Managing Cardiometabolic Risk

Key Points

• Elevated waist circumference, a crude anthropometric index of the absolute amount of intra-abdominal adipose tissue, better predicts the risk of developing the metabolic syndrome and related disorders than BMI.
• A preferential loss of intra-abdominal adipose tissue can improve cardiometabolic risk markers and insulin resistance variables.
• Several lifestyle intervention trials have highlighted the fact that increasing physical activity and adopting healthy eating habits can reduce body weight and waist circumference and lower the risk of developing diabetes in patients with impaired glucose tolerance.
• Even without weight loss, physical activity can reduce intra-abdominal adipose tissue and improve indices of plasma glucose-insulin homeostasis.
• Pharmacological compounds aimed at reducing intra-abdominal fat deposition need to be developed and used in conjunction with lifestyle modification therapies to reduce the risk and complications of type 2 diabetes. 
• Data on the pharmacological treatment of intra-abdominal obesity is needed.