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October 6, 2009European Journal of Clinical Investigation

Fat distribution influences the cardio‐metabolic profile in a clinically healthy European population

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Why the study?

Does fat distribution, specifically adjusted waist and hip circumferences, influence the cardio-metabolic profile and carotid IMT in a clinically healthy population?

Population

1,115 clinically healthy European adults from the RISC study

Comparison

Enlarged waist circumference vs Smaller waist circumference

Design

Cohort

Authors

EBElisabetta Bobbioni-HarschUniversity of GenevaZPZoltan PatakyUniversity of PisaVMVincent MakoundouUniversity of Geneva

Discussion

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Implication

Enlarged waist was associated with adverse metabolic markers in healthy adults; hypothesis-generating for fat distribution effects, needs prospective confirmation before practice change.

Key Points

  • To assess the specific impact of preferential fat distribution on cardiometabolic parameters in a clinically healthy population after adjusting waist and hip circumferences for their primary physiological determinants.
  • Evaluated 625 females and 490 males from the Relationship between Insulin Sensitivity and Cardiovascular Disease (RISC) study.
  • Measured insulin sensitivity via hyperinsulinaemic euglycaemic clamp and carotid intima-media thickness (IMT) using ultrasound imaging.
  • Adjusted waist and hip circumferences for age, height, fat mass, and fat-free mass, with mutual waist-hip adjustment applied in males.
  • Both females and males with enlarged adjusted waist circumferences had significantly elevated plasma insulin, C-peptide, total cholesterol, non-HDL cholesterol, LDL cholesterol, and triglycerides.
  • Males with larger adjusted waists also demonstrated reduced glucose uptake, higher resting heart rates, and increased internal carotid artery intima-media thickness.
  • Larger adjusted hip circumference in both sexes was associated with significantly greater suppression of free fatty acids during hyperinsulinaemic clamp testing.

Structured PICO

Does fat distribution, specifically adjusted waist and hip circumferences, influence the cardio-metabolic profile and carotid IMT in a clinically healthy population?

P
Population
1,115 clinically healthy European adults (625 females, 490 males) from the RISC (Relationship between Insulin Sensitivity and Cardiovascular Disease) study
I
Intervention
Enlarged waist circumference (adjusted for age, height, fat and fat-free mass)
C
Comparator
Smaller waist circumference
O
Outcome
Insulin sensitivity (measured by hyperinsulinaemic euglycaemic clamp) and intima-media thickness (IMT) of the common and internal carotid arterysurrogate

Adjusting waist circumference for body composition determinants helps detect early impairments in cardiovascular function and glucose/lipid metabolism in clinically healthy individuals.

Cite This Study

Bobbioni-Harsch et al. (2009) studied this question.

synapsesocial.com/papers/6a8a837afe45b30291c14731https://doi.org/10.1111/j.1365-2362.2009.02211.x
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1RELATION OF BODY FATNESS AND ITS DISTRIBUTION TO CARDIOVASCULAR RISK FACTORS IN YOUNG BLACKS AND WHITES1989 · 145 citations
  2. 2Body Fat Distribution and Risk of Coronary Heart Disease in Men and Women in the European Prospective Investigation Into Cancer and Nutrition in Norfolk Cohort2007 · 476 citations
  3. 3Waist circumference is a strong and independent determinant of the distribution of HDL subfractions in overweight patients with cardiovascular risk factors2012 · 9 citations
  4. 4Distribution of body fat and risk of coronary heart disease in men and women2008 · 174 citations
  5. 5Relationship of Body Fat Distribution Pattern to Atherogenic Risk Factors in NIDDM: Preliminary Results1988 · 61 citations