Visceral and subcutaneous adipose tissue association with metabolic syndrome and its components in a South African population

Abstract

A number of studies concur that visceral abdominal tissue (VAT) is a metabolic organ that mostly contributes to the metabolic consequences of obesity, however reports regarding subcutaneous adipose tissue (SAT) are controversial. We aimed to investigate the association between computed tomography measured visceral and subcutaneous adipose tissue and metabolic syndrome as well as its individual components. Computed tomography at level L4/L5 intervertebral disc space was performed in 401 mixed ancestry individuals from the Bellville South community of Cape Town. Data collections included OGTT, anthropometric, blood pressure, lipids, insulin cotinine, and alcohol consumption history. Both VAT and SAT were increased in subjects with metabolic syndrome (p<0.0001). In logistic regression, adjusted for age, gender, BMI, smoking, alcohol use, hypertension, diabetes and dyslipidaemia treatment (for women also adjusted for menopausal age) increasing quartiles of VAT were associated with metabolic syndrome {odds ratio (95% confidence interval)≥4.14 (1.92-8.93), p<0.001} and any type of hyperglycaemia (≥4.45 (1.89-10.47), p≤0.001) whilst decreasing quartiles of SAT were associated with metabolic syndrome, p≤0.037. In gender specific multivariate linear regression models, increased SAT levels were associated with 2-h plasma glucose, insulin levels and triglycerides in men, β≥0.999, p≤0.01. Our study shows that increased VAT and decreased SAT are associated with metabolic syndrome in women, but in men increased SAT has deleterious effects to metabolic syndrome components. Therefore, in men increased SAT may like VAT increase the risk of diabetes development.