[Influence of body fat topography on glucose homeostasis and serum lipids]

Predominant fat distribution in the upper body segment evaluated by waist to hip circunference ratio (WHR) has been associated with diabetes mellitus and cardiovascular morbidity excess. To investigate metabolic alterations underlying this risk excess, we selected 2 groups of 10 obese women without history of hypertension, menstrual irregularities or oral contraceptives, matched according to age (mean +/- SD): 30.5 +/- 5.3 vs 30.6 +/- 5.8 years and BMI 35.5 +/- 6.5 vs 35.7 +/- 6.7 Kg/m2. Each matched pair had a difference in WHR superior to 0.15 (0.83 +/- 0.04 vs 1.02 +/- 0.05). Insulin and C peptide were determined during an oral glucose tolerance test (75 g). At 30, 60, 90 and 120 minutes differences were significant for glycaemia, insulinaemia and C peptide. Fasting triglycerides were 103 +/- 48 in the lower WHR group vs 164 +/- 84 mg/dl (p less than 0.05); total cholesterol 186.5 +/- 31 vs 215.2 +/- 29.4 mg/dl (p less than 0.05); LDL cholesterol/HDL cholesterol 2.46 +/- 0.89 vs 3.18 +/- 0.96 (p less than 0.05). No significant differences were found in androgenic activity. We conclude that preferential fat distribution in the upper segment is, by itself, an aggravating factor of metabolic alterations associated with obesity, particularly dyslipidaemia and hyperinsulinaemia.