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Cardiometabolic Health Outcomes Associated With Discordant Visceral and Liver Fat Phenotypes: Insights From the
Sanaa Tejani1, Cody McCoy2, Colby R Ayers2
1University of Texas Southwestern Medical School, Dallas, TX.
Insights
High visceral adipose tissue (VAT) and liver fat (LF) increase cardiometabolic risks like cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). Understanding discordant VAT and LF patterns is crucial for assessing individual health risks.
Area of Science:
- Cardiovascular Science
- Metabolic Health
- Obesity Research
Background:
- Visceral adipose tissue (VAT) and liver fat (LF) are independently linked to cardiometabolic risk.
- Phenotypes of discordant VAT and LF may have distinct implications for health outcomes.
- Evaluating these distinct patterns is essential for accurate risk assessment.
Purpose of the Study:
- To investigate the cardiometabolic outcomes associated with discordant visceral adipose tissue (VAT) and liver fat (LF) phenotypes.
- To assess the association of different VAT-LF combinations with prevalent and incident cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM).
Main Methods:
- Utilized data from the Dallas Heart Study (N=2064) and the UK Biobank (N=22,354).
- Categorized participants into low-low, high-low, low-high, and high-high VAT-LF groups.
- Employed multivariable-adjusted regression models to assess associations with prevalent and incident CVD and T2DM.
Main Results:
- High VAT-high LF and high VAT-low LF were linked to prevalent atherosclerosis.
- High VAT-high LF and high VAT-low LF were associated with increased risks of incident CVD and T2DM in the Dallas Heart Study.
- In the UK Biobank, high VAT-low LF remained significantly associated with increased CVD risk after adjustments.
Conclusions:
- Cardiometabolic risk stratification requires consideration of both visceral adipose tissue and liver fat levels independently.
- Discordant VAT and LF phenotypes have differential associations with cardiometabolic outcomes.
- Separating the implications of VAT and LF presence or absence is vital for understanding individual risk profiles.
Objective:
To evaluate the cardiometabolic outcomes associated with discordant visceral adipose tissue (VAT) and liver fat (LF) phenotypes in 2 cohorts.
Patients And Methods:
Participants in the Dallas Heart Study underwent baseline imaging from January 1, 2000, through December 31, 2002, and were followed for incident cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) through 2013. Associations between VAT-LF groups (low-low, high-low, low-high, and high-high) and outcomes were assessed using multivariable-adjusted regression and were replicated in the independent UK Biobank.
Results:
The Dallas Heart Study included 2064 participants (mean ± SD age, 44±9 years; 54% female; 47% black). High VAT-high LF and high VAT-low LF were associated with prevalent atherosclerosis, whereas low VAT-high LF was not. Of 1731 participants without CVD/T2DM, 128 (7.4%) developed CVD and 95 (5.5%) T2DM over a median of 12 years. High VAT-high LF and high VAT-low LF were associated with increased risk of CVD (hazard ratios [HRs], 2.0 [95% CI, 1.3 to 3.2] and 2.4 [95% CI, 1.4 to 4.1], respectively) and T2DM (odds ratios [ORs], 7.8 [95% CI, 3.8 to 15.8] and 3.3 [95% CI, 1.4 to 7.8], respectively), whereas low VAT-high LF was associated with T2DM (OR, 2.7 [95% CI, 1.1 to 6.7]). In the UK Biobank (N=22,354; April 2014-May 2020), only high VAT-low LF remained associated with CVD after multivariable adjustment for age and body mass index (HR, 1.5 [95% CI, 1.2 to 1.9]).
Conclusion:
Although VAT and LF are each associated with cardiometabolic risk, these observations demonstrate the importance of separating their cardiometabolic implications when there is presence or absence of either or both in an individual.