The more visceral fat that is present in the body, the greater the burden of atherosclerotic plaque narrowing and weakening major blood vessels. This isn’t just for those people who are very overweight, but the data shows that any degree of excess visceral fat correlates with a relative degree of acceleration of atherosclerosis: the more fat the worse the outcome. Visceral fat also contributes to other age-related conditions, with the most likely link being promotion of chronic inflammation via a number of different mechanisms. Visceral fat tissue promotes a greater burden of cellular senescence, fat cells produce signaling that mimics infected cells, and so forth.
Visceral fat (VAT), a type of fat stored in the abdomen, and buildup of fat within the liver are known to increase type 2 diabetes, high blood pressure, and heart disease risk. This study aims to see how these types of fat affect artery health. Participants in the Canadian Alliance of Healthy Hearts and Minds (CAHHM) cohort study (n = 6760; average age = 57.1; 54.9% female) underwent MRI for VAT volume, hepatic fat fraction (HFF), and carotid atherosclerosis assessed by carotid wall volume (CWV). Regression models were used to assess the associations of VAT and HF with carotid atherosclerosis, separately in males and females, controlling for other cardiovascular risk factors. Associations of VAT and proton-density hepatic fat fraction (PDFF) with ultrasound-measured carotid-intima media thickness (CIMT) were also assessed in the UK Biobank (UKB; n = 26,547; average age = 54.7; 51.9% female).
In CAHHM, we show that a 1 standard deviation higher VAT volume is associated with a 6.16 mm^3 higher CWV, but there is no association between HFF and CWV. In the UK Biobank cohort, a 1 standard deviation higher VAT volume is associated with a 0.016 ± 0.009 mm higher CIMT, and a 1 standard deviation higher PDFF is associated with a 0.012 ± 0.010 mm higher CIMT. After adjustment for CV risk factors, these associations are attenuated. A pooled analyses of CAHHM and UKB support a direct, positive association of VAT and HFF with subclinical atherosclerosis in both sexes, albeit slightly weaker for hepatic fat. Thus visceral fat, and to a lesser extent, hepatic fat, are associated with increased carotid atherosclerosis.
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