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Coronary artery calcified atherosclerotic plaque (CP) is strongly associated with nonsubcutaneous adipose tissue, particularly pericardial adipose tissue (PAT), in community-based studies. We tested for relationships between regional adipose tissue depots and CP in African Americans with longstanding type 2 diabetes. Infrarenal aorta, coronary, and carotid artery CP and pericardial, visceral, intermuscular, and subcutaneous organ-specific adipose tissue volumes were measured using single and multidetector computed tomography (CT) in 422 African Americans with type 2 diabetes. Generalized estimating equations using exchangeable correlation and the sandwich estimator of the variance were used to test for associations between CP and adipose tissue depots. Mean (s.d.) age was 56.5 (7.6) years, diabetes duration 10.3 (7.6) years, PAT 85.3 (36.1) cm(3)/45 mm and visceral adipose tissue (VAT) 174.9 (70.1) cm(3)/15 mm. Adjusting for age, gender, BMI, blood pressure, medications, proteinuria, smoking, lipids, and 25-hydroxyvitamin D, PAT was positively associated with the presence (P = 0.009) and quantity of coronary artery CP in African Americans (P = 0.004), as well as the quantity of infrarenal aorta CP (P = 0.004). As in European Americans, PAT is associated with CP in African Americans with type 2 diabetes. Ethnic differences in the relationships between organ-specific adipose tissue depots and atherosclerosis require further study.
BACKGROUND AND AIMS - Visceral fat accumulation reportedly increases the risk of hepatocellular carcinoma (HCC) development in patients with chronic liver disease. However, it has not been fully elucidated whether visceral fat accumulation increases the risk of HCC recurrence after curative treatment in patients with suspected non-alcoholic steatohepatitis (NASH). Therefore this was investigated in the current study.
METHODS - 62 patients with naive HCC with suspected NASH were enrolled. All were curatively treated with percutaneous radiofrequency ablation between 1999 and 2006. The visceral fat area (VFA) was determined in each patient from CT images, taken at the time of HCC diagnosis. Patients were divided into two groups based on VFA: the high VFA group (>130 cm(2) in males, >90 cm(2) in females, n = 27) and the others (n = 35). The effects of VFA on HCC recurrence were analysed together with other factors including patients' background, tumour-related factors and liver function-related factors.
RESULTS - The cumulative recurrence rates differed significantly between the two groups; 15.9, 56.5 and 75.1% at 1, 2 and 3 years, respectively, in the high VFA group, and 9.7, 31.1 and 43.1%, respectively, in the controls (p = 0.018). Multivariate analysis indicated visceral fat accumulation (risk ratio 1.08, per 10 cm(2), p = 0.046) and older age (risk ratio 1.06 per 1 year, p = 0.04) as independent risk factors of HCC recurrence.
CONCLUSIONS - Visceral fat accumulation is an independent risk factor of HCC recurrence after curative treatment in patients with suspected NASH.
OBJECTIVE - To examine whether childbearing is associated with increased visceral adiposity and whether the increase is proportionally larger than other depots.
METHODS AND PROCEDURES - This prospective study examined changes in adiposity assessed via computed tomography (CT) and dual-energy X-ray absorptiometry among 122 premenopausal women (50 black, 72 white) examined in 1995-1996 and again in 2000-2001. During the 5-year interval, 14 women had one interim birth and 108 had no interim births. Multiple linear regression models estimated mean (95% confidence interval (CI)) 5-year changes in anthropometric and adiposity measures by interim births adjusted for age, race, and changes in total and subcutaneous adiposity.
RESULTS - We found no significant differences between one interim birth and no interim births for 5-year changes in weight, BMI, total body fat, subcutaneous adipose tissue, or total abdominal adipose tissue. Visceral adipose tissue increased by 40 and 14% above initial levels for 1 birth and 0 birth groups, respectively. Having 1 birth vs. 0 births was associated with a greater increase in visceral adipose tissue of 18.0 cm2 (4.8, 31.2), P<0.01; gain of 27.1 cm2 (14.5, 39.7) vs. 9.2 cm2 (4.8, 13.6), and a borderline greater increase in waist girth of 2.3 cm (0, 4.5), P=0.05; gain of 6.3 cm (4.1, 8.5) vs. 4.0 cm (3.2, 4.8), controlling for gain in total body fat and covariates.
DISCUSSION - Pregnancy may be associated with preferential accumulation of adipose tissue in the visceral compartment for similar gains in total body fat. Further investigation is needed to confirm these findings and determine whether excess visceral fat deposition with pregnancy adversely affects metabolic risk profiles among women.
Intraabdominal fat (IAF) area is often measured indirectly in epidemiologic studies. The authors recruited 147 participants from the second examination (1990-1992) of the Atherosclerosis Risk in Communities Study to examine IAF area and determine whether there were differences in IAF area and distribution by location. Magnetic resonance imaging was used to image four 10-mm slices between the second and fourth lumbar vertebrae by an inverse recovery method, and IAF was calculated from each image. The authors constructed gender-specific mixed models with IAF area as the outcome and the location of imaging along the torso as the independent variable, using random intercepts to account for between-person variation in IAF area. The torso location of IAF measurement was a significant predictor of IAF area in both men (p = 0.02) and women (p < 0.0001) after adjustment for body mass index. A significant positive interaction between age and location was seen in men, with increasing IAF area moving down the torso with older ages. Using magnetic resonance imaging, location along the torso yields different IAF areas and distributions independently of body mass index in both genders, with measurement at the second lumbar vertebra (slightly above the umbilicus) capturing the largest amount of IAF. Studies that attempt to link IAF with cardiovascular disease risk factors should consider measurement location to accurately capture the association.