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

Abstract

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.

Value of body fat mass vs anthropometric obesity indices in the assessment of metabolic risk factors

“…[35][36][37] Imaging technologies identified WC as an suitable index of visceral FM. [38][39][40] In our study, indices of central obesity (WC/ ht in both sexes and WC in men) were more closely related to %FM than BMI (Table 4). Additionally, when compared to %FM or BMI, both indices of central obesity (WC/ht in women and WC in men) were more closely associated with metabolic risk (Figure 1).…”

Prevalência de obesidade visceral estimada por equação preditiva em mulheres jovens pernambucanas

“…Unlike the above, Onat et al 25 found in their study, which also involved women classified as overweight with abdominal obesity according to the mean BMI and WC, respectively, a much higher mean of VVF than that of the present study (120.5 ± 58 cm 2 ). It is noteworthy the fact that the study was conducted in a population with a mean age of 49 ± 8.7 years with a high prevalence of metabolic syndrome (34%) 25 .…”

“…It is noteworthy the fact that the study was conducted in a population with a mean age of 49 ± 8.7 years with a high prevalence of metabolic syndrome (34%) 25 . These authors emphasized the significant increase in VAT with age and a 42% higher mean in the group with metabolic syndrome 25 , which may explain the difference observed when compared with the present study, which involved younger women, less likely to have metabolic syndrome.…”

Effects of physical activity, body mass index, waist-to-hip ratio and waist circumference on total mortality risk in the Swedish National March Cohort

“…No clear pattern was seen for WHR, for either gender -but WHR may be more difficult to interpret since it could reflect an effect of larger waist as well as a smaller hip circumference [21], while waist circumference alone is more strongly correlated with visceral adiposity [53].…”