Obesity, regional body fat distribution, and the metabolic syndrome in older men and women.
BACKGROUND
The metabolic syndrome is a disorder that includes dyslipidemia, insulin resistance, and hypertension and is associated with an increased risk of diabetes and cardiovascular disease. We determined whether patterns of regional fat deposition are associated with metabolic syndrome in older adults.


METHODS
A cross-sectional study was performed that included a random, population-based, volunteer sample of Medicare-eligible adults within the general communities of Pittsburgh, Pa, and Memphis, Tenn. The subjects consisted of 3035 men and women aged 70 to 79 years, of whom 41.7% were black. Metabolic syndrome was defined by Adult Treatment Panel III criteria, including serum triglyceride level, high-density lipoprotein cholesterol level, glucose level, blood pressure, and waist circumference. Visceral, subcutaneous abdominal, intermuscular, and subcutaneous thigh adipose tissue was measured by computed tomography.


RESULTS
Visceral adipose tissue was associated with the metabolic syndrome in men who were of normal weight (odds ratio, 95% confidence interval: 2.1, 1.6-2.9), overweight (1.8, 1.5-2.1), and obese (1.2, 1.0-1.5), and in women who were of normal weight (3.3, 2.4-4.6), overweight (2.4, 2.0-3.0), and obese (1.7, 1.4-2.1), adjusting for race. Subcutaneous abdominal adipose tissue was associated with the metabolic syndrome only in normal-weight men (1.3, 1.1-1.7). Intermuscular adipose tissue was associated with the metabolic syndrome in normal-weight (2.3, 1.6-3.5) and overweight (1.2, 1.1-1.4) men. In contrast, subcutaneous thigh adipose tissue was inversely associated with the metabolic syndrome in obese men (0.9, 0.8-1.0) and women (0.9, 0.9-1.0).


CONCLUSIONS
In addition to general obesity, the distribution of body fat is independently associated with the metabolic syndrome in older men and women, particularly among those of normal body weight.
Goodpaster
Bret H
BH
Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. bgood@pitt.edu
Krishnaswami
Shanthi
S
Harris
Tamara B
TB
Katsiaras
Andreas
A
Kritchevsky
Steven B
SB
Simonsick
Eleanor M
EM
Nevitt
Michael
M
Holvoet
Paul
P
Newman
Anne B
AB
D000273:Adipose Tissue / Q000033:anatomy & histology*; D000367:Age Factors; D000368:Aged; D044383:Black People; D001823:Body Composition; D001835:Body Weight; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology*; D009765:Obesity / Q000150:complications* / Q000473:pathology*; D012307:Risk Factors; D012737:Sex Factors; D014481:United States; D044465:White People; D001741:Black or African American