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Intraabdominal Fat Ups Health Risks in Absence of Obesity

MONDAY, April 26, 2021 -- Intraabdominal fat increases the risk for metabolic and cardiovascular disease (CVD) even in the absence of a body mass index (BMI) indicating obesity, according to a scientific statement issued by the American Heart Association and published online April 22 in Circulation.

Tiffany M. Powell-Wiley, M.D., M.P.H., from the National Institutes of Health in Bethesda, Maryland, and colleagues examined the influence of obesity on noninvasive and invasive diagnostic procedures for coronary artery disease and reviewed the impact of obesity on cardiac function. Furthermore, the effects of lifestyle and surgical weight loss interventions were described.

The researchers note that obesity is a heterogeneous condition in which individuals with similar BMIs may have distinct risk profiles for metabolic and cardiovascular diseases. There is considerable individual variation in the amount of subcutaneous versus intraabdominal or visceral adipose tissue (VAT) in the abdominal cavity; individuals with low levels of VAT are characterized by a more favorable cardiovascular disease risk profile. Interventions to reduce these adipose tissue depots have been investigated, with lifestyle interventions as effective as medications (or more so). Although intervention trials of medical weight loss have not demonstrated a clear reduction in coronary artery disease risk, rates of fatal and nonfatal cardiovascular events are significantly lower in those undergoing bariatric surgery. Mechanisms underlying obesity-related cardiac dysfunction should be evaluated to improve management of patients with obesity and CVD.

"Studies that have examined the relationship between abdominal fat and cardiovascular outcomes confirm that visceral fat is a clear health hazard," Powell-Wiley said in a statement.

Several authors disclosed financial ties to the pharmaceutical industry.

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