Measures of central and overall adiposity are highly correlated (BMI has r2∼0.9 with waist circumference [WC] and ∼0.6 with waist-hip ratio [WHR], Table S1). WC and WHR are correlated with more precise measures of intra-abdominal fat measured by MRI in obese women (r2∼0.6 and 0.5, respectively) [4]. Several lines of evidence indicate that individual variability in patterns of fat distribution involves local, depot-specific processes, which are independent of the predominantly neuronal mechanisms that control overall energy balance. First, anthropometric measures of central adiposity are highly heritable [5] and, after correcting for BMI, heritability estimates remain high (∼60% for WC and ∼45% for WHR) [6]. Second, there are substantial gender-specific differences in fat distribution, and these appear to reflect genetic influences [7]. Third, uncommon monogenic syndromes (the partial lipodystrophies) demonstrate that DNA variants can have dramatic effects on the development and/or maintenance of specific regional fat-depots [8].
