Nutrition and adipose tissue distribution in low cardiovascular risk individuals, depending on the central obesity

Abstract

The low cardiovascular risk group according to SCORE in relation to the clinical and laboratory characteristics of patients is very heterogeneous, which leads to the presence of a residual risk of cardiovascular events. This category may include individuals with a family history of cardiovascular disease at a young age, with abdominal obesity (AO), endothelial dysfunction, and high levels of triglyceride-rich lipoproteins. In this regard, an active search is underway for new metabolic markers within the low cardiovascular risk group.

The purpose of the study was to compare the nutrition, the adipose tissue distribution in low cardiovascular risk individuals, depending on the AO.

Material and methods. The study included 86 healthy low risk (SCORE<1%) patients (mean age 42.6±2 years), who were divided into 2 groups: with AO [waist circumference (WC) ≥94 cm in men and ≥80 cm in women] – 44 patients (32% of men) and without AO – 42 patients (38% of men). The body composition was carried out using the bioimpedance analyzer. The distribution of ectopic fat deposits in the liver, pancreas and epicardial region was studied using ultrasound methods. A frequency questionnaire (Diet Risk Score) was used to assess nutrition.

Results. In low risk patients with AO, signs of unhealthy diet are statistically significantly more common (in 52 in the main group vs 2% in the control group, p<0.01), ectopic deposition of adipose tissue in the liver (53 vs 9%, p<0.001), pancreas (56% in the main group, absent in the control group, p<0.001), epicardia l region (the epicardial fat thickness median is 4.24 mm in the main group vs 2.15 mm in the control group) compared with a control group.

Conclusion. The low cardiovascular risk group is very heterogeneous. One of the markers of heterogeneity is central obesity – a marker of unhealthy diet, subclinical ectopic fat deposition and hypertriglyceridemia. Patients with AO of the low cardiovascular risk group require a more thorough examination with the obligatory determination of waist circumference, ultrasound assessment of the liver and pancreas parenchyma, and determination of the epicardial fat thickness. Using a short nutrition questionnaire allows you to quickly identify signs of unhealthy diet and discuss them with the patient.

Keywords:abdominal obesity; epicardial fat thickness; steatosis; low cardiovascular risk; nutrition scale

Funding. The study was not sponsored.

Conflict of interest. Authors declare no conflict of interest.

Contribution. Concept and design of the study – Eliashevich S.O., Drapkina O.M.; collecting and processing the material – Eliashevich S.O., Kuznetsovа A.V.; statistical data processing – Khudyakov M.B., Senko O.V.; text writing – Eliashevich S.O., Nunez Araujo D.D.; editing – Drapkina O.M., Kim O.T.; approval of the final version of the article; responsibility for the integrity of all parts of the article – all authors.

For citation: Eliashevich S.O., Khudyakov M.B., Senko O.V., Kuznetsova A.V., Kim O.T., Nunes Araukho D.D., Drapkina О.М. Nutrition and adipose tissue distribution in low cardiovascular risk individuals, depending on the central obesity. Voprosy pitaniia [Problems of Nutrition]. 2023; 92 (1): 74–84. DOI: https://doi.org/10.33029/0042-8833-2023-92-1-74-84 (in Russian)

References

1. Hoogeveen R.C., Ballantyne C.M. Residual cardiovascular risk at low LDL: Remnants, Lipoprotein(a), and Inflammation. Clin Chem. 2021; 67 (1): 143–53. DOI: https://doi.org/10.1093/clinchem/hvaa252

2. Visseren F.L.J., Mach F., Smulders Y.M., Carballo D., Koskinas K.C., Bäck M., et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice: Developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies with the special contribution of the European Association of Preventive Cardiology (EAPC). Eur J Prev Cardiol. 2022; 29 (1): 5–115. https://doi.org/10.1093/eurjpc/zwab154

3. Chiuve S.E., Rexrode K.M., Spiegelman D., Logroscino G., Manson J.A.E., Rimm E.B. Primary prevention of stroke by healthy lifestyle. Circulation. 2008; 118 (9): 947–54. DOI: https://doi.org/10.1161/CIRCULATIONAHA.108.781062

4. Spenc J.D. Nutrition and risk of stroke. Nutrients. 2019; 11 (3): 647. DOI: https://doi.org/10.3390/nu11030647

5. Kuharchuk V.V., Ezhov M.V., Sergienko I.V., Arabidze G.G., Bubnova M.G., Balakhonova T.V., et al. Diagnostics and correction of lipid metabolism disorders in order to prevent and treat of atherosclerosis. Russian recommendations, VII revision. Ateroskleroz i dislipidemii [Atherosclerosis and Dyslipidemia]. 2020; 1 (38): 7–42. DOI: https://doi.org/10.34687/2219-8202.JAD.2020.01.0002 (in Russian)

6. Grundy S.M., Stone N.J., Bailey A.L., Beam C., Birtcher K.K., Blumenthal R.S., et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019; 73 (24): 3168–209. DOI: https://doi.org/10.1016/j.jacc.2018.11.002

7. Drapkina O.M., Karamnova N.S., Kontsevaya A.V., Gorny B.E., Dadaeva V.A., Drozdova L.Yu., et al. Russian Society for the Prevention of Noncommunicable Diseases (ROPNIZ). Alimentary-dependent risk factors for chronic non-communicable diseases and eating habits: dietary correction within the framework of preventive counseling. Methodological Guidelines. Kardiovaskulyarnaya terapiya i profilaktika [Cardiovascular Therapy and Prevention]. 2021; 20 (5): 273–334. DOI: https://doi.org/10.15829/1728-8800-2021-2952 (in Russian)

8. Chait A., den Hartigh L.J. Adipose tissue distribution, inflammation and its metabolic consequences, including diabetes and cardiovascular disease. Front Cardiovasc Med. 2020; 7: 22. DOI: https://doi.org/10.3389/fcvm.2020.00022

9. Iacobellis G. Local and systemic effects of the multifaceted epicardial adipose tissue depot. Nat Rev Endocrinol. 2015; 11 (6): 363–71. DOI: https://doi.org/10.1038/nrendo.2015.58

10. Gaborit B., Venteclef N., Ancel P., Pelloux V., Gariboldi V., Leprince P., et al. Human epicardial adipose tissue has a specific transcriptomic signature depending on its anatomical peri-atrial, peri-ventricular, or peri-coronary location. Cardiovasc Res. 2015; 108 (1): 62–73. DOI: https://doi.org/10.1093/cvr/cvv208

11. Al-Daghri N.M., Al-Attas О.S., Alokail M.S., Alkharfy K.M., Charalampidis P., Livadas S., et al. Visceral adiposity index is highly associated with adiponectin values and glycaemic disturbances. Eur J Clin Invest. 2013; 43 (2): 183–9. DOI: https://doi.org/10.1111/eci.12030

12. Johnston E.A., Petersen K.S., Beasley J.M., Krussig T., Mitchell D.C., Van Horn L.V., et al. Relative validity and reliability of a diet risk score (DRS) for clinical practice. BMJ Nutr Prev Health. 2020; 3 (2): 263–9. DOI: https://doi.org/10.1136/bmjnph-2020-000134

13. Heinrich K.M., Gurevich K.G., Arkhangelskaia A.N., Karazhelyaskov O.P., Poston W.S.C. Despite low obesity rates, body mass index under-estimated obesity among Russian police officers when compared to body fat percentage. Int J Environ Res Public Health. 2020; 17 (6): 1937. DOI: https://doi.org/10.3390/ijerph17061937

14. Toledano B., Yap E.M., Vilela G. Normal weight central obesity among Filipinos and its association with cardiovascular diseases: a cross-sectional study. Eur Heart J. 2022; 43 (1): 194–5. DOI: https://doi.org/10.1093/eurheartj/ehab849.155

15. Raffield L.M., Howard A.G., Graff M., Lin D.Y., Cheng S., Demerath E., et al. Obesity duration, severity, and distribution trajectories and cardiovascular disease risk in the atherosclerosis risk in communities study. J Am Heart Assoc. 2021; 10 (24): e019946. DOI: https://doi.org/10.1161/JAHA.121.019946

16. Neif G., Musse V., Moreira T., Kimura M., Pereira F.W.L., Okoshi K., et al. Skipping breakfast concomitant with late-night dinner eating is associated with worse outcomes following ST-segment elevation myocardial infarction. Eur J Prev Cardiol. 2020; 27 (19): 2311–3. DOI: https://doi.org/10.1177/2047487319839546

17. Neeland I.J., Poirier P., Despres J.P. Cardiovascular and metabolic heterogeneity of obesity: clinical challenges and implications for management. Circulation. 2018; 137 (13): 1391–406. DOI: https://doi.org/10.1161/CIRCULATIONAHA.117.029617

18. Reis J.P., Allen N., Gunderson E.P., Lee J.M., Lewis C.E., Loria C.M., et al. Excess body mass index-and waist circumference-years and incident cardiovascular disease: the CARDIA study. Obesity (Silver Spring). 2015; 23 (4): 879–85. DOI: https://doi.org/10.1002/oby.21023

19. Reis J.P., Hankinson A.L., Loria C.M., Lewis C.E., Powell-Wiley T.M., Wei G.S., et al. Duration of abdominal obesity beginning in young adulthood and incident diabetes through middle age: the CARDIA study. Diabetes Care. 2013; 36 (5): 1241–7. DOI: https://doi.org/10.2337/dc12-1714

20. Reis J.P., Loria C.M., Lewis C.E., Powell-Wiley T.M., Wei G.S., Carr J.J., et al. Association between duration of overall and abdominal obesity beginning in young adulthood and coronary artery calcification in middle age. JAMA. 2013; 310 (3): 280–8. DOI: https://doi.org/10.1001/jama.2013.7833

21. Pischon T., Boeing H., Hoffmann K., Bergmann M., Schulze M.B., Overvad K., et al. General and abdominal adiposity and risk of death in Europe. N Engl J Med. 2008; 359 (20): 2105–20. DOI: https://doi.org/10.1056/NEJMoa0801891

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CHIEF EDITOR
CHIEF EDITOR
Viktor A. Tutelyan
Full Member of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor, Scientific Director of the Federal Research Centre of Nutrition, Biotechnology and Food Safety (Moscow, Russia)

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