Ectopic fat and adipokines in metabolically benign overweight/obese women: the kronos early estrogen prevention study

Document Type



Family Medicine


Objective: It is unclear why despite a comparable cardiometabolic risk profile, “metabolically benign” overweight/obese individuals show an elevated risk of cardiovascular disease compared to normal weight individuals.
Design and Methods: In cross-sectional analyses, we compared levels of ectopic fat (epicardial, pericardial, and hepatic fat) and adipokines (leptin, soluble leptin receptor, and high molecular weight [HMW] adiponectin) among metabolically benign (MBOO) and at-risk overweight/obese (AROO), and metabolically benign normal weight (MBNW) women, screened for the Kronos Early Estrogen Prevention Study. We defined “metabolically benign” with ≤ 1, and “at-risk” with ≥2 components of the metabolic syndrome.
Results: Compared to MBOO women, AROO women had significantly elevated odds of being in the top tertile of epicardial fat (OR:1.76, 95%CI:1.04–2.99), hepatic fat (OR:1.90, 95%CI:1.12– 3.24) and leptin (OR:2.15, 95%CI:1.23–3.76), and the bottom tertile of HMW-adiponectin (OR: 2.90, 95%CI:1.62–5.19). Compared to MBNW women, MBOO women had significantly higher odds of being in the top tertile of epicardial fat (OR:5.17, 95%CI:3.22–8.29), pericardial fat (OR: 9.27, 95%CI:5.52–15.56) and hepatic fat (OR:2.72, 95%CI:1.77–4.19) and the bottom tertile of HMW adiponectin levels (OR:2.51, 95%CI:1.60–3.94).
Conclusions: Levels of ectopic fat and the adverse adipokine profile increase on a continuum of BMI, suggesting that the metabolically benign phenotype may be a transient state.


This work was published before the author joined Aga Khan University.

Publication ( Name of Journal)

Obesity (Silver Spring)

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.