Association Between Visceral and Subcutaneous Adipose Depots and Incident Cardiovascular Disease Risk Factors
Open accessAbstract
Background—: Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) vary in volume and quality. We evaluated whether fat volume or attenuation (indirect measure of quality) predicts metabolic risk factor changes. Methods and Results—: Framingham Heart Study Multi-detector Computed Tomography Substudy participants (n=1730, 45% women) were followed up over a mean of 6.2 years. Baseline VAT and SAT volume (in cm 3 ) and attenuation (in Hounsfield units) were assessed. Outcomes included blood pressure, lipids, and glucose. We constructed multivariable regression models predicting change from baseline to follow-up. Baseline VAT was associated with metabolic risk factors at follow-up. Per 500-cm 3 increase in baseline VAT, glucose was 2.34 mg/dL higher (95% confidence interval, 1.71–2.97) and high-density lipoprotein was 1.62 mg/dL lower (95% confidence interval, 0.97–2.28) in women ( P <0.0001 for both). These findings remained significant after adjustment for body mass index. Results for SAT were similar although less striking. Lower (more negative) fat attenuation was associated with more adverse metabolic profiles at follow-up. For example, per 5-unit decrease in baseline VAT Hounsfield units, log triglycerides increased by 0.08 mg/dL (95% confidence interval, 0.05–0.12; P =0.005), which remained significant after adjustment for baseline VAT. Among men, VAT and SAT Hounsfield units were associated with changes in cardiovascular disease risk factors but were mostly attenuated after baseline volume adjustment. Conclusions—: VAT volume and SAT volume are associated with incident metabolic risk factors beyond overall adiposity. Decreases in fat attenuation are also associated with incident risk factors. These findings suggest that both volume and quality of VAT and SAT contribute to metabolic risk.
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Increased visceral and subcutaneous adipose tissue volume and reduced adipose tissue quality assessed as reduced attenuation on CT are associated with increased cardiovascular risk that is not explained by increased BMI.
“Increased VAT and SAT volume as well as reduced adipose tissue quality (assessed indirectly as reduced attenuation in Hounsfield units on CT) were reported to be associated with increased cardiovascular risk that was not explained by increased BMI111.”
From Obesity, kidney dysfunction and hypertension: mechanistic links (2019) · cites this paper as [111]
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- Authors
- Abraham, T. M., Pedley, A., Massaro, J. M., Hoffmann, U., & Fox, C. S.
- Affiliations
- Boston University (US)
- Venue
- Circulation
- Published
- 2015-10-27
- Volume
- 132
- Issue
- 17
- Pages
- 1639-1647
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC4779497
- OpenAlex
- W1916252988
- Cited by
- 353
- References
- 31
- Citations by year
- 2026: 14 · 2025: 48 · 2024: 36 · 2023: 43 · 2022: 31 · 2021: 30 · 2020: 41 · 2019: 36 · 2018: 33 · 2017: 24 · 2016: 15 · 2015: 1 · 2014: 1
- FWCI
- 17.70
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (Z99 HL999999, n01hc25195-41-0-1)
- National Heart, Lung, and Blood Institute (ZIAHL006094, N01‐HC25195, N01-HC-025195)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- visceral adipose tissue, subcutaneous adipose tissue, fat attenuation, adipose tissue volume, cardiovascular risk factors, metabolic risk factors, blood pressure, lipids, glucose, HDL cholesterol, triglycerides, sex differences, body mass index
- MeSH terms
- Adult, Alcohol Drinking, Anthropometry, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Humans, Hyperlipidemias, Hypertension, Male, Middle Aged, Organ Size, Prospective Studies, Risk, Sex Factors, Smoking, United States, Body Mass Index, Incidence, Metabolic Syndrome, Subcutaneous Fat, Intra-Abdominal Fat, Adiposity, Multidetector Computed Tomography
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