Cardiovasc Diabetol. 2024;23(1):44.

Independent association of thigh muscle fat density with vascular events in Korean adults.

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제1저자 최훈지 · 교신저자 임수

PMID 38281946 PMC10823598 DOI 10.1186/s12933-024-02138-w IF 15.6 내분비대사내과

소속 (6)

Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, South Korea.
Seoul National University College of Medicine, Seoul, South Korea.
Department of Radiology, Seoul National University Bundang Hospital, Seongnam, South Korea.
Helmholtz Institute for Metabolic, Obesity and Vascular Research of the Helmholtz Zentrum München at the University of Leipzig and University Hospital, Leipzig, Germany.
Pennington Biomedical Research Center, Baton Rouge, LA, USA.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam, 13620, South Korea. limsoo@snu.ac.kr.

Abstract

BACKGROUND We aimed to explore the associations between thigh muscle fat density and vascular events.

METHODS A total of 3,595 adults (mean age, 57.2 years; women, 1,715 [47.7%]) without baseline cardiovascular events from the Korean Atherosclerosis Study-2 were included. Muscle and fat area at the mid-thigh level were measured by computed tomography (CT) using the following Hounsfield Unit range: 0-30 for low density muscle (LDM); 31-100 for normal density muscle (NDM); and - 250 to - 50 for fat.

RESULTS During a median follow-up period of 11.8 (4.3-13.9) years, vascular events occurred in 11.6% of men and 5.9% of women. Individuals with vascular events had a larger LDM area (men: 48.8 ± 15.5 cm² vs. 44.6 ± 14.5 cm²; women: 39.4 ± 13.2 cm² vs. 35.0 ± 11.8 cm², both P < 0.001) compared with those who did not have vascular events during the follow-up of at least 5 years. The LDM/NDM ratio was also independently associated with vascular events after adjusting for cardiometabolic risk factors. Moreover, the LDM/NDM ratio improved the prognostic value for vascular events when added to conventional risk factors.

CONCLUSIONS The current study suggests that a higher thigh muscle fat infiltration is associated with an increased risk of developing vascular events among Korean adults.

Keywords

Cardiovascular diseaseCoronary artery diseaseEctopic fatMyosteatosis

Figures

**Fig. 1** **(A)** Measurement of visceral fat area at umbilical level. **(B)** Measurement of fat area and low density muscle (LDM) and normal density muscle (NDM) area at mid-thigh level. C and D. Representative photos of individuals who had small LDM and large NDM area **(C)** and who had large LDM and small NDM area **(D)**

**Fig. 2** Incidence of vascular event according to **(A)** LDM area (cm²) or **(B)** LDM/NDM ratio (%). Red and blue indicates the participants who did or did not develop the disease, respectively. VE, vascular event; CAD, coronary artery disease; CeVD, cerebrovascular disease; PAD, peripheral artery disease. P value between the groups is listed above the bars

**Fig. 3** The Kaplan–Meier survival curve demonstrating the incidence of vascular events over the follow-up period, stratified by the optimal cutoff values for LDM/NDM ratio. Participants with high LDM/NDM ratios are represented by black line and low LDM/NDM ratios are in red line, with the 95% confidence interval in shades

**Fig. 4** Summary receiver operating characteristic (ROC) curves for predicting vascular events. **(A)** Vascular events in men. Model 1 (black solid line) was adjusted for age, HbA1c, hsCRP, hypertension, and dyslipidemia. Model 2 (red dashed line) was further adjusted for LDM/NDM ratio. **(B)** Vascular events in women. Model 1 was adjusted for age, HbA1c, dyslipidemia, and smoking. Model 2 was further adjusted for LDM/NDM ratio

그림 출처: PubMed Central 공개 논문 (PMC10823598)

Conflict of interest statement

The authors declare no conflict of interest.

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