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FAT PARTITIONING AND SUBCLINICAL CARDIOVASCULAR DISEASE AMONG WOMEN IN MENOPAUSAL TRANSITION

by Dhakal, Sanjaya

Abstract (Summary)
Obesity is one of the major risk factors of atherosclerosis and arterial stiffness. Recent evidence suggests detrimental effect of fat mass rather than overall body mass. Abdominal fat has been indicated to have more negative impact than other fat depots. We evaluated the impact of regional fat distribution on atherosclerosis and compared the variances explained by 11-different adiposity measures on atherosclerosis and arterial stiffness among bi-racial women in menopausal transition. All analyses were cross-sectional. In the first analysis, adjusted for age, race, menopausal status, insulin, systolic blood pressure (SBP), triglycerides, height, high-density lipoprotein (HDL) and smoking; proportions of total (p= 0.03) and trunk fats (p= 0.03) were positively associated with common carotid adventitial diameter (AD). In contrast, proportion of leg fat was negatively associated with AD (p= 0.03). SBP attenuated the significant associations of total and regional fat distribution with carotid IMT. In the second analysis, adjusted for age, race, menopausal status, height, SBP, low-density lipoprotein (LDL), HDL and insulin; waist circumference (WC) explained 25.2% of variance in IMT and 27.0% of variance in AD, while proportion of trunk fat explained 22.7% of variance in IMT and 25.1% of variance in AD, and area of visceral adipose tissue (VAT) explained 22.7% of variance in IMT and 25.8% of variance in AD. When adjusted for age, race, menopausal status, height, SBP, insulin and C-reactive protein; WC, proportion of trunk fat and VAT explained comparable proportions of the variance in carotid-femoral pulse wave velocity (cfPWV) (WC, 9.0% of variance; proportion of trunk fat, 9.9%; and VAT, 10.3%). After adjusting for above mentioned variables, only proportion of total fat remained positively associated with cfPWV (p= 0.04). Overall, our findings provide evidence for differential role of regional fat distribution on atherosclerosis but not on arterial stiffness. Moreover, WC seems to be as good as computed tomography (CT) and dual-energy x-ray absorptiometry (DXA) measures of fat in explaining variability on atherosclerosis and arterial stiffness. Given the cost, difficulty in maintenance and exposure to radiation associated with CT and DXA, the use of WC in future research may have great public health significance.
Bibliographical Information:

Advisor:Janet M. Johnston; Maria M. Brooks; Kim Sutton-Tyrrell; Bret H. Goodpaster; Akira Sekikawa

School:University of Pittsburgh

School Location:USA - Pennsylvania

Source Type:Master's Thesis

Keywords:epidemiology

ISBN:

Date of Publication:06/27/2008

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