Anatomic fat depots and cardiovascular risk: a focus on the leg fat using nationwide surveys (KNHANES 2008–2011)

Han, Eugene; Lee, Yong-Ho; Lee, Byung Wan; Kang, Eun Seok; Lee, In Kyu; Soo, Bong

doi:10.1186/s12933-017-0536-4

Cited by 36 publications

(42 citation statements)

References 49 publications

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“…Sophie et al found that thigh subcutaneous adipose tissue was protective for diabetes [ 6 ]. Han et al documented that higher leg fat to total fat ratio was associated with decreased risk of CVD assessed by atherosclerotic cardiovascular disease risk equations [ 53 ]. More evidence was needed to elucidate the impact of adipose distribution on CVD.…”

Section: Discussionmentioning

confidence: 99%

Abdominal subcutaneous adipose tissue: a favorable adipose depot for diabetes?

Chen

Hou

et al. 2018

Cardiovasc Diabetol

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BackgroundPrevious studies have documented that visceral adipose tissue is positively associated with the risk of diabetes. However, the association of subcutaneous adipose tissue with diabetes risk is still in dispute. We aimed to assess the associations between different adipose distributions and the risk of newly diagnosed diabetes in Chinese adults.MethodsThe Shanghai Nicheng Cohort Study was conducted among Chinese adults aged 45–70 years. The baseline data of 12,137 participants were analyzed. Subcutaneous and visceral fat area (SFA and VFA) were measured by magnetic resonance imaging. Diabetes was newly diagnosed using a 75 g oral glucose tolerance test.ResultsThe multivariable-adjusted odds ratios (OR) and 95% confidence intervals (CI) of newly diagnosed diabetes per 1—standard deviation increase in SFA and VFA were 1.29 (1.19–1.39) and 1.61 (1.49–1.74) in men, and 1.10 (1.03–1.18) and 1.56 (1.45–1.67) in women, respectively. However, the association between SFA and newly diagnosed diabetes disappeared in men and was reversed in women (OR 0.86 [95% CI, 0.78–0.94]) after additional adjustment for body mass index (BMI) and VFA. The positive association between VFA and newly diagnosed diabetes remained significant in both sexes after further adjustment for BMI and SFA. Areas under the receiver operating characteristic curve of newly diagnosed diabetes predicted by VFA (0.679 [95% CI, 0.659–0.699] for men and 0.707 [95% CI, 0.690–0.723] for women) were significantly larger than by the other adiposity indicators.ConclusionsSFA was beneficial for lower risk of newly diagnosed diabetes in women but was not associated with newly diagnosed diabetes in men after taking general obesity and visceral obesity into account. VFA, however, was associated with likelihood of newly diagnosed diabetes in both Chinese men and women.Electronic supplementary materialThe online version of this article (10.1186/s12933-018-0734-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Abdominal subcutaneous adipose tissue: a favorable adipose depot for diabetes?

Chen

Hou

et al. 2018

Cardiovasc Diabetol

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“…The key risk factors are similar to those related to CVD, including age, sex, tobacco smoking, systolic blood pressure, and plasma concentrations of lipids [ 12 , 13 , 16 ]. A recent study has suggested that the leg fat distribution may be used as a potential marker for predicting CVD [ 17 ].…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Lower extremity arterial disease in patients with diabetes: a contemporary narrative review

Nativel

Potier

Alexandre

et al. 2018

Cardiovasc Diabetol

143

119

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Lower-extremity arterial disease (LEAD) is a major endemic disease with an alarming increased prevalence worldwide. It is a common and severe condition with excess risk of major cardiovascular events and death. It also leads to a high rate of lower-limb adverse events and non-traumatic amputation. The American Diabetes Association recommends a widespread medical history and clinical examination to screen for LEAD. The ankle brachial index (ABI) is the first non-invasive tool recommended to diagnose LEAD although its variable performance in patients with diabetes. The performance of ABI is particularly affected by the presence of peripheral neuropathy, medial arterial calcification, and incompressible arteries. There is no strong evidence today to support an alternative test for LEAD diagnosis in these conditions. The management of LEAD requires a strict control of cardiovascular risk factors including diabetes, hypertension, and dyslipidaemia. The benefit of intensive versus standard glucose control on the risk of LEAD has not been clearly established. Antihypertensive, lipid-lowering, and antiplatelet agents are obviously worthfull to reduce major cardiovascular adverse events, but few randomised controlled trials (RCTs) have evaluated the benefits of these treatments in terms of LEAD and its related adverse events. Smoking cessation, physical activity, supervised walking rehabilitation and healthy diet are also crucial in LEAD management. Several advances have been achieved in endovascular and surgical revascularization procedures, with obvious improvement in LEAD management. The revascularization strategy should take into account several factors including anatomical localizations of lesions, medical history of each patients and operator experience. Further studies, especially RCTs, are needed to evaluate the interest of different therapeutic strategies on the occurrence and progression of LEAD and its related adverse events in patients with diabetes.

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“…Nevertheless, SFA and VFA have different anatomical and functional significance [69,70]. The results of previous studies regarding the relationship between SFA and CVD are controversial [71][72][73]. Some studies have suggested that increased SFA was positively associated with CVD, while some studies have suggested that moderately increased SFA is beneficial for the balance of blood glucose and blood lipids, thereby exerting protective effects on cardiovascular health.…”

Section: The Influence Of Traditional Obesity-related Factors On Cimtmentioning

confidence: 99%

Analysis of risk factors for carotid intima-media thickness in patients with type 2 diabetes mellitus in Western China assessed by logistic regression combined with a decision tree model

Zhou

Qiu

Yang

et al. 2020

Diabetol Metab Syndr

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Background: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in patients with type 2 diabetes (T2DM). Carotid intima-media thickness (CIMT) is considered a preclinical stage of atherosclerosis. Therefore, it is necessary to identify the related risk factors for CIMT to facilitate the early prevention of CVD. Previous studies have shown that visceral fat area (VFA) is a risk factor for T2DM and CVD. However, few studies have focused on the effects of VFA on CIMT associated with T2DM. Moreover, considering that the body fat distribution shows regional and racial heterogeneity, the purpose of this study was to investigate the predictive value of VFA and other risk factors for CIMT associated with T2DM in Western China. Methods: In a cross-sectional study, a total of 1372 patients with T2DM were divided into the CIMT (−) group (n = 965) and the CIMT (+) group (n = 407) based on CIMT values. In addition to the univariate analyses, logistic regression analysis and a decision tree model were simultaneously performed to establish a correlation factor model for CIMT. Results: Univariate analyses showed that sex, smoking status, age, heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), height, weight, body mass index (BMI), waist circumference, hip circumference, waist-hip ratio, VFA, subcutaneous fat area, and the levels of 2-h C-peptide, serum creatinine, urea nitrogen and uric acid were significantly different between the two groups (all p < 0.05). Smoking, increased VFA, female sex and increased BMI were risk factors in the logistic regression analyses (OR = 5.759, OR = 1.364, OR = 2.239, OR = 1.186, respectively). In the decision tree model, smoking was the root node, followed by sex, waist circumference, VFA and chronic kidney disease (CKD) in order of importance. Conclusions: In addition to smoking, sex and BMI, VFA has a significant effect on CIMT associated with T2DM in the Chinese Han population in Western China. In addition, the decision tree model could help clinicians make more effective decisions, with its simplicity and intuitiveness, making it worth promoting in future medical research.

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Anatomic fat depots and cardiovascular risk: a focus on the leg fat using nationwide surveys (KNHANES 2008–2011)

Cited by 36 publications

References 49 publications

Abdominal subcutaneous adipose tissue: a favorable adipose depot for diabetes?

Abdominal subcutaneous adipose tissue: a favorable adipose depot for diabetes?

Lower extremity arterial disease in patients with diabetes: a contemporary narrative review

Analysis of risk factors for carotid intima-media thickness in patients with type 2 diabetes mellitus in Western China assessed by logistic regression combined with a decision tree model

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