Coexistence of Visceral Fat and Multiple Risk Factor Accumulations is Strongly Associated with Coronary Artery Disease in Japanese (The VACATION-J Study)

Abstract

Aim: Multiple risk factor syndrome is a target for the prevention of coronary artery disease (CAD).A cluster of multiple risk factors, such as hypertension, glucose intolerance, and/or dyslipidemia, is encountered in Japanese without and with excess visceral fat. The present study investigated the relationship between multiple risk factor accumulation and CAD in Japanese without and with visceral fat accumulation. Methods: The study subjects comprised 257 Japanese with suspected CAD (males/females= 153/ 104), who underwent 64-row multislice computed tomography (CT) coronary angiography and visceral fat area (VFA) measurement by CT. Based on the Japanese criteria for visceral fat accumulation, they were divided into those with VFA ＜100 and ≥ 100 cm 2 . Results: In subjects with VFA ＜100 cm 2 , the age-and sex-adjusted odds ratios (ORs) for 2 and 3 risk factors were 5.33 (95% confidence intervals; 1.04-27.38, p=0.0449) and 4.07 (0.72-23.15, p=0.1138), respectively, compared with VFA ＜100 cm 2 and 0 risk factor set at 1.0 (p=0.0569 for trend). In contrast, the respective ORs for subjects with VFA ≥ 100 cm 2 were much higher [6.46 (1.25-33.44, p=0.0261) and 20.42 (3.60-115.73, p=0.0007)] (p＜0.0001 for trend). The multivariate adjusted model demonstrated a significant relative excess CAD risk of 1.08 (p=0.0484) and 5.01 (p＜0.0001) for the interactions of 2 risk factors and VFA ≥ 100 cm 2 , and 3 risk factors and VFA ≥ 100 cm 2 , whereas multiple risk factor accumulation was not related with the increase of CAD risk in subjects with VFA ＜100 cm 2 . Conclusions: Coexistence of visceral fat and risk factor accumulations is strongly associated with CAD in Japanese.

Determinants of Extraaortic Arterial 18F-FDG Accumulation in Asymptomatic Cohorts: Sex Differences in the Association with Cardiovascular Risk Factors and Coronary Artery Stenosis

“…Lear et al claimed that VAT is the primary adiposity associated with atherosclerosis and likely represents an additional risk factor for carotid atherosclerosis in men (26). Shimizu et al contended that VAT accumulation acts in concert with CRF accumulation to increase the risk for CAD (27). Our results showed that men had a higher VAT volume and a significant association with extensive extraaortic arterial 18 F-FDG accumulation and suggest that VAT both played a key role in the extensive extraaortic arterial 18 F-FDG accumulation in the men examined and was related to the development of CAD.…”

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

“…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.…”

Obesity in China: its characteristics, diagnostic criteria, and implications

“…A Japanese study, the VACATION-J study, found a similar result. The coexistence of visceral fat (visceral adipose tissue volume ≥ 100 cm 2 ) and risk factor accumulations (i.e., hypertension, glucose intolerance, and/or dyslipidemia) is strongly associated with coronary artery disease in the Japanese population [22]. Moreover, the study in Shanghai by Zhang et al [23] revealed that the CVD incidence was independently related to increased waist circumference in the middle-aged group and to elevated blood glucose in the elderly group.…”