Fat distribution and cardiovascular risk factors in obese adolescent girls: importance of the intraabdominal fat depot.

The regional distribution of body fat has repeatedly been found to be a significant and independent risk factor for cardiovascular disease in both obese men and women. To determine whether abnormalities in the lipid-lipoprotein profile and systolic and diastolic blood pressure are related to specific fat depots early in the course of obesity, we used magnetic resonance imaging to measure accurately intraabdominal and subcutaneous fat masses in 14 obese [body mass index (BMI; in kg/m2) 30 +/- 1.3] and 10 nonobese (BMI: 21 +/- 0.5) adolescent girls matched for age and Tanner stage of development. Intraabdominal and subcutaneous fat depots were two- to threefold greater in obese than in nonobese girls (P < 0.01). Total cholesterol, triacylglycerol, low-density-lipoprotein (LDL) cholesterol, basal insulin, and systolic and diastolic blood pressure were significantly higher in obese adolescent girls than in control subjects. In obese girls, intraabdominal fat but not BMI or waist-to-hip ratio was highly correlated with basal insulin (r = 0.55, P < 0.04), triacylglycerols (r = 0.53, P < 0.03), and high-density-lipoprotein (HDL) cholesterol (r = -0.54, P < 0.04). Femoral adipose tissue was inversely related to triacylglycerol (r = -0.51) and LDL cholesterol (r = -0.56, P < 0.05) concentrations in obese girls. The study indicates that early in the natural history of obese adolescent girls, cardiovascular risk factors are related to the amount of intraabdominal fat.