Abdominal and gluteofemoral fat depots show opposing associations with postprandial lipemia

Abstract

Background High postprandial lipemia is associated with increased risk of cardiovascular disease, independently of fasting lipid concentrations. Abdominal and gluteofemoral fat depots handle lipoproteins differently, which could affect postprandial lipemia and contribute to the relation between abdominal fat distribution and cardiovascular disease risk. Objectives We aimed to study the influences of higher abdominal compared with gluteofemoral fat on postprandial lipemia after a high-fat meal in individuals with obesity. Methods A total of 755 adults with obesity from a randomized controlled trial in 7 European countries consumed a liquid high-fat meal. Concentrations of triglycerides (TG), glycerol, free fatty acids, and the cholesterol component of remnant-like particles (RLP), LDL, and HDL were measured postprandially for 3 h. Associations of waist circumference (WC), hip circumference (HC), and waist-hip ratio (WHR) with changes in postprandial lipid concentrations, adjusted for fasting concentrations and BMI, were examined using linear regression models. To assess whether the association of WHR with postprandial lipemia could be causal, we performed instrumental variable analyses using a genetic score of 442 variants known to be associated with WHR adjusted for BMI in 2-stage least-squares regression models. Results WHR was associated with higher TG and RLP cholesterol concentrations, independent of fasting lipid concentrations and BMI. Instrumental variable analyses suggested that the associations of WHR with postprandial TG (β = 0.038 μmol/L*min, SE = 0.019 μmol/L*min, P = 0.044) and RLP cholesterol concentrations (β = 0.059 mmol/L, SE = 0.025 mmol/L, P = 0.020) may be causal. WC and HC showed opposite effects: higher WC was associated with higher TG and RLP cholesterol concentrations whereas higher HC was associated with lower concentrations. Conclusions Our results suggest that higher fat deposition abdominally versus gluteofemorally may be causally associated with elevated postprandial lipemia after a high-fat meal, independent of fasting lipid concentrations and BMI. Furthermore, higher abdominal and gluteofemoral fat depots show opposing effects on postprandial lipemia. This trial was registered at www.isrctn.com as ISRCTN25867281.

High-Risk Obesity Phenotypes: Target for Multimorbidity Prevention at the ROFEMI Study

“…Similarly, de Hollander et al reported that age-adjusted and smoking-adjusted mortality was greater for those with an elevated WC in every BMI category [ 24 ]. It appears that the amount of intra-abdominal adipose tissue—not subcutaneous adipose tissue—critically correlates with the atherogenic and diabetogenic metabolic abnormalities observed among individuals with obesity, an assertion supported by the results of this study [ 25 ]. These findings provide a plausible mechanism by which lower BMI values in an individual with a high-risk WC would entail increased adverse health risk, especially for older adults such as those in our study, whose mean age was 64 years [ 26 ].…”

The triglyceride‐glucose index as an adiposity marker and a predictor of fat loss induced by a low‐calorie diet

“…Furthermore, preliminary analysis within the DIOGenes trial is revealing abdominal and gluteofemoral fat depot influences on postprandial lipaemia. 47 Regarding the predictive role of the metabolic status involving the feedback to dietary interventions, it was possible to identify those patients with a better response to insulin resistance based on the combination of multiple variables (baseline BMI, Matsuda index, lipid concentrations, sex and age). 48 Similarly, patients with higher basal glucose levels had a better response in terms of weight loss influenced by the type of dietary intervention.…”

“…This outcome provides additional support to consider TyG index as a surrogate marker of fat content in a feasible approach, as evaluated with DEXA or BIA tools. Furthermore, preliminary analysis within the DIOGenes trial is revealing abdominal and gluteofemoral fat depot influences on postprandial lipaemia 47 …”

Reduced leukocyte mitochondrial copy number in metabolic syndrome and metabolically healthy obesity

“…In meta-regression analysis both waist circumference and the waist-to-hip ratio were associated with elevated incident CVD risk in both sexes ( 56 ). Recently, the Brazilian Longitudinal Study of Adult Health reported that a higher lower limb: trunk fat ratio was related to a reduced 10-year cardiovascular risk, mediated by lower systolic blood pressure, lower total cholesterol, and increased HDL-C levels ( 57 , 58 ). Central fat depots contain dysfunctional adipocytes characterized by a pro-inflammatory nature, restricted hyperplasia, and higher turnover of bioactive lipids.…”