Abstract 17930: Indices of Adiposity and Subclinical Cardiovascular Disease: the Jackson Heart Study(JHS)

Abstract

Background: Evidence that indices of adiposity, which better account for central obesity, outperform body mass index (BMI) in discriminating presence versus absence of cardiovascular disease (CVD) are largely derived from Caucasian populations with limited and inconsistent findings in African Americans (AA). Characterization of the optimal measure of adiposity for improving CVD risk prediction and stratification in AAs is needed. Aim: We cross-sectionally evaluated the performance of BMI, waist circumference (WC), % body fat (%BF), waist to height ratio (WHtR), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) in predicting the presence of subclinical CVD as defined by coronary artery calcification (CAC) and abdominal aorta calcification (AAC) in the JHS, a cohort of AAs. Methods: 2,253 participants (66% female, mean age: 55 years) with no prior CVD were studied. VAT, SAT, CAC and AAC were determined using CT scan, %BF was assessed with bioelectric impedance and other adiposity indices were measured using standard protocols. Logistic regression models were constructed and c statistic from receiver operating characteristic curve was used to assess the utility of each adiposity index in predicting CAC and AAC. Results: Prevalence of CAC and AAC were 43% and 63% respectively. In univariate analyses with CAC as outcome, c statistic for VAT, WHtR, WC, %BF, SAT and BMI ranged from 0.60-0.51 in decreasing order, and were statistically significantly higher when compared with BMI, except SAT and %BF. Similar results were noted for AAC. However, none of the indices improved risk discrimination beyond traditional CVD risk factors (Table). Conclusion: VAT had the highest discrimination capacity for subclinical CVD followed by WHtR and WC. These results suggest that though other adiposity measures performed slightly better than BMI, none of the measures contributed significantly to discriminating subclinical CVD beyond the traditional CVD risk factors.