Abstract 19558: An Increase in Visceral Adipose Tissue Attenuation After a One-Year Lifestyle Intervention in Men with Features of the Metabolic Syndrome is Related to Improvements in Lipid Profile Independent of the Reduction in Visceral Adiposity

Abstract

Background: On the basis of its specific attenuation range (expressed in Hounsfields units, HU), visceral adipose tissue (VAT) can be identified and quantified by computed tomography (CT). In addition, cross-sectional studies have suggested that mean VAT attenuation in HU could reflect variation in VAT density. Objectives: The present study examined: 1) the effect of a one year lifestyle modification program on VAT attenuation in a sample of abdominally obese subjects with features of the metabolic syndrome, 2) whether changes in VAT attenuation were independently associated with improvements in the cardiometabolic risk (CMR) profile, beyond the reduction in VAT area. Methods: From the 144 subjects initially recruited, 109 men with features of the metabolic syndrome (age: 48±9 y, waist circumference: 108±9 cm, triglycerides: 2.46±0.92 mmol/L) who had an abdominal CT scan at the L4-L5 level at both baseline and after one year of lifestyle intervention were included in the present analyses. VAT area and VAT attenuation were assessed as well as a comprehensive CMR profile. Results: After one year of the lifestyle intervention, VAT attenuation significantly increased (+5.6 ± 3.9 HU, p<0.0001). One-year changes in VAT attenuation were significantly correlated with changes in VAT area (r=-0.62, p<0.0001), triglycerides (r=-0.40, p<0.0001), HDL cholesterol (r=0.35, p=0.0002), apolipoprotein B (r=-0.42, p<0.0001) and HOMA-IR (r=-0.24, p=0.01). Multiple regression analyses including changes in both VAT attenuation and VAT area showed that only VAT attenuation was an independent correlate of changes in triglycerides, HDL cholesterol and apolipoprotein B, whereas VAT area alone explained the variance in changes in HOMA-IR. Conclusion: The increase in VAT attenuation after one year of lifestyle intervention is independently associated with improvements in lipid profile, beyond the reduction in visceral adiposity.