title: Visceral Fat Is an Independent Predictor of Cerebral Microbleeds in Neurologically Healthy People.
abstract: Obesity has a significant contribution to the risk of intracerebral hemorrhage (ICH). However, little is known about the association between central obesity and the presence of cerebral microbleeds (CMBs), a precursor of ICH. We sought to assess whether visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) are associated with the presence of CMB.
  
  
  
  We conducted a cross-sectional study of 1,737 neurologically healthy people (mean age 55.9 ± 9.1; 790 men), who underwent brain MRI and abdominal CT. Risk factors, anthropometric parameters and clinical information were obtained. CMBs were evaluated through T2*-weighted gradient-recalled echo MRI. The cross-sectional surface areas of the abdominal fat compartments were calculated. Study subjects were stratified into quartiles according to the distribution of VAT/SAT ratio.
  
  
  
  A total of 75 (4.3%) subjects were found to have CMBs. Subjects with a greater quartile of VAT/SAT ratio were more likely to have higher numbers of CMBs (0 to ≥2; p = 0.001). In multivariable analysis, age and history of hypertension were associated with the presence of CMB (OR 1.09, 95% CI 1.06-1.13, p < 0.001; OR 1.70, 95% CI 1.01-2.84, p = 0.046, respectively). A dose-response relationship was observed between the extent of VAT/SAT quartile and CMB: compared to the lowest VAT/SAT quartile, OR 2.14 (95% CI 0.86-5.35) for second VAT/SAT quartile; OR 2.26 (95% CI 0.86-5.92) for third VAT/SAT quartile; and OR 2.91 (95% CI 1.04-8.12) for the highest VAT/SAT quartile (p for trend 0.03).
  
  
  
  In our study, higher VAT/SAT ratios were found to be independent predictors of CMBs in neurologically healthy people. This finding strengthens previous data, suggesting that visceral fat distribution is an important contributor to cerebral small vessel disease.
authors.affiliation: Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea.
authors.forename: Hyung-Min
authors.initials: HM
authors.lastname: Kwon
authors.forename: Jong-Ho
authors.initials: JH
authors.lastname: Park
authors.forename: Jin Ho
authors.initials: JH
authors.lastname: Park
authors.forename: Han-Yeong
authors.initials: HY
authors.lastname: Jeong
authors.forename: Jae-Sung
authors.initials: JS
authors.lastname: Lim
authors.forename: Han-Gil
authors.initials: HG
authors.lastname: Jeong
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Shin
authors.forename: Jae Moon
authors.initials: JM
authors.lastname: Yun
authors.forename: Hyejin
authors.initials: H
authors.lastname: Lee
mesh_terms: D050154:Adiposity; D000368:Aged; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology*; D059345:Cerebral Small Vessel Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016014:Linear Models; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D056128:Obesity, Abdominal / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012307:Risk Factors; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed