title: Upper Body Subcutaneous Fat Is Associated with Cardiometabolic Risk Factors.
abstract: Upper body subcutaneous fat is a distinct fat depot that may confer increased cardiometabolic risk. We examined the cross-sectional associations between upper body subcutaneous fat volume and cardiometabolic risk factors.
  
  
  
  Participants were patients from the Framingham Heart Study who underwent multi-detector computed tomography between 2008 and 2011. Sex-specific multivariable-adjusted regression analyses were conducted. Covariates included age, ethnicity, smoking status, alcohol intake, physical activity, postmenopausal status, and hormone replacement therapy. Additional models included adjustment for body mass index (BMI), neck circumference, or abdominal visceral adipose tissue.
  
  
  
  There were 2306 participants (mean age 60 years, 54.4% women) included. Mean upper body subcutaneous fat was 309.9 cm3in women and 345.6 cm3in men. Higher upper body subcutaneous fat volume was associated with adverse cardiometabolic risk factors. In women and men, each additional 50-cm3increment in upper body subcutaneous fat was associated with a 3.23 and 2.65 kg/m2increase in BMI; 2.16 and 0.88 mm Hg increase in systolic blood pressure; 2.53 and 1.66 mg/dL increase in fasting plasma glucose; 0.12 and 0.11 mg/dL increase in log triglycerides; and 4.17 and 3.68 mg/dL decrease in high-density lipoprotein cholesterol, respectively (all P ≤.008). Similar patterns were observed with prevalent cardiometabolic risk factors. These associations remained significant after additional adjustment for BMI, neck circumference, or abdominal visceral adipose tissue.
  
  
  
  Higher upper body subcutaneous fat is cross-sectionally associated with adverse cardiometabolic risk factors. Our findings underscore the importance of subcutaneous adiposity in the upper body region that may provide a better understanding of the pathogenic properties of obesity in the development of cardiometabolic sequelae.
authors.affiliation: Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, Md; Framingham Heart Study, Mass.
authors.forename: Jane J
authors.initials: JJ
authors.lastname: Lee
authors.affiliation: Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, Md; Framingham Heart Study, Mass.
authors.forename: Alison
authors.initials: A
authors.lastname: Pedley
authors.affiliation: Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, Md; Framingham Heart Study, Mass.
authors.forename: Kate E
authors.initials: KE
authors.lastname: Therkelsen
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston.
authors.forename: Udo
authors.initials: U
authors.lastname: Hoffmann
authors.affiliation: Department of Biostatistics, Boston University, Mass.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Massaro
authors.affiliation: Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, Md; Framingham Heart Study, Mass; Boston University School of Medicine, Mass.
authors.forename: Daniel
authors.initials: D
authors.lastname: Levy
authors.affiliation: Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, Md; Framingham Heart Study, Mass; Department of Medicine, Division of Gastroenterology, Boston University School of Medicine, Mass. Electronic address: mtlong@bu.edu.
authors.forename: Michelle T
authors.initials: MT
authors.lastname: Long
mesh_terms: D050154:Adiposity; D015992:Body Mass Index; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D012044:Regression Analysis; D012307:Risk Factors; D017678:Sex Distribution; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging; D060726:Torso / Q000000981:diagnostic imaging
keywords: Epidemiology; Imaging; Metabolic diseases; Subcutaneous adipose tissue