Adipose tissue attenuation as a marker of adipose tissue quality: Associations with six-year changes in body weight

Abstract

Objective Weight gain is associated with fat volume increases, but associations with fat quality are less well characterized The associations of weight change with visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) volume and attenuation were investigated. Methods Computed tomography abdominal scans were acquired on a Framingham Heart Study subset (N = 836; 40.2% women; mean age 45.7 years), a mean of 6.1 years apart. Fat attenuation estimated fat quality. Results Mean weight change was +2.0 (SD 6.8; IQR -0.7, 5.0) kg in women and +2.7 (SD 6.0; IQR -0.5, 5.4) kg in men. Per 2.5 kg weight increase in women, VAT volume increased 126 cm3 (95% CI, 112-140, p < 0.0001), SAT volume increased 258 cm3 (95% CI, 239-278, p < 0.0001), and fat attenuation decreased (i.e.; fat quality worsened) in VAT and SAT (p < 0.0001). Increasing VAT volume was associated with decreasing fat attenuation even after accounting for weight change. Relative to weight-stable women (n = 129), women who lost >2.5 kg (n = 58) had smaller SAT attenuation decreases (p < 0.0001). Similar patterns were seen in men. Conclusions Weight gain was associated with decreases in fat attenuation independent of VAT and SAT volume changes. These findings highlighted the associations of weight gain and worsening fat attenuation, suggesting fat attenuation may be dynamic.