Abdominal visceral and subcutaneous adipose tissue and associations with cardiometabolic risk in Inuit, Africans and Europeans: a cross-sectional study

• Published in: BMJ Open
• Main Authors: Rønn, Pernille Falberg, Andersen, Gregers Stig, Lauritzen, Torsten, Christensen, Dirk Lund, Aadahl, Mette, Carstensen, Bendix, Grarup, Niels, Jørgensen, Marit Eika
• Other Authors: Danida, Steno Diabetes Center A/S, Karen Elise Jensen’s Foundation, Cluster of International Health, Kong Christian den Tiende’s Foundation, Commission for Scientific Research in Greenland, Medical Research Council of Greenland, Dr. Thorvald Madsen’s Grant, Medical Research Council of Denmark, Dagmar Marshall Foundation, NunaFonden, Beckett Foundation, Timber Merchant Vilhelm Bang’s Foundation, Brdr. Hartmann Foundation, Hjerteforeningen, Centre for Arctic Health, Health Insurance Foundation
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMJ 2020
• Subjects: General Medicine; Greenland; inuit
• Online Access: http://dx.doi.org/10.1136/bmjopen-2020-038071; https://syndication.highwire.org/content/doi/10.1136/bmjopen-2020-038071

Objectives Abdominal fat has been identified as a risk marker of cardiometabolic disease independent of overall adiposity. However, it is not clear whether there are ethnic disparities in this risk. We investigated the associations of visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue (SAT) with cardiometabolic risk factors in three ethnic diverse populations of Inuit, Africans and Europeans. Design Cross-sectional pooled study. Setting Greenland, Kenya and Denmark. Methods A total of 5113 participants (2933 Inuit, 1397 Africans and 783 Europeans) from three studies in Greenland, Kenya and Denmark were included. Measurements included abdominal fat distribution assessed by ultrasound, oral glucose tolerance test, hepatic insulin resistance, blood pressure and lipids. The associations were analysed using multiple linear regressions. Results Across ethnic group and gender, an increase in VAT of 1 SD was associated with higher levels of hepatic insulin resistance (ranging from 14% to 28%), triglycerides (8% to 16%) and lower high-density lipoprotein cholesterol (HDL-C, −1.0 to −0.05 mmol/L) independent of body mass index. VAT showed positive associations with most of the other cardiometabolic risk factors in Inuit and Europeans, but not in Africans. In contrast, SAT was mainly associated with the outcomes in Inuit and Africans. Of notice was that higher SAT was associated with higher HDL-C in African men (0.11 mmol/L, 95% CI: 0.03 to 0.18) and with lower HDL-C in Inuit (−0.07 mmol/L, 95% CI: -0.12 to –0.02), but not in European men (−0.02 mmol/L, 95% CI: −0.09 to 0.05). Generally weaker associations were observed for women. Furthermore, the absolute levels of several of the cardiometabolic outcomes differed between the ethnic groups. Conclusions VAT and SAT were associated with several of the cardiometabolic risk factors beyond overall adiposity. Some of these associations were specific to ethnicity, suggesting that ethnicity plays a role in the pathway from abdominal fat to selected ...