Body fatness and fat distribution as predictors of metabolic abnormalities and early carotid atherosclerosis.
OBJECTIVE
To test the hypothesis that intra-abdominal fat plays a primary role over general adiposity for metabolic abnormalities and atherosclerosis.


METHODS
We cross-sectionally studied 849 Japanese men aged 50.3 +/- 8.5 years (range 20-78) with BMI 23.5 +/- 2.9 kg/m(2). Intimal-medial thickness (IMT) of the carotid artery was measured by ultrasound. General adiposity was assessed by BMI. Waist circumference and waist-to-hip ratio (WHR) were used as a surrogate measure for abdominal fat. Abdominal subcutaneous fat area (ASF) and intra-abdominal fat area (IAF) were measured by computed tomography. Correlations between these measures and carotid IMT were analyzed. The interaction of generalized adiposity (BMI) and IAF in relation to metabolic variables, such as glucose tolerance, insulin resistance, and serum lipids, was also evaluated.


RESULTS
BMI, waist circumference, WHR, ASF, and IAF were all correlated with carotid IMT. Adjustment for BMI eliminated the associations between IMT and waist circumference, ASF, and IAF. In contrast, WHR retained a significant correlation with IMT. BMI and IAF were associated with insulin resistance, glucose tolerance, HDL cholesterol, and blood pressure independently of each other. IAF was an independent correlate for serum triglyceride, but BMI was not.


CONCLUSIONS
The primary importance of IAF over general adiposity for carotid atherosclerosis was not confirmed. Caution is recommended when using WHR as a measure of abdominal fat. The roles of IAF for metabolic abnormalities may be more limited than conventionally thought. BMI and WHR are simple and better clinical predictors for carotid atherosclerosis versus IAF.
Takami
R
R
Department of Internal Medicine, Matsunami General Hospital, Kasamatsu, Japan.
Takeda
N
N
Hayashi
M
M
Sasaki
A
A
Kawachi
S
S
Yoshino
K
K
Takami
K
K
Nakashima
K
K
Akai
A
A
Yamakita
N
N
Yasuda
K
K
D000005:Abdomen; D000273:Adipose Tissue / Q000033:anatomy & histology*; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D001824:Body Constitution; D015992:Body Mass Index; D002339:Carotid Arteries / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000453:epidemiology*; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D018149:Glucose Intolerance / Q000453:epidemiology*; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D007564:Japan; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014280:Triglycerides / Q000097:blood; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography
D001786:Blood Glucose; D007328:Insulin; D014280:Triglycerides; D002784:Cholesterol