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Visceral fat and respiratory complications

In the last 20 years, fat distribution has been considered a crucial causative factor of the excess morbidity and mortality found in obese patients. Several experimental evidences definitely linked visceral fat accumulation to metabolic disturbances [1–5]. The evaluation of fat distribution by the simple measurement of the waist circumference has been therefore suggested by guidelines to determine cardiovascular risk of overweight in obese patients [6]. At the same time, less attention has been paid to the relationship between visceral fat accumulation and respiratory complications, despite these complications frequently represented an important clinical problem in obese patients. This review focuses on the role played by visceral fat accumulation on the decrease of pulmonary function and on the prevalence of obstructive sleep apnoea syndrome (OSAS) in obese patients. The effects of weight loss in respiratory complications will be also briefly summarized with a particular emphasis on the role played by visceral fat removal.