Abstract 12141: Body Fat Distribution and Incident Cardiovascular Disease in Obese Adults
Background: Differences in body fat distribution may underpin heterogeneity in cardiovascular disease (CVD) risk associated with obesity. However, relative contributions of specific adipose tissue depots to CVD risk have not been fully explored.
Methods: We analyzed data from obese (BMI ≥ 30 kg/m2) participants in the Dallas Heart Study without baseline CVD who underwent dual energy x-ray absorptiometry and MRI assessment of adipose tissue distribution (visceral, abdominal subcutaneous, lower body subcutaneous) between 2000 and 2002. The composite outcome of incident and recurrent CVD events (CV death, myocardial infarction, stroke, coronary or peripheral artery revascularization, heart failure, or atrial fibrillation) was assessed over 8 years of follow-up. Associations between adipose depots and CVD events were assessed with multivariable-adjusted Cox proportional hazards models using the Wei-Lin-Weissfeld method for recurrent events.
Results: The study cohort included 972 obese participants with mean age 44 yrs; 62% women; 54% African-Americans. 91 CVD events occurred in 68 participants (7.0%). After multivariable adjustment for age, sex, race, and traditional risk factors, visceral adipose tissue was independently associated with development of CVD (HR per 1 SD: 1.24 [95% CI 1.02, 1.50]), while lower body subcutaneous adipose tissue was inversely associated with CVD (HR per 1 SD: 0.73 [95% CI 0.54, 0.99], Figure). In contrast, no significant associations with CVD were observed for BMI, waist circumference, waist-hip ratio, or abdominal subcutaneous fat. Associations were consistent across components of the composite outcome and in age, sex, race, and BMI subgroups.
Conclusions: Among obese adults, excess visceral adipose tissue was associated with higher CVD risk while increased lower body subcutaneous fat had a protective association. These findings highlight the biological importance of fat distribution with regard to CVD risk in obesity.
- © 2013 by American Heart Association, Inc.