Qiang Zeng1, Ling Wang2, Shengyong Dong1, Xiaojuan Zha3, Limei Ran4, Yongli Li5, Shuang Chen6, Jianbo Gao7, Shaolin Li8, Yong Lu9, Yuqin Zhang10, Xigang Xiao11, Yuehua Li12, Xiao Ma13, Xiangyang Gong14, Wei Chen15, Yingying Yang3, Xia Du16, Bairu Chen5, Yinru Lv6, Yan Wu7, Guobin Hong8, Yaling Pan9, Jun Jiao16, Yan Yan2, Huijuan Qi3, Jian Zhai17, Kai Li2, Kaiping Zhao18, Jing Wu19, Shiwei Liu19, Glen M Blake20, Haihong Fu21, Xiaoxia Fu22, Zhiping Guo23, Isabelle Lemieux24, Jean-Pierre Després25, Xiaoguang Cheng26. 1. Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China. 2. Department of Radiology, Beijing, Jishuitan Hospital, Beijing, China. 3. Department of Health Center, Yijishan Hospital of Wannan Medical College, Wuhu, China. 4. Department of Health Management, The Affiliated Hospital of Guizhou Medical University, Guiyang, China. 5. Department of Health Management, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China. 6. Department of Radiology, The Affiliated Huashan Hospital of Fudan University, Shanghai, China. 7. Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. 8. Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. 9. Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 10. Department of Radiology, Ningbo Medical Center Li Huili Hospital, Ningbo, China. 11. Department of CT, The First Affiliated Hospital of Harbin Medical University, Harbin, China. 12. Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China. 13. China-Japan Friendship Hospital, Beijing, China. 14. Department of Radiology, The People's Hospital of Zhengjiang Province, Hangzhou, China. 15. Department of Radiology, Southwest Hospital, Army Medical University, Chongqing, China. 16. Department of Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China. 17. Department of Radiology Yijishan Hospital of Wannan Medical College, Wuhu, China. 18. Department of Medical Record Management and Statistics, Beijing, Jishuitan Hospital, Beijing, China. 19. National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. 20. School of Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital, London SE1 7EH, United Kingdom. 21. Department of Radiology, Beijing, PUMC Hospital, Beijing, China. 22. Editorial Office of the Chinese Health Management Journal, Beijing, China. 23. Orthopedic Institute of Henan Province, Zhengzhou, China. 24. Québec Heart and Lung Institute, Québec City, QC, Canada. 25. Québec Heart and Lung Institute, Québec City, QC, Canada; Department of Kinesiology, Faculty of Medicine, Université Laval, Québec City, QC, Canada. Electronic address: Jean-Pierre.Despres@criucpq.ulaval.ca. 26. Department of Radiology, Beijing, Jishuitan Hospital, Beijing, China. Electronic address: xiao65@263.net.
Abstract
BACKGROUND: Although abdominal adiposity is associated with an altered cardiometabolic risk profile, the specific contribution of abdominal adipose tissue distribution remains not fully understood. Computed tomography (CT) is a well-established and precise method to measure abdominal adipose tissue distribution. The present study investigated abdominal adiposity assessed by CT in a large-scale Chinese population. METHOD: A total of 59,429 adults who underwent a low dose chest CT for lung cancer screening at one of 13 health checkup centers throughout China were evaluated. Abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) areas were measured at the center of the 2nd lumbar vertebra with Mindways quantitative CT software using the existing CT dataset without any additional radiation exposure. The ratio of visceral to total adipose tissue (TAT) areas (VAT/TAT ratio) was calculated and expressed as a percentage. Anthropometric indices including body mass index (BMI) and waist circumference were also obtained. RESULTS: BMI, waist circumference, VAT area, SAT area, and the VAT/TAT ratio were 25.0 ± 3.0 kg/m2, 90 ± 8 cm, 194 ± 77 cm2, 85 ± 41 cm2, and 69.5 ± 9.1%, respectively, in men and 23.3 ± 3.1 kg/m2, 79 ± 8 cm, 120 ± 57 cm2, 123 ± 53 cm2, and 48.9 ± 9.7% in women. With increasing age, VAT area and the VAT/TAT ratio increased in both sexes whereas SAT area decreased in men (P < 0.001 for all). After adjustment for BMI and waist circumference, older individuals showed higher VAT area and higher VAT/TAT ratio than younger subjects (P < 0.001 for all). Adjusted VAT areas in participants aged 75 or older was 45 cm2 (95% confidence interval [CI]: 41 cm2, 50 cm2) higher in men and 43 cm2 (95% CI: 37 cm2, 49 cm2) higher in women compared with participants aged 31-44 years. Additionally, differences in VAT area across age groups increased as BMI or waist circumference increased. VAT and SAT areas, but not the VAT/TAT ratio, were positively associated with BMI and waist circumference in every age group. CONCLUSION: In a nationwide study conducted in China, distributions of CT-derived measures of visceral and subcutaneous adiposity were found to vary significantly between sex and age groups. Our study also revealed that the proportion of VAT (an important driver of cardiometabolic risk) could not be predicted from BMI in a Chinese population.
BACKGROUND: Although abdominal adiposity is associated with an altered cardiometabolic risk profile, the specific contribution of abdominal adipose tissue distribution remains not fully understood. Computed tomography (CT) is a well-established and precise method to measure abdominal adipose tissue distribution. The present study investigated abdominal adiposity assessed by CT in a large-scale Chinese population. METHOD: A total of 59,429 adults who underwent a low dose chest CT for lung cancer screening at one of 13 health checkup centers throughout China were evaluated. Abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) areas were measured at the center of the 2nd lumbar vertebra with Mindways quantitative CT software using the existing CT dataset without any additional radiation exposure. The ratio of visceral to total adipose tissue (TAT) areas (VAT/TAT ratio) was calculated and expressed as a percentage. Anthropometric indices including body mass index (BMI) and waist circumference were also obtained. RESULTS: BMI, waist circumference, VAT area, SAT area, and the VAT/TAT ratio were 25.0 ± 3.0 kg/m2, 90 ± 8 cm, 194 ± 77 cm2, 85 ± 41 cm2, and 69.5 ± 9.1%, respectively, in men and 23.3 ± 3.1 kg/m2, 79 ± 8 cm, 120 ± 57 cm2, 123 ± 53 cm2, and 48.9 ± 9.7% in women. With increasing age, VAT area and the VAT/TAT ratio increased in both sexes whereas SAT area decreased in men (P < 0.001 for all). After adjustment for BMI and waist circumference, older individuals showed higher VAT area and higher VAT/TAT ratio than younger subjects (P < 0.001 for all). Adjusted VAT areas in participants aged 75 or older was 45 cm2 (95% confidence interval [CI]: 41 cm2, 50 cm2) higher in men and 43 cm2 (95% CI: 37 cm2, 49 cm2) higher in women compared with participants aged 31-44 years. Additionally, differences in VAT area across age groups increased as BMI or waist circumference increased. VAT and SAT areas, but not the VAT/TAT ratio, were positively associated with BMI and waist circumference in every age group. CONCLUSION: In a nationwide study conducted in China, distributions of CT-derived measures of visceral and subcutaneous adiposity were found to vary significantly between sex and age groups. Our study also revealed that the proportion of VAT (an important driver of cardiometabolic risk) could not be predicted from BMI in a Chinese population.