Upper body adiposity and the risk for atherosclerosis

Area of Science:

• Endocrinology
• Cardiovascular Disease Risk Factors
• Metabolic Syndrome

Background:

• Fat distribution, particularly abdominal obesity, is increasingly recognized as a critical predictor of cardiovascular disease (CVD) risk, potentially more so than overall obesity.
• Understanding the relationship between fat distribution and metabolic disturbances is crucial for managing atherosclerosis risk, especially in at-risk populations like middle-aged men with type 2 diabetes.

Purpose of the Study:

• To evaluate risk factors for atherosclerosis in middle-aged male type 2 diabetics and obese individuals with varying glucose tolerance.
• To investigate the association between abdominal obesity (waist-to-hip circumference ratio - WHR) and metabolic, lipid, and glycemic parameters in non-insulin-dependent diabetics (NIDD).

Main Methods:

• Comparison of risk factors in middle-aged male type 2 diabetics and obese subjects (with and without glucose intolerance).
• Analysis of waist-to-hip circumference ratio (WHR) in relation to HbA1, high-density-lipoprotein cholesterol (HDL-C), total/HDL-C ratio, apolipoprotein B, and atherogenic index.
• Assessment of fasting and postprandial insulin and C-peptide levels, fasting glycemia, and insulin response during oral glucose load in relation to WHR.

Main Results:

• High WHR in NIDD was significantly associated with higher HbA1 values, lower HDL-C, higher total/HDL-C ratio, increased apolipoprotein B, and an elevated atherogenic index.
• Abdominal obesity correlated with poorer metabolic control, lipid profiles, and increased prevalence of glucose intolerance and diabetes.
• Individuals with upper body fat accumulation exhibited lower HDL-C and a higher incidence of glucose intolerance compared to those with lower body fat distribution.

Conclusions:

• Abdominal obesity, as measured by WHR, is a significant indicator of metabolic disturbances and increased atherogenesis risk in middle-aged men, including those with type 2 diabetes.
• Excess abdominal fat, even without overt obesity, is linked to metabolic abnormalities that heighten the risk of cardiovascular morbidity and mortality.
• Abdominal adipocyte characteristics may underlie the increased atherogenic risk associated with central obesity.