Relation Between Adiposity Measures and the Risk of a Composite of Cardiovascular Events, Diabetes, and Cancer in Patients With Cardiovascular Disease.

All adiposity measures except subcutaneous adipose tissue (SAT) were associated with higher risk of the composite outcome of recurrent cardiovascular events, incident type 2 diabetes, and incident cancer.

• Study used data from 6138 patients with cardiovascular disease from the UCC-SMART cohort study
• Cox proportional hazard models estimated HRs and 95% CIs for adiposity measures modelled as quartiles and per 1 SD increase
• SAT was the only adiposity measure not significantly related to the composite outcome
• Adiposity measures examined included waist circumference (WC), BMI, waist-to-height ratio (WtHR), abdominal subcutaneous adipose tissue (SAT), and visceral adipose tissue (VAT)

Waist circumference and visceral adipose tissue showed the strongest association with the composite outcome.

• WC HR 1.62 (95% CI: 1.43, 1.83) per 1 SD increase
• VAT HR 1.62 (95% CI: 1.44, 1.83) per 1 SD increase
• Both WC and VAT showed identical point estimates for the composite outcome
• The composite outcome included recurrent cardiovascular events, incident type 2 diabetes, and incident cancer

Only waist circumference and visceral adipose tissue were significantly associated with all-cause mortality.

• WC HR for all-cause mortality: 1.17 (95% CI: 1.01, 1.37) per 1 SD increase
• VAT HR for all-cause mortality: 1.26 (95% CI: 1.08, 1.46) per 1 SD increase
• BMI, WtHR, and SAT were not significantly associated with all-cause mortality
• VAT showed a stronger association with all-cause mortality than WC

The study population consisted of patients with established cardiovascular disease from the UCC-SMART cohort.

• 6138 patients with cardiovascular disease were included
• The UCC-SMART cohort study provided the data source
• Multiple adiposity measures were assessed including both clinical measures (WC, BMI, WtHR) and imaging-derived measures (SAT, VAT)
• Outcomes included recurrent cardiovascular events, incident type 2 diabetes, incident cancer, and all-cause mortality

Monitoring adiposity with waist circumference and VAT was recommended to identify high-risk patients and guide earlier interventions in those with cardiovascular disease.

• WC is a practical clinical measure that showed equivalent composite outcome risk association to VAT (HR 1.62 for both)
• VAT was additionally associated with all-cause mortality (HR 1.26, 95% CI: 1.08, 1.46)
• The authors concluded that WC and VAT monitoring 'may help identify high-risk patients and could guide earlier interventions'
• SAT did not show significant associations, suggesting location of fat deposition matters more than total adiposity alone