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Visceral Fat Linked With Metabolic Syndrome

Body fat distribution appears to be more important than obesity itself in determining risk for metabolic syndrome. Body composition and inflammation are also associated with the severity of the syndrome.
With the goal of understanding why not all obese individuals are affected by metabolic syndrome, Dr. Barbara J. Nicklas, at Wake Forest University School of Medicine in Winston-Salem, North Carolina, and associates examined 58 obese women. They report their findings in the November Journal of Clinical Endocrinology and Metabolism.

All subjects were postmenopausal and sedentary, but only 27 exhibited three or more of the components associated with metabolic syndrome, which included hypertension, hyperglycemia, hypertriglyceridemia, low HDL, and waist circumference > 88 cm.

Maximal aerobic capacity was measured on a motor-driven treadmill. The researchers estimated body composition with dual energy absorptiometry, while computed tomography was used to gauge visceral and subcutaneous adipose tissue areas.

Subcutaneous adipose tissue from the abdominal and gluteal region was obtained by aspiration in order to measure adipocyte sizes. Blood samples were collected to measure markers of inflammation (C-reactive protein, interleukin 6 and TNF-alpha and their soluble receptors).

There were no differences between women with and those without metabolic syndrome in aerobic fitness, body weight, BMI, fat mass, percent body fat, subcutaneous fat area, or adipocyte size. Plasma concentrations of most markers of inflammation were also similar between groups.
Lean mass, visceral fat and soluble TNF receptor 1 (sTNFR1) were significantly higher in the metabolic syndrome group. Group differences in lean mass and visceral fat remained significant after adjustment for age. Lean mass, visceral fat area and sTNFR1 concentrations were independently related to the number of components of metabolic syndrome.

Visceral fat is probably the most important factor associated with the syndrome, Dr. Nicklas said at the American Medical Association’s 23rd Annual Science Reporters Conference in Washington, DC. "In my opinion, heredity is probably the most important factor in determining fat distribution," she said.

Losing weight is clearly important for reducing cardiovascular risk in obese individuals. She added, "There is some evidence that for individuals who lose weight with exercise rather than with dieting alone, there will be selective loss of visceral fat. It seems that exercise causes intraabdominal fat to be mobilized more quickly." J Clin Endocrinol Metab 2004;89

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