Obesity, Regional Body Fat Distribution, and the Metabolic Syndrome in Older Men and Women

Published on Apr 11, 2005in JAMA Internal Medicine20.77
· DOI :10.1001/archinte.165.7.777
Bret H. Goodpaster80
Estimated H-index: 80
(University of Pittsburgh),
Shanthi Krishnaswami6
Estimated H-index: 6
(University of Pittsburgh)
+ 6 AuthorsA. B. Newman140
Estimated H-index: 140
(University of Pittsburgh)
Background:Themetabolicsyndromeisadisorderthat includes dyslipidemia, insulin resistance, and hypertension and is associated with an increased risk of diabetes andcardiovasculardisease.Wedeterminedwhetherpatterns of regional fat deposition are associated with metabolic syndrome in older adults. Methods: A cross-sectional study was performed that included a random, population-based, volunteer sample of Medicare-eligible adults within the general communities of Pittsburgh, Pa, and Memphis, Tenn. The subjects consisted of 3035 men and women aged 70 to 79 years, of whom 41.7% were black. Metabolic syndrome was defined by Adult Treatment Panel III criteria, including serum triglyceride level, high-density lipoprotein cholesterol level, glucose level, blood pressure, and waist circumference. Visceral, subcutaneous abdominal, intermuscular, and subcutaneous thigh adipose tissue was measured by computed tomography. Results:Visceral adipose tissue was associated with the metabolic syndrome in men who were of normal weight (odds ratio, 95% confidence interval: 2.1, 1.6-2.9), overweight (1.8, 1.5-2.1), and obese (1.2, 1.0-1.5), and in women who were of normal weight (3.3, 2.4-4.6), overweight (2.4, 2.0-3.0), and obese (1.7, 1.4-2.1), adjustingforrace.Subcutaneousabdominaladiposetissuewas associated with the metabolic syndrome only in normalweight men (1.3, 1.1-1.7). Intermuscular adipose tissue was associated with the metabolic syndrome in normalweight (2.3, 1.6-3.5) and overweight (1.2, 1.1-1.4) men. In contrast, subcutaneous thigh adipose tissue was inversely associated with the metabolic syndrome in obese men (0.9, 0.8-1.0) and women (0.9, 0.9-1.0). Conclusion: In addition to general obesity, the distribution of body fat is independently associated with the metabolic syndrome in older men and women, particularly among those of normal body weight. Arch Intern Med. 2005;165:777-783
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