Background:Obesity is highly prevalent among blacks and is associated with a greater risk of heart failure (HF). However, the contribution of regional adiposity depots such as visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue toward risk of HF in blacks is unknown.Methods and Results:We included 2602 participants (mean age: 59 years, 35% men) from the Jackson Heart Study without prevalent HF who underwent computed tomography quantification of VAT and subcutaneous adipose tissue during the second visit (2005–2009). The associations between different adiposity measures and HF were evaluated using adjusted Cox models. There were 122 incident HF events over a median follow-up of 7.1 years. Higher amounts of VAT were associated with greater risk of HF in age- and sex-adjusted analyses (hazard ratio [95% CI] per 1-SD higher VAT: 1.29 [1.09–1.52]). This association was attenuated and not significant after additional adjustment for traditional HF risk factors and body mass index. Overall obesity, represented by body mass index, was associated with higher risk of HF independent of risk factors and VAT (hazard ratio [95% CI] per 1-kg/m² higher body mass index: 1.06 [1.02–1.11]). Subcutaneous adipose tissue was not associated with risk of HF in adjusted analyses.Conclusions:In a community-dwelling black population, higher amounts of overall and visceral adiposity are associated with higher risk of HF. The association between VAT and HF risk in blacks may reflect differences in traditional HF risk factor burden. Future studies are needed to confirm this observation and clarify the independent role of different measures of adiposity on HF outcomes.

中文翻译：

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黑人之间区域脂肪组织分布与心力衰竭风险之间的关联

背景：肥胖症在黑人中非常普遍，并伴有更大的心力衰竭（HF）风险。然而，未知内脏脂肪组织（VAT）和腹部皮下脂肪组织等区域性肥胖源对黑人患HF的贡献。方法和结果：我们纳入了2602名参与者（平均年龄：59岁，男性35％），来自黑人。在第二次访视（2005-2009年）期间，对没有流行心衰的杰克逊心脏研究进行了计算机断层扫描，对增值税和皮下脂肪组织进行了定量分析。使用调整后的Cox模型评估了不同肥胖测量指标与HF之间的关联。在7.1年的中位随访期间，发生了122起HF事件。在年龄和性别调整后的分析中，较高的增值税与HF的风险较高相关（每1-SD较高的增值税风险比[95％CI]：1。29 [1.09–1.52]）。在对传统的HF危险因素和体重指数进行额外调整后，这种关联性减弱并且不显着。以体重指数表示的总体肥胖与HF的较高风险相关，而不受HF和危险因素的影响（每1-kg / m的危险比[95％CI]²更高的体重指数：1.06 [1.02-1.11]）。皮下脂肪组织经调整后的分析与HF的危险性无关。结论：在居住于社区的黑人人群中，较高的总体和内脏肥胖与HF的危险性有关。黑人的增值税和HF风险之间的关联可能反映了传统HF风险因素负担的差异。需要进一步的研究来证实这一观察结果，并阐明不同肥胖测量方法对HF结局的独立作用。