High trunk fat mass may increase CVD risk in postmenopausal women regardless of BMI

High levels of trunk fat mass (FM) may be associated with an increased risk of cardiovascular disease (CVD)-related events such as coronary death, nonfatal myocardial infarction, or coronary heart disease in postmenopausal women with normal body mass index (BMI), according to a recent study presented at AHA 2019.

Using data from the Women’s Health Initiative database, the researchers conducted a study involving 2,683 postmenopausal women with a normal BMI (18.5 to <25.0 kg/m²) and without a history of CVD at baseline. Dual energy X-ray absorptiometry was used to measure the percentage of regional body FM level, mainly trunk and leg FM. [AHA 2019, abstract 206]

Over a median follow-up of 17.9 years, a total of 291 incident cases of CVD were reported.

An increased risk of CVD was significantly more common among women with high trunk FM levels compared with those with low trunk FM levels (41.80 percent vs 22.99 percent; hazard ratio [HR], 1.91, 95 percent confidence interval [CI], 1.33–2.74; p_trend<0.001).

In contrast, CVD risk was reduced more frequently in women with high leg FM levels than those with low leg FM levels (52.62 percent vs 37.94 percent; HR, 0.62, 95 percent CI, 0.43–0.89; p_trend=0.008).

Women with both high trunk and low leg FM levels demonstrated an exceptionally higher risk of CVD (HR, 3.33, 95 percent CI, 1.46–7.62). “[Of note,] trunk and leg FM [levels] were contrastingly associated with several biomarkers implicated in the development of CVD,” the researchers said.

“Among postmenopausal women with normal BMI, higher trunk fat was associated with increased risk of CVD, while higher leg fat was associated with decreased risk of CVD, independently of central adiposity measures,” they concluded.