Excess accumulation of body fat is related to dyslipidemia in normal-weight subjects

OBJECTIVE: To assess the relationship of fat mass (FM) and its distribution to hypertension and dyslipidemia in normal-weight Japanese individuals.DESIGN: Cross-sectional study.SUBJECTS: Apparently healthy Japanese subjects with a body mass index (BMI) between 20 and 23.5 kg/m2 (265 males and 741 females, age 21–69 y).MEASUREMENTS: BMI, waist circumference (WC), waist-hip ratio (WHR), systolic and diastolic blood pressure, serum levels of total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C) and triglyceride (TG) were measured. Low-density lipoprotein-cholesterol (LDL-C) was calculated by the Friedewald formula. Percentage fat mass (%FM) and trunk fat mass–leg fat mass ratio (FMtrunk/FMlegs) were obtained by dual-energy X-ray absorptiometry.RESULTS: WC, WHR, %FM and FMtrunk/FMlegs were significantly correlated with TC, LDL-C, HDL-C and TG with the tendency of FMtrunk/FMlegs to show the strongest correlations. For %FM and FMtrunk/FMlegs in both sexes, odds ratios (ORs) of the third tertiles with respect to the first tertiles increased for LDL-C elevation, TG elevation and dyslipidemia. In males, ORs of the third tertiles of WC were significantly high for LDL-C elevation and dyslipidemia whereas those of WHR were high for TG elevation and dyslipidemia. ORs of the third tertiles of WC and WHR were significantly high for TG elevation in females. BMI was not associated with the risk of abnormal lipid levels. ORs for hypertension showed significant increases in none of the variables of obesity.CONCLUSIONS: Excess accumulation of FM, especially to the upper body, was related to dyslipidemia in normal-weight subjects. Simple anthropometric variables, WC and WHR, may be useful for screening and management of dyslipidemia in these subjects.

[1]  N. Skakkebaek,et al.  Cardiovascular risk factors in men: The role of gonadal steroids and sex hormone-binding globulin. , 2001, Metabolism: clinical and experimental.

[2]  Y. Matsuzawa,et al.  Sexual dimorphism of age-related changes in whole-body fat distribution in the obese. , 1994, International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity.

[3]  G. Colditz,et al.  The disease burden associated with overweight and obesity. , 1999, JAMA.

[4]  W. Yao,et al.  Low body mass index but high percent body fat in Taiwanese subjects: implications of obesity cutoffs , 2003, International Journal of Obesity.

[5]  Y. Matsuzawa,et al.  Analysis of serum lipid levels in Japanese men and women according to body mass index. Increase in risk of atherosclerosis in postmenopausal women. Research Group on Serum Lipid Survey 1990 in Japan. , 1999, Atherosclerosis.

[6]  T. Lakka,et al.  Abdominal obesity is associated with increased risk of acute coronary events in men. , 2002, European heart journal.

[7]  D. Chisholm,et al.  The metabolically obese, normal-weight individual revisited. , 1998, Diabetes.

[8]  W. Shau,et al.  Optimal cut-off values for obesity: using simple anthropometric indices to predict cardiovascular risk factors in Taiwan , 2002, International Journal of Obesity.

[9]  E. Tai,et al.  Body fat distribution and cardiovascular risk in normal weight women. Associations with insulin resistance, lipids and plasma leptin , 2000, International Journal of Obesity.

[10]  Ralph B D'Agostino,et al.  Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. , 2002, Archives of internal medicine.

[11]  C. Pichard,et al.  Body mass index compared to dual-energy x-ray absorptiometry: evidence for a spectrum bias. , 1997, Journal of clinical epidemiology.

[12]  J. Blangero,et al.  Genetic and environmental contributions to cardiovascular risk factors in Mexican Americans. The San Antonio Family Heart Study. , 1996, Circulation.

[13]  T. Maruyama,et al.  Weight Reduction Decreases Soluble Cellular Adhesion Molecules In Obese Women , 2002, Clinical and experimental pharmacology & physiology.

[14]  Ying Li,et al.  Overweight is an independent risk factor for cardiovascular disease in Chinese populations , 2002, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[15]  D Kromhout,et al.  Long-term and recent time trends in the prevalence of obesity among Dutch men and women , 2002, International Journal of Obesity.

[16]  N. Yoshiike,et al.  Twenty‐year changes in the prevalence of overweight in Japanese adults: The National Nutrition Survey 1976–95 , 2002, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[17]  K. Flegal,et al.  Prevalence and trends in obesity among US adults, 1999-2000. , 2002, JAMA.

[18]  A Berber,et al.  Anthropometric indexes in the prediction of type 2 diabetes mellitus, hypertension and dyslipidaemia in a Mexican population , 2001, International Journal of Obesity.

[19]  S A Jebb,et al.  Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index. , 2000, The American journal of clinical nutrition.

[20]  C. Bouchard,et al.  Is adiposity at normal body weight relevant for cardiovascular disease risk? , 2002, International Journal of Obesity.

[21]  P. Deurenberg,et al.  Body mass index and percent body fat: a meta analysis among different ethnic groups , 1998, International Journal of Obesity.

[22]  E. Poehlman,et al.  Phenotypic characteristics associated with insulin resistance in metabolically obese but normal-weight young women. , 1999, Diabetes.

[23]  H. Tanaka,et al.  Relation between body composition and age in healthy Japanese subjects , 2001, European Journal of Clinical Nutrition.

[24]  K. Kosaka,et al.  Health risks among Japanese men with moderate body mass index , 2000, International Journal of Obesity.

[25]  R. Levy,et al.  Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. , 1972, Clinical chemistry.

[26]  J A Colliver,et al.  Reassessment of body mass indices. , 1990, The American journal of clinical nutrition.

[27]  S. Haffner,et al.  Endogenous sex hormones: impact on lipids, lipoproteins, and insulin. , 1995, The American journal of medicine.

[28]  G A Colditz,et al.  Abdominal adiposity and coronary heart disease in women. , 1998, JAMA.

[29]  H. Ito,et al.  Detection of cardiovascular risk factors by indices of obesity obtained from anthropometry and dual-energy X-ray absorptiometry in Japanese individuals , 2003, International Journal of Obesity.