CENTRAL OBESITY - MEASUREMENT AND METABOLIC EFFECTS

Abdominal-visceral obesity plays a causative role in a cluster of rela ted metabolic abnormalities. The clinical components of this metabolic syndrome include glucose intolerance and NIDDM, dyslipidemia and coro nary heart disease, and blood pressure elevation and hypertension. Bot h prospective and cross-sectional studies demonstrate strong relations hips between the size of abdominally deposited adipose tissue and incr eased frequencies of these clinical components. The waist-to-hip ratio , (WHR), an index of body fat distribution, has proved effective in pr edicting insulin-glucose homeostasis, plasma lipid and lipoprotein lev els, and blood pressure regulation. Increasing WHR is accompanied by i ncreasing frequencies of overt NIDDM, dyslipidemia, hypertension, coro nary heart disease, stroke, and early mortality. Advances in imaging m ethodologies have revealed that the WHR predicts occurrence of these c onditions, because there is a strong correlation between WHR and intra abdominal visceral fat, This article briefly reviews means of assessin g regional fat distribution, examines the relationship between central obesity and the associated metabolic profile, and discusses the possi ble etiologies of this form of obesity and its adverse metabolic conse quences. The pathway of potential linkages between this phenotype and the adverse metabolic profile appears to involve complex interactions among genetics, environment, and phenotype.