Abstract
OBJECTIVE: To assess the relative importance of the extent and regional distribution of fat for metabolic risk factors in young adults.
DESIGN: Cross-sectional study of findings from a hospital-based case–control study.
SUBJECTS: A total of 46 adult Danish Caucasian patients (40 men and six women, aged 34–54 y). Of these, 22 had had non fatal acute myocardial infarction before 41 y of age and 24 were age- and gender-matched controls without coronary heart disease.
MEASUREMENTS: Four measurements of fat: body mass index (BMI, kg/m2), body fat percentage measured using a dual energy X-ray absorptiometry (DEXA) scanner, waist/hip circumference ratio (WHR), and intra-abdominal adipose tissue area measured using computed tomography (CT) scanning, and eight metabolic risk factors: systolic and diastolic blood pressure, HbA1c percentage, fasting concentrations of capillary whole blood glucose, high-density lipoprotein (HDL) cholesterol, serum triglyceride, plasma plasminogen activator inhibitor 1 (PAI-1), and urinary albumin:creatinine excretion ratio.
RESULTS: Of 46 participants, 10 were obese (BMI >30 kg/m2), 12 were abdominally obese (WHR >0.90 for men and >0.85 for women), and 20 were intra-abdominally obese (intra-abdominal adipose tissue area >135 cm2). Men had a higher intra-abdominal adipose tissue area than women (P=0.0053, Mann–Whitney U-test). In multiple regression analyses of the four fat variables, only intra-abdominal adipose tissue area significantly predicted the levels of six metabolic risk factors: systolic blood pressure, diastolic blood pressure, fasting concentrations of capillary whole blood glucose, serum HDL cholesterol, serum triglyceride, and PAI-1. The intra-abdominal adipose tissue area had a linear relation with the six metabolic risk factors.
CONCLUSIONS: For young individuals, intra-abdominal fat is the important component of the body fat for six of the eight metabolic risk factors. Intra-abdominal fat might contribute to that most patients with acute myocardial infarction at a young age are men.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Rent or buy this article
Prices vary by article type
from$1.95
to$39.95
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
von Eyben FE, von Eyben R . Smoking and other major coronary risk factors and acute myocardial infarction before 41 years of age: two Danish Case–Control studies. Scand Cardiovasc J 2001; 35: 25–29.
von Eyben FE, Mouridsen E, Holm J, Montvillas P, Dimcevski G, Helleberg I, Kristensen L, Suciu G, von Eyben R . Smoking, low density lipoprotein cholesterol, fibrinogen, and acute myocardial infarction before 41 years of age. A Danish case–control study. J Cardiovasc Risk 2002; 9: 171–178.
Larsson B, Bengtsson C, Bjorntorp P, Lapidus L, Sjostrom L, Svardsudd K, Tibblin G, Wedel H, Welin L, Wilhelmsen L . Is abdominal body fat distribution a major explanation for the sex difference in the incidence of myocardial infarction? The study of men born in 1913 and the study of women, Goteborg, Sweden. Am J Epidemiol 1992; 135: 266–273.
Despres JP, Marette A . Obesity and insulin resistance. Epidemiologic, metabolic, and molecular aspects. In: Reaven GM, Laws A (eds). Insulin resistance. The metabolic syndrome X. Humana Press: Totowa, NJ; 1999. pp 51–81.
Van den Kooy K, Seidell JC . Techniques for the measurement of visceral fat: a practical guide. Int J Obes Relat Metab Disord 1993; 17: 187–196.
Anonymous. Clinical Guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. Obesity Res 1998; 6 (Suppl 2): 51S–209S.
Alberti KG, Zimmet PZ . Definition, diagnosis and classification of diabetes mellitus and its complications: Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabetes Med 1998; 15: 539–553.
Despres JP . Dyslipidaemia and obesity. Bailliére's Clin Endocrinol Metab 1994; 8: 629–660.
Lemieux S, Despres JP . Metabolic complications of visceral obesity: contribution to the etiology of type 2 diabetes and implications for prevention and treatment. Diabetes Metab 1994; 20: 375–393.
Lemieux S, Prud'Homme D, Tremblay A, Bouchard C, Despres JP . Anthropometric correlates in changes in visceral adipose tissue over 7 years in women. Int J Obes Relat Metab Disord 1996; 20: 618–624.
Fujioka S, Matsuzawa Y, Tokunaga K, Kawamoto T, Kobatake T, Keno Y, Kotani K, Yoshida S, Tarui S . Improvement of glucose and lipid metabolism associated with selective reduction of intra-abdominal visceral fat in premenopausal women with visceral fat obesity. Int J Obes Relat Metab Disord 1991; 15: 853–859.
Rimm EB, Stampfer MJ, Giovannucci E, Ascherio E, Spiegelman D, Colditz GA, Willett WC . Body size and fat distribution as predictors of coronary heart disease among middle-aged and older US men. Am J Epidemiol 1995; 141: 1117–1127.
Rexrode KM, Carey CJ, Hennekens CH, Walters EE, Colditz GA, Stampfer MJ, Willett WC, Manson JE . Abdominal obesity and coronary heart disease in women. JAMA 1998; 280: 1843–1848.
Freedman DS, Williamson DF, Croft JB, Ballew C, Byers T . Relation of body fat distribution to ischemic heart disease. The National Health and Nutrition Examination Survey I (NHANES I) Epidemiologic Follow-up Study. Am J Epidemiol 1995; 142: 53–63.
Rexrode KM, Buring JE, Manson JE . Abdominal and total adiposity and risk of coronary heart disease in men. Int J Obes Relat Metab Disord 2001; 25: 1047–1056.
Despres JP, Moorjani S, Ferland M, Tremblay A, Lupien P, Nadeau A, Pineault S, Theriault G, Bouchard G . Adipose tissue distribution and plasma lipoprotein levels in obese women: importance of intra-abdominal fat. Arteriosclerosis 1989; 9: 203–210.
Pouliot M, Despres J, Nadeau A, Moorjani S, Prud'Homme D, Lupien P, Tremblay A, Bouchard C . Visceral obesity in men. Associations with glucose tolerance, plasma insulin, and lipoprotein levels. Diabetes 1992; 41: 826–834.
Despres J, Nadeau A, Tremblay A, Ferland M, Moorjani S, Lupien P, Theriault G, Pineault S, Bouchard G . Role of deep abdominal fat in the association between regional adipose tissue distribution and glucose tolerance in obese women. Diabetes 1989; 38: 304–309.
Peiris AN, Sothmann MS, Hennes ML, Lee MB, Wilson CR, Gustafson AB, Kissebah AH . Relative contribution of obesity and body fat distribution to alterations in glucose insulin homeostasis: predictive values of selected indices in premenopausal women. Am J Clin Nutr 1989; 49: 758–764.
Lakka HM, Lakka TA, Tuomilehto J, Salonen JT . Abdominal obesity is associated with increased risk of acute coronary events in men. Eur Heart J 2002; 23: 709–713.
Osokun IS, Prewitt TE, Cooper RS . Abdominal obesity in the United States: prevalence and attributable risk of hypertension. J Hum Hypertens 1999; 13: 425–430.
Giltay EJ, Elbers JM, Gooren LJ, Emeis JJ, Kooistra T, Asschemann H, Stehouwer CD . Visceral fat accumulation is an important determinant of PAI-1 levels in young, nonobese men and women: modulation by cross-sex hormone administration. Arterioscler Thromb Vasc Biol 1998; 18: 1716–1722.
Sasaki A, Kuriso A, Ohno M, Ikeda Y . Overweight/obesity, smoking, and heavy alcohol consumption are important determinants of plasma PAI-1 levels in healthy men. Am J Med Sci 2001; 322: 19–23.
Norhammar A, Tenerz A, Nilsson G, Hamsten A, Efendic S, Ryden L, Malmberg K . Glucose metabolism in patients with acute myocardial infarction and no previous diagnosis of diabetes mellitus: a prospective study. Lancet 2002; 359: 2140–2144.
Weber M, McNicholl S, Marcil M, Connelly P, Lussier Cacan S, Davignon J, Latour Y, Genest Jr J . Metabolic factor clustering, lipoprotein, cholesterol, apolipoprotein B, lipoprotein(a) and apolipoprotein E phenotypes in premature coronary artery disease in French Canadians. Can J Cardiol 1997; 13: 253–260.
Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, Salonen JT . The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 2002; 288: 2709–2716.
Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M, Taskinen MR, Groop L . Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001; 24: 683–689.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 285: 2486–2497.
Balkau B, Charles MA . Comment on the provisional report from WHO consultation: European Group for the Study of Insulin Resistance (EGIR). Diabet Med 1999; 16: 442–443.
Anonymous. The Coronary Drug Project. Findings leading to discontinuation of the 2.5-mg day estrogen group. The Coronary Drug Project Research Group. JAMA 1973; 226: 652–657.
Grady D, Herrington D, Bittner V, Blumenthal R, Davidson M, Hlatky M, Hsia J, Hulley S, Herd A, Khan S, Newby LK, Waters D, Vittinghoff E, Wenger N. Cardiovascular disease outcomes during 6.8 years of hormone therapy: heart and estrogen/progestin replacement study follow-up (HERS II). JAMA 2002; 288: 49–57.
Writing Group for the Women's Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women. Principal results from the Womens's Health Initiative randomized controlled trial. JAMA 2002; 288: 321–333.
Rifkind BM, Tamir I, Heiss G, Wallace RB, Tyroler HA . Distribution of high density and other lipoprotein in selected LRC prevalence study populations: a brief survey. Lipids 1979; 14: 105–112.
Freedman DS, Jacobsen SJ, Barboriak JJ, Sobocinski K, Anderson HW, Kissebah AH, Sasse EA, Gruchow HW . Body fat distribution and male/female differences in lipids and lipoproteins. Circulation 1990; 81: 1498–1506.
Acknowledgements
The study received financial support from the Foundation for Medical Research of Ringkoebing, Ribe, and Southern Jutland Counties, director Jacob Madsen and wife Olga Madsens Foundation, Lyksfeldts Foundation, and Johannes Klein's Foundation. Professor R Mazess, Lunar Radiation Corporation, Wisconsin, USA, provided a phantom for calibrating the DEXA scannings at Herning Central Hospital.
Author information
Authors and Affiliations
Corresponding author
Additional information
Presented in part at the Hypertension 2002 conference, Mölmdal, Sweden, 24 May 2002, and in a letter to the editor, Lancet 2002; 360: 1978–1979.
Rights and permissions
About this article
Cite this article
von Eyben, F., Mouritsen, E., Holm, J. et al. Intra-abdominal obesity and metabolic risk factors: a study of young adults. Int J Obes 27, 941–949 (2003). https://doi.org/10.1038/sj.ijo.0802309
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ijo.0802309
Keywords
This article is cited by
-
Type-2 Diabetes Mellitus (T2DM): Spatial-temporal Patterns of Incidence, Mortality and Attributable Risk Factors from 1990 to 2019 among 21 World Regions
Endocrine (2022)
-
Using LMS tables to determine waist circumference and waist-to-height ratios in Colombian children and adolescents: the FUPRECOL study
BMC Pediatrics (2017)
-
Overweight and obesity are progressively associated with lower work ability in the general working population: cross-sectional study among 10,000 adults
International Archives of Occupational and Environmental Health (2017)
-
DXA-Based Measurements in Diabetes: Can They Predict Fracture Risk?
Calcified Tissue International (2017)
-
High Intensity Interval- vs Resistance or Combined- Training for Improving Cardiometabolic Health in Overweight Adults (Cardiometabolic HIIT-RT Study): study protocol for a randomised controlled trial
Trials (2016)