Anatomic fat depots and cardiovascular risk: A focus on the leg fat using nationwide surveys (KNHANES 2008-2011)

Eugene Han, Yong ho Lee, Byung Wan Lee, Eun Seok Kang, In Kyu Lee, Bong Soo Cha

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24 Citations (Scopus)


Background: Although central fat is a well-known risk factor for cardiovascular disease (CVD) and cardiometabolic disorders, the effect of other regional fats or muscle distribution on CVD risk has not been fully investigated. Methods: This was a cross-sectional study using nationally representative samples of 15,686 subjects from the 2008-2011 Korea National Health and Nutrition Examination Survey. Individual CVD risk was evaluated in adults aged≥20 without prior CVD, using atherosclerotic cardiovascular disease (ASCVD) risk equations according to the 2013 ACC/AHA guidelines. Body composition was assessed by dual X-ray absorptiometry. Results: Ratio of leg fat to total fat (LF/TF ratio) was the most predictive for CVD among body fat or muscle distribution parameters (AUC=0.748, 95% CI 0.741-0.755). ASCVD risk score was gradually increased with decreased LF/TF ratio (P<0.001), and individuals whose LF/TF ratio in lowest tertile tended to belong to the high-risk (10-year risk >10%) group compared to those in the highest tertile (OR=6.25, 95% CI 5.60-6.98). Subjects in the lowest tertile showed increased risk of cardiometabolic risk factor components including obesity, hypertension, diabetes, dyslipidemia, chronic kidney disease, and albuminuria (OR range 2.57-11.24, all P<0.001). In addition, a higher LF/TF ratio was associated with decreased ASCVD risk, even in subjects with multiple CVD risk factors. Multiple logistic regression analyses also demonstrated this association (OR=1.85, 95% CI 1.36-2.52). Conclusions: Among various body composition parameters, LF/TF ratio was superior in predicting higher CVD risk and a higher LF/TF ratio was independently associated with decreased risk of CVD and each cardiometabolic risk factor.

Original languageEnglish
Article number54
JournalCardiovascular Diabetology
Issue number1
Publication statusPublished - 2017 Apr 26

Bibliographical note

Funding Information:
This research was supported by the grant from the Korea Healthcare Technol‑ ogy Research & Development (R&D) Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health and Welfare, Republic of Korea (HI14C2476 and HI16C1501).

Publisher Copyright:
© 2017 The Author(s).

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine


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