Journal Article Journal Article Ppublish 4 citations
PubMed: 38461055 DOI: 10.1016/j.soard.2024.01.009
Risk stratification using magnetic resonance imaging-derived, personalized z-scores of visceral adipose tissue, subcutaneous adipose tissue, and liver fat in persons with obesity.
Surg Obes Relat Dis 20(5):419-424
Authors: Jennifer Linge, Per Widholm, Daniel Nilsson, Alexander Kugelberg, Torsten Olbers, Olof Dahlqvist Leinhard
Affiliations
- AMRA Medical AB, Linköping, Sweden; Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
- AMRA Medical AB, Linköping, Sweden; Department of Radiology and Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden.
- AMRA Medical AB, Linköping, Sweden.
- Department of Surgery, Vrinnevi Hospital, Norrköping, Sweden.
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Wallenberg Center for Molecular Medicine, Linköping University, Linköping, Sweden.
- AMRA Medical AB, Linköping, Sweden; Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden.
Abstract
BACKGROUND
Individual patterns of fat accumulation (visceral, subcutaneous, and/or liver fat) can determine cardiometabolic risk profile.
OBJECTIVE
To investigate risk stratification using personalized fat z-scores in persons with a body mass index (BMI) of 30-40 kg/m 2 from the UK Biobank imaging study.
SETTING
Population-based study.
METHODS
Whole-body magnetic resonance (MR) images of 40,174 participants from the UK Biobank imaging study were analyzed for visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (aSAT), and liver fat (LF) and used to calculate sex- and body size-invariant fat z-scores (VATz, aSATz, LFz). Associations between z-scores and later incident cardiovascular disease (CVD) and type 2 diabetes (T2D) were investigated using Cox proportional hazards modeling and Kaplan-Meier curves in participants with BMI 30-40 kg/m 2.
RESULTS
A total of 6716 participants had BMI 30-40 kg/m 2 and within this group, CVD was positively associated with VATz (crude hazard ratio (cHR) [95% CI]: 1.30 [1.20-1.40], P < .001) and negatively associated with aSATz and LFz (cHR: 0.91 [0.85-0.99], P = .028, and 0.88 [0.82-0.95], P = .002). All z-scores remained significant after adjustment for sex, BMI, and age, but only VATz was significant when previous CVD was added. T2D was positively associated with VATz and LFz (cHR: 1.53 [1.40-1.67], P < .001, and 1.35 [1.23-148], P < .001) and negatively associated with aSATz (cHR: 0.90 [0.81-0.99], P = .026). All z-scores remained significant after adjustment for sex, BMI, and age.
CONCLUSIONS
Personalized MR-derived fat z-scores can identify phenotypes of obesity with specific cardiometabolic risk profiles regardless of BMI. Current guidelines for bariatric surgery based on BMI exclude some of these high-risk patients.
MeSH
Subcutaneous Fat, Magnetic Resonance Imaging, Liver, Subcutaneous Tissue, Obesity, Sex, Tissues, Adipose Tissue