{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:08:24Z","timestamp":1789186104297,"version":"build-2803163510"},"reference-count":43,"publisher":"The Endocrine Society","issue":"3","license":[{"start":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T00:00:00Z","timestamp":1696464000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer Inc","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Fat distribution pattern could help determine cardiometabolic risk profile. This study aimed to evaluate the association of balance\/imbalance between visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (aSAT), and liver fat (LF) with incident type 2 diabetes (T2D) and cardiovascular disease (CVD) in the UK Biobank prospective cohort study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Magnetic resonance images of 40 174 participants were analyzed for VAT, aSAT, and LF using AMRA\u00ae Researcher. To assess fat distribution patterns independent of body mass index (BMI), fat z-scores (z-VAT, z-aSAT, z-LF) were calculated. Participants without prevalent T2D\/CVD (N = 35 138) were partitioned based on balance between (1) z-VAT and z-LF (z-scores = 0 as cut-points for high\/low), (2) z-VAT and z-aSAT, and (3) z-LF and z-aSAT. Associations with T2D\/CVD were investigated using Cox regression (crude and adjusted for sex, age, BMI, lifestyle, arterial hypertension, statin treatment).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>T2D was significantly associated with z-LF (hazard ratio, [95% CI] 1.74 [1.52-1.98], P &amp;lt; .001) and z-VAT (1.70 [1.49-1.95], P &amp;lt; .001). Both remained significant after full adjustment. For z-scores balance, strongest associations with T2D were z-VAT &amp;gt; 0 and z-LF &amp;gt; 0 (4.61 [2.98-7.12]), z-VAT &amp;gt; 0 and z-aSAT &amp;lt; 0 (4.48 [2.85-7.06]), and z-LF &amp;gt; 0 and z-aSAT &amp;lt; 0 (2.69 [1.76-4.12]), all P &amp;lt; .001. CVD was most strongly associated with z-VAT (1.22 [1.16-1.28], P &amp;lt; .001) which remained significant after adjustment for sex, age, BMI, and lifestyle. For z-scores balance, strongest associations with CVD were z-VAT &amp;gt; 0 and z-LF &amp;lt; 0 (1.53 [1.34-1.76], P &amp;lt; .001) and z-VAT &amp;gt; 0 and z-aSAT &amp;lt; 0 (1.54 [1.34-1.76], P &amp;lt; .001). When adjusted for sex, age, and BMI, only z-VAT &amp;gt; 0 and z-LF &amp;lt; 0 remained significant.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>High VAT in relation to BMI (z-VAT &amp;gt; 0) was consistently linked to both T2D and CVD; z-LF &amp;gt; 0 was linked to T2D only. Skewed fat distribution patterns showed elevated risk for CVD (z-VAT &amp;gt; 0 and z-LF &amp;lt; 0 and z-VAT &amp;gt; 0 and z-aSAT &amp;lt; 0) and T2D (z-VAT &amp;gt; 0 and z-aSAT &amp;lt; 0).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgad570","type":"journal-article","created":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T13:09:51Z","timestamp":1696511391000},"page":"783-791","source":"Crossref","is-referenced-by-count":19,"title":["Skewness in Body fat Distribution Pattern Links to Specific Cardiometabolic Disease Risk Profiles"],"prefix":"10.1210","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7399-8375","authenticated-orcid":false,"given":"Jennifer","family":"Linge","sequence":"first","affiliation":[{"name":"AMRA Medical AB , Badhusgatan 5 , SE-58222 Link\u00f6ping, Sweden"},{"name":"Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Link\u00f6ping University , SE-58183 Link\u00f6ping , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Cariou","sequence":"additional","affiliation":[{"name":"l\u2019institut du thorax, Department of Endocrinology, Nantes Universit\u00e9, CHU Nantes, CNRS, Inserm , 44000 Nantes , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian J","family":"Neeland","sequence":"additional","affiliation":[{"name":"Department of Medicine, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Centre and Case Western Reserve University School of Medicine , Westlake, OH 44145 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikael","family":"Petersson","sequence":"additional","affiliation":[{"name":"AMRA Medical AB , Badhusgatan 5 , SE-58222 Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1ngel","family":"Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company , 893 Delaware St, Indianapolis, IN 46225 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olof","family":"Dahlqvist Leinhard","sequence":"additional","affiliation":[{"name":"AMRA Medical AB , Badhusgatan 5 , SE-58222 Link\u00f6ping, Sweden"},{"name":"Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Link\u00f6ping University , SE-58183 Link\u00f6ping , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2023,10,5]]},"reference":[{"issue":"10","key":"2024031313221509400_dgad570-B1","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1161\/CIRCULATIONAHA.111.067264","article-title":"Body fat distribution and risk of cardiovascular disease: an update","volume":"126","author":"Despr\u00e9s","year":"2012","journal-title":"Circulation"},{"issue":"13","key":"2024031313221509400_dgad570-B2","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1161\/CIRCULATIONAHA.117.029617","article-title":"Cardiovascular and metabolic heterogeneity of obesity: clinical challenges and implications for management","volume":"137","author":"Neeland","year":"2018","journal-title":"Circulation"},{"key":"2024031313221509400_dgad570-B3","doi-asserted-by":"crossref","first-page":"154388","DOI":"10.1016\/j.metabol.2020.154388","article-title":"Factors affecting weight loss variability in obesity","volume":"113","author":"Dent","year":"2020","journal-title":"Metab Clin Exp"},{"issue":"11","key":"2024031313221509400_dgad570-B4","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1161\/CIRCRESAHA.120.316101","article-title":"Obesity phenotypes, diabetes, and cardiovascular diseases","volume":"126","author":"Pich\u00e9","year":"2020","journal-title":"Circ Res"},{"issue":"1009","key":"2024031313221509400_dgad570-B5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1259\/bjr\/38447238","article-title":"The clinical importance of visceral adiposity: a critical review of methods for visceral adipose tissue analysis","volume":"85","author":"Shuster","year":"2012","journal-title":"Br J Radiol"},{"issue":"5","key":"2024031313221509400_dgad570-B6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/jim-2018-000722","article-title":"Advanced body composition assessment: from body mass index to body composition profiling","volume":"66","author":"Borga","year":"2018","journal-title":"J Investig Med"},{"issue":"1","key":"2024031313221509400_dgad570-B7","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1161\/CIRCULATIONAHA.106.675355","article-title":"D'Agostino RB sr, O'Donnell CJ. 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