Does visceral fat cause inflammation — and how does that affect the heart?

Visceral adipose tissue is an active endocrine and immune organ that secretes inflammatory adipokines, particularly IL-6 (a primary hs-CRP inducer) and TNF-α, and reduces secretion of anti-inflammatory adiponectin in a volume-dependent manner, making elevated visceral fat the most common single cause of elevated hs-CRP in otherwise healthy middle-aged men without infection or autoimmune disease (Fontana et al., Diabetes, 2007).

For the cardiologist, this visceral fat-hs-CRP-inflammation pathway is a direct cardiovascular risk mechanism: elevated hs-CRP (above 2 mg/L) independently predicts major adverse cardiovascular events beyond LDL cholesterol in large studies including the JUPITER trial. The man who comes to my office with an hs-CRP of 3.2 mg/L without infectious illness, autoimmune disease, or known inflammatory condition is, in the majority of cases, carrying excess visceral fat as the primary driver. The hs-CRP is not the disease, it is the smoke from the visceral fat fire.

Honesty Scale: Solid (1) for visceral fat as the primary driver of elevated hs-CRP in non-infectious, non-autoimmune men.

What to do: If your hs-CRP is elevated (above 1.0 mg/L) and you do not have an active infection or autoimmune condition, measure your waist circumference. Visceral fat reduction should be your primary treatment for elevated hs-CRP before considering other interventions.

For the full picture, read The Visceral Fat Deep Dive