The Concept of CMR

Intra-abdominal Adipose Tissue: the Culprit?

Complications of Intra-abdominal Obesity

Obesity increases the risk of chronic complications. There is also compelling evidence that a high-risk form of overweight/obesity—intra-abdominal (visceral) obesity—is linked to the most severe metabolic abnormalities. With its peculiar metabolism, hyperlipolytic activity, and anatomic location, excess intra-abdominal fat plays a key role in insulin resistance, especially in the liver. This can cause glucose intolerance and type 2 diabetes in genetically susceptible individuals. High amounts of intra-abdominal fat are also closely tied to the typical atherogenic dyslipidemia found in individuals with abdominal obesity. High blood pressure, a pro-thrombotic state, and—more recently—a pro-inflammatory profile are other abnormalities seen mainly in individuals with excess intra-abdominal fat, irrespective of body weight. In addition to its possible role in causing insulin resistance and related metabolic abnormalities, excess intra-abdominal fat may also be a marker of ectopic fat deposition. This means that intra-abdominal obesity may indicate that an obese individual has too much fat at undesirable locations—such as the liver, skeletal muscle, and the pancreas—which can cause serious problems with carbohydrate and lipid metabolism.