{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T11:19:22Z","timestamp":1781608762783,"version":"3.54.5"},"reference-count":54,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2014,8,15]]},"abstract":"\n Background<\/jats:title>\n \n Ectopic fat density is associated with cardiovascular disease (\n CVD<\/jats:styled-content>\n ) risk factors above and beyond fat volume. Volumetric measures of ectopic fat have been associated with\n CVD<\/jats:styled-content>\n risk factors and subclinical atherosclerosis. The aim of this study was to investigate the association between fat density and subclinical atherosclerosis.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Participants were drawn from the Multi\u2010Detector Computed Tomography (\n MDCT<\/jats:styled-content>\n ) substudy of the Framingham Heart Study (n=3079; mean age, 50.1\u00a0years; 49.2% women). Fat density was indirectly estimated by computed tomography attenuation (Hounsfield Units [\n HU<\/jats:styled-content>\n ]) on abdominal scan slices. Visceral fat (\n VAT<\/jats:styled-content>\n ), subcutaneous fat (\n SAT<\/jats:styled-content>\n ), and pericardial fat\n HU<\/jats:styled-content>\n and volumes were quantified using standard protocols; coronary and abdominal aortic calcium (\n CAC<\/jats:styled-content>\n and\n AAC<\/jats:styled-content>\n , respectively) were measured radiographically. Multivariable\u2010adjusted logistic regression models were used to evaluate the association between adipose tissue\n HU<\/jats:styled-content>\n and the presence of\n CAC<\/jats:styled-content>\n and\n AAC<\/jats:styled-content>\n . Overall, 17.1% of the participants had elevated\n CAC<\/jats:styled-content>\n (Agatston score [\n AS<\/jats:styled-content>\n ]>100), and 23.3% had elevated\n AAC<\/jats:styled-content>\n (\n AS<\/jats:styled-content>\n >age\u2010\/sex\u2010specific cutoffs). Per 5\u2010unit decrement in\n VAT HU<\/jats:styled-content>\n , the odds ratio (\n OR<\/jats:styled-content>\n ) for elevated\n CAC<\/jats:styled-content>\n was 0.76 (95% confidence interval [\n CI],<\/jats:styled-content>\n 0.65 to 0.89;\n P<\/jats:italic>\n =0.0005), even after adjustment for body mass index or\n VAT<\/jats:styled-content>\n volume. Results were similar for\n SAT HU<\/jats:styled-content>\n . With decreasing\n VAT HU<\/jats:styled-content>\n , we also observed an\n OR<\/jats:styled-content>\n of 0.79 (95%\n CI,<\/jats:styled-content>\n 0.67 to 0.92;\n P<\/jats:italic>\n =0.004) for elevated\n AAC<\/jats:styled-content>\n after multivariable adjustment. We found no significant associations between\n SAT HU<\/jats:styled-content>\n and\n AAC<\/jats:styled-content>\n . There was no significant association between pericardial fat\n HU<\/jats:styled-content>\n and either\n CAC<\/jats:styled-content>\n or\n AAC<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Lower\n VAT<\/jats:styled-content>\n and\n SAT HU<\/jats:styled-content>\n , indirect estimates of fat quality, are associated with a lower risk of subclinical atherosclerosis.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.114.000788","type":"journal-article","created":{"date-parts":[[2014,8,29]],"date-time":"2014-08-29T04:52:33Z","timestamp":1409287953000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":58,"title":["Association of Fat Density With Subclinical Atherosclerosis"],"prefix":"10.1161","volume":"3","author":[{"given":"Nicholas J.","family":"Alvey","sequence":"first","affiliation":[{"name":"Harvard Medical School, Boston, MA"},{"name":"National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Pedley","sequence":"additional","affiliation":[{"name":"National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klara J.","family":"Rosenquist","sequence":"additional","affiliation":[{"name":"National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA"},{"name":"Division of Endocrinology and Metabolism, Brigham and Women's Hospital and Harvard Medical School, Boston, MA"},{"name":"NHLBI Division of Intramural Research and the Center for Population Studies, Framingham, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M.","family":"Massaro","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Boston University School of Public Health, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"O'Donnell","sequence":"additional","affiliation":[{"name":"National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA"},{"name":"Cardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA"},{"name":"NHLBI Division of Intramural Research, Cardiovascular Epidemiology and Human Genomics Research, Bethesda, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Udo","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline S.","family":"Fox","sequence":"additional","affiliation":[{"name":"National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA"},{"name":"Division of Endocrinology and Metabolism, Brigham and Women's Hospital and Harvard Medical School, Boston, MA"},{"name":"NHLBI Division of Intramural Research and the Center for Population Studies, Framingham, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","first-page":"22","volume-title":"Global Status Report on Noncommunicable Diseases 2010: Description of the Global Burdens of NCDs, Their Risk Factors and Determinants","author":"World Health Organization","year":"2011","unstructured":"Burden mortality, morbidity and risk factors. 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