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Increased Visceral Adipose Tissue Is an Independent Predictor for Future Development of Atherogenic Dyslipidemia
You-Cheol Hwang1, Wilfred Y Fujimoto1, Tomoshige Hayashi1
1Seattle Epidemiologic Research and Information Center (Y.-C.H., E.J.B.), VA Puget Sound Health Care System, Seattle, Washington 98108; Division of Endocrinology and Metabolism (Y.-C.H.), Department of Medicine, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul 134-727, Korea; Division of Metabolism, Endocrinology and Nutrition (W.Y.F., S.E.K.), Department of Medicine, University of Washington School of Medicine, Seattle, Washington 98105; Department of Preventive Medicine and Environmental Health (T.H.), Graduate School of Medicine, Osaka City University, Osaka 3-3-138, Japan; Hospital and Specialty Medicine Service (S.E.K.), VA Puget Sound Health Care System, Seattle, Washington 98108; and Department of Anthropology (D.L.L.), University of Washington, Seattle, Washington 98195.
Context:
Atherogenic dyslipidemia is frequently observed in persons with a greater amount of visceral adipose tissue (VAT). However, it is still uncertain whether VAT is independently associated with the future development of atherogenic dyslipidemia.
Objectives:
The aim of this study was to determine whether baseline and changes in VAT and subcutaneous adipose tissue (SAT) are associated with future development of atherogenic dyslipidemia independent of baseline lipid levels and standard anthropometric indices.
Design And Setting:
Community-based prospective cohort study with 5 years of follow-up.
Participants:
A total of 452 Japanese Americans (240 men, 212 women), aged 34-75 years were assessed at baseline and after 5 years of follow-up.
Main Outcome Measures:
Abdominal fat areas were measured by computed tomography. Atherogenic dyslipidemia was defined as one or more abnormalities in high-density lipoprotein (HDL) cholesterol, triglycerides, or non-HDL cholesterol levels.
Results:
Baseline VAT and change in VAT over 5 years were independently associated with log-transformed HDL cholesterol, log-transformed triglyceride, and non-HDL cholesterol after 5 years (standardized β = -0.126, 0.277, and 0.066 for baseline VAT, respectively, and -0.095, 0.223, and 0.090 for change in VAT, respectively). However, baseline and change in SAT were not associated with any future atherogenic lipid level. In multivariate logistic regression analysis, incremental change in VAT (odds ratio [95% confidence interval], 1.73 [1.20-2.48]; P = .003), triglycerides (4.01 [1.72-9.33]; P = .001), HDL cholesterol (0.32 [0.18-0.58]; P < .001), and non-HDL cholesterol (7.58 [4.43-12.95]; P < .001) were significantly associated with the future development of atherogenic dyslipidemia independent of age, sex, diastolic blood pressure, homeostasis model assessment insulin resistance, body mass index (BMI), change in BMI, SAT, and baseline atherogenic lipid levels.
Conclusion:
Baseline and change in VAT were independent predictors for future development of atherogenic dyslipidemia. However, BMI, waist circumference, and SAT were not associated with future development of atherogenic dyslipidemia.
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