Association of Changes in Abdominal Fat Quantity and Quality With Incident Cardiovascular Disease Risk Factors.
Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) are associated with adverse cardiometabolic risk profiles.



This study explored the degree to which changes in abdominal fat quantity and quality are associated with changes in cardiovascular disease (CVD) risk factors.



Study participants (n = 1,106; 44.1% women; mean baseline age 45.1 years) were drawn from the Framingham Heart Study Third Generation cohort who participated in the computed tomography (CT) substudy Exams 1 and 2. Participants were followed for 6.1 years on average. Abdominal adipose tissue volume in cm(3) and attenuation in Hounsfield units (HU) were determined by CT-acquired abdominal scans.



The mean fat volume change was an increase of 602 cm(3) for SAT and an increase of 703 cm(3) for VAT; the mean fat attenuation change was a decrease of 5.5 HU for SAT and an increase of 0.07 HU for VAT. An increase in fat volume and decrease in fat attenuation were associated with adverse changes in CVD risk factors. An additional 500 cm(3) increase in fat volume was associated with incident hypertension (odds ratio [OR]: 1.21 for SAT; OR: 1.30 for VAT), hypertriglyceridemia (OR: 1.15 for SAT; OR: 1.56 for VAT), and metabolic syndrome (OR: 1.43 for SAT; OR: 1.82 for VAT; all p < 0.05). Similar trends were observed for each additional 5 HU decrease in abdominal adipose tissue attenuation. Most associations remained significant even after further accounting for body mass index change, waist circumference change, or respective abdominal adipose tissue volumes.



Increasing accumulation of fat quantity and decreasing fat attenuation are associated with worsening of CVD risk factors beyond the associations with generalized adiposity, central adiposity, or respective adipose tissue volumes.
National Heart, Lung, and Blood Institute's Division of Intramural Research, the Framingham Heart Study, and the Population Studies Branch, Framingham, Massachusetts.
Jane J
JJ
Lee
National Heart, Lung, and Blood Institute's Division of Intramural Research, the Framingham Heart Study, and the Population Studies Branch, Framingham, Massachusetts.
Alison
A
Pedley
Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts.
Udo
U
Hoffmann
Department of Biostatistics, Boston University, Boston, Massachusetts.
Joseph M
JM
Massaro
National Heart, Lung, and Blood Institute's Division of Intramural Research, the Framingham Heart Study, and the Population Studies Branch, Framingham, Massachusetts; Division of Endocrinology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Electronic address: foxca@nhlbi.nih.gov.
Caroline S
CS
Fox
D050153:Abdominal Fat / Q000033:anatomy & histology* / Q000473:pathology; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
cardiovascular disease; computed tomography; epidemiology; fat attenuation; subcutaneous adipose tissue; visceral adipose tissue
Nat Rev Immunol. 2011 Feb;11(2):85-97
21252989
J Am Heart Assoc. 2016 May 04;5(5):null
27146446
AJR Am J Roentgenol. 2009 Oct;193(4):1077-87
19770332
J Am Heart Assoc. 2016 Feb 29;5(3):e002545
26927600
Am J Epidemiol. 2007 Jun 1;165(11):1328-35
17372189
JACC Cardiovasc Imaging. 2014 Dec;7(12 ):1221-35
25440591
J Clin Invest. 2011 Jun;121(6):2094-101
21633177
J Comput Assist Tomogr. 2011 Jan-Feb;35(1):65-71
21245691
Arterioscler Thromb. 1993 Apr;13(4):487-94
8466884
J Clin Endocrinol Metab. 2015 Aug;100(8):E1056-64
26062015
J Clin Endocrinol Metab. 2015 Jan;100(1):227-34
25226289
Circulation. 2015 Oct 27;132(17 ):1639-47
26294660
ISRN Inflamm. 2013 Dec 22;2013:139239
24455420
Hypertension. 2015 Jul;66(1):134-40
26063668
Nature. 2006 Dec 14;444(7121):881-7
17167477
Int J Obes. 1991 Dec;15(12):853-9
1794928
Physiol Rev. 2013 Jan;93(1):1-21
23303904
Diabetes Care. 2009 Jun;32(6):1068-75
19244087
Nat Genet. 2009 Jun;41(6):677-87
19430479
Hypertension. 2003 Feb;41(2):207-10
12574083
JAMA. 2001 May 16;285(19):2486-97
11368702
Int J Obes (Lond). 2007 Mar;31(3):500-6
16953256
Med Clin North Am. 2011 Sep;95(5):903-17
21855699
Am J Clin Nutr. 1983 May;37(5):749-54
6846213
PLoS Med. 2006 Nov;3(11):e442
17132052
J Clin Endocrinol Metab. 2012 May;97(5):1517-25
22337910
Obes Rev. 2010 Jan;11(1):11-8
19656312
Arterioscler Thromb Vasc Biol. 2008 Jun;28(6):1039-49
18356555
Ann N Y Acad Sci. 1963 May 22;107:539-56
14025561
Obesity (Silver Spring). 2016 Feb;24(2):499-505
26694629
J Clin Endocrinol Metab. 2010 Dec;95(12):5419-26
20843952
Hypertension. 1996 Jan;27(1):125-9
8591874
Diabetes Care. 2014 Jul;37(7):1831-6
24760260
J Clin Endocrinol Metab. 2011 May;96(5):1462-8
21325457
Obesity (Silver Spring). 2013 Oct;21(10):2126-9
23408393
Diabetes Care. 2013 Feb;36(2):289-93
22966093
Circulation. 2007 Jul 3;116(1):39-48
17576866
Circulation. 2015 Jan 27;131(4):e29-322
25520374
Diabetes Care. 2007 Sep;30(9):2392-4
17563343
Diabetes Care. 2012 May;35(5):1139-43
22432120
J Clin Endocrinol Metab. 2011 Nov;96(11):E1756-60
21865361
Arch Intern Med. 1979 Aug;139(8):857-61
464698
J Gerontol A Biol Sci Med Sci. 2014 Jan;69(1):109-17
23707956
JACC Cardiovasc Imaging. 2013 Jul;6(7):762-71
23664720
J Nucl Med. 2010 Feb;51(2):246-50
20124047
Diabetes. 2010 Mar;59(3):627-33
20028945