Y. Matsuzawa et al., PATHOPHYSIOLOGY AND PATHOGENESIS OF VISCERAL FAT OBESITY, Diabetes research and clinical practice, 24, 1994, pp. 190000111-190000116
Based on the analysis of fat distribution by CT scanning, we have prop
osed a classification of obesity: visceral fat obesity, in which fat a
ccumulation is predominant in the intra-abdominal cavity. This type of
obesity is more frequently accompanied by disorders of glucose and li
pid metabolism, and also with hypertension, than subcutaneous fat obes
ity. We also showed that almost 90% of obese patients with ischemic he
art disease have visceral fat accumulation. From clinical and basic ex
periments, aging, imbalance of sex hormone, overintake of sucrose and
lack of physical exercise have been suggested to be major factors for
visceral fat accumulation. Since intra-abdominal fat (mesenteric and o
mentum fat) have been show to have high activities of both lipogenesis
and lipolysis, its accumulation induces a high content of free fatty
acids, a product of lipolysis, in portal circulation which goes into t
he liver directly. Excess free fatty acid may cause the enhancement of
lipid synthesis and gluconeogenesis as well as insulin resistance, re
sulting in hyperlipidemia, glucose intolerance and hypertension and fi
nally atherosclerosis.