Anthropometric Measurements, Adipokines and Abdominal Aortic Calcification

Chapter

Abstract

Obesity and arterial calcification are associated with increased cardiovascular morbidity and mortality. The relationship between obesity and abdominal aortic calcification has been under investigated. The majority of research has focused on the relationship between clinical anthropometric measures and aortic calcification, with mixed results. Numerous calcification measurement protocols have hindered appropriate analysis of the literature. However, recently a reproducible computed tomography method for aortic calcification quantification has been published. Similarly, many methods are available for anthropometric assessment. Clinical measures include body mass index, waist circumference, waist to hip ratio, skin fold and percent body fat. Alternatively, computed tomography can be reproducibly utilized to measure abdominal adipose diameters, area and volume. Recently, the relationship between calcification and anthropometric measurements has been investigated by computed tomography. It was found that a measure of visceral adiposity was associated with abdominal aortic calcification. In addition, visceral adiposity was positively and negatively correlated to circulating concentrations of osteoprotegerin and leptin, respectively. This has provided a possible pathogenic mechanism for the accumulation of abdominal aortic calcification. The aims of this chapter are two fold: 1. To outline the various anthropometric and calcification protocols currently employed for vascular research. 2. To review the current literature regarding the relationship between anthropometric measures and abdominal aortic calcification.

Keywords

Cholesterol Obesity Osteoporosis Creatinine Triglyceride 

Abbreviations

AAA

Abdominal Aortic Aneurysm

AP1

Anterior-posterior diameter – skin to skin

AP2

Anterior-posterior diameter – muscle to muscle

APR

Anterior-posterior ratio (AP2/AP1)

BMI

Body mass index

CT

Computed tomography

CH

Center hounsfield unit

EBCT

External beam computed tomography

HU

Hounsfield unit

IDF

International diabetes federation

SC

Subcutaneous fat

T1

Transverse diameter – skin to skin

T2

Transverse diameter – muscle to muscle

TR

Transverse ratio

US

Ultrasound

WH

Window width hounsfield unit

WHR

Waist hip ratio

WHO

World Health Organisation

Notes

Acknowledgements

We would like to thank Ms Moira McCann, Ms Barbara Bradshaw, Mr Keith Rich and The Townsville Hospital radiology and vascular surgery departments.

References

  1. Alexanderson P, Tanko LB, Bagger YZ, Jespersen J, Skouby SO, Christiansen C. Obesity. 2006;14:1571–8.CrossRefGoogle Scholar
  2. Allison MA, Wright CM. (2004). Body morphology differentially predicts coronary calcium. Int J Obes Relat Metab Disord. 28:396–401.PubMedCrossRefGoogle Scholar
  3. Allison MA, Criqui MH, Wright CM. (2004). Patterns and risk factors for systemic calcified atherosclerosis. Arterioscler Thromb Vasc Biol. 24:331–6.PubMedCrossRefGoogle Scholar
  4. Allison MA, Pavlinac P, Wright CM. (2007). The differential associations between HDL, non-HDL and total cholesterols and atherosclerotic calcium deposits in multiple vascular beds. Atherosclerosis. 194:87–94.CrossRefGoogle Scholar
  5. Allison MA, Kwan K, Ditomasso D, Wright CM, Criqui MH. (2008). The epidemiology of abdominal aortic diameter. J Vasc Surg. 48:121–7.PubMedCrossRefGoogle Scholar
  6. Arai Y, Hirose N, Yamamura K, Kimura M, Murayama A, Fujii I, Tsushima M. (2002). Long-term effect of lipid-lowering therapy on atherosclerosis of abdominal aorta in patients with hypercholesterolemia: noninvasive evaluation by a new image analysis program. Angiology. 53:57–68.PubMedCrossRefGoogle Scholar
  7. Bigaard J, Frederiksen K, Tjonneland A, Thomsen BL, Overvad K, Heitmann BL, Sorensen TI. (2005). Waist circumference and body composition in relation to all-cause mortality in middle-aged men and women. Int J Obes. 29:778–84.CrossRefGoogle Scholar
  8. Blancher J, Guerin AP, Pannier B, Marchais SJ, London GM. (2001). Arterial calcifications, arterial stiffness, and cardiovascular risk in end-stage renal disease. Hypertension. 38:938–42.CrossRefGoogle Scholar
  9. Clancy P, Oliver L, Jayalath R, Buttner P, Golledge J. (2006). Assessment of a Serum Assay for Quantification of Abdominal Aortic Calcification. Arterioscler Thromb Vasc Biol. 26:2574–6.PubMedCrossRefGoogle Scholar
  10. Diamant M, Lamb HJ, Van De Ree MA, Endert EL, Groeneveld Y, Bots ML, Kostense PJ, Radder JK. (2005). The association between abdominal visceral fat and carotid stiffness is mediated by circulating inflammatory markers in uncomplicated type 2 diabetes. J Clin Endocrinol Metab. 90:1495–501.PubMedCrossRefGoogle Scholar
  11. Friedman JM, Halaas JL. (1998). Leptin and the regulation of body weight in mammals. Nature. 395:763–70.PubMedCrossRefGoogle Scholar
  12. Golledge J, Muller J, Daugherty A, Norman P. (2006). Abdominal aortic aneurysm: pathogenesis and implications for management. Arterioscler Thromb Vasc Biol. 26:2605–13.PubMedCrossRefGoogle Scholar
  13. Golledge J, Clancy P, Jamrozik K, Norman PE. (2007a). Obesity, adipokines, and abdominal aortic aneurysm: Health in Men study. Circulation. 116:2275–9.PubMedCrossRefGoogle Scholar
  14. Golledge J, Leicht A, Crowther RG, Clancy P, Spinks WL, Quigley F. (2007b). Association of obesity and metabolic syndrome with the severity and outcome of intermittent claudication. J Vasc Surg. 45:40–6.PubMedCrossRefGoogle Scholar
  15. Golledge J, Jayalath R, Oliver L, Parr A, Schurgers L, Clancy P. (2008). Relationship between CT anthropometric measurements, adipokines and abdominal aortic calcification. Atherosclerosis. 197:428–34.PubMedCrossRefGoogle Scholar
  16. Hak AE, Pols HA, Van Hemert AM, Hoffan A, Witteman JC. (2000). Progression of aortic calcification is associated with metacarpal bone loss during menopause: a population-based longitudinal study. Arterioscler Thromb Vasc Biol. 20:1926–31.PubMedCrossRefGoogle Scholar
  17. Iribarren C, Husson G, Go AS, Lo JC, Fair JM, Rubin GD, Hlatky MA, Fortmann SP. J Clin Endocrinol Metab. 2007;92:729–32.PubMedCrossRefGoogle Scholar
  18. Janssen I, Katzmarzyk PT, Ross R. (2004). Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr. 79:379–84.PubMedGoogle Scholar
  19. Jayalath RW, Mangan SH, Golledge J. (2005). Aortic Calcification. Eur J Vasc Endovasc Surg. 30:476–88.PubMedCrossRefGoogle Scholar
  20. Jensen MD, Kanaley JA, Reed JE, Sheedy PF. (1995). Measurement of abdominal and visceral fat with computed tomography and dual-energy x-ray absorptiometry. Am J Clin Nutr. 61:274–8.PubMedGoogle Scholar
  21. Jie KS, Bots ML, Vermeer C, Witteman JC, Grobbee DE. (1995). Vitamin K intake and osteocalcin levels in women with and without aortic atherosclerosis: a population-based study. Atherosclerosis. 116:117–123.PubMedCrossRefGoogle Scholar
  22. Kim DJ, Bergstrom J, Barrett-Connor E, Laughlin GA. (2008). Visceral adiposity and subclinical coronary artery disease in elderly adults: Rancho Bernardo Study. Obesity. 16:853–8.PubMedCrossRefGoogle Scholar
  23. Kuller LH, Matthews KA, Sutton-Tyrrell K, Edmundowicz D, Bunker CH. (1999). Coronary and aortic calcification among women 8 years after menopause and their premenopausal risk factors : the healthy women study. Arterioscler Thromb Vasc Biol. 19:2189–98.PubMedCrossRefGoogle Scholar
  24. Lihn AS, Bruun JM, He G, Pedersen SB, Jensen PF, Richelsen B. (2004). Lower expression of adiponectin mRNA in visceral adipose tissue in lean and obese subjects. Mol Cell Endocrinol. 219:9–15.PubMedCrossRefGoogle Scholar
  25. Lindholt JS. (2008). Aneurysmal wall calcification predicts natural history of small abdominal aortic aneurysms. Atherosclerosis. 197:673–8.PubMedCrossRefGoogle Scholar
  26. Maurovich-Horvat P, Massaro J, Fox CS, Moselewski F, O’Donnell CJ, Hoffmann U. (2006). Comparison of anthropometric, area- and volume-based assessment of abdominal subcutaneous and visceral adipose tissue volumes using multi-detector computed tomography. Int J Obes. 31:500–06.CrossRefGoogle Scholar
  27. Michel JB. (2001). Contrasting outcomes of atheroma evolution: intimal accumulation versus medial destruction. Arterioscler Thromb Vasc Biol. 21:1389–92.PubMedGoogle Scholar
  28. Min H, Morony S, Sarosi I, Dunstan CR, Capparelli C, Scully S, Van G, Kaufman S, Kostenuik PJ, Lacey DL, Boyle WJ, Simonet WS. (2000). Osteoprotegerin reverses osteoporosis by inhibiting endosteal osteoclasts and prevents vascular calcification by blocking a process resembling osteoclastogenesis. J Exp Med. 192:463–74.PubMedCrossRefGoogle Scholar
  29. Nicklas BJ, Penninx BW, Cesari M, Kritchevsky SB, Newman AB, Kanaya AM, Pahor M, Jingzhong D, Harris TB. (2004). Association of visceral adipose tissue with incident myocardial infarction in older men and women: the Health, Aging and Body Composition Study. Am J Epidemiol. 160:741–9.PubMedCrossRefGoogle Scholar
  30. O’Donnell CJ, Chazaro I, Wilson PW, Fox C, Hannan MT, Kiel DP, Cupples LA. Circulation. 2002;106:337–41.PubMedCrossRefGoogle Scholar
  31. O’Malley PG, Taylor AJ, Jackson JL, Doherty TM, Detrano RC. (2000). Prognostic value of coronary electron-beam computed tomography for coronary heart disease events in asymptomatic populations. Am J Cardiol. 2000;85:945–8.PubMedCrossRefGoogle Scholar
  32. Parr A, McLaughlin S, McLaughlin M, Golledge J. (2009). Aortic calcification and abdominal aortic aneurysm expansion Atherosclerosis. 202:350.PubMedCrossRefGoogle Scholar
  33. Reaven PD, Sacks J. (2005). Investigators for the V. Coronary artery and abdominal aortic calcification are associated with cardiovascular disease in type 2 diabetes. Diabetologia. 48:379–85.PubMedCrossRefGoogle Scholar
  34. Shinagawa T, Hiraiwa Y, Mizuno S, Kusunoki N, Nitta Y, Matsubara T, Iwainaka Y, Konishi H. (1992). Quantitative X-ray CT analysis of calcification of the abdominal aorta and its relationship to obesity Nippon Ronen Igakkai Zasshi. 29:271–8.PubMedCrossRefGoogle Scholar
  35. Siegel CL, Cohan RH, Korobkin M, Alpern MB, Courneya DL, Leder RA. (1994). Abdominal aortic aneurysm morphology: CT features in patients with ruptured and nonruptured aneurysms. Am. J. Roentgenol. 163:1123–9.Google Scholar
  36. Van Gaal LF, Mertens IL, De Block CE. (2006). Mechanisms linking obesity with cardiovascular disease. Nature. 444:875–80.PubMedCrossRefGoogle Scholar
  37. Vega De Ceniga M, Gomez R, Estallo L, Roderiguez L, Baquer M, Barba A. (2006). Eur J Vasc Endovasc Surg. Growth Rate and Associated Factors in Small Abdominal Aortic Aneurysms. 31:231–6.PubMedCrossRefGoogle Scholar
  38. Wilson PW, Kauppila LI, O’Donnell CJ, Kiel DP, Hannan M, Polak JM, Cupples LA. Circulation. (2001). Abdominal aortic calcific deposits are an important predictor of vascular morbidity and mortality. 103:1529–34.PubMedCrossRefGoogle Scholar
  39. Yoshizumi T, Nakamura T, Yamane M, Islam AH, Menju M, Yamasaki K, Arai T, Kotani K, Funahashi T, Yamashita S, Matsuzawa Y. Radiology. (1999). Abdominal fat: standardized technique for measurement at CT. 211:283–6.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.The Vascular Biology UnitJames Cook UniversityTownsvilleAustralia

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