The association between body fat distribution patterns and cardiovascular disease risk variables (high density lipoprotein (HDL) cholesterol, total cholesterol, diastolic and systolic blood pressures, and fasting blood glucose levels) was sought in a sample of Mexican American adults who were studied during 1981-1983 in Starr County, Texas. In the sample, all diabetics were excluded to see whether centralized obesity carried any risk for cardiovascular disease independent of diabetes. A component of centralized body fat distribution was identified through the use of principal components analysis of five skinfold measurements, which included the upper and lower extremities and trunk areas. The centralized obese were compared with generalized (peripheral) obese and nonobese controls in four subgroups of the population: younger and older adult males and females. The means of all cardiovascular risk variables were in a direction indicating that the centralized obese were significantly at greater risk than nonobese controls (in particular, HDL cholesterol, total cholesterol, and blood glucose levels). The generalized obese differed from the centralized obese in having significantly lower blood glucose levels, and tended to be intermediate between centralized obese and nonobese controls in the other variables. The data confirm that centralized obesity as defined by a linear combination of skinfold measures works in the same way as the waist-to-hip circumference ratio in describing a body build factor which heightens the risk of cardiovascular disease in the obese independent of the clinical diabetic state.