Intra-Abdominal Adipose Tissue Cut-Points Related to Elevated Cardiovascular Risk in Women.

Williams, M. J.; Gr, Hunter; Kekes‐Szabo, Tamas; Treuth, Margarita S.; Nyikos, Ildiko; Snyder, Scott W.; Berland, Lincoln L.

doi:10.1249/00005768-199505001-01034

Cited by 62 publications

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“…The threshold values for VAT=SAT area (ie 0.276 vs 0.4 in Japanese adults 14 ) and sagittal diameter (ie 19.2 cm) obtained here were also much lower than those reported in adult studies. 15 According to the ROC analysis of VAT area in women performed by Williams et al, 31 the VAT area above which disease risk would be increased was 110 cm 2 , and that below which the risk would not be affected was 40 cm 2 . Thus, the present threshold value for VAT area was higher than the low threshold value of adults.…”

Section: Discussionmentioning

confidence: 99%

Threshold values of visceral fat measures and their anthropometric alternatives for metabolic derangement in Japanese obese boys

et al. 2002

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OBJECTIVE:To determine whether the direct measure of visceral adipose tissue (VAT) by computed tomography (CT) is a superior diagnostic criterion to the anthropometric surrogates and more classical criteria of obesity. DESIGN: Cross-sectional, clinical study. Obese boys were classified according to the occurrence of abnormal values in either serum triglyceride, alanine aminotransferase or insulin level. A threshold value of each criterion for such metabolic derangement was calculated, using the analysis of receiver operating characteristic (ROC) curve. SUBJECTS: Seventy-five consecutive outpatient Japanese obese boys, ranging in age from 6 to 14 y, were studied. MEASUREMENTS: Anthropometric indices measured were height, body weight, waist girth, hip girth, triceps and subscapular skinfold thicknesses. Classical criteria for obesity used were percentage overweight (POW), body mass index (BMI) and percentage body fat. Waist girth, sagittal diameter by CT and waist -hip ratio (WHR) were evaluated as anthropometric surrogates for VAT. The areas of total abdominal fat (TAF), VAT and subcutaneous adipose tissue (SAT) were measured by CT at the level of the umbilicus. Clinical blood biochemistry was analyzed in fasting blood samples of obese boys. RESULTS: Thirty-three boys were classified into a no-complication group, and 42 into a complication group. TAF, VAT and SAT areas were closely associated with age, body size and degree of overweight and adiposity, while VAT=SAT was not. VAT area, sagittal diameter, TAF area and waist girth were closely correlated with alanine aminotransferase, insulin, TG and HDL-C. VAT=SAT, BMI, SAT area, WHR, percentage body fat and POW were less closely associated with these biochemical indices. The descending order of the values of area under the curve for the ROC curves were as follows: VAT > sagittal diameter > TAF > VAT=SAT > waist girth > BMI > WHR > percentage body fat > POW. Both VAT area and VAT=SAT gave > 80% of sensitivity and specificity. Among the anthropometric indices studied, the sagittal diameter was the best surrogate of visceral fat measure. The sensitivity and specificity for the rest of the anthropometric indices were in an unsatisfactory range. The threshold values for VAT area, VAT=SAT and sagittal diameter were 58.0 cm 2 , 0.276 and 19.2 cm, respectively. CONCLUSION: The threshold values for VAT area, VAT=SAT and sagittal diameter for detecting biochemical complication in Japanese obese boys were lower than the respective values reported in adults. These values can be used for classifying the obese boys into two types: those with medical problem and those without.

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Section: Discussionmentioning

confidence: 99%

Threshold values of visceral fat measures and their anthropometric alternatives for metabolic derangement in Japanese obese boys

et al. 2002

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“…Likelihood ratios for positive and negative results were calculated for each level of VAT, and specific cut-off points were identified as those with the highest likelihood ratio for positive results or with the lowest ratio for negative results. 4 Depending on the studied risk factor, cut-off points ranged from 158 to 102.7 cm 2 . Therefore, a VAT value of 117.8 cm 2 was considered the best cut-off point to identify women with an increased cardiovascular risk profile, as this was the value within the ROC calculated cut-off points, where most risk factors showed an important increase in mean values.…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2002

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OBJECTIVE:To investigate in a population-based random sample of postmenopausal women the adjusted association of visceral adipose tissue (VAT) with coronary risk factors. DESIGN: Cross-sectional population-based random sample study. SUBJECTS: Ninety-eight postmenopausal women (age 50 -65 y). MEASUREMENTS: Visceral and subcutaneous fat areas by computer axial tomography, anthropometry, lipid profile, fasting glucose and insulin, diet, physical activity, smoking status and alcohol intake. RESULTS: Compared to women with low VAT, women with high VAT ( > 117.8 cm 2 ) had a less favorable metabolic profile with significantly higher fasting glucose (120 AE 50 vs 98 AE 39), insulin (7.9 AE 10 vs 5 AE 8), triglycerides (172 AE 69 vs 127 AE 72), apolipoprotein B (119 AE 24 vs 98 AE 32) and significantly lower HDL-C (38 AE 10 vs 46 AE 14) values in the whole sample (n ¼ 98). A similar profile was found in women without diabetes and hypertension (n ¼ 39). In multiple regression models, VAT explained a portion of the variance of TG (6.2%) in the entire sample and of total cholesterol (12.4%), LDL-C (15.8%), triglycerides (16.3%), apolipoprotein B (11.6%), and fasting glucose (28.4%) in the group of non-diabetic or hypertensive women. Our VAT cut-off point of 117.8 cm 2 corresponded to a waist circumference of 84 cm. CONCLUSION: Our results in a random population-based sample of postmenopausal women confirm the association of VAT with most coronary risk factors. These associations persisted after adjusting for diet, physical activity, smoking status and alcohol intake.

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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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Intra-Abdominal Adipose Tissue Cut-Points Related to Elevated Cardiovascular Risk in Women.

Cited by 62 publications

References 0 publications

Threshold values of visceral fat measures and their anthropometric alternatives for metabolic derangement in Japanese obese boys

Threshold values of visceral fat measures and their anthropometric alternatives for metabolic derangement in Japanese obese boys

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

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

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