Relationship of American Heart Association's Life Simple 7, Ectopic Fat and Insulin Resistance in 5 racial/ethnic groups

Authors

Parag Anilkumar Chevli, Section on Hospital Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
Anurag Mehta, Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Atlanta, GA.
Matthew Allison, Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA.
Jingzhong Ding, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
Khurram Nasir, Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX.
Michael J. Blaha, Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD.
Ron Blankstein, Department of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital, USA.
Sameera A. Talegawkar, Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC.
Alka M. Kanaya, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA.
Michael D. Shapiro, Center for the Prevention of Cardiovascular Disease Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC.
Morgana Mongraw-Chaffin, Department of Epidemiology & Prevention, Wake Forest School of Medicine, Winston-Salem, NC.

Document Type

Journal Article

Publication Date

2-21-2022

Journal

The Journal of clinical endocrinology and metabolism

DOI

10.1210/clinem/dgac102

Keywords

Cardiovascular health; Ectopic fat; Insulin resistance; Life’s Simple 7

Abstract

BACKGROUND: The inverse association between ideal cardiovascular health (CVH) as measured by the American Heart Association's Life Simple 7 (LS7) and cardiovascular disease (CVD) incidence is well documented. However, research exploring the association between CVH and specific risk factors for cardiometabolic disease is sparse in diverse cohorts. METHODS: This study included 7717 participants from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) and the Multi-Ethnic Study of Atherosclerosis (MESA) cohorts. We assigned each LS7 component a 0, 1, and 2 and summed these scores to derive an overall CVH score. Visceral, subcutaneous, and intermuscular fat area, pericardial fat volume, and hepatic fat attenuation were measured using non-contrast computed tomography. Multivariable linear regression was used to examine associations between CVH categories and each log-transformed ectopic fat depot, as well as the homeostatic assessment for insulin resistance (HOMA-IR). RESULTS: In adjusted analysis, compared to those with ideal CVH, participants with poor CVH demonstrated 63.4% (95% CI, 54.3 - 73.0) higher visceral fat area, 84.0% (76.5 - 92.1) higher pericardial fat volume, 61.6% (50.7 - 73.2) higher subcutaneous fat area, and 40.6% (30.2 - 52.0) higher intermuscular fat area, and 15.1% (13.1 - 17.2) higher hepatic fat (all p<0.001). Also, poor CVH was associated with 148.2% (131.1 - 166.7) higher HOMA-IR. We also found significant heterogeneity in the strengths of association by race/ethnicity for each ectopic fat depot. CONCLUSION: Poor and intermediate CVH, as defined by LS7 metrics, were associated with significantly higher measures of ectopic fat and insulin resistance among individuals from 5 racial/ethnic groups.

APA Citation

Chevli, Parag Anilkumar; Mehta, Anurag; Allison, Matthew; Ding, Jingzhong; Nasir, Khurram; Blaha, Michael J.; Blankstein, Ron; Talegawkar, Sameera A.; Kanaya, Alka M.; Shapiro, Michael D.; and Mongraw-Chaffin, Morgana, "Relationship of American Heart Association's Life Simple 7, Ectopic Fat and Insulin Resistance in 5 racial/ethnic groups" (2022). GW Authored Works. Paper 128.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/128

Department

Exercise and Nutrition Sciences