ABSTRACT
Introduction ............................................................................................................ 382 Central Abdominal Obesity .................................................................................... 383
Relationship between Central Obesity and Cardiovascular Disease .................384 Thin-on-the-Outside, Fat-on-the-Inside ............................................................ 385
Visceral Adiposity .................................................................................................. 385 Visceral Fat ........................................................................................................ 385 Lipid Metabolism and Visceral Adiposity ......................................................... 386 Sex and Continent of Origin Effects ................................................................. 386 Genetic Factors ..................................................................................................386 Assessment of Intra-Abdominal Adipose Tissue .............................................. 387 Anthropometric Measurement .......................................................................... 387 Dual-Energy X-Ray Absorptiometry ................................................................ 387 Abdominal Ultrasonography ............................................................................. 387
Peripheral Fat Does No Harm ................................................................................ 388 Biological Differences: Visceral versus Subcutaneous Body Fat ..................... 389
Nonalcoholic Fatty Liver Disease .......................................................................... 392 Fatty Liver ......................................................................................................... 393 Development of Nonalcoholic Liver Disease.................................................... 393 Portal Vein Connection ...................................................................................... 394 Imaging the Liver .............................................................................................. 394
Are Weight Gain, Abdominal Obesity, and Development of Fatty Liver a One-Way Street? ................................................................................................. 395
Diet .................................................................................................................... 395 Exercise ............................................................................................................. 396 Drugs ................................................................................................................. 396 Bariatric Surgery ............................................................................................... 397 Therapies for NASH .......................................................................................... 397
Other Ectopic Depots ............................................................................................. 398 Conclusion ............................................................................................................. 398 References .............................................................................................................. 398
The obesity epidemic is a public health concern in high-income countries and is dramatically rising in low-and middle-income countries [1]. The medical community has taken notice and, not unlike investigation of smoking in relation to cancer in the 1950s and 1960s, has conducted research to carefully document the perils of excess adiposity. Signicant to this evolution is the realization that adipose tissue functions as an endocrine entity. In addition, as the awareness of the importance of the distribution of body fat is rising, methods to assess it in the clinic are being perfected, and utility dened.
