Ectopic fat and adipokines in metabolically benign overweight/obese women: The kronos early estrogen prevention study

Authors


  • Disclosure: Dr. Brinton was a consultant to Abbott Laboratories for products not related to menopausal hormone therapy and other authors report no conflicts of interest.

  • Disclaimer: The Aurora Foundation did not have input into the design or conduct of the study or the review or approval of this article. The contents of the article are solely the responsibility of the authors and do not necessary represent the official view of the NCRR or NIH. The sponsors had no role in the design, conduct or reporting of the study.

  • Funding agencies: KEEPS was funded by grants from the Aurora Foundation to the Kronos Longevity Research Institute, NIH HL90639 to VMM, 1 UL1 RR024150, and the Mayo Foundation. Ectopic fat measures reported herein were funded by NIH HL094581 (to Dr. Wildman). This study was also supported by grant # 10PRE3410007 from the American Heart Association (to Dr. Ogorodnikova). This publication was also made possible by CTSA Grants UL1 RR025750 and KL2 RR025749 and TL1 RR025748 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. This publication was also made possible by CTSA Grants UL1 RR025750 and KL2 RR025749 and TL1 RR025748 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research.

  • ClinicalTrials.gov number: NCT00154180.

Correspondence: Unab I. Khan (ukhan@montefiore.org)

Abstract

Objective

It is unclear why despite a comparable cardiometabolic risk profile, “metabolically benign” overweight/obese individuals show an elevated risk of cardiovascular disease compared to normal weight individuals.

Design and Methods

In cross-sectional analyses, we compared levels of ectopic fat (epicardial, pericardial, and hepatic fat) and adipokines (leptin, soluble leptin receptor, and high molecular weight [HMW] adiponectin) among metabolically benign (MBO) and at-risk overweight/obese (ARO), and metabolically benign normal weight (MBNW) women, screened for the Kronos Early Estrogen Prevention Study. We defined “metabolically benign” with ≤ 1, and “at-risk” with ≥2 components of the metabolic syndrome.

Results

Compared to MBO women, ARO women had significantly elevated odds of being in the top tertile of epicardial fat (OR: 1.76, 95% CI: 1.04-2.99), hepatic fat (OR: 1.90, 95% CI:1.12-3.24) and leptin (OR: 2.15, 95% CI: 1.23-3.76), and the bottom tertile of HMW-adiponectin (OR: 2.90, 95% CI: 1.62-5.19). Compared to MBNW women, MBO women had significantly higher odds of being in the top tertile of epicardial fat (OR: 5.17, 95% CI: 3.22-8.29), pericardial fat (OR: 9.27, 95% CI: 5.52-15.56) and hepatic fat (OR: 2.72, 95% CI: 1.77-4.19) and the bottom tertile of HMW adiponectin levels (OR: 2.51, 95% CI: 1.60-3.94).

Conclusions

Levels of ectopic fat and the adverse adipokine profile increase on a continuum of BMI, suggesting that the metabolically benign phenotype may be a transient state.

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