A sex hormone alteration may underlie visceral fat accumulation and thus ultimately metabolic syndrome
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Insulin, adiposity variables, sex hormones, and risk factors for myocardial infarction (MI) were measured in 58 premenopausal and 20 postmenopausal healthy women in order to establish their interrelationship. Visceral adipose tissue (VAT) correlated more strongly with risk factors for MI, insulin, and free testosterone (FT) than did total adipose tissue and subcutaneous adipose tissue. For further data analysis, VAT was thus used as the adiposity variable. VAT correlated positively with insulin, FT, triglyceride, and glucose, and negatively with high-density lipoprotein and sex hormone-binding globulin. When controlling for age, FT and insulin correlated with risk factors for MI and with each other, but when controlling for age and VAT, all correlations lost statistical significance except FT-triglyceride and FT-insulin in the postmenopausal women. In conclusion, VAT accumulation in women, independently of other measures of adiposity, may largely explain the correlations of insulin, obesity, and sex hormones with risk factors for MI. VAT accumulation may thus be the immediate underlying factor that links risk factors for MI to form metabolic syndrome. Moreover, the authors hypothesize that in women a sex hormone alteration may underlie VAT accumulation and thus ultimately underlie the metabolic syndrome.
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