In a cross-sectional study performed in 58 premenopausal and 20 postmenopausal women, Phillips et al. sought to identify which underlying risk factor for the metabolic syndrome showed the strongest associations with cardiovascular disease risk (CVD) factors. The possible underlying risk factors for the metabolic syndrome were adiposity (intra-abdominal adipose tissue), insulin resistance (fasting insulin levels), and sex hormone levels (testosterone and sex hormone binding globulin). Intra-abdominal adipose tissue and age were strongly correlated (r=0.67, p<0.001). After controlling for age, intra-abdominal adipose tissue accumulation showed strong associations with cardiometabolic risk markers such as triglyceride (r=0.50), HDL cholesterol (r=-0.63), insulin (r=0.43), free testosterone (r=0.40), and sex hormone binding globulin (r=-0.38, p<0.001 for all) levels. Insulin and free testosterone levels also showed strong associations with these cardiometabolic risk markers. However, after adjusting for intra-abdominal adipose tissue accumulation, most of the associations were not significant. Based on these relationships, the authors hypothesized that intra-abdominal obesity was likely to be the most important underlying risk factor for the metabolic syndrome and that insulin resistance and sex hormones were likely to be part of the pathway linking intra-abdominal obesity and the metabolic syndrome.
Documentation centre