Body fat distribution is more predictive of all-cause mortality than overall adiposity

Sung Woo Lee, Jee Young Son, Jeong Min Kim, Seung Sik Hwang, Jin Suk Han, Nam Ju Heo

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Aims: The relationship between directly measured body fat and all-cause mortality has been rarely studied. The aim of this study was to evaluate the predictive significance of computed tomography (CT)-measured body fat, including both visceral fat area (VFA) and subcutaneous fat area (SFA), for mortality. Methods: The study included 36 656 participants who underwent abdominal CT as part of a health check-up at a single university-affiliated healthcare center in 2007 to 2015. Of those, 32 593 participants with data regarding vital status as of May 2016 were included in the final analysis. The main factors evaluated were VFA, SFA and visceral-to-subcutaneous fat area ratio (VSR), and the primary outcome was all-cause mortality. Results: There were 253 deaths during a mean follow-up of 5.7 years. Increased SFA was associated with decreased all-cause mortality, whereas an increased VFA and VSR were related to increased all-cause mortality. Compared with the predictive power of body mass index (BMI), SFA and VSR showed a larger area under the curve than did BMI. In Kaplan–Meier survival curve analysis, increased SFA and VSR were associated with decreased and increased hazard of all-cause death, respectively. However, in multivariate Cox proportional hazard regression analysis, only VSR was independently associated with all-cause mortality. Moreover, this relationship was paralleled by the harmful impact of increased VSR on metabolic profiles. Conclusion: Increased VSR was an independent predictor of all-cause mortality. This suggests that the location of fat deposits may be more important than the actual amount of body fat.

Original languageEnglish
Pages (from-to)141-147
Number of pages7
JournalDiabetes, Obesity and Metabolism
Volume20
Issue number1
DOIs
StatePublished - 1 Jan 2018

Fingerprint

Body Fat Distribution
Adiposity
Subcutaneous Fat
Mortality
Intra-Abdominal Fat
Adipose Tissue
Body Mass Index
Tomography
Metabolome
Survival Analysis
Area Under Curve
Cause of Death
Fats
Regression Analysis
Delivery of Health Care
Health

Keywords

  • body composition
  • cohort study
  • insulin resistance

Cite this

Lee, Sung Woo ; Son, Jee Young ; Kim, Jeong Min ; Hwang, Seung Sik ; Han, Jin Suk ; Heo, Nam Ju. / Body fat distribution is more predictive of all-cause mortality than overall adiposity. In: Diabetes, Obesity and Metabolism. 2018 ; Vol. 20, No. 1. pp. 141-147.
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Body fat distribution is more predictive of all-cause mortality than overall adiposity. / Lee, Sung Woo; Son, Jee Young; Kim, Jeong Min; Hwang, Seung Sik; Han, Jin Suk; Heo, Nam Ju.

In: Diabetes, Obesity and Metabolism, Vol. 20, No. 1, 01.01.2018, p. 141-147.

Research output: Contribution to journalArticle

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T1 - Body fat distribution is more predictive of all-cause mortality than overall adiposity

AU - Lee, Sung Woo

AU - Son, Jee Young

AU - Kim, Jeong Min

AU - Hwang, Seung Sik

AU - Han, Jin Suk

AU - Heo, Nam Ju

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N2 - Aims: The relationship between directly measured body fat and all-cause mortality has been rarely studied. The aim of this study was to evaluate the predictive significance of computed tomography (CT)-measured body fat, including both visceral fat area (VFA) and subcutaneous fat area (SFA), for mortality. Methods: The study included 36 656 participants who underwent abdominal CT as part of a health check-up at a single university-affiliated healthcare center in 2007 to 2015. Of those, 32 593 participants with data regarding vital status as of May 2016 were included in the final analysis. The main factors evaluated were VFA, SFA and visceral-to-subcutaneous fat area ratio (VSR), and the primary outcome was all-cause mortality. Results: There were 253 deaths during a mean follow-up of 5.7 years. Increased SFA was associated with decreased all-cause mortality, whereas an increased VFA and VSR were related to increased all-cause mortality. Compared with the predictive power of body mass index (BMI), SFA and VSR showed a larger area under the curve than did BMI. In Kaplan–Meier survival curve analysis, increased SFA and VSR were associated with decreased and increased hazard of all-cause death, respectively. However, in multivariate Cox proportional hazard regression analysis, only VSR was independently associated with all-cause mortality. Moreover, this relationship was paralleled by the harmful impact of increased VSR on metabolic profiles. Conclusion: Increased VSR was an independent predictor of all-cause mortality. This suggests that the location of fat deposits may be more important than the actual amount of body fat.

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