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Distinct Distribution of Intrathoracic and Visceral Fat in Asthma
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A1383 - Distinct Distribution of Intrathoracic and Visceral Fat in Asthma
Author Block: A. Perelas1, S. A. A. Comhair2, L. A. Mavrakis2, S. C. Erzurum2, J. Lempel3; 1Respiratory Institute, Cleveland Clinic Foundation, Cleveland, OH, United States, 2Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH, United States, 3Imaging Institute, Cleveland Clinic Foundation, Cleveland, OH, United States.
Rationale: There is a growing body of literature linking obesity with asthma, however the mechanisms behind this association remain elusive. In this study, we examined the interplay between asthma and adiposity, focusing on fat distribution in relation to lung function. Methods: This is a cross-sectional retrospective review of a prospectively maintained registry of participant data. Data analysis was conducted using information from adult participants enrolled at the Cleveland Clinic. Patient demographics, pulmonary function tests and asthma- related metrics (use of rescue inhaler, number of emergency department visits, symptom scores) were recorded. Non contrast CT images obtained on each participant at end inspiration formed the datasets that were analyzed in this study. With the undersurface of the heart base and upper sternal margin as inferior and superior landmarks, respectively, fat volume analysis was performed using intuition volume rendered imaging software (Terrarecon, Foster City, CA ). Optimal measurements for intrathoracic fat were calculated at the T7 level. The maximum preperitoneal fat thickness and the minimum abdominal subcutaneous fat thickness were measured at the level of the xiphoid process. The abdominal wall fat index was calculated as the ratio of preperitoneal to subcutaneous fat.
Results: A total of 27 subjects (22 asthmatics and 5 controls) were included. Mean BMI was not different between asthmatics and controls (BMI: controls, 34±13; asthma, 33±5; p=0.83). Asthmatic subjects had an increased % intrathoracic fat (controls: 7.9±1.6; asthma: 11.6±5;p=0.02) decreased % thoracic subcutaneous fat (controls: 92±1.6; asthma: 88±6;p=0.02) and an increased abdominal wall fat index fat (controls: 0.7±0.1; asthma: 1.6±0.2;p=0.005) compared to controls. Intrathoracic and preperitoneal fat accumulation in asthma was negatively correlated with FEV1% [intrathoracic fat: R2=0.253, p=0.028; preperitoneal fat:R2 =0.219, p=0.04)]. Conclusion: Asthmatic patients have a different adipose tissue distribution than controls characterized by increased accumulation of intrathoracic and visceral fat and relatively decreased amount of subcutaneous fat.
Author Block: A. Perelas1, S. A. A. Comhair2, L. A. Mavrakis2, S. C. Erzurum2, J. Lempel3; 1Respiratory Institute, Cleveland Clinic Foundation, Cleveland, OH, United States, 2Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH, United States, 3Imaging Institute, Cleveland Clinic Foundation, Cleveland, OH, United States.
Rationale: There is a growing body of literature linking obesity with asthma, however the mechanisms behind this association remain elusive. In this study, we examined the interplay between asthma and adiposity, focusing on fat distribution in relation to lung function. Methods: This is a cross-sectional retrospective review of a prospectively maintained registry of participant data. Data analysis was conducted using information from adult participants enrolled at the Cleveland Clinic. Patient demographics, pulmonary function tests and asthma- related metrics (use of rescue inhaler, number of emergency department visits, symptom scores) were recorded. Non contrast CT images obtained on each participant at end inspiration formed the datasets that were analyzed in this study. With the undersurface of the heart base and upper sternal margin as inferior and superior landmarks, respectively, fat volume analysis was performed using intuition volume rendered imaging software (Terrarecon, Foster City, CA ). Optimal measurements for intrathoracic fat were calculated at the T7 level. The maximum preperitoneal fat thickness and the minimum abdominal subcutaneous fat thickness were measured at the level of the xiphoid process. The abdominal wall fat index was calculated as the ratio of preperitoneal to subcutaneous fat.
Results: A total of 27 subjects (22 asthmatics and 5 controls) were included. Mean BMI was not different between asthmatics and controls (BMI: controls, 34±13; asthma, 33±5; p=0.83). Asthmatic subjects had an increased % intrathoracic fat (controls: 7.9±1.6; asthma: 11.6±5;p=0.02) decreased % thoracic subcutaneous fat (controls: 92±1.6; asthma: 88±6;p=0.02) and an increased abdominal wall fat index fat (controls: 0.7±0.1; asthma: 1.6±0.2;p=0.005) compared to controls. Intrathoracic and preperitoneal fat accumulation in asthma was negatively correlated with FEV1% [intrathoracic fat: R2=0.253, p=0.028; preperitoneal fat:R2 =0.219, p=0.04)]. Conclusion: Asthmatic patients have a different adipose tissue distribution than controls characterized by increased accumulation of intrathoracic and visceral fat and relatively decreased amount of subcutaneous fat.
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