Impact of Visceral Obesity on the Risk of Incident Metabolic Syndrome in Metabolically Healthy Normal Weight and Overweight Groups: A Longitudinal Cohort Study in Korea
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background: Although both obesity, measured by body mass index, and visceral obesity are known to be major risk factors of metabolic syndrome and its components, there have been debates on the relative contribution of general obesity and visceral obesity to the development of metabolic syndrome. Methods: We performed a large longitudinal cohort study of 3,093 subjects (age range, 18–65 years) who were metabolically healthy and had a normal weight who received health screenings over a 3-year follow-up period. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for incident metabolic syndrome and its components per sex-specific 1-standard deviation (SD) increase in visceral adipose tissue (VAT) and body mass index. Results: Both obesity and visceral obesity increased the risk of incident metabolic syndrome, but when HR was compared per sex-specific 1-SD, visceral obesity appeared to confer more risk than simple obesity. The HR for 1-SD of body mass index was 1.19 (95% CI, 1.07–1.32; P=0.001) in men and 1.29 (95% CI, 1.10–1.52; P=0.002) in women, while the HR for 1-SD of VAT was 1.29 (95% CI, 1.15–1.44; P<0.001) in men and 1.50 (95% CI, 1.28–1.75; P<0.001) in women. Conclusion: Visceral obesity and obesity were longitudinally associated with an increased risk of incident metabolic syndrome among metabolically healthy adults, and visceral fat accumulation appears to be better predictor of metabolic syndrome.
Abstract
Background: Although both obesity, measured by body mass index, and visceral obesity are known to be major risk factors of metabolic syndrome and its components, there have been debates on the relative contribution of general obesity and visceral obesity to the development of metabolic syndrome. Methods: We performed a large longitudinal cohort study of 3,093 subjects (age range, 18–65 years) who were metabolically healthy and had a normal weight who received health screenings over a 3-year follow-up period. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for incident metabolic syndrome and its components per sex-specific 1-standard deviation (SD) increase in visceral adipose tissue (VAT) and body mass index. Results: Both obesity and visceral obesity increased the risk of incident metabolic syndrome, but when HR was compared per sex-specific 1-SD, visceral obesity appeared to confer more risk than simple obesity. The HR for 1-SD of body mass index was 1.19 (95% CI, 1.07–1.32; P=0.001) in men and 1.29 (95% CI, 1.10–1.52; P=0.002) in women, while the HR for 1-SD of VAT was 1.29 (95% CI, 1.15–1.44; P<0.001) in men and 1.50 (95% CI, 1.28–1.75; P<0.001) in women. Conclusion: Visceral obesity and obesity were longitudinally associated with an increased risk of incident metabolic syndrome among metabolically healthy adults, and visceral fat accumulation appears to be better predictor of metabolic syndrome.
참고문헌 (30)
- Isomaa B, "Cardiovascular morbidity and mortality associated with the metabolic syndrome", Diabetes Care, 24, pp.683~689 (2001)
- Grundy SM, "Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute", American Heart Association conference on scientific issues related to definition, 2004, pp.109, 433~438
- Furukawa S, "Increased oxidative stress in obesity and its impact on metabolic syndrome", J Clin Invest, 114, pp.1752~1761 (2004)
- Bergman RN, "Why visceral fat is bad: mechanisms of the metabolic syndrome", Obesity (Silver Spring), 14, pp.16S~19S (2006)
- Mokdad AH, "Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001", JAMA, 289, pp.76~79 (2003)
- Stefan N, "Metabolically healthy obesity : epidemiology, mechanisms, and clinical implications", Lancet Diabetes Endocrinol, 1, pp.152~162 (2013)
- Phillips CM, "Metabolically healthy obesity : definitions, determinants and clinical implications", Rev Endocr Metab Disord, 14, pp.219~227 (2013)
- Hwang YC, "Visceral abdominal fat accumulation predicts the conversion of metabolically healthy obese subjects to an unhealthy phenotype", Int J Obes(Lond), 39, pp.1365~1370 (2015)
- Sandeep S, "Visceral & subcutaneous abdominal fat in relation to insulin resistance & metabolic syndrome in non-diabetic south Indians", Indian J Med Res, 131, pp.629~635 (2010)
- Pickhardt PJ, "Visceral adiposity and hepatic steatosis at abdominal CT : association with the metabolic syndrome", AJR Am J Roentgenol, 198, pp.1100~1107 (2012)
- Kim S, "Distribution of abdominal visceral and subcutaneous adipose tissue and metabolic syndrome in a Korean population", Diabetes Care, 34, pp.504~506 (2011)
- 김홍일, "Gender Differences in Diagnostic Values of Visceral Fat Area and Waist Circumference for Predicting Metabolic Syndrome in Koreans", Journal of Korean Medical Science, 26(7), pp.906~913 (2011), 대한의학회
- 박대웅, "Relationship between Abdominal Fat Area Measured by Screening Abdominal Fat CT and Metabolic Syndrome in Asymptomatic Korean Individuals", 대한영상의학회지, 77(1), pp.1~8 (2017), 대한영상의학회[DOI]
- Fox CS, "Abdominal visceral and subcutaneous adipose tissue compartments : association with metabolic risk factors in the Framingham Heart Study", Circulation, 116, pp.39~48 (2007)
- Rheaume C, "Contributions of cardiorespiratory fitness and visceral adiposity to six-year changes in cardiometabolic risk markers in apparently healthy men and women", J Clin Endocrinol Metab, 96, pp.1462~1468 (2011)
- Kang YM, "Visceral adiposity index predicts the conversion of metabolically healthy obesity to an unhealthy phenotype", PLoS One, 12, pp.e0179635~ (2017)
- Kwon H, "Body fat distribution and the risk of incident metabolic syndrome : a longitudinal cohort study", Sci Rep, 7, pp.10955~ (2017)
- Kwak MS, "The preventive effect of sustained physical activity on incident nonalcoholic fatty liver disease", Liver Int, 37, pp.919~926 (2017)
- Chung SJ, "Metabolic syndrome and visceral obesity as risk factors for reflux oesophagitis : a cross-sectional case-control study of 7078 Koreans undergoing health check-ups", Gut, 57, pp.1360~1365 (2008)
- Grundy SM, "Diagnosis and management of the metabolic syndrome : an American Heart Association", National Heart, Lung, and Blood Institute Scientific Statement, 2005, pp.112, 2735~2752
- WHO Expert Consultation, "Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies", Lancet, 363, pp.157~163 (2004)
- Han JH, "Visceral adipose tissue as a predictor for metabolic risk factors in the Korean population", Diabet Med, 25, pp.106~110 (2008)
- Nakao YM, "Intra-abdominal fat area is a predictor for new onset of individual components of metabolic syndrome : Metabolic Syndrome and AbdominaL Obesity(MERLOT study)", Proc Jpn Acad Ser B Phys Biol Sci, 88, pp.454~461 (2012)
- Tu AW, "Longitudinal changes in visceral and subcutaneous adipose tissue and metabolic syndrome : results from the Multicultural Community Health Assessment Trial(M-CHAT)", Diabetes Metab Syndr Clin Res Rev, 11, pp.S957~S961 (2017)
- Shah RV, "Visceral adiposity and the risk of metabolic syndrome across body mass index : the MESA Study", JACC Cardiovasc Imaging, 7, pp.1221~1235 (2014)
- Arsenault BJ, "Body composition, cardiorespiratory fitness, and low-grade inflammation in middle-aged men and women", Am J Cardiol, 104, pp.240~246 (2009)
- Koh SB, "Preliminary report : a serious link between adiponectin levels and metabolic syndrome in a Korean nondiabetic population", Metabolism, 59, pp.333~337 (2010)
- "MR-guided focused ultrasound ablation of visceral fat: a new treatment for metabolic syndrome" (2018)[URL]
- Miazgowski T, "The associations between cardiometabolic risk factors and visceral fat measured by a new dual-energy X-ray absorptiometry-derived method in lean healthy Caucasian women", Endocrine, 47, pp.500~505 (2014)
- Nomura K, "Visceral fat accumulation and metabolic risk factor clustering in older adults", J Am Geriatr Soc, 58, pp.1658~1663 (2010)
