Associations of Abdominal Visceral Fat Content and Plasma Adiponectin Level With Intracranial Atherosclerotic Stenosis: A Cross-Sectional Study

Abstract

BackgroundAbdominal obesity and adipocytokines are closely related to atherosclerosis, and adiponectin level is considered one of the important clinical indicators. This study aimed to analyze the associations of abdominal visceral fat content and adiponectin level with intracranial atherosclerotic stenosis (ICAS).MethodsA total of 186 patients were enrolled in this study. Patients were distributed into ICAS and non-ICAS by the degree of artery stenosis. Plasma adiponectin levels and the ratio of visceral adipose tissue (VAT) to subcutaneous adipose tissue (SAT) were measured. The related factors of intracranial atherosclerotic stenosis were determined using multivariable logistic regression analysis.ResultsThe VAT/SAT ratio (OR, 26.08; 95% CI, 5.92–114.83; p < 0.001) and adiponectin (OR, 0.61; 95% CI, 0.44–0.84; p = 0.002) were found to be the independent predictors of ICAS in a multivariable logistic regression analysis. The prevalence of ICAS increased (T1: 27.4%; T2: 50.0%; T3: 75.8%) as the VAT/SAT ratio tertile increased (p < 0.001). The prevalence of ICAS decreased (T1: 72.6%; T2: 54.8%; T3: 25.8%) as the adiponectin tertile increased (p < 0.001). In ROC curves analysis, VAT/SAT ratio had a sensible accuracy for the prediction of ICAS. The optimal cut-off value of VAT/SAT ratio to predict ICAS in this study was 1.04 (AUC: 0.747; p < 0.001; sensitivity: 67.4%; specificity: 74.7%). The optimal adiponectin cutoff was 3.03 ug/ml (AUC: 0.716; p < 0.001; sensitivity:75.8%; specificity: 61.5%).ConclusionHigher VAT/SAT ratio and lower plasma adiponectin levels were closely related to the increased risk of intracranial atherosclerotic stenosis.

The association between the visceral to subcutaneous abdominal fat ratio and the risk of cardiovascular diseases: a systematic review

“…Finally, 27 papers (18 cross-sectional and 9 cohort studies) published between 2010 and 2023, which met our inclusion criteria, were included. Amongst the included studies, six articles examined the association between VAT-to-SAT ratio and blood pressure (BP) [ 15 , 23 , 31 – 34 ], 9 studies examined atherosclerosis indices [ 24 , 35 – 42 ], 10 studies examined CVDs events [ 26 , 43 – 51 ] and remaining two studies assessed CVDs risk scores [ 25 , 52 ]. Among the reviewed studies, eleven were conducted in Japan [ 26 , 31 , 33 , 36 , 38 , 39 , 41 , 43 , 47 , 48 , 51 ], six in USA [ 15 , 40 , 42 , 44 , 49 , 52 ], three in Brazil [ 25 , 35 , 45 ], three in China [ 24 , 34 , 50 ], two in South Korea [ 23 , 32 ], one in Netherlands [ 37 ], and one in Portugal [ 46 ].…”

“…Moreover, Bogorodskaya et al [ 42 ] suggested that there is a correlation between VAT-to-SAT ratio and CAC score > 0 (OR = 3.57, p < 0.001) in CVD-free patients with human immunodeficiency virus (HIV) as well as an increased risk of the presence of atherosclerotic plaques (OR = 3.30, p = 0.03). According to the study conducted by Wang et al [ 24 ], the VAT-to-SAT ratio was proposed as an independent predictor for intracranial atherosclerosis (ICAS) (OR = 26.08; 95% confidence interval (CI): 5.92–114.83; p < 0.001) in a sample of 186 patients with an average age of 67.19 ± 8.68. Higuchi et al [ 39 ] conducted a cross-sectional study on 3007 healthy Japanese adults.…”

“…However, given the distinctive properties of SAT in the pathophysiology of metabolic abnormalities from those of VAT, measuring an index that includes both compartments, i.e., the visceral-to-subcutaneous fat (VAT-to-SAT) ratio, might theoretically provide a more comprehensive insight into the individual’s future risk [ 23 ]. A number of studies have examined the association between the VAT-to-SAT ratio and cardio-metabolic risk factors [ 24 – 27 ]. Therefore, given the abundance of existing literature and the rise of controversial invasive fat reduction methods that primarily target SAT, the aim of the present study was to conduct a systematic review of the available literature which investigated the association between the abdominal ratio of VAT-to-SAT and the risk of CVDs.…”

Adipokines in atherosclerosis: unraveling complex roles

“…Decreased plasma adiponectin levels are associated with an increased risk of intima-media thickness ( 145 ) and intracranial AS stenosis ( 146 ). Gasbarrino et al analyzed plasma adiponectin in patients with severe carotid AS undergoing carotid endarterectomy ( 147 ).…”