Endocrinol Metab.  2014 Mar;29(1):1-4. 10.3803/EnM.2014.29.1.1.

Ectopic Fat Assessment Focusing on Cardiometabolic and Renal Risk

• Lim S

• KMID: 2169344
• DOI: http://doi.org/10.3803/EnM.2014.29.1.1

Abstract

It is well known that people with high levels of body fat are at higher risk for developing diabetes mellitus, kidney disease, and cardiovascular disorders. Since individuals who are slightly overweight, or even individuals of normal weight, can vary in body fat distribution, their metabolic profiles and the degree of association of these profiles with cardiometabolic risk factors may differ. Fat distribution might be more of a predictive factor for cardiorenometabolic risk than obesity itself, which has led researchers to investigate whether ectopic fat accumulation may partially account for the development of cardiorenometabolic disorders. In addition to visceral obesity, fat can accumulate in the liver and muscle, and these intrahepatic and intramuscular lipid stores are associated with insulin resistance and adverse metabolic phenotypes. More recently, pericardial fat, perivascular fat, and perirenal fat were found to be associated with coronary atherosclerosis, cardiovascular diseases, and kidney damage, respectively. Thus, regional fat distribution may play a key role in understanding the development of cardiorenometabolic diseases in nonobese people.

Keyword

Ectopic fat; Cardiorenometabolic risk; Imaging techniques

MeSH Terms

Adipose Tissue
Body Fat Distribution
Cardiovascular Diseases
Coronary Artery Disease
Diabetes Mellitus
Insulin Resistance
Kidney
Kidney Diseases
Liver
Metabolome
Muscles
Obesity
Obesity, Abdominal
Overweight
Phenotype
Risk Factors

Reference

1. Lim S, Despres JP, Koh KK. Prevention of atherosclerosis in overweight/obese patients: in need of novel multi-targeted approaches. Circ J. 2011; 75:1019–1027.

2. Speliotes EK, Massaro JM, Hoffmann U, Vasan RS, Meigs JB, Sahani DV, Hirschhorn JN, O'Donnell CJ, Fox CS. Fatty liver is associated with dyslipidemia and dysglycemia independent of visceral fat: the Framingham Heart Study. Hepatology. 2010; 51:1979–1987.

3. Lo L, McLennan SV, Williams PF, Bonner J, Chowdhury S, McCaughan GW, Gorrell MD, Yue DK, Twigg SM. Diabetes is a progression factor for hepatic fibrosis in a high fat fed mouse obesity model of non-alcoholic steatohepatitis. J Hepatol. 2011; 55:435–444.

4. Meshkani R, Adeli K. Hepatic insulin resistance, metabolic syndrome and cardiovascular disease. Clin Biochem. 2009; 42:1331–1346.

5. Targher G, Bertolini L, Poli F, Rodella S, Scala L, Tessari R, Zenari L, Falezza G. Nonalcoholic fatty liver disease and risk of future cardiovascular events among type 2 diabetic patients. Diabetes. 2005; 54:3541–3546.

6. Qayyum A, Chen DM, Breiman RS, Westphalen AC, Yeh BM, Jones KD, Lu Y, Coakley FV, Callen PW. Evaluation of diffuse liver steatosis by ultrasound, computed tomography, and magnetic resonance imaging: which modality is best? Clin Imaging. 2009; 33:110–115.

7. Petersen KF, Dufour S, Befroy D, Garcia R, Shulman GI. Impaired mitochondrial activity in the insulin-resistant offspring of patients with type 2 diabetes. N Engl J Med. 2004; 350:664–671.

8. Phillips DI, Caddy S, Ilic V, Fielding BA, Frayn KN, Borthwick AC, Taylor R. Intramuscular triglyceride and muscle insulin sensitivity: evidence for a relationship in nondiabetic subjects. Metabolism. 1996; 45:947–950.

9. Kelley DE, Goodpaster BH. Skeletal muscle triglyceride: an aspect of regional adiposity and insulin resistance. Diabetes Care. 2001; 24:933–941.

10. Snijder MB, Visser M, Dekker JM, Goodpaster BH, Harris TB, Kritchevsky SB, De Rekeneire N, Kanaya AM, Newman AB, Tylavsky FA, Seidell JC. Health ABC Study. 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.

11. Hansen RD, Williamson DA, Finnegan TP, Lloyd BD, Grady JN, Diamond TH, Smith EU, Stavrinos TM, Thompson MW, Gwinn TH, Allen BJ, Smerdely PI, Diwan AD, Singh NA, Singh MA. Estimation of thigh muscle cross-sectional area by dual-energy X-ray absorptiometry in frail elderly patients. Am J Clin Nutr. 2007; 86:952–958.

12. Goodpaster BH, Thaete FL, Kelley DE. Thigh adipose tissue distribution is associated with insulin resistance in obesity and in type 2 diabetes mellitus. Am J Clin Nutr. 2000; 71:885–892.

13. Rosito GA, Massaro JM, Hoffmann U, Ruberg FL, Mahabadi AA, Vasan RS, O'Donnell CJ, Fox CS. Pericardial fat, visceral abdominal fat, cardiovascular disease risk factors, and vascular calcification in a community-based sample: the Framingham Heart Study. Circulation. 2008; 117:605–613.

14. Yudkin JS, Eringa E, Stehouwer CD. "Vasocrine" signalling from perivascular fat: a mechanism linking insulin resistance to vascular disease. Lancet. 2005; 365:1817–1820.

15. Iacobellis G, Assael F, Ribaudo MC, Zappaterreno A, Alessi G, Di Mario U, Leonetti F. Epicardial fat from echocardiography: a new method for visceral adipose tissue prediction. Obes Res. 2003; 11:304–310.

16. Kim TH, Yu SH, Choi SH, Yoon JW, Kang SM, Chun EJ, Choi SI, Shin H, Lee HK, Park KS, Jang HC, Lim S. Pericardial fat amount is an independent risk factor of coronary artery stenosis assessed by multidetector-row computed tomography: the Korean Atherosclerosis Study 2. Obesity (Silver Spring). 2011; 19:1028–1034.

17. Fluchter S, Haghi D, Dinter D, Heberlein W, Kuhl HP, Neff W, Sueselbeck T, Borggrefe M, Papavassiliu T. Volumetric assessment of epicardial adipose tissue with cardiovascular magnetic resonance imaging. Obesity (Silver Spring). 2007; 15:870–878.

18. Henrichot E, Juge-Aubry CE, Pernin A, Pache JC, Velebit V, Dayer JM, Meda P, Chizzolini C, Meier CA. Production of chemokines by perivascular adipose tissue: a role in the pathogenesis of atherosclerosis? Arterioscler Thromb Vasc Biol. 2005; 25:2594–2599.

19. Schlett CL, Massaro JM, Lehman SJ, Bamberg F, O'Donnell CJ, Fox CS, Hoffmann U. Novel measurements of periaortic adipose tissue in comparison to anthropometric measures of obesity, and abdominal adipose tissue. Int J Obes (Lond). 2009; 33:226–232.

20. Rittig K, Staib K, Machann J, Bottcher M, Peter A, Schick F, Claussen C, Stefan N, Fritsche A, Haring HU, Balletshofer B. Perivascular fatty tissue at the brachial artery is linked to insulin resistance but not to local endothelial dysfunction. Diabetologia. 2008; 51:2093–2099.

21. Chughtai HL, Morgan TM, Rocco M, Stacey B, Brinkley TE, Ding J, Nicklas B, Hamilton C, Hundley WG. Renal sinus fat and poor blood pressure control in middle-aged and elderly individuals at risk for cardiovascular events. Hypertension. 2010; 56:901–906.

22. Montani JP, Carroll JF, Dwyer TM, Antic V, Yang Z, Dulloo AG. Ectopic fat storage in heart, blood vessels and kidneys in the pathogenesis of cardiovascular diseases. Int J Obes Relat Metab Disord. 2004; 28:Suppl 4. S58–S65.

23. Reisin E, Jack AV. Obesity and hypertension: mechanisms, cardio-renal consequences, and therapeutic approaches. Med Clin North Am. 2009; 93:733–751.

24. Foster MC, Hwang SJ, Porter SA, Massaro JM, Hoffmann U, Fox CS. Development and reproducibility of a computed tomography-based measurement of renal sinus fat. BMC Nephrol. 2011; 12:52.

25. Lamacchia O, Nicastro V, Camarchio D, Valente U, Grisorio R, Gesualdo L, Cignarelli M. Para- and perirenal fat thickness is an independent predictor of chronic kidney disease, increased renal resistance index and hyperuricaemia in type-2 diabetic patients. Nephrol Dial Transplant. 2011; 26:892–898.