Genetic and Environmental Factors Contributing to Visceral Adiposity in Asian Populations

Abstract

Obesity-associated metabolic illnesses are increasing at an alarming rate in Asian countries. A common feature observed in the Asian population is a higher incidence of abdominal obesity—the “skinny-fat” Asian syndrome. In this review, we critically evaluate the relative roles of genetics and environmental factors on fat distribution in Asian populations. While there is an upward trend in obesity among most Asian countries, it appears particularly conspicuous in Malaysia. We propose a novel theory, the Malaysian gene-environment multiplier hypothesis, which explains how ancestral variations in feast-and-famine cycles contribute to inherited genetic predispositions that, when acted on by modern-day stressors—most notably, urbanization, westernization, lifestyle changes, dietary transitions, cultural pressures, and stress—contribute to increased visceral adiposity in Asian populations. At present, the major determinants contributing to visceral adiposity in Asians are far from conclusive, but we seek to highlight critical areas for further research.

Unravelling Polycystic Ovary Syndrome and Its Comorbidities

“…The accompanying obesity rate in PCOS patients varies from 50% to 80%, depending on ethnicity and the study population. 4 The prevalence of overweight or obesity has nearly tripled in the last 40 years; 5 in Korean, there has been an alarming increase in young adults (20–39 years of age) with a high degree of obesity. 6 Furthermore, Asian women tend to accumulate more visceral fat than Caucasian women.…”

“…6 Furthermore, Asian women tend to accumulate more visceral fat than Caucasian women. 5 From 2005 to 2015, the incidence rates of PCOS increased by 3.5- to 4.0-fold according to the increase in waist circumference and body mass index (BMI) based on the Korean National Health Insurance Service cohort. 7 This paper will review the precise pathophysiology of PCOS, its challenging diagnosis, and evidence-based treatments for the condition and its comorbidities.…”

Obesity epidemic through the prism of evolutionary processes

“…Эта гипотеза может помочь объяснить несколько феноменов, связанных с Ож. К примеру, известно, что среди жителей Юго-Восточной Азии чаще встречается фенотип TOFI (thin-outside-fat-inside, парадокс Y-Y, метаболически нездоровый при нормальном весе), при котором увеличено количество висцерального жира при нормальном ИМТ и значительно повышен кардиометаболический риск по сравнению с представителями европейских стран [45,46]. Согласно гипотезе о приоритизации висцеральной ЖТ, перераспределение ЖТ у народов, долгое время проживавших в странах с низким или средним уровнем дохода и низким уровнем санитарии, может иметь защитный эффект от многочисленных кишечных инфекций.…”

Expert opinion on the preoperative medical optimization of adults with diabetes undergoing metabolic surgery

“…Visceral adipose tissue is closely linked to insulin resistance and has been explored as a marker of remission[ 65 - 67 ]. BMI and waist circumference however might underestimate the amount of visceral adiposity in Asian population[ 68 , 69 ]. VFA as assessed by magnetic resonance imaging was associated with a higher chance of remission in candidates with BMI < 35 kg/m 2 [ 57 ].…”