1. Risk stratification using magnetic resonance imaging-derived, personalized z-scores of visceral adipose tissue, subcutaneous adipose tissue, and liver fat in persons with obesity.
- Author
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Linge J, Widholm P, Nilsson D, Kugelberg A, Olbers T, and Dahlqvist Leinhard O
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Body Mass Index, Cardiovascular Diseases diagnostic imaging, Cardiovascular Diseases epidemiology, Liver diagnostic imaging, Liver pathology, Obesity complications, Risk Assessment, United Kingdom epidemiology, Diabetes Mellitus, Type 2, Intra-Abdominal Fat diagnostic imaging, Intra-Abdominal Fat pathology, Magnetic Resonance Imaging, Subcutaneous Fat diagnostic imaging, Subcutaneous Fat pathology
- Abstract
Background: Individual patterns of fat accumulation (visceral, subcutaneous, and/or liver fat) can determine cardiometabolic risk profile., Objective: To investigate risk stratification using personalized fat z-scores in persons with a body mass index (BMI) of 30-40 kg/m
2 from the UK Biobank imaging study., Setting: Population-based study., Methods: Whole-body magnetic resonance (MR) images of 40,174 participants from the UK Biobank imaging study were analyzed for visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (aSAT), and liver fat (LF) and used to calculate sex- and body size-invariant fat z-scores (VATz, aSATz, LFz). Associations between z-scores and later incident cardiovascular disease (CVD) and type 2 diabetes (T2D) were investigated using Cox proportional hazards modeling and Kaplan-Meier curves in participants with BMI 30-40 kg/m2 ., Results: A total of 6716 participants had BMI 30-40 kg/m2 and within this group, CVD was positively associated with VATz (crude hazard ratio (cHR) [95% CI]: 1.30 [1.20-1.40], P < .001) and negatively associated with aSATz and LFz (cHR: 0.91 [0.85-0.99], P = .028, and 0.88 [0.82-0.95], P = .002). All z-scores remained significant after adjustment for sex, BMI, and age, but only VATz was significant when previous CVD was added. T2D was positively associated with VATz and LFz (cHR: 1.53 [1.40-1.67], P < .001, and 1.35 [1.23-148], P < .001) and negatively associated with aSATz (cHR: 0.90 [0.81-0.99], P = .026). All z-scores remained significant after adjustment for sex, BMI, and age., Conclusions: Personalized MR-derived fat z-scores can identify phenotypes of obesity with specific cardiometabolic risk profiles regardless of BMI. Current guidelines for bariatric surgery based on BMI exclude some of these high-risk patients., (Copyright © 2024 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)- Published
- 2024
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