Association between fat mass, adipose tissue, fat fraction per adipose tissue, and metabolic risks: a cross-sectional study in normal, overweight, and obese adults

Eur J Clin Nutr. 2019 Jan;73(1):62-71. doi: 10.1038/s41430-018-0150-x. Epub 2018 Apr 18.


Background/objectives: We investigated whether fat mass (FM) and total adipose tissue (TAT) can be used interchangeably and FM per TAT adds to metabolic risk assessment.

Subjects/methods: Cross-sectional data were assessed in 377 adults (aged 18-60 years; 51.2% women). FM was measured by either 4-compartment (4C) model or quantitative magnetic resonance (QMR); total-, subcutaneous- and visceral adipose tissue (TAT, SAT, VAT), and liver fat by whole-body MRI; leptin, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), C-reactive protein (CRP), and triglycerides; resting energy expenditure and respiratory quotient by indirect calorimetry were determined. Correlations and stepwise multivariate regression analyses were performed.

Results: FM4C and FMQMR were associated with TAT (r4C = 0.96, rQMR = 0.99) with a mean FM per TAT of 0.85 and 1.01, respectively. Regardless of adiposity, there was a considerable inter-individual variance of FM/TAT-ratio (FM4C/TAT-ratio: 0.77-0.94; FMQMR/TAT-ratio: 0.89-1.10). Both, FM4C and TAT were associated with metabolic risks. Further, FM4C/TAT-ratio was positively related to leptin but inversely with CRP. There was no association between FM4C/TAT-ratio and VAT/SAT or liver fat. FM4C/TAT-ratio added to the variance of leptin and CRP.

Conclusions: Independent of FM or TAT, FM4C/TAT-ratio adds to metabolic risk assessment. Therefore, the interchangeable use of FM and TAT to assess metabolic risks is questionable as both parameters may complement each other.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipose Tissue / diagnostic imaging
  • Adolescent
  • Adult
  • Body Fat Distribution / methods
  • Body Fat Distribution / statistics & numerical data*
  • Calorimetry, Indirect / methods
  • Cross-Sectional Studies
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Metabolic Diseases / etiology*
  • Middle Aged
  • Multivariate Analysis
  • Obesity / complications
  • Obesity / diagnosis*
  • Observer Variation
  • Overweight / complications
  • Overweight / diagnosis*
  • Regression Analysis
  • Reproducibility of Results
  • Risk Assessment / methods*
  • Whole Body Imaging / methods
  • Young Adult