program, Department of Imaging and Division of Cardiology (A.L.F., R.A.P.T., M.H.M., A.A., Z.R.L., R.S.K., B.B.G., U.H., A.T.), Program in Nutritional Metabolism (J.L., S.K.G.), and Division of Cardiology, Department of Medicine (A.T.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.); and Department of Radiology, Weill Cornell College of Medicine, New York, NY (Q.A.T.). atawakol@partners.org.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Tawakol
mesh_terms: D050154:Adiposity; D000368:Aged; D001167:Arteritis / Q000000981:diagnostic imaging*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: adipose tissue; atherosclerosis; cardiovascular events; obesity; positron emission tomography