[Visceral fat and metabolic syndrome: more than a simple association].

Metabolic syndrome (MS) is seen nowadays as a worldwide epidemic event associated with high cardiovascular morbi-mortality and high socioeconomic cost. The ponderal gain is an independent predictor for the development of MS, although not all obese individuals present it. On the other hand, some populations with low obesity prevalence present high prevalence of MS and cardiovascular mortality. The distribution of corporal fat is relevant and visceral fat (VF), specifically, seems to be the link between adipose tissue and insulin resistance (IR), a mean feature of MS. Adipose tissue is now considered a complex organ with multiple functions. VF presents metabolic properties, which are different from the gluteo-femoral subcutaneous fat and related to IR. Several studies show the narrow relationship of abdominal adiposity with the glucose tolerance, hyperinsulinemia, hypertriglyceridemia and arterial hypertension. More than a simple association, recently it is thought that the VF plays a central part in the physiopathology of MS. Consequently, the quantification of VF plays an important role to identify individuals with larger risk for development of MS, who should be chosen for early interventions in the attempt of reducing the impact of metabolic abnormalities on cardiovascular mortality. This article discusses particularities of the central distribution of fat in MS context, possible physiopathogenic mechanisms related to the VF and available methods for the evaluation of abdominal adiposity.