The aim of this study was to determine the respective contribution of abdominal visceral adipose tissue (AT) accumulation and insulin resistance (IR) to the determination of a comprehensive cardiovascular metabolic risk profile in 108 postmenopausal women not receiving hormone therapy. Insulin sensitivity (M/I) was determined by a hyperinsulinemic-euglycemic clamp, and visceral AT area was measured by computed tomography. Median values of visceral AT (133.9 cm 2 ) and insulin sensitivity (0.010189 mg ⅐ kg ؊1 ⅐ min ؊1 ⅐ pmol ؊1 ) were used to form four subgroups: 1) low visceral AT-low IR (n ‫؍‬ 35), 2) low visceral AT-high IR (n ‫؍‬ 19), 3) high visceral AT-low IR (n ‫؍‬ 19), and 4) high visceral AT-high IR (n ‫؍‬ 35). Women with isolated IR (low visceral AT and high IR) were characterized by significantly higher fasting and 2-h glycemia and higher fibrinogen, triglyceride, and VLDL-apolipoprotein (apo)B concentrations than women with low visceral AT and low IR (P < 0.05). The plasma lipid-lipoprotein profile and inflammatory markers were not significantly different between women with high visceral AT and low IR and women with low visceral AT and low IR. Women with high visceral AT and high IR had higher fasting and 2-h glycemia, triglyceride, and VLDL-apoB levels; lower apoAI and HDL 2 cholesterol levels; as well as higher C-reactive protein and interleukin-6 concentrations than women with low visceral AT and low IR (P < 0.05). In addition, 15 of the 35 women (42.9%) in the high visceral AT and high IR group were newly diagnosed with type 2 diabetes, whereas no women were diagnosed with type 2 diabetes in the group of women with low visceral AT and low IR. These results show that although the presence of high IR in its isolated form is associated with some metabolic alterations, it is the combination of both high visceral AT and high IR that is the most detrimental for the metabolic health in postmenopausal women. Diabetes 54:770 -777, 2005 P ostmenopausal women are at higher risk of cardiovascular disease (CVD) than premenopausal women. This increased CVD risk after menopause has been partly attributed to the increment in visceral adipose tissue (AT) deposition and worsening insulin-stimulated glucose disposal observed during the menopause transition (1,2). There is also evidence indicating that there is an increase in insulin resistance (IR) with aging (3). Insulin resistance has been suggested as an important risk factor in the development of the metabolic syndrome, a cluster of abnormalities comprising glucose intolerance, dyslipidemia, high blood pressure, and impaired fibrinolysis activity that is associated with increased risk of developing type 2 diabetes and CVD (4). It is well demonstrated that obesity is a risk factor for type 2 diabetes and CVD (5). In addition, body fat distribution is also related to the risk of type 2 diabetes and CVD, and studies have shown that individuals with increased accumulation of visceral AT appear to develop the metabolic syndrome more frequently than those with an incr...

Psychological correlates of obesity remain under controversy. As eating behaviors and dieting history have been previously related to obesity status, these dietary variables may contribute to identify overweight and obese individuals who are at higher risk of having an impaired psychological well-being. Objective: The main purpose of this cross-sectional study was to verify the hypothesis of a relationship between weight status and psychological well-being, and to examine whether cognitive dietary restraint, disinhibition, susceptibility to hunger and dieting history could be related to psychological well-being. Design and subjects: In a sample of 101 postmenopausal women, we performed anthropometric measurements (weight, height and body mass index (BMI)), and measured psychological well-being (PER Questionnaire). The Three-Factor Eating Questionnaire (TFEQ) and a questionnaire about dieting history (dieters: had already been on a diet; non-dieters: had never been on a diet) were also administrated. Results: A trend for a significant relationship was observed between BMI and psychological well-being (r ¼ À0.17; P ¼ 0.08). Significant negative relationships were observed for disinhibition, susceptibility to hunger and all their subscales with psychological well-being (À0.28prpÀ0.48), whereas no significant differences in psychological well-being were observed between dieters and non-dieters. Finally, women displaying a higher score for habitual susceptibility to disinhibition (which is the subscale of TFEQ that was the most closely related to psychological well-being) had a lower level of psychological wellbeing, regardless of their weight status.