The Relationship Between Remnant Cholesterol and Visceral Adipose
                    Tissue: A National Cross-Sectional Study

Zhaoxiang Wang; Shao Zhong; Menghuan Wu; Xuejing Shao; Tian Gu; Mengjiao Xu; Qichao Yang

doi:10.1055/a-2357-2579

Hormone and Metabolic Research, Table of Contents

Horm Metab Res 2025; 57(01): 47-54
DOI: 10.1055/a-2357-2579

Original Article: Endocrine Care

The Relationship Between Remnant Cholesterol and Visceral Adipose Tissue: A National Cross-Sectional Study

Authors

Zhaoxiang Wang

¹Endocrinology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China
Shao Zhong

²Clinical Nutrition, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China
Menghuan Wu

³Endocrinology, Shanghai Putuo District Liqun Hospital, Shanghai, China
Xuejing Shao

⁴Endocrinology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, China

⁵Endocrinology, Wujin Clinical College of Xuzhou Medical University, Changzhou, China
Tian Gu

⁴Endocrinology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, China

⁵Endocrinology, Wujin Clinical College of Xuzhou Medical University, Changzhou, China
Mengjiao Xu

⁴Endocrinology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, China

⁵Endocrinology, Wujin Clinical College of Xuzhou Medical University, Changzhou, China
Qichao Yang

⁴Endocrinology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, China

⁵Endocrinology, Wujin Clinical College of Xuzhou Medical University, Changzhou, China

Abstract

The aim of our study is to explore the relationship between remnant cholesterol (RC) levels and visceral adipose tissue (VAT) in the US adult population. This cross-sectional study utilized data from 5301 participants aged 20 to 59 years gathered by the National Health and Nutrition Examination Survey (NHANES). RC was determined by deducting both high-density lipoprotein cholesterol (HDL-c) and low-density lipoprotein cholesterol (LDL-c) from total cholesterol (TC), and VAT was measured using dual-energy X-ray absorptiometry. Visceral obesity is defined as a VAT area ≥ 100 cm². With increasing quartiles of RC levels, the prevalence of visceral obesity rises (16.51% vs. 36.11% vs. 55.66% vs. 74.48%, p<0.001). After adjusting for confounders, RC levels positively correlate with visceral obesity risk (OR=1.039, 95% CI 1.031–1.048, p<0.001). Additionally, individuals with low LDL-c/high RC and those with high LDL-c/low RC showed 2.908-fold (95% CI 1.995–4.241) and 1.310-fold (95% CI 1.022–1.680) higher risk of visceral obesity, respectively, compared to those with low LDL-c/low RC. Receiver Operating Characteristic (ROC) and Decision Curve Analysis (DCA) show RC’s superior predictive ability over other lipid markers. Subgroup analysis showed that the relationship between RC and visceral obesity was more ronounced in those with cardiovascular disease. Smooth curve fitting indicated a nonlinear relationship between RC levels and VAT area. Our study highlights that elevated levels of RC are associated with adverse accumulation of VAT. However, the causal relationship between RC and visceral obesity requires additional investigation.

Keywords

remnant cholesterol - visceral adipose tissue - visceral obesity - NHANES - population-based study - nonlinear relationship

Full Text

References

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