Association of visceral fat with coronary risk factors in a population-based sample of postmenopausal women

Hernandez‐Ono, Antonio; Monter-Carreola, Gustavo Aarón; Zamora-González, José; Cardoso-Saldaña, Guillermo; Posadas-Sánchez, Rosalinda; Torres-Tamayo, Margarita; Posadas‐Romero, Carlos

doi:10.1038/sj.ijo.0801842

Cited by 65 publications

(41 citation statements)

References 31 publications

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“…However, there have been discrepancies between studies that have used such values, and the differences are not completely explained by ethnic-or sex-related confounders across investigations. For example, in a study on 220 pre-and post-menopausal white women from 18-77 years of age, a visceral fat area of ≥110 cm 2 was suggested to identify individuals at high risk of cardiovascular and metabolic disease [42], while other studies on 98 post-menopausal Mexican women aged 50-65 years or on 146 healthy men aged 30-71 years, the value was set at ≥117.8 cm 2 or ≥130 cm 2 , respectively [43,44]. Similarly, one intervention study has claimed that a reduction in visceral fat area to <60 cm 2 is necessary to improve risk factors for CHD [45], whereas another study found improvements in plasma HDL-cholesterol levels, the cholesterol:HDL-cholesterol ratio and insulin sensitivity in subjects who reduced their visceral fat to below 110 cm 2 compared with those who did not [46].…”

Section: What Do We Learn From Body Fat Distribution?mentioning

confidence: 99%

Adipose tissue distribution and risk of metabolic disease: does thiazolidinedione-induced adipose tissue redistribution provide a clue to the answer?

2007

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The relative effect of visceral and subcutaneous obesity on the risk of chronic metabolic disease has been a matter of long-term dispute. While ample data support either of the fat depots being causative or associative, valid argument for one depot often automatically belittles the other. Paradigms such as the visceral/portal hypothesis and the acquired lipodystrophy/ectopic fat storage and endocrine hypothesis have been proposed. Nevertheless, neither hypothesis alone explains the entire pathophysiological setting. Treatment of diabetes with thiazolidinediones selectively increases fat partitioning to the subcutaneous adipose depot but does not change visceral fat accumulation. This is in contrast to the preferential visceral fat mobilisation by diet and exercise. Surgical removal of visceral or subcutaneous adipose tissue yields relatively long-lasting metabolic improvement only when combined with procedures that ameliorate adipose tissue cell composition. These studies illustrate that human adipose tissue in different anatomic locations does not work in isolation, and that there is a best-fit relationship in terms of volume and function among different fat depots that needs to be met to maintain the systemic energy balance and to prevent the complications related to obesity.

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Section: What Do We Learn From Body Fat Distribution?mentioning

confidence: 99%

Adipose tissue distribution and risk of metabolic disease: does thiazolidinedione-induced adipose tissue redistribution provide a clue to the answer?

2007

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“…27 On the other hand, a cutoff of 118 cm 2 of VAT was regarded as high among 98 postmenopausal Mexican women (which corresponded to a waist circumference of 84 cm), based on a less favorable metabolic profile comprising insulin, triglycerides, apo B and HDL-C values. 28 The threshold of 94 cm of waist circumference in men to reflect visceral adiposity is in keeping with the information as to the most appropriate cutpoint of waist circumference to be used in the prediction of CHD events in a population inclined to insulin resistance, obtained in the entire cohort of the Turkish Adult Risk Factor study in a recent analysis of 2350 men and women. In that study, Z96 cm appeared the best threshold in men, which was associated with significantly elevated levels of selected cutpoints of apolipoprotein B, CRP, fasting insulin, and with the prevalence of diabetes mellitus.…”

Section: Best Index Of Visceral Adipositymentioning

confidence: 99%

Measures of abdominal obesity assessed for visceral adiposity and relation to coronary risk

et al. 2004

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AIMS:We aimed to identify by computed tomography (CT) the best suited of three anthropometric indices that reflect the visceral adipose tissue (VAT), and to discern the relationship between VAT and certain atherogenic risk factors and coronary heart disease (CHD) diagnosis in a population sample which had a high (34%) prevalence of the metabolic syndrome (MS). METHODS: A single-scan CT was performed between the fourth and fifth lumbar vertebrae in 157 unselected men and women aged 34-69 y. Total adipose tissue area, abdominal VAT area and the abdominal sagittal diameter were determined. Diagnosis of CHD was based on clinical findings and Minnesota coding of resting electrocardiograms. RESULTS: Men had significantly higher VAT than women. Linear regression analysis for correlates of abdominal VAT area, in a model comprising age, sex, waist circumference, waist-to-hip ratio (WHR) and body mass index (BMI) identified waist circumference as the only independent variable (Po0.001). Waist circumference in men and BMI in women were the independently associated parameters of sagittal diameter (Po0.001). By stepwise linear regression, it was elicited that VAT area rose significantly by a mean of 6.8 cm 2 in men and 3 cm 2 in women for every 1 cm increment in waist circumference, independent of WHR. Age in women and (inversely) BMI in men were further independent variables, indicating in men that a lower BMI at a given waist girth suggests the existence of a higher VAT. Apo B and HDL-cholesterol (HDL-C) in men, and the latter in women were independently associated with VAT area in linear regression models that also comprised triglycerides, fasting insulin and C-reactive protein concentrations. In the study sample comprising 13 individuals with a CHD diagnosis, the age-adjusted odds ratio of cutpoints of VAT area 4 vs o140 cm 2 in men and 4 vs o120 cm 2 in women was 11.3 (95% CI (1.37, 93)). CONCLUSIONS: The best surrogate of visceral adiposity across a wide age range is waist circumference, in a population in which MS prevails. Apo B and HDL-C in men, and the latter in women were independently associated with VAT area, which proved to be closely related to CHD risk. A lower BMI at a given waist girth in men suggests the existence of a higher VAT.

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“…Both obesity and depression are becoming increasingly prevalent and are associated with numerous complications, including hypertension and coronary heart disease (1,2). Although the underlying mechanisms of the effects of obesity on these complications are well documented, those of depression are unclear and controversial.…”

Section: Introductionmentioning

confidence: 99%

“…This has drawn much attention because it may help to explain findings linking depression to coronary heart disease and other metabolic complications. However, these studies have some limitations: 1) most of the studies did not fully control for the effects of other important confounding variables, such as exercise and diet (3)(4)(5)(6), and 2) most of them did not consider the distribution of visceral adipose tissue (VAT) 1 and subcutaneous adipose tissue (SAT), which have different clinical implications.…”

Section: Introductionmentioning

confidence: 99%

Depressive Mood and Abdominal Fat Distribution in Overweight Premenopausal Women

et al. 2005

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Objective: There is increasing evidence that depressive mood is associated with central obesity, but little is known about the association between depression and abdominal fat distribution. This study investigated this relationship in premenopausal women. Research Methods and Procedures:We recruited 101 overweight premenopausal women who had no eating disorders as defined using the DSM IV criteria. Depressive mood was assessed using Zung's Self-Rating Depression Scale (SDS). Areas of visceral (VAT) and subcutaneous (SAT) adipose tissue at the level of vertebral body L 4 -L 5 were measured using computed tomography. Associations of VAT, SAT, and the ratio of VAT to SAT with natural logarithmic transformation [(ln)]SDS were evaluated using linear regression. Anthropometric indices and physical fitness were also measured. Information on socioeconomic status, education level, and alcohol and smoking habits was obtained using self-administered questionnaires. A hospital nutritionist assessed nutritional status. All of these factors were adjusted for as possible confounding factors in the analyses. Results: The (ln)SDS score showed a positive association with the area of VAT, even after adjusting for the confounders mentioned above (p Ͻ 0.01). BMI, waist circumference, maximal oxygen uptake, and age were also associated with the area of VAT (all p Ͻ 0.05). In contrast, the (ln)SDS score was not associated with SAT (p Ͼ 0.10). Discussion: We showed that depressive mood is associated with VAT, not with SAT, in overweight premenopausal women. These findings may explain some of the association between depression and coronary heart disease. More studies are needed to elucidate the causal relationship.

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Association of visceral fat with coronary risk factors in a population-based sample of postmenopausal women

Cited by 65 publications

References 31 publications

Adipose tissue distribution and risk of metabolic disease: does thiazolidinedione-induced adipose tissue redistribution provide a clue to the answer?

Adipose tissue distribution and risk of metabolic disease: does thiazolidinedione-induced adipose tissue redistribution provide a clue to the answer?

Measures of abdominal obesity assessed for visceral adiposity and relation to coronary risk

Depressive Mood and Abdominal Fat Distribution in Overweight Premenopausal Women

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