Obesity, fat patterning and cardiovascular risk.

Investigators have refined the study of the relationship of adiposity to disease by differentiating body shapes on the basis of the physical location of adipose tissue on the body. Different combinations of anthropometric measurements have been investigated as indicators of fat distribution. Recently combinations of easily obtained anthropometric measurements have been studied as correlates of visceral fat as measured by more complex measures such as computed tomography and magnetic resonance imaging. Despite difficulties in the measurement of the regional distribution of adipose tissue, several studies have shown that an upper body, centralized or abdominal fat pattern is correlated with increased CVD risk factors and CVD risk. The majority of studies have been cross-sectional, although several prospective cohort studies have examined relationships between fat distribution and mortality or incidence of morbidity over rather long time intervals. Results from the Charleston Heart Study indicate these relationships may differ by race and gender. More research is needed to define the role of fat patterning and changes in fat patterning on disease. Also, the relationship between total fatness and fat distribution to morbidity and mortality in specific populations and ethnic groups needs further exploration.