Abdominal adipose tissue depots and cardiometabolic disease risk in postmenopausal women

项目总结 积累基础、临床和人群研究表明，大量的腹部脂肪，特别是 内脏脂肪组织(VAT)位于腹内储存库，在糖尿病的病理生理过程中起重要作用。 心脏代谢性疾病(即2型糖尿病、心血管疾病和中风)。这 研究优雅地将增值税的亲密本质描述为胰岛素的强大代谢驱动因素 抵抗力、血脂异常和高血压。它还表明，全身脂肪，更具体地说， 皮下脂肪组织(SAT)在糖尿病的病理生理学中可能相对不那么重要，甚至是良性的。 心脏代谢疾病。尽管这一知识框架正在蓬勃发展，但关于 腹部VAT和SAT水平与心脏代谢性疾病事件的关系 证据基础上的差距，因为对这一主题的研究产生的进一步洞察将具有重大意义 与身体成分和肥胖在心脏代谢性疾病预防中的重要性有关的含义。 证据基础出现瓶颈的主要原因是可行性。研究人员和临床医生 不得不依赖成像技术，如计算机断层扫描(CT)和磁共振成像 (MRI)来测量特定的脂肪组织储存库。成本、辐射和可获得性等问题 这些方法在临床和大型研究中是不切实际的；少数研究具有 合并这些技术可能样本量有限，或者没有积累足够的跟踪时间和 活动，以充分解决这一主题。然而，有一个有效和经济的解决方案来解决这个问题。 通过应用新技术，从现有的双能X射线中量化腹部VAT和SAT 吸光度(DXA)扫描。这项技术已经证明了强大的有效性，以黄金标准衡量 核磁共振和CT扫描显示的腹部脂肪组织。因此，我们建议将这部小说 将技术用于现有的妇女健康倡议(WHI)DXA队列以量化腹部增值税和SAT 从现有的DXA扫描中。这项提议将创造一个有价值的、新的、丰富的、分析的纵向 将在基线(N=10,607)、第3年(N=8,939)在WHI中使用重复DXA测量的队列 6年级(N=8,239)和9年级(N=4,595)，以解决关于腹部肥胖/身体主题的基本问题 随着年龄的增长，绝经后妇女的心脏代谢疾病风险。这个项目充分利用 在丰富的科学资源上，并将提供新的和先进的结果，将描绘出 腹部脂肪组织在心脏代谢性疾病风险中的作用及针对性干预的可能性 和预防工作。

PROJECT SUMMARY Accumulating basic, clinical, and population research suggests that high amounts of abdominal fat, particularly visceral adipose tissue (VAT) in the intra-abdominal depot, plays a crucial role in the pathophysiology of cardiometabolic diseases (i.e. type 2 diabetes (T2D), cardiovascular diseases (CVD) and stroke). This research has elegantly described the intimate nature of VAT as a powerful metabolic driver of insulin resistance, dyslipidemia, and hypertension. It also suggests that total body fat, and more specifically subcutaneous adipose tissue (SAT), may be relatively less important or even benign in the pathophysiology of cardiometabolic disease. Despite this burgeoning framework of knowledge, much remains unknown about the relationship between abdominal VAT and SAT levels with incident cardiometabolic disease events – a critical gap in the evidence base since further insight resulting from research on this topic would have major implications related to the importance of body composition and obesity in cardiometabolic disease prevention. The central reason for the bottleneck in the evidence base has been feasibility. Researchers and clinicians have had to rely on imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) to measure specific adipose tissue depots. Issues such as cost, radiation, and availability have made these methods impractical in the clinic and for large research studies; and the few studies which have incorporated these technologies may have limited sample size, or have not accrued enough follow up time and events to adequately address the topic. However, there is an efficient and economical solution to this problem via the application of new technology that quantifies abdominal VAT and SAT from existing Dual Energy X-Ray Absorptiometry (DXA) scans. This technology has demonstrated strong validity with gold-standard measures of abdominal adipose tissue depots from MRI and CT scans. Therefore, we propose to apply this novel technology to the existing Women's Health Initiative (WHI) DXA cohort to quantify abdominal VAT and SAT from existing DXA scans. This proposal will create a valuable, new, minority enriched, analytic longitudinal cohort that will utilize repeated DXA measurements in the WHI at baseline (N=10,607), year 3 (N=8,939), year 6 (N=8,239), and year 9 (N=4,595) to address essential questions on the topic of abdominal adiposity/body composition, and cardiometabolic disease risk in postmenopausal women as they age. This project capitalizes on a rich scientific resource and will provide new and advanced results that will delineate the importance of abdominal adipose tissue depots in cardiometabolic disease risk and the potential for targeted interventions and prevention efforts.