Abstract
BackgroundFat accumulation in android compartments may confer increased metabolic risk. The incremental utility of measuring regional fat deposition in association with metabolic syndrome (MS) has not been well described particularly in an elderly population.Methods and FindingsAs part of the Korean Longitudinal Study on Health and Aging, which is a community-based cohort study of people aged more than 65 years, subjects (287 male, 75.9±8.6 years and 278 female, 76.0±8.8 years) with regional body composition data using Dual energy X-ray absorptiometry for android/gynoid area, computed tomography for visceral/subcutaneous adipose tissue (VAT/SAT), and cardiometabolic markers including adiponectin and high-sensitivity CRP were enrolled. We investigated the relationship between regional body composition and MS in multivariate regression models. Mean VAT and SAT area was 131.4±65.5 cm2 and 126.9±55.2 cm2 in men (P = 0.045) and 120.0±46.7 cm2 and 211.8±65.9 cm2 in women (P<0.01). Mean android and gynoid fat amount was 1.8±0.8 kg and 2.5±0.8 kg in men and 2.0±0.6 kg and 3.3±0.8 kg in women, respectively (both P<0.01). VAT area and android fat amount was strongly correlated with most metabolic risk factors compared to SAT or gynoid fat. Furthermore, android fat amount was significantly associated with clustering of MS components after adjustment for multiple parameters including age, gender, adiponectin, hsCRP, a surrogate marker of insulin resistance, whole body fat mass and VAT area.ConclusionsOur findings are consistent with the hypothesized role of android fat as a pathogenic fat depot in the MS. Measurement of android fat may provide a more complete understanding of metabolic risk associated with variations in fat distribution.
Highlights
Obesity is a heterogeneous disorder characterized by multifactorial etiology
Android fat amount was significantly associated with clustering of metabolic syndrome (MS) components after adjustment for multiple parameters including age, gender, adiponectin, high-sensitivity CRP (hsCRP), a surrogate marker of insulin resistance, whole body fat mass and visceral adipose tissue (VAT) area
Measurement of android fat may provide a more complete understanding of metabolic risk associated with variations in fat distribution
Summary
Obese individuals vary in their body fat distribution, their metabolic profile and the degree of associated cardiovascular and metabolic risks. Regional fat distribution rather than overall fat volume has been considered to be more important in understanding the link between obesity and metabolic disorders. Fat accumulation in the abdominal area has a greater risk of developing diabetes and future cardiovascular events than the peripheral area [8]. There are differences between adipose tissue present in subcutaneous areas and in the abdominal cavity. These include anatomical, cellular, molecular, physiological, clinical and prognostic differences [2,7,9]. Fat distribution rather than its magnitude may be more significant in understanding metabolic risk, the varying impacts of VAT and SAT. The incremental utility of measuring regional fat deposition in association with metabolic syndrome (MS) has not been well described in an elderly population
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