Intra-Abdominal Fat and High Density Lipoprotein Cholesterol Are Associated in a Non-Linear Pattern in Japanese-Americans

Diabetes Metab J. 2020 Apr;44(2):277-285. doi: 10.4093/dmj.2019.0008. Epub 2020 Mar 10.


Background: We describe the association between high density lipoprotein cholesterol (HDL-C) concentration and computed tomography (CT)-measured fat depots.

Methods: We examined the cross-sectional associations between HDL-C concentration and intra-abdominal (IAF), abdominal subcutaneous (SCF), and thigh fat (TF) areas in 641 Japanese-American men and women. IAF, SCF, and TF were measured by CT at the level of the umbilicus and mid-thigh. The associations between fat area measurements and HDL-C were examined using multivariate linear regression analysis adjusting for age, sex, diabetes family history, homeostasis model assessment of insulin resistance (HOMA-IR), and body mass index (BMI). Non-linearity was assessed using fractional polynomials.

Results: Mean±standard deviation of HDL-C concentration and IAF in men and women were 1.30±0.34 mg/dL, 105±55.3 cm², and 1.67±0.43 mg/dL, 74.4±46.6 cm² and differed significantly by gender for both comparisons (P<0.001). In univariate analysis, HDL-C concentration was significantly associated with CT-measured fat depots. In multivariate analysis, IAF was significantly and non-linearly associated with HDL-C concentration adjusted for age, sex, BMI, HOMA-IR, SCF, and TF (IAF: β=-0.1012, P<0.001; IAF²: β=0.0008, P<0.001). SCF was also negatively and linearly associated with HDL-C (β=-0.4919, P=0.001).

Conclusion: HDL-C does not linearly decline with increasing IAF in Japanese-Americans. A more complex pattern better fits this association.

Keywords: Cholesterol, HDL; Epidemiology; Intra-abdominal fat; Japanese American.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Asian Americans / statistics & numerical data*
  • Body Mass Index
  • Cholesterol, HDL / blood*
  • Cross-Sectional Studies
  • Dyslipidemias / blood*
  • Dyslipidemias / diagnosis
  • Dyslipidemias / ethnology
  • Female
  • Humans
  • Intra-Abdominal Fat / diagnostic imaging*
  • Linear Models
  • Male
  • Middle Aged
  • Nonlinear Dynamics
  • Tomography, X-Ray Computed / methods


  • Cholesterol, HDL