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Journal Article Ppublish 21 citations

PubMed: 37795945 DOI: 10.1210/clinem/dgad570

Skewness in Body fat Distribution Pattern Links to Specific Cardiometabolic Disease Risk Profiles.

J Clin Endocrinol Metab 109(3):783-791

Authors: Jennifer Linge, Bertrand Cariou, Ian J Neeland, Mikael Petersson, Ángel Rodríguez, Olof Dahlqvist Leinhard

Affiliations

  • AMRA Medical AB, Badhusgatan 5, SE-58222 Linköping, Sweden.
  • Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, SE-58183 Linköping, Sweden.
  • l'institut du thorax, Department of Endocrinology, Nantes Université, CHU Nantes, CNRS, Inserm, 44000 Nantes, France.
  • Department of Medicine, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Centre and Case Western Reserve University School of Medicine, Westlake, OH 44145, USA.
  • Eli Lilly and Company, 893 Delaware St, Indianapolis, IN 46225, USA.

Abstract

OBJECTIVE

Fat distribution pattern could help determine cardiometabolic risk profile. This study aimed to evaluate the association of balance/imbalance between visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (aSAT), and liver fat (LF) with incident type 2 diabetes (T2D) and cardiovascular disease (CVD) in the UK Biobank prospective cohort study.

METHODS

Magnetic resonance images of 40 174 participants were analyzed for VAT, aSAT, and LF using AMRA® Researcher. To assess fat distribution patterns independent of body mass index (BMI), fat z-scores (z-VAT, z-aSAT, z-LF) were calculated. Participants without prevalent T2D/CVD (N = 35 138) were partitioned based on balance between (1) z-VAT and z-LF (z-scores = 0 as cut-points for high/low), (2) z-VAT and z-aSAT, and (3) z-LF and z-aSAT. Associations with T2D/CVD were investigated using Cox regression (crude and adjusted for sex, age, BMI, lifestyle, arterial hypertension, statin treatment).

RESULTS

T2D was significantly associated with z-LF (hazard ratio, [95% CI] 1.74 [1.52-1.98], P < .001) and z-VAT (1.70 [1.49-1.95], P < .001). Both remained significant after full adjustment. For z-scores balance, strongest associations with T2D were z-VAT > 0 and z-LF > 0 (4.61 [2.98-7.12]), z-VAT > 0 and z-aSAT < 0 (4.48 [2.85-7.06]), and z-LF > 0 and z-aSAT < 0 (2.69 [1.76-4.12]), all P < .001. CVD was most strongly associated with z-VAT (1.22 [1.16-1.28], P < .001) which remained significant after adjustment for sex, age, BMI, and lifestyle. For z-scores balance, strongest associations with CVD were z-VAT > 0 and z-LF < 0 (1.53 [1.34-1.76], P < .001) and z-VAT > 0 and z-aSAT < 0 (1.54 [1.34-1.76], P < .001). When adjusted for sex, age, and BMI, only z-VAT > 0 and z-LF < 0 remained significant.

CONCLUSION

High VAT in relation to BMI (z-VAT > 0) was consistently linked to both T2D and CVD; z-LF > 0 was linked to T2D only. Skewed fat distribution patterns showed elevated risk for CVD (z-VAT > 0 and z-LF < 0 and z-VAT > 0 and z-aSAT < 0) and T2D (z-VAT > 0 and z-aSAT < 0).

MeSH

Life Style, Subcutaneous Fat, Magnetic Resonance Imaging, Body Fat Distribution, Sex, Tissues, Adipose Tissue

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