Is there a threshold of visceral fat loss that improves the metabolic profile in obese postmenopausal women?

• Published in: Metabolism, clinical and experimental clinical and experimental, 2003-05, Vol.52 (5), p.599-604
• Main Authors: Brochu, Martin, Tchernof, André, Turner, Amy N., Ades, Philip A., Poehlman, Eric T.
• Format: Article
• Language: English
• Subjects: Adipose Tissue - physiology; Aged; Biological and medical sciences; Blood Glucose - metabolism; Blood Pressure - physiology; Body Composition - physiology; Female; Humans; Insulin - blood; Insulin Resistance - physiology; Lipids - blood; Medical sciences; Metabolic diseases; Middle Aged; Obesity; Obesity - metabolism; Obesity - physiopathology; Oxygen Consumption - physiology; Postmenopause - metabolism; Tomography, X-Ray Computed; Weight Loss - physiology
• ISSN: 0026-0495; 1532-8600
• DOI: 10.1053/meta.2003.50095

It is presently unclear how much visceral adipose tissue (VAT) loss is needed to induce favorable metabolic changes. Cross-sectional studies have proposed that a threshold level of VAT exceeding 110 cm2 in women induces deleterious changes in the metabolic profile. It is presently unclear, however, if significant decreases in VAT below this given threshold significantly improve the metabolic profile more as compared to decreases that remain below 110 cm2. To examine whether achieving versus not achieving the proposed VAT threshold impacts differently on the metabolic profile in postmenopausal women, we examined the effects of a VAT loss below the 110-cm2 threshold versus those individuals who remained higher than 110 cm2 after a weight loss program. Twenty-five sedentary obese (baseline % body fat, 47.7% ± 4.1%; [mean ± SD]) postmenopausal women aged between 51 and 71 years (59.7 ± 5.6 years) and displaying high baseline levels of VAT accumulation (223 ± 45 cm2) were submitted to a 1-year weight loss program with weight stabilization periods before and after weight reduction. Based on their loss of VAT after weight loss, subjects were characterized as “attainers” (post VAT levels < 110 cm2; average, 96 ± 10 cm2; n = 10) or “non-attainers” (post VAT levels > 110 cm2; average, 171 ± 34 cm2; n = 15). We compared changes in (1) plasma lipid-lipoprotein levels, (2) insulin sensitivity (euglycemic/hyperinsulinemic clamp), and (3) supine resting blood pressure between groups who achieved these 2 distinct levels of VAT. Attainers showed a 2-fold greater loss of VAT compared to non-attainers (−51.5% v −27.5%, P