Regional Fat Deposition in the Legs Is Useful as a Presumptive Marker of Antiatherogenesity in Japanese

Abstract

Abstract. To examine the pathological role of regional fat deposition in development of metabolic and cardiovascular disorders, regional fat distribution was evaluated using metabolites and hormones as measures of obesity‐related disorders. The subjects enrolled were 100 sex‐matched inpatients, who were admitted, regardless of their body mass index values, for further examination of unusual results from periodic medical screening tests, and for examination of obesity‐induced complications and treatment of obesity. Body fat distribution was analyzed using dual energy X‐ray absorptiometry (DEXA). Analysis of parameters regarding fat distribution showed that gender was one of the determinants affecting correlation between fat distribution and metabolites of fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), total cholesterol (TC), or triglyceride (TG). However, regardless of gender, both leg trunk fat (L/Tr) and arm trunk fat (A/Tr) ratios negatively correlated with a total body fat (% total fat) ratio, whereas the intercept value of female regression line in L/Tr was greater than that in males, but not in A/Tr. Percentage total fat, L/Tr, and A/Tr in males correlated significantly with FPG, TC, TG, low‐density lipoprotein (LDL), very low density lipoprotein (VLDL), atherogenic index (A.I.), and apoB/A1 only low density lipoprotein (LDL) was significantly correlated solely to L/Tr and A/Tr. These results indicate that regional fat distribution in males may not be a major determinant for development of metabolic disorders in obese patients. Unlike male regional fat distribution, female L/Tr correlated significantly not only with TC, TG, and LDL, but also with FPG and HbA1c, although both of the latter 2 glucose‐related parameters in males showed no correlation with any parameters of fat deposition. The remaining female parameters of fasting plasma insulin, VLDL, A.I., and ApoB/A1 correlated with each of the three parameters of fat deposition, as similarly shown in males. The powerful and negative correlation was thus evident, particularly in females, between leg fat deposition and parameters of glucose and lipid metabolites. The resulting information provides a novel insight that regional fat deposition at the legs is useful as a marker for metabolic and cardiovascular disorders associated with obesity.

Is the reduction of lower-body subcutaneous adipose tissue associated with elevations in risk factors for diabetes and cardiovascular disease?

“…In line with this, several studies report that after control for abdominal AT and/or VAT, greater levels of LBSAT are associated with reduced risk of glucose intolerance, insulin resistance, dyslipidaemia and arterial stiffness [10][11][12][13][14][15][16]. However, extrapolation of this notion to suggest that, controlling for changes in abdominal adiposity, reductions in LBSAT during weight reduction may lead to deterioration in cardiometabolic profile, and thus increase the risk of type 2 diabetes and cardiovascular disease, counters current knowledge.…”

“…However, independent of changes in LBSAT, reductions in VAT and abdominal SAT were associated with improvements in cardiometabolic risk. A number of cross-sectional studies have previously shown that, after control for abdominal AT and/or VAT, greater levels of lower-body AT, specifically SAT, are associated with reduced risk of glucose intolerance, insulin resistance, dyslipidaemia and arterial stiffness [10][11][12][13][14][15][16]. While we could not corroborate this finding for glucose tolerance, the results of the current report demonstrate that, independent of VAT and abdominal SAT, greater lowerbody SAT is associated with lower triacylglycerol and higher HDL-cholesterol levels.…”

Indices of central and peripheral body fat: association with non-fatal acute myocardial infarction

“…A few studies have suggested that fat accumulated in peripheral depots, such as arms and legs, has less adverse effects on cardiovascular risk than other types of fat store. [15][16][17][18][19] Peripheral adipose tissue seems to have a high lipoprotein lipase activity and a low fatty acid turnover, 20 and to secrete higher quantities of adiponectin with antiatherogenic properties. 21 There is also evidence that adipocytes have distinct intrinsic characteristics (for example, fatty acid-binding proteins and enzymes of fat metabolism), which further contribute to the heterogeneity in free fatty acids handling by the different fat depots.…”

“…Only a few studies have addressed the cardiovascular role of peripheral fat mass, [15][16][17][18][19] which might be less atherogenic than abdominal fat, due to a low fatty acid turn-over, and a differential hormone production. 20,21 Moreover, because women and men have different patterns of fat distribution, 22 the association of peripheral fat with coronary outcomes might also vary with sex.…”

Associations of Lower-Body Fat Mass with Favorable Profile of Lipoproteins and Adipokines in Healthy, Slim Women in Early Adulthood

“…Studies in postmenopausal women have revealed that trunk fat mass (TFM) measured using dual energy X-ray absorptiometry (DXA) is a strong independent predictor of insulin resistance and dyslipidemia [9][10][11][12] . Several studies have also suggested that in contrast with trunk fat, peripheral adiposity may attenuate both insulin resistance and dyslipidemia [10][11][12][13][14][15] or just lipid levels 16) in normal and overweight postmenopausal women. Although these differences may be due to differences in adipokine secretion from regional adipose tissue, a few studies have determined serum adipokine levels 17,18) .…”