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Association between non-subcutaneous adiposity and calcified coronary plaque: a substudy of the Multi-Ethnic Study of Atherosclerosis^1,2,3

¹ From the Sticht Center on Aging (JD and SBK), and Division of Public Health Science (F-CH and GLB), Wake Forest University School of Medicine, Winston-Salem, NC; Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, MD (TBH); Division of Cardiology, Los Angeles Biomedical Research Institute, Torrance, CA (RCD); Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (MS); Department of Family & Preventive Medicine, University of California, San Diego, CA (MHC and MA); Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland (PO); Department of Biostatistics, University of Washington, Seattle, WA (ERB); Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC (JJC)

Background:Excessive non-subcutaneous fat deposition may impair the functions of surrounding tissues and organs through the release of inflammatory cytokines and free fatty acids.

Objective:We examined the cross-sectional association between non-subcutaneous adiposity and calcified coronary plaque, a noninvasive measure of coronary artery disease burden.

Design:Participants in the Multi-Ethnic Study of Atherosclerosis underwent computed tomography (CT) assessment of calcified coronary plaque. We measured multiple fat depots in 398 white and black participants (47% men, 43% black), aged 47–86 y, from Forsyth County, NC, during 2002–2005, with the use of cardiac and abdominal CT scans. In addition to examining each depot separately, we also created a non-subcutaneous fat index with the standard scores of non-subcutaneous fat depots.

Results:A total of 219 participants (55%) were found to have calcified coronary plaque. After adjusting for demographics, lifestyle factors, and height, calcified coronary plaque was associated with a 1 SD increment in the non-subcutaneous fat index [odds ratio (OR): 1.41; 95% CI: 1.08, 1.84], pericardial fat (OR: 1.38; 95% CI: 1.04, 1.84), abdominal visceral fat (OR: 1.35; 95% CI: 1.03, 1.76) but not with fat content in the liver, intermuscular fat, or abdominal subcutaneous fat. The relation between non-subcutaneous fat index and calcified coronary plaque remained after further adjustment for abdominal subcutaneous fat (OR: 1.40; 95% CI: 1.00, 1.94). The relation did not differ by sex and ethnicity.

Conclusions:The overall burden of non-subcutaneous fat deposition, but not abdominal subcutaneous fat, may be a correlate of coronary atherosclerosis.