Abstract P382: Visceral Adiposity is a Stronger Correlate of Plasma C-Reactive Protein Levels than Liver Fat in the INSPIRE ME IAA Study.
Although it is well established than plasma C-reactive protein (CRP) levels predicts cardiovascular events beyond traditional risk factors, the main drivers of elevated CRP in the population are still under investigation. Among those, obesity and body fat distribution have been suggested to be important correlates of circulating CRP concentrations. The present analysis explored the correlates of CRP in the INSPIRE ME IAA cohort, a large CT imaging cardiometabolic risk study involving 2262 men and 2093 women for whom complete CT imaging and cardiometabolic, as well as CRP data, were available. CRP>10mg/l were excluded (N= 327). Both visceral adiposity (Men r=0.41 p<0.0001; Women r=0.50 p<0.0001) and liver attenuation, inversely related to liver fat, (Men r=-0.24 p<0.0001; Women r=-0.27 p<0.0001) were significantly correlated with plasma CRP levels. When both liver fat and visceral adiposity were placed in a multivariate model including age, region and physician’s specialty, we found that visceral adiposity (Men: partial R2=17.4 p<0.0001; Women: partial R2=24.1 p<0.0001) was more strongly related to CRP level than liver attenuation (Men: partial R2=0.3 p<0.0001; Women: partial R2=2.0 p<0.0001). Further adjustment for BMI, smoking status and statin use yielded similar results. We then divided patients into six groups according to tertiles of visceral fat (VAT) and the median of liver fat (LF): 1) lowVAT-lowLF, 2) lowVAT-highLF, 3) midVAT-lowLF, 4) midVAT-highLF, 5) highVAT-lowLF, 6) highVAT-highLF. In both men and women, CRP levels were higher in the midVAT and highVAT groups compared to the lowVAT group; yet, there was no difference between low and high LF within each respective VAT tertile after adjustment for age, BMI, region and specialty. This pattern was similar when statin use, smoking status, and the presence/absence of type 2 diabetes or cardiovascular disease (CVD) or metabolic syndrome were included. Our results show that CRP is strongly related to visceral adiposity, independent of several other covariates including liver fat. Due to the role of CRP in the prediction and prognosis of CVD, the assessment/management of visceral adiposity, by its surrogate marker waist circumference, will provide clinicians and patients with valuable information regarding an important correlate of this key inflammation marker.
- © 2012 by American Heart Association, Inc.