Association between visceral and subcutaneous adipose depots and incident cardiovascular disease risk factors.
Association between visceral and subcutaneous adipose depots and incident cardiovascular disease risk factors.
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DOI：
10.1161/circulationaha.114.015000
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发表时间：
2015-10-27
期刊：
影响因子：
37.8
通讯作者：
Fox CS
中科院分区：
文献类型：
--
作者：
Abraham TM;Pedley A;Massaro JM;Hoffmann U;Fox CS
内脏和皮下脂肪组织(VAT和SAT)的体积和质量各不相同。我们评估了脂肪体积或脂肪衰减(质量的间接测量)是否可以预测代谢危险因素的变化。弗雷明翰心脏研究多探测器计算机断层摄影子研究参与者(n=1730，45%为女性)接受了平均6.2年的跟踪调查。评估基线VAT和SAT容量(以cm3为单位)和衰减(以Hounsfield单位为单位)。结果包括血压、血脂和血糖。我们建立了多变量回归模型，预测从基线到随访的变化。在随访中，基线增值税与代谢危险因素相关。基础增值税每增加500cm3，女性血糖升高2.34 mg/dL(95%可信区间1.71-2.97)，高密度脂蛋白降低1.62 mg/dL(95%可信区间0.97-2.28)(P<；两者均为0.0001)。在对BMI进行调整后，这些发现仍然显著。SAT的结果类似，尽管不那么引人注目。较低(更负面)的脂肪衰减与随访时更不利的代谢特征有关。例如，基础增值税HU每降低5个单位，对数甘油三酯增加0.08 mg/dL(95%可信区间0.05-0.12，p=0.005)，经基础增值税调整后仍显著。在男性中，VAT和SAT HU与心血管危险因素的变化有关，但在基线容量调整后大多减弱。VAT和SAT容量除了对总体肥胖有贡献外，还与意外代谢危险因素有关。脂肪减少也与意外危险因素有关。这些发现表明，增值税和SAT的数量和质量都会增加代谢风险。
Visceral and subcutaneous adipose tissue (VAT and SAT) vary in volume and quality. We evaluated whether fat volume or attenuation (indirect measure of quality) predicts metabolic risk factor changes. Framingham Heart Study Multi-detector Computed Tomography Substudy participants (n=1730, 45% women) were followed over a mean of 6.2 years. Baseline VAT and SAT volume (in cm3) and attenuation (in Hounsfield units, HU) were assessed. Outcomes included blood pressure, lipids and glucose. We constructed multivariable regression models predicting change from baseline to follow-up. Baseline VAT was associated with metabolic risk factors at follow-up. Per 500 cm3 increment in baseline VAT, glucose was 2.34 mg/dL higher (95% CI 1.71–2.97) and HDL was 1.62 mg/dL lower (95% CI 0.97–2.28) in women (p<0.0001 for both). These findings remained significant after adjustment for BMI. Results for SAT were similar, although less striking. Lower (more negative) fat attenuation was associated with more adverse metabolic profiles at follow-up. For example, per 5 unit decrease in baseline VAT HU, log triglycerides increased by 0.08 mg/dL (95% CI 0.05–0.12,p=0.005), which remained significant after adjustment for baseline VAT. Among men, VAT and SAT HU were associated with changes in CVD risk factors, but were mostly attenuated after baseline volume adjustment. VAT and SAT volume are associated with incident metabolic risk factors beyond their contributions to overall adiposity. Decrements in fat attenuation are also associated with incident risk factors. These findings suggest that both volume and quality of VAT and SAT contribute to metabolic risk.