Arteriosclerosis, Vol 10, 497-511, Copyright © 1990 by American Heart Association

ARTICLES

Regional distribution of body fat, plasma lipoproteins, and cardiovascular disease

JP Despres, S Moorjani, PJ Lupien, A Tremblay, A Nadeau and C Bouchard
Physical Activity Sciences Laboratory, Laval University, Ste-Foy, Quebec, Canada.

Several epidemiological studies have reported that the regional distribution of body fat is a significant and independent risk factor for cardiovascular disease (CVD) and related mortality. Although these associations are well established, the causal mechanisms are not fully understood. Numerous studies have, however, shown that specific topographic features of adipose tissue are associated with metabolic complications that are considered as risk factors for CVD such as insulin resistance, hyperinsulinemia, glucose intolerance and type II diabetes mellitus, hypertension, and changes in the concentration of plasma lipids and lipoproteins. The present article summarizes the evidence on the metabolic correlates of body fat distribution. Potential mechanisms for the association between body fat distribution, metabolic complications, and CVD are reviewed, with an emphasis on plasma lipoprotein levels and plasma lipid transport. From the evidence available, it seems likely that subjects with visceral obesity represent the subgroup of obese individuals with the highest risk for CVD. Although body fat distribution is now considered as a more significant risk factor for CVD and related death rate than obesity per se, further research is clearly needed to identify the determinants of body fat distribution and the causal mechanisms involved in the metabolic alterations. It appears certain, however, that an altered plasma lipid transport is a significant component of the relation between body fat distribution and CVD.

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				M. R. Peluso, T. A. Winters, M. F. Shanahan, and W. J. Banz A Cooperative Interaction between Soy Protein and Its Isoflavone-Enriched Fraction Lowers Hepatic Lipids in Male Obese Zucker Rats and Reduces Blood Platelet Sensitivity in Male Sprague-Dawley Rats J. Nutr., September 1, 2000; 130(9): 2333 - 2342. [Abstract] [Full Text]

				J.-P. Despres, C. Couillard, J. Gagnon, J. Bergeron, A. S. Leon, D. C. Rao, J. S. Skinner, J. H. Wilmore, and C. Bouchard Race, Visceral Adipose Tissue, Plasma Lipids, and Lipoprotein Lipase Activity in Men and Women : The Health, Risk Factors, Exercise Training, and Genetics (HERITAGE) Family Study Arterioscler Thromb Vasc Biol, August 1, 2000; 20(8): 1932 - 1938. [Abstract] [Full Text] [PDF]

				R. Ross, D. Dagnone, P. J.H. Jones, H. Smith, A. Paddags, R. Hudson, and I. Janssen Reduction in Obesity and Related Comorbid Conditions after Diet-Induced Weight Loss or Exercise-Induced Weight Loss in Men: A Randomized, Controlled Trial Ann Intern Med, July 18, 2000; 133(2): 92 - 103. [Abstract] [Full Text] [PDF]

				J. Sundquist and M. Winkleby Country of birth, acculturation status and abdominal obesity in a national sample of Mexican-American women and men Int. J. Epidemiol., June 1, 2000; 29(3): 470 - 477. [Abstract] [Full Text] [PDF]

				G.F. WATTS, S. HERRMANN, and F.M. RICHES Effects of diet and serotonergic agonist on hepatic apolipoprotein B-100 secretion and endothelial function in obese men QJM, March 1, 2000; 93(3): 153 - 161. [Abstract] [Full Text] [PDF]

				M. G. Baroni, M. P. D’Andrea, A. Montali, G. Pannitteri, F. Barilla, F. Campagna, E. Mazzei, S. Lovari, F. Seccareccia, P. P. Campa, et al. A Common Mutation of the Insulin Receptor Substrate-1 Gene Is A Risk Factor for Coronary Artery Disease Arterioscler Thromb Vasc Biol, December 1, 1999; 19(12): 2975 - 2980. [Abstract] [Full Text] [PDF]

				S. Lemieux, G. F. Lewis, A. Ben-Chetrit, G. Steiner, and E. M. Greenblatt Correction of Hyperandrogenemia by Laparoscopic Ovarian Cautery in Women with Polycystic Ovarian Syndrome Is Not Accompanied by Improved Insulin Sensitivity or Lipid-Lipoprotein Levels J. Clin. Endocrinol. Metab., November 1, 1999; 84(11): 4278 - 4282. [Abstract] [Full Text]

				M. Odamaki, R. Furuya, S. Ohkawa, T. Yoneyama, M. Nishikino, A. Hishida, and H. Kumagai Altered abdominal fat distribution and its association with the serum lipid profile in non-diabetic haemodialysis patients Nephrol. Dial. Transplant., October 1, 1999; 14(10): 2427 - 2432. [Abstract] [Full Text] [PDF]

				F. M. Riches, G. F. Watts, J. Hua, G. R. Stewart, R. P. Naoumova, and P. H. R. Barrett Reduction in Visceral Adipose Tissue Is Associated with Improvement in Apolipoprotein B-100 Metabolism in Obese Men J. Clin. Endocrinol. Metab., August 1, 1999; 84(8): 2854 - 2861. [Abstract] [Full Text]

				R. E. Schoen, C. M. Tangen, L. H. Kuller, G. L. Burke, M. Cushman, R. P. Tracy, A. Dobs, and P. J. Savage Increased Blood Glucose and Insulin, Body Size, and Incident Colorectal Cancer J Natl Cancer Inst, July 7, 1999; 91(13): 1147 - 1154. [Abstract] [Full Text] [PDF]

				R. B. Singh, M. A. Niaz, R. Beegom, G. S Wander, A. S Thakur, and H. S Rissam Body Fat Percent by Bioelectrical Impedance Analysis and Risk of Coronary Artery Disease Among Urban Men with Low Rates of Obesity: The Indian Paradox J. Am. Coll. Nutr., June 1, 1999; 18(3): 268 - 273. [Abstract] [Full Text] [PDF]

				J. Saleh, N. Christou, and K. Cianflone Regional specificity of ASP binding in human adipose tissue Am J Physiol Endocrinol Metab, May 1, 1999; 276(5): E815 - E821. [Abstract] [Full Text] [PDF]

				A. Rosengren, H. Wedel, and L. Wilhelmsen Body weight and weight gain during adult life in men in relation to coronary heart disease and mortality: A prospective population study Eur. Heart J., February 2, 1999; 20(4): 269 - 277. [Abstract] [PDF]

				D. S Freedman, M. K Serdula, S. R Srinivasan, and G. S Berenson Relation of circumferences and skinfold thicknesses to lipid and insulin concentrations in children and adolescents: the Bogalusa Heart Study Am. J. Clinical Nutrition, February 1, 1999; 69(2): 308 - 317. [Abstract] [Full Text] [PDF]

				J. M. H. Elbers, H. Asscheman, J. C. Seidell, and L. J. G. Gooren Effects of sex steroid hormones on regional fat depots as assessed by magnetic resonance imaging in transsexuals Am J Physiol Endocrinol Metab, February 1, 1999; 276(2): E317 - E325. [Abstract] [Full Text] [PDF]