Correlation of Lipid Profiles and Inflammatory Markers with

Visceral Fat in Young Adult Men with Normal and Higher Body

Mass Index

Mayesti Akhriani

1,*

and Wimba Widagdho Dinutanayo

Department of Nutrition, University of Aisyah Pringsewu, Lampung Province, Indonesia

Department of Medical Laboratory Technology, Poltekkes Kemenkes Tanjung Karang, Lampung Province, Indonesia

Keywords: Visceral Fat, Inflammatory Markers, Lipid Profiles.

Abstract: Excessive visceral fat is correlated to the increased risk of cardiovascular and metabolic diseases by increased

lipid profiles and circulation of inflammatory cytokines. Men have higher accumulated visceral fat due to

hormone and other factors. The aim of this research is to study the correlation of lipid profiles (total

cholesterol, high-density lipoprotein/HDL, low-density lipoprotein/LDL, and triglyceride/TG and

inflammatory markers (Leukocyte, Neutrophil, Lymphocyte, Erythrocyte Sediment Rate/ESR, Monocyte,

Eosinophil). The cross-sectional study recruited 37 adult men with the mean age 24 years old. BIA was used

to measure visceral fat rating (r = 0.465, p = 0.002), and samples of blood were collected following an

overnight fast. The results showed that significant correlations were found between the serum cholesterol (r

= 0.524, p = 0.001), LDL (r = 0.547, p = 0.001), triglyceride and visceral fat. From variables of inflammatory

markers, the significant positive correlations were shown between leukocyte between visceral fat (r = 0.281,

p = 0.046) and between ESR and visceral fat (r = 0.402, p = 0.007). In conclusion, statistically significant

positive correlations were found between several lipid profiles (total cholesterol, LDL and TG) and visceral

fat, and between specific inflammatory markers (leukocyte and ESR) and visceral fat.

1 INTRODUCTION

An excessive amount of visceral fat (VF) is linked to

metabolic and cardiovascular disorders and could

indicate defective subcutaneous fat that results in

ectopic fat deposition, or the build-up of unwanted

lipids in the pancreas, liver, heart, or skeletal muscle

(Lim and Meigs, 2014). In fact, visceral adipose

tissue is an important part of total body fat, and

visceral obesity is defined as an excessively increased

deposition of visceral adipose tissue. However, both

metabolic and cardiovascular diseases are linked to

this body composition (Piche et al, 2020). In order to

estimate the possible risk of developing metabolic

and cardiovascular diseases, visceral obesity must be

quantitatively assessed

Numerous techniques, including computed

tomography (CT) scanning, ultrasonography, dual-

energy X-ray absorptiometry (DXA), bioelectrical

impedance analysis (BIA), and magnetic resonance

imaging (MRI), can be used to evaluate visceral fat in

the abdominal cavity. BIA is a radiation-free,

noninvasive technique that can be used to evaluate

visceral fat in the abdominal cavity (Schwartz et al,

2017). The abdominal cavity's visceral fat is

evaluated by BIA, which also provides the visceral fat

grading level (Sukkriang et al, 2021). Therefore,

accesible and afffordable measurement of VF using

BIA could be used in many health facilities.

Compared to adult women, adult males have

lower average body fat percentages. Even with these

variations in overall body fat, adult males specifically

have higher abdominal VF depots than

premenopausal women (Nauli and Matin, 2019).

Research has attempted to ascertain the role that

testosterone plays in controlling the distribution of

body fat. Testosterone production increases

throughout puberty (about age 45) and begins to

decrease after age 20 to 30 by up to 1% annually,

reaching its lowest points in males 70 years of age

(Frank et al, 2019). Reduced testosterone levels have

been linked to an increase in the accumulation of

abdominal VF (He et al, 2018). Thus, the

accumulation of abdominal visceral fat could begin in

young age.

Akhriani, M. and Dinutanayo, W. W.

Correlation of Lipid Proﬁles and Inﬂammatory Markers with Visceral Fat in Young Adult Men with Normal and Higher Body Mass Index.

DOI: 10.5220/0013087500003873

Paper published under CC license (CC BY-NC-ND 4.0)

In Proceedings of the 1st International Conference on Medical Science and Health (ICOMESH 2023), pages 17-20

ISBN: 978-989-758-740-5

Studies investigating correlation lipid profiles and

inflammatory markers and VF mostly conducted in

obese adults. In fact, a study in Chinese adults showed

that an increased total cholesterol and low-density

protein was correlated with VF in participants with

normal Body Mass Index (BMI) (Lu et al, 2022).

Meanwhile, an observational study indicated that VF

in Korean adults with higher BMI was strongly

associated with white blood cells (WBC) and

neutrophil lymphocyte ratio (NLR) as inflammatory

markers (Yu et al, 2019). Thus, further research is

needed to evaluate the relationship between VF and

biomarkers of inflammatory and cardiovascular

diseases including subjects with normal BMI.

This study aimed to investigate the relationship

between VF and various serum lipid profiles (total

cholesterol, high-density lipoprotein/HDL, low-

density lipoprotein/LDL, and triglyceride/TG), and

inflammatory markers (leukocyte, neutrophil,

lymphocyte, Erythrocyte Sediment Rate/ESR,

monocyte, eosinophil) in young adult men with

normal and higher BMI.

2 MATERIALS AND METHODS

2.1 Study Design, Setting and Sample

Size

This cross-sectional study was conducted in Bandar

Lampung, Lampung Province, Indonesia, from

December 2019 to January 2020. The study was

granted by the ethics committee of Politeknik

Kesehatan Kementrian Kesehatan Tanjung Karang,

Bandar Lampung, Indonesia. A total of 37 men was

included in this study using purposive sampling. The

inclusion criteria were (i) aged 18-35 years old, (ii)

undiagnosed by type 2 diabetes, cardiovascular

diseases, metabolic syndrome and cancer, (iii) no

smoking, (iii) no fluctuated weight changes for 6

months.

2.2 Anthropometric and Biochemical

Variables

The measurement of height (cm) and weight (kg) was

collected using a stadiometer to the nearest 0.5 cm

and digital weight scale to the nearest 0.1 kg. BMI

was a result of body weight divided by the square of

body height in kg/m2. Visceral fat (VF) was

measured using BIA, a body composition analyser

(OMRON HBF 375) in standing position. VF was

rated by the BIA between 1 and 59 (low to high level

which greater visceral fat indicated a greater level.

Samples of blood were collected following an

overnight fast (>12 hours). A Hitachi 7600 Automatic

analyser (High-Technologies Corporation, Hitachi;

Tokyo, Japan) was used to test the serum levels of

total cholesterol, HDL, LDL, and TG. With the aid of

an automated blood counter system (ADVIA 120,

Bayer; Whippany, NJ, USA), total differential blood

counts were recorded as Leukocyte, Neutrophil,

Lymphocyte, ESR, Monocyte, Eosinophil

2.3 Stastical Analysis

Characteristics and variables were shown as the mean

with standard deviation (SD) for normally distributed

data. Kolmogorov-Sminrov test assessed normality of

variables. Person’s correlation analysis was used to

compute the correlation of lipid profiles and

inflammatory markers with VF rating. Data were

analyzed by SPSS version 25 (SPSS Inc., IBM,

Armonk, NY, USA) for IOS. Significance was

defined as p value below 0.05.

3 RESULTS

A total 37 males aged 24.6 years old in average were

recruited in this study. Table 1 presents the age,

anthropometric and biochemical data. The mean all

anthropometric data of male subjects were higher

than the recommendation value. The man of BMI

(24.6 ± 5.6 kg/m2) was above the cut off of normal

BMI (25-29.9 kg/m2) according to WHO. The mean

of total body fat, subcutaneous fat and muscle mass

were 26.7 ± 8.5 %, 19.3 ± 6.3 %, and 31.1 ± 3.6 %

respectively. In addition, the mean of visceral fat was

14.4 ± 8.5 %.

The mean inflammatory markers and lipid

variables are also shown in Table 1. The mean ESR

and was 33.7 mm/h, and the mean leukocyte 9105.4

/uL. The mean total cholesterol, LDL and triglyceride

were 158.7 mg/dL, 82.4 mg/dL and 139.1 mg/dL

respectively.

Table 2 displays the correlation of inflammatory

markers and lipid profiles with visceral fat. In

variables of inflammatory markers, significant

positive correlations between ESR and visceral fat (r

= 0.402, p = 0.007). It is shown similar results

between leukocyte and visceral fat (r = 0.281, p =

0.046), although no significant were found for

lymphocyte, neutrophil, monocyte, and eosinophil

level in relation to visceral fat.

ICOMESH 2023 - INTERNATIONAL CONFERENCE ON MEDICAL SCIENCE AND HEALTH

Table 1: Descriptive characteristic of subjects

Variables Mean Values

ear

)

24.6 ± 5.6

Anthro

ometr

BMI (kg/m

) 30.2 ± 7.3

Body Fat Percentage (%) 26.7 ± 8.5

Visceral Fat (%) 14.4 ± 7.9

Subcutaneous Fat

(

)

19.3 ± 6.3

Skeletal Muscle

(

)

31.1 ± 3.6

Inflammation Markers

ESR (mm/h) 33.7 ± 20

Leukocyte (

uL) 9105.4 ± 3457.7

hoc

(

)

19.9 ± 7.3

Neutro

hil se

ment

(

)

58.2 ± 8.6

Neutro

hil

(

)

3.9 ± 2.4

Monocyte (%) 12.6 ± 4.2

Eosinophil (%) 5.4 ± 4.5

Lipid Profiles

Total Cholesterol

(

/dL

)

158.7 ± 37.9

HDL Cholesterol

(

/dL

)

48.5 ± 9.9

LDL Cholesterol

(

/dL

)

82.4 ± 32.6

Triglyceride (mg/dL) 139.1 ± 46.5

Significant positive correlations were found

between the serum total cholesterol and visceral fat (r

= 0.524, p = 0.001) and between serum LDL and

visceral fat (r = 0.547, p = 0.001). In addition, there

was a significant correlation between serum

triglyceride and visceral fat (r = 0.465, p = 0.002).

However, there was no correlation between serum

HDL and visceral fat (r = -0.232, p = 0.084)

Table 2: Correlation of Inflammatory markers and Lipid

Profiles with Visceral Fat rating

Variables

Visceral fat rating

Correlation

Coefficient

p-value

Inflammatory markers

ESR (mm/h) 0.402* 0.007

Leukoc

)

0.281* 0.046

hoc

(

)

-0.052 0.381

Neutro

hil se

ment

(

)

0.243 0.074

Neutrophil (%) -0.152 0.184

Monocyte (%) -0.232 0.083

Eosinophil (%) 0.005 0.488

id Profiles

Total Cholesterol

(

/dL

)

0.524** 0.001

HDL Cholesterol (mg/dL) -0.232 0.084

LDL Cholesterol (mg/dL) 0.547** 0.001

Triglyceride (mg/dL) 0.465* 0.002

*statistically significant at P < 0.05 ** statistically

significant at P < 0.001

4 DISCUSSION

This study found that certain lipid profiles

(Cholesterol, LDL and Triglyceride) were

significantly correlated with VF in healthy and young

adult men, but not with serum HDL. This is similar to

previous studies in nondiabetic population Taiwan

(Huang et al, 2015), Chinese (Lu et al, 2022) and

Korea (Yu et al, 2019), which VF was measured using

Magnetic Resonance Imaging (MRI). Asian

population have higher risk factors for metabolic and

cardiovascular disease, since they have more total

body fat and visceral adipose tissue, despite normal

BMI (Katsuki et al, 2003).

In addition, significant correlations with VF were

only shown in ESR and leukocyte levels. Leukocyte

or White Blood Cells (WBC) and ESR has been used

to assess the risk of cardiovascular and inflammatory

diseases (Danesh et al, 1998), and has also correlated

with the increased visceral obese measured by waist-

hip ratio (Faam et al, 2014). Similar findings were

shown in the previous study that increased VF was

associated with increased inflammation (Srinivasa, et

al, 2019). The mechanism of this finding is unclear,

visceral fat could secret adipokines and pro-

inflammatory cytokines that could alter metabolism

(Deng et al, 2010). Increased leukocyte and ESR in

this study might occur due to inflammation process of

this altered metabolism.

Healthy individuals from Asia with increased

visceral fat should concern on this condition,

especially men (He et al, 2018). This is caused that a

large number of studies, including this study,

indicates higher visceral fat could be an independent

predictor of pro-inflammatory cytokines and

component of metabolic syndrome, leading to

cardiovascular diseases. According to these findings,

biochemical assessments of lipid profiles and

inflammatory markers could be a part of

cardiometabolic screening (Arakaki et al, 2018).

Indeed, preventive efforts of CVD risk should include

lifestyle modification such as limited alcohol and

saturated fat intake, along with weight management

and limited smoking habit (Traversy and Chaput,

2015).

We acknowledge that there were several

limitations in this study, First, it was unable to

determine causality or causation due to its

observational cross-sectional design, and any

potential confounding variables were unable to be

controlled. Secondly, the number of subjects were

limited, which might not be represent the population.

Third, different adipokines or other inflammatory

mediators were not collected in this study. Despite

Correlation of Lipid Proﬁles and Inﬂammatory Markers with Visceral Fat in Young Adult Men with Normal and Higher Body Mass Index

these limitations, studies investigating correlation of

visceral fat in young and healthy adult men with lipid

profiles and inflammatory markers are still limited,

thus this study could be the baseline to conduct the

similar studies with the retrospective design.

5 CONCLUSIONS

This study indicated that statistically significant

positive correlations were found between several

lipid profiles (total cholesterol, LDL and TG) and

visceral fat, and between specific inflammatory

markers (leukocyte and ESR) and visceral fat.

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