Intramuscular Fat and Associations With Metabolic Risk Factors in the Framingham Heart Study

Abstract

Objective Intramuscular fat accumulates between muscle fibers or within muscle cells. We investigated the association of intramuscular fat with other ectopic fat deposits and metabolic risk factors. Approach and Results Participants (n = 2945; 50.2% women; mean age 50.8 years) from the Framingham Heart Study underwent multidetector computed tomography scanning of the abdomen. Regions of interest were placed on the left and right paraspinous muscle and the muscle attenuation (MA) in Hounsfield units were averaged. We examined the association between MA and metabolic risk factors in multivariable models and additionally adjusted for BMI and visceral fat (VAT) in separate models. MA was associated with dysglycemia, dyslipidemia, and hypertension in both sexes. In women, per standard deviation decrease in MA, there was a 1.34 (95% CI 1.10–1.64) increase in the odds of diabetes, a 1.40 (95% CI 1.22 – 1.61) increase in the odds of high triglycerides, and a 1.29 (95% CI 1.12 – 1.48) increase in the odds of hypertension. However, none of these associations persisted after adjustment for BMI or VAT. In men, we observed similar patterns for most risk factors. The exception was metabolic syndrome, which retained association in women even after adjustment for BMI and VAT, and low HDL and high triglycerides in men, whose associations also persisted after adjustment for BMI and VAT. Conclusions MA was associated with metabolic risk factors, but most of these associations were lost after adjustment for BMI or VAT. However, a unique association remained for metabolic syndrome in women and lipids in men.

Grim status of hypertension in rural China: results from Northeast China Rural Cardiovascular Health Study 2013

“…26,27 Results from the Framingham study have also suggested that people with higher BP also have higher levels of TC. 28 In the present study, multivariate analysis showed that participants with either high TC, low HDL-C, high LDL-C, or high TG were more likely associated with hypertension.…”

Deficits in Muscle Mass, Muscle Density, and Modified Associations With Fat in Rheumatoid Arthritis

“…Furthermore, RA patients may have reduced muscle strength due to greater intramuscular fat infiltration, which is indicated by decreased muscle density on peripheral quantitative computed tomography (QCT) scans. Studies in a large community-based cohort demonstrated that greater fat indices were associated with greater intramuscular fat infiltration (12,13). One should also recognize that the association between muscle outcomes and adiposity might be altered in a disease state characterized by inflammatory cachexia such as RA.…”

The Growing Problem of Obesity

“…None of the associations, however, persisted after correction for BMI and visceral adipose tissue. In men, there remained an association between muscle attenuation and lipid levels and in women, an association between muscle attenuation and metabolic syndrome remained 13 .…”

“…Goodpaster used that measure to test the relationship of muscle content to strength in older subjects. In recently reported studies by Therkelsen and colleagues in ATVB , the relationship between muscle attenuation coefficient with metabolic risk factors and additionally adjusted for BMI and visceral adipose tissue was addressed in subjects of the Framingham Heart Study 13 . The authors showed that in both men and women, muscle attenuation was associated with dysglycemia, dyslipidemia and hypertension.…”