Visceral adipose tissue is an independent predictor and mediator of the progression of coronary calcification: a prospective sub-analysis of the GEA study
Authors' conclusion
This study supports the hypothesis that VAT is a mediator of the risk conferred by subcutaneous adipose tissue dysfunction. METS-VF is an efficient clinical surrogate that could facilitate the identification of at-risk adiposity subjects in daily clinical practice.
Study context
- Population
- Adults (53 ± 9 years, 53% women) with coronary artery calcium (CAC) quantified by computed tomography (CT) at baseline and after 5 years
- Participants
- 862 adults
- Outcome
- CAC progression
- Follow-up
- 5 years
Methodological detailssub-analysis of the GEA study, adjusted Cox proportional hazard models, mediation and interaction models
- Sub-analysis of the GEA study
- Adjusted Cox proportional hazard models
- Mediation and interaction models
Main finding
As reported in the abstract
Visceral adipose tissue (VAT) independently predicted CAC progression
HR 1.004
95% CI 1.001–1.007p < 0.01
METS-VF independently predicted CAC progression
HR 1.001
95% CI 1.0–1.001p < 0.05
Incidence of CAC progression per 1000 person-years
30.2
95% CI 25.3–35.8
Observational data: associations, not effects.
Further findings
VAT-associated CAC progression risk by ASCVD risk
- Evident among low-risk ASCVD subjects, attenuated among medium-high-risk subjects
Mediation by VAT of the effect of insulin resistance (IR) with adipose tissue dysfunction on CAC progression
- Proportion mediated by VAT
- 51.8% (95% CI 44.5-58.8%)
Original publication
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