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Fat Distribution May Make a Difference

Metabolic syndrome—a cluster of symptoms including hypertension,insulin resistance, high serum triglycerides and HDL cholesterol, and largewaist size—has a known link to obesity. But previous studies of waistcircumference typically have not distinguished between subcutaneous fat andfat within the viscera.

The research involved computed tomography that was performed on 3,035 maleand female volunteers ranging in age from 70 to 79 years to determine how fatis distributed on the body of each person. Through CAT scans, investigatorswere able to determine precisely the amounts of visceral, abdominalsubcutaneous, intermuscular, and subcutaneous thigh fat.

Overall, 39% of participants had metabolic syndrome, which was more commonin the obese than in normal-weight or overweight people. Researchers foundimportant differences in the risk of metabolic syndrome, depending on how fatis distributed in the body.

Data showed that metabolic syndrome was associated with visceral fat amongnormal-weight, overweight, and obese participants. Metabolic syndrome was twoto three times more likely to present in those with visceral fat in everyweight category. Abdominal subcutaneous fat was linked to metabolic syndromeonly among men of normal weight. Intermuscular fat raised the risk ofmetabolic syndrome among normal-weight and overweight men. In contrast,subcutaneous fat in the thigh area was inversely associated with metabolicsyndrome.

Clearly, the association between body fat and metabolic syndrome is complexand involves more than mere obesity. In fact, according to researchers, obesewomen without metabolic syndrome had a higher proportion of body fat thanthose with the condition.

Clinicians should not make quick judgments about patients' risk ofmetabolic syndrome based on weight or body mass index (BMI), researcherscaution.

Goodpaster BH, Krishnaswami S, Harris TB, et al.: Obesity,regional body fat distribution, and the metabolic syndrome in older men andwomen. Arch Intern Med 165:777–783, 2005.[Abstract/Free Full Text]

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