Association between regional body fat and cardiovascular disease risk among postmenopausal women with normal body mass index
Open Access
- 30 June 2019
- journal article
- research article
- Published by Oxford University Press (OUP) in European Heart Journal
- Vol. 40 (34), 2849-2855
- https://doi.org/10.1093/eurheartj/ehz391
Abstract
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. We included 2683 postmenopausal women with normal BMI (18.5 to 2) 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 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). Among postmenopausal women with normal BMI, both elevated trunk fat and reduced leg fat are associated with increased risk of CVD.Keywords
Funding Information
- NIH
- National Heart, Lung, and Blood Institute
- NHLBI
- National Institutes of Health
- U.S. Department of Health and Human Services (HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, HHSN268201600004C)
- NHLBI (K01HL129892, R01HL060712, R01HL140976)
- National Institute of Diabetes and Digestive and Kidney Diseases
- NIDDK (R01DK119268)
This publication has 36 references indexed in Scilit:
- Body Fat Distribution, Incident Cardiovascular Disease, Cancer, and All-Cause MortalityJournal of the American College of Cardiology, 2013
- Hip Hip Hurrah! Hip size inversely related to heart disease and total mortalityObesity Reviews, 2010
- Abdominal and gynoid adipose distribution and incident myocardial infarction in women and menInternational Journal of Obesity, 2010
- Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortalityEuropean Heart Journal, 2009
- Abdominal Obesity and the Risk of All-Cause, Cardiovascular, and Cancer MortalityCirculation, 2008
- Differentiating between body fat and lean mass—how should we measure obesity?Nature Clinical Practice Endocrinology & Metabolism, 2008
- Comparison of Self-Report, Hospital Discharge Codes, and Adjudication of Cardiovascular Events in the Women's Health InitiativeAmerican Journal of Epidemiology, 2004
- Regional Body Composition Changes Exhibit Opposing Effects on Coronary Heart Disease Risk FactorsArteriosclerosis, Thrombosis, and Vascular Biology, 2004
- Peripheral Adiposity Exhibits an Independent Dominant Antiatherogenic Effect in Elderly WomenCirculation, 2003
- Gender differences in regional fatty acid metabolism before and after meal ingestion.JCI Insight, 1995