Journal
FRONTIERS IN ENDOCRINOLOGY
Volume 13, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fendo.2022.922931
Keywords
systematic review; visceral adipose tissue; abdominal visceral fat; fatal outcome; all-cause mortality
Categories
Funding
- Fogarty International Center and Office of Dietary Supplements of the National Institutes of Health
- [D43 TW009118]
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This study examined the association between abdominal visceral adipose tissue (VAT) parameters and all-cause mortality risk. The findings suggest that a higher abdominal VAT area is associated with increased mortality risk in individuals aged 65 years or younger, possibly mediated by metabolic complications. However, this association becomes weaker and may even reverse in older individuals.
Introduction: Increased abdominal visceral adipose tissue (VAT) implies an adverse cardio-metabolic profile. We examined the association of abdominal VAT parameters and all-cause mortality risk. Methods: We systematically searched four databases. We performed citations/articles screening, data abstraction, and quality assessment in duplicate and independently (CRD42020205021). Results: We included 12 cohorts, the majority used computed tomography to assess abdominal VAT area. Six cohorts with a mean age <= 65 years, examining all-cause mortality risk per increment in VAT area (cm(2)) or volume (cm(3)), showed a 11-98% relative risk increase with higher VAT parameters. However, the association lost significance after adjusting for glycemic indices, body mass index, or other fat parameters. In 4 cohorts with a mean age > 65 years, the findings on mortality were inconsistent. Conversely, in two cohorts (mean age 73-77 years), a higher VAT density, was inversely proportional to VAT area, and implied a higher mortality risk. Conclusion: A high abdominal VAT area seems to be associated with increased all-cause mortality in individuals & LE; 65 years, possibly mediated by metabolic complications, and not through an independent effect. This relationship is weaker and may reverse in older individuals, most likely secondary to confounding bias and reverse causality. An individual participant data meta-analysis is needed to confirm our findings, and to define an abdominal VAT area cutoff implying increased mortality risk.
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