Visceral Adipose Tissue Cutoffs Associated With Metabolic Risk Factors for Coronary Heart Disease in Women

• Published in: Diabetes care Vol. 26; no. 5; pp. 1413 - 1420
• Main Authors: NICKLAS, Barbara J, PENNINX, Brenda W. J. H, RYAN, Alice S, BERMAN, Dora M, LYNCH, Nicole A, DENNIS, Karen E
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.05.2003
• Subjects: Absorptiometry, Photon; Adipose Tissue - anatomy & histology; Aged; Analysis. Health state; Biological and medical sciences; Black or African American; Black People; Blood Glucose - metabolism; Body Composition; Body Constitution; Body fat; Cardiology. Vascular system; Cardiovascular disease; Cholesterol - blood; Coronary Disease - epidemiology; Coronary heart disease; Epidemiology; Fasting; Female; General aspects; Health risk assessment; Heart; Humans; Insulin - blood; Lipoproteins - blood; Medical sciences; Metabolism; Middle Aged; Postprandial Period; Public health. Hygiene; Public health. Hygiene-occupational medicine; Regression Analysis; Risk Factors; Tissues; Tomography, X-Ray Computed; United States; Viscera - anatomy & histology; White People; Women; United States; Human; Adipose tissue; Biological marker; Cardiovascular disease; Coronary heart disease; Fat mass; Body composition; Visceral obesity; Association; Distribution; Risk factor; Adult; Female
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.26.5.1413

Visceral Adipose Tissue Cutoffs Associated With Metabolic Risk Factors for Coronary Heart Disease in Women Barbara J. Nicklas , PHD 1 , Brenda W.J.H. Penninx , PHD 1 , Alice S. Ryan , PHD 2 , Dora M. Berman , PHD 2 , Nicole A. Lynch , PHD 2 and Karen E. Dennis , PHD 3 1 Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina 2 Division of Gerontology, University of Maryland School of Medicine and the Geriatric Research, Education and Clinical Center (GRECC), Baltimore VA Medical Center, Baltimore, Maryland 3 School of Nursing, University of Central Florida, Orlando, Florida Abstract OBJECTIVE —This study determined whether there is a critical level of visceral adipose tissue (VAT) associated with elevated coronary heart disease (CHD) risk factors in a cohort of women >45 years of age. RESEARCH DESIGN AND METHODS —Measurements of body composition (dual-energy X-ray absorptiometry), body fat distribution (computed tomography), fasting and 2-h postprandial (75-g) glucose concentrations, and fasting lipoprotein lipid and insulin concentrations were performed in 233 perimenopausal (9%) and postmenopausal women (age 59 ± 6 years, 79% Caucasian, 16% on hormone replacement therapy). RESULTS —Women in the lowest VAT quintile (≤105 cm 2 ) had higher concentrations of HDL and HDL 2 cholesterol, lower LDL/HDL cholesterol ratios and triglyceride concentrations, and lower fasting glucose and insulin concentrations than women in the remaining four quintiles ( P values <0.05–0.001). Women in the second lowest VAT quintile (106–139 cm 2 ) had higher HDL and HDL 2 cholesterol and lower LDL/HDL ratios than women with a VAT ≥163 cm 2 ( P < 0.05). Logistic regression analyses showed that women with a VAT of 106–162 cm 2 are 2.5 times more likely to have a low HDL cholesterol ( P < 0.05), while women with a VAT ≥163 cm 2 are 5.5 times more likely to have a low HDL cholesterol ( P < 0.01) and ∼4.0 times more likely to have a high LDL/HDL ratio ( P < 0.05) compared with women with a VAT ≤105 cm 2 . Women with a VAT ≥163 cm 2 are at a higher risk of having impaired glucose tolerance ( P < 0.01). CONCLUSIONS —A VAT ≥106 cm 2 is associated with an elevated risk, and a VAT ≥163 cm 2 with an even greater risk, for these metabolic CHD risk factors compared with women with a VAT ≤105 cm 2 . These values may prove useful for defining “visceral obesity” and for identifying women most likely to benefit from preventative interventions. CHD, coronary heart disease CT, computed tomography HRT, hormone replacement therapy VAT, visceral adipose tissue WHR, waist-to-hip ratio Footnotes Address correspondence and reprint requests to Barbara J. Nicklas, PhD, Section on Gerontology and Geriatric Medicine, Wake Forest University Medical Center, J. Paul Sticht Center on Aging, Medical Center Boulevard, Winston-Salem, NC 27157. E-mail: bnicklas{at}wfubmc.edu . Received for publication 25 July 2002 and accepted in revised form 14 February 2003. A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. DIABETES CARE