• Jane J Lee, Alison Pedley, Kate E Therkelsen, Udo Hoffmann, Joseph M Massaro, Daniel Levy, and Michelle T Long.
• Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, Md; Framingham Heart Study, Mass.
• Am. J. Med. 2017 Aug 1; 130 (8): 958-966.e1.

BackgroundUpper body subcutaneous fat is a distinct fat depot that may confer increased cardiometabolic risk. We examined the cross-sectional associations between upper body subcutaneous fat volume and cardiometabolic risk factors.MethodsParticipants were patients from the Framingham Heart Study who underwent multi-detector computed tomography between 2008 and 2011. Sex-specific multivariable-adjusted regression analyses were conducted. Covariates included age, ethnicity, smoking status, alcohol intake, physical activity, postmenopausal status, and hormone replacement therapy. Additional models included adjustment for body mass index (BMI), neck circumference, or abdominal visceral adipose tissue.ResultsThere were 2306 participants (mean age 60 years, 54.4% women) included. Mean upper body subcutaneous fat was 309.9 cm3 in women and 345.6 cm3 in men. Higher upper body subcutaneous fat volume was associated with adverse cardiometabolic risk factors. In women and men, each additional 50-cm3 increment in upper body subcutaneous fat was associated with a 3.23 and 2.65 kg/m2 increase in BMI; 2.16 and 0.88 mm Hg increase in systolic blood pressure; 2.53 and 1.66 mg/dL increase in fasting plasma glucose; 0.12 and 0.11 mg/dL increase in log triglycerides; and 4.17 and 3.68 mg/dL decrease in high-density lipoprotein cholesterol, respectively (all P ≤.008). Similar patterns were observed with prevalent cardiometabolic risk factors. These associations remained significant after additional adjustment for BMI, neck circumference, or abdominal visceral adipose tissue.ConclusionsHigher upper body subcutaneous fat is cross-sectionally associated with adverse cardiometabolic risk factors. Our findings underscore the importance of subcutaneous adiposity in the upper body region that may provide a better understanding of the pathogenic properties of obesity in the development of cardiometabolic sequelae.Published by Elsevier Inc.

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