BMI-adjusted adipose tissue volumes exhibit depot-specific and divergent associations with cardiometabolic diseases

Nat Commun. 2023 Jan 17;14(1):266. doi: 10.1038/s41467-022-35704-5.


For any given body mass index (BMI), individuals vary substantially in fat distribution, and this variation may have important implications for cardiometabolic risk. Here, we study disease associations with BMI-independent variation in visceral (VAT), abdominal subcutaneous (ASAT), and gluteofemoral (GFAT) fat depots in 40,032 individuals of the UK Biobank with body MRI. We apply deep learning models based on two-dimensional body MRI projections to enable near-perfect estimation of fat depot volumes (R2 in heldout dataset = 0.978-0.991 for VAT, ASAT, and GFAT). Next, we derive BMI-adjusted metrics for each fat depot (e.g. VAT adjusted for BMI, VATadjBMI) to quantify local adiposity burden. VATadjBMI is associated with increased risk of type 2 diabetes and coronary artery disease, ASATadjBMI is largely neutral, and GFATadjBMI is associated with reduced risk. These results - describing three metabolically distinct fat depots at scale - clarify the cardiometabolic impact of BMI-independent differences in body fat distribution.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adipose Tissue / diagnostic imaging
  • Adiposity
  • Body Mass Index
  • Cardiovascular Diseases* / diagnostic imaging
  • Cardiovascular Diseases* / metabolism
  • Diabetes Mellitus, Type 2* / metabolism
  • Humans
  • Intra-Abdominal Fat / diagnostic imaging
  • Intra-Abdominal Fat / metabolism
  • Risk Factors