Hypertriglyceridemic waist: missing piece of the global cardiovascular risk assessment puzzle?

Abstract

The global prevalence of obesity is increasing at a rapid pace and is likely to have an impact on the prevalence of Type 2 diabetes and cardiovascular disease (CVD). Identifying individuals carrying a high–risk obesity phenotype, such as those patients with an accumulation of visceral or intra–abdominal fat, goes beyond the assessment of the BMI and even waist circumference. An increasing amount of population-based studies have shown that the hypertriglyceridemic waist phenotype (the combination of an elevated waist girth and triglyceride levels) could identify individuals with increased amounts of visceral fat that are characterized by a concomitant deteriorated cardiometabolic risk profile and prospectively, with an increased risk of developing both Type 2 diabetes and CVD. Our objective is to review the evidence on the relationship between the hypertriglyceridemic waist phenotype and the risk of CVD and Type 2 diabetes as well as to discuss how to identify and manage individuals who have this high-risk obesity phenotype.

Keywords:

• abdominal obesity
• cardiovascular disease
• ectopic fat
• inflammation
• insulin resistance
• lifestyle modification therapy
• triglycerides
• Type 2 diabetes