OBJECTIVE: To examine the relationships between the distribution and composition of subfractions of very low density (VLDL), low density (LDL) and high density (HDL) lipoproteins and central fat deposition as measured by the waist-to-hip ratio (WHR). DESIGN: Participants (n 62, 44 women and 18 men; body mass index (BMI) ! 25.0) were recruited from those consecutively attending the outpatient obesity clinic at the University Hospital, Geneva. MEASUREMENTS: Lipoprotein subfractions were isolated from fasting blood samples by cumulative¯otation or density gradient ultracentrifugation. Concentration and composition were analysed as a function of obesity indices. RESULTS: There were signi®cant correlations between the WHR and the pro®les of the three major lipoprotein subclasses. Central obesity was associated with larger VLDL, small, dense LDL and lower levels of HDL-2 independently of other indices of obesity and plasma triglycerides. Central obesity was also signi®cantly and independently associated with compositional anomalies, speci®cally an increased free cholesterol content of VLDL and LDL. CONCLUSIONS: Central body fat was associated with modi®cations of an atherogenic nature to lipoprotein distribution and composition. The data are consistent with an impact of body fat distribution on cardiovascular disease (CVD) via the agency of modi®ed lipoprotein metabolism independently of raised triglycerides.