For men aged 65 and older, central obesity might not be an effective predictor for atherosclerotic cardiovascular disease events, according to a study published in the Journal of the American Heart Association.
The investigators of this large cohort study sought to estimate the associations of visceral adipose tissue and the android-gynoid fat mass ratio in older men with incident atherosclerotic cardiovascular disease events and determine whether these measures of central obesity could predict atherosclerotic cardiovascular disease in this population.
The study cohort included 2899 men aged 65 years or older enrolled in the Outcomes of Sleep Disorders in Older Men study with data on incident atherosclerotic cardiovascular disease events, including myocardial infarction, coronary heart disease death, or fatal or nonfatal stroke. Of the 2899 participants, 424 men (14.6%) reported an incident atherosclerotic cardiovascular disease event during a mean follow-up period of 7.9 years.
In the overall cohort, incident atherosclerotic cardiovascular disease events were not associated with visceral adipose tissue or android-gynoid fat mass ratio, even after multivariable adjustment; the hazard ratio per standard deviation increase for visceral adipose tissue was 1.02 (95% CI, 0.92-1.13) and for android-gynoid fat mass ratio was 1.05 (95% CI, 0.95-1.17).
Men who experienced an incident atherosclerotic cardiovascular disease event were independently associated with factors that included increasing age, higher systolic blood pressure, and a greater likelihood to report use of hypertension medications at baseline.
The study investigators estimated the hazard ratios for incident atherosclerotic cardiovascular disease events per standard deviation increase of visceral adipose tissue measurements or android-gynoid fat mass ratio using proportional hazard models, adjusting for age, education, race, systolic blood pressure, smoking status, oxidized low-density lipoprotein level, presence of diabetes, statin use, aspirin use, or treatment for hypertension.
A limitation of the study is a cohort of only older, primarily white men, meaning the findings are not generalizable to women, younger populations, or other racial/ethnic groups. Furthermore, participants self-reported baseline diagnoses of comorbid conditions, and researchers did not confirm them through medical records.
Among older men, central obesity, as measured by visceral adipose tissue and android-gynoid fat mass ratio, had no significant association with incident atherosclerotic cardiovascular disease events. The authors suggest that weight loss to reduce central obesity may not reduce risk of incident atherosclerotic cardiovascular disease events in obese men over 65.
Schousboe JT, Kats AM, Langsetmo L, et al. Central obesity and visceral adipose tissue are not associated with incident atherosclerotic cardiovascular disease events in older men [published online August 20, 2018]. J Am Heart Assoc. doi:10.1161/JAHA.118.009172