Visceral fat and liver fat are independent predictors of metabolic risk factors in men. Am J Physiol Endocrinol Metab 284: E1065-E1071, 2003. First published January 28, 2003 10.1152/ajpendo.00442.2002We examined the independent associations among abdominal adipose tissue (AT), liver fat, cardiorespiratory fitness (CRF), and lipid variables in 161 Caucasian men who had a wide variation in adiposity. We measured AT and liver fat by computed tomography and CRF by a maximal exercise test on a treadmill. Visceral AT remained a significant (P Յ 0.05) predictor of plasma triglycerides (TG), high-density-lipoprotein cholesterol (HDL-C), and total cholesterol (TC)/HDL-C ratio (TC/HDL-C) after statistical control for abdominal subcutaneous AT, CRF, and alcohol consumption. Abdominal subcutaneous AT was not a significant (P Ն 0.05) correlate of any lipid variable after control for visceral AT and CRF. Furthermore, subdivision of subcutaneous AT into deep and superficial depots did not alter these observations. Visceral AT was the strongest correlate of liver fat and remained so after control for abdominal subcutaneous AT, CRF, and alcohol consumption (r ϭ Ϫ0.34, P Ͻ 0.01). In contrast, abdominal subcutaneous AT and CRF were not significant (P Ͼ 0.10) correlates of liver fat after control for visceral AT. Visceral AT remained a significant (P Ͻ 0.01) correlate of TG, HDL-C, and TC/HDL-C independent of liver fat. However, liver fat was also a significant correlate (P Յ 0.05) of fasting glucose and TG independent of visceral AT. These observations reinforce the importance of visceral obesity in the pathogenesis of dyslipidemia in men, and they suggest that visceral AT and liver fat carry independent health risk.abdominal adipose tissue; cardiorespiratory fitness; metabolic risk THE CONTRIBUTION of abdominal subcutaneous and visceral adipose tissue (AT) to the established association between abdominal adiposity and health risk remains a subject of debate (14). Initial attempts to resolve the confusion by subdivision of abdominal subcutaneous AT into its metabolically determined components have failed to provide consistent results. For insulin resistance, some suggest that the deep metabolically active depot of subcutaneous AT is a strong marker independent of visceral AT (21, 42); others provide evidence to the contrary (40, 43a). Whether subdivision of subcutaneous AT provides insight into the relationships between abdominal obesity and lipid profile is unknown. Given the strong association between elevated free fatty acid (FFA) levels and lipid metabolism (26), it is reasonable to think that the isolation of deep from superficial subcutaneous AT would provide insight into the relationships between abdominal adiposity and dyslipidemia. Indeed, DeNino et al. (9) report that both visceral and deep subcutaneous AT abolish the agerelated differences in lipid and lipoprotein levels in women. Whether the association between deep subcutaneous AT and lipid profile remained significant independent of visceral AT was not reported. Fu...