Differential effects of body fatness and body fat distribution on risk factor for cardiovascular disease in women. Impact of weight loss.

This study examines the role of obesity and body fat distribution (ie, waist-to-hip ratio [WHR]) on cardiovascular disease (CVD) risk factors in 50 nondiabetic, obese (body mass index [BMI], 31 +/- 2 kg/m2, mean +/- SD), 45 +/- 10-year-old women. The data obtained at baseline and after weight loss were analyzed after dividing subjects by WHR into upper-body (WHR > 0.80) and lower-body (WHR < or = 0.80) groups and by median-split BMI into more obese (BMI > or = 31) and less obese (BMI < 31) groups. At baseline, the upper-body obese women, when compared with lower-body obese women, had higher plasma triglycerides (TGs) (175 +/- 85 versus 111 +/- 47 mg/dL, respectively; P < .001) and lower high-density lipoprotein cholesterol (HDL-C) (44 +/- 10 versus 54 +/- 11, respectively; P < .01) but similar total and low-density lipoprotein cholesterol levels and blood pressure. There were no significant differences in these CVD risk factors at baseline by BMI split. Although weight loss (-9 +/- 5 kg) lowered blood pressure and TGs irrespective of WHR or BMI, only upper-body obese women raised HDL-C. Moreover, the magnitude of the changes was greatest in women with an upper-body fat distribution. In women with WHR > 0.80, HDL-C increased by 11%, to 49 mg/dL (P < .001), and TGs decreased by 24%, to 134 mg/dL (P < .001).(ABSTRACT TRUNCATED AT 250 WORDS)