Fox CS, Massaro JM, Hoffmann U, Pou KM, Maurovich-Horvat P, Liu CY et al.. Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation 116, 39-48

Division of Mathematics, Boston University, Boston, Massachusetts, United States
Circulation (Impact Factor: 14.43). 08/2007; 116(1):39-48. DOI: 10.1161/CIRCULATIONAHA.106.675355
Source: PubMed


Visceral adipose tissue (VAT) compartments may confer increased metabolic risk. The incremental utility of measuring both visceral and subcutaneous abdominal adipose tissue (SAT) in association with metabolic risk factors and underlying heritability has not been well described in a population-based setting.
Participants (n=3001) were drawn from the Framingham Heart Study (48% women; mean age, 50 years), were free of clinical cardiovascular disease, and underwent multidetector computed tomography assessment of SAT and VAT volumes between 2002 and 2005. Metabolic risk factors were examined in relation to increments of SAT and VAT after multivariable adjustment. Heritability was calculated using variance-components analysis. Among both women and men, SAT and VAT were significantly associated with blood pressure, fasting plasma glucose, triglycerides, and high-density lipoprotein cholesterol and with increased odds of hypertension, impaired fasting glucose, diabetes mellitus, and metabolic syndrome (P range < 0.01). In women, relations between VAT and risk factors were consistently stronger than in men. However, VAT was more strongly correlated with most metabolic risk factors than was SAT. For example, among women and men, both SAT and VAT were associated with increased odds of metabolic syndrome. In women, the odds ratio (OR) of metabolic syndrome per 1-standard deviation increase in VAT (OR, 4.7) was stronger than that for SAT (OR, 3.0; P for difference between SAT and VAT < 0.0001); similar differences were noted for men (OR for VAT, 4.2; OR for SAT, 2.5). Furthermore, VAT but not SAT contributed significantly to risk factor variation after adjustment for body mass index and waist circumference (P < or = 0.01). Among overweight and obese individuals, the prevalence of hypertension, impaired fasting glucose, and metabolic syndrome increased linearly and significantly across increasing VAT quartiles. Heritability values for SAT and VAT were 57% and 36%, respectively.
Although both SAT and VAT are correlated with metabolic risk factors, VAT remains more strongly associated with an adverse metabolic risk profile even after accounting for standard anthropometric indexes. Our findings are consistent with the hypothesized role of visceral fat as a unique, pathogenic fat depot. Measurement of VAT may provide a more complete understanding of metabolic risk associated with variation in fat distribution.

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    • "Excess adipose tissue (i.e., defined with increased body mass index (BMI)) is an independent risk factor for cardiovascular disease (CVD) in both sexes and includes spectrum of overweight (BMI P 25 kg/m 2 ), obese (BMI P 30 kg/m 2 ) and extreme obese (BMI P 40 kg/m 2 ) [2]. Many studies established that visceral adipose tissue (VAT) – 'belly fat' – has stronger association with CVD than subcutaneous adipose tissue (SAT) [3] [4] [5]. VAT is endocrinely more active and most abundant cytokines secreted are interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-a (TNF-a), and they have an important role in the atherogenesis [6]. "
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    ABSTRACT: Background: Obesity is associated with coronary artery disease (CAD), where epicardial adipose tissue (EAT) express proatherogenic cytokines (i.e., interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)) and decreases production of beneficial adiponectin. Studies on endocrine role of EAT are mostly based on assessing cytokines' mRNAs, whereas cytokine blood levels might not readily correlate. In order to get better insight into the endocrine role of thickened EAT in CAD, we assessed transcardial gradient of adiponectin, IL-6 and TNF-α. Methods: We assessed anthropometric and ultrasound measures in cohort of fifty nondiabetic subjects (21 CAD and 29 non-CAD). Blood sampled from aortic root and coronary sinus was assayed for adiponectin, IL-6 and TNF-α, using ELISA. Results: Except thicker EAT in CAD subjects, anthropometric measures were similar (overweight), with higher adiponectin in coronary sinus than in aortic root (p<0.001) in both groups. CAD subjects had lower adiponectin in aortic root (p<0.001) and higher levels of TNF-α in coronary sinus than in aortic root (p=0.05). EAT thickness positively correlated with hip circumference (p=0.038) and negatively correlated with adiponectin levels (for both p<0.05). Conclusions: Transcardial gradient of adiponectin in non-CAD and CAD overweight subjects was similar, while latter had lower systemic adiponectin level and thicker EAT. EAT with thickening reaches the threshold level of near-maximal down-regulation of adiponectin and its further thickening is not associated with continued decrease of adiponectin production. In CAD patients levels of TNF-α were higher, but IL-6 were not, and these cytokines might be flush out by lymphatic route.
    Cytokine 09/2015; 76(2). DOI:10.1016/j.cyto.2015.09.009 · 2.66 Impact Factor
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    • "measured directly or estimated by body condition index) may be poorly correlated with health or evolutionary fitness due to the health consequences of different lipid storage deposits. For example, in humans, intra-abdominal fat deposits are more strongly correlated with obesity-related health consequences than subcutaneous fat (Fox et al. 2007 "
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    ABSTRACT: 1.Body condition indices, measures of body “plumpness” or mass relative to frame size, are often used as a proxy for lipid reserves or fitness-related traits of animals and assumed to be positively related to fitness.2.The quantification and analysis of body condition indices has been the subject of debate for decades. Here we summarize three additional concerns with the use of body condition indices.3.First, body condition index is often poorly correlated with lipid content in animals. Second, even if body condition index and lipid content are correlated, lipid content of an animal may not be the most important aspect of body composition influencing fitness. Finally, neither body condition index nor lipid reserves are likely to be directly positively related to fitness in animals, as many animals homeostatically regulate intermediate levels of condition index or lipid reserves, with both higher and lower values incurring fitness costs.4.A wide range of analytical methods, including some relatively inexpensive and simple measures, are available for more detailed measures of animal body composition or fitness-related traits. Replacing body condition indices with more direct measures of body composition - even relatively simple measures - can inform understanding of the physiological mechanisms underlying animal responses in a wide range of behavioral, ecological and evolutionary studies.This article is protected by copyright. All rights reserved.
    Functional Ecology 04/2015; DOI:10.1111/1365-2435.12460 · 4.83 Impact Factor
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    • "Adipose tissue is also an abundant source of inflammatory cytokines and an excess of fat mass has been associated with a chronic subclinical inflammatory state [7]. It is recognized that important differences exist in the gene expression profile of abdominal SAT and VAT [8e10] and that these two fat depots independently enhance the risk of CV complications [11]. However, with respect to inflammatory genes, only few studies explored a large set of pro-inflammatory and anti-inflammatory cytokines [12] [13] and the results are controversial. "
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    ABSTRACT: Background and Aims Pro-inflammatory molecules produced by adipose tissue have been implicated in the risk of cardiovascular (CV) disease in obesity. We investigated the expression profile of 19 pro-inflammatory and 7 anti-inflammatory genes in subcutaneous adipose tissue (SAT) and in visceral adipose tissue (VAT) in 44 severely obese individuals who underwent bariatric surgery. Methods and Results SAT and VAT expressed an identical series of pro-inflammatory genes. Among these genes, twelve were significantly more expressed in SAT than in VAT while just one (IL18) was more expressed in VAT. The remaining genes were equally expressed. Among pro-inflammatory cytokines, both IL6 and IL8 were about 20 times more intensively expressed in SAT than in VAT. The expression of nine genes was highly associated in SAT and VAT. Only for 3 pro-inflammatory cytokines (IL8, IL18, SAA1) in SAT the gene expression in adipose tissue associated with the circulating levels of the corresponding gene products while no such an association was found as for VAT. Conclusions The expression of critical pro-inflammatory genes is substantially higher in SAT than in VAT in individuals with morbid obesity. The variability in circulating levels of pro-inflammatory cytokines is, in small part and just for three pro-inflammatory cytokines, explained by underlying gene expression in SAT but not in VAT. These results point to a compartment-specific adipose tissue contribution to inflammation in obesity and indicate that abdominal SAT contributes more than VAT to the pro-inflammatory milieu associated with severe obesity.
    Nutrition Metabolism and Cardiovascular Diseases 10/2014; 24(10). DOI:10.1016/j.numecd.2014.04.017 · 3.32 Impact Factor
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