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The relation between intra-abdominal visceral fat accumulation and blood pressure was investigated in 67 obese women (mean body mass index, 33.6±3.1; average age, 50±ll years). As an index of intra-abdominal fat accumulation, the ratio of the intra-abdominal visceral fat area to subcutaneous fat area was determined using a computed tomographic section at the level of the umbilicus. When the obese subjects were divided into a hypertensive group and a normotensive group, the ratio of the intra-abdominal visceral fat area to subcutaneous fat area in the hypertensive group was significantly higher (0.53±0.33 versus 0.29±0.12, p<0.01). Significant correlations between the ratio of intra-abdominal visceral fat area to subcutaneous fat area and systolic blood pressure (r=0.62, p< 0.001) and diastolic blood pressure (r=0.53, p< 0.001) also were found. However, no significant difference existed in either the body mass index or the waist-to-hip circumference ratio between the hypertensive and normotensive groups. Plasma renin activity, aldosterone, epinephrine, and norepinephrine levels were not significantly different between the two groups. Moreover, the correlation between the ratio of the intra-abdominal visceral fat area to subcutaneous fat area ratio and blood pressure was found independent of age and body mass index by multiple regression analyses. We conclude that intra-abdominal fat accumulation itself may play an important role in the pathogenesis of hypertension in obesity. (Hypertension 1990;16:484-490) I t has been noted that the incidence of circulatory and metabolic complications among comparably obese subjects differs depending on their body habitus.1 We have developed a method to estimate fat distribution using computed tomography (CT) scan, which clearly distinguishes between subcutaneous fat and intra-abdominal visceral fat 2 and have demonstrated a close correlation between intra-abdominal fat accumulation and metabolic disturbances.3 Further, using this method we reported that the accumulation of intra-abdominal visceral fat itself may reflect cardiac dysfunction and metabolic disorders better than subcutaneous fat. 4 -7 Therefore, we propose the existence of two types of obesity: visceral fat obesity, characterized by a pronounced accumulation of fat in the abdominal cavity, and subcutaneous fat obesity, From The Second Department of Internal Medicine, Osaka University Medical School, Fukushima-ku, Osaka, Japan.Presented in part at the 62nd Annual Scientific Sessions of the American Heart Association, New Orleans, Louisiana, November [13][14][15][16] 1989.Address for correspondence: Hideyuki Kanai, MD, The Second Department of Internal Medicine, Osaka University Medical School, 1-1-50 Fukushima, Fukushima-ku, Osaka 553, Japan.Received March 7,199O, accepted in revised form June 15,1990. characterized by an accumulation mainly in the subcutis (Figure 1). We also reported 8 that this classification is more useful than other classifications of fat distribution, 9 "16 including the waist-to-hip circum...

We investigated the biological activity of IL-4 to murine connective tissue-type mast cells (CTMC). When purified peritoneal mast cells, typical CTMC, were incubated with pokeweed mitogen-stimulated spleen cell-conditioned medium (PWM-SCM) in methylcellulose, about one-fifth of mast cells showed clonal growth. Recombinant IL-4 alone did not stimulate the clonal growth, and purified IL-3 alone induced development of a small number of tiny clusters. In contrast, addition of IL-4 to IL-3 increased the number of clusters by a factor of 10. The number and size of clusters induced by the combination of IL-3 and IL-4 were comparable to those of mast cell clusters induced by PWM-SCM. The present results indicate that IL-4 is an essential factor for in vitro clonal growth of CTMC.

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