Obesity is a public health problem. The prevalence of obesity is increasing in all industrialized countries. Android obesity is associated with excess cardiovascular mortality and type 2 diabetes, which justifies early management of this disease [1]. Visceral adipose tissue, via portal drainage, could be an important source of free fatty acids with complex metabolic effects: participation in hepatic lipogenesis, increase in hepatic neoglucogenic flux, decrease in metabolic clearance of insulin and participation in Peripheral insulin resistance via a Randle-type substrate competition phenomenon [2]. These phenomena increase the risk of cardiovascular diseases, cancers and major metabolic disorders [3]. To this end, we want to research the risk factors likely to favor the development of visceral adiposity and the unfavorable repercussions on the cardio-metabolic level.

Characteristics of the population

During this study we collected 55 obese diabetic adult patients of both sexes followed in consultation for metabolic diseases at the EPSP of Blida and the Physiology department of the N. Hamoud hospital of Hussein Dey grouped into three classes according to the level of visceral adiposity (Tables 1 & 2) (Figures 1 & 2). Anthropometric measurements for the calculation of body mass index (BMI) and impedance measurements to assess the level of visceral fat using the BF 508 type OMRON body composition monitor were undertaken (Table 3) (Figures 3 & 4). The variables associated with the level of visceral fat were researched by Statistical analysis was performed with SPSS software version 25 (IBM SPSS). The qualitative variable (sex) is described in numbers (percentage), the continuous variables (quantitative) are presented in the form of means +/- standard deviations. Student’s t test and anova test were used to compare quantitative variables. A p-value less than 0.05 is assumed to be statistically significant (Tables 4 & 5) (Figures 5 & 6).

Table 1: Distribution of patients according to level of visceral fat.

Table 2: Distribution of patients by gender.

Table 3: Comparison of levels of visceral adiposity according to age

Table 4: Comparison of visceral adiposity levels according to sex.

Table 5: Comparison of BMI by gender.

Figure 1: More than 50% of the population has a high level of visceral adiposity and less than 10% has a normal level.

Figure 2: There is a strong correlation between the level of adiposity and the age of the patients.

Figure 3: The distribution of patients by gender shows a clear female.

Figure 4: The patients with a very high level of visceral adiposity (15 -30) were very significantly older (p < 0.0001).

Figure 5: The average visceral adiposity was very significantly higher in men than in women (p < 0.0001) and corresponds to a high level in women and very high in men.

Figure 6: Female patients had a very significantly elevated BMI (p<0.0006).

Demographic data: There is a strong correlation between the level of visceral adiposity and the age of patients with an average age of 54.18 +/- 8.38 years.

The importance of the regional distribution of adipose tissue as a factor closely associated with dyslipoproteinaemia and cardiovascular disease and type 2 diabetes has been highlighted by the scientific community interested in obesity and its complications [4]. Moreover, multivariate analyzes revealed that the amount of visceral adipose tissue measured by axial tomography was the variable most strongly correlated with different ratios of parameters used in the prediction of the risk of metabolic disorders [5,6]. Our results plead in favor of a relationship between age and the importance of visceral adiposity that may implicate sedentary lifestyle and the drop in the level of energy expenditure consistent with the current environment, which corroborates the data from the literature. However, the comparison of the BMI of the two sexes shows that there is no relationship between this index and the level of visceral fat due to the significant particularity of this visceral adipose tissue which may be present in subjects with an index of normal body weight and who may still be exposed to the metabolic and cardiovascular risks of obesity [7].

In contrast, there are a small number of android obese patients without increased visceral fat (1 in 3 cases) [8]. Moreover, contrary to generally accepted ideas, the subcutaneous adipose tissue also participates in the pool of easily mobilized free fatty acids in the obese [9]. Thus, the links between obesity and metabolic diseases could go through the facilitated availability of fatty acids from adipose tissue (visceral and subcutaneous) in otherwise genetically predisposed subjects [10].

This study clearly shows the role of age in the expansion of visceral adipose tissue; this trend is more marked in men than in women who generally have a higher BMI. Visceral fat exposes to more cardiometabolic risk than subcutaneous fat which, nevertheless, has a relative deleterious potential.

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