Association between regional body fat and cardiovascular disease risk among postmenopausal women with normal body mass index.

Publisher: Oxford University Press Country of Publication: England NLM ID: 8006263 Publication Model: Print Cited Medium: Internet ISSN: 1522-9645 (Electronic) Linking ISSN: 0195668X NLM ISO Abbreviation: Eur Heart J Subsets: MEDLINE

Publication: 2005- : Oxford : Oxford University Press
Original Publication: London, Saunders [etc.]

Body Fat Distribution* ; Body Mass Index*; Cardiovascular Diseases/*epidemiology; Aged ; Female ; Humans ; Middle Aged ; Postmenopause ; Prospective Studies ; Risk Assessment ; Risk Factors

Aims: Central adiposity is associated with increased cardiovascular disease (CVD) risk, even among people with normal body mass index (BMI). We tested the hypothesis that regional body fat deposits (trunk or leg fat) are associated with altered risk of CVD among postmenopausal women with normal BMI.
Methods and Results: We included 2683 postmenopausal women with normal BMI (18.5 to <25 kg/m2) who participated in the Women's Health Initiative and had no known CVD at baseline. Body composition was determined by dual energy X-ray absorptiometry. Incident CVD events including coronary heart disease and stroke were ascertained through February 2017. During a median 17.9 years of follow-up, 291 incident CVD cases occurred. After adjustment for demographic, lifestyle, and clinical risk factors, neither whole-body fat mass nor fat percentage was associated with CVD risk. Higher percent trunk fat was associated with increased risk of CVD [highest vs. lowest quartile hazard ratio (HR) = 1.91, 95% confidence interval (CI) 1.33-2.74; P-trend <0.001], whereas higher percent leg fat was associated with decreased risk of CVD (highest vs. lowest quartile HR = 0.62, 95% CI 0.43-0.89; P-trend = 0.008). The association for trunk fat was attenuated yet remained significant after further adjustment for waist circumference or waist-to-hip ratio. Higher percent trunk fat combined with lower percent leg fat was associated with particularly high risk of CVD (HR comparing extreme groups = 3.33, 95% CI 1.46-7.62).
Conclusion: Among postmenopausal women with normal BMI, both elevated trunk fat and reduced leg fat are associated with increased risk of CVD.
(Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.)

Comment in: Eur Heart J. 2019 Sep 7;40(34):2856-2858. (PMID: 31256195)

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HHSN268201600002C United States HL NHLBI NIH HHS; HHSN268201600018C United States HL NHLBI NIH HHS; R01 DK119268 United States DK NIDDK NIH HHS; P30 CA008748 United States CA NCI NIH HHS; HHSN268201600003C United States HL NHLBI NIH HHS; HHSN268201600001C United States HL NHLBI NIH HHS; R01 HL060712 United States HL NHLBI NIH HHS; K01 HL129892 United States HL NHLBI NIH HHS; P30 DK111022 United States DK NIDDK NIH HHS; HHSN268201600004C United States HL NHLBI NIH HHS; R01 HL140976 United States HL NHLBI NIH HHS

Keywords: Body fat; Cardiovascular disease; Metabolically unhealthy normal weight; Normal-weight obesity; Postmenopausal

Date Created: 20190701 Date Completed: 20201116 Latest Revision: 20201116

20221213

PMC6933870

10.1093/eurheartj/ehz391

31256194