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Cited by 167Cardiovascular Disease and AdiposityDiabetes, Cardiovascular Risks, and LipoproteinsAdipokines, Inflammation, and Metabolic Diseases

Body fat distribution, in particular visceral fat, is associated with cardiometabolic risk factors in obese women

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Elffers, Theodora W., de Mutsert, Renée, Lamb, Hildo J., de Roos, Albert, Willems van Dijk, Ko, Rosendaal, Frits R., Jukema, J. Wouter, Trompet, Stella·2017·PLOS ONE
DOI 10.1371/journal.pone.0185403PMC PMC5619737
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Abstract

BACKGROUND: Body fat distribution is, next to overall obesity, an important risk factor for cardiometabolic outcomes in the general population. In particular, visceral adipose tissue (VAT) is strongly associated with cardiometabolic risk factors. Since it is unclear whether body fat distribution is also important in men and women with obesity we investigated the associations between measures of body fat distribution and cardiometabolic risk factors in men and women with obesity. METHODS: In this cross-sectional analysis of obese men and women (BMI≥30 kg/m2) included in the Netherlands Epidemiology of Obesity Study, waist:hip ratio(WHR), waist circumference, and MRI-based abdominal subcutaneous adipose tissue (aSAT) and VAT were determined. Associations between measures of body fat distribution and presence of ≥1 risk factor, such as hypertension or hypertriglyceridemia, were examined using logistic regression analyses; stratified by sex and adjusted for age, ethnicity, education, tobacco smoking, alcohol consumption, physical activity and depending on the association additionally for total body fat or VAT. RESULTS: We included 2,983 obese individuals (57% women) with a mean age of 56 and standard deviation (SD) of 6 and mean BMI of 34.0 kg/m2 (4.0), after exclusion of individuals with missing values of cardiometabolic risk factors (n = 33). 241 individuals were obese without other cardiometabolic risk factors. In obese women, all measures of body fat distribution except aSAT (OR per SD:0.76, 95%CI: 0.53, 1.10) were associated with having ≥1 cardiometabolic risk factor, of which VAT most strongly associated (5.77; 3.02, 11.01). In obese men, associations of body fat distribution and the presence of cardiometabolic risk factors were attenuated. (e.g. VAT:1.42; 0.84, 2.41). CONCLUSIONS: In obese women, but less so in men, measures of body fat distribution, of which VAT most strongly, are associated with cardiometabolic risk factors.

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  • Elffers et al. suggested that postmenopausal female may experience more adverse cardiometabolic consequences of visceral obesity compared with male of similar age.

    “Elffers et al. [26] suggested that postmenopausal female may experience more adverse cardiometabolic consequences of visceral obesity compared with male of similar age.”

    From The discriminatory ability of the body roundness index and body mass index for metabolic diseases in Korean adults: a comparative study (2025) · cites this paper as [26]

    The Discussion (page unavailable) reports a stronger association between visceral fat and cardiometabolic risk factors in obese women than in obese men, and notes that women's fat distribution shifts toward visceral fat after menopause. It does not report a comparison specifically between postmenopausal women and men of similar age, so that qualifier is not established. (LLM, conf=0.86)

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  • Polycystic ovary syndrome (PCOS) is associated with an increased risk of cardiovascular diseases (CVD).

    “Polycystic ovary syndrome (PCOS) is associated with an increased risk of cardiovascular diseases (CVD).”

    From Association of dietary phytochemical index with metabolic markers, serum asymmetric dimethylarginine and atherogenic indices in patients with polycystic ovary syndrome (2025) · cites this paper as [6]

    The Introduction (page not provided) links obesity and abdominal fat distribution to cardiovascular disease, not polycystic ovary syndrome. Searches for “polycystic ovary syndrome,” “PCOS,” and its association with CVD found no passage addressing that claim in our copy. (LLM, conf=0.76)

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Cited by

Sorted by citations

Authors
Elffers, T. W., de Mutsert, R., Lamb, H. J., de Roos, A., Willems van Dijk, K., Rosendaal, F. R., Jukema, J. W., & Trompet, S.
Affiliations
Leiden University Medical Center (NL)
Corresponding author
Elffers, Theodora W.
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2017-09-28
Volume
12
Issue
9
Pages
e0185403
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0185403
PMC
PMC5619737
OpenAlex
W2760191199
Cited by
167
References
5
Citations by year
2026: 10 · 2025: 18 · 2024: 14 · 2023: 15 · 2022: 30 · 2021: 33 · 2020: 21 · 2019: 14 · 2018: 12
FWCI
9.95
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Leiden Repository (Leiden University) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Universiteit Leiden
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
Keywords
body fat distribution, visceral adipose tissue, subcutaneous abdominal fat, cardiometabolic risk factors, obesity, women, waist-to-hip ratio, waist circumference, hypertension, hypertriglyceridemia, sex differences
MeSH terms
Aged, Cardiovascular Diseases, Female, Humans, Male, Middle Aged, Obesity, Risk Factors, Odds Ratio, Metabolic Syndrome, Intra-Abdominal Fat, Body Fat Distribution

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