CoChat
Sign Up
Cited by 483Adipokines, Inflammation, and Metabolic DiseasesDiabetes, Cardiovascular Risks, and LipoproteinsCardiovascular Disease and Adiposity

Visceral Obesity: A “Civilization Syndrome”

Open access
Björntorp, Per·1993·Obesity Research
DOI 10.1002/j.1550-8528.1993.tb00614.x
Open this paper in CoChat — free accountOpen PDF

Abstract

The controversial question of the relationship between obesity and disease has been considerably clearer after the demonstration in several prospective, epidemiological studies that the subgroup of central, visceral obesity is particularly prone to develop cardiovascular disease, stroke, and noninsulin dependent diabetes mellitus. Visceral obesity is associated with multiple central endocrine aberrations. The hypothalamo‐adrenal axis is apparently sensitive to stimuli, sex steroid hormone secretion blunted, and hyperandrogenicity is found in women. In addition, there seem to be signs of central dysfunctions in the regulation of hemodynamic factors after stress, and growth hormone secretion appears to be particularly blunted. Several of these endocrine abnormalities are associated with insulin resistance, particularly glycogen synthesis in muscle. Fiber composition with low type I/type II ratio might be secondary to the prevailing hyperinsulinemia, but low capillary density in muscle may well be of importance. In combination with elevated turn‐over of free fatty acids (FFA) this will probably provide powerful mechanisms whereby insulin resistance is created. Portal FFA, from the highly lipolytic visceral depots may, in addition, affect hepatic metabolism to induce increased gluco‐neogenesis, production of very low density lipoproteins as well as to perhaps inhibit clearance of insulin. By these mechanisms a Metabolic Syndrome may arise in which visceral obesity is a central part. Visceral adipocytes seem to have a high density of several steroid hormone receptors, directing steroid hormone effects particularly to these depots. The net effect of cortisol is apparently a stimulation of lipid storage, with opposing effects of sex steroid hormones which also facilitate lipid mobilization, regulations most often found at the gene transcription level. Growth hormone inhibits cortisol effects on lipid accumulation, and amplifies the lipid mobilizing effects of steroid hormones. The combined perturbations of hormonal secretions will therefore probably direct triglycerides toward visceral depots. Circulatory and nervous regulatory mechanisms require, however, more attention. The multiple central endocrine and nervous aberrations of visceral obesity suggest neuroendocrine dys‐regulations, and have features characteristic of the hypothalamic arousal seen after certain types of stress, alcohol intake, and smoking. Such factors can be traced to subjects with visceral fat accumulation. Standardized stress, eliciting a “defeat reaction” in primates is followed by an apparently identical syndrome. This integrated picture of the multiple symptoms of visceral obesity is based on epidemiological, clinical, experimental, cellular, and molecular evidence. The ingredients of positive energy balance, including physical inactivity, stress, smoking, and alcohol consumption are frequent features of modern, urbanized society. Visceral obesity may therefore be an expression of a “Civilization Syndrome.”

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1002/j.1550-8528.1993.tb00614.x

Cites

110 of 110 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 15

  1. Andersson B, Hahn L, Mattson L-A, Bjorntorp P. OBESITY RESEARCH Vol.1 No.3 May 1993 21 8 of the Novo Nordisk International Symposium, Copenhagen. Denmark, Wells Medical Ltd. Novo Copenhagen 199335-92.
  2. stress, diabetes, obesity, hypertension, and altered lipopro- tein metabolism that may result in atherosclerosis. Clin Sci 1989;77:453-461.
  3. Chrousos G, Gold PW. The concept of stress and stress system disorders. JAMA 1992;267: 1244-1252.
  4. Desprhs JP, Pouliot M-C, Moorjam S, Nadeau A, Tremblay A, Lupien PJ, Theriault G, Bouchard C. Loss of abdominal fat and metabolic response to exercise 33. DesprCs J-P, Moorjani S, Lupien P J, Tremblay A, OBESITY RESEARCH Vol.1 No.3 May 1993 21 9 15508528, 1993, 3, Visceral Obesity: A "Civilization Syndrome," Bjorntorp training in obese women. Am J Physiol 1991;26l:E159- E167. · DOI
  5. Hallback M, Magnussom G, Weiss L. Stress-induced ulcer in spontaneously hypertensive rats. Acta Physiol, Scand 1974;91:617.
  6. Hauner H, Ditschuneit HH, Pol SB, Pfeiffer EF. Fettgewebscerteilung und Adipositaskomplikationen bei- iibergewichtigen Frauen mit und ohne Hirsutismus. Dtsch Med Wochensekr. 1987;112:709-713.
  7. Kissebah AH, Peiris AN. Biology of regional fat distrib- ution: relationship to non-insulin-dependent diabetes mellitus. Diabetes Metab Rev 1989;5:83-109.
  8. Krotkiewski K, Butruk E, Zembrzuska Z. Les fonctions corticosurrenales dans les divers type morphologiques d'obesite. Le Diabete 1966;19:229-233.
  9. Lundgren H, Bergstrom C, Blohme G, Lapidus L, 72. Lapidus L, Bengtsson C, Hallstrom T, Bjorntorp P. Appetite 1989; 12:25-35
  10. Li M, Yang S, Bjorntorp P. Metabolism of different adi- 78. Lithell H, Lindgarde F, Hellsing K, Lundquist G, 79. Liu L, Merriam GR, Sherins RJ. Chronic sex steroid 1987;64:651-656.
  11. Mirin P, Bjorntorp p. Androgen treatment of middle- aged obese men: effects on glucose tolerance, insulin sen- sitivity, and fat distribution. Obesity Research, 1993; in press.
  12. Ohlsson L, Larsson B, Svardsudd K, Welin L, Eriksson H, Wilhelmsen L, Bjorntorp P, Tibblin G. The influ- ence of body fat distribution on the incidence of diabetes mellitus. Diabetes 1985;34:1055-1058. circulating monocytes from obese subjects. J Clin Inv 1976;57:1165-1172.
  13. Rebuff6-Scrive M, Lundholm K, Bjorntorp P. Glucocorticoid binding of human adipose tissue. Eur J Clin Inv 1985;15:267-272.
  14. Rimm A, Werner L, Bernstein RH, Van Yserloo B. Disease and obesity in 73,532 women. Obesity Bariat Med 1972;1:77-82.
  15. Rohner-Jcanrenaud F, Walker CD, Greco-Perotto R, Jeanrenaud B. Chronic intracerebroventricular adminis- tration of corticotropin releasing factor (CRF) to genetical- ly obese fdfa rats arrests further increase of their body weight. In: Bjorntorp P, Rossner S ( 4 s ) Obesity in Europe, Libbey, London 1988:253-255. Physiol Rev 1979;59:1078-1104.

Cited by

Sorted by citations

Related

Authors
Björntorp, P.
Affiliations
Sahlgrenska University Hospital (SE)
Corresponding author
Björntorp, Per
Venue
Obesity Research
Publisher
Wiley
Published
1993-05
Volume
1
Issue
3
Pages
206-222
ISSN
  • 1071-7323 (ISSN-L)
  • 1550-8528
DOI
10.1002/j.1550-8528.1993.tb00614.x
OpenAlex
W2139548473
Cited by
483
References
110
Citations by year
2026: 3 · 2025: 3 · 2024: 13 · 2023: 7 · 2022: 5 · 2021: 5 · 2020: 9 · 2019: 8 · 2018: 7 · 2017: 9 · 2016: 7 · 2015: 12 · 2014: 9 · 2013: 12 · 2012: 17
FWCI
4.62
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 7068 d)
Locations
  • Obesity Research (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
Keywords
visceral obesity, metabolic syndrome, cardiovascular disease, type 2 diabetes, insulin resistance, hypothalamic-pituitary-adrenal axis, sex hormones, hyperandrogenism, growth hormone, cortisol, free fatty acids, hepatic gluconeogenesis, visceral adipocytes, steroid hormone receptors, neuroendocrine dysfunction, stress, physical inactivity, smoking, alcohol consumption, energy balance
MeSH terms
Adipose Tissue, Anthropometry, Body Composition, Body Constitution, Body Height, Body Weight, Endocrine System, Fats, Female, Hormones, Humans, Life Style, Male, Models, Biological, Nutritional Status, Obesity, Risk, Syndrome, Body Mass Index, Guidelines as Topic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review