Fat Patterns Linked With Metabolic Syndrome in Normal-Weight Elderly

[Guest guest]

NEW YORK (Reuters Health) Apr 14 - Older people who carry their weight

around their waist are at risk of developing metabolic syndrome, even if

their BMI is normal, a new study shows.

In fact, the association between visceral adipose tissue and the

syndrome was stronger in normal-weight subjects than in overweight or obese

individuals. Also, women who did not have the syndrome had a higher

proportion of overall body fat than women who did, Dr. Bret H. Goodpaster of

the University of Pittsburgh Medical Center, Pennsylvania, and colleagues

found.

" Clearly there's something going on other than just total obesity or

total body fat, " Dr. Goodpaster told Reuters Health.

There is little information on specific risk factors for the metabolic

syndrome in older individuals, Dr. Goodpaster and his team note in their

report in the April 11th issue of the Archives of Internal Medicine. They

investigated whether the amount of abdominal adipose tissue and skeletal

muscle-associated adipose tissue were associated with the syndrome in 3305

men and women between 70 and 79 years old.

Overall, 39% of the subjects had the metabolic syndrome, with the

condition being more common in women and obese individuals. While the same

proportion of white and black study participants had the syndrome, the

prevalence of the five factors that constitute the syndrome varied by race.

Whites were more likely to have dyslipidemia, while African-Americans had

higher rates of high blood pressure and abnormal glucose metabolism.

This makes it clear, Dr. Goodpaster told Reuters Health, that

clinicians are far from being able to treat metabolic syndrome as a single

unified disorder, but must still focus on treating individual components.

The researchers also found that visceral adipose tissue increased the

risk of metabolic syndrome, with the association being particularly strong

in normal-weight individuals.

For example, men of normal weight with excess abdominal fat were 2.1

times more likely to have the syndrome, while abdominal fat increased the

syndrome risk by 1.8-fold in overweight men and by 1.2-fold in obese men. A

similar association was seen in women, with normal-weight women with

abdominal fat at 3.3 times greater risk of the metabolic syndrome, compared

with a 2.4-fold greater risk of the syndrome among overweight women and a

1.7-fold increased risk in obese women.

Subcutaneous abdominal fat was only associated with metabolic syndrome

in normal-weight men, the researchers found, while subcutaneous fat in the

thighs of obese men and women seemed to be protective against the syndrome.

The good news, noted Dr. Goodpaster, is that the fat deposits

associated with metabolic syndrome are often the first to go when a person

loses weight. " When these people lose weight either with exercise or dieting

these seem to be the fastest depots to be burned, " he said.

The findings also show, the researcher added, that clinicians should

look beyond body weight and overall body composition in assessing older

patients' risk of metabolic syndrome.

Arch Intern Med 2005;165:777-783.

--------------------------------------------------------------------------