Fatty Liver, Abdominal Visceral Fat, and Cardiometabolic Risk Factors The Jackson Heart Study

Objective-The goal of this study was to examine whether fatty liver and abdominal visceral adipose tissue (VAT) are jointly associated with cardiometabolic abnormalities. Methods and Results-Black participants were from the Jackson Heart Study (n = 2882, 65% women) who underwent computed tomography. Fatty liver was measured by liver attenuation in Hounsfield units (LA), and VAT was quantified volumetrically. Cross-sectional associations between LA, VAT, and cardiometabolic risk factors were assessed using linear and logistic regression, and their joint associations were further examined in 4 subgroups: high-LA/low-VAT (n = 1704), low-LA/low-VAT (n = 422), high-LA/high-VAT (n = 436), and low-LA/high-VAT (n = 320). Both LA and VAT were associated with most cardiometabolic traits (all P < 0.0001), which persisted after additional adjustment for each other (LA, P < 0.01-0.0001; VAT, P < 0.0001). In bootstrap analyses, the regression coefficient of VAT was significantly greater than LA for triglycerides, high-density lipoprotein cholesterol, impaired glucose, and metabolic syndrome (P = 0.009-0.0001). The interaction between LA and VAT was significant for high-density lipoprotein cholesterol (P = 0.002), impaired glucose (P = 0.003), and metabolic syndrome (P = 0.04). Among 4 subgroups, participants with higher VAT and lower LA had higher prevalence of cardiometabolic traits than those with each condition alone. Conclusion-Both fatty liver and VAT are independent correlates of cardiometabolic risk, but the associations are stronger for VAT than for fatty liver. (Arterioscler Thromb Vasc Biol. 2011;31:2715-2722.)