The following is a summary of “Skewness in Body fat Distribution Pattern Links to Specific Cardiometabolic Disease Risk Profiles,” published in the March 2024 issue of Endocrinology by Linge, et al.

For a study, researchers sought to assess the association between the balance/imbalance of visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (aSAT), and liver fat (LF) with incident type 2 diabetes (T2D) and cardiovascular disease (CVD).

They analyzed magnetic resonance images of 40,174 participants for VAT, aSAT, and LF using AMRA® Researcher. Fat z-scores (z-VAT, z-aSAT, z-LF) were calculated to evaluate fat distribution patterns independent of body mass index (BMI). Participants without prevalent T2D/CVD (N = 35,138) were categorized based on the balance between z-VAT and z-LF, z-VAT and z-aSAT, and z-LF and z-aSAT. Cox regression analysis, adjusted for various factors, including sex, age, BMI, lifestyle, arterial hypertension, and statin treatment, was used to investigate associations with incident T2D/CVD.

T2D incidence was significantly associated with z-LF (hazard ratio [HR], 1.74; 95% CI, 1.52-1.98; P < .001) and z-VAT (HR, 1.70; 95% CI, 1.49-1.95; P < .001). These associations remained significant after full adjustment. Skewed fat distribution patterns, such as z-VAT > 0 and z-LF > 0, z-VAT > 0 and z-aSAT < 0, and z-LF > 0 and z-aSAT < 0, were strongly associated with T2D (P < .001). CVD incidence was most strongly associated with z-VAT (HR, 1.22; 95% CI, 1.16-1.28; P < .001), which remained significant after adjustment for several factors. Skewed fat distribution patterns, specifically z-VAT > 0 and z-LF < 0, and z-VAT > 0 and z-aSAT < 0, were associated with elevated risk for CVD (P < .001). However, after adjusting for sex, age, and BMI, only z-VAT > 0 and z-LF < 0 remained significant.

High VAT about BMI consistently showed associations with T2D and CVD, while high LF was linked to T2D only. Skewed fat distribution patterns, particularly those involving high VAT and low LF or low aSAT, were associated with increased risk for CVD and T2D.

Reference: academic.oup.com/jcem/article/109/3/783/7289549