The Longitudinal Association of Alcohol Intake and Cigarette Smoking With Levels of Visceral and Subcutaneous Abdominal Adipose Tissue Depots in Postmenopausal Women

Abstract

ObjectivesTo examine the longitudinal relation between alcohol intake and cigarette smoking with levels of abdominal visceral (VAT) and subcutaneous adipose tissue (SAT) in postmenopausal women. MethodsWe analyzed data from 9,779 participants (age: 50–79) from a sub-cohort of the Women’s Health Initiative study. VAT and SAT was derived from whole-body DXA scans at baseline and at least 1 follow-up scan visit (year 1, 3, or 6) and validated against MRI (r > .90 respectively). Habitual alcohol intake was assessed at baseline, year 3 and 6, and categorized into never, past, rare (< 1 drink/month), infrequent (<1 drink/week), light (1–3.5 drinks/week), moderate (3.5–7 drinks/week) and heavy (8 + drinks/week) drinkers. Cigarette smoking was concomitantly assessed and categorized as never, past, light (<5 cigarettes/day), moderately heavy (5–14 cigarettes/day) and heavy smokers (15 + cigarettes/day). We used linear mixed models to estimate the longitudinal relationship between time-varying alcohol habits, smoking and VAT and SAT dynamics, adjusting for sociodemographic and diet/lifestyle covariates. ResultsAt baseline, participants with higher alcohol intake had lower VAT and SAT levels. VAT levels increased by 0.30, 0.58, 2.01, 1.27, 1.26, 1.52, and 1.97 cm2 per year in never, past, rare, infrequent, light, moderate and heavy drinkers, with faster increases in higher alcohol intake (compared to never, P < 0.01). We did not observe any statistically significant differences in change rate in SAT levels across alcohol intake groups. When categorizing by smoking habits, current smokers had lower VAT and SAT levels at baseline. Longitudinally, VAT in never, past, light, moderately heavy and heavy smokers increased by 0.76, 1.43, 0.94, 0.43 and 1.77 cm2 per year, with past and heavy smokers increasing faster (compared to never, P < 0.01). Stronger associations were observed for subgroups of age <65 and BMI < 30 kg/m2. SAT areas decreased by 0.93 cm2 per year in never smokers, with slower decrease in past smokers (compared to never, P = 0.02) and similar change rate in other smoking groups. ConclusionsIn postmenopausal women, alcohol intake has a nuanced relation with levels of VAT and SAT, however heavy alcohol intake and heavy smoking were avenues for accumulating greater VAT, the central hypothesized driver of adipose tissue related chronic disease risk. Funding SourcesNIH/NIA.