Abstract MP35: Discordant Visceral and Liver Fat Phenotypes are Differentially Associated With Incident Cardiovascular Disease and Type 2 Diabetes

Abstract

Background: Visceral adipose tissue (VAT) and ectopic liver fat (ELF) are linked with cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) but little is known about their joint associations when they are discordant in an individual. Objective and Hypothesis: This study aims to evaluate cardiometabolic health outcomes associated with discordant VAT-ELF phenotypes in a multi-ethnic, population-based cohort of adults. We hypothesized that high VAT-low ELF, but not low VAT-high ELF, would be associated with incident cardiovascular disease, but both would be associated with incident T2DM. Methods: Participants of the Dallas Heart Study with no history of CVD or T2DM had assessments of VAT and ELF by MRI and MRS, respectively, between 2000 and 2002 and were followed for a median (IQR) of 12.0 (11.5-12.7) years for the incidence of CVD or T2DM. Associations between VAT-ELF phenotypes (high/low based on sex- and race-specific median values) and outcomes were evaluated using multivariable adjusted Cox proportional hazards and logistic regression models, as appropriate. Results: The study cohort included 1731 participants (mean age 43, 54% female, 44% black, 18% Hispanic, 41% obese). 128 (7.4%) participants had incident CVD and 95 (5.5%) had incident T2DM during follow-up. In unadjusted models, those with high VAT-low ELF had the highest hazard for CVD ( Table ), but associations were attenuated after multivariable adjustment. In both unadjusted and adjusted models, high VAT and/or high ELF phenotypes were associated with T2DM, with the high VAT-high ELF phenotype demonstrating the highest odds for T2DM ( Table ). Conclusions: In conclusion, we found that the heterogeneous manifestations of abdominal obesity impact cardiometabolic health outcomes. Elevated liver fat in the presence of low or normal VAT is associated with incident T2DM but not CVD.