Background: Certain adipose tissue depots infer higher cardiometabolic risk than body mass index (BMI).
Purpose: To assess breast adipose tissue (BrAT) attenuation as a novel imaging biomarker for cardiometabolic risk.
Material and methods: We studied 151 women (mean age = 56 ± 1 years) across the weight spectrum. BrAT attenuation, abdominal adipose tissue cross-sectional areas (CSA), and attenuation were quantified using non-contrast computed tomography (CT) scans. Cardiometabolic risk factors were assessed from medical records.
Results: BrAT attenuation was lower in obese women compared to lean women. BrAT attenuation was inversely associated with BMI, waist circumference, abdominal fat CSA, fasting glucose, and triglycerides (P ≤ 0.02), and positively associated with abdominal adipose tissue attenuation (P < 0.001). BrAT attenuation had a sensitivity of 90% but a specificity of only 35% in detecting the metabolic syndrome (area under the curve = 0.63).
Conclusion: BrAT attenuation is associated with cardiometabolic risk markers and could serve as an imaging biomarker for opportunistic risk assessment in patients undergoing CT examination of the chest.
Keywords: Breast adipose tissue; biomarker; cardiometabolic risk; computed tomography; metabolic syndrome; opportunistic screening.