- •SAT is negatively associated with WMH volume in a neurologically healthy population.
- •This association was more prominent in female or severely obese participants.
- •Attenuated vascular risk factor, endothelial dysfunction, and chronic hypo-perfusion may be possible mechanisms.
Although obesity has been proven as a risk factor of metabolic and cardiovascular diseases, there have been few studies addressing the association between obesity and cerebral white matter hyperintensity (WMH) volume with controversial findings. In this study, we evaluated the relationship between abdominal fat distribution and WMH volume in a neurologically healthy population. We performed an observational study in a consecutive series of subjects who were examined during voluntary health check-ups between January 2006 and December 2013. We directly measured both visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) using abdominal computed tomography. The WMH volumes were also recorded quantitatively. A total of 2504 subjects were included in this study. In multivariate analysis, the relationship between SAT and WMH volume remained significant (β = −0.170, standard error [SE] = 0.065, P = .006) after adjusting for confounding factors. The protective effects of SAT on the WMH volume were more prominent in female participants (β = −0.295, SE = 0.138, P = .033) and in severely obese participants (β = −0.358, SE = 0.167, P = .033). Conclusively, we demonstrated a negative association between SAT and WMH volume in a healthy population.
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- Pathogenesis of leukoaraiosis: a review.Stroke. 1997; 28: 652-659
- Stroke outcomes are worse with larger leukoaraiosis volumes.Brain. 2016; 140: 158-170
- Association of cardiac hemodynamic factors with severity of white matter hyperintensities in chronic Valvular heart disease.JAMA Neurol. 2018 Jan 1; 75: 80-87
- Cerebral blood flow in small vessel disease: a systematic review and meta-analysis.J. Cereb. Blood Flow Metab. 2016; 36: 1653-1667
- Endothelial function and white matter hyperintensities in older adults with cardiovascular disease.Stroke. 2007; 38: 308-312
- Abdominal obesity and metabolic syndrome.Nature. 2006; 444: 881
- Obesity, inflammation, and atherosclerosis.Nat. Rev. Cardiol. 2009; 6: 399
- Body fat distribution and the risk of incident metabolic syndrome: a longitudinal cohort study.Sci. Rep. 2017; 710955
- Obesity, insulin resistance, and incident small vessel disease on magnetic resonance imaging: atherosclerosis risk in communities study.Stroke. 2015; 46: 3131-3136
- Metabolically healthy obesity and risk of leukoaraiosis; a population based cross-sectional study.Endocr. J. 2018; : EJ18-0023
- Effect of normal aging versus hypertension, abnormal body mass index, and diabetes mellitus on white matter hyperintensity volume.Stroke. 2014; 45: 255-257
- Harmonizing the metabolic syndrome: a joint interim statement of the international diabetes federation task force on epidemiology and prevention; national heart, lung, and blood institute; American heart association; world heart federation; international atherosclerosis society; and international association for the study of obesity.Circulation. 2009; 120: 1640-1645
- Visceral fat accumulation is a significant risk factor for white matter lesions in Japanese type 2 diabetic patients.Eur. J. Clin. Investig. 2009; 39: 368-374
- Visceral fat accumulation is associated with cerebral small vessel disease.Eur. J. Neurol. 2014; 21: 667-673
- Visceral obesity is associated with white matter hyperintensity and lacunar infarct.Int. J. Obes. 2017; 41: 683
- Visceral-to-subcutaneous fat ratio is independently related to small and large cerebrovascular lesions even in healthy subjects.Atherosclerosis. 2017; 259: 41-45
- High neutrophil to lymphocyte ratios predict intracranial atherosclerosis in a healthy population.Atherosclerosis. 2018 Feb; 269: 117-121
- Cerebral white matter hyperintensity is associated with intracranial atherosclerosis in a healthy population.Atherosclerosis. 2017; 265: 179-183
- Metabolic syndrome and visceral obesity as risk factors for reflux oesophagitis: a cross-sectional case–control study of 7078 Koreans undergoing health check-ups.Gut. 2008; 57: 1360-1365
- Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study.Circulation. 2007; 116: 39-48
- Abdominal superficial subcutaneous fat: a putative distinct protective fat subdepot in type 2 diabetes.Diabetes Care. 2012; 35: 640-647
- High visceral fat with low subcutaneous fat accumulation as a determinant of atherosclerosis in patients with type 2 diabetes.Cardiovasc. Diabetol. 2015; 14: 136
- Abdominal subcutaneous adipose tissue: a protective fat depot?.Diabetes Care. 2009; 32: 1068-1075
- Subcutaneous adipose tissue in relation to subclinical atherosclerosis and cardiometabolic risk factors in midlife women.Am. J. Clin. Nutr. 2011; 93: 719-726
- Association of obesity with cerebral microbleeds in neurologically asymptomatic elderly subjects.J. Neurol. 2012; 259: 2599-2604
- Distribution of subcutaneous fat predicts insulin action in obesity in sex-specific manner.Obesity. 2008; 16: 2003-2009
- Low subcutaneous thigh fat is a risk factor for unfavourable glucose and lipid levels, independently of high abdominal fat. The Health ABC Study.Diabetologia. 2005; 48: 301-308
- Effect of pioglitazone on abdominal fat distribution and insulin sensitivity in patients with type 2 diabetes mellitus (T2DM).Diabetes. 2000; 87: 2784-2791
- Absence of an effect of liposuction on insulin action and risk factors for coronary heart disease.N. Engl. J. Med. 2004; 350: 2549-2557
- Is visceral obesity the cause of the metabolic syndrome?.Ann. Med. 2006; 38: 52-63
- Arteriolar function in visceral adipose tissue is impaired in human obesity.Arterioscler. Thromb. Vasc. Biol. 2012; 32: 467-473
- Increased visceral adipose tissue as a potential risk factor in patients with embolic stroke of undetermined source (ESUS).PLoS One. 2015; 10e0120598
- Relationship between abdominal visceral fat and lacunar infarcts in Japanese men.Circ. J. 2004; 68: 982-987
- Increased subcutaneous fat accumulation has a protective role against subclinical atherosclerosis in asymptomatic subjects undergoing general health screening.Int. J. Cardiol. 2009; 135: 150-155
- Body fat distribution as a risk factor for cerebrovascular disease: an MRI-based body fat quantification study.Cerebrovasc. Dis. 2013; 35: 341-348
- Subcutaneous and visceral adipose tissue: structural and functional differences.Obes. Rev. 2010; 11: 11-18
- Preferential fat deposition in subcutaneous versus visceral depots is associated with insulin sensitivity.J. Clin. Endocrinol. Metabol. 2011; 96: E1756-E1760
- Association between visceral and subcutaneous adipose depots and incident cardiovascular disease risk factors.Circulation. 2015 Oct 27; 132 (CIRCULATIONAHA. 114.015000): 1639-1647
- Associations of visceral and abdominal subcutaneous adipose tissue with markers of cardiac and metabolic risk in obese adults.Obesity. 2013; 21
Published online: July 12, 2019
Accepted: July 11, 2019
Received in revised form: July 1, 2019
Received: April 19, 2019
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