Visceral fat and race-dependent health risks in obese nondiabetic premenopausal women

• Published in: Diabetes (New York, N.Y.) Vol. 46; no. 3; pp. 456 - 462
• Main Authors: Albu, J. B., Murphy, L., Frager, D. H., Johnson, J. A., Pi-Sunyer, F. X.
• Format: Journal Article
• Language: English
• Published: American Diabetes Association 01-03-1997
• ISSN: 0012-1797; 1939-327X; 0012-1797
• DOI: 10.2337/diabetes.46.3.456

Visceral fat and race-dependent health risks in obese nondiabetic premenopausal women.
J B Albu ,
L Murphy ,
D H Frager ,
J A Johnson and
F X Pi-Sunyer
Department of Medicine, Columbia University, New York, New York 10025, USA.
Abstract
Our previous finding that a waist-to-hip ratio (WHR) >0.85 was not associated with similar health risks in black, compared
with white, obese premenopausal non-diabetic women of similar fatness is attributed to either 1) a different relationship
between WHR and visceral adiposity or 2) differences in the relationship between visceral adiposity and the metabolic abnormalities
of obesity. We measured visceral (VAT) and subcutaneous adipose tissue (SCAT) areas at midwaist in 25 black and 25 white obese
nondiabetic pre-menopausal women with similar BMI, percentage body fat, and wide range of WHR (0.7-0.95 for black women and
0.7-0.9 for white women) and then compared insulin sensitivity index (SI), glucose and insulin areas under the 2-h curve (AUCs)
during an oral glucose tolerance test (OGTT), and blood lipids in the two groups before and after adjustments for total body
and visceral adiposity. After adjusting for total body fat mass (FM), obese black women had significantly less VAT (by 32
cm2) and lower VAT/SCAT for any given WHR. The regression equations predicting the SI the glucose and insulin AUCs, and the
triglyceride and HDL cholesterol levels from regional adipose tissue measurements (VAT, SCAT, or VAT/SCAT) and from total
body fat (FM or percentage body fat) had slopes that were not significantly different for black and white women. LDL cholesterol
levels were independently related to VAT in black but not in white women. The black women had a similar SI insulin AUC, and
triglyceride levels but significantly lower glucose AUC and higher HDL cholesterol levels (P < 0.001), after adjusting for
VAT and FM. Regression analysis of the pooled data showed that high VAT and high VAT/SCAT, but not SCAT, predicted lower SI
higher glucose and insulin AUCs during OGTT, and higher triglyceride levels, independent of total adiposity. We conclude that
while increases in VAT and VAT/SCAT adversely affect metabolism in both black and white obese premenopausal women, similar
levels of total body and visceral adiposity are associated with different metabolic risk factors in these groups.