Ectopic Fat Depots and Cardiometabolic Burden: A Possible Dangerous Liaison in Women Planning Assisted Reproduction
Ectopic fat and Assisted Reproduction
Abstract
Objective: We evaluated cardiometabolic burden in women planning assisted reproduction in order to identify subgroups at higher risk of pregnancy complications and cardiovascular disease.
Materials and methods: In this cross-sectional study we investigated 60 infertile women with BMI≥25 kg/m2 referred to the Center for Assisted Reproduction. All women underwent metabolic, anthropometric parameters and ultrasound evaluation of ectopic fat depots.
Results: All women had waist ≥80 cm. We found that 93.3% of women had pathological subcutaneous, 58.3% visceral and 80% para-perirenal fat; all women had fatty liver. Visceral fat and severity of steatosis were significantly related to the presence of metabolic syndrome (OR =5.7; p=0.03). A significant negative correlation between low HDL-c and para-perirenal fat (p<0.0001), a significant positive correlation with fasting plasma glucose and para-perirenal fat (p=0.001) were found. We observed a significant positive correlation between visceral fat and hs-CRP (p=0.002), HOMA-IR (p=0.04) and triglycerides (p=0.002), a significant negative correlation with HDL-c (p=0.05).
Conclusion: This study by highlighting a clinically “dangerous liaison” between ectopic fat depots and metabolic/inflammatory markers, might permit to identify women with a worse metabolic phenotype and encourage lifestyle changes for improving their general and reproductive health together.
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2. Fox CS, Massaro JM, Hoffmann U, Pou KM, Maurovich-Horvat P, Liu CY, et al. Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation 2007; 116: 39–48.
3. Despres JP. Body Fat Distribution and Risk of Cardiovascular Disease: An Update. Circulation 2012; 126: 1301-13.
4. Ferrara D, Montecucco F, Dallegri F, Carbone F. Impact of Different Ectopic Fat Depots on Cardiovascular and Metabolic Diseases. J Cell Physiol 2019; 234: 21630-41.
5. Speliotes EK, Massaro JM, Hoffmann U, Vasan RS, Meigs JB, Sahani DV, et al. Fatty liver is associated with dyslipidemia and dysglycemia independent of visceral fat: The Framingham Heart Study. Hepatology 2010; 51: 1979–87.
6. Broughton DE, Moley KH. Obesity and Female
Infertility: Potential Mediators of Obesity's Impact. Fertil Steril 2017; 107: 840-47.
7. Weiss JL, Malone FD, Emig D, Ball RH, Nyberg DA, Comstock CH, et al. Obesity, Obstetric Complications and Cesarean Delivery Rate--A Population-Based Screening Study. Am J Obstet Gynecol 2004; 190: 1091-7.
8. Veleva Z, Tiitinen A, Vilska S, Hydén-Granskog C, Tomás C, Martikainen H, et al. High and Low BMI Increase the Risk of Miscarriage After IVF/ICSI and FET. Hum Reprod 2008; 23: 878-84.
9. Ciavattini A, Montik N, Clemente N, Santoni F, Moriconi L, Serri M, et al. Obesity and Ultrasound-Estimated Visceral Fat Deposits in Women Undergoing Assisted Reproductive Technology (ART) Procedures. Gynecol Endocrinol 2017; 33: 972-6.
10. Gaskins AJ, Arvizu M, Mínguez-Alarcón L, Dadd R, Souter I, Chavarro JE, et al. Substantial Weight Gain in Adulthood Is Associated with Lower Probability of Live Birth Following Assisted Reproduction. J Nutr 2021; 151: 649-56.
11. Alberti KG, Zimmet P, Shaw J; IDF Epidemiology Task Force Consensus Group. The metabolic syndrome--a new worldwide definition. Lancet 2005; 366: 1059-62.
12. European Association for Cardiovascular Prevention & Rehabilitation, Reiner Z, Catapano AL, De Backer G, Graham I, Taskinen MR, et al. ESC/EAS Guidelines for the management of dyslipidaemias: The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). European Heart Journal 2016; 37: 2999–3058.
13. Kawasaki S, Aoki K, Hasegawa O, Numata K, Tanaka K, Shibata N, et al. Sonographic Evaluation of Visceral Fat by Measuring Para- And Perirenal Fat. J Clin Ultrasound 2008; 36: 129-33.
14. Ballestri S, Nascimbeni F, Baldelli E, Marrazzo A, Romagnoli D, Targher G, et al. Ultrasonographic Fatty Liver Indicator Detects Mild Steatosis and Correlates with Metabolic/Histological Parameters in Various Liver Diseases. Metabolism 2017; 72: 57-65.
15. Esposito K, Marfella R, Ciotola M, Di Palo C, Giugliano F, Giugliano G, et al. Effect of a Mediterranean-Style Diet on Endothelial Dysfunction and Markers of Vascular Inflammation in the Metabolic Syndrome: A Randomized Trial. JAMA 2004; 292: 1440-6.
16. Ribeiro-Filho FF, Faria AN, Azjen S, Zanella MT, Ferreira SR. Methods of Estimation of Visceral Fat: Advantages of Ultrasonography. Obes Res 2003; 11: 1488-94.
17. Lee JJ, Pedley A, Hoffmann U, Massaro JM, Levy D,
Long MT. Visceral and Intrahepatic Fat Are Associated with Cardiometabolic Risk Factors Above Other Ectopic Fat Depots: The Framingham Heart Study. Am J Med 2018; 131: 684-92.e12.
18. Hokanson JE, Austin MA. Plasma Triglyceride Level Is a Risk Factor for Cardiovascular Disease Independent of High-Density Lipoprotein Cholesterol Level: A Meta-Analysis of Population-Based Prospective Studies. J Cardiovasc Risk 1996; 3: 213-9.
19. Robins SJ, Lyass A, Zachariah JP, Massaro JM, Vasan RS. Insulin resistance and the relationship of a dyslipidemia to coronary heart disease: The Framingham Heart Study. Arterioscler Thromb Vasc Biol 2011; 31: 1208–14.
20. Longo M, Zatterale F, Naderi J, Parrillo L, Formisano P, Raciti GA, et al. Adipose Tissue Dysfunction as Determinant of Obesity-Associated Metabolic Complications. Int J Mol Sci 2019; 20: 2358.
21. Yousuf O, Mohanty BD, Martin SS, Joshi PH, Blaha MJ, Nasir K, et al. High-sensitivity C-reactive Protein and Cardiovascular Disease: A Resolute Belief or an Elusive Link? J Am Coll Cardiol 2013; 62: 397-408.
22. Christen T, Trompet S, Rensen PCN, Willems van Dijk K, Lamb HJ, Jukema JW, et al. The Role of Inflammation in the Association between Overall and Visceral Adiposity and Subclinical Atherosclerosis.
Nutr Metab Cardiovasc Dis 2019; 29: 728-35.
23. Manno C, Campobasso N, Nardecchia A, Triggiani V, Zupo R, Gesualdo L, et al. Relationship of Para- And Perirenal Fat and Epicardial Fat with Metabolic Parameters in Overweight and Obese Subjects. Eat Weight Disord 2019; 24: 67-72.
24. Liu BX, Sun W, Kong XQ. Perirenal Fat: A Unique Fat Pad and Potential Target for Cardiovascular Disease. Angiology 2019;70: 584-93.
25. Kawwass JF, Kulkarni AD, Hipp HS, Crawford S, Kissin DM, Jamieson DJ. Extremities of Body Mass Index and Their Association with Pregnancy Outcomes in Women Undergoing in Vitro Fertilization in the United States. Fertil Steril 2016; 106: 1742-50.
26. Heindel JJ, Balbus J, Birnbaum L, Brune-Drisse MN, Grandjean P, Gray K, et al. Developmental Origins of Health and Disease: Integrating Environmental Influences. Endocrinology 2015; 156: 3416-21.
2. Fox CS, Massaro JM, Hoffmann U, Pou KM, Maurovich-Horvat P, Liu CY, et al. Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation 2007; 116: 39–48.
3. Despres JP. Body Fat Distribution and Risk of Cardiovascular Disease: An Update. Circulation 2012; 126: 1301-13.
4. Ferrara D, Montecucco F, Dallegri F, Carbone F. Impact of Different Ectopic Fat Depots on Cardiovascular and Metabolic Diseases. J Cell Physiol 2019; 234: 21630-41.
5. Speliotes EK, Massaro JM, Hoffmann U, Vasan RS, Meigs JB, Sahani DV, et al. Fatty liver is associated with dyslipidemia and dysglycemia independent of visceral fat: The Framingham Heart Study. Hepatology 2010; 51: 1979–87.
6. Broughton DE, Moley KH. Obesity and Female
Infertility: Potential Mediators of Obesity's Impact. Fertil Steril 2017; 107: 840-47.
7. Weiss JL, Malone FD, Emig D, Ball RH, Nyberg DA, Comstock CH, et al. Obesity, Obstetric Complications and Cesarean Delivery Rate--A Population-Based Screening Study. Am J Obstet Gynecol 2004; 190: 1091-7.
8. Veleva Z, Tiitinen A, Vilska S, Hydén-Granskog C, Tomás C, Martikainen H, et al. High and Low BMI Increase the Risk of Miscarriage After IVF/ICSI and FET. Hum Reprod 2008; 23: 878-84.
9. Ciavattini A, Montik N, Clemente N, Santoni F, Moriconi L, Serri M, et al. Obesity and Ultrasound-Estimated Visceral Fat Deposits in Women Undergoing Assisted Reproductive Technology (ART) Procedures. Gynecol Endocrinol 2017; 33: 972-6.
10. Gaskins AJ, Arvizu M, Mínguez-Alarcón L, Dadd R, Souter I, Chavarro JE, et al. Substantial Weight Gain in Adulthood Is Associated with Lower Probability of Live Birth Following Assisted Reproduction. J Nutr 2021; 151: 649-56.
11. Alberti KG, Zimmet P, Shaw J; IDF Epidemiology Task Force Consensus Group. The metabolic syndrome--a new worldwide definition. Lancet 2005; 366: 1059-62.
12. European Association for Cardiovascular Prevention & Rehabilitation, Reiner Z, Catapano AL, De Backer G, Graham I, Taskinen MR, et al. ESC/EAS Guidelines for the management of dyslipidaemias: The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). European Heart Journal 2016; 37: 2999–3058.
13. Kawasaki S, Aoki K, Hasegawa O, Numata K, Tanaka K, Shibata N, et al. Sonographic Evaluation of Visceral Fat by Measuring Para- And Perirenal Fat. J Clin Ultrasound 2008; 36: 129-33.
14. Ballestri S, Nascimbeni F, Baldelli E, Marrazzo A, Romagnoli D, Targher G, et al. Ultrasonographic Fatty Liver Indicator Detects Mild Steatosis and Correlates with Metabolic/Histological Parameters in Various Liver Diseases. Metabolism 2017; 72: 57-65.
15. Esposito K, Marfella R, Ciotola M, Di Palo C, Giugliano F, Giugliano G, et al. Effect of a Mediterranean-Style Diet on Endothelial Dysfunction and Markers of Vascular Inflammation in the Metabolic Syndrome: A Randomized Trial. JAMA 2004; 292: 1440-6.
16. Ribeiro-Filho FF, Faria AN, Azjen S, Zanella MT, Ferreira SR. Methods of Estimation of Visceral Fat: Advantages of Ultrasonography. Obes Res 2003; 11: 1488-94.
17. Lee JJ, Pedley A, Hoffmann U, Massaro JM, Levy D,
Long MT. Visceral and Intrahepatic Fat Are Associated with Cardiometabolic Risk Factors Above Other Ectopic Fat Depots: The Framingham Heart Study. Am J Med 2018; 131: 684-92.e12.
18. Hokanson JE, Austin MA. Plasma Triglyceride Level Is a Risk Factor for Cardiovascular Disease Independent of High-Density Lipoprotein Cholesterol Level: A Meta-Analysis of Population-Based Prospective Studies. J Cardiovasc Risk 1996; 3: 213-9.
19. Robins SJ, Lyass A, Zachariah JP, Massaro JM, Vasan RS. Insulin resistance and the relationship of a dyslipidemia to coronary heart disease: The Framingham Heart Study. Arterioscler Thromb Vasc Biol 2011; 31: 1208–14.
20. Longo M, Zatterale F, Naderi J, Parrillo L, Formisano P, Raciti GA, et al. Adipose Tissue Dysfunction as Determinant of Obesity-Associated Metabolic Complications. Int J Mol Sci 2019; 20: 2358.
21. Yousuf O, Mohanty BD, Martin SS, Joshi PH, Blaha MJ, Nasir K, et al. High-sensitivity C-reactive Protein and Cardiovascular Disease: A Resolute Belief or an Elusive Link? J Am Coll Cardiol 2013; 62: 397-408.
22. Christen T, Trompet S, Rensen PCN, Willems van Dijk K, Lamb HJ, Jukema JW, et al. The Role of Inflammation in the Association between Overall and Visceral Adiposity and Subclinical Atherosclerosis.
Nutr Metab Cardiovasc Dis 2019; 29: 728-35.
23. Manno C, Campobasso N, Nardecchia A, Triggiani V, Zupo R, Gesualdo L, et al. Relationship of Para- And Perirenal Fat and Epicardial Fat with Metabolic Parameters in Overweight and Obese Subjects. Eat Weight Disord 2019; 24: 67-72.
24. Liu BX, Sun W, Kong XQ. Perirenal Fat: A Unique Fat Pad and Potential Target for Cardiovascular Disease. Angiology 2019;70: 584-93.
25. Kawwass JF, Kulkarni AD, Hipp HS, Crawford S, Kissin DM, Jamieson DJ. Extremities of Body Mass Index and Their Association with Pregnancy Outcomes in Women Undergoing in Vitro Fertilization in the United States. Fertil Steril 2016; 106: 1742-50.
26. Heindel JJ, Balbus J, Birnbaum L, Brune-Drisse MN, Grandjean P, Gray K, et al. Developmental Origins of Health and Disease: Integrating Environmental Influences. Endocrinology 2015; 156: 3416-21.
| Files | ||
| Issue | Vol 15, No 2 (June 2021) | |
| Section | Original Articles | |
| DOI | https://doi.org/10.18502/jfrh.v15i2.6453 | |
| Keywords | ||
| Assisted Reproductive Techniques Heart Disease Risk Factors Obesity Metabolic Syndrome Women’s Health | ||
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How to Cite
1.
Cirillo M, Boddi M, Coccia M, Attanasio M, Fatini C. Ectopic Fat Depots and Cardiometabolic Burden: A Possible Dangerous Liaison in Women Planning Assisted Reproduction. J Family Reprod Health. 2021;15(2):118-124.
