Body Fat Distribution Of Metabolic Syndrome Patients And Its Effect On Metabolic Disturbance

ObjectiveTo analyse body fat distribution of the metabolic syndrome (MS) patients and the differences of body fat distribution between MS patients and non-MS in gender and living area. Also we will study the influence of body fat distribution on metabolic disturbance and provide a reference for MS prevention and control.MethodsTotally 7177 residents aged 30-60 years old living in Beijing and Jiaxing urban and rural areas were included in the survey through cluster sampling in June and July of 2010.7087 of them (male 3070, female 4017) with complete information were analysed. The survey contained questionnaire interview, physical examination, and laboratory testing. The questionnaire invterveiw was applied to collect information such as demographic data, history of smoking and alcohol comsumption,chronic disease history of hypertension and diabetes,family history, and physical activity level, etc. Physical examination information included height, weight, waist circumference (WC), and blood pressure. Body fat percentage and visceral fat value were measured by bioelectrical impedance analysis (BIA). Also the venous blood were collected to assay fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-c). Those subjects who have a FPG that was equal or greater than 6.1mmol/L would run the oral glucose tolerance test (OGTT) to diagnosis the diabetes. Finally, the criterion of MS was based on the diagnosis criteria for metabolic syndrome (Chinese Diabetes Society, CDS,2004).Data were input in computer by assigned person. Ratio comparison was conducted by Chi-square test and the size of test was 0.05. Receiver operating characteristic (ROC) curve was used to analyze the simplified body fat indicators to determine the cut-off point of metabolic disturbance. Multiple regression analysis was used to find the relationship between the indicators and metabolic disturbance. Reference population adopted in standardized ratio comparison was population census data of 2000 in China. SPSS 17.0 and Medcalc were used to analysis the data.Results1. Body fat percentage, waist circumference and visceral fat value of metabolic syndrome patients (n=1289) were higher than those of non-MS population (P<0.01). Especially, MS patients got a 12-13cm higher in WC and 4-6 higher in visceral fat value compared with non-MS subjects. Compared with male patients, female patients got a higher body fat percentage (P<0.01). However, male patients have a higher waist circumference and visceral fat value (P<0.01) than those of female ones. Body fat percentage and waist circumference were higher of Beijing MS patients than those of Jiaxing MS subjects (P<0.01), while the value of visceral fat had was lower (P<0.05) between Beijing and Jiaxing patients.2. Body fat percentage, waist circumference, visceral fat value and BMI showed significant positive correlation with each other (P<0.01). There was no significant relationship exsited among body fat, waist circumference, visceral fat, and the number of TG and HDL-C.3. In terms of the diagnosis on at least one metabolic disturbance, male BMI, WC and visceral fat value showed a similar efficiency and they were higher than the body fat percentage. Female BMI and visceral fat value got a higher prediction efficiency. The cut-off points were BMI 24.0 kg/m2 and 24.4kg/m2, WC 84.0 cm and 80.3cm, body fat percentage 23.1% and 32.8%, and visceral fat value 10.5 and 6.5 for male and female, respectively.4. Different body fat distribution may increase different components of metabolic syndrome. For male, BMI≥24 kg/m2 and body fat percentage≥15% will increase the risk of high blood glucose and high blood pressure. Increased visceral fat value and waist circumference≥85cm will raise the risk of high blood pressure and dyslipidemia. For female, BMI≥18.5 kg/m2 and body fat percentage≥35% will incur higher risk of high blood pressure and dyslipidemia. Increased visceral fat value and waist circumference≥85cm will resulted in higher risk of high blood glucose.Conclusions1. Body fat distribution of MS patients is characterized by higher body fat percentage and accumulation of abdominal fat. It is more popular in men and Beijing people.2. Simplified body fat indicators may be used for preliminarily assessment on metabolic disturbance.3. Different body fat distribution would increase the risk of different components of metabolic syndrome, and there are differences between male and female.4. Bioelectrical impedance analysis (BIA) combined with simplified body fat indicators may show the situation of body fat distribution, and it is suitable for large sample epidemiology survey on metabolic syndrome.