The objective of this study was to investigate the contribution of adipocyte size versus body composition to the metabolic complications associated with obesity. The cohort included 432 largely Caucasian volunteers (264 premenopausal women and 168 age-matched men). In contrast to the author’s hypothesis, results showed body fat distribution variables were better predictors of most metabolic characteristics than adipocyte size. In univariate and multivariate regression analysis, visceral adipose tissue explained most of the variation in fasting triglycerides in both women and men. As for fasting insulin concentrations, subcutaneous adipose tissue was the best predictor in women, whereas body mass index (BMI) was the best correlate in men. In women, the subcutaneous adipose tissue predicted the largest proportion of the explained variance in fasting glucose concentration. In men, fasting glucose concentrations were predicted by thigh adipocyte size and BMI. Thus, body fat distribution, especially abdominal adiposity, is more closely related to metabolic complications such as fasting insulin, fasting glucose and fasting triglyceride concentrations than adipocyte size.
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