Division of Cardiology Department of Internal Medicine at The University of Texas Health Science Center at Houston Houston TX.
School of Public Health The University of Texas Health Science Center at Houston Brownsville TX.
J Am Heart Assoc. 2020 Oct 20;9(20):e017373. doi: 10.1161/JAHA.120.017373. Epub 2020 Oct 15.
Background Excess visceral adipose tissue (VAT) is a primary driver for the cardiometabolic complications of obesity; VAT-associated cardiovascular disease risk varies by race, but most studies have been done on Non-Hispanics. This study aimed to evaluate the clinical and metabolic correlates of VAT, its association with subclinical atherosclerosis, and the factors affecting this association in Mexican Americans. Methods and Results Participants (n=527) were drawn from the Cameron County Hispanic Cohort (CCHC), on whom a carotid ultrasound to assess carotid intima media thickness and a dual-energy X-ray absorptiometry scan to assess for VAT were obtained. Those in the highest quartiles of VAT were more likely to have hypertension, hypertriglyceridemia, low high-density lipoprotein, diabetes mellitus, and metabolic syndrome. Increased carotid intima media thickness was more prevalent in those in the highest quartile for VAT (57.4% versus 15.4% for the lowest quartile; <0.001). There was a graded increase in mean carotid intima media thickness with increasing VAT, after adjusting for covariates; for every 10 cm increase in VAT, there was an increase of 0.004 mm (SE=0.002; =0.0299) in mean carotid intima media thickness. However, this association was only seen among second or higher generation US-born Mexican Americans but not among first generation immigrants (=0.024). Conclusions Excess VAT is associated with indicators of metabolic disorders and subclinical atherosclerosis in Mexican Americans regardless of body mass index. However, acculturation appears to be an important modulator of this association. Longitudinal follow-up with targeted interventions among second or higher generation Hispanics to lower VAT and improve cardiometabolic risk may help prevent premature cardiovascular disease in this cohort.
过多的内脏脂肪组织(VAT)是肥胖引起代谢并发症的主要原因;与 VAT 相关的心血管疾病风险因种族而异,但大多数研究都是针对非西班牙裔人群进行的。本研究旨在评估墨西哥裔美国人中 VAT 的临床和代谢相关性、与亚临床动脉粥样硬化的关系,以及影响这种关系的因素。
参与者(n=527)来自卡梅伦县西班牙裔队列(CCHC),对他们进行了颈动脉超声检查以评估颈动脉内膜中层厚度,以及双能 X 射线吸收法扫描以评估 VAT。VAT 最高四分位数的参与者更可能患有高血压、高甘油三酯血症、低高密度脂蛋白、糖尿病和代谢综合征。VAT 最高四分位数的参与者颈动脉内膜中层厚度更常见(57.4%比最低四分位数的 15.4%;<0.001)。在调整了协变量后,随着 VAT 的增加,平均颈动脉内膜中层厚度呈梯度增加;VAT 每增加 10 cm,平均颈动脉内膜中层厚度增加 0.004 mm(SE=0.002;=0.0299)。然而,这种关联仅见于第二代或以上出生于美国的墨西哥裔美国人中,而第一代移民中则没有(=0.024)。
无论体重指数如何,过多的 VAT 与墨西哥裔美国人代谢紊乱和亚临床动脉粥样硬化的指标有关。然而,文化适应似乎是这种关联的一个重要调节因素。针对第二代或以上出生的西班牙裔人群进行的 VAT 降低和改善代谢风险的纵向随访,可能有助于预防该人群的心血管疾病过早发生。