body fat is most simply classified as subcutaneous and visceral fat - visceral fat is the intra-abdominal fat mass
females have more fat in total (about a fifth of body weight) with relatively more subcutaneous fat and less visceral fat than males
visceral fat has its origins as brown adipose tissue
visceral fat retains a high blood supply and density of mitochondria (which are metabolically highly active)
visceral fat generates heat. It also serves as a rapid-access reservoir for fatty acids to be released into the circulation at times of need for peripheral oxidation
problems arise when the intra-abdominal fat mass is expanded and there is sustained high release of fatty acids into the portal circulation
as a consequence of the release of fatty acids there is an interference with the hepatic clearance of insulin leading to hyperinsulinaemia and this also prevents the normal suppression of glucose release from the liver (leading to a state of insulin resistance)
there is an elevation of triglyceride and suppression of high-density lipoprotein (HDL) develop
subcutaneous adipose tissue normally functions as a storage site for excess circulating triglycerides, but this requires normal insulin action
increased visceral fat is associated with a cluster of metabolic disturbances which are aggravated as total fat mass that increases with age, and which contribute to cardiovascular disease (1)
waist circumference correlates highly with this visceral mass and has been shown to predict metabolic risks and CHD better than other indices of adiposity including BMI
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