Journal article
Body Fat Distribution, Cardiometabolic Traits, and Risk of Major Lower-Extremity Arterial Disease in Postmenopausal Women
Diabetes care, Vol.45(1), pp.222-231
01/01/2022
DOI: 10.2337/dc21-1565
PMCID: PMC8753769
PMID: 34732526
Abstract
To assess the relationship between body fat distribution and incident lower-extremity arterial disease (LEAD).
We included 155,925 postmenopausal women with anthropometric measures from the Women's Health Initiative who had no known LEAD at recruitment. A subset of 10,894 participants had body composition data quantified by DXA. Incident cases of symptomatic LEAD were ascertained and adjudicated through medical record review.
We identified 1,152 incident cases of LEAD during a median 18.8 years follow-up. After multivariable adjustment and mutual adjustment, waist and hip circumferences were positively and inversely associated with risk of LEAD, respectively (both P-trend < 0.0001). In a subset (n = 22,561) where various cardiometabolic biomarkers were quantified, a similar positive association of waist circumference with risk of LEAD was eliminated after adjustment for diabetes and HOMA of insulin resistance (P-trend = 0.89), whereas hip circumference remained inversely associated with the risk after adjustment for major cardiometabolic traits (P-trend = 0.0031). In the DXA subset, higher trunk fat (P-trend = 0.0081) and higher leg fat (P-trend < 0.0001) were associated with higher and lower risk of LEAD, respectively. Further adjustment for diabetes, dyslipidemia, and blood pressure diminished the association for trunk fat (P-trend = 0.49), yet the inverse association for leg fat persisted (P-trend = 0.0082).
Among U.S. postmenopausal women, a positive association of upper-body fat with risk of LEAD appeared to be attributable to traditional risk factors, especially insulin resistance. Lower-body fat was inversely associated with risk of LEAD beyond known risk factors.
Details
- Title: Subtitle
- Body Fat Distribution, Cardiometabolic Traits, and Risk of Major Lower-Extremity Arterial Disease in Postmenopausal Women
- Creators
- Guo-Chong Chen - Albert Einstein College of MedicineRhonda Arthur - Albert Einstein College of MedicineVictor Kamensky - Albert Einstein College of MedicineJin Choul Chai - Albert Einstein College of MedicineBing Yu - The University of Texas Health Science Center at HoustonAladdin H Shadyab - University of California SystemMatthew Allison - University of California SystemYangbo Sun - University of Tennessee Health Science CenterNazmus Saquib - Sulaiman Al Rajhi CollegesRobert A Wild - University of Oklahoma Health Sciences CenterWei Bao - University of IowaAndrew J Dannenberg - Cornell UniversityThomas E Rohan - Albert Einstein College of MedicineRobert C Kaplan - Fred Hutch Cancer CenterSylvia Wassertheil-Smoller - Albert Einstein College of MedicineQibin Qi - Albert Einstein College of Medicine
- Resource Type
- Journal article
- Publication Details
- Diabetes care, Vol.45(1), pp.222-231
- DOI
- 10.2337/dc21-1565
- PMID
- 34732526
- PMCID
- PMC8753769
- NLM abbreviation
- Diabetes Care
- ISSN
- 0149-5992
- eISSN
- 1935-5548
- Grant note
- HHSN268201600018C / NHLBI NIH HHS R01 HL140976 / NHLBI NIH HHS R01 DK120870 / NIDDK NIH HHS HHSN268201600003C / NHLBI NIH HHS P30 DK020541 / NIDDK NIH HHS HHSN268201600004C / NHLBI NIH HHS HHSN268201600002C / NHLBI NIH HHS HHSN268201600001C / NHLBI NIH HHS R01 DK119268 / NIDDK NIH HHS K01 HL129892 / NHLBI NIH HHS R01 HL146132 / NHLBI NIH HHS R01 HL060712 / NHLBI NIH HHS
- Language
- English
- Date published
- 01/01/2022
- Academic Unit
- Epidemiology
- Record Identifier
- 9984364544102771
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