The prevalence of abdominal obesity (intra-abdominal or visceral and subcutaneous obesity) was assessed in 3,348 participants of the Framingham Heart Study. Cutoff values for elevated subcutaneous or intra-abdominal adipose tissue were derived from the 90th percentile values of a healthy reference sample. The prevalence of high subcutaneous adipose tissue was 30% in women and 31% in men, while the prevalence of high intra-abdominal adipose tissue was 44% in women and 42% in men. The prevalence of the metabolic syndrome was higher in men and women with subcutaneous adipose tissue <90th percentile and elevated intra-abdominal adipose tissue than in those with high subcutaneous adipose tissue but intra-abdominal adipose tissue <90th percentile, despite lower body mass index and waist circumference values. These results suggest that intra-abdominal adipose tissue is more closely associated with metabolic complications than subcutaneous obesity.
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