Figures & data
Figure 1. CT scanning images of obese subjects. Note the huge amount of subcutaneous fat in the lower right panel(D). Note also the relatively small amount of subcutaneous fat but massive intra‐abdominal visceral fat in the lower left panel (C).
Figure 2. Visceral fat accumulation in a patient with coronary artery disease(CAD). Note accumulation of visceral fat and relatively thin subcutaneous fat in the CAD(+) versus the CAD(−) case.
Figure 3. Visceral fat accumulation and hyperlipidemia. A large amount of FFA reaches the liver where it activates triglyceride(TG) synthesis. FFA inhibits intrahepatic degradation of apoB, resulting in overproduction of VLDL. Prolonged overnutrition causes lipid accumulation in visceral fat, liver, and muscle, resulting in insulin resistance.
Figure 4. Profile of genes expressed in human visceral fat. Genes expressed in human visceral fat were categorized according to function or subcellular localization. Approximately 30% of genes were those encoding secretory proteins.
Figure 5. Correlation between CT‐determined visceral fat area and plasma levels of adiponectin and plasminogen activator inhibitor type 1 (PAI‐1). Plasma adiponectin levels correlated negatively, and plasma PAI‐1 levels correlated positively with the visceral fat area determined by CT scan.
Figure 6. Effects of adiponectin on vascular endothelial cells, vascular smooth muscle cells, and macrophages. Administration of adiponectin suppressed TNFα‐induced expression of VCAM‐1 in endothelial cells through the inhibition of NF‐κB activation, platelet derived growth factor (PDGF) induced proliferation of vascular smooth muscle cells partly by inhibition of ERK activation, and lipopolysaccharide‐induced expression and secretion of TNFα.
Table I. Worldwide criteria and Japanese criteria for the diagnosis of the metabolic syndrome.
Figure 7. Representative CT scanning images of middle‐aged man and woman. In general, women have relatively larger amounts of subcutaneous fat in the abdomen compared to men.
Figure 8. Percentages of Japanese men and women with a provisional diagnosis of metabolic syndrome. A total of 3421 families by stratified sampling were included in the National Health and Nutrition Survey 2004 by the Ministry of Health, Labor, and Welfare. The prevalence of metabolic syndrome was investigated in individuals⩾20 years of age strongly suspected of having the metabolic syndrome, based on findings of occasional blood sampling. The following criteria were adopted for the diagnosis of metabolic syndrome: Waist circumference of 85 cm for men and 90 cm for women, plus two of the following three: 1) HDL‐C level <40 mg/dL; 2) blood pressure ⩾130/85 mmHg; and 3) hemoglobin A1c ⩾5.5%. From the Report of National Health and Nutrition Survey 2004 by the Ministry of Health, Labor, and Welfare, Japan.
Figure 9. Management of metabolic syndrome leads to reduction of cardiovascular‐related deaths. A health promotion program directed against the metabolic syndrome was conducted in Amagasaki Municipal Government offices, Hyogo Prefecture, in 3946 workers from Hyogo. After the introduction of this program in 2000, the incidence of cardiovascular deaths in this office was clearly reduced. From data of Kenko Amagasakishi 21: Health Survey and Health Promotion Program for staff of the Amagasaki Municipal Government office in 2004.
