Visceral adiposity, not abdominal subcutaneous fat area, is associated with high blood pressure in Japanese men: the Ohtori study

Abstract

Visceral adiposity is considered to have a key role in cardiometabolic diseases. The purpose of this study is to investigate cross-sectionally the association between intra-abdominal fat area (IAFA) measured by computed tomography (CT) and high blood pressure independent of abdominal subcutaneous fat area (ASFA) and insulin resistance. Study participants included 624 Japanese men not taking oral hypoglycemic medications or insulin. Abdominal, thoracic and thigh fat areas were measured by CT. Total fat area (TFA) was calculated as the sum of abdominal, thoracic and thigh fat area. Total subcutaneous fat area (TSFA) was defined as TFA minus IAFA. Hypertension and high normal blood pressure were defined using the 1999 criteria of the World Health Organization. Multiple-adjusted odds ratios of hypertension for tertiles of IAFA were 2.64 (95% confidence interval, 1.35-5.16) for tertile 2, and 5.08 (2.48-10.39) for tertile 3, compared with tertile 1 after adjusting for age, fasting immunoreactive insulin, diabetes status, ASFA, alcohol consumption, regular physical exercise and smoking habit. IAFA remained significantly associated with hypertension even after adjustment for ASFA, TSFA, TFA, body mass index or waist circumference, and no other measure of regional or total adiposity was associated with the odds of hypertension in models, which included IAFA. Similar results were obtained for the association between IAFA and the prevalence of high normal blood pressure or hypertension. In conclusion, greater visceral adiposity was associated with a higher odds of high blood pressure in Japanese men.

Utility of the Visceral Adiposity Index and Hypertriglyceridemic Waist Phenotype for Predicting Incident Hypertension

“…Although the VAI could be an alternative index to predict HTN, the HTGW phenotype appeared to be a stronger predictor than the VAI. Our findings are consistent with the limited number of cross-sectional studies [1213141516] and a longitudinal study [11] showing that visceral adiposity measured by CT was an independent predictor of HTN. In cross-sectional and cohort studies of Japanese-Americans [111217], visceral adiposity measured by CT, but not the abdominal subcutaneous adipose tissue, was associated with the prevalence and incidence of HTN.…”

“…Magnetic resonance imaging and computed tomography (CT) are gold standards for the measurement of visceral fat, but they are not appropriate for epidemiological studies and everyday practice for practical, ethical, and economic reasons. Only limited investigations have examined the association between visceral adiposity measured by CT and the risk of HTN [111213141516171819], with inconclusive results. Some studies showed a significant or borderline significant association [111315161718], whereas others reported no association [19] or an association in women but not men [14].…”

Identification of Obesity and Cardiovascular Risk in Ethnically and Racially Diverse Populations

“…Imaging modalities such as computed tomography (CT), magnetic resonance imaging (MRI), and ultrasonography may be used to measure both overall body composition and adipose tissue distribution, including distinguishing subcutaneous adipose tissue from VAT, which, as noted, is closely linked to CVD risk. [89][90][91][92][93] Additionally, modalities such as DEXA, bioelectrical impedance analysis (BIA), and air displacement plethysmography (ADP) may be used to assess body composition. These tools measure %BF, which, although not as closely linked to CVD risk as VAT, is still a useful marker of cardiovascular risk.…”

Association of Visceral Fat and Liver Fat With Hyperuricemia

“…The Ohtori Study is an ongoing prospective cohort study designed to investigate the relationship of body composition to chronic diseases . It is made up of 1,036 Japanese men ages 25–77 years who visited the Ohtori Health Promotion Center for a medical checkup between December 2005 and April 2010.…”