Regional fat distribution and cardiometabolic risk in healthy postmenopausal women

• DXA-derived indices correlate in an opposite way with metabolic syndrome in healthy postmenopausal women.
• In opposite to the lower, upper body fat is adversely associated with cardiometabolic variables, in postmenopausal women.
• Thoracic fat mass may constitute a metabolically distinct upper body fat depot and merits thus further investigation.
• Arm fat mass may reflect a metabolically central rather than peripheral pattern of fat distribution.
• Indices of peripheral fat distribution, emerge as important determinants of metabolic syndrome.
• The annual osteoporosis screening could combine an additional evaluation of total and regional adiposity.

BackgroundRegional fat distribution is an important determinant of cardiometabolic risk after menopause. The aim of the present study was to investigate the association between indices of fat distribution obtained by Dual-energy X-ray Absorptiometry (DXA) and representative cardiometabolic risk factors in a cohort of healthy postmenopausal women.MethodsIn this cross-sectional study, cardiometabolic risk factors were correlated with a variety of central and peripheral fat depots obtained by DXA, in a total of 150 postmenopausal women, free of diabetes and cardiovascular disease (age 54 ± 7 years, BMI 29.6 ± 5.8 kg/m2, mean ± 1 SD).ResultsAfter adjusting for age and total adiposity, DXA-derived indices of central and peripheral fat distribution displayed opposite associations (positive versus negative) with the examined cardiometabolic risk factors. In multivariate regression analysis, thoracic fat mass % was an independent predictor of blood pressure, HOMA index and triglycerides, abdominal fat mass % was an independent predictor of high sensitivity C-reactive protein, and abdominal-to-gluteofemoral fat ratio was an independent predictor of high density lipoprotein cholesterol. An index of peripheral fat distribution, gluteofemoral fat mass %, proved to be the most important determinant of metabolic syndrome (Odds Ratio 0.76, 95% confidence intervals 0.67–0.87, p < 0.001), independent of total and central adiposity.ConclusionDXA-derived indices of regional fat distribution such as thoracic, abdominal and gluteofemoral fat, correlate significantly with cardiometabolic risk factors in healthy postmenopausal women, and may serve as clinically useful tools for evaluating cardiometabolic risk after menopause.