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Updated: Aug 19, 2025
Assessment of Human Adipose Tissue Microvascular Function Using Videomicroscopy
Published on: September 29, 2017
Visceral adipose tissue quantity and dysfunction and the occurrence of major bleeding in patients with established
Maria C Castelijns1, Steven H J Hageman1, Ynte M Ruigrok2
1Department of Vascular Medicine, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, the Netherlands.
Insights
This study found no link between visceral fat or adipose tissue dysfunction and major bleeding risk in cardiovascular disease patients. These findings suggest fat quantity and dysfunction do not predict bleeding events in this population.
Area of Science:
- Cardiology
- Metabolic Syndrome
- Vascular Disease
Background:
- Cardiovascular disease (CVD) patients are at increased risk for bleeding events.
- Visceral fat accumulation and adipose tissue dysfunction are linked to metabolic abnormalities and cardiovascular risk.
- The relationship between visceral fat, adipose tissue dysfunction, and major bleeding in CVD patients remains unclear.
Purpose of the Study:
- To investigate the association between visceral fat quantity and adipose tissue dysfunction with major bleeding risk.
- To determine if these factors predict bleeding events in patients with established cardiovascular disease.
Main Methods:
- Utilized data from the Second Manifestations of ARTerial disease study.
- Measured visceral fat via ultrasound and assessed adipose tissue dysfunction using metabolic syndrome criteria.
- Employed Cox regression models to analyze the relationship with major bleeding (BARC type 3/5 or ISTH major bleeding).
Main Results:
- In 6927 patients followed for 9.2 years, visceral fat quantity and metabolic syndrome were not associated with major bleeding events.
- Sensitivity analyses using C-reactive protein levels yielded similar results.
- No significant effect modification was observed based on sex, antithrombotic therapy, or diabetes.
Conclusions:
- Visceral fat quantity and adipose tissue dysfunction are not associated with an increased risk of major bleeding in patients with established cardiovascular disease.
- These findings hold true regardless of antithrombotic agent use.
Objectives:
To determine the association between both visceral fat quantity and adipose tissue dysfunction, and major bleeding in patients with established cardiovascular disease.
Methods:
Patients from the Second Manifestations of ARTerial disease study with established cardiovascular disease were included. Visceral fat was measured using ultrasound and adipose tissue dysfunction was depicted using metabolic syndrome criteria (revised National Cholesterol Education Program). Cox regression models were fitted to study the relation with major bleeding defined as Bleeding Academic Research Consortium (BARC) type 3 or 5, or International Society on Thrombosis and Haemostasis (ISTH) major bleeding. Sensitivity analyses were performed using C-reactive protein levels to reflect adipose tissue dysfunction.
Results:
In 6927 patients during a median follow up of 9.2 years, a total of 237 BARC type 3 or 5 bleedings and 224 ISTH major bleedings were observed. Visceral fat quantity was not related to major bleeding (HR 1.01, 95%CI 0.88-1.16 for BARC type 3 or 5 bleeding and HR 1.00, 95%CI 0.87-1.15 for ISTH major bleeding), nor was metabolic syndrome (HR 0.97, 95%CI 0.75-1.26 for BARC type 3 or 5 bleeding and HR 0.98, 95%CI 0.75-1.28 for ISTH major bleeding). Sensitivity analyses using C-reactive protein levels showed similar results. No effect modification was observed by sex, antithrombotic therapy, presence of metabolic syndrome or diabetes.
Conclusion:
In patients with cardiovascular disease, no association was found between visceral fat quantity measured with ultrasound or measures of adipose tissue dysfunction and the risk of major bleeding, irrespective of antithrombotic agent use.
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