It's not the amount of fat in the body but where it's stored that may increase the risk for heart attack, stroke and diabetes. People of the same weight or body mass index (BMI) may have different risk profiles, based on genetics, lifestyle and diet. In addition, body composition differs between men and women, with women having proportionately more fat and men having more muscle mass.
Fat distribution is an important determinant of cardiometabolic risk. There are different body shapes, common descriptors of human body shapes, based on where fat tends to be stored in the body. In apple-shaped bodies, fat is distributed largely around the midsection, while in pear-shaped bodies, fat is distributed lower around the hips and thighs. The type of fat stored also plays a role in cardiometabolic risk. One type of fat-ectopic fat-is dangerous. It may be found in places such as the abdominal region, muscles, liver and other organs.
There are gender-based differences in body composition and ectopic fat depots and that these could be associated with gender-specific risk profiles for diseases like diabetes, heart disease and stroke, researchers examined overweight and obese men and women wit the same BMI who were otherwise healthy. After fasting overnight, the study participants underwent dual-energy x-ray absorptiometry (DXA) and CT scans to determine body composition, as well as magnetic resonance spectroscopy (MRS) for fat quantification and analysis.
The results showed that the women had a higher percentage of fat and more subcutaneous (below-the-skin) fat but lower lean mass, compared to men. However, men had more visceral adipose tissue (VAT), or ectopic fat depots located in the abdomen around the internal organs known as a "beer belly", and more ectopic fat in the muscles and liver. Obese men have relatively higher visceral fat, fat within muscle cells and liver fat, which are all risk factors for cardiometabolic disease, compared to women with the same BMI. However, men have higher muscle and lean mass, which are protective for cardiometabolic health.
Women have a higher relative amount of total body fat and higher superficial thigh fat, which is protective for cardiometabolic health. Compared to women, men had higher measures of cardiometabolic risk overall, but ectopic fat was not significantly associated with cardiometabolic risk in men. Ectopic fat in women, however, was strongly associated with cardiometabolic risk measures. The detrimental fat depots deep in the belly, muscles and liver are more damaging for cardiometabolic health in women compared to men.
The researchers looked at the relationship between sarcopenic obesity-or the loss of skeletal lean muscle mass in the presence of obesity and its relationship to cardiometabolic risk. Many factors can lead to sarcopenic obesity in young adults, particularly obesity and lack of exercise. Growth hormone helps to build muscle mass. Nutrition also plays an important role, and too little intake of protein can lead to muscle loss. The researchers studied young, overweight and obese adults who were otherwise healthy.
Participants underwent DXA and CT scans and various metabolic tests. Results showed that having a lower lean muscle mass to BMI ratio was associated with cardiometabolic risk, and these effects were stronger in women than in men. Sarcopenic obesity may be an under-appreciated mechanism linking obesity to cardiometabolic disease.
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