Contribution of visceral fat accumulation to carotid intima–media thickness in a Chinese population

OBJECTIVE: Recent observational studies have reported that body fat distribution might be differentially associated with subclinical atherosclerosis. We previously reported that visceral fat area (VFA) ≥ 80 cm2 is the optimal cutoff for identifying abdominal obesity in Chinese subjects. We examined whether VFA ≥ 80 cm2 reflects the association between abdominal obesity and subclinical atherosclerosis, and if determination of the visceral fat quantity is useful for assessing subclinical atherosclerosis in asymptomatic individuals. METHODS AND RESULTS: Participants (N=1005, men 515, women 490, 34-66 years) free of cardiovascular disease underwent magnetic resonance imaging and carotid ultrasound assessment to quantify VFA and carotid intima-media thickness (C-IMT). Overweight/obese subjects (body mass index (BMI) ≥ 25.0 kg m(-2)) had a higher C-IMT than lean subjects (BMI <25.0 kg m(-2)) (P<0.01). Subjects with VFA ≥ 80 cm2 had significantly higher C-IMT than those without abdominal obesity regardless of BMI (P<0.01). By multivariate regression analysis adjusted for anthropometric measurements and cardiovascular risk factors, waist circumference but not BMI was independently correlated with C-IMT in men (P<0.001). Similar findings were observed with an accurate obesity indices adjusted model, which showed that VFA was an independent risk factor for increased C-IMT in men but not in women. CONCLUSIONS: VFA 80 cm2 effectively identified carotid atherosclerosis for both lean and obese individuals in middle-aged Chinese men.