Visceral Adipose Tissue and Cardiovascular Disease Risk
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NOVEL AND EMERGING RISK FACTORS (N WONG AND C LEWIS, SECTION EDITORS)
Visceral Adipose Tissue and Cardiovascular Disease Risk Jan M. Hughes-Austin & Britta A. Larsen & Matthew A. Allison
Published online: 5 February 2013 # Springer Science+Business Media New York 2013
Abstract Adipose tissue has been recognized as an endocrine organ. Cytokines released from adipose tissue not only influence lipid metabolism, they also affect multiple organ systems such as the immune and nervous systems, and of interest in this review, the cardiovascular system. While there are multiple depots of adipose tissue, visceral adipose tissue appears to be the most metabolically active. This fat depot has been linked to dysfunction of the vascular endothelium with the subsequent development of atherosclerosis and incident cardiovascular events. In this regard and within the last two years, several studies have examined the effect of visceral adipose tissue on subclinical and clinical CVD outcomes. This review highlights these findings and focuses on the associations between visceral adipose tissue and ethnicity, risk factors, vascular changes, clinical effects and cardiovascular disease outcomes. Keywords Visceral adipose tissue . Visceral fat . Cardiovascular disease . Atherosclerosis . Coronary artery calcium . Visceral fat risk factors . Oxidative stress
J. M. Hughes-Austin (*) : B. A. Larsen Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, 9500 Gilman Drive, Mail Code 0607, La Jolla, CA 92093-0607, USA e-mail: [email protected] B. A. Larsen e-mail: [email protected] M. A. Allison Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, 9500 Gilman Drive, Mail Code 0965, La Jolla, CA 92093-0965, USA e-mail: [email protected]
Introduction It is well established that overweight and obesity (BMI>25 and BMI>30, respectively) significantly contribute to cardiovascular disease risk. Not everyone with this phenotype, however, experiences the same metabolic risk. Conversely, the obesity paradox suggests that even those with normal BMI may have increased CVD risk, not because of the excess energy storage per se, but because of underlying disease or potentially where this excess energy is stored [1]. In this respect, recent studies have investigated various adipose tissue depots (such as visceral, subcutaneous, pericardial, intramuscular, and intrathoracic adipose tissue) and whether they differentially affect risk for cardiovascular disease. Because of its local and systemic effects on organ systems, and more specifically, cardiovascular function, visceral adipose tissue (VAT) has been the focus of many recent research studies. In this review, we focus on the most recent literature, from 2011 through 2012, concerning associations between visceral adipose tissue and ethnicity, risk factors, vascular changes, clinical effects and cardiovascular disease outcomes in order to better understand the role that visceral adipose tissue plays in cardi
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