Visceral obesity in patients with various body mass index

The relationship between body mass index (BMI), visceral adipose tissue, and TG, glucose, and HDL-C was estimated. A total of 150 patients were examined.

According to BMI, in individuals with various degrees of obesity, there were no significant differences in the number of visceral adipose tissue and in the effect on the level of TG, glucose and HDL-C. An increase in the content of visceral adipose tissue leads to a significant increase in the level of triglycerides, glucose and a decrease in the content of HDL-C. In patients with a visceral adipose tissue content less than 10%, the median TG was 1.13 [0.76; 1.46] mmol / l; glucose 5.52 [4.99; 5.71] mmol / l; HDL-C 1.24 [1.06; 1.42] mmol / l. In patients with a visceral adipose tissue content 11% or more, the median TG was 1.585 [1.12; 2.12] mmol / l; glucose 5.97 [5.46; 6.93] mmol / l; HDL-C 1.02 [0.86; 1.31] mmol / l. All differences are highly significant p < 0.004. The level of visceral adipose tissue 16% or more is combined with an increase in the median of triglycerides and glucose above normal values: more than 1.7 mmol / l and 6.5 mmol / l, respectively.

The degree of obesity does not reflect the severity of metabolic disorders, which play an important role, as factors in the development of cardiovascular diseases. The accumulation of visceral adipose tissue is clearly associated with an increase in the level of TG and glucose and a decrease in the level of HDL-C. Thus, the current classification of obesity by degrees does not take into account the accumulation of visceral adipose tissue, which has the most adverse effect on metabolic disorders and, accordingly, on the risk of CVD. 

1. Neeland I.J., Ross R., Després J.P. et al. Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: a position statement. Lancet Diabetes Endocrinol. 2019; 7:715–725. DOI: 10.1016/S2213-8587(19)30084-1.

2. Dedov I.I., Melnichenko G.A., Shestakova M.V., Troshina E.A., Mazurina N.V., Shestakova E.A. et al. Natsional‘nyye klinicheskiye rekomendatsii po lecheniyu morbidnogo ozhireniya u vzroslykh. 3-iy peresmotr (Lecheniye morbidnogo ozhireniya u vzroslykh). [Russian National clinical recommenations for morbid obesity treatment in adults. 3rd revision (Morbid obesity treatment in adults). Obesity and metabolism 2018; 15(1): pp 53-70. (In Russ.). DOI: 10.14341/omet2018153-70.

3. Natsional’nyye klinicheskiye rekomendatsii po diagnostike, lecheniyu, profilaktike ozhireniya i assotsiirovannykh s nim zabolevaniy. [National clinical guidelines for the diagnosis, treatment, prevention of obesity and its associated diseases. Sankt-Peterburg 2017g.https://scardio.ru/content/Guidelines/project/Ozhirenie_klin_rek_ proekt.pdf]

4. Gonzalez-Muniesa P., Martinez-Gonzalez M.A., Hu F.B., et al. Obesity. Nat Rev Dis Primers 2017; 3: 17034. DOI: 10.1038/nrdp.2017.34.

5. Després J.P. What is «metabolically healthy obesity»?: from epidemiology to pathophysiological insights. J Clin Endocrinol Metab 2012; 97: 2283–85. DOI: 10.1210/jc.2012-2081.

6. Neeland I.J., Poirier P., Després J.P. Cardiovascular and Metabolic Heterogeneity of Obesity: Clinical Challenges and Implications for Management. Circulation 2018; 137: 1391–1406. DOI: 10.1161/CIRCULATIONAHA.117.029617

7. Koster A., Murphy R.A., Eiriksdottir G. et al. Fat Distribution and Mortality: The AGES-Reykjavik Study. Obesity 2015; 23, 893–897. DOI:10.1002/oby.21028.

8. Scaglione R., Di Chiara T., Cariello T. et al. Visceral obesity and metabolic syndrome: two faces of the same medal? Intern Emerg Med (2010) 5: 111. DOI: 10.1007/s11739-009-0332-6.

9. Druzhilov M.A., Druzhilova O.Yu., Beteleva Yu.Ye., Kuznetsova T.Yu. Ozhireniye kak faktor serdechno-sosudistogo riska: aktsent na kachestvo i funktsional‘nuyu aktivnost‘ zhirovoy tkani. [Obesity as a factor in cardiovascular risk: an emphasis on the quality and functional activity of adipose tissue.]//Rossiyskiy kardiologicheskiy zhurnal 2015, 4 (120): 111–117. DOI: 10.15829/1560-4071-2015-4-111-117.

10. Cornier M.A., Després J.P., Davis N., Daurice A Grossniklaus D.A., Klein S., Lamarche B. et al. Assessing Adiposity A Scientific Statement From the American Heart Association. Circulation 2011;124: 1996-2019. DOI: 10.1161/CIR.0b013e318233bc6a.

11. https://www.accessdata.fda.gov/cdrh_docs/pdf5/K052522.pdf

12. Garvey W.T., Mechanick J.I., Brett E.M., Garber A.J., Hurley D.L., Jastreboff A.M. Reviewers of the kAACE/ACE Obesity Clinical Practice Guidelines. American Association of clinical Endocrinologists and American College of Endocrinology Comprehensive clinical practice Guidelines for medical care of patients with obesity. Endocr Pract, 22 Suppl 3, 1–203. DOI: 10.4158/EP161365.GL

13. Grundy S.M., Cleeman J.I., Daniels S.R. et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112: 2735–52. DOI:10.1161/CIRCULATIONAHA.105.169404.

14. Ibrahim M.M. Subcutaneous and Visceral Adipose Tissue: Structural and Functional Differences. ObesRev 2010; 11 (1): 11-18. DOI: 10.1111/j.1467-789X.2009.00623.x.

15. Neeland I.J., Ross R., Després J.P. et al. Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: a position statement. Lancet Diabetes Endocrinol. 2019 ;7:715-725. DOI: 10.1016/S2213-8587(19)30084-1.

16. Chumakova G.A., Kuznetsova T.YU., Druzhilov M.A., Veselovskaya N.G. Vistseral’noye ozhireniye kak global’nyy faktor serdechno-sosudistogo riska. [Visceral obesity as a global factor in cardiovascular risk.]//Rossiyskiy kardiologicheskiy zhurnal 2018; 23 (5): 7–14. DOI: 10.15829/1560-4071-2018-5-7-14.