Disclosures: Dr. de Lemos has received grant support from Roche Diagnostics; consulting income from Tethys Bioscience, AstraZeneca, and Daiichi Sankyo; and lecture honoraria from BMS/Sanofi-Aventis. Dr. McGuire has received consulting income from F. Hoffmann LaRoche, Genentech, Sanofi-Aventis, Daiichi Sankyo, Novo Nordisk, and Tethys Bioscience.
Associations of visceral and abdominal subcutaneous adipose tissue with markers of cardiac and metabolic risk in obese adults
Article first published online: 19 MAY 2013
Copyright © 2012 The Obesity Society
Volume 21, Issue 9, pages E439–E447, September 2013
How to Cite
Neeland, I. J., Ayers, C. R., Rohatgi, A. K., Turer, A. T., Berry, J. D., Das, S. R., Vega, G. L., Khera, A., McGuire, D. K., Grundy, S. M. and de Lemos, J. A. (2013), Associations of visceral and abdominal subcutaneous adipose tissue with markers of cardiac and metabolic risk in obese adults. Obesity, 21: E439–E447. doi: 10.1002/oby.20135
Funding agencies: This work was supported by Award Number T32HL007360 from the National Heart, Lung, and Blood Institute to Dr. Neeland, the Donald W. Reynolds Foundation (Las Vegas, NV), by grants UL1DE019584 and PL1DK081182 from the National Institutes of Health, and by grant #UL1TR000451 from the National Center for Advancing Translational Sciences/National Institutes of Health. Biomarker measurements were supported by investigator-initiated grants from Alere Inc (San Diego CA) and Roche Diagnostics (Indianapolis IN).
- Issue published online: 23 SEP 2013
- Article first published online: 19 MAY 2013
- Accepted manuscript online: 6 NOV 2012 08:14AM EST
- Manuscript Accepted: 22 OCT 2012
- Manuscript Received: 28 MAR 2012
Objective: Visceral (VAT) and abdominal subcutaneous (SAT) adipose tissues contribute to obesity but may have different metabolic and atherosclerosis risk profiles. We sought to determine the associations of abdominal VAT and SAT mass with markers of cardiac and metabolic risk in a large, multiethnic, population-based cohort of obese adults.
Design and Methods: Among obese participants in the Dallas Heart Study, we examined the cross-sectional associations of abdominal VAT and SAT mass, assessed by magnetic resonance imaging (MRI) and indexed to body surface area (BSA), with circulating biomarkers of insulin resistance, dyslipidemia, and inflammation (n = 942); and with aortic plaque and liver fat by MRI and coronary calcium by computed tomography (n = 1200). Associations of VAT/BSA and SAT/BSA were examined after adjustment for age, sex, race, menopause, and body mass index.
Results: In multivariable models, VAT significantly associated with the homeostasis model assessment of insulin resistance (HOMA-IR), lower adiponectin, smaller LDL and HDL particle size, larger VLDL size, and increased LDL and VLDL particle number (p < 0.001 for each). VAT also associated with prevalent diabetes, metabolic syndrome, hepatic steatosis, and aortic plaque (p < 0.001 for each). VAT independently associated with C-reactive protein but not with any other inflammatory biomarkers tested. In contrast, SAT associated with leptin and inflammatory biomarkers, but not with dyslipidemia or atherosclerosis. Associations between SAT and HOMA-IR were significant in univariable analyses but attenuated after multivariable adjustment.
Conclusion: VAT associated with an adverse metabolic, dyslipidemic, and atherogenic obesity phenotype. In contrast, SAT demonstrated a more benign phenotype, characterized by modest associations with inflammatory biomarkers and leptin, but no independent association with dyslipidemia, insulin resistance, or atherosclerosis in obese individuals. These findings suggest that abdominal fat distribution defines distinct obesity sub-phenotypes with heterogeneous metabolic and atherosclerosis risk.