Abdominal Visceral Adipose Tissue is Associated with Myocardial Infarction in Patients with COPD
Alejandro A Diaz1, Tom P Young1, Sila Kurugol2
1Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Insights
Increased abdominal visceral fat (VAT) is linked to a higher risk of myocardial infarction (MI) in patients with chronic obstructive pulmonary disease (COPD). This finding highlights VAT as a key indicator for cardiovascular risk in COPD patients.
Area of Science:
- Cardiology
- Pulmonology
- Radiology
Background:
- Cardiovascular diseases (CVDs) are a leading cause of mortality in patients with chronic obstructive pulmonary disease (COPD).
- Abdominal visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and liver fat are associated with CVD risk in the general population.
- The relationship between these fat depots and myocardial infarction (MI) risk in COPD patients requires further investigation.
Purpose of the Study:
- To investigate the association between different adipose tissue compartments (VAT, SAT, liver fat) and the prevalence of MI in patients with COPD.
- To determine if abdominal visceral fat is an independent predictor of MI in this patient group.
Main Methods:
- Computed tomography (CT) scans were used to quantify VAT and SAT areas and assess liver attenuation in 1267 COPD patients.
- MI was defined as a self-reported physician-diagnosed outcome.
- Logistic regression analysis was employed to assess the association between fat depots and MI history, adjusting for relevant covariates.
Main Results:
- A history of MI was reported by 6.6% of the COPD patients.
- Patients with a prior MI exhibited significantly larger VAT areas compared to those without MI (303.4 vs. 226.8 cm²).
- Higher VAT area, specifically in the upper tertile, was independently associated with increased odds of MI (OR 1.86, 95% CI 1.02-3.41) after adjusting for multiple risk factors.
Conclusions:
- Increased abdominal visceral fat is independently associated with a history of myocardial infarction in individuals with COPD.
- VAT may serve as a crucial imaging biomarker for cardiovascular risk stratification in COPD patients.
Background:
Cardiovascular diseases are frequent and a major cause of death in patients with chronic obstructive pulmonary disease (COPD). In the general population, various fat depots including abdominal visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and liver fat have been linked to increased risk of cardiovascular diseases. We hypothesize that these adipose tissue compartments are associated with myocardial infarction (MI) in patients with COPD.
Methods:
We collected measures of VAT and SAT areas and liver attenuation on the computed tomography scan of the chest from 1267 patients with COPD. MI was a self-reported physician-diagnosed outcome. The association between fat depots and self-reported history of MI was assessed by logistic regression analysis in which the patients within the 2 lowest tertiles of VAT and SAT areas were the reference group.
Results:
Eighty three patients (6.6%) reported a history of MI at the time of enrollment. Compared to patients who did not have an MI episode, those who had a prior MI had a higher VAT area (mean ± SD, 303.4 ± 208.5 vs. 226.8 ± 172.6 cm2; P=0.002) with no differences in SAT area and liver fat. After adjustment for age, gender, obesity, pack years of smoking, hypertension, high cholesterol, and diabetes, patients within the upper tertile (vs. those in the lower tertiles) of VAT area had increased odds of MI (odds ratio [OR] 1.86, 95% confidence interval [CI] 1.02 - 3.41).
Conclusion:
Increased abdominal visceral fat is independently associated with a history of MI in individuals with COPD.
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