Calcium Metabolism and Osteoporosis Program, World Health Organization (WHO) Collaborating Center for Metabolic Bone Disorders, Division of Endocrinology and Metabolism, Department of Internal Medicine - American University of Beirut Medical Center, Beirut, Lebanon.
Departement of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Front Endocrinol (Lausanne). 2022 Aug 22;13:922931. doi: 10.3389/fendo.2022.922931. eCollection 2022.
Increased abdominal visceral adipose tissue (VAT) implies an adverse cardio-metabolic profile. We examined the association of abdominal VAT parameters and all-cause mortality risk.
We systematically searched four databases. We performed citations/articles screening, data abstraction, and quality assessment in duplicate and independently (CRD42020205021).
We included 12 cohorts, the majority used computed tomography to assess abdominal VAT area. Six cohorts with a mean age ≤ 65 years, examining all-cause mortality risk per increment in VAT area (cm) or volume (cm), showed a 11-98% relative risk increase with higher VAT parameters. However, the association lost significance after adjusting for glycemic indices, body mass index, or other fat parameters. In 4 cohorts with a mean age >65 years, the findings on mortality were inconsistent. Conversely, in two cohorts (mean age 73-77 years), a higher VAT density, was inversely proportional to VAT area, and implied a higher mortality risk.
A high abdominal VAT area seems to be associated with increased all-cause mortality in individuals ≤ 65 years, possibly mediated by metabolic complications, and not through an independent effect. This relationship is weaker and may reverse in older individuals, most likely secondary to confounding bias and reverse causality. An individual participant data meta-analysis is needed to confirm our findings, and to define an abdominal VAT area cutoff implying increased mortality risk.
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=205021, identifier CRD42020205021.
腹部内脏脂肪组织（VAT）的增加意味着不良的心脏代谢状况。我们研究了腹部 VAT 参数与全因死亡率风险的关系。
我们系统地检索了四个数据库。我们进行了重复和独立的引文/文章筛选、数据提取和质量评估（CRD42020205021）。
我们纳入了 12 项队列研究，其中大多数使用计算机断层扫描评估腹部 VAT 面积。6 项平均年龄≤65 岁的队列研究，每增加 1cm 的 VAT 面积或体积（cm）检查全因死亡率风险，显示 VAT 参数较高时相对风险增加 11%-98%。然而，在调整了血糖指数、体重指数或其他脂肪参数后，这种关联失去了意义。在 4 项平均年龄>65 岁的队列研究中，死亡率的发现不一致。相反，在 2 项队列研究（平均年龄 73-77 岁）中，较高的 VAT 密度与 VAT 面积呈反比，意味着更高的死亡率风险。
在≤65 岁的个体中，较高的腹部 VAT 面积似乎与全因死亡率增加相关，可能是代谢并发症的介导，而不是通过独立作用。这种关系较弱，在年龄较大的个体中可能会逆转，这很可能是混杂偏差和反向因果关系的结果。需要进行个体参与者数据的荟萃分析来证实我们的发现，并确定一个意味着增加死亡率风险的腹部 VAT 面积截断值。
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=205021，标识符 CRD42020205021。
