[Abdominal adipose tissue--significance and methods of detection]

The presence of excess fat in the abdomen, out of proportion to total body fat, is associated with increased risk for cardiovascular and metabolic diseases and other complications of obesity.

In regard to subcutaneous fat, accumulation of visceral abdominal adipose tissue is more associated with increased metabolic risk However, men have more visceral fat than premeno-pausal women. Compared with premenopausal women, postmenopausal women have 49% more intra-abdominal fat, regardless of age and total fat mass. MEASUREMENT OF ABDOMINAL FAT DEPOTS: Various anthropometric indicators have been suggested for measuring body fat distribution. All of them have advantages and disadvantages, in relation to their interpretation and use. Many are specified as ratios and are difficult to interpret biologically, whereas a change in body fat distribution may exhibit little or no change in the ratios. Waist circumference and sagittal abdominal diameter are good predictors of visceral fat. But, extreme individual variations in visceral to subcutaneous ratio demonstrate the limitations of external anthropometry. The best methods to estimate the amount of visceral fat are imaging techniques like computed tomography or magnetic resonance, but they are expensive and inconvenient in routine practice.

Further investigations should provide a simple and optimal indicator of abdominal obesity which should correlate with the amount of viscelar fat and the risk.