Visceral-to-subcutaneous fat ratio is independently related to small and large cerebrovascular lesions even in healthy subjects

Abstract

Background and aims: The severity of obesity is evaluated by visceral-to-subcutaneous fat ratio (VS ratio), which may be useful for predicting atherosclerosis. However, it is unclear how VS ratio affects different types of cerebrovascular lesions. This study was conducted to evaluate the clinical impact of visceral fat accumulation on the cerebrovascular lesions.

Methods: This cross-sectional study included 980 apparently healthy Japanese adults who underwent a health check-up program focused toward atherosclerosis, between 2011 and 2014. Visceral and subcutaneous fat accumulation was measured using abdominal computed tomography, and its relation to cerebrovascular disease was surveyed.

Results: Visceral and subcutaneous fat accumulation was 88 ± 50 cm² and 141 ± 77 cm², respectively. VS ratio was 0.69 ± 0.38. Intimal thickening in the carotid arteries was detected in 849 cases (86.6%) and stenosis was observed in seven (0.7%). Brain magnetic resonance imaging showed white matter hyperintensities regarded as ischemic changes in 196 subjects (20.0%). Multiple logistic regression analysis adjusted for age, gender, diabetes mellitus, dyslipidemia, hypertension, and hyperuricemia showed that a 0.1 increase in VS ratio was related to the presence of ischemic changes [odds ratio (OR): 1.05, 95% CI: 1.01-1.10, p = 0.009], cerebral artery stenosis or occlusion (OR: 1.14, 95% CI: 1.03-1.25, p = 0.007), and cervical plaque (OR: 1.09, 95% CI: 1.05-1.13, p < 0.001).

Conclusions: VS ratio was independently associated with both large and small vessel lesions in apparently healthy subjects.

Keywords: Cerebral ischemic change; Cerebrovascular disease; Subcutaneous fat accumulation; Visceral fat accumulation; White matter hyperintensity.