Visceral fat diameter as a major determinant of endothelial dysfunction in obese subjects
This study was designed to determine the interrelationships between endothelial function and carotid intima-media thickness (IMT), two markers of subclinical atherosclerosis, with visceral and subcutaneous adipose tissue accumulation, and liver steatosis in severely obese subjects. To this end, endothelial function (estimated from flow-mediated dilatation (FMD) of brachial artery), carotid IMT, visceral fat diameter, and degree of liver steatosis from ultrasonography were determined in 64 severely obese patients. FMD inversely correlated with visceral fat diameter and degree of steatosis; carotid IMT was associated with visceral fat mass but not with liver steatosis. After adjusting for conventional risk factors, independent predictors of FMD included visceral fat diameter, age, and gender, but not the degree of liver steatosis or plasma adiponectin, whereas age and gender were the only predictors of IMT. In conclusion, independent of traditional risk factors or degree of liver steatosis and plasma adiponectin, visceral fat diameter appears to be a major determinant of endothelial dysfunction in obese patients.


















