This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Vega, G. L. Articles by Grundy, S. M. Search for Related Content PubMed PubMed Citation Articles by Vega, G. L. Articles by Grundy, S. M. Related Collections Metabolism Obesity

Influence of Body Fat Content and Distribution on Variation in Metabolic Risk

Donald W. Reynolds Cardiovascular Clinical Research Center and the Department of Internal Medicine (G.L.V., R.P., D.W., S.M.G.), Center for Human Nutrition (G.L.V., B.S., S.M.G.), and Departments of Clinical Sciences and Internal Medicine (B.A.-H.), University of Texas Southwestern Medical Center, Dallas, Texas 75390

Address all correspondence and requests for reprints to: Scott M. Grundy, M.D., Ph.D., Center for Human Nutrition (Y3-206), University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390-9052. E-mail: scott.grundy{at}utsouthwestern.edu.

Objectives: Several reports indicate that the body fat compartments, especially ip fat, predict metabolic risk better than total body fat. The objective of the study was to determine whether this can be confirmed and generalized throughout the population.

Participants: A representative sample of 1934 Black and White women and men of the Dallas Heart Study participated in the study.

Design: We measured the fat in total body, trunk, and lower body with dual-energy x-ray absorptiometry and in abdominal compartments (sc, ip, and retroperitoneal) with magnetic resonance imaging. Other measurements included body mass index (BMI), waist circumference, blood pressure, plasma lipids, glucose, insulin (including homeostasis model), and C-reactive protein.

Results: In all groups, total body fat correlated positively with key metabolic risk factors, i.e. homeostasis model, triglyceride/high-density lipoprotein-cholesterol ratios, C-reactive protein, and blood pressure; however, it explained less than one third of the variability of all the risk factors. After adjustment for total body fat, truncal fat conferred additional positive correlation with risk factors. Furthermore, with multivariable regression analysis, ip fat conferred independent correlation with plasma lipids beyond a combination of other compartments including truncal fat. Still, except for insulin levels, all combinations including ip fat still explained less than one third of the variability in risk-factor levels. Conversely, lower body fat correlated negatively with risk factors; i.e. lower body fat appeared to offer some protection against risk factors.

Conclusions: Body fat distribution has some influence on risk factors beyond total body fat content. Both waist circumference and BMI significantly predicted risk factors after adjustment for total body fat, and for clinical purposes, most of the predictive power for men was contained in waist circumference, whereas for women, BMI and waist circumference were similarly predictive. Finally, even though the correlations between combined body fat parameters and risk factors explained only a portion of the variation in the latter, the average number of categorical metabolic risk factors increased progressively with increasing obesity. Hence, obesity seemingly has more clinical impact than revealed in these correlative studies.

This article has been cited by other articles:

				P. Iozzo Viewpoints on the Way to the Consensus Session: Where does insulin resistance start? The adipose tissue Diabetes Care, November 1, 2009; 32(suppl_2): S168 - S173. [Full Text] [PDF]

				T. J. Saunders, L. E. Davidson, P. M. Janiszewski, J.-P. Despres, R. Hudson, and R. Ross Associations of the Limb Fat to Trunk Fat Ratio With Markers of Cardiometabolic Risk in Elderly Men and Women J Gerontol A Biol Sci Med Sci, October 1, 2009; 64A(10): 1066 - 1070. [Abstract] [Full Text] [PDF]

				E. Fabbrini, F. Magkos, B. S. Mohammed, T. Pietka, N. A. Abumrad, B. W. Patterson, A. Okunade, and S. Klein Intrahepatic fat, not visceral fat, is linked with metabolic complications of obesity PNAS, September 8, 2009; 106(36): 15430 - 15435. [Abstract] [Full Text] [PDF]

				A. Khera, G. L. Vega, S. R. Das, C. Ayers, D. K. McGuire, S. M. Grundy, and J. A. de Lemos Sex Differences in the Relationship between C-Reactive Protein and Body Fat J. Clin. Endocrinol. Metab., September 1, 2009; 94(9): 3251 - 3258. [Abstract] [Full Text] [PDF]

				L. R. Meacham, C. A. Sklar, S. Li, Q. Liu, N. Gimpel, Y. Yasui, J. A. Whitton, M. Stovall, L. L. Robison, and K. C. Oeffinger Diabetes Mellitus in Long-term Survivors of Childhood Cancer: Increased Risk Associated With Radiation Therapy: A Report for the Childhood Cancer Survivor Study Arch Intern Med, August 10, 2009; 169(15): 1381 - 1388. [Abstract] [Full Text] [PDF]

				K. C. Oeffinger, B. Adams-Huet, R. G. Victor, T. S. Church, P. G. Snell, A. L. Dunn, D. A. Eshelman-Kent, R. Ross, P. M. Janiszewski, A. J. Turoff, et al. Insulin Resistance and Risk Factors for Cardiovascular Disease in Young Adult Survivors of Childhood Acute Lymphoblastic Leukemia J. Clin. Oncol., August 1, 2009; 27(22): 3698 - 3704. [Abstract] [Full Text] [PDF]

				C. Brufani, A. Tozzi, D. Fintini, P. Ciampalini, A. Grossi, R. Fiori, D. Kiepe, M. Manco, R. Schiaffini, O. Porzio, et al. Sexual dimorphism of body composition and insulin sensitivity across pubertal development in obese Caucasian subjects Eur. J. Endocrinol., May 1, 2009; 160(5): 769 - 775. [Abstract] [Full Text] [PDF]

				H.-Y. Chen, Y.-L. Chiu, S.-P. Hsu, M.-F. Pai, C.-F. Lai, Y.-S. Peng, T.-W. Kao, K.-Y. Hung, T.-J. Tsai, and K.-D. Wu Association of serum fetuin A with truncal obesity and dyslipidemia in non-diabetic hemodialysis patients Eur. J. Endocrinol., May 1, 2009; 160(5): 777 - 783. [Abstract] [Full Text] [PDF]

				S. H. Jain, J. M. Massaro, U. Hoffmann, G. A. Rosito, R. S. Vasan, A. Raji, C. J. O'Donnell, J. B. Meigs, and C. S. Fox Cross-Sectional Associations Bet ween Abdominal and Thoracic Adipose Tissue Compartments and Adiponectin and Resistin in the Framingham Heart Study Diabetes Care, May 1, 2009; 32(5): 903 - 908. [Abstract] [Full Text] [PDF]

				A. A. Mahabadi, J. M. Massaro, G. A. Rosito, D. Levy, J. M. Murabito, P. A. Wolf, C. J. O'Donnell, C. S. Fox, and U. Hoffmann Association of pericardial fat, intrathoracic fat, and visceral abdominal fat with cardiovascular disease burden: the Framingham Heart Study Eur. Heart J., April 1, 2009; 30(7): 850 - 856. [Abstract] [Full Text] [PDF]

				E. S. Ford, C. Li, G. Zhao, W. S. Pearson, and A. H. Mokdad Hypertriglyceridemia and Its Pharmacologic Treatment Among US Adults Arch Intern Med, March 23, 2009; 169(6): 572 - 578. [Abstract] [Full Text] [PDF]

				S. Ledoux, I. Queguiner, S. Msika, S. Calderari, P. Rufat, J.-M. Gasc, P. Corvol, and E. Larger Angiogenesis Associated With Visceral and Subcutaneous Adipose Tissue in Severe Human Obesity Diabetes, December 1, 2008; 57(12): 3247 - 3257. [Abstract] [Full Text] [PDF]

				J. A. Young, S.-J. Hwang, M. J. Sarnak, U. Hoffmann, J. M. Massaro, D. Levy, E. J. Benjamin, M. G. Larson, R. S. Vasan, C. J. O'Donnell, et al. Association of Visceral and Subcutaneous Adiposity with Kidney Function Clin. J. Am. Soc. Nephrol., November 1, 2008; 3(6): 1786 - 1791. [Abstract] [Full Text] [PDF]

				S. Sam, S. Haffner, M. H. Davidson, R. B. D'Agostino Sr., S. Feinstein, G. Kondos, A. Perez, and T. Mazzone Relationship of Abdominal Visceral and Subcutaneous Adipose Tissue With Lipoprotein Particle Number and Size in Type 2 Diabetes Diabetes, August 1, 2008; 57(8): 2022 - 2027. [Abstract] [Full Text] [PDF]

				S. M. Grundy Metabolic Syndrome Pandemic Arterioscler Thromb Vasc Biol, April 1, 2008; 28(4): 629 - 636. [Abstract] [Full Text] [PDF]

				S. M. Grundy A changing paradigm for prevention of cardiovascular disease: emergence of the metabolic syndrome as a multiplex risk factor Eur. Heart J. Suppl., March 1, 2008; 10(suppl_B): B16 - B23. [Abstract] [Full Text] [PDF]

				R. See, S. M. Abdullah, D. K. McGuire, A. Khera, M. J. Patel, J. B. Lindsey, S. M. Grundy, and J. A. de Lemos The Association of Differing Measures of Overweight and Obesity With Prevalent Atherosclerosis: The Dallas Heart Study J. Am. Coll. Cardiol., August 21, 2007; 50(8): 752 - 759. [Abstract] [Full Text] [PDF]

				C. S. Fox, J. M. Massaro, U. Hoffmann, K. M. Pou, P. Maurovich-Horvat, C.-Y. Liu, R. S. Vasan, J. M. Murabito, J. B. Meigs, L. A. Cupples, et al. Abdominal Visceral and Subcutaneous Adipose Tissue Compartments: Association With Metabolic Risk Factors in the Framingham Heart Study Circulation, July 3, 2007; 116(1): 39 - 48. [Abstract] [Full Text] [PDF]

				M. J. Laye, J. P. Thyfault, C. S. Stump, and F. W. Booth Inactivity induces increases in abdominal fat J Appl Physiol, April 1, 2007; 102(4): 1341 - 1347. [Abstract] [Full Text] [PDF]