Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: a position statement

Abstract

Findings from epidemiological studies over the past 30 years have shown that visceral adipose tissue, accurately measured by CT or MRI, is an independent risk marker of cardiovascular and metabolic morbidity and mortality. Emerging evidence also suggests that ectopic fat deposition, including hepatic and epicardial fat, might contribute to increased atherosclerosis and cardiometabolic risk. This joint position statement from the International Atherosclerosis Society and the International Chair on Cardiometabolic Risk Working Group on Visceral Obesity summarises the evidence for visceral adiposity and ectopic fat as emerging risk factors for type 2 diabetes, atherosclerosis, and cardiovascular disease, with a focus on practical recommendations for health professionals and future directions for research and clinical practice. We discuss the measurement of visceral and ectopic fat, pathophysiology and contribution to adverse health outcomes, response to treatment, and lessons from a public health programme targeting visceral and ectopic fat. We identify knowledge gaps and note the need to develop simple, clinically applicable tools to be able to monitor changes in visceral and ectopic fat over time. Finally, we recognise the need for public health messaging to focus on visceral and ectopic fat in addition to excess bodyweight to better combat the growing epidemic of obesity worldwide. Measurement of visceral and ectopic fatThe development of medical imaging has been a remarkable advance that has revolutionised the study of human body composition, including visceral fat. [18][19][20] Cross-sectional

Phenotypes of Sarcopenic Obesity: Exploring the Effects on Peri-Muscular Fat, the Obesity Paradox, Hormone-Related Responses and the Clinical Implications

“…This definition is meaningless, however, due to the lack of established guidelines related to the visceral and subcutaneous adipose tissue [1]. A recent position statement on obesity claims the need for public health messaging to focus on visceral and ectopic fat, in addition to excess bodyweight to better combat the growing obesity epidemic worldwide [2]. Body changes in the elderly involve the loss of lean body mass while fat mass may be preserved or even increased in two different directions (visceral or subcutaneous), thereby giving rise to the specific condition of sarcopenic obesity [3].…”

Recent Evidence on the Impact of Ramadan Diurnal Intermittent Fasting, Mealtime, and Circadian Rhythm on Cardiometabolic Risk: A Review

“…Moreover, Faris et al reported that serum levels of adiponectin, IL-6, TNF-a, and insulin-like growth factor-1 were significantly decreased. However, there was a significant increase in the serum levels of visfatin, leptin, apelin, and IL-10, at the end of Ramadan (71,72). Previous studies have reported contradictory results regarding the effect of diurnal IF on leptin levels.…”

“…At the end of Ramadan, visceral fat tissue area, weight, and systolic blood pressure were significantly decreased compared to the baseline (70). Visceral adiposity has been shown to have a significant association with cardiometabolic risk, even in non-obese individuals (71,72). Moreover, Faris et al reported that serum levels of adiponectin, IL-6, TNF-a, and insulin-like growth factor-1 were significantly decreased.…”

Phenotypes of prediabetes: pathogenesis and consequences for prediction and prevention of type 2 diabetes and cardiovascular diseases

“…Очень интересные исследования, выполненные в популяции индейцев Пима, имеющих наибольший риск СД2, показали, что низкая секреция инсулина и высокая степень инсулинорезистентности независимо друг от друга предсказывали повышенный риск СД2 [12,13]. Кроме того, увеличение содержания висцерального жира и повышенное отложение жира в печени ассоциированы с повышенным риском СД2 и ССЗ [14,15].…”