Association between android fat mass, gynoid fat mass and cardiovascular and all-cause mortality in adults: NHANES 2003–2007

Abstract

ObjectivesEvidence of the relationship between android fat mass and gynoid fat mass with the mortality prediction is still limited. Current study analyzed the NHANES database to investigate the relationship between android fat mass, gynoid fat mass and CVD, with all-cause mortality.MethodThe study subjects were NHANES participants over 20 years old, two indicators of regional body composition, android fat and gynoid fat were measured by Dual Energy x-ray Absorptiometry (DEXA). The other various covariates data obtained from the NHANES questionnaire and laboratory measurements, including age, gender, education, race/ethnicity, uric acid, total serum cholesterol, albumin, Vitamin C, folate, alcohol drinking, smoking status, history of diabetes, and hypertension. Mortality status was ascertained from a linked mortality file prepared by the National Center for Health Statistics. The study population was divided quartiles based on the distribution of android fat mass and gynoid fat mass. The relationship between these two indicators with cardiovascular and all-cause mortality was investigated by using Cox regression. The covariates age, gender, smoking status, drinking status, history of diabetes, and history of hypertension were stratified.ResultsIn the fully adjusted model, Q3 had the lowest HR in android fat mass and gynoid fat mass. When examining the relationship between android fat mass and CVD mortality, current smokers and drinkers had the lowest CVD risk in Q2 [smoking: 0.21 (0.08, 0.52), drinking: 0.14 (0.04, 0.50)]. In diabetic patients, compared with Q1, other groups with increased android fat mass can significantly reduce the risk of CVD [Q4: 0.17 (0.04, 0.75), Q3: 0.18 (0.03, 1.09), Q2: 0.27 (0.09, 0.83)]. In ≥60 years old and female, the greater the gynoid fat mass, the smaller the HR of all-cause mortality [Q4 for ≥60 years old: 0.57 (0.33, 0.96), Q4 for female: 0.37 (0.23, 0.58)]. People <60 years old had a lower risk of all-cause mortality with gynoid fat mass in Q3 than those ≥60 years old [<60 years: 0.50 (0.27, 0.91), ≥60 years: 0.65 (0.45, 0.95)]. Among subjects without hypertension, the group with the largest android fat mass had the lowest risk of CVD mortality, and the group with the largest gynoid fat mass had the lowest risk of all-cause mortality [Android fat mass: 0.36 (0.16, 0.81), gynoid fat mass: 0.57 (0.39, 0.85)].ConclusionModerate android fat mass and gynoid fat mass (Q3) had the most protective effect. Smokers and drinkers need to control their body fat. Being too thin is harmful to people with diabetes. Increased gynoid fat mass is a protective factor for all-cause mortality in older adults and females. Young people's gynoid fat mass is more protective in the moderate range than older people's. If no high blood pressure exists, people with more android and gynoid fat mass have a lower risk of CVD or all-cause mortality.

The association between reproductive history and abdominal adipose tissue among postmenopausal women: results from the Women’s Health Initiative

“…The combination of early menarche and early menopause may indicate a phenotype at increased risk of cardiometabolic disease due, in part, to increased visceral adiposity. Android fat mass deposition is another particularly high-risk phenotype; central adiposity is associated with metabolic abnormalities, chronic disease, and mortality risk ( Ma et al , 2023 ). Women who experienced early menarche and/or early menopause also had highest levels of android fat.…”

“…The novel DXA-derived indices of abdominal adiposity presented in this manuscript add to our understanding of these complex relationships. The quantity and patterning of adipose tissue have important health implications: visceral fat and high android fat mass are associated with greater cardiometabolic complications than subcutaneous fat or gynoid fat mass ( Ma et al , 2023 ). These results could have broad implications for primary prevention of chronic disease risk in postmenopausal women because visceral fat is a modifiable risk factor via diet, exercise, and medication ( Gepner et al , 2018 ; Wilding et al , 2021 ).…”

Surrogate indices of insulin resistance using the Matsuda index as reference in adult men—a computational approach

“…Additionally, previous studies have shown that the use of fasting and 2h-PG levels has relatively low accuracy for early prediction of impaired glucose tolerance and T2DM, cardiovascular disease (CVD), and mortality rate (14). In this way, several surrogate indices that evaluate IR have been validated, including Matsuda, HOMA-IR, QUICKI, triglyceride-glucose (TyG) index, triglycerides-to-HDL-C ratio (TG/HDL-c), BMI (kg/m 2 ), visceral adiposity index (VAI), TyGwaist circumference (TyG-WC), TyG-body mass index (TyG-BMI), TyG-waist-to-height ratio (TyG-WHtR), lipid accumulation product (LAP), leptin/adiponectin ratio (LAR), total body fat percentage (TFM %), android fat (AF %), waist circumference (WC), and waist-to-height ratio (WHtR) (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23).…”