Introduction
Methods
Study design and population
Health assessment
Magnetic resonance imaging
Assessment of abdominal adipose tissue by magnetic resonance imaging
Assessment of hepatic lipids by magnetic resonance imaging
Assessment of cardiac function and morphology by magnetic resonance imaging
Statistical analysis
Results
All subjects | VAT—lower tertile | VAT—mid tertile | VAT—upper tertile | p value* | |
---|---|---|---|---|---|
N | 374 | 124 | 125 | 125 | |
Age (years) | 56.2 ± 9.1 | 51.8 ± 7.8 | 57.0 ± 9.3 | 59.8 ± 8.3 | < 0.001 |
Sex (men) | 57.8% (216) | 35.5% (44) | 61.6% (77) | 76.0% (95) | < 0.001 |
BMI (kg/m2) | 27.9 ± 4.8 | 24.2 ± 3.1 | 28.7 ± 4.1 | 30.9 ± 4.3 | < 0.001 |
Diabetes status | |||||
Normal | 60.4% (226) | 91.9% (114) | 63.2% (79) | 26.4% (33) | < 0.001 |
Prediabetes | 26.5% (99) | 6.5% (8) | 28.8% (36) | 44.0% (55) | |
Diabetes | 13.1% (49) | 1.6% (2) | 8.0% (10) | 29.6% (37) | |
HbA1c | 5.6 ± 0.7 | 5.3 ± 0.4 | 5.6 ± 0.9 | 5.8 ± 0.8 | < 0.001 |
Hypertension | 33.4% (125) | 13.7% (17) | 30.4% (38) | 56.0% (70) | < 0.001 |
Systolic RR (mmHg) | 121 ± 17 | 110 ± 12 | 123 ± 16 | 129 ± 16 | < 0.001 |
Diastolic RR (mmHg) | 75 ± 10 | 70 ± 8 | 77 ± 10 | 79 ± 10 | < 0.001 |
Antihypertensive medication | 24.6% (92) | 12.1% (15) | 22.4% (28) | 39.2% (49) | < 0.001 |
Triglyceride levels (mg/dL) | 130.5 ± 84.3 | 83.9 ± 38.9 | 132.2 ± 80.9 | 175.0 ± 95.6 | < 0.001 |
Total cholesterol (mg/dL) | 217.6 ± 36.4 | 207.8 ± 33.9 | 225.9 ± 36.4 | 219.1 ± 36.8 | < 0.001 |
HDL (mg/dL) | 62.0 ± 17.5 | 69.8 ± 19.3 | 61.6 ± 14.4 | 54.7 ± 15.1 | < 0.001 |
LDL (mg/dL) | 139.4 ± 33.0 | 129 ± 30.5 | 147.6 ± 31.4 | 141.4 ± 34.5 | < 0.001 |
Lipid lowering medication | 10.4% (39) | 3.2% (4) | 9.6% (12) | 18.4% (23) | < 0.001 |
Smoking status | |||||
Never-smoker | 36.1% (135) | 41.9% (52) | 36.0% (45) | 30.4% (38) | 0.03 |
Ex-smoker | 43.9% (164) | 33.1% (41) | 44.8% (56) | 53.6% (67) | |
Current-smoker | 20.1% (75) | 25.0% (31) | 19.2% (24) | 16.0% (20) | |
MRI-based adiposity measures | |||||
VAT (cm2) | 147.31 ± 85.02 | 57.8 ± 23.23 | 139.77 ± 22.56 | 243.64 ± 57.22 | N/A |
SAT (cm2) | 278.51 ± 117.44 | 210.00 ± 86.43 | 308.84 ± 119.13 | 316.73 ± 113.14 | < 0.001 |
PDFFhepatic (%) | 8.4 ± 8.4 | 2.8 ± 2.3 | 7.0 ± 6.7 | 15.5 ± 8.9 | < 0.001 |
MR-based LV measures | |||||
LV mass, indexed (LVM; g/m2) | 71.7 ± 13.9 | 67.0 ± 11.8 | 72.5 ± 15.2 | 75.6 ± 13.2 | < 0.001 |
LV concentricity index (LVCI; g/mL) | 1.13 ± 0.30 | 0.94 ± 0.19 | 1.11 ± 0.23 | 1.33 ± 0.33 | < 0.001 |
LV end-diastolic volume, indexed (LVEDV; mL/m2) | 66.20 ± 14.87 | 72.52 ± 13.41 | 66.82 ± 13.65 | 59.3 ± 14.56 | < 0.001 |
LV ejection fraction (LVEF; %) | 69.2 ± 8.2 | 68.5 ± 8.6 | 69.4 ± 7.3 | 69.6 ± 8.6 | 0.53 |
LV stroke volume, indexed (LVSV; mL/m2) | 45.4 ± 9.7 | 49.4 ± 9.6 | 45.9 ± 8.5 | 40.8 ± 9.0 | < 0.001 |
LV morphology and function and its correlation with adiposity
Multivariable analysis of the association between abdominal adiposity and LV measures
LVM | LVCI | LVEDV | LVSV | |||||
---|---|---|---|---|---|---|---|---|
β (95% CI) | p | β (95% CI) | p | β (95% CI) | p | β (95% CI) | p | |
Separate models adjusted for age, sex | ||||||||
VAT | 0.78 (− 0.68; 2.23) | 0.29 | 0.14 (0.11; 0.17) | < 0.001 | − 6.79 (− 8.36; − 5.21) | < 0.001 | − 4.26 (− 5.30; − 3.22) | < 0.001 |
SAT | 0.83 (− 0.45; 2.10) | 0.21 | 0.07 (0.04; 0.10) | < 0.001 | − 2.98 (− 4.45; -1.50) | < 0.001 | − 2.02 (− 2.99; − 1.05) | < 0.001 |
PDFFhepatic | 0.37 (− 0.98; 1.71) | 0.59 | 0.10 (0.07; 0.13) | < 0.001 | − 4.75 (− 6.26; − 3.24) | < 0.001 | − 3.15 (− 4.14; − 2.16) | < 0.001 |
Separate models adjusted for age, sex, BMI | ||||||||
VAT | – | 0.15 (0.11; 0.19) | < 0.001 | − 7.92 (− 9.93; − 5.91) | < 0.001 | − 4.8 (− 6.13; − 3.47) | < 0.001 | |
SAT | – | 0.01 (− 0.05; 0.06) | 0.83 | − 1.69 (− 4.72; 1.34) | 0.28 | − 1.42 (− 3.41; 0.58) | < 0.001 | |
PDFFhepatic | – | 0.09 (0.06; 0.12) | < 0.001 | − 4.43 (− 6.10; − 2.76) | < 0.001 | − 2.91 (− 4.00; − 1.81) | < 0.001 | |
Separate, fully adjusted modelsa | ||||||||
VAT | – | 0.11 (0.07; 0.15) | < 0.001 | − 6.70 (− 8.84; − 4.55) | < 0.001 | − 3.91 (− 5.32; − 2.50) | < 0.001 | |
SAT | – | – | – | − 1.75 (− 3.66; 0.16) | 0.07 | |||
PDFFhepatic | – | 0.06 (0.02; 0.09) | 0.001 | − 3.23 (− 5.03; − 1.44) | < 0.001 | − 2.20 (− 3.37; − 1.04) | < 0.001 |
Effect of the diabetic status on the observed associations
Controls | Pre-diabetics | Diabetics | p value inter-action | |
---|---|---|---|---|
β (95% CI) | β (95% CI) | β (95% CI) | ||
VAT—LVCI | 0.11 (0.08; 0.15) | 0.10 (0.03; 0.16) | 0.16 (0.04; 0.28) | 0.74 |
VAT—LVEDV | − 6.59 (− 8.81; − 4.36) | − 3.91 (− 7.05; − 0.77) | − 4.18 (− 9.7; 1.34) | 0.77 |
VAT—LVSV | − 4.03 (− 5.62; − 2.44) | − 2.46 (− 4.4; − 0.53) | − 3.90 (− 6.86; − 0.94) | 0.81 |