title: Visceral-to-subcutaneous fat ratio is independently related to small and large cerebrovascular lesions even in healthy subjects.
abstract: The severity of obesity is evaluated by visceral-to-subcutaneous fat ratio (VS ratio), which may be useful for predicting atherosclerosis. However, it is unclear how VS ratio affects different types of cerebrovascular lesions. This study was conducted to evaluate the clinical impact of visceral fat accumulation on the cerebrovascular lesions.
  
  
  
  This cross-sectional study included 980 apparently healthy Japanese adults who underwent a health check-up program focused toward atherosclerosis, between 2011 and 2014. Visceral and subcutaneous fat accumulation was measured using abdominal computed tomography, and its relation to cerebrovascular disease was surveyed.
  
  
  
  Visceral and subcutaneous fat accumulation was 88 ± 50 cm2and 141 ± 77 cm2, respectively. VS ratio was 0.69 ± 0.38. Intimal thickening in the carotid arteries was detected in 849 cases (86.6%) and stenosis was observed in seven (0.7%). Brain magnetic resonance imaging showed white matter hyperintensities regarded as ischemic changes in 196 subjects (20.0%). Multiple logistic regression analysis adjusted for age, gender, diabetes mellitus, dyslipidemia, hypertension, and hyperuricemia showed that a 0.1 increase in VS ratio was related to the presence of ischemic changes [odds ratio (OR): 1.05, 95% CI: 1.01-1.10, p = 0.009], cerebral artery stenosis or occlusion (OR: 1.14, 95% CI: 1.03-1.25, p = 0.007), and cervical plaque (OR: 1.09, 95% CI: 1.05-1.13, p < 0.001).
  
  
  
  VS ratio was independently associated with both large and small vessel lesions in apparently healthy subjects.
authors.affiliation: Department of Cardiology, Kyorin University Hospital, Tokyo, Japan. Electronic address: sahiguchi-circ@umin.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Higuchi
authors.affiliation: Department of Internal Medicine, Tokai University Hachioji Hospital, Tokyo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kabeya
authors.affiliation: Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan.
authors.forename: Kiyoe
authors.initials: K
authors.lastname: Kato
mesh_terms: D050154:Adiposity; D000368:Aged; D016893:Carotid Stenosis / 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*; D056784:Leukoencephalopathies / Q000000981:diagnostic imaging / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D016017:Odds Ratio; D012307:Risk Factors; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed
keywords: Cerebral ischemic change; Cerebrovascular disease; Subcutaneous fat accumulation; Visceral fat accumulation; White matter hyperintensity