Abstract 16878: Visceral Adipose Tissue Activity Independently Predicts the Risk of Future Cardiovascular Events
Background: Obesity is associated with an increased cardiovascular disease (CVD) risk; the type, mass and activity of adipose tissues may differentially impact that risk. FDG PET and CT imaging provide measures of adipose tissue metabolic activity and volume, respectively. Here we assess the association between CVD risk and adipose tissue metrics using combined PET/CT imaging.
Methods: We consecutively identified 508 individuals (median age[IQR], 55[45,66], 42% male) who underwent FDG PET imaging at the Massachusetts General Hospital between 2005-2008 who were free of active cancer, prior history of CVD, or acute or chronic inflammatory conditions. CVD events (n=44) were independently adjudicated (as incident stroke, TIA, ACS, revascularization, new-onset angina, or peripheral arterial disease). Fat metabolic activity was measured using FDG PET/CT, within subcutaneous adipose tissue (SQAT) and visceral adipose tissue (VAT) as a target-to-background ratio (TBR). VAT volume and coronary calcium score (CAC) were independently measured using CT, all blinded to clinical data.
Results: The risk of subsequent CVD was not related to BMI (HR[95% CI], 1.03[0.97,1.1], p=0.35), or SQAT TBR (16[0.31,1,925],p=0.26). However, the product of VAT activity and VAT volume (VAP) predicted subsequent CVD, independent of CVD risk factors (including age, gender, LDL, HTN, smoking, BMI and CAC). Individuals in the highest (vs. lowest) VAP tertile had greater CVD risk (3.36[1.04, 10.83], p=0.04, figure A ). High VAP was associated with a higher CVD risk regardless of presence or absence of obesity, figure B . Further, VAT activity correlated with arterial FDG uptake, a measure of arterial inflammation (r=0.28, p<0.0001).
Conclusion: Imaging measures of visceral (but not subcutaneous) adipose tissue are associated with increased arterial inflammation and independently predict increased risk of subsequent CVD. This finding should be prospectively validated in a larger cohort.
- © 2013 by American Heart Association, Inc.