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Dhakal, Sanjaya (2008) FAT PARTITIONING AND SUBCLINICAL CARDIOVASCULAR DISEASE AMONG WOMEN IN MENOPAUSAL TRANSITION. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Obesity is one of the major risk factors of atherosclerosis and arterial stiffness. Recent evidence suggests detrimental effect of fat mass rather than overall body mass. Abdominal fat has been indicated to have more negative impact than other fat depots. We evaluated the impact of regional fat distribution on atherosclerosis and compared the variances explained by 11-different adiposity measures on atherosclerosis and arterial stiffness among bi-racial women in menopausal transition. All analyses were cross-sectional.In the first analysis, adjusted for age, race, menopausal status, insulin, systolic blood pressure (SBP), triglycerides, height, high-density lipoprotein (HDL) and smoking; proportions of total (p= 0.03) and trunk fats (p= 0.03) were positively associated with common carotid adventitial diameter (AD). In contrast, proportion of leg fat was negatively associated with AD (p= 0.03). SBP attenuated the significant associations of total and regional fat distribution with carotid IMT.In the second analysis, adjusted for age, race, menopausal status, height, SBP, low-density lipoprotein (LDL), HDL and insulin; waist circumference (WC) explained 25.2% of variance in IMT and 27.0% of variance in AD, while proportion of trunk fat explained 22.7% of variance in IMT and 25.1% of variance in AD, and area of visceral adipose tissue (VAT) explained 22.7% of variance in IMT and 25.8% of variance in AD.When adjusted for age, race, menopausal status, height, SBP, insulin and C-reactive protein; WC, proportion of trunk fat and VAT explained comparable proportions of the variance in carotid-femoral pulse wave velocity (cfPWV) (WC, 9.0% of variance; proportion of trunk fat, 9.9%; and VAT, 10.3%). After adjusting for above mentioned variables, only proportion of total fat remained positively associated with cfPWV (p= 0.04).Overall, our findings provide evidence for differential role of regional fat distribution on atherosclerosis but not on arterial stiffness. Moreover, WC seems to be as good as computed tomography (CT) and dual-energy x-ray absorptiometry (DXA) measures of fat in explaining variability on atherosclerosis and arterial stiffness. Given the cost, difficulty in maintenance and exposure to radiation associated with CT and DXA, the use of WC in future research may have great public health significance.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Dhakal,, everest_sanju@hotmail.comSAD16
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairJohnston, Janet
Committee MemberSekikawa, Akiraakira@pitt.eduAKIRA
Committee MemberGoodpaster, Bret H.Goodpaster@dom.pitt.eduBGOOD
Committee MemberTyrell, Kim
Committee MemberBrooks, Maria M.Brooks@edc.pitt.eduMBROOKS
Date: 27 June 2008
Date Type: Completion
Defense Date: 27 November 2007
Approval Date: 27 June 2008
Submission Date: 19 March 2008
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: arterial stiffness; atherosclerosis; IMT; fat partitioning; PWV
Other ID:, etd-03192008-105945
Date Deposited: 10 Nov 2011 19:32
Last Modified: 15 Nov 2016 13:37


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