Ectopic adipose tissue: frequency and clinical characteristics of obesity phenotypes in patients
V. I. Podzolkov,
A. E. Bragina,
Yu. N. Rodionova,
K. K. Osadchiy,
M. K. Vasilchenko,
A. P. Muravlev,
V. S. Ananeva,
A. V. Balutskaya,
M. O. Pilipenko https://doi.org/10.15829/1728-8800-2024-3980
EDN: KWHLVW
Abstract
Aim. To study the frequency and clinical characteristics of ectopic obesity in patients with different body weights and hypertension (HTN).
Material and methods. The study included 326 patients (145 men and 181 women, mean age 63±8 years). Patients underwent chest and retroperitoneal space computed tomography with calculation of the volumes of perivascular adipose tissue (AT) (PVAT), pericardial AT (PAT) and perirenal fat thickness (PFT) using specialized software QCT Pro Tissue Composition Module (Mindways Software, USA). PAT volume ≥3,2 cm3, PVAT volume ≥0,4 cm3, PFT ≥1,91 cm were considered criteria for pericardial (PCO), perivascular (PVO) and perirenal (PRO) obesity.
Results. When studying the prevalence of ectopic (EO) and abdominal (AO) obesity phenotypes, patients were divided into groups: 1) with isolated EO without AO (n=17), 2) with PCO and AO (n=31), 3) with PVO and AO (n=22), 4) with PRO and AO (n=33), 5) with mixed EO (PKO+PVO, or PKO+PRO, or PVO+PRO, or PKO+PVO+PRO) and AO, 6) with isolated AO without EO (n=74), 7) without obesity (n=32). Isolated EO was significantly more common in individuals with normal and overweight compared to patients with obesity: 8,9 and 12 vs 1,1% (p=0,001), respectively. The prevalence of the mixed EO+AO phenotype in obese patients was significantly higher than in patients with normal and overweight as follows: 41,7 vs 19,6 and 21,7% (p=0,001), respectively. In patients with HTN, PVO+AO was significantly more common compared to patients without HTN as follows: 12,8 vs 3% (p=0,001), respectively.
Conclusion. The study results indicate the heterogeneity of the distribution of obesity phenotypes in people with different body mass index, which emphasizes the importance of taking into account all its variants, including EO, for timely and adequate cardiovascular risk assessment.
About the Authors
V. I. Podzolkov
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Valeriy I. Podzolkov – MD, PhD, Professor, Head of 2nd Faculty Therapy Department, Director of the Faculty Therapy Clinic, I.M. Sechenov First Moscow State Medical University (Sechenov University).
Moscow
A. E. Bragina
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Anna E. Bragina – MD, PhD, Professor, 2nd Faculty Therapy Department, I.M. Sechenov First Moscow State Medical University (Sechenov University).
Moscow
Yu. N. Rodionova
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Yulia N. Rodionova – MD, PhD, Associate Professor, 2nd Faculty Therapy Department, I.M. Sechenov First Moscow State Medical University (Sechenov University).
Moscow
K. K. Osadchiy
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Konstantin K. Osadchiy – MD, PhD, Associate Professor, 2nd Faculty Therapy Department, I.M. Sechenov First Moscow State Medical University (Sechenov University).
Moscow
M. K. Vasilchenko
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Maria K. Vasilchenko – MD, Associate Professor, 2nd Faculty Therapy Department, I.M. Sechenov First Moscow State Medical University (Sechenov University).
Moscow
A. P. Muravlev
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Alexey P. Muravlev – MD, radiologist at the radiology department, University Clinical Hospital №4, Sechenov First Moscow State Medical University (Sechenov University).
Moscow
V. S. Ananeva
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Vera S. Ananeva – Student of I.M. Sechenov First Moscow State Medical University (Sechenov University).
Moscow
A. V. Balutskaya
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Anastasia V. Balutskaya – Student of I.M. Sechenov First Moscow State Medical University (Sechenov University).
Moscow
M. O. Pilipenko
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Miroslava O. Pilipenko - Student of I.M. Sechenov First Moscow State Medical University (Sechenov University).
Moscow
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Supplementary files
What is already known about the subject?
- The introduction of highly informative imaging techniques into routine practice has expanded the understanding of adipose tissue (AT) distribution and made it possible to evaluate various ectopic depots in more detail.
- Dysfunctional ectopic AT has pro-inflammatory, pro-fibrotic and pro-atherogenic effects.
What might this study add?
- The distribution of obesity phenotypes in people with different body mass index is heterogeneous, which emphasizes the importance of taking into account all its variants.
- Isolated ectopic obesity is more common in individuals without general obesity, which delves into the need to identify ectopic fat deposits independently of obesity in general.
- The article demonstrates a high incidence of perivascular obesity in patients with hypertension, which confirms the concept of its relationship and raises the question of perivascular AT assessment in the context of hypertension progression assessment.
Review
For citations:
Podzolkov V.I., Bragina A.E., Rodionova Yu.N., Osadchiy K.K., Vasilchenko M.K., Muravlev A.P., Ananeva V.S., Balutskaya A.V., Pilipenko M.O. Ectopic adipose tissue: frequency and clinical characteristics of obesity phenotypes in patients. Cardiovascular Therapy and Prevention. 2024;23(6):3980. (In Russ.) https://doi.org/10.15829/1728-8800-2024-3980. EDN: KWHLVW
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