Increased subcutaneous fat accumulation has a protective role against subclinical atherosclerosis in asymptomatic subjects undergoing general health screening

Abstract

Purpose To evaluate the clinical role of subcutaneous fat accumulation in subclinical arteriosclerosis, using computed tomography (CT), we measured the subcutaneous fat area (SFA), the visceral fat area (VFA) and the VFA/SFA ratio and compared these with the calcium score of the whole aorta (CSWA) in asymptomatic subjects who were undergoing general health screening. Methods 122 consecutive asymptomatic subjects (40 female, mean age 56.2 ± 8.4 years) were analyzed. Whole-body low-dose CT scan (mAs = 50, slice thickness = 5 mm) was performed. The SFA and VFA were measured at the umbilical level. Calcification of whole aorta was defined as an area with > 90HU and 1 mm 2, and CSWA was calculated using the modified Agatston method. Results Mean ± SD of SFA, VFA and log CSWA were 158 ± 67.1 cm 2, 94.0 ± 44.8 cm 2, and 7.93 ± 1.08, respectively. SFA was significantly and inversely correlated with log CSWA ( r = − 0.219, P = 0.015) but VFA was not ( r = 0.105, P = 0.250) and as a result, the VFA/SFA ratio was significantly and positively correlated with log CSWA ( r = 0.221, P = 0.015). Subsequently, all predictor variables were used in a stepwise multiple regression model with log CSWA as dependent variable, and age, SFA and fasting plasma glucose significantly influenced log CSWA ( P < 0.001) by the multiple regression formula Y = 0.046X1*** − 0.005X2** + 0.015X3* + 4.426, (*** P < 0.001, ** P < 0.01, and * P < 0.05) where Y = log CSWA, X1 = age, X2 = SFA, and X3 = fasting plasma glucose). Conclusions SFA was significantly and inversely associated with log CSWA, in an independent fashion. These results suggest that subcutaneous fat accumulation might have a protective role against atherosclerosis in asymptomatic subjects.