title: Visceral adipose tissue cutoffs associated with metabolic risk factors for coronary heart disease in women.
abstract: OBJECTIVE
  This study determined whether there is a critical level of visceral adipose tissue (VAT) associated with elevated coronary heart disease (CHD) risk factors in a cohort of women >45 years of age.
  
  
  METHODS
  Measurements of body composition (dual-energy X-ray absorptiometry), body fat distribution (computed tomography), fasting and 2-h postprandial (75-g) glucose concentrations, and fasting lipoprotein lipid and insulin concentrations were performed in 233 perimenopausal (9%) and postmenopausal women (age 59 +/- 6 years, 79% Caucasian, 16% on hormone replacement therapy).
  
  
  RESULTS
  Women in the lowest VAT quintile (< or =105 cm(2)) had higher concentrations of HDL and HDL(2) cholesterol, lower LDL/HDL cholesterol ratios and triglyceride concentrations, and lower fasting glucose and insulin concentrations than women in the remaining four quintiles (P values <0.05-0.001). Women in the second lowest VAT quintile (106-139 cm(2)) had higher HDL and HDL(2) cholesterol and lower LDL/HDL ratios than women with a VAT > or =163 cm(2) (P < 0.05). Logistic regression analyses showed that women with a VAT of 106-162 cm(2) are 2.5 times more likely to have a low HDL cholesterol (P < 0.05), while women with a VAT > or =163 cm(2) are 5.5 times more likely to have a low HDL cholesterol (P < 0.01) and approximately 4.0 times more likely to have a high LDL/HDL ratio (P < 0.05) compared with women with a VAT < or =105 cm(2). Women with a VAT > or =163 cm(2) are at a higher risk of having impaired glucose tolerance (P < 0.01).
  
  
  CONCLUSIONS
  A VAT > or =106 cm(2) is associated with an elevated risk, and a VAT > or =163 cm(2) with an even greater risk, for these metabolic CHD risk factors compared with women with a VAT < or =105 cm(2). These values may prove useful for defining "visceral obesity" and for identifying women most likely to benefit from preventative interventions.
authors.affiliation: Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA. bnicklas@wfubmc.edu
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Nicklas
authors.forename: Brenda W J H
authors.initials: BW
authors.lastname: Penninx
authors.forename: Alice S
authors.initials: AS
authors.lastname: Ryan
authors.forename: Dora M
authors.initials: DM
authors.lastname: Berman
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Lynch
authors.forename: Karen E
authors.initials: KE
authors.lastname: Dennis
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000033:anatomy & histology*; D000368:Aged; D044383:Black People; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D001824:Body Constitution; D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000453:epidemiology*; D005215:Fasting; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D008074:Lipoproteins / Q000097:blood; D008875:Middle Aged; D019518:Postprandial Period; D012044:Regression Analysis; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014481:United States; D014781:Viscera / Q000033:anatomy & histology; D044465:White People; D001741:Black or African American
chemical_list: D001786:Blood Glucose; D007328:Insulin; D008074:Lipoproteins; D002784:Cholesterol