Abdominal Visceral and Subcutaneous Adipose Tissue Compartments

Abstract

Background-Visceral adipose tissue (VAT) compartments may confer increased metabolic risk. The incremental utility of measuring both visceral and subcutaneous abdominal adipose tissue (SAT) in association with metabolic risk factors and underlying heritability has not been well described in a population-based setting. Methods and Results-Participants (nϭ3001) were drawn from the Framingham Heart Study (48% women; mean age, 50 years), were free of clinical cardiovascular disease, and underwent multidetector computed tomography assessment of SAT and VAT volumes between 2002 and. Metabolic risk factors were examined in relation to increments of SAT and VAT after multivariable adjustment. Heritability was calculated using variance-components analysis. Among both women and men, SAT and VAT were significantly associated with blood pressure, fasting plasma glucose, triglycerides, and high-density lipoprotein cholesterol and with increased odds of hypertension, impaired fasting glucose, diabetes mellitus, and metabolic syndrome (P range Ͻ0.01). In women, relations between VAT and risk factors were consistently stronger than in men. However, VAT was more strongly correlated with most metabolic risk factors than was SAT. For example, among women and men, both SAT and VAT were associated with increased odds of metabolic syndrome. In women, the odds ratio (OR) of metabolic syndrome per 1-standard deviation increase in VAT (OR, 4.7) was stronger than that for SAT (OR, 3.0; P for difference between SAT and VAT Ͻ0.0001); similar differences were noted for men (OR for VAT, 4.2; OR for SAT, 2.5). Furthermore, VAT but not SAT contributed significantly to risk factor variation after adjustment for body mass index and waist circumference (P Յ0.01). Among overweight and obese individuals, the prevalence of hypertension, impaired fasting glucose, and metabolic syndrome increased linearly and significantly across increasing VAT quartiles. Heritability values for SAT and VAT were 57% and 36%, respectively. Conclusions-Although both SAT and VAT are correlated with metabolic risk factors, VAT remains more strongly associated with an adverse metabolic risk profile even after accounting for standard anthropometric indexes. Our findings are consistent with the hypothesized role of visceral fat as a unique, pathogenic fat depot. Measurement of VAT may provide a more complete understanding of metabolic risk associated with variation in fat distribution. (Circulation.

Proposed cut‐off values of the waist circumference for metabolic syndrome based on visceral fat volume in a Japanese population

“…However, the sex difference of SFV and VFV has not been fully investigated. Fox et al 13. compared the partial (not total) abdominal visceral and subcutaneous fat volumes in 1,649 men and 1,452 women from the Framingham Heart Study cohort by analyzing a region of 125 mm above S1 on CT scans.…”

“…Although the VFA at the umbilicus has been widely used to identify visceral obesity13, 14, 15, 16, 17, 18, 19, we previously showed that the maximal VFA was not at the umbilicus, but was widely distributed from L1 to L520, 21.…”

“…In contrast, the Japan Society for the Study of Obesity (JASSO) has recommended that the appropriate cut‐off values of WC for detecting visceral obesity are 85 cm in Japanese men and 90 cm in Japanese women from the general population12, and these values are widely used for diagnosis of MetS in Japan. As the JASSO cut‐off value of WC is higher for women than men, unlike the criteria used in other Asian countries, reassessment of the cut‐off values for Japanese persons has been carried out previously, and different values have been proposed13, 14, 15, 16, 17, 18, 19. However, these previous Japanese studies were based on WC and/or the visceral fat area (VFA) at the umbilicus determined by CT scanning.…”

Association of Body Fat Mass and Fat Distribution With the Incidence of Hypertension in a Population‐Based Chinese Cohort: A 22‐Year Follow‐Up

“…Baseline characteristics were compared between nonhypertension and hypertension groups by the Wilcoxon rank sum test and Z statistic for continuous variables and by the χ 2 test and χ 2 statistic for categorical variables. According to previous studies, there were significant differences in the relationship of total body fat and hypertension between men and women 33, 34. Therefore, Cox regressions were stratified by sex, with hypertension as the end event and the time interval between baseline and hypertension diagnosis as the time variable, and the χ 2 statistic was used to test the regression coefficients.…”

Increased Epicardial, Pericardial, and Subcutaneous Adipose Tissue Is Associated with the Presence and Severity of Coronary Artery Calcium

“…Fox et al (29) analyzed SATand visceral adipose tissue in individuals without known CAD and found that SAT and VAT were significantly associated with blood pressure, fasting plasma glucose, triglycerides, and high-density lipoprotein, with increased odds of hypertension, impaired fasting glucose, and metabolic syndrome in both genders. VAT was more strongly correlated with most metabolic risk factors than was SAT.…”