Background
Metabolic syndrome (MS) is a well-known risk factor of cardiovascular diseases that is focused on central obesity. Recent studies have reported the association between pericardial adipose tissue (PAT) volume and MS. However, no studies have demonstrated the cutoff PAT volume that represents the best association with MS.
Methods
The data of 374 subjects were analyzed cross-sectionally to compare PAT, measured on coronary multidetector computed tomography, and various metabolic parameters according to MS. After PAT volumes were divided into tertiles, various metabolic parameters were compared among tertiles; furthermore, the odds ratio for developing MS was calculated. Finally, we demonstrated the cutoff PAT volume that represented the best association with MS by using the receiver-operating characteristic curve.
Results
We found that 27.5% of the subjects had MS, and the mean PAT volume was 123.9 cm³ . PAT showed a significant positive correlation with body mass index, waist circumference, and levels of glucose, triglyceride, high-sensitivity C-reactive protein, uric acid, and homocysteine, but a negative correlation with high-density lipoprotein cholesterol. Furthermore, after dividing into tertiles, PAT volume was also significantly associated with various metabolic parameters. The odds ratio for having MS was 4.19 (95% confidence interval, 2.27–7.74) in the top tertile of PAT volumes after adjusting for age, sex, and smoking. The cutoff PAT volume that represented the best association with MS was 142.2 cm³ .
Conclusion
PAT was significantly associated with MS and various metabolic parameters. The cutoff PAT volume of 142.2 cm³ showed the best association with MS.

Citations

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Background
It is well known that the metabolic syndrome is associated with visceral adipose tissue (VAT), but several recent studies showed stronger association between the subcutaneous adipose tissue (SAT) and insulin resistance. The purpose of this study was to investigate the clinical significance of deep SAT as a cardiovascular and a metabolic risk factor. Methods: A cross-sectional survey was conducted among fifty-one subjects (21 men and 30 women) who visited an obesity clinic in Yeungnam University Hospital. We performed cross-sectional abdominal CT, and undertook the novel approach of partitioning SAT into the plane superficial to the fascia within SAT (Superficial SAT) and within subcutaneous adipose tissue (deep SAT), as well as the measurement of VAT. Percent body fat was measured by bioimpedance analysis (Inbody 2.0, Biospace). Fasting blood samples were analyzed for total cholesterol, HDL-cholesterol, TG, LDL-cholesterol, FFA, insulin, uric acid and glucose. Resting blood pressure was measured. Results: After adjustment for age, sex, smoking, alchol and exercise, deep SAT was proved to be significantly and positively correlated with fasting insulin, FFA, and uric acid (P＜0.05). VAT was significantly correlated with unfavorable levels of FFA, insulin, HDL-cholesterol, TG and diastolic blood pressure (P＜0.05). In stepwise multiple regression analysis, deep SAT was shown to be the most powerful of the adiposity measures for explaining the variance in fasting insulin and uric acid levels (r2=0.196 and 0.225, respectively; both P＜0.001; including superficial SAT, deep SAT, VAT). Conclusion: Our results suggest that the association exists between deep SAT and fasting insulin, a finding which provides further support to the observation that deep SAT may be involved in insulin sensitivity. (J Korean Acad Fam Med 2007;28:100-105)

Background
: Vascular endothelial dysfunction (VED) plays a pivotal role in the pathogenesis of atherosclerosis and is associated with insulin resistance and with visceral obesity. Therefore, in this study the predicting factor of vascular endothelial dysfunction was investigated in healthy premenopausal obese women by pulse-wave analysis (PWA) combined with provocative pharmacological testing.

Methods : Thirty three obese women (BMI≥25), aged 20∼45 y and 25 age-matched control subjects (BMI; 18.5∼22.9) were examined. All women were sedentary (＜1 hr/wk of physical activity), non-smoker and were excluded if they had type 2 diabetes melitus, hypertension, hyperlipidemia, cardiovascular disease, or acute inflammatory disease and were studied in folicullar phase of the cycle, within the first week after cessation of menstrual bleeding. They underwent determination of anthropometric measurements, metabolic variables, adipose tissue regional distribution, and endothelial function by performing pulse-wave analysis (PWA) combined with provocative pharmacological testing.

Results : Augmentation Index (AIx) fell significantly after the administration of salbutamol, which causes endothelium-dependent vasodilatation, but response was significantly reduced in obese women compared with controls (10.28 6.72% vs 17.2 6.84%, P=0.0003). The change in after Nitroglycerin, which causes endothelium-independent vasodilatation, did not differ significantly (30.86 9.67% vs 30.6 10.11%, P=0.9172). In our obese subjects, visceral adipose tissue area was independently a significant predictor of vascular endothelial dysfunction (β= 0.1381, P=0.0038, Adj-R2=0.348).

Conclusion : Increased abdominal adiposity is a powerful independent predictor of VED in obese healthy women. Future studies of vascular endothelial function should account for the independent effects of abdominal fat.

Background
: Obesity and its complications are increasing as social economic standard of living is improving and life style has been changing in Korea. There is growing evidence that the visceral/subcutaneus adipose tissue area ratio (VSR) on computed tomography (CT) is closely related to the obesity complication. Therefore, it is important to determine whether the VSR reduction is produced during weight loss. The purpose of this study was to observe and compare the amount of reduction of intraabdominal fat between low calorie diet(LCD) alone and LCD with exercise.

Methods : Sixty obese females were randomly prescribed a LCD alone or a LCD with exercise. Thirty obese females were treated with a LCD of 1,000kcal/d for 8 weeks (group A). Another thirty obese females were treated with a LCD of 1,000kcal/d combined with supervised aerobic exercise for 8 weeks(group B). Weight, height, BMI, and body fat distribution were measured in all subjects immediately before and after 8 weeks of this study. The body fat distribution was assessed by CT, by which the total abdominal adipose tissue area (AT), subcutaneous abdominal adipose tissue (SAT), intraabdominal adipose tissue(VAT), and visceral/subcutaneous adipose tissue ara ratio (VSR) were measured at the level of the umbilicus. A venous blood sample was taken after an overnight fast to determine lipid, glucose, and insulin concentrations in all subjects before and after 8 weeks of this study.

Results : Body weight, BMI, CT measurement of total(AT), visceral (VAT), and subcutaneous(SAT) fat were found to be decreased significantly in the two groups B decreased significantly (P<0.05) during weight loss. Fasting plasma glucose and total cholesterol levels significantly decreased in the both groups(P<0.001). Fasting plasma insulin and triglyceride levels significantly decreased in the group B, but not in group A.

Conclusion : This study shows that the VSR decreased significantly in group B, but not in group A. Fasting plasma inulin and triglyceride levels decreased significantly in group B, but not in group A. These results suggest that the LCD with exercise is more effective in reducing expected complications of obesity than LCD alone.