Skip to main content
Top
Published in: Abdominal Radiology 1/2015

01-01-2015

Visceral fat quantification in asymptomatic adults using abdominal CT: is it predictive of future cardiac events?

Authors: Eva M. Ryckman, Ronald M. Summers, Jiamin Liu, Alejandro Munoz del Rio, Perry J. Pickhardt

Published in: Abdominal Radiology | Issue 1/2015

Login to get access

Abstract

Purpose

The purpose of this study was to determine if quantifying visceral adipose tissue (VAT) at CT in asymptomatic adults can predict the likelihood of future cardiac events.

Methods

Subcutaneous and visceral fat volumes were obtained from abdominal CT utilizing a validated semi-automated software tool in 663 asymptomatic adults (mean age 57.3 years, 379F/284M) undergoing colorectal screening. Patients were followed for subsequent cardiac events, defined as myocardial infarction or coronary intervention for a mean follow-up interval of 7.0 ± 1.4 years. Relevant clinical data including Framingham risk score (FRS) were also collected. Statistical analysis included logistic regression, Pearson correlation coefficients, and Welch and Wilcoxon rank sum tests.

Results

Cardiac events were documented in 32 subjects (4.8%) an average 3.0 years after index CT. FRS was predictive of future cardiac events, signified by a higher score (mean score 11.9 vs. 7.4; p < 0.001). HDL levels were significantly lower in the cardiac event cohort (mean 52.2 vs. 61.0; p < 0.01). None of the other clinical variables were predictive and none of the CT-based fat measurements (visceral, subcutaneous, and total adipose tissue; visceral fat %) correlated with future cardiac events (p = 0.561–0.886). Mean visceral fat % in the cardiac event cohort was 38.1% vs. 39.1% for the non-event group.

Conclusion

Quantification of VAT at abdominal CT was not predictive of future cardiac events in this asymptomatic cohort, whereas HDL levels and FRSs correlated well with risk.
Literature
1.
go back to reference Ogden CL, Carroll MD, Kit BK, Flegal KM (2014) Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA 311:806–814PubMedCrossRef Ogden CL, Carroll MD, Kit BK, Flegal KM (2014) Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA 311:806–814PubMedCrossRef
2.
go back to reference Ogden CL, Carroll MD, Kit BK, Flegal KM (2012) Prevalence of obesity in the United States, 2009–2010. Natl Cent Health Stat Data Brief 82:8 Ogden CL, Carroll MD, Kit BK, Flegal KM (2012) Prevalence of obesity in the United States, 2009–2010. Natl Cent Health Stat Data Brief 82:8
3.
go back to reference Preis SR, Massaro JM, Robins SJ, et al. (2010) Abdominal subcutaneous and visceral adipose tissue and insulin resistance in the Framingham Heart Study. Obesity 18:2191–2198PubMedCentralPubMedCrossRef Preis SR, Massaro JM, Robins SJ, et al. (2010) Abdominal subcutaneous and visceral adipose tissue and insulin resistance in the Framingham Heart Study. Obesity 18:2191–2198PubMedCentralPubMedCrossRef
4.
go back to reference Fox CS, Massaro JM, Hoffmann U, et al. (2007) Abdominal visceral and subcutaneous adipose tissue compartments—association with metabolic risk factors in the Framingham Heart Study. Circulation 116:39–48PubMedCrossRef Fox CS, Massaro JM, Hoffmann U, et al. (2007) Abdominal visceral and subcutaneous adipose tissue compartments—association with metabolic risk factors in the Framingham Heart Study. Circulation 116:39–48PubMedCrossRef
5.
go back to reference Kissebah AH, Vydelingum N, Murray R, et al. (1982) Relation of body-fat distribution to metabolic complications of obesity. J Clin Endocrinol Metab 54:254–260PubMedCrossRef Kissebah AH, Vydelingum N, Murray R, et al. (1982) Relation of body-fat distribution to metabolic complications of obesity. J Clin Endocrinol Metab 54:254–260PubMedCrossRef
6.
go back to reference Larsson SC, Wolk A (2007) Obesity and colon and rectal cancer risk: a meta-analysis of prospective studies. Am J Clin Nutr 86:556–565PubMed Larsson SC, Wolk A (2007) Obesity and colon and rectal cancer risk: a meta-analysis of prospective studies. Am J Clin Nutr 86:556–565PubMed
7.
go back to reference Larsson B, Svardsudd K, Welin L, et al. (1984) Abdominal adipose-tissue distribution, obesity, and risk of cardiovascular-disease and death—13 year follow up of participants in the study of men born in 1913. Br Med J 288:1401–1404CrossRef Larsson B, Svardsudd K, Welin L, et al. (1984) Abdominal adipose-tissue distribution, obesity, and risk of cardiovascular-disease and death—13 year follow up of participants in the study of men born in 1913. Br Med J 288:1401–1404CrossRef
8.
go back to reference Otake S, Takeda H, Suzuki Y, et al. (2005) Association of visceral fat accumulation and plasma adiponectin with colorectal adenoma: evidence for participation of insulin resistance. Clin Cancer Res 11:3642–3646PubMedCrossRef Otake S, Takeda H, Suzuki Y, et al. (2005) Association of visceral fat accumulation and plasma adiponectin with colorectal adenoma: evidence for participation of insulin resistance. Clin Cancer Res 11:3642–3646PubMedCrossRef
9.
go back to reference Kissebah AH, Krakower GR (1994) Regional adiposity and morbidity. Physiol Rev 74:761–811PubMed Kissebah AH, Krakower GR (1994) Regional adiposity and morbidity. Physiol Rev 74:761–811PubMed
10.
go back to reference Giovannucci E (2001) Insulin, insulin-like growth factors and colon cancer: a review of the evidence. J Nutr 131:3109S–3120SPubMed Giovannucci E (2001) Insulin, insulin-like growth factors and colon cancer: a review of the evidence. J Nutr 131:3109S–3120SPubMed
11.
go back to reference Ouchi N, Kihara S, Arita Y, et al. (2000) Adiponectin, an adipocyte-derived plasma protein, inhibits endothelial NF-kappa B signaling through a cAMP-dependent pathway. Circulation 102:1296–1301PubMedCrossRef Ouchi N, Kihara S, Arita Y, et al. (2000) Adiponectin, an adipocyte-derived plasma protein, inhibits endothelial NF-kappa B signaling through a cAMP-dependent pathway. Circulation 102:1296–1301PubMedCrossRef
12.
go back to reference Paz G, Lim EL, Wong ML, Licinio J (2011) Associations between adipokines and obesity-related cancer. Front Biosci Landmark 16:1634–1650CrossRef Paz G, Lim EL, Wong ML, Licinio J (2011) Associations between adipokines and obesity-related cancer. Front Biosci Landmark 16:1634–1650CrossRef
13.
go back to reference Matsuzawa Y (2010) Establishment of a concept of visceral fat syndrome and discovery of adiponectin. Proc Jpn Acad Ser B 86:131–141CrossRef Matsuzawa Y (2010) Establishment of a concept of visceral fat syndrome and discovery of adiponectin. Proc Jpn Acad Ser B 86:131–141CrossRef
14.
go back to reference Summers RM, Liu JM, Sussman DL, et al. (2012) Association between visceral adiposity and colorectal polyps on CT colonography. Am J Roentgenol 199:48–57CrossRef Summers RM, Liu JM, Sussman DL, et al. (2012) Association between visceral adiposity and colorectal polyps on CT colonography. Am J Roentgenol 199:48–57CrossRef
15.
go back to reference Pickhardt PJ, Jee Y, O’Connor SD, del Rio AM (2012) Visceral adiposity and hepatic steatosis at abdominal CT: association with the metabolic syndrome. Am J Roentgenol 198:1100–1107CrossRef Pickhardt PJ, Jee Y, O’Connor SD, del Rio AM (2012) Visceral adiposity and hepatic steatosis at abdominal CT: association with the metabolic syndrome. Am J Roentgenol 198:1100–1107CrossRef
16.
go back to reference Hassan C, Pickhardt P, Laghi A, et al. (2008) Computed tomographic colonography to screen for colorectal cancer, extracolonic cancer, and aortic aneurysm. Arch Intern Med 168:696–705PubMedCrossRef Hassan C, Pickhardt P, Laghi A, et al. (2008) Computed tomographic colonography to screen for colorectal cancer, extracolonic cancer, and aortic aneurysm. Arch Intern Med 168:696–705PubMedCrossRef
17.
go back to reference Pickhardt PJ, Hanson ME, Vanness DJ, et al. (2008) Unsuspected extracolonic findings at screening CT colonography: clinical and economic impact. Radiology 249:151–159PubMedCrossRef Pickhardt PJ, Hanson ME, Vanness DJ, et al. (2008) Unsuspected extracolonic findings at screening CT colonography: clinical and economic impact. Radiology 249:151–159PubMedCrossRef
18.
go back to reference Pickhardt PJ, Kim DH, Meiners RJ, et al. (2010) Colorectal and extracolonic cancers detected at screening CT colonography in 10,286 asymptomatic adults. Radiology 255:83–88PubMedCrossRef Pickhardt PJ, Kim DH, Meiners RJ, et al. (2010) Colorectal and extracolonic cancers detected at screening CT colonography in 10,286 asymptomatic adults. Radiology 255:83–88PubMedCrossRef
19.
go back to reference Pickhardt PJ, Lee LJ, del Rio AM, et al. (2011) Simultaneous screening for osteoporosis at CT colonography: bone mineral density assessment using MDCT attenuation techniques compared with the DXA reference standard. J Bone Miner Res 26:2194–2203PubMedCentralPubMedCrossRef Pickhardt PJ, Lee LJ, del Rio AM, et al. (2011) Simultaneous screening for osteoporosis at CT colonography: bone mineral density assessment using MDCT attenuation techniques compared with the DXA reference standard. J Bone Miner Res 26:2194–2203PubMedCentralPubMedCrossRef
20.
go back to reference Wilson PWF, D’Agostino RB, Levy D, et al. (1998) Prediction of coronary heart disease using risk factor categories. Circulation 97:1837–1847PubMedCrossRef Wilson PWF, D’Agostino RB, Levy D, et al. (1998) Prediction of coronary heart disease using risk factor categories. Circulation 97:1837–1847PubMedCrossRef
21.
go back to reference Kim DH, Pickhardt PJ, Taylor AJ, et al. (2007) CT colonography versus colonoscopy for the detection of advanced neoplasia. N Engl J Med 357:1403–1412PubMedCrossRef Kim DH, Pickhardt PJ, Taylor AJ, et al. (2007) CT colonography versus colonoscopy for the detection of advanced neoplasia. N Engl J Med 357:1403–1412PubMedCrossRef
22.
go back to reference Pickhardt PJ, Choi JR, Hwang I, et al. (2003) Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med 349:2191–2200PubMedCrossRef Pickhardt PJ, Choi JR, Hwang I, et al. (2003) Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med 349:2191–2200PubMedCrossRef
23.
go back to reference Yao J, Sussman DL, Summers RM (2011) Fully automated adipose tissue measurement on abdominal CT. Proceedings of the SPIE Medical Imaging, vol 7965 Yao J, Sussman DL, Summers RM (2011) Fully automated adipose tissue measurement on abdominal CT. Proceedings of the SPIE Medical Imaging, vol 7965
24.
go back to reference Demerath EW, Shen W, Lee M, et al. (2007) Approximation of total visceral adipose tissue with a single magnetic resonance image. Am J Clin Nutr 85:362–368PubMedCentralPubMed Demerath EW, Shen W, Lee M, et al. (2007) Approximation of total visceral adipose tissue with a single magnetic resonance image. Am J Clin Nutr 85:362–368PubMedCentralPubMed
25.
go back to reference Balentine CJ, Marshall C, Robinson C, et al. (2010) Validating quantitative obesity measurements in colorectal cancer patients. J Surg Res 164:18–22PubMedCrossRef Balentine CJ, Marshall C, Robinson C, et al. (2010) Validating quantitative obesity measurements in colorectal cancer patients. J Surg Res 164:18–22PubMedCrossRef
26.
go back to reference Borkan GA, Gerzof SG, Robbins AH, et al. (1982) Assessment of abdominal fat-content by computed-tomography. Am J Clin Nutr 36:172–177PubMed Borkan GA, Gerzof SG, Robbins AH, et al. (1982) Assessment of abdominal fat-content by computed-tomography. Am J Clin Nutr 36:172–177PubMed
27.
go back to reference Kamimura MA, Carrero JJ, Canziani MEF, et al. (2013) Visceral obesity assessed by computed tomography predicts cardiovascular events in chronic kidney disease patients. Nutr Metab Cardiovasc Dis 23:891–897PubMedCrossRef Kamimura MA, Carrero JJ, Canziani MEF, et al. (2013) Visceral obesity assessed by computed tomography predicts cardiovascular events in chronic kidney disease patients. Nutr Metab Cardiovasc Dis 23:891–897PubMedCrossRef
28.
go back to reference Nakagawa Y, Kishida K, Mazaki T, et al. (2011) Impact of sleep-disordered breathing, visceral fat accumulation and adiponectin levels in patients with night-time onset of acute coronary syndrome. Am J Cardiol 108:1266–1271PubMedCrossRef Nakagawa Y, Kishida K, Mazaki T, et al. (2011) Impact of sleep-disordered breathing, visceral fat accumulation and adiponectin levels in patients with night-time onset of acute coronary syndrome. Am J Cardiol 108:1266–1271PubMedCrossRef
29.
go back to reference Kim DJ, Bergstrom J, Barrett-Connor E, Laughlin GA (2008) Visceral adiposity and subclinical coronary artery disease in elderly adults: Rancho Bernardo study. Obesity 16:853–858PubMedCentralPubMedCrossRef Kim DJ, Bergstrom J, Barrett-Connor E, Laughlin GA (2008) Visceral adiposity and subclinical coronary artery disease in elderly adults: Rancho Bernardo study. Obesity 16:853–858PubMedCentralPubMedCrossRef
Metadata
Title
Visceral fat quantification in asymptomatic adults using abdominal CT: is it predictive of future cardiac events?
Authors
Eva M. Ryckman
Ronald M. Summers
Jiamin Liu
Alejandro Munoz del Rio
Perry J. Pickhardt
Publication date
01-01-2015
Publisher
Springer US
Published in
Abdominal Radiology / Issue 1/2015
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-014-0192-z

Other articles of this Issue 1/2015

Abdominal Radiology 1/2015 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine