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Risk for metabolic diseases in normal weight individuals with visceral fat accumulation: a cross-sectional study in Japan
  1. Yukako Tatsumi1,2,
  2. Yoko M Nakao2,3,
  3. Izuru Masuda4,
  4. Aya Higashiyama2,
  5. Misa Takegami2,
  6. Kunihiro Nishimura2,
  7. Makoto Watanabe3,
  8. Takayoshi Ohkubo1,
  9. Tomonori Okamura5,
  10. Yoshihiro Miyamoto2,3
  1. 1Department of Hygiene and Public Health, Teikyo University School of Medicine, Itabashi, Japan
  2. 2Department of Preventive Medicine and Epidemiology Informatics, National Cerebral and Cardiovascular Center, Suita, Japan
  3. 3Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
  4. 4Takeda Hospital Group, Kyoto, Japan
  5. 5Department of Preventive Medicine and Public Health, Keio University, Shinjuku, Japan
  1. Correspondence to Yukako Tatsumi; y.tatsumi{at}


Objective To investigate the association between visceral fat area (VFA) and metabolic syndrome (Mets) among normal weight Japanese.

Design A cross-sectional study.

Setting The health check-up centre of the Takeda Hospital group in Kyoto, Japan.

Methods This study involved 1674 men and 1448 women aged 30–74 years who underwent medical check-ups in 2012 in the health check-up centre. They were stratified by Body Mass Index (BMI cut-off for obesity is set at 23.0 kg/m2 for Asians): normal weight 18.5–22.9 kg/m2 or higher weight ≥23.0 kg/m2. The age-adjusted ORs of the 2nd to 4th groups of sex-specific VFA quartiles compared with the 1st quartile for a Mets component clustering were estimated. The clustering was having two or more of the following factors: high blood pressure, high fasting blood glucose (FBG), low high-density lipoprotein cholesterol (HDL-C) and high triglycerides. Statistical analyses were conducted in 2016.

Results Participants in the 2nd to 4th VFA quartiles had significantly higher clustering risks; ORs were 3.4 (1.5 to 8.0), 6.3 (2.8 to 14.2) and 9.3 (4.2 to 20.7) for normal weight participants, and 1.7 (1.2 to 2.6), 2.6 (1.8 to 3.9) and 6.0 (4.1 to 8.8) for higher weight participants, respectively. The ORs of the 4th VFA quartile for Mets components were significantly higher; ORs for normal weight participants were 2.1 (1.5 to 3.0) (high blood pressure), 2.4 (1.4 to 4.2) (high FBG), 5.2 (2.1 to 12.9) (low HDL-C) and 12.0 (5.7 to 25.3) (high triglycerides), and higher weight participants were 3.9 (2.8 to 5.5), 4.1 (2.8 to 6.2), 3.9 (2.2 to 6.9) and 5.0 (3.4 to 7.4), respectively.

Conclusions Among participants with normal weight, as well as those of higher weight, dose-dependent responses were observed between VFA and risk for Mets components and the clustering among Japanese adults. VFA may be useful information for interventions to improve metabolic risk factors in people with normal weight.

  • visceral fat

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  • Contributors YT contributed to the conception of the work, performed statistical analysis and drafted the manuscript. YMN contributed to the conception of the work and revising the manuscript critically. IM contributed to the conception of the work and reviewed the manuscript. AH, MT, KN, MW contributed to the interpretation of the result and reviewed the manuscript. TaO and ToO contributed to the interpretation of the result and revising the manuscript critically. YM contributed to the design of the work and the interpretation of the result and reviewed the manuscript. All authors read and approved the final manuscript.

  • Funding This study was supported by a grant-in-aid for Young Scientists from the Japan Society for the Promotion of Science (15H06913), a grant-in-aid from the Ministry of Health, Labour and Welfare, Health and Labour Sciences research grants, Japan (Comprehensive Research on Cardiovascular Disease, Diabetes and Life-Style Related Diseases: H27–Junkankitou (Seishuu)–Ippan–009), and an Intramural Research Fund (27-4-3) for Cardiovascular Diseases of National Cerebral and Cardiovascular Center.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The study was approved by the Ethics Committee of the National Cerebral and Cardiovascular Center and Takeda Hospital Group (committee approval number: 1404).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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