Increased subcutaneous fat accumulation has a protective role against subclinical atherosclerosis in asymptomatic subjects undergoing general health screening.

PURPOSE: To evaluate the clinical role of subcutaneous fat accumulation in subclinical arteriosclerosis, using computed tomography (CT), we measured the subcutaneous fat area (SFA), the visceral fat area (VFA) and the VFA/SFA ratio and compared these with the calcium score of the whole aorta (CSWA) in asymptomatic subjects who were undergoing general health screening.

METHODS: 122 consecutive asymptomatic subjects (40 female, mean age 56.2+/-8.4 years) were analyzed. Whole-body low-dose CT scan (mAs=50, slice thickness=5 mm) was performed. The SFA and VFA were measured at the umbilical level. Calcification of whole aorta was defined as an area with >90 HU and 1 mm(2), and CSWA was calculated using the modified Agatston method.

RESULTS: Mean+/-SD of SFA, VFA and log CSWA were 158+/-67.1 cm(2), 94.0+/-44.8 cm(2), and 7.93+/-1.08, respectively. SFA was significantly and inversely correlated with log CSWA (r=-0.219, P=0.015) but VFA was not (r=0.105, P=0.250) and as a result, the VFA/SFA ratio was significantly and positively correlated with log CSWA (r=0.221, P=0.015). Subsequently, all predictor variables were used in a stepwise multiple regression model with log CSWA as dependent variable, and age, SFA and fasting plasma glucose significantly influenced log CSWA (P<0.001) by the multiple regression formula Y=0.046X1***-0.005X2**+0.015X3*+4.426, (***P<0.001, **P<0.01, and *P<0.05) where Y=log CSWA, X1=age, X2=SFA, and X3=fasting plasma glucose).

CONCLUSIONS: SFA was significantly and inversely associated with log CSWA, in an independent fashion. These results suggest that subcutaneous fat accumulation might have a protective role against atherosclerosis in asymptomatic subjects.