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Objective: Greater accumulation of visceral fat is strongly linked to risk of cardiovascular
disease. However, elevated waist circumference by itself does not always identify individuals
with increased visceral fat.
Research Design and Methods : We examined 375 subjects with type 2 diabetes from the
CHICAGO cohort for presence of hypertriglyceridemic waist phenotype (waist circumference
>90 cm in men or >85 cm in women, in conjunction with a plasma triglyceride concentration of
177 mg/dl) to determine its usefulness for identifying subjects with increased amount of
visceral fat. We divided subjects into three groups: Group 1 ( low waist and low triglyceride;
waist 90 cm in men or 85 cm in women and triglyceride<177 mg/dl, n=18), Group 2 (high
waist and low triglyceride; waist >90 cm in men or >85 cm in women and triglyceride<177
mg/dl, n=230) and Group 3 (high waist and high triglyceride; waist >90 cm in men or >85 cm in
women and triglyceride 177 mg/dl, n=127).
Results : Subjects in Group 3 had significantly higher visceral fat (P<0.0001), hemoglobin A1c
(P<0.01) and coronary artery calcium (P<0.05) compared to Group 2 despite similar age, BMI
and waist circumference. The relationship of the phenotype to atherosclerosis, however, was
attenuated by adjustment for HDL, triglyceride-rich lipoprotein cholesterol, Apo B or LDL
particle number.
Conclusions: The presence of hypertriglyceridemic waist phenotype in subjects with type 2
diabetes identifies a subset with greater degree of visceral adiposity. This subset also has greater
degree of subclinical atherosclerosis that may be related to the pro-atherogenic lipoprotein
changes.
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