December 16, 2008Diabetes Care173 citationsOpen Access
Patterns of Abdominal Fat Distribution
Key Result
Over 40% of the sample had high visceral adipose tissue, which was associated with a higher prevalence of metabolic syndrome compared to high subcutaneous fat alone, despite lower BMI.
Study Design
Type
Cross-Sectional (n=3,348)
Structured PICO
P
Population
3,348 participants from the Framingham Heart Study (48% women, mean age 52 years) who underwent multidetector computed tomography to assess abdominal fat distribution.
O
Outcome
Prevalence of abdominal subcutaneous and visceral obesity and patterns of fat distribution assessed by multidetector computed tomographysurrogate
Visceral adiposity is highly prevalent and more strongly associated with metabolic risk factors than subcutaneous adiposity, suggesting that clinical measures like BMI and waist circumference may misclassify metabolic risk.
Abstract
OBJECTIVE: The prevalence of abdominal obesity exceeds that of general obesity. We sought to determine the prevalence of abdominal subcutaneous and visceral obesity and to characterize the different patterns of fat distribution in a community-based sample. RESEARCH DESIGN AND METHODS: Participants from the Framingham Heart Study (n = 3,348, 48% women, mean age 52 years) underwent multidetector computed tomography; subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) volumes were assessed. Sex-specific high SAT and VAT definitions were based on 90th percentile cut points from a healthy referent sample. Metabolic risk factors were examined in subgroups with elevated SAT and VAT. RESULTS: The prevalence of high SAT was 30% (women) and 31% (men) and that for high VAT was 44% (women) and 42% (men). Overall, 27.8% of the sample was discordant for high SAT and high VAT: 19.9% had SAT less than but VAT equal to or greater than the 90th percentile, and 7.9% had SAT greater than but VAT less than the 90th percentile. The prevalence of metabolic syndrome was higher among women and men with SAT less than the 90th percentile and high VAT than in those with high SAT but VAT less than the 90th percentile, despite lower BMI and waist circumference. Findings were similar for hypertension, elevated triglycerides, and low HDL cholesterol. CONCLUSIONS: Nearly one-third of our sample has abdominal subcutaneous obesity, and >40% have visceral obesity. Clinical measures of BMI and waist circumference may misclassify individuals in terms of VAT and metabolic risk.