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Master of Public Health

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

AUTHORS

Chevli PA , Mehta A , Allison M , Ding J , Nasir K , Blaha MJ , Blankstein R , Talegawkar SA , Kanaya AM , Shapiro MD , Mongraw-Chaffin M , . The Journal of clinical endocrinology and metabolism. 2022 2 21; ().

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.

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