The major objectives of this study are to determine: a) the role of visceral (intraabdominal) fat independent of total fat in determining risk factors for coronary heart disease (CHD) and type 2 diabetes mellitus (DM), and how this may differ by race and by gender; and b) race/gender differences in resting energy expenditure (REE) and the relationship of REE to adiposity and longitudinal change in adiposity. A 5-year follow-up examination including REE and the CT measurement of visceral fat will be performed in a biracial (white and black men and women) study group of 320 participants from the Oakland and Birmingham clinical centers of the Coronary Artery Risk Development in Young Adults (CARDIA) study, representing 80 percent of the participants who underwent these assessments at a baseline exam in 1995-96 conducted in conjunction with their CARDIA study examination. The CARDIA examination conducted in conjunction with this 5-year follow-up examination will provide funding for cardiovascular risk factor measurements including blood pressure, lipids, and anthropometry. The major hypotheses (specific aims) to be tested in the next funding period are: 1) For a given 5-year change in overall body fat, black men will have a smaller change in visceral fat than white men, but there will be no difference in visceral fat change between black women and white women; 2) Change in visceral fat will be more highly correlated with change in CHD risk factors than change in most other measures of adiposity in all race/gender groups. However, change in visceral fat and change in waist circumference will have similar correlations to CHD risk factor change, providing support for the use of waist circumference as a reasonably adequate surrogate for CT-assessed visceral fat; and 3) Baseline mean REE (adjusted for body composition) and change in physical activity will be associated with change in body composition. This study will provide information regarding racial differences in disease risk associated with body composition and fat distribution, a research priority highlighted by the recently released report of the NHLBI Obesity Education Task Force.
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