Hypertriglyceridemic waist phenotype predicts increased visceral fat in subjects with type 2 diabetes.
OBJECTIVE
Greater accumulation of visceral fat is strongly linked to risk of cardiovascular disease. However, elevated waist circumference by itself does not always identify individuals with increased visceral fat.


METHODS
We examined 375 subjects with type 2 diabetes from the CHICAGO cohort for presence of hypertriglyceridemic waist phenotype (waist circumference >90 cm in men or >85 cm in women, in conjunction with a plasma triglyceride concentration of > or =177 mg/dl) to determine its usefulness for identifying subjects with increased amounts of visceral fat. We divided subjects into three groups: group 1 (low waist circumference and low triglycerides; waist circumference < or =90 cm in men or < or =85 cm in women and triglyceride <177 mg/dl, n = 18), group 2 (high waist circumference and low triglycerides; waist circumference >90 cm in men or >85 cm in women and triglycerides <177 mg/dl, n = 230), and group 3 (high waist circumference and high triglycerides; waist circumference >90 cm in men or >85 cm in women and triglycerides > or =177 mg/dl, n = 127).


RESULTS
Subjects in group 3 had significantly higher visceral fat (P < 0.0001), A1C (P < 0.01), and coronary artery calcium (P < 0.05) compared with group 2, despite similar age, BMI, and waist circumference. The relationship of the phenotype to atherosclerosis, however, was attenuated by adjustment for HDL cholesterol, triglyceride-rich lipoprotein cholesterol, apolipoprotein B, or LDL particle number.


CONCLUSIONS
The presence of hypertriglyceridemic waist phenotype in subjects with type 2 diabetes identifies a subset with greater degree of visceral adiposity. This subset also has greater degree of subclinical atherosclerosis that may be related to the proatherogenic lipoprotein changes.
Sam
Susan
S
Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Illinois, Chicago, Illinois. susansam@uic.edu
Haffner
Steven
S
Davidson
Michael H
MH
D'Agostino
Ralph B
RB
Feinstein
Steven
S
Kondos
George
G
Perez
Alfonso
A
Mazzone
Theodore
T
D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism* / Q000473:pathology*; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000503:physiopathology*; D050152:Intra-Abdominal Fat / Q000378:metabolism* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D055105:Waist Circumference / Q000502:physiology*