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Biomedical subjects

M Zamboni

Publications and source records attributed to M Zamboni.

At least 19 recordsLinked to original sources
PubMed2006

Reversible nonfluent aphasia and left frontal hypoperfusion during topiramate treatment.

We report the case of a patient with complex partial seizures who developed a nonfluent aphasia when topiramate was added to his therapy. This emergent adverse effect appeared to be reversible, as language performance improved after discontinuation of topiramate. Interictal SPECT performed when the patient was aphasic revealed a focal perfusion reduction in the left lateral and mesial frontal cortex, which was no longer evident at a follow-up study after language recovery.

Anticonvulsants↗
PubMed2006

Effect of native somatostatin on Sphincter of Oddi motility in patients with acute recurrent pancreatitis. A pilot study with Ultrasound-Secretin test.

BACKGROUND: The effect of native somatostatin on Sphincter of Oddi motility still remains controversial. Sphincter of Oddi inhibition was demonstrated at manometry in patients in the acute phase of alcoholic pancreatitis. Other investigators showed marked somatostatin-induced impairment of bile flow by hepato-biliary scintigraphy. AIM: Aim of the study was to determine the effects of therapeutical doses of exogenous somatostatin on Sphincter of Oddi motility. PATIENTS AND METHODS: We studied eight patients (two men, six women, age 18-42), in the quiescent phase of idiopathic recurrent pancreatitis. We directly studied Sphincter of Oddi motility by perendoscopic manometry and, indirectly, secretin-stimulated pancreatic juice outflow by Ultrasound-Secretin test. The two tests were repeated before and after somatostatin infusion. RESULTS: Manometry was performed in two patients. After 250 microg somatostatin bolus the sphincter showed an increase of motor activity. At Ultrasound-Secretin test mean diameters were significantly larger at 40-60 min evaluation intervals during 250 microg/h somatostatin infusion as compared to saline infusion, showing a delayed pancreatic duct emptying. CONCLUSIONS: Acute administration of somatostatin seems to induce an excitatory effect on Sphincter of Oddi motility, with impaired pancreatic outflow in patients in the quiescent phase of recurrent pancreatitis.

Acute Disease↗
PubMed2005

Health consequences of obesity in the elderly: a review of four unresolved questions.

Obesity prevalence is growing progressively even among older age groups. Controversy exists about the potential harms of obesity in the elderly. Debate persists about the relation between obesity in old age and total or disease-specific mortality, the definition of obesity in the elderly, its clinical relevance, and about the need for its treatment. Knowledge of age-related body composition and fat distribution changes will help us to better understand the relationships between obesity, morbidity and mortality in the elderly. Review of the literature supports that central fat and relative loss of fat-free mass may become relatively more important than BMI in determining the health risk associated with obesity in older ages. Weight gain or fat redistribution in older age may still confer adverse health risks (for earlier mortality, comorbidities conferring independent adverse health risks, or for functional decline). Evaluation of comorbidity and weight history should be performed in the elderly in order to generate a comprehensive assessment of the potential adverse health effects of overweight or obesity. The risks of obesity in the elderly have been underestimated by a number of confounders such as survival effect, competing mortalities, relatively shortened life expectancy in older persons, smoking, weight change and unintentional weight loss. Identification of elderly subjects with sarcopenic obesity is probably clinically relevant, but the definition of sarcopenic obesity, the benefits of its clinical identification, as well as its relation to clinical consequences require further study. Studies on the effect of voluntary weight loss in the elderly are scarce, but they suggest that even small amounts of weight loss (between 5-10% of initial body weight) may be beneficial. In older as well as in younger adults, voluntary weight loss may help to prevent the adverse health consequences of obesity.

Adipose Tissue↗
PubMed2004

The relationship between body image and quality of life in treatment-seeking overweight women.

OBJECTIVE: To test the impact of body image on quality of life in overweight and obese people; to evaluate longitudinally the relationship between changes in body image, anthropometrical measurements and quality of life. DESIGN: A cross-sectional study and a longitudinal study in a sub-sample after 6 months. SUBJECTS: 308 women in the cross-sectional study and 56 in the longitudinal study, aged 21-65, with body mass index (BMI) > 25 kg/m2 and selected from people who had been sought treatment for overweight in our Institute from 1998 to 2001. MEASUREMENTS: Body weight, body height, waist and hip circumferences. The ORWELL 97 questionnaire to evaluate the obesity related quality of life (ORQL) and the BUT questionnaire to assess the body image (BI) were used. RESULTS: The BUT score was the variable that explained the greatest amount of variance of ORWELL 97 both in cross-sectional and longitudinal studies. Despite no significant differences in athropometrical variables were found between subjects who dropped out and those who did not, psychometrical scores were significantly better in patients still in treatment in follow-up. CONCLUSION: BI is related to subjective ORQL independently of anthropometrical measurements both at baseline and after treatment. Better psychometrical scores in people still in treatment after 6 months suggest that BI could be considered one of the variables which influence compliance to the treatment program, this fact needs more investigations and could be of interest in obesity treatment outcome studies.

Adult↗
PubMed2004

Physical disability and muscular strength in relation to obesity and different body composition indexes in a sample of healthy elderly women.

OBJECTIVES: The aim of the present study was to test the association between muscular strength, functional limitations, body composition measurements and indexes of sarcopenia in a sample of community-dwelling, elderly women at the high end of the functional spectrum. DESIGN: Cross-sectional. SUBJECTS: In all, 167 women aged 67-78 y were selected from the general population in central Verona. A group of 120 premenopausal healthy women aged 20-50 y represented the young reference group. MEASUREMENTS: Body weight, height, body mass index (BMI) and the presence of acute and chronic conditions were evaluated in each subject. Body composition was measured by dual-energy X-ray absorptiometry (DXA). Physical functioning was assessed using a modified version of the Activities of Daily Living Scale. Dominant leg isometric strength was measured with a Spark Handheld Dynamometer. RESULTS: Elderly women with BMI higher than 30 kg/m(2) and in the highest quintile of body fat percent showed a significantly higher prevalence of functional limitation. In our population study, about 40% of sarcopenic elderly women and 50% of elderly women with high body fat and normal muscle mass were functionally limited. The prevalence of functional limitation significantly increased in subjects with class II sarcopenia, defined according to the skeletal muscle mass index (SMI=skeletal muscle mass/body mass x 100). In logistic regression models, after adjusting for age and different chronic health conditions, subjects with BMI higher than 30 kg/m(2), in the highest quintile of body fat, or with high body fat and normal muscle mass or class II sarcopenia according to SMI, had a 3-4 times increased risk of functional limitations. Finally, isometric leg strength was significantly lower in subjects in the lowest quintile of relative muscle mass and in sarcopenic and sarcopenic obese women. CONCLUSIONS: High body fat and high BMI values were associated with a greater probability of functional limitation in a population of elderly women at the high end of the functional spectrum. Among the different indexes of sarcopenia used in this study, only SMI predicted functional impairment and disability. Isometric leg strength was significantly lower in subjects with sarcopenia and sarcopenic obesity.

Absorptiometry, Photon↗
PubMed2003

Relationship between lipids and bone mass in 2 cohorts of healthy women and men.

A number of recent findings seem to indicate that fat and bone metabolism are strictly connected. We investigated the relationship between lipid profile and bone mineral density (BMD) in 236 either pre- or postmenopausal women, aged 35-81 years, attending our osteoporosis center ("clinic group"). In order to verify the consistency of the results, 265 men and 481 women aged 68-75, participating in a population-based epidemiological investigation ("community cohort"), were also studied. Lumbar spine, femoral neck, total hip and total body BMD, total body fat, % fat mass and lean mass were measured using dual energy X-ray absorptiometry (DXA). In the clinic group, lumbar spine and hip BMD Z score values were both strongly related to all measured serum lipids: the relationship was negative for HDL cholesterol ( P < 0.05) and Apo A lipoprotein ( P < 0.000) and positive for LDL cholesterol ( P < 0.05), Apo B lipoprotein ( P < 0.001) and triglycerides ( P < 0.05). When BMD values were adjusted for body weight and BMI, most relationships remained statistically significant. In the community cohort, total body and hip BMD values were strongly related in both men and women to age, body weight, height, BMI, fat mass, lean mass, % fat mass. Total body and hip BMD were significantly related to serum lipids in both women and men. The relationship was negative for HDL cholesterol and positive for total cholesterol, triglycerides and LDL cholesterol. Most of these relationships (triglycerides, HDL cholesterol, LDL/HDL cholesterol ratio in women, and all measured lipids in men) remained statistically significant ( P values ranging from 0.000 to 0.03) when the BMD values were adjusted also for anthropometric measures (body weight, height, fat mass). This study demonstrates for the first time that the lipid profile is strictly related to bone mass in both men and women. The interpretation of this association remains hypothetical but it might open new perspectives for understanding the mechanisms controlling bone metabolism.

Absorptiometry, Photon↗
PubMed2003

IL-2 receptor blockers in liver transplantation: initial experience with daclizumab in Chile.

UNLABELLED: Monoclonal antibodies against the interleukin 2 receptor have been developed in an effort to decrease rejection rates and spare calcineurin inhibitors when renal dysfunction occurs after transplant. While success has been reported in kidney transplantation, its effectiveness in liver transplantation is less clear. METHODS: This prospective nonrandomized study including adult patients was performed between October 2000 and April 2003. Two groups of immunosuppressive regimens were compared: group A received 2 g of methylprednisolone intraoperatively followed by a rapid reduction with intention to withdraw by month 4, continuing on Neoral monotherapy. Cellcept was also given for 2 months in the absence or for up to 4 months in the presence of rejection. Group B received the same immunosuppressive regimen but, in addition, daclizumab 1 to 1.5 mg/kg on day 1 and day 5 posttransplant. Rejection diagnosis is made on histology basis. Protocol biopsies were performed in all the patients on day 7 and if indicated by biochemistry thereafter. RESULTS: Both groups were similar in terms of preoperative CHILD score, serum creatinine, incidence of status I, donor and recipient age and ischemia times. The mean follow-up time was 20 months for Group B (n = 24) and 7 months for Group A (n = 10). The 1-month and 1-year rejection rates are 29.1% and 41% in Group A versus 20% and 30% in group B. Rejection severity was similar between both groups. One-year patient and graft survival rates were 96% and 92% in group A and 100% for both in Group B. CONCLUSIONS: In this series, daclizumab induction therapy seems to display a trend toward a lower rejection rate without increasing infectious complications nor affecting graft survival rates.

Adult↗
PubMed2002

Relationship among VDR (BsmI and FokI), COLIA1, and CTR polymorphisms with bone mass, bone turnover markers, and sex hormones in men.

Osteoporosis is a disease characterized by low bone mineral density (BMD) and up to 80% of its variance is under genetic control. Although osteoporosis is more frequent in women, one-third of hip fractures also occur in men. Much information on genetic factors and bone density has been obtained in women, but only a few studies have been performed in osteoporotic men. We have evaluated the relationship between polymorphisms for several candidate genes such as vitamin D receptor (VDR), collagen type Ia1 (COLIA1), and calcitonin receptor (CTR) in a sample of unrelated Italian men (n = 253, mean age 58.41 +/- 15.64 SD). We found no significant differences in BMD when subjects were stratified for their VDR (BsmI and FokI) and COLIA1 genotypes. BMD both at the lumbar spine and at the femoral neck were associated with polymorphism of CTR gene. The CC genotype of CTR gene had the lowest BMD value (P <0.05 and P <0.01 at the spine and hip, respectively) and its prevalence was significantly over-represented in the subgroup of men with prior hip or vertebral fracture as compared with controls (P = 0.004% c2 = 11.10). The men with the CC genotype also showed significantly lower body mass index (BMI), serum sex hormone binding globulin (SHBG), estradiol, total alkaline phosphatase-(total AP) and bone alkaline phosphatase (bone AP) levels and significantly higher free androgen index (FAI). In conclusion, the polymorphism of CTR gene but not VDR and COLIA1 is associated with osteoporosis incidence and the levels of alkaline phosphatase and estradiol. The lower BMD in CC genotype is apparently associated in males with depressed bone formation and lower estradiol levels.

Adult↗
PubMed2002

Effect of vegetarian diet on homocysteine levels.

OBJECTIVE: To compare fasting total plasma homocysteine (tHcy) levels in vegans, lacto-ovovegetarians and control subjects, and to evaluate the relationships between tHcy levels and nutritional variables in vegetarians. METHODS: The study was conducted on 45 vegetarian subjects: 31 vegans (19 males, 12 females, mean age 45.8 +/- 15.8 years); 14 lacto-ovovegetarians (6 males, 8 females, mean age 48.5 +/- 14.5 years), and 29 control subjects (19 males, 10 females, mean age 43.4 +/- 16.7 years). tHcy was evaluated by high-performance liquid chromatography. Serum vitamin B(12) and folate were analyzed by automated chemiluminescence systems. Clinical records, nutritional and anthropometric variables were collected for all vegetarian subjects. RESULTS: tHcy was significantly higher in vegetarian subjects than in controls (23.9 +/- 21.3 vs. 11.6 +/- 4.9 micromol/l, p < 0.001). The prevalence of hyperhomocysteinemia was higher in vegetarians than in controls (53.3 vs. 10.3%, p < 0.001). Serum vitamin B(12) levels were lower in vegetarians than in control subjects (171.2 +/- 73.6 vs. 265.0 +/- 52.2 pmol/l, p < 0.01; normal range 220-740 pmol/l). In vegetarian subjects, significant inverse correlations were found between tHcy and serum vitamin B(12) levels (r = -0.776, p < 0.001) and between tHcy and serum folate levels (r = -0.340, p < 0.05). Positive correlations were found between tHcy and mean red cell volume (r = 0.44, p < 0.01) and between tHcy and fat-free mass (r = 0.36, p < 0.05). CONCLUSION: Vegetarian subjects presented significantly higher tHcy levels, higher prevalence of hyperhomocysteinemia, and lower serum vitamin B(12) levels than controls.

Adult↗
PubMed2002

Energy balance in Alzheimer's disease.

Alzheimer s disease is the most frequent cause of dementia in elderly people and it is one of the leading causes of death among older individuals. Weight loss is a frequent clinical finding in Alzheimer s disease patients, and it is actually listed as a symptom consistent with the diagnosis of Alzheimer s disease, but its significance has not been clearly understood until now. This review examines the role of the components of energy balance in determining weight loss in AD patients, on the basis of data collected from the literature. We also considered the possible causes of anorexia in AD patients. In the last years many researchers investigated the possible role of abnormally high energy expenditure, or low energy intakes, or both, to explain weight loss in these patients. Studies on energy intake, energy expenditure and body composition in AD patients have been reviewed. The results of published studies do not seem to support the hypothesis of an hypermetabolic state or inadequate energy intake in AD patients, but further studies, with greater samples are necessary in the future to investigate weight loss in AD patients. A better understanding of this finding could be important to obtain the maximal lifespan of demented patients.

Aged↗
PubMed2001

Skeletal muscle mass independently predicts peak oxygen consumption and ventilatory response during exercise in noncachectic patients with chronic heart failure.

OBJECTIVES: We sought to assess whether skeletal muscle mass might be a predictor of peak oxygen consumption (Vo2) and relation of the ventilation to carbon dioxide production (VE/VCo2) slope in patients with chronic heart failure (CHF) independent of clinical conditions, neurohormonal activation and resting hemodynamics. BACKGROUND: A variety of abnormalities characterize skeletal muscle and contribute to exercise intolerance in patients with CHF. Skeletal muscle mass is a determinant of peak Vo2 both in healthy patients and in patients with CHF, but there are no reports on the independent predictive value of this parameter, which can be measured with great accuracy by whole-body dual energy X-ray absorptiometry (DEXA). The influence of skeletal muscle mass on VE/VCo2 slope is not known either. METHODS: We prospectively evaluated 120 consecutive noncachectic patients with CHF. Every patient underwent a cardiopulmonary exercise test, an echo-Doppler examination and an evaluation of neurohormonal activation and body composition as assessed by DEXA. RESULTS: At the univariate analysis, New York Heart Association (NYHA) class (p < 0.0001), age (p < 0.0001), male gender (p < 0.0001) and plasma renin (p < 0.0001) significantly related with peak Vo2. There was a significant correlation between lean mass and absolute peak Vo2 (r = 0.70, p < 0.0001) and VE/VCo2 slope (r = -0.27; p < 0.01). At the multivariate analysis, lean mass predicted peak Vo2 and VE/VCo2 slope independently of NYHA functional class, age, gender, neurohormonal activation and resting hemodynamics. CONCLUSIONS: Skeletal muscle mass is an independent predictor of peak Vo2 and VE/VCo2 slope in stable noncachectic patients with CHF. Future studies will determine whether an increase in skeletal muscle mass in the individual patient might result in an improvement in parameters of exercise capacity.

Aged↗
PubMed2001

Extrapyramidal symptoms and antidepressant drugs: neuropharmacological aspects of a frequent interaction in the elderly.

Depression is the most prevalent functional psychiatric disorder in late life. The problem of motor disorders associated with antidepressant use is relevant in the elderly. Elderly people are physically more frail and more likely to be suffering from physical illness, and any drug given may exacerbate pre-existing diseases, or interact with other drug treatments being administered for physical conditions. Antidepressants have been reported to induce extrapyramidal symptoms, including parkinsonism. These observations prompted us to review the neurobiological mechanism that may be involved in this complex interplay including neurotransmitters and neuronal circuits involved in movement and emotion control and their changes related to aging and disease. The study of the correlations between motor and mood disorders and their putative biochemical bases, as presented in this review, provide a rationale either to understand or to foresee motor side effects for psychotropic drugs, in particular antidepressants.

Aged↗
PubMed2001

Relation between body composition, fat distribution, and lung function in elderly men.

BACKGROUND: Body composition changes with age, with increases in fat mass and visceral fat and declines in skeletal muscle mass; lung function also declines with age. Age-related changes in body composition and fat distribution may be associated with the pulmonary impairment observed in the elderly. OBJECTIVE: Our goal was to evaluate the relations between body composition, fat distribution, and lung function in elderly men. DESIGN: We studied 97 men aged 67-78 y with body mass indexes (BMIs; in kg/m2) ranging from 19.8 to 37.1. Body composition was evaluated by using dual-energy X-ray absorptiometry and fat distribution was evaluated by using waist and hip circumferences, waist-to-hip ratio, and sagittal abdominal diameter (SAD). Spirometry was done in all subjects and the distance walked by each subject during a 6-min walking test was evaluated as was leg strength. RESULTS: A significant negative correlation was found between adiposity, fat distribution indexes, forced vital capacity (FVC), and forced expiratory volume in 1 s (FEV1). A positive correlation was found between fat-free mass and FVC. After adjustment for age, height, and weight, SAD still correlated negatively with FVC and FEV1 (r = -0.367 and -0.348, respectively; P < 0.01), whereas percentage body fat and fat mass correlated negatively and fat-free mass correlated positively with FVC (r = -0.313, -0.323, and 0.299, respectively; all P < 0.01). After the sample was subdivided by tertile of fat-free mass adjusted for age and BMI, FVC and FEV1 were significantly lower in the lowest fat-free mass tertile (P < 0.01). Stepwise multiple regression analysis performed with use of lung function variables as the dependent variables and age, height, fat mass, fat-free mass, waist circumference, and SAD as the independent variables showed that 3 variables entered the regression for predicting FVC: height, which entered the regression first; SAD, which entered second; and fat-free mass, which entered third. Only 2 variables entered the regression for predicting FEV1: height, which entered the regression first, and SAD, which entered second. CONCLUSION: Our cross-sectional data show a significant association between body composition, fat distribution, and lung function in elderly men.

Absorptiometry, Photon↗
PubMed2001

Homocysteine plasma levels are independently associated with insulin resistance in normal weight, overweight and obese pre-menopausal women.

OBJECTIVES: The aim of the present study was to examine the relationship of homocysteine (Hcy) plasma levels to insulin resistance (IR). DESIGN: A cross-sectional study in a primary care setting. SUBJECTS AND METHODS: Fasting Hcy levels were measured in the plasma of 44 pre-menopausal women [17 normal weight (body mass index BMI 20.0-24.9 kg/m2), 7 overweight (BMI 25.0-29.9 kg/m2), 20 obese (BMI> or =30.0 kg/m2)], aged 18-45 yr. Other measurements included: central fat accumulation, as evaluated by waist circumference; IR, as calculated by homeostatic model assessment (HOMAIR); systolic and diastolic blood pressure; and fasting concentrations of glucose, insulin and lipids (total cholesterol, HDL-cholesterol, triglycerides). RESULTS: Hcy was positively correlated with insulin concentrations (p<0.01), HOMAIR (p<0.01), and systolic and diastolic blood pressure (p<0.01 and p<0.05, respectively). After multivariate analysis, only HOMAIR maintained an independent association with Hcy (p<0.05), irrespective of age and other anthropometric and biochemical variables. Lastly, we observed a gradual increase in Hcy plasma levels across the age- and BMI-matched quartiles in which the whole population was divided according to HOMAIR levels (F: 2.73, p<0.05 for linear trend). CONCLUSIONS: Our study shows that Hcy plasma levels are independently associated with IR in apparently healthy normal weight, overweight and obese pre-menopausal women, thus suggesting a possible role of IR and/or hyperinsulinaemia in increasing Hcy plasma levels. Since Hcy is a well-known cardiovascular risk factor, higher Hcy plasma levels may well be a further mechanism explaining the higher risk of coronary heart disease in patients affected by IR.

Adolescent↗
PubMed2001

Homocysteine and life-style in the elderly.

Elevated homocysteine increases the risk of vascular diseases but little information is available about this issue in the elderly. The aim of this cross-sectional study was to evaluate the relationships between homocysteinemia and gender, anthropometric, and life-style characteristics in a community-dwelling elderly population (65 men and 120 women; 67-78 years). Basal plasma homocysteine levels were determined by High Performance Liquid Chromatography (HPLC). Clinical records, and nutritional and anthropometric variables were collected in all subjects. Body composition was evaluated in all subjects by Dual energy X-ray Absorptiometry (DXA). Thirty-three percent of women and 66% of men had hyper-homocysteinemia. In women, a positive correlation was present between homocysteinemia, age, diastolic blood pressure and plasmatic creatinine, and a negative correlation between homocysteine, fiber intake and folates. In males, there was a positive correlation between plasma homocysteine, age, and body mass index. Multiple regression analysis showed that fat-free mass, cigarette smoking, fiber intake, vitamin B6 and total kcal intake accounted for 18% of homocysteine variance in males (R2 = 0.18, p<0.05). Significantly higher homocysteine values were found in women with a history of cardiovascular disease than in those without (16.6 +/- 9.4 vs 13.8 +/- 4.4 micromol/L, p<0.05). Homocysteinemia was significantly higher in elderly men compared to women (16.7 +/- 4.7 vs 15.3 +/- 7.6; p<0.05). Gender differences in homocysteine disappeared after adjusting for fat-free mass. This study confirms the age-related increase in plasma homocysteine. Life-style characteristics seem to influence significantly homocysteine levels in the elderly. Our study shows that gender effects on homocysteine may be attributed to differences in body composition.

Aged↗
PubMed2000

Postabsorptive resting metabolic rate and thermic effect of food in relation to body composition and adipose tissue distribution.

One hundred thirty subjects were studied to investigate relationships between the body composition and fat distribution as evaluated by computed tomography and the resting metabolic rate (RMR) as evaluated by indirect calorimetry: 82 premenopausal women (age, 18 to 52 years; body mass index [BMI], 27 to 52 kg/m2), 27 postmenopausal women (46 to 71 years; 28 to 49 kg/m2), and 21 men (18 to 70 years; 31 to 43 kg/m2). The thermic effect of food (TEF) was evaluated in all men and in 2 subgroups of 55 and 19 women. The best-fitting equations for predicting RMR, obtained by multiple regression, included the following as covariates: fat-free mass and both subcutaneous and visceral adipose tissue in premenopausal women (R2 = .55, P = .0001), fat-free mass and visceral adipose tissue in postmenopausal women (R2 = .58, P = .001), and age, with minus sign, and visceral adipose tissue in men (R2 = .44, P = .0051). Fasting insulin and fat-free mass, with minus sign, and both visceral and subcutaneous adipose tissue were the predictors of the TEF (R2 = .25, P = .0055) in premenopausal women. This study demonstrates that visceral fat distribution is important in determining the RMR in postmenopausal women and men. In premenopausal women, total adipose tissue is a main determinant of both the RMR and TEF This last effect could be counterbalanced by insulin resistance.

Adipose Tissue↗
PubMed2000

Hormones and body composition in humans: clinical studies.

Leptin in relation to body fat and hormonal regulation of body fat distribution will be treated. Leptin circulating levels are strongly related to the percentage of body fat and in women leptin values are always twofold those observed in men. A role of androgens has been suggested to explain this gender difference. Insulin resistance may contribute to the wide variation in leptin levels. Leptin levels and insulin resistance are increased at the end of pregnancy and normalize after delivery. Furthermore, insulin resistance is associated with elevated plasma leptin levels independent of body fat mass and leptin levels are significantly related to insulin sensitivity independent of BMI. Energy restriction can strongly influence leptin levels, overcoming the effects of body composition changes. The shift from a state of triglycerides storage to a state of release could down-regulate leptin production. Triglyceride flux at the intra-abdominal level depends on the balance between insulin and corticosteroids, which have liposynthetic activity, and between sexual and growth hormones, which have lipolytic activity. Both hormonal and body composition change with ageing, primarily due to a decrease in lipolytic activity, with consequent prevalence of liposynthesis and visceral fat accumulation. Enlargement of intra-abdominal adipose cells is more gradual in men and more abrupt in women after menopause.

Adipose Tissue↗