Carta Acesso aberto Revisado por pares

Energy Partitioning in Gluteal-Femoral Fat: Does the Metabolic Fate of Triglycerides Affect Coronary Heart Disease Risk?

2004; Lippincott Williams & Wilkins; Volume: 24; Issue: 5 Linguagem: Inglês

10.1161/01.atv.0000126485.80373.33

ISSN

1524-4636

Autores

Isabelle Lemieux,

Tópico(s)

Cardiovascular Effects of Exercise

Resumo

HomeArteriosclerosis, Thrombosis, and Vascular BiologyVol. 24, No. 5Energy Partitioning in Gluteal-Femoral Fat: Does the Metabolic Fate of Triglycerides Affect Coronary Heart Disease Risk? Free AccessEditorialPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessEditorialPDF/EPUBEnergy Partitioning in Gluteal-Femoral Fat: Does the Metabolic Fate of Triglycerides Affect Coronary Heart Disease Risk? Isabelle Lemieux Isabelle LemieuxIsabelle Lemieux From the Québec Heart Institute, Laval Hospital Research Center, Québec, Canada Originally published1 May 2004https://doi.org/10.1161/01.ATV.0000126485.80373.33Arteriosclerosis, Thrombosis, and Vascular Biology. 2004;24:795–797Jean Vague from the University of Marseille was the first to foresee the importance of regional adipose tissue distribution when he suggested that a "male" pattern of body fat distribution, which he referred to as android obesity, was the form of obesity more likely to be accompanied by diabetes, hypertension, and heart disease, as opposed to the typical, rather benign, "female" pattern of body fatness, which he described as gynoid obesity.1 In the early 80's, the late Per Björntörp from the University of Gothenburg in Sweden had come across Vague's literature, and he took advantage of the availability of anthropometric variables such as waist and hip circumferences to develop a simple index of body fat distribution, the waist to hip ratio (WHR).2–5 Having access to two prospective studies of middle-aged men and women, the Swedish team found that the proportion of abdominal fat (as crudely appreciated by the WHR) was an independent risk factor for the development of cardiovascular disease and diabetes over a follow-up period of more than a decade.2,3 Simultaneously, in the United States, Ahmed Kissebah and his group6 also generated results emphasizing the importance of regional adipose tissue distribution as an important correlate of metabolic complications that had been, in the past, associated with excess weight per se. These results published in the early 80's have generated great interest from the scientific and medical community, and over the last 20 years a flourishing and abundant literature has been published on the topic. As for many groups around the world, the publication of Björntörp's early results raised our interest, and we initially focused our investigations on the study of the contribution of adipose tissue distribution to the variation of plasma lipid and lipoprotein levels. Using simple skinfold measurements as indices of subcutaneous fat accumulation, we first reported in 1985 that abdominal fat accumulation was a correlate of the reduced high-density lipoprotein (HDL)-cholesterol levels found in obesity, whereas leg fat accumulation was not associated with any evidence of metabolic prejudice whatsoever.7 With the development of imaging techniques such as MRI or computed tomography, it has been possible to measure with greater accuracy regional adipose tissue accumulation and, particularly, to distinguish subcutaneous abdominal fat from the fat located in the abdominal cavity which we described as intra-abdominal or visceral adipose tissue. In an issue of this journal published 14 years ago,8 we reviewed the evidence that we had published at that time which had clearly indicated that a selective deposition of visceral adipose tissue was associated with a whole cluster of metabolic abnormalities which were later defined as the features of the metabolic syndrome. Thus, in 1990, we had already described the relationship between abdominal fat mass, visceral adipose tissue accumulation, and the features of the atherogenic dyslipidemia of the metabolic syndrome, which include hypertriglyceridemia, elevated apolipoprotein B concentration, an increased proportion of small low-density lipoprotein (LDL) particles, and reduced HDL-cholesterol levels, particularly in the cardioprotective HDL2 subfraction.8See page 923In this issue of Arteriosclerosis, Thrombosis, and Vascular Biology, Okura et al9 report further evidence that body fat distribution, as assessed by either dual-energy X-ray absorptiometry (DXA) or computed tomography, is an important correlate of metabolic risk variables modulating coronary heart disease risk in women. However, they found no relationship between abdominal subcutaneous adipose tissue and metabolic parameters. Not only did they find evidence that abdominal fat accumulation causes prejudice to the metabolic risk profile, but they also observed that peripheral subcutaneous fat accumulation (fat tissue in legs) might be cardioprotective. The authors also reported similar findings after a 14-week weight reduction program with diet and exercise. These results are interesting and add to the already published evidence for such cardioprotective "effect" of peripheral fat accumulation. For instance, Terry et al10 have shown that for any given waist circumference, individuals with a preferential thigh fat accumulation had a more favorable plasma lipoprotein-lipid profile. In 1991, our group also published evidence that mid-thigh fat accumulation was positively correlated with HDL2-cholesterol levels and with the HDL2-cholesterol/HDL3-cholesterol ratio, and this relationship could be explained by the elevated mid-thigh adipose tissue lipoprotein lipase activity, contributing to raise HDL2-cholesterol levels.11 Finally, also using DXA methodology, Tanko et al12 recently reported that the localization of body fat in elderly women was apparently more important than total fatness per se as a predictor of the comorbidities of obesity. They also found in that study that among women with a history of myocardial infarction, the percentage of central fat was significantly higher compared with women with no manifest coronary disease, with no differences in the percentage of peripheral fat being noted. The authors also concluded that whereas a central fat mass pattern was associated with an atherogenic profile, a peripheral fat mass pattern rather appeared to be predictive of a favorable metabolic profile.Why Would Gluteal-Femoral Fat Be Cardioprotective?It is possible that when exposed to an energy surplus, subcutaneous peripheral fat might represent an insulin sensitive "metabolic sink" which may, through an elevated adipose tissue lipoprotein lipase activity, favor the catabolism of triglyceride-rich lipoproteins, the clearance of triglycerides of dietary origin, and their storage in adipose cells (Figure). Such preferential partitioning of extra energy into gluteal-femoral fat in women might eventually lead to a more favorable lipid profile (lower triglyceride and increased HDL-cholesterol levels) leading to some cardioprotection. In this context, the paper by Okura and colleagues9 provides further evidence that adipose tissue is not a homogeneous organ and that it has a much more important role to play than simply the storage and mobilization of fat (Figure). In both men and women, there is probably a minimal amount of insulin-sensitive adipose tissue, which is required for the proper clearance of dietary triglycerides. A clinical example of the consequence of a lack of adipose tissue is found in the lipodystrophic patients who are characterized by a severe insulin resistant state and by ectopic triglyceride accumulation causing serious metabolic prejudice as fat accumulates in the liver, pancreas, and in muscles (Figure).13,14 Clearly, the optimal approach to limit fat accumulation in ectopic depots and in the atherogenic visceral adipose tissue is to remain in energy balance with proper nutritional habits and an adequate level of physical activity. However, a better understanding of the complex interrelationships between visceral adipose tissue accumulation and metabolic processes governing regional adipose tissue accumulation may lead to the development of new pharmacological approaches to limit ectopic fat accumulation and related health hazards. In this regard, the development of glitazones which have been shown to promote the channelling of energy in "good" subcutaneous adipose tissue has provided further evidence that regional adipose tissue distribution plays an important role, and that glitazones may create a healthy "metabolic sink" by reshaping adipose tissue distribution in previously insulin resistant individuals.15,16Download figureDownload PowerPointModel showing the potential contribution of subcutaneous gluteal-femoral adipose tissue (AT) as a possible cardioprotective "metabolic sink". Two obesity phenotypes at both ends of the spectrum are shown: 1, The energy surplus is preferentially accumulated in gluteal-femoral fat, having little impact on the metabolic risk profile. 2, The energy surplus accumulates in the atherogenic visceral depot (which could be crudely assessed by an increased waist circumference) as well as in liver, pancreas, and muscle mass due to a lack (absolute or relative) of subcutaneous AT or in the presence of insulin resistant markedly hypertrophied adipose cells leading to a cluster of metabolic abnormalities referred to as the metabolic syndrome. CHD indicates coronary heart disease.In summary, results of the intervention study by Okura and colleagues9 demonstrate that localization of fat mass is clearly more important than obesity per se in the evaluation of the atherogenic metabolic risk profile in women. Thus, information on regional body composition changes during weight reduction is also essential to properly evaluate the impact on coronary heart disease risk factors.AcknowledgmentsThe author thanks Dr. Jean-Pierre Després for his review and feedback. Dr Lemieux is a member of a research team (Dr Després and colleagues) supported by the Canadian Institutes of Health Research.FootnotesCorrespondence to Isabelle Lemieux, Québec Heart Institute, Laval Hospital Research Center, 2725 Chemin Ste-Foy, Pavilion Marguerite-D'Youville, 4th Floor, Ste-Foy, Québec, Canada G1V 4G5. E-mail [email protected] References 1 Vague J. Sexual differentiation, a factor affecting the forms of obesity. Presse Méd. 1947; 30: 339–340.Google Scholar2 Ohlson LO, Larsson B, Svardsudd K, Welin L, Eriksson H, Wilhelmsen L, Björntorp P, Tibblin G. The influence of body fat distribution on the incidence of diabetes mellitus: 13.5 years of follow-up of the participants in the study of men born in 1913. Diabetes. 1985; 34: 1055–1058.CrossrefMedlineGoogle Scholar3 Larsson B, Svardsudd K, Welin L, Wilhelmsen L, Björntorp P, Tibblin G. Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13 year follow-up of participants in the study of men born in 1913. BMJ. 1984; 288: 1401–1404.CrossrefMedlineGoogle Scholar4 Lapidus L, Bengtsson C, Larsson B, Pennert K, Rybo E, Sjöström L. Distribution of adipose tissue and risk of cardiovascular disease and death: a 12 year follow up of participants in the population study of women in Gothenburg, Sweden. BMJ. 1984; 289: 1257–1261.CrossrefMedlineGoogle Scholar5 Krotkiewski M, Björntorp P, Sjöström L, Smith U. Impact of obesity on metabolism in men and women. Importance of regional adipose tissue distribution. J Clin Invest. 1983; 72: 1150–1162.CrossrefMedlineGoogle Scholar6 Kissebah AH, Vydelingum N, Murray R, Evans DJ, Hartz AJ, Kalkhoff RK, Adams PW. Relation of body fat distribution to metabolic complications of obesity. J Clin Endocrinol Metab. 1982; 54: 254–260.CrossrefMedlineGoogle Scholar7 Després JP, Allard C, Tremblay A, Talbot J, Bouchard C. Evidence for a regional component of body fatness in the association with serum lipids in men and women. Metabolism. 1985; 34: 967–973.CrossrefMedlineGoogle Scholar8 Després JP, Moorjani S, Lupien PJ, Tremblay A, Nadeau A, Bouchard C. Regional distribution of body fat, plasma lipoproteins, and cardiovascular disease. Arteriosclerosis. 1990; 10: 497–511.LinkGoogle Scholar9 Okura T, Nakata Y, Yamabuki K, Tanaka K. Regional body composition changes exhibit opposing effects on coronary heart disease risk factors. Arterioscler Thromb Vasc Biol. 2004; 24: 923–929.LinkGoogle Scholar10 Terry RB, Stefanick ML, Haskell WL, Wood PD. Contributions of regional adipose tissue depots to plasma lipoprotein concentrations in overweight men and women: possible protective effects of thigh fat. Metabolism. 1991; 40: 733–740.CrossrefMedlineGoogle Scholar11 Pouliot MC, Després JP, Moorjani S, Lupien PJ, Tremblay A, Nadeau A, Bouchard C. Regional variation in adipose tissue LPL activity: association with plasma high density lipoproteins levels. Eur J Clin Invest. 1991; 21: 398–405.CrossrefMedlineGoogle Scholar12 Tanko LB, Bagger YZ, Alexandersen P, Larsen PJ, Christiansen C. Peripheral adiposity exhibits an independent dominant antiatherogenic effect in elderly women. Circulation. 2003; 107: 1626–1631.LinkGoogle Scholar13 Schmidt HH, Genschel J, Baier P, Schmidt M, Ockenga J, Tietge UJ, Propsting M, Buttner C, Manns MP, Lochs H, Brabant G. Dyslipemia in familial partial lipodystrophy caused by an R482W mutation in the LMNA gene. J Clin Endocrinol Metab. 2001; 86: 2289–2295.CrossrefMedlineGoogle Scholar14 Hegele RA. Insulin resistance in human partial lipodystrophy. Curr Atheroscler Rep. 2000; 2: 397–404.CrossrefMedlineGoogle Scholar15 Miyazaki Y, Mahankali A, Matsuda M, Mahankali S, Hardies J, Cusi K, Mandarino LJ, DeFronzo RA. Effect of pioglitazone on abdominal fat distribution and insulin sensitivity in type 2 diabetic patients. J Clin Endocrinol Metab. 2002; 87: 2784–2791.CrossrefMedlineGoogle Scholar16 Mori Y, Murakawa Y, Okada K, Horikoshi H, Yokoyama J, Tajima N, Ikeda Y. Effect of troglitazone on body fat distribution in type 2 diabetic patients. Diabetes Care. 1999; 22: 908–912.CrossrefMedlineGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetailsCited By Scarano E, Solari D, Riccio E, Arianna R, Somma T, Cavallo L, Romano F, Colao A and Di Somma C (2022) Craniopharyngioma and Metabolic Syndrome: A 5-Year Follow-Up Single-Center Experience, Frontiers in Neurology, 10.3389/fneur.2022.783737, 13 Shan Z, Nisar M, Li M, Zhang C, Wan C and Chen L (2021) Theaflavin Chemistry and Its Health Benefits, Oxidative Medicine and Cellular Longevity, 10.1155/2021/6256618, 2021, (1-16), Online publication date: 18-Nov-2021. Gowri S M, Antonisamy B, Geethanjali F, Thomas N, Jebasingh F, Paul T, Karpe F, Osmond C, Fall C and Vasan S (2021) Distinct opposing associations of upper and lower body fat depots with metabolic and cardiovascular disease risk markers, International Journal of Obesity, 10.1038/s41366-021-00923-1, 45:11, (2490-2498), Online publication date: 1-Nov-2021. Durcan E, Sahin S, Dedeoglu S, Ozkaya H and Gonen M (2021) Can "VAI" Better Indicate Metabolic Syndrome Compared with Other Metabolic Syndrome-Related Parameters in Patients with Thyroid Nodules? A Study from Turkey, Metabolic Syndrome and Related Disorders, 10.1089/met.2020.0147, 19:6, (358-366), Online publication date: 1-Aug-2021. Yoon S, Kim S, Lee N, Choi Y, Kim H, Gupta H, Youn G, Sung H, Shin M and Suk K (2021) Effect of Korean Red Ginseng on metabolic syndrome, Journal of Ginseng Research, 10.1016/j.jgr.2020.11.002, 45:3, (380-389), Online publication date: 1-May-2021. Yan Y, Liu J, Zhao X, Cheng H, Huang G, Mi J, Mi J, Yan Y, Dong H, Liu J, Zhao X, Cheng H, Hou D, Chen F, Huang G, Meng L, Liu Q, Zhang M, Wang W, Wu L, Shan X, Yang P, Sun J, Wang X, Li Y, Yan W, Liu F, Zhang Y, Cheng Y, Chen S, Zhao Q, Cao F, Mu K, Niu D, Xi B, Zhao M, Xiong F, Zhu G, Ding W, Zhang L and Jia L (2019) Regional Adipose Compartments Confer Different Cardiometabolic Risk in Children and Adolescents:, Mayo Clinic Proceedings, 10.1016/j.mayocp.2019.05.026, 94:10, (1974-1982), Online publication date: 1-Oct-2019. Tanaka T, Kishi S, Ninomiya K, Tomii D, Koseki K, Sato Y, Okuno T, Sato K, Koike H, Yahagi K, Komiyama K, Aoki J and Tanabe K (2019) Impact of abdominal fat distribution, visceral fat, and subcutaneous fat on coronary plaque scores assessed by 320-row computed tomography coronary angiography, Atherosclerosis, 10.1016/j.atherosclerosis.2019.06.910, 287, (155-161), Online publication date: 1-Aug-2019. Park P, Rha C and Kim S (2019) Theaflavin-Enriched Fraction Stimulates Adipogenesis in Human Subcutaneous Fat Cells, International Journal of Molecular Sciences, 10.3390/ijms20082034, 20:8, (2034) Koliaki C, Liatis S and Kokkinos A (2019) Obesity and cardiovascular disease: revisiting an old relationship, Metabolism, 10.1016/j.metabol.2018.10.011, 92, (98-107), Online publication date: 1-Mar-2019. Guarnotta V, Vigneri E, Pillitteri G, Ciresi A, Pizzolanti G and Giordano C (2018) Higher cardiometabolic risk in idiopathic versus autoimmune type 1 diabetes: a retrospective analysis, Diabetology & Metabolic Syndrome, 10.1186/s13098-018-0341-6, 10:1, Online publication date: 1-Dec-2018. Ghanemi A and St-Amand J (2018) Redefining obesity toward classifying as a disease, European Journal of Internal Medicine, 10.1016/j.ejim.2018.05.025, 55, (20-22), Online publication date: 1-Sep-2018. Anderson C and Mongraw‐Chaffin M (2018) Central Obesity in Older Adults: What Should Be the Priority?, Journal of the American Heart Association, 7:16, Online publication date: 21-Aug-2018. Piché M, Vasan S, Hodson L and Karpe F (2018) Relevance of human fat distribution on lipid and lipoprotein metabolism and cardiovascular disease risk, Current Opinion in Lipidology, 10.1097/MOL.0000000000000522, 29:4, (285-292), Online publication date: 1-Aug-2018. Piché M, Poirier P, Lemieux I and Després J (2018) Overview of Epidemiology and Contribution of Obesity and Body Fat Distribution to Cardiovascular Disease: An Update, Progress in Cardiovascular Diseases, 10.1016/j.pcad.2018.06.004, 61:2, (103-113), Online publication date: 1-Jul-2018. Lee D, Ha K, Kim H and Kim D (2018) Association of Body Mass Index with Risk of Major Adverse Cardiovascular Events and Mortality in People with Diabetes, Journal of Obesity & Metabolic Syndrome, 10.7570/jomes.2018.27.1.61, 27:1, (61-70), Online publication date: 30-Mar-2018. Chen Y, Lai S, Tsai Y and Chang S (2018) Visceral Adiposity Index as a Predictor of Chronic Kidney Disease in a Relatively Healthy Population in Taiwan, Journal of Renal Nutrition, 10.1053/j.jrn.2017.07.006, 28:2, (91-100), Online publication date: 1-Mar-2018. Caprio S, Pierpont B and Kursawe R The "adipose tissue expandability" hypothesis: a potential mechanism for insulin resistance in obese youth, Hormone Molecular Biology and Clinical Investigation, 10.1515/hmbci-2018-0005, 33:2 Leggio M, Lombardi M, Caldarone E, Severi P, D'Emidio S, Armeni M, Bravi V, Bendini M and Mazza A (2017) The relationship between obesity and hypertension: an updated comprehensive overview on vicious twins, Hypertension Research, 10.1038/hr.2017.75, 40:12, (947-963), Online publication date: 1-Dec-2017. Kouli G, Panagiotakos D, Kyrou I, Georgousopoulou E, Chrysohoou C, Tsigos C, Tousoulis D and Pitsavos C (2017) Visceral adiposity index and 10-year cardiovascular disease incidence: The ATTICA study, Nutrition, Metabolism and Cardiovascular Diseases, 10.1016/j.numecd.2017.06.015, 27:10, (881-889), Online publication date: 1-Oct-2017. Lee E, Lee Y, Yi S, Shin S and Yi J (2017) BMI and All-Cause Mortality in Normoglycemia, Impaired Fasting Glucose, Newly Diagnosed Diabetes, and Prevalent Diabetes: A Cohort Study, Diabetes Care, 10.2337/dc16-1458, 40:8, (1026-1033), Online publication date: 1-Aug-2017. Cheung Y, Joham A, Marks S and Teede H (2017) The obesity paradox: an endocrine perspective, Internal Medicine Journal, 10.1111/imj.13257, 47:7, (727-733), Online publication date: 1-Jul-2017. Lu X, Bai D, Liu X, Zhou C and Yang G (2017) Sedentary lifestyle related exosomal release of Hotair from gluteal-femoral fat promotes intestinal cell proliferation, Scientific Reports, 10.1038/srep45648, 7:1 Khanal P and Nielsen M (2017) Maternal Undernutrition and Visceral Adiposity Diet, Nutrition, and Fetal Programming, 10.1007/978-3-319-60289-9_8, (91-105), . Kim S, Després J and Koh K (2015) Obesity and cardiovascular disease: friend or foe?, European Heart Journal, 10.1093/eurheartj/ehv509, 37:48, (3560-3568), Online publication date: 21-Dec-2016. Park K, Yoo Y, Ryu S and Lee S (2016) Nelumbo Nucifera leaf protects against UVB-induced wrinkle formation and loss of subcutaneous fat through suppression of MCP3, IL-6 and IL-8 expression, Journal of Photochemistry and Photobiology B: Biology, 10.1016/j.jphotobiol.2016.04.006, 161, (211-216), Online publication date: 1-Aug-2016. Hernandez T, Bessesen D, Cox-York K, Erickson C, Law C, Anderson M, Wang H, Jackman M and Van Pelt R (2015) Femoral lipectomy increases postprandial lipemia in women, American Journal of Physiology-Endocrinology and Metabolism, 10.1152/ajpendo.00080.2015, 309:1, (E63-E71), Online publication date: 1-Jul-2015. Normandin E, Houston D and Nicklas B (2015) Caloric Restriction for Treatment of Geriatric Obesity: Do the Benefits Outweigh the Risks?, Current Nutrition Reports, 10.1007/s13668-015-0123-9, 4:2, (143-155), Online publication date: 1-Jun-2015. Swarbrick M (2014) A Lifetime on the Hips: Programming Lower-Body Fat to Protect Against Metabolic Disease, Diabetes, 10.2337/db14-1085, 63:11, (3575-3577), Online publication date: 1-Nov-2014. Staiano A, Gupta A and Katzmarzyk P (2014) Cardiometabolic Risk Factors and Fat Distribution in Children and Adolescents, The Journal of Pediatrics, 10.1016/j.jpeds.2013.10.064, 164:3, (560-565), Online publication date: 1-Mar-2014. Khanal P, Husted S, Axel A, Johnsen L, Pedersen K, Mortensen M, Kongsted A and Nielsen M (2013) Late gestation over- and undernutrition predispose for visceral adiposity in response to a post-natal obesogenic diet, but with differential impacts on glucose-insulin adaptations during fasting in lambs, Acta Physiologica, 10.1111/apha.12129, 210:1, (110-126), Online publication date: 1-Jan-2014. Lim S and Meigs J (2013) Ectopic fat and cardiometabolic and vascular risk, International Journal of Cardiology, 10.1016/j.ijcard.2013.08.077, 169:3, (166-176), Online publication date: 1-Nov-2013. Ho C, Tsao Y, Chen J, Chang K, Tsai Y, Lin J and Chang S (2013) Gamma-glutamyl transpeptidase and the metabolic syndrome in a Taiwanese aboriginal population, International Journal of Diabetes in Developing Countries, 10.1007/s13410-013-0127-1, 33:3, (147-154), Online publication date: 1-Sep-2013. Gao X, Wang G, Wang A, Xu T, Tong W and Zhang Y (2013) Comparison of lipid accumulation product with body mass index as an indicator of hypertension risk among Mongolians in China, Obesity Research & Clinical Practice, 10.1016/j.orcp.2012.02.002, 7:4, (e308-e314), Online publication date: 1-Jul-2013. Zhang X, Hu E, Wu H, Malik V and Sun Q (2013) Associations of leg fat accumulation with adiposity-related biological factors and risk of metabolic syndrome, Obesity, 10.1002/oby.20028, 21:4, (824-830), Online publication date: 1-Apr-2013. Min J, Cho J, Lee K, Park J and Min K (2013) Thigh circumference and low ankle brachial index in US adults: Results from the National Health and Nutrition Examination Survey 1999–2004, International Journal of Cardiology, 10.1016/j.ijcard.2012.10.039, 163:1, (40-45), Online publication date: 1-Feb-2013. Østergaard J, Grønbaek M, Ängquist L, Schnohr P, Sørensen T and Heitmann B (2013) Combined influence of leisure-time physical activity and hip circumference on all-cause mortality, Obesity, 10.1002/oby.20062, 21:1, (E78-E85), Online publication date: 1-Jan-2013. Manolopoulos K, Karpe F and Frayn K (2012) Marked resistance of femoral adipose tissue blood flow and lipolysis to adrenaline in vivo, Diabetologia, 10.1007/s00125-012-2676-0, 55:11, (3029-3037), Online publication date: 1-Nov-2012. Bećarević M, Seferović J, Ignjatović S, Singh S and Majkić-Singh N Adiponectin, Non-Esterified Fatty Acids and Antiphospholipid Antibodies in Type II Diabetes Mellitus, Journal of Medical Biochemistry, 10.2478/v10011-012-0009-y, 31:3, (199-204) Amato M, Giordano C, Pitrone M and Galluzzo A (2011) Cut-off points of the visceral adiposity index (VAI) identifying a visceral adipose dysfunction associated with cardiometabolic risk in a Caucasian Sicilian population, Lipids in Health and Disease, 10.1186/1476-511X-10-183, 10:1, Online publication date: 1-Dec-2011. Kim E, Kim Y, Kim J, Kim S, Kim M, Park C and Chung J (2011) UV Modulation of Subcutaneous Fat Metabolism, Journal of Investigative Dermatology, 10.1038/jid.2011.106, 131:8, (1720-1726), Online publication date: 1-Aug-2011. Schautz B, Later W, Heller M, Müller M and Bosy-Westphal A (2011) Associations between breast adipose tissue, body fat distribution and cardiometabolic risk in women: cross-sectional data and weight-loss intervention, European Journal of Clinical Nutrition, 10.1038/ejcn.2011.35, 65:7, (784-790), Online publication date: 1-Jul-2011. Conway B, Xiang Y, Villegas R, Zhang X, Li H, Wu X, Yang G, Gao Y, Zhang W and Shu X (2011) Hip Circumference and the Risk of Type 2 Diabetes in Middle-Aged and Elderly Men and Women: The Shanghai Women and Shanghai Men's Health Studies, Annals of Epidemiology, 10.1016/j.annepidem.2011.02.005, 21:5, (358-366), Online publication date: 1-May-2011. Terán Lantarón Á and Crespo García J (2011) Cribado de la enfermedad hepática por depósito de grasa: cómo y a quién, Gastroenterología y Hepatología, 10.1016/j.gastrohep.2010.11.010, 34:4, (278-288), Online publication date: 1-Apr-2011. Kovesdy C, Czira M, Rudas A, Ujszaszi A, Rosivall L, Novak M, Kalantar-Zadeh K, Molnar M and Mucsi I (2010) Body Mass Index, Waist Circumference and Mortality in Kidney Transplant Recipients, American Journal of Transplantation, 10.1111/j.1600-6143.2010.03330.x, 10:12, (2644-2651), Online publication date: 1-Dec-2010. McQuaid S, Humphreys S, Hodson L, Fielding B, Karpe F and Frayn K (2010) Femoral Adipose Tissue May Accumulate the Fat That Has Been Recycled as VLDL and Nonesterified Fatty Acids, Diabetes, 10.2337/db10-0678, 59:10, (2465-2473), Online publication date: 1-Oct-2010. Bays H, Fox K and Grandy S (2010) Anthropometric Measurements and Diabetes Mellitus: Clues to the "Pathogenic" and "Protective" Potential of Adipose Tissue, Metabolic Syndrome and Related Disorders, 10.1089/met.2009.0089, 8:4, (307-315), Online publication date: 1-Aug-2010. Magkos F, Fabbrini E, Mohammed B, Patterson B and Klein S (2012) Increased Whole-Body Adiposity Without a Concomitant Increase in Liver Fat is Not Associated With Augmented Metabolic Dysfunction, Obesity, 10.1038/oby.2010.90, 18:8, (1510-1515), Online publication date: 1-Aug-2010. Janiszewski P, Saunders T and Ross R (2012) Breast Volume is an Independent Predictor of Visceral and Ectopic Fat in Premenopausal Women, Obesity, 10.1038/oby.2009.336, 18:6, (1183-1187), Online publication date: 1-Jun-2010. Manolopoulos K, Karpe F and Frayn K (2010) Gluteofemoral body fat as a determinant of metabolic health, International Journal of Obesity, 10.1038/ijo.2009.286, 34:6, (949-959), Online publication date: 1-Jun-2010. Kuk J, Saunders T, Davidson L and Ross R (2009) Age-related changes in total and regional fat distribution, Ageing Research Reviews, 10.1016/j.arr.2009.06.001, 8:4, (339-348), Online publication date: 1-Oct-2009. Després J (2009) Endocannabinoid Receptor Blockers Clinical Lipidology, 10.1016/B978-141605469-6.50032-9, (339-351), . Pownall H and Gotto A (2009) Human Plasma Lipoprotein Metabolism Clinical Lipidology, 10.1016/B978-141605469-6.50005-6, (1-10), . Janiszewski P, Kuk J and Ross R (2008) Is the reduction of lower-body subcutaneous adipose tissue associated with elevations in risk factors for diabetes and cardiovascular disease?, Diabetologia, 10.1007/s00125-008-1058-0, 51:8, (1475-1482), Online publication date: 1-Aug-2008. Ebal E, Cavalié H, Michaux O and Lac G (2008) Visceral fat and total body fat mass correlate differently with hormones in rat, Pathologie Biologie, 10.1016/j.patbio.2007.09.002, 56:5, (283-285), Online publication date: 1-Jul-2008. Després J, Lemieux I, Bergeron J, Pibarot P, Mathieu P, Larose E, Rodés-Cabau J, Bertrand O and Poirier P (2008) Abdominal Obesity and the Metabolic Syndrome: Contribution to Global Cardiometabolic Risk, Arteriosclerosis, Thrombosis, and Vascular Biology, 28:6, (1039-1049), Online publication date: 1-Jun-2008. Fuster V and Ibáñez B (2008) Diabetes y enfermedad cardiovascular, Revista Española de Cardiología Suplementos, 10.1016/S1131-3587(08)73553-2, 8:3, (35C-44C), Online publication date: 1-Jan-2008. (2007) Diagnóstico y tratamiento del riesgo cardiometabólico, Medicina Clínica, 10.1157/13111713, 129:15, (588-596), Online publication date: 1-Oct-2007. Kuk J, Janiszewski P and Ross R (2007) Body mass index and hip and thigh circumferences are negatively associated with visceral adipose tissue after control for waist circumference, The American Journal of Clinical Nutrition, 10.1093/ajcn/85.6.1540, 85:6, (1540-1544), Online publication date: 1-Jun-2007. Lloyd E, Gaubatz J, Burns A and Pownall H (2007) Sustained elevations in NEFA induce cyclooxygenase-2 activity and potentiate THP-1 macrophage foam cell formation, Atherosclerosis, 10.1016/j.atherosclerosis.2006.06.014, 192:1, (49-55), Online publication date: 1-May-2007. Ziegler O, Trebea A, Tourpe D, Böhme P, Quilliot D and Guerci B (2007) Tissu adipeux viscéral : rôle majeur dans le syndrome métabolique, Cahiers de Nutrition et de Diététique, 10.1016/S0007-9960(07)88706-2, 42:2, (85-89), Online publication date: 1-Apr-2007. Després J and Lemieux I (2006) Abdominal obesity and metabolic syndrome, Nature, 10.1038/nature05488, 444:7121, (881-887), Online publication date: 14-Dec-2006. Wagenmakers A, Frayn K, Arner P and Yki-Järvinen H (2006) Fatty acid metabolism in adipose tissue, muscle and liver in health and disease, Essays in Biochemistry, 10.1042/bse0420089, 42, (89-103), Online publication date: 27-Nov-2006. Després J (2009) Is visceral obesity the cause of the metabolic syndrome?, Annals of Medicine, 10.1080/07853890500383895, 38:1, (52-63), Online publication date: 1-Jan-2006. Kahn H (2005) The "lipid accumulation product" performs better than the body mass index for recognizing cardiovascular risk: a population-based comparison, BMC Cardiovascular Disorders, 10.1186/1471-2261-5-26, 5:1, Online publication date: 1-Dec-2005. Frayn K, Fielding B and Karpe F (2005) Adipose tissue fatty acid metabolism and cardiovascular disease, Current Opinion in Lipidology, 10.1097/01.mol.0000171919.62129.6b, 16:4, (409-415), Online publication date: 1-Aug-2005. May 2004Vol 24, Issue 5 Advertisement Article InformationMetrics https://doi.org/10.1161/01.ATV.0000126485.80373.33PMID: 15132969 Originally publishedMay 1, 2004 PDF download Advertisement

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