Evaluation of regional body fat distribution: comparison between W/H ratio and computed tomography in obese women

Abstract

Measurements of regional body fat distribution as determined by waist-to-hip ratio and visceral-to-subcutaneous adipose tissue ratio were compared in 63 obese women. Subjects were divided into three CT-evaluated tertiles on the basis of visceral-to-subcutaneous adipose tissue ratio (group I, 0.05-0.231; group II, 0.232-0.344; group III, 0.345-0.781). The three groups showed no appreciable differences in body weight, body mass index or total abdominal adipose tissue. Waist-to-hip ratio values were significantly lower in group I than in groups II and III. There was no statistically significant difference between groups II and III. Visceral abdominal adipose tissue was significantly and progressively higher in the three groups. Subcutaneous abdominal adipose tissue was significantly lower in group III than in group I. All metabolic variables and systolic and diastolic blood pressure were higher when visceral-to-subcutaneous adipose tissue ratio cut-off values were increased. Waist-to-hip ratio was significantly correlated with total adipose tissue, body mass index, visceral abdominal adipose tissue and subcutaneous abdominal adipose tissue. Visceral-to-subcutaneous adipose tissue ratio was correlated with visceral abdominal adipose tissue (r = 0.84, P < 0.01) and subcutaneous abdominal adipose tissue (r = -0.28, P < 0.05). There was no correlation between visceral-to-subcutaneous adipose tissue ratio and body mass index or total abdominal adipose tissue. Visceral-to-subcutaneous adipose correlated more closely with metabolic variables than did waist-to-hip ratio. Partial correlations between waist-to-hip ratio and visceral-to-subcutaneous adipose tissue ratio and metabolic variables, adjusted for body mass index, showed statistically significant relationships for visceral-to-subcutaneous adipose tissue ratio, but not for waist-to-hip ratio. Visceral-to-subcutaneous adipose tissue ratio correlated with waist-to-hip ratio in the study population as a whole, but only in group I did the correlation between visceral-to-subcutaneous adipose tissue ratio and waist-to-hip ratio prove statistically significant. The present study demonstrates that visceral-to-subcutaneous adipose tissue ratio is a better index of body fat distribution than waist-to-hip ratio.

Association of visceral fat with coronary risk factors in a population-based sample of postmenopausal women

“…Healthy women with high VAT had significantly higher concentrations of TG and ApoB and non-significant higher levels of TC and LDL-C, when compared to healthy women with low VAT. This is similar to what has been noted in men 23 and in premenopausal women, 24 but different from older 10 or more obese postmenopausal women with high VAT 25 in whom TC and LDL-C have been significantly higher. However, TC and LDL-C had significant univariate and multivariate correlation with VAT in our healthy women, which persisted after adjusting for confounding variables.…”

“…As has been reported in men 23 and in premenopausal women, 25 in the present study, healthy women with high VAT had significantly higher fasting insulin and glucose levels, suggesting insulin resistance. 27 This finding is in agreement with a recent study by Brochu et al, 8 where by using hyperinsulinemic=euglucemic clamp technique it was demonstrated that VAT is an important and independent predictor of glucose disposal in apparently healthy postmenopausal women.…”

“…However, TC and LDL-C had significant univariate and multivariate correlation with VAT in our healthy women, which persisted after adjusting for confounding variables. According to what has been found by Després and colleagues 24 in premenopausal women, by Zamboni and colleagues in a heterogeneous group of preand postmenopausal women, 25 and by DiPietro et al in older women, 10 our healthy women with high VAT showed lower HDL-C values, but the difference did not reach statistical significance, probably because of the small number of subjects. Although we did not find significantly higher LDL-C levels in healthy women with high VAT, these women may still have an increased coronary risk due to significantly higher Apo B levels in the presence of normal LDL-C values, suggesting an increase in small, dense LDL particles which are considered a more atherogenic lipoproteic fraction.…”

Relationship of metabolic variables to abdominal adiposity measured by different anthropometric measurements and dual-energy X-ray absorptiometry in obese middle-aged women

“…Moreover, our measurement sites differed from those of previous studies. 6,17,18 Instead of skin landmarks, we used bone landmarks, the midway between the lower rib margin and the superior anterior iliac crest as the level for measuring waist circumference, transverse and sagittal diameters and the level of throchanters for measuring hip circumference. These levels are recommended by WHO 10 and they were shown to be associated with metabolic variables by Seidell and co-workers.…”

Rapid Communications: Management of Metabolic Complications Associated With Antiretroviral Therapy for Hiv-1 Infection: Recommendations of an International Aids Society-Usa Panel

“…The major advantages of anthropometry are its safety, portability, and low cost. The lack of specificity of changes in the waist-to-hip ratio limits its use as a clinical tool (124)(125)(126)(127)(128)(129)(130)(131)(132). Waist circumference alone, as well as sagittal diameter, are more sensitive and specific measures than waist-to-hip ratio (120,(128)(129)(130)133).…”