Associations between body fat distribution and cardiometabolic risk factors in mixed-ancestry South African women and men

Abstract

Objective: To investigate the relationship between body fat distribution and cardiometabolic risk in mixed-ancestry South African (SA) men and women, and to explore the effect of menopausal status on these relationships in women. Methods: In a cross-sectional study, 207 mixed-ancestry SA women and 46 men underwent measurement of body composition using dual-energy X-ray absorptiometry, blood pressure, oral glucose tolerance, lipid profile and high-sensitivity C-reactive protein determination. The associations between different body fat compartments and associated cardiometabolic risk factors were explored. Results: Men had less percentage fat mass (%FM) [26.5% (25–75th percentiles: 19.9–32.5) vs 44.0% (39.8–48.6), p ≤ 0.001], but more central and less peripheral fat (both p < 0.001) than women. Post-menopausal women had greater %FM, waist and visceral adipose tissue (VAT), and less gynoid %FM than pre-menopausal women (all p ≤ 0.004). After adjusting for age and gender, VAT accounted for the greatest variance in insulin resistance (R2 = 0.27), while trunk %FM and leg %FM accounted for the greatest variance in triglyceride (R2 = 0.13) and high-density lipoprotein cholesterol concentrations (R2 = 0.14). The association between fat mass and regional subcutaneous adipose tissue and cardiometabolic risk factors differed by gender and menopausal status. Conclusion: Central fat was the most significant correlate of cardiometabolic risk and lower body fat was associated with reduced risk. These relationships were influenced by gender and menopausal status.