Abstract 15531: Abdominal Visceral Adiposity, Fatty Liver and Renin-Angiotensin-Aldosterone System: The Jackson Heart Study

Abstract

Background - The renin-angiotensin-aldosterone system plays an important role in the association of cardiometabolic disorders and cardiovascular disease. However, whether obesity, particularly abdominal visceral (VAT), subcutaneous (SAT) adipose tissue and fatty liver, which are metabolically connected, is associated with the renin-angiotensin-aldosterone activity needs to be further investigated.

Methods - Jackson Heart Study (JHS) participants (mean age 60 years, 65% women) underwent CT assessment of fatty liver, defined by liver attenuation (LA; low LA=high fatty liver) and volumetric abdominal visceral (VAT), subcutaneous (SAT) adipose tissue. Plasma renin and aldosterone were measured by Immunoradiometric assay and radioimmunoassay, respectively. Cross-sectional associations of LA, VAT and SAT with plasma renin and aldosterone were assessed using multivariable linear regression, and their joint associations were further examined in 4 subgroups based on the 75^th percentile of VAT, SAT and the 25^th percentile of LA.

Results - Both VAT and LA (per 1-standard deviation [SD] decrement) were associated with plasma aldosterone after multivariable adjustment (p<0.0007), which persisted after additional adjustment for each other and for body mass index (p range 0.0004-0.0007). There was a significant interaction observed between VAT and LA (p _interaction =0.002 for aldosterone between VAT and LA). Among 4 subgroups, participants with high VAT, low LA or both had higher plasma aldosterone levels than those without (p range 0.01-0.04) (Figure). For plasma renin, the association was only present with VAT (p<0.02) but not with LA and SAT. Finally, we did not observe association of SAT with plasma renin and aldosterone.

Conclusion - Both fatty liver and VAT are independent correlates of plasma aldosterone level, but the association with plasma renin is present only for VAT, not for fatty liver.