Adiposity and lean muscle indices that associate with cardiometabolic risk factors and inflammatory mediators in a South Asian population

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Abstract Background Cardiovascular diseases (CVD) are the leading cause of death in South Asia with visceral adiposity and sarcopenic obesity emerging as critical risk factors. Methods We conducted a cross-sectional study in 139 Sri Lankan adults (mean age 39.3, SD ± 10.7, 52 females and 87 males) to assess visceral adipose tissue (VAT) area, fat mass index (FMI), fat mass ratio (FMR) and lean muscle mass, expressed as the appendicular lean mass index (ALMI) using dual energy Xray absorptiometry (DEXA). Fasting blood sugar (FBS, lipid profiles, apolipoproteins (A1 and B) and inflammatory markers (IL-6 and IL-1b) were analysed. Results 23 (44%) females and 67 (77%) of males had a VAT area of ≥ 100cm 2 , 34 (65%) females and 79 (91%) males had an FMI of above the cut-off value and 30 (58%) females, and 33 (38%) males had an FMR above the cut-off value. Females with high VAT area (≥100cm 2 ) had significantly higher levels of FBS (p=0.008) and lower HDL and Apo A1 (p<0.05) compared to females with a VAT area of <100cm 2 . Further, females with an FMI of ≥9 had significantly higher FBS levels (p=0.01), and those with a FMR of ≥ of 1.2 were had significantly higher FBS and ApoB levels with significantly lower ApoA1 levels. There were no differences in metabolic risk factors or inflammatory mediators in males with an FMI above the cut-off value (≥6) or with a high FMR. 34 (65%) females had a low ALMI below (<5.5), while 47 (54%) males had a low ALMI (<7). ApoB levels, ApoB/ApoA1 ratio and serum cholesterol were significantly higher in males with a ALMI <7, than those with normal ALMI. Conclusion Visceral adiposity and a low lean muscle mass appear to be prevalent in South Asians with gender specific metabolic implications. Given the marked rise in CVD, diabetes and obesity related diseases in South Asia, urgent measures should be adopted to reduce the burden of illness due to these illnesses and diseases associated with frailty.

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