Treatment of obesity: need to focus on high risk abdominally obese patients

Jean-Pierre Després, professor,^a Isabelle Lemieux, PhD student,^b and Denis Prud'homme, professor

Summary points

• A simple measurement such as waist circumference can indicate accumulation of abdominal fat
• Viscerally obese men are characterised by an atherogenic plasma lipoprotein profile
• A triad of non-traditional markers for coronary heart disease found in viscerally obese middle aged men (hyperinsulinaemia, raised apolipoprotein B concentration, and small LDL particles) increases the risk of coronary heart disease 20-fold
• Four out of five middle aged men with a waist measurement 90 cm and triglyceride concentrations 2 mmol/l are characterised by this triad
• Even in the absence of hypercholesterolaemia, hyperglycaemia, or hypertension, obese patients could be at high risk of coronary heart disease if they have this “hypertriglyceridaemic waist” phenotype

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1119905/