Archives of Obesity and Metabolism (비만대사연구학술지)

The Study of Obesity and Metabolic Syndrome, KAFM (대한가정의학회 비만대사증후군연구회)
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Associations of Abdominal Fat Distribution with Carotid Atherosclerosis

복부 지방의 분포와 경동맥 죽상동맥경화증의 연관성

  • Su Jin Kim (Department of Family Medicine, Seoul National University Hospital) ;
  • Hyuktae Kwon (Department of Family Medicine, Seoul National University Hospital) ;
  • Ha Jin Kim (Department of Family Medicine, Seoul National University Hospital) ;
  • Jae Moon Yun (Department of Family Medicine, Seoul National University Hospital)
  • 김수진 (서울대학교병원 가정의학과) ;
  • 권혁태 (서울대학교병원 가정의학과) ;
  • 김하진 (서울대학교병원 가정의학과) ;
  • 윤재문 (서울대학교병원 가정의학과)
  • Received : 2026.02.26
  • Accepted : 2026.06.02
  • Published : 2026.06.30
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Abstract

Background: Adipose tissue, carotid intima-media thickness (CIMT), and carotid plaque (CP) are predictors of cardiovascular disease. However, previous studies examining the associations of visceral fat area (VFA) or subcutaneous fat area (SFA) with CIMT or CP have reported inconsistent results. We investigated the associations of computed tomography-derived adipose tissue distribution (VFA, SFA, and the VFA/SFA ratio), as well as body mass index (BMI) and waist circumference (WC), with carotid atherosclerosis, increased CIMT (≥1.0 mm), and CP. Methods: A total of 1,502 men and 1,290 women who underwent comprehensive health examinations between 2020 and 2024 were included. Sex-specific associations of VFA, SFA, the VFA/SFA ratio, BMI, and WC with carotid atherosclerosisrelated outcomes were evaluated using multivariable logistic regression models adjusted for age, lifestyle factors, serum uric acid levels, metabolic comorbidities, and menopausal status (in women). Additionally, age-stratified subgroup analyses were performed by categorizing participants into <60 and ≥60 years. Results: The mean age of participants was 60 years. Carotid atherosclerosis was present in 68.04% of men and 55.04% of women. Among men, each 0.1-unit increase in the VFA/SFA ratio was positively associated with carotid atherosclerosis (odds ratio [OR] 1.037; 95% confidence interval [CI], 1.001 to 1.075) and CP (OR 1.037; 95% CI, 1.001 to 1.075). In women, WC was positively associated with increased CIMT (OR 1.041; 95% CI, 1.004 to 1.078), mainly among those aged ≥60 years. Conclusion: Our findings suggest sex- and age-specific associations between adiposity measures and carotid atherosclerosis-related outcomes, providing insights into the relationship between fat distribution and vascular health.

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