Cited by 1,589Diabetes, Cardiovascular Risks, and LipoproteinsAdipokines, Inflammation, and Metabolic DiseasesCardiovascular Disease and Adiposity

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Abdominal Obesity and the Metabolic Syndrome: Contribution to Global Cardiometabolic Risk

Després, Jean-Pierre, Lemieux, Isabelle, Bergeron, Jean, Pibarot, Philippe, Mathieu, Patrick, Larose, Eric, Rodés-Cabau, Josep, Bertrand, Olivier F., Poirier, Paul·2008·Arteriosclerosis Thrombosis and Vascular Biology

DOI 10.1161/atvbaha.107.159228

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Abstract

There is currently substantial confusion between the conceptual definition of the metabolic syndrome and the clinical screening parameters and cut-off values proposed by various organizations (NCEP-ATP III, IDF, WHO, etc) to identify individuals with the metabolic syndrome. Although it is clear that in vivo insulin resistance is a key abnormality associated with an atherogenic, prothrombotic, and inflammatory profile which has been named by some the "metabolic syndrome" or by others "syndrome X" or "insulin resistance syndrome", it is more and more recognized that the most prevalent form of this constellation of metabolic abnormalities linked to insulin resistance is found in patients with abdominal obesity, especially with an excess of intra-abdominal or visceral adipose tissue. We have previously proposed that visceral obesity may represent a clinical intermediate phenotype reflecting the relative inability of subcutaneous adipose tissue to act as a protective metabolic sink for the clearance and storage of the extra energy derived from dietary triglycerides, leading to ectopic fat deposition in visceral adipose depots, skeletal muscle, liver, heart, etc. Thus, visceral obesity may partly be a marker of a dysmetabolic state and partly a cause of the metabolic syndrome. Although waist circumference is a better marker of abdominal fat accumulation than the body mass index, an elevated waistline alone is not sufficient to diagnose visceral obesity and we have proposed that an elevated fasting triglyceride concentration could represent, when waist circumference is increased, a simple clinical marker of excess visceral/ectopic fat. Finally, a clinical diagnosis of visceral obesity, insulin resistance, or of the metabolic syndrome is not sufficient to assess global risk of cardiovascular disease. To achieve this goal, physicians should first pay attention to the classical risk factors while also considering the additional risk resulting from the presence of abdominal obesity and the metabolic syndrome, such global risk being defined as cardiometabolic risk.

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Untitled work
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10.1161/atvb.20.8.1932 · DOI
10.1161/atvb.21.6.961 · DOI
10.1161/atvb.19.10.2448 · DOI

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Pathophysiology of human visceral obesity: an update
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Sugar-Sweetened Beverages and Risk of Metabolic Syndrome and Type 2 Diabetes
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Obesity Phenotypes, Diabetes, and Cardiovascular Diseases
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American Association of Clinical Endocrinologists and American College of Endocrinology Comprehensive Clinical Practice Guidelines For Medical Care of Patients with Obesity
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Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association
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See all 1,589

Authors: Després, J.-P., Lemieux, I., Bergeron, J., Pibarot, P., Mathieu, P., Larose, E., Rodés-Cabau, J., Bertrand, O. F., & Poirier, P.
Affiliations: From the Hôpital Laval Research Centre (J.-P.D., I.L., P. Pibarot, P.M., E.L., J.R.-C., O.F.B., P. Poirier); the Institut universitaire de cardiologie et de pneumologie (J.-P.D., P.M., E.L., J.R.-C., O.F.B., P. Poirier), Hôpital Laval; the Division of Kinesiology (J.-P.D.), Department of Social and Preventive Medicine, Université Laval; the Lipid Research Centre (J.B.), CHUQ Research Centre; the Department of Medicine (P. Pibarot), Université Laval; the Department of Surgery (P.M.), Université...
Université Laval (CA)
ORCID: Lemieux, Isabelle
Bergeron, Jean
Mathieu, Patrick
Bertrand, Olivier F.
Poirier, Paul
Venue: Arteriosclerosis Thrombosis and Vascular Biology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2008-06
Volume: 28
Issue: 6
Pages: 1039-1049
ISSN: 1079-5642 (ISSN-L)
1524-4636
DOI: 10.1161/atvbaha.107.159228
OpenAlex: W2106690226
Cited by: 1,589
References: 129
Citations by year: 2026: 39 · 2025: 52 · 2024: 63 · 2023: 71 · 2022: 120 · 2021: 92 · 2020: 86 · 2019: 74 · 2018: 91 · 2017: 86 · 2016: 91 · 2015: 108 · 2014: 115 · 2013: 101 · 2012: 97
FWCI: 12.68
Type: journal article
Language: en
Update notices: correction (2008-07-01)
Open access: closed
Locations: Arteriosclerosis Thrombosis and Vascular Biology (publishedVersion)
PubMed (publishedVersion)
Corpus Université Laval (Université Laval) (submittedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
Keywords: abdominal obesity, metabolic syndrome, visceral adipose tissue, insulin resistance, cardiometabolic risk, waist circumference, fasting triglycerides, ectopic fat deposition, cardiovascular risk, diagnostic thresholds
MeSH terms: Cardiovascular Diseases, Humans, Insulin Resistance, Obesity, Risk Factors, Triglycerides, Metabolic Syndrome, Intra-Abdominal Fat

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Abdominal Obesity and the Metabolic Syndrome: Contribution to Global Cardiometabolic Risk

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