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Obesity, Regional Body Fat Distribution, and the Metabolic Syndrome in Older Men and Women
Bret H. Goodpaster, PhD;
Shanthi Krishnaswami, MPH;
Tamara B. Harris, MD;
Andreas Katsiaras, PhD;
Steven B. Kritchevsky, PhD;
Eleanor M. Simonsick, PhD;
Michael Nevitt, PhD;
Paul Holvoet, PhD;
Anne B. Newman, MD
Arch Intern Med. 2005;165:777-783.
Background The metabolic syndrome is a disorder that includes dyslipidemia, insulin resistance, and hypertension and is associated with an increased risk of diabetes and cardiovascular disease. We determined whether patterns 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), adjusting for race. Subcutaneous abdominal adipose tissue was associated with the metabolic syndrome only in normal-weight men (1.3, 1.1-1.7). Intermuscular adipose tissue was associated with the metabolic syndrome in normal-weight (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.
Author Affiliations: Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pa (Drs Goodpaster, Katsiaras, and Newman); Graduate School of Public Health, University of Pittsburgh (Drs Krishnaswami and Newman); Intramural Research Program, National Institute on Aging, Baltimore, Md (Drs Harris and Simonsick); Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, NC (Dr Kritchevsky); Prevention Sciences Group, University of California at San Francisco (Dr Nevitt); and Center for Experimental Surgery and Anesthesiology, Catholic University, Louvain, Belgium (Dr Holvoet).
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