Abstract
The objective of the study was to identify associations of longitudinal trajectories of traditional cardiometabolic risk factors with abdominal and ectopic adipose tissue depots measured by magnetic resonance imaging (MRI). We measured total abdominal, visceral, and subcutaneous adipose tissue in liter and intrahepatic, intrapancreatic and renal sinus fat as fat fractions by MRI in 325 individuals free of cardiovascular disease at Exam 3 of a population-based cohort. We related these MRI measurements at Exam 3 to longitudinal risk profile trajectory clusters, based on risk factor measurements from Exam 3, Exam 2 (seven years prior to MRI) and Exam 1 (14 years prior to MRI). Based on the levels and longitudinal trajectories of several risk factors (blood pressure, lipid profile, anthropometric measurements, HbA1c), we identified three different trajectory clusters. These clusters displayed a graded association with all adipose tissue traits after adjustment for potential confounders (e.g. visceral adipose tissue: βClusterII = 1.30 l, 95%-CI:[0.84 l;1.75 l], βClusterIII = 3.32 l[2.74 l;3.90 l]; intrahepatic: EstimateClusterII = 1.54[1.27,1.86], EstimateClusterIII = 2.48[1.93,3.16]. Associations remained statistically significant after additional adjustment for the risk factor levels at Exam 1 or Exam 3, respectively. Trajectory clusters provided additional information in explaining variation in the different fat compartments beyond risk factor profiles obtained at individual exams. In conclusion, sustained high risk factor levels and unfavorable trajectories are associated with high levels of adipose tissue; however, the association with cardiometabolic risk factors varies substantially between different ectopic adipose tissues. Trajectory clusters, covering longitudinal risk profiles, provide additional information beyond single-point risk profiles. This emphasizes the need to incorporate longitudinal information in cardiometabolic risk estimation.
Highlights
The objective of the study was to identify associations of longitudinal trajectories of traditional cardiometabolic risk factors with abdominal and ectopic adipose tissue depots measured by magnetic resonance imaging (MRI)
We aim to identify distinct longitudinal risk profile trajectory clusters, quantify the association of these clusters with adipose tissue traits and to determine their incremental value compared to single-point measurements of individual risk factors
This MRI sub-sample included a high proportion of participants with prediabetes (26%) and diabetes (14%), because a specific aim of the KORA-MRI substudy was to evaluate subclinical cardiovascular disease (CVD) burden in individuals with prediabetes and diabetes[5]
Summary
The objective of the study was to identify associations of longitudinal trajectories of traditional cardiometabolic risk factors with abdominal and ectopic adipose tissue depots measured by magnetic resonance imaging (MRI). Visceral, and subcutaneous adipose tissue in liter and intrahepatic, intrapancreatic and renal sinus fat as fat fractions by MRI in 325 individuals free of cardiovascular disease at Exam 3 of a population-based cohort We related these MRI measurements at Exam 3 to longitudinal risk profile trajectory clusters, based on risk factor measurements from Exam 3, Exam 2 (seven years prior to MRI) and Exam 1 (14 years prior to MRI). Obesity is an established risk factor for several disease conditions, including cardiovascular disease (CVD) and type 2 diabetes[1,2], and clusters with other traditional CVD risk factors, such as hypertension and hypercholesterolemia[3] Applicable metrices such as body mass index (BMI) and waist circumference (WC) are often used as measures of obesity. Prior studies have shown that accurate quantification of adipose tissue, including VAT and SAT, provides additional value in the prediction of cardiometabolic outcomes (e.g. incident CVD, type 2 diabetes), beyond anthropometric measures[10,11,12,13]
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