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

## TL;DR

Tibetan adults have a unique body fat distribution pattern that increases their risk of metabolic syndrome, with specific lipoprotein ratios playing a key role.

## Contribution

Identified trunk fat percentage and specific lipoprotein ratios as novel indicators linking fat distribution to metabolic syndrome in Tibetans.

## Key findings

- Tibetans have distinct trunk and total fat mass compared to other ethnic groups.
- Trunk fat percentage is a significant risk factor for metabolic syndrome (OR = 1.59).
- L3TGP and TGHCR ratios mediate the link between trunk fat and metabolic syndrome.

## Abstract

To characterize the specific pattern of body fat distribution and its association with metabolic syndrome (MetS) among Tibetan adults, an understudied population with distinct high-altitude adaptations, and to identify potential mediating biomarkers in serum lipoprotein profiles.

A total of 1480 participants from the Tibetan cohort and the NHANES were included. Principal component analysis and Mantel tests were employed to identify Tibetan-specific body fat indicators. Linear models assessed associations with metabolic syndrome (MetS), and mediation analyses evaluated the indirect effects of serum lipoproteins.

Tibetans showed distinct trunk and total fat mass compared to other ethnic/racial groups. Trunk fat percentage was identified as a risk factor for MetS (OR = 1.59, 95% CI: 1.27 ~ 1.91, p = 0.004). The triglycerides to total lipids ratio in low density lipoprotein 3 (L3TGP) and triglycerides to high density lipoprotein cholesterol ratio (TGHCR) exhibited significant mediating effect between trunk fat percentage and MetS (L3TGP:β = 1.7 × 10− 4g, 95% CI: 4 × 10− 5~3.6 × 10− 4, p<0.001;TGHCR: β = 1.8 × 10− 4g, 95% CI: 4 × 10− 5~4.6 × 10− 4, p<0.001).

This study revealed novel evidence for distinct fat distribution in Tibetans, linked to elevated MetS risk. L3TGp and TGHCR were identified as key lipoprotein mediators, supporting the need for environmental- and ethnicity-specific indicators in metabolic risk assessment.

The online version contains supplementary material available at 10.1186/s12944-025-02808-y.