TY - JOUR
T1 - CT-derived abdominal adiposity
T2 - Distributions and better predictive ability than BMI in a nationwide study of 59,429 adults in China
AU - the China Health Big Data (China Biobank) project investigators
AU - Zeng, Qiang
AU - Wang, Ling
AU - Dong, Shengyong
AU - Zha, Xiaojuan
AU - Ran, Limei
AU - Li, Yongli
AU - Chen, Shuang
AU - Gao, Jianbo
AU - Li, Shaolin
AU - Lu, Yong
AU - Zhang, Yuqin
AU - Xiao, Xigang
AU - Li, Yuehua
AU - Ma, Xiao
AU - Gong, Xiangyang
AU - Chen, Wei
AU - Yang, Yingying
AU - Du, Xia
AU - Chen, Bairu
AU - Lv, Yinru
AU - Wu, Yan
AU - Hong, Guobin
AU - Pan, Yaling
AU - Jiao, Jun
AU - Yan, Yan
AU - Qi, Huijuan
AU - Zhai, Jian
AU - Li, Kai
AU - Zhao, Kaiping
AU - Wu, Jing
AU - Liu, Shiwei
AU - Blake, Glen M.
AU - Fu, Haihong
AU - Fu, Xiaoxia
AU - Guo, Zhiping
AU - Lemieux, Isabelle
AU - Després, Jean Pierre
AU - Cheng, Xiaoguang
N1 - Funding Information:
This work is supported by the Beijing Natural Science Foundation -Haidian Primitive Innovation Joint Fund (grant no. L172019 ).
Funding Information:
The authors thank all participants for their important contributions. This work is supported by the Beijing Natural Science Foundation-Haidian Primitive Innovation Joint Fund (grant no. L172019).
Publisher Copyright:
© 2020 The Authors
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/2
Y1 - 2021/2
N2 - Background: Although abdominal adiposity is associated with an altered cardiometabolic risk profile, the specific contribution of abdominal adipose tissue distribution remains not fully understood. Computed tomography (CT) is a well-established and precise method to measure abdominal adipose tissue distribution. The present study investigated abdominal adiposity assessed by CT in a large-scale Chinese population. Method: A total of 59,429 adults who underwent a low dose chest CT for lung cancer screening at one of 13 health checkup centers throughout China were evaluated. Abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) areas were measured at the center of the 2nd lumbar vertebra with Mindways quantitative CT software using the existing CT dataset without any additional radiation exposure. The ratio of visceral to total adipose tissue (TAT) areas (VAT/TAT ratio) was calculated and expressed as a percentage. Anthropometric indices including body mass index (BMI) and waist circumference were also obtained. Results: BMI, waist circumference, VAT area, SAT area, and the VAT/TAT ratio were 25.0 ± 3.0 kg/m2, 90 ± 8 cm, 194 ± 77 cm2, 85 ± 41 cm2, and 69.5 ± 9.1%, respectively, in men and 23.3 ± 3.1 kg/m2, 79 ± 8 cm, 120 ± 57 cm2, 123 ± 53 cm2, and 48.9 ± 9.7% in women. With increasing age, VAT area and the VAT/TAT ratio increased in both sexes whereas SAT area decreased in men (P < 0.001 for all). After adjustment for BMI and waist circumference, older individuals showed higher VAT area and higher VAT/TAT ratio than younger subjects (P < 0.001 for all). Adjusted VAT areas in participants aged 75 or older was 45 cm2 (95% confidence interval [CI]: 41 cm2, 50 cm2) higher in men and 43 cm2 (95% CI: 37 cm2, 49 cm2) higher in women compared with participants aged 31–44 years. Additionally, differences in VAT area across age groups increased as BMI or waist circumference increased. VAT and SAT areas, but not the VAT/TAT ratio, were positively associated with BMI and waist circumference in every age group. Conclusion: In a nationwide study conducted in China, distributions of CT-derived measures of visceral and subcutaneous adiposity were found to vary significantly between sex and age groups. Our study also revealed that the proportion of VAT (an important driver of cardiometabolic risk) could not be predicted from BMI in a Chinese population.
AB - Background: Although abdominal adiposity is associated with an altered cardiometabolic risk profile, the specific contribution of abdominal adipose tissue distribution remains not fully understood. Computed tomography (CT) is a well-established and precise method to measure abdominal adipose tissue distribution. The present study investigated abdominal adiposity assessed by CT in a large-scale Chinese population. Method: A total of 59,429 adults who underwent a low dose chest CT for lung cancer screening at one of 13 health checkup centers throughout China were evaluated. Abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) areas were measured at the center of the 2nd lumbar vertebra with Mindways quantitative CT software using the existing CT dataset without any additional radiation exposure. The ratio of visceral to total adipose tissue (TAT) areas (VAT/TAT ratio) was calculated and expressed as a percentage. Anthropometric indices including body mass index (BMI) and waist circumference were also obtained. Results: BMI, waist circumference, VAT area, SAT area, and the VAT/TAT ratio were 25.0 ± 3.0 kg/m2, 90 ± 8 cm, 194 ± 77 cm2, 85 ± 41 cm2, and 69.5 ± 9.1%, respectively, in men and 23.3 ± 3.1 kg/m2, 79 ± 8 cm, 120 ± 57 cm2, 123 ± 53 cm2, and 48.9 ± 9.7% in women. With increasing age, VAT area and the VAT/TAT ratio increased in both sexes whereas SAT area decreased in men (P < 0.001 for all). After adjustment for BMI and waist circumference, older individuals showed higher VAT area and higher VAT/TAT ratio than younger subjects (P < 0.001 for all). Adjusted VAT areas in participants aged 75 or older was 45 cm2 (95% confidence interval [CI]: 41 cm2, 50 cm2) higher in men and 43 cm2 (95% CI: 37 cm2, 49 cm2) higher in women compared with participants aged 31–44 years. Additionally, differences in VAT area across age groups increased as BMI or waist circumference increased. VAT and SAT areas, but not the VAT/TAT ratio, were positively associated with BMI and waist circumference in every age group. Conclusion: In a nationwide study conducted in China, distributions of CT-derived measures of visceral and subcutaneous adiposity were found to vary significantly between sex and age groups. Our study also revealed that the proportion of VAT (an important driver of cardiometabolic risk) could not be predicted from BMI in a Chinese population.
KW - Abdominal adipose tissue
KW - Age
KW - Body mass index
KW - Computed tomography
KW - Visceral adipose tissue
KW - Waist circumference
UR - http://www.scopus.com/inward/record.url?scp=85097456548&partnerID=8YFLogxK
U2 - 10.1016/j.metabol.2020.154456
DO - 10.1016/j.metabol.2020.154456
M3 - Article
C2 - 33259834
AN - SCOPUS:85097456548
SN - 0026-0495
VL - 115
JO - Metabolism: clinical and experimental
JF - Metabolism: clinical and experimental
M1 - 154456
ER -