Distinct body fat distribution and its association with metabolic syndrome in Tibetan population.

Tibetans demonstrated distinct trunk and total fat mass distribution compared to other ethnic/racial groups.

• A total of 1480 participants from the Tibetan cohort and the NHANES were included in the study.
• Principal component analysis and Mantel tests were employed to identify Tibetan-specific body fat indicators.
• The distinct fat distribution pattern was characterized relative to multiple other ethnic/racial groups represented in NHANES.
• Tibetan-specific differences were observed in both trunk fat and total fat mass measurements.

Trunk fat percentage was identified as a significant risk factor for metabolic syndrome in the Tibetan population.

• OR = 1.59, 95% CI: 1.27~1.91, p = 0.004.
• Linear models were used to assess associations with metabolic syndrome (MetS).
• Trunk fat percentage was identified as a Tibetan-specific body fat indicator through principal component analysis and Mantel tests.

The triglycerides to total lipids ratio in low density lipoprotein 3 (L3TGP) exhibited a significant mediating effect between trunk fat percentage and metabolic syndrome.

• β = 1.7 × 10⁻⁴, 95% CI: 4 × 10⁻⁵ ~ 3.6 × 10⁻⁴, p < 0.001.
• Mediation analyses were used to evaluate indirect effects of serum lipoproteins.
• L3TGP represents the triglycerides to total lipids ratio specifically within the low density lipoprotein 3 subfraction.
• L3TGP was identified as a key lipoprotein mediator in the trunk fat percentage–MetS pathway.

The triglycerides to HDL cholesterol ratio (TGHCR) exhibited a significant mediating effect between trunk fat percentage and metabolic syndrome.

• β = 1.8 × 10⁻⁴, 95% CI: 4 × 10⁻⁵ ~ 4.6 × 10⁻⁴, p < 0.001.
• TGHCR represents the ratio of triglycerides to high density lipoprotein cholesterol.
• Both L3TGP and TGHCR were identified through serum lipoprotein profiling as mediators.
• The mediation findings support the need for ethnicity-specific indicators in metabolic risk assessment.

The study supports the need for environmental- and ethnicity-specific indicators in metabolic risk assessment for populations with distinct high-altitude adaptations.

• Tibetan adults represent an understudied population with distinct high-altitude adaptations.
• Standard metabolic risk indicators may not adequately capture metabolic risk in Tibetan populations given their distinct fat distribution patterns.
• The findings provide novel evidence for distinct fat distribution in Tibetans linked to elevated MetS risk.
• L3TGP and TGHCR were highlighted as key lipoprotein mediators specific to this population's metabolic risk pathway.