Adiposity, fat distribution, and cardiovascular risk.
OBJECTIVE
To determine the relative importance of adiposity and fat distribution to cardiovascular risk profile.


METHODS
A cross-sectional study.


METHODS
Clinical research center funded by the National Institutes of Health.


METHODS
Convenience sample of 33 healthy premenopausal women with a wide range of body weight who did not have diabetes mellitus, hirsutism and virilism, gynecologic disorder, cardiac disease, or hypertension. Women participating in exercise or dietary programs or taking medication were excluded. All subjects completed the study.


METHODS
Total body fat mass was determined by hydrostatic weighting, and fat distribution was assessed by subscapular skinfold thickness, subscapular-to-triceps skinfold ratio, the waist-to-hip ratio, and computed tomography. Cardiovascular risk was assessed by the serum insulin response during oral glucose stimulation; levels of triglycerides and total cholesterol; high-density lipoprotein cholesterol to total cholesterol concentrations; and systolic and diastolic blood pressures.


RESULTS
The anthropometric parameters chosen were significantly associated with the cardiovascular risk profile (P less than 0.001). Visceral fat distribution assessed by computed tomography accounted for a significantly greater degree of variance in the cardiovascular risk factors than the total body fat mass (P less than 0.05). The cumulative insulin response was the primary metabolic variable relating the anthropometric indices to cardiovascular risk.


CONCLUSIONS
Intra-abdominal fat deposition constitutes a greater cardiovascular risk than obesity alone. Hyperinsulinemia may constitute an important component of the increased cardiovascular risk of abdominal obesity.
Peiris
A N
AN
Medical College, Milwaukee, Wisconsin.
Sothmann
M S
MS
Hoffmann
R G
RG
Hennes
M I
MI
Wilson
C R
CR
Gustafson
A B
AB
Kissebah
A H
AH
D000273:Adipose Tissue / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D000328:Adult; D000886:Anthropometry; D001794:Blood Pressure; D001823:Body Composition; D001824:Body Constitution; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology* / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D008055:Lipids / Q000097:blood; D009765:Obesity / Q000150:complications* / Q000473:pathology; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
D007328:Insulin; D008055:Lipids