Visceral adipose tissue cutoffs associated with metabolic risk factors for coronary heart disease in women

Barbara J. Nicklas, Brenda W.J.H. Penninx, Alice S. Ryan, Dora M. Berman, Nicole A. Lynch, Karen E. Dennis

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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 cm2) had higher concentrations of HDL and HDL2 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 cm2) had higher HDL and HDL2 cholesterol and lower LDL/HDL ratios than women with a VAT ≥163 cm2 (P < 0.05). Logistic regression analyses showed that women with a VAT of 106-162 cm2 are 2.5 times more likely to have a low HDL cholesterol (P < 0.05), while women with a VAT ≥163 cm2 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 cm2. Women with a VAT ≥163 cm2 are at a higher risk of having impaired glucose tolerance (P < 0.01). CONCLUSIONS - A VAT ≥106 cm2 is associated with an elevated risk, and a VAT ≥163 cm2 with an even greater risk, for these metabolic CHD risk factors compared with women with a VAT ≤105 cm2. These values may prove useful for defining "visceral obesity" and for identifying women most likely to benefit from preventative interventions.

Original languageEnglish
Pages (from-to)1413-1420
Number of pages8
JournalDiabetes Care
Issue number5
Publication statusPublished - 1 May 2003
Externally publishedYes

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