Fat Distribution and Mortality: The AGES-Reykjavik Study

OBJECTIVE: This study examined associations of regional fat depots with all-cause mortality over 11 years of follow-up. DESIGN AND METHODS: Data were from 2187 men and 2900 women, aged 66–96 years in AGES-Reykjavik Study. Abdominal visceral fat and subcutaneous fat, and thigh intermuscular fat and subcutaneous fat were measured by CT. RESULTS: In men, every standard deviation (SD) increment in thigh intermuscular fat was related to a significantly greater mortality risk (HR:1.17, 95%CI:1.08–1.26) after adjustment for age, education, smoking, physical activity, alcohol, BMI, type 2 diabetes and coronary heart disease. In women, visceral fat (per SD increment) significantly increased mortality risk (HR:1.13, 95%CI:1.03–1.25) while abdominal subcutaneous fat (per SD increment) was associated with a lower mortality risk (HR:0.70; 95%CI:0.61–0.80). Significant interactions with BMI were found in women indicating that visceral fat was a strong predictor of mortality in obese women while abdominal and thigh subcutaneous fat were associated with a lower mortality risk in normal and overweight women. CONCLUSIONS: Fat distribution is associated with mortality over 11 years of follow-up independent of overall fatness. The divergent mortality risks for visceral fat and subcutaneous fat in women suggest complex relationships between overall fatness and mortality.