• Cardiometabolic Disorder
• Obesity

• Cardiometabolic Disorder
• Endocrinology
• Diabetes & Metabolic Syndrome
• Obesity

Visceral fat area, abnormal waist circumference, and metabolic abnormalities are closely related. Mitsuyoshi Takahara, MD, Osaka University, Osaka, Japan, explained that the Japanese diagnostic criteria for metabolic syndrome are unique. In Japan, metabolic syndrome is defined by an increased visceral fat area (as measured by a waist circumference ≥85 cm for men, ≥90 cm for women), plus 2 or more of the usual metabolic abnormalities. The waist circumference criterion is based on data from 12,443 Japanese subjects in the general population showing men and women have 1 or more metabolic abnormalities when their visceral fat area, as measured by CT scan, exceeds 100 cm², corresponding to the diagnostic waist circumference cut-offs [Hiuge-Shimizu A et al. Ann Med 2012]. A direct association between waist circumference and the number of metabolic abnormalities in men and women was shown by Takahara and colleagues [Takahara M et al. J Atheroscler Thromb 2012].

A reduction in visceral fat at 1 year has been associated with improvements in a number of metabolic abnormalities [Okauchi Y et al. Diabetes Care 2007]. Furthermore, reduction in visceral fat area was associated with a significant reduction in cardiovascular (CV) events [Okauchi Y et al. Atherosclerosis 2010].

Levels of adiponectin, an adipose-derived plasma protein with antiatherogenic and insulin-sensitizing activity, are substantially modulated by obesity and by genetic polymorphisms. A study by Ryo and colleagues found an inverse relation between visceral fat area and adiponectin levels, and a relationship between low adiponectin levels and the increased number of metabolic abnormalities [Ryo M et al. Circ J 2004]. A reduction in visceral fat area led to an increase in adiponectin levels at 1 year in men (p<0.001) and women (p=0.015) [Okauchi Y et al. Diabetes Care 2009].

The APN I164T gene polymorphism was associated with lower adiponectin levels (about two-thirds less than in persons without the polymorphism). Persons with this polymorphism had a significantly higher risk for type 2 diabetes (OR, 10; p<0.01) [Kondo H et al. Diabetes 2002], and for coronary artery disease (about 3%; p<0.05) [Ohashi K et al. J Am Coll Cardiol 2004]. The G276T gene polymorphism was associated with decreased circulating adiponectin levels, which decreased as weight increased [Hara K et al. Diabetes 2002], and increased cardiovascular risk in patients with type 2 diabetes [Katakami N et al. Atherosclerosis 2012].

Prof. Takahara stated that adiponectin has a significant and independent relationship with cardiometabolic risk, independent of abdominal obesity.

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