Abdullah Shazana Rifham, Nur Zati Iwani Ahmad Kamil, Ahmad Zamri Liyana, Wan Mohd Zin Ruziana Mona, Abu Seman Norhashimah, Zainal Abidin Nur Azlin, Hamzah Siti Sarah, Azizul Nur Hayati, Omar Azahadi, Seman Zamtira, Yahya Abqariyah, Md Noh Mohd Fairulnizal
Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Selangor, Shah Alam, Malaysia.
Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Selangor, Shah Alam, Malaysia.
Front Endocrinol (Lausanne). 2025 Jun 4;16:1576599. doi: 10.3389/fendo.2025.1576599. eCollection 2025.
Visceral adiposity is closely linked with cardiometabolic disorders, but evidence on the extent of visceral fat loss required for significant improvement in cardiometabolic markers remains limited. This study aims to investigate the association between visceral fat area (VFA) reductions and improvements in cardiometabolic markers following a 3-month dietary intervention.
A total of 175 adults with overweight and obesity were involved in this non-randomized controlled trial. Data on sociodemographic, anthropometric, body composition and biochemistry were collected at baseline and after 3 months of intervention. The multiple logistic regression analysis was conducted to determine the association between VFA loss (no loss, < 5% loss, and ≥ 5% loss) and improvement in cardiometabolic markers. For each cardiometabolic marker, an improvement surpassing the minimum threshold of the third tertile was classified as a good improvement.
Compared to those with no VFA loss, participants with VFA loss of ≥ 5% were significantly associated with a higher improvement in waist circumference (OR 2.97, 95% CI 1.16-7.64), high-density lipoprotein cholesterol (HDL-C) (OR 4.19, 95% CI 1.58-11.14), triglycerides (OR 3.01, 95% CI 1.14-7.92), and glycated hemoglobin (HbA1C) (OR 2.95, 95% CI 1.12-7.79). Other than that, those with < 5% VFA loss were 3.6 times more likely to have a higher improvement in HDL-C compared to those with no VFA loss (OR 4.08, 95% CI 1.36-12.22).
This study found that the magnitude of VFA loss is an independent determinant of improvements in cardiometabolic markers and should be set as a clear target when designing obesity prevention programs.
内脏脂肪过多与心脏代谢紊乱密切相关，但关于显著改善心脏代谢指标所需的内脏脂肪减少程度的证据仍然有限。本研究旨在调查3个月饮食干预后内脏脂肪面积（VFA）减少与心脏代谢指标改善之间的关联。
共有175名超重和肥胖成年人参与了这项非随机对照试验。在基线和干预3个月后收集社会人口统计学、人体测量学、身体成分和生物化学数据。进行多因素逻辑回归分析以确定VFA减少（无减少、减少<5%和减少≥5%）与心脏代谢指标改善之间的关联。对于每个心脏代谢指标，超过第三个三分位数最低阈值的改善被分类为良好改善。
与VFA无减少的参与者相比，VFA减少≥5%的参与者腰围（优势比2.97，95%置信区间1.16 - 7.64）、高密度脂蛋白胆固醇（HDL-C）（优势比4.19，95%置信区间1.58 - 11.14）、甘油三酯（优势比3.01，95%置信区间1.14 - 7.92）和糖化血红蛋白（HbA1C）（优势比2.95，95%置信区间1.12 - 7.79）的改善明显更高。除此之外，VFA减少<5%的参与者HDL-C改善较高的可能性是VFA无减少参与者的3.6倍（优势比4.08，95%置信区间1.36 - 12.22）。
本研究发现VFA减少的幅度是心脏代谢指标改善的独立决定因素，在设计肥胖预防计划时应将其设定为明确目标。
