[Obesity: a time bomb to be defused].
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Cardiovascular Diseases↗
Biomedical subjects
O Bosello
Publications and source records attributed to O Bosello.
Divergent effects of short-term, very-low-calorie diet on insulin-like growth factor-I and insulin-like growth factor binding protein-3 serum concentrations in premenopausal women with obesity.
OBJECTIVE: Insulin-like growth factor-I (IGF-I) and insulin-like growth factor binding protein-3 (IGFBP-3) serum concentrations provide a good measure of the biological effects of growth hormone. The aims of the present study were to: (1) investigate the associations of IGF-I and IGFBP-3 with body fat mass and distribution, and (2) evaluate the effects of 3 weeks of very-low-calorie diet (VLCD) (318 kcal/day, with 40 g protein, 35 g carbohydrate, and 2 g fat) on IGF-I and IGFBP-3 serum concentrations. RESEARCH METHODS AND PROCEDURES: The study was performed in 21 nondiabetic premenopausal women with obesity (body mass index >27.0 kg/m2; age: ranging from 18 to 48 years). Body fat mass and distribution were measured by computed tomography. RESULTS: Before dietary treatment, IGF-I and IGFBP-3 serum concentrations were inversely associated with visceral adipose tissue (VAT) area (p<0.005 and p<0.05, respectively), but not with either total body fat or subcutaneous adipose tissue area. VLCD produced a significant decrease of body mass index (p<0.001), total body fat (p<0.001), VAT (p<0.005), subcutaneous adipose tissue (p<0.001), IGF-I concentrations (p<0.05), and an increase of IGFBP-3 serum levels (p<0.001). The association of VAT with either IGF-I or IGFBP-3 serum concentrations was not maintained following VLCD. DISCUSSION: Our study suggests that visceral adipose tissue, rather than adiposity per se, accounts for IGF-I and IGFBP-3 serum concentrations, and that rapid weight loss, possibly due to nutritional changes, results in lower IGF-I concentrations, higher IGFBP-3 concentrations, and abrogation of the inverse associations of VAT with IGF-I and IGFBP-3.
Adipose Tissue↗
Sagittal abdominal diameter as a practical predictor of visceral fat.
OBJECTIVE: To evaluate the relationships between the supine sagittal abdominal diameter (SAD) and visceral fat, as well as to evaluate intra- and inter-observer reliability of sagittal diameter measurement. PATIENTS: Twenty-eight women ranging in age from 27-78 y with a body mass index (BMI) ranging from 16.9-48.1 kg/m2 and 23 men ranging in age from 32-75 y with BMI ranging from 20-41.6 kg/m2. MEASUREMENT: Body fat distribution was measured by waist circumference, waist to hip ratio (WHR), SAD, anthropometrically assessed and a single slice of computed tomography (CT) at the L4-L5 level. RESULTS: In both genders, a significant association was found between visceral adipose tissue (AT) and SAD, as evaluated by CT (women r = 0.80; men r = 0.83, P < 0.001), and SAD by anthropometry (women r = 0.76; men r = 0.82, P < 0.001), as well as between visceral AT and waist circumference (women r = 0.76, men r = 0.86, P < 0.001) and WHR (women r = 0.57, P < 0.01, men r = 0.80, P < 0.001). A significant association was also found between subcutaneous AT and SAD by anthropometry (women r = 0.79, men r = 0.74, P < 0.001). After adjusting for BMI, the association between subcutaneous AT and SAD was no longer significant in men and only moderately significant in women (r = 0.42, P < 0.05), while the association between visceral AT and SAD by anthropometry remained significant in both genders (women r = 0.63, P < 0.001; men r = 0.66, P < 0.001). When the subjects were divided into two groups according to BMI (lean to moderately overweight women with BMI < 28 and men with BMI < 30 and obese women with BMI > 28 and men with BMI > 30) we found that the relationships between SAD by anthropometry, as well as SAD by CT and visceral AT, were higher in lean to moderately overweight subjects than in those who were obese. High inter-observer correlation was found concerning SAD measurement (r = 0.99, P < 0.001). Intra- and inter-observer precision as evaluated by coefficient of variation and intraclass correlation coefficient for SAD measurement was very high. CONCLUSION: Our study shows the usefulness of SAD by anthropometry to predict visceral fat and its very high inter- and intra-observer precision.
Abdomen↗
Nuts and plasma lipids: an almond-based diet lowers LDL-C while preserving HDL-C.
OBJECTIVE: To compare lipid-altering effects of an almond-based diet with an olive oil-based diet, against a cheese and butter-based control diet. METHODS: Forty-five free-living hyperlipidemic men (n = 12) and women (n = 33) with a mean plasma total cholesterol (TC) of 251 +/- 30 mg/dL followed one of three diets; almond-based, olive oil-based, or dairy-based for 4 weeks. Total fat in each diet was matched, and the study-provided sources of fat comprised the major portion of fat intake. RESULTS: Reductions in TC and low-density lipoprotein-cholesterol (LDL-C) between the three groups were significantly different from the almond group (both p < 0.001). Within group analysis revealed that the almond-based diet induced significant reductions in TC (p < 0.05), LDL-C (p < 0.001), and the TC:HDL ratio (p < 0.001), while HDL-C levels were preserved. TC and HDL-C in the control diet were significantly increased from baseline (both p < 0.05), while the olive oil-based diet resulted in no significant changes over the study period. Weight did not change significantly. CONCLUSION: Results suggest that the more favorable lipid-altering effects induced by the almond group may be due to interactive or additive effects of the numerous bioactive constituents found in almonds.
Adult↗
Sagittal diameter minus subcutaneous thickness. An easy-to-obtain parameter that improves visceral fat prediction.
Two groups of 99 and 98 women were studied to test if correcting sagittal diameter by subtracting the thickness of subcutaneous abdominal adipose tissue improves its degree of association with visceral adipose tissue. The first group (age, 40 +/- 14 years; body mass index [BMI], 36 +/- 6 kg/m2) was used to calculate the predictive equations for visceral adipose tissue. The second group (age, 43 +/- 14 years; BMI, 37 +/- 6 kg/m2) was used for cross-validation. Various anthropometric parameters were measured by ultrasound and computed tomography. Correlation coefficients with single-slice visceral adipose tissue area, after sagittal diameter was corrected by subtracting subcutaneous thickness, rose from 0.63 to 0.72 in the first group and from 0.64 to 0.71 in the second group. The standard error of residuals of the regression formula for visceral adipose tissue area was 10% lower with modified sagittal diameter than with sagittal diameter alone. During cross-validation, the standard error of differences was 5% lower with modified sagittal diameter. The visceral adipose tissue estimate was also less biased by the size of the area when sagittal diameter minus subcutaneous thickness was used. Results show that subtracting the thickness of abdominal subcutaneous adipose tissue from sagittal diameter significantly improves the predictive power of sagittal diameter for visceral adipose tissue and could be a useful tool for epidemiological studies.
Adipose Tissue↗
Effects of visceral fat and weight loss on lipoprotein(a) concentration in subjects with obesity.
We studied the relationships between regional body fat distribution and metabolic variables with lipoprotein(a) [Lp(a)] as well as the effects of weight loss on Lp(a) in 25 women and 9 men with obesity. Regional body fat distribution, as evaluated by the use of computed tomography; Lp(a); and fasting glucose, insulin, cholesterol, and triglycerides were analyzed before and after a very low-energy diet. No significant correlations were found between visceral, subcutaneous, and total fat and Lp(a) or between metabolic variables and Lp(a). All anthropometric variables significantly decreased after a very low-energy diet. Fasting glucose, insulin, triglycerides, and cholesterol significantly decreased after a very low-energy diet. No significant changes in Lp(a) concentration after a very low-energy diet were found. The correlation between the initial values of Lp(a) and changes of Lp(a) after a very low-energy diet was slightly significant (rho = 0.33, p < 0.06). In conclusion, our study shows that Lp(a) is not influenced by obesity, visceral fat, metabolic variables, or weight loss induced by a very low-energy diet.
Adipose Tissue↗
Body fat distribution before and after weight gain in anorexia nervosa.
OBJECTIVE: To study abdominal fat distribution in anorexia nervosa subjects and to assess the effects of initial weight regain on abdominal fat distribution. DESIGN: Longitudinal, clinical study. The baseline measurement was acquired within four days of admission to the eating disorders clinic. All patients were treated by re-feeding, reinforced by psychotherapy. Following weight regain of at least 5 kg, a second body fat distribution evaluation was performed. Of the 21 subjects evaluated at baseline, 14 achieved the goal of body weight regain and were retested. PATIENTS: Fourteen subjects (age: 18-38 y; body mass index: 11.5-18.3; relative body weight: 54.9-88.3%). MEASUREMENTS: Total, subcutaneous and visceral abdominal adipose tissue areas at the L4-L5 level were evaluated by computed tomography. RESULTS: At baseline the subjects showed a higher proportion of visceral adipose tissue (% visceral adipose tissue = 55.3 +/- 26.1). A significant association was observed between body weight and both subcutaneous adipose tissue and total adipose tissue. A regain of body weight of 7.3 +/- 1.6 kg was accompanied by a significant increase in total adipose tissue, comprising both subcutaneous and visceral adipose tissue. The increase observed in subcutaneous adipose tissue, however, was significantly greater than for visceral adipose tissue (212.6% vs 116.8%, respectively, P < 0.01). CONCLUSION: The results of the current study show a higher proportion of visceral adipose tissue than subcutaneous adipose tissue in anorexia nervosa subjects. With regain of body weight there is a preferential regain of subcutaneous adipose tissue. These data demonstrate a redistribution of abdominal adipose tissue with weight regain in anorexia nervosa subjects.
Abdomen↗
Interrelationships between weight loss, body fat distribution and sex hormones in pre- and postmenopausal obese women.
OBJECTIVES: Relationships between regional body fat distribution and sex hormones as well as changes in sex hormones after weight loss were evaluated. SETTING: All subjects were hospitalized in the Institute of Internal Medicine of the University of Verona. SUBJECTS: Twenty-six premenopausal (age 33.7 +/- 10.2 years) and 15 postmenopausal (age 57.9 +/- 5.9 years) obese women. INTERVENTIONS: Body weight, body-mass index, waist and hip circumferences, visceral fat by computed tomography and sex hormones were evaluated before and after 4 weeks on a very low energy diet. RESULTS: Body-mass index was higher in pre-than in postmenopausal women, although the difference was not significant. Total and free testosterone were significantly higher in the pre- than in the postmenopausal group (P < 0.001). Significant negative correlations were found between age and total testosterone (r = -0.65; P < 0.001), free testosterone (r = -0.54; P < 0.001), androstenedione (r = -0.46; P < 0.01) and urinary cortisol excretion (r = -0.50; P < 0.01). A negative correlation was found between visceral fat and total testosterone (r = -0.41; P < 0.01). After adjusting for age, the negative correlation between total testosterone and visceral fat encountered both in the subject group as a whole and in premenopausal women was no longer significant, whilst a significant negative association between visceral fat and sex hormone binding globulin (SHBG) (r = -0.56; P < 0.001) was always found. When step-down regression analysis was used to evaluate the joint effect of age, menopausal status, and anthropometric and metabolic variables on sex hormones, age was the most powerful independent variable for predicting total testosterone, free testosterone and androstenedione levels, whilst menopausal status was the most powerful predictor of FSH and LH levels. Changes in hormones after VLED were analysed separately in pre- and postmenopausal women. None of the hormones changed significantly after VLED in the postmenopausal group, except for FSH values. LH, free testosterone and urinary cortisol excretion values decreased significantly after VLED in the premenopausal group. CONCLUSIONS: Our data show that age, to a greater extent than visceral fat, seems to be negatively associated with steroid sex hormones. Weight loss seems to be associated with changes in sex hormones only in premenopausal women.
Adolescent↗
The effects of high altitude trekking on body composition and resting metabolic rate.
Resting metabolic rate (RMR) and body composition were evaluated in 12 healthy volunteers before and after 16 days of high altitude trekking and climbing. RMR was measured by indirect calorimetry and body composition by electrical impedance. A 29% reduction in energy intake during high altitude exposure was observed. Fat mass loss averaged about 2.2 kg (p < 0.05) and lean body mass about 1.1 kg, which was almost significant (p = 0.07). As expected, estimated RMR at the end of the expedition--calculated by predictive formulae including body fat and lean body mass as covariates--was significantly reduced by 119 kcal/day as a consequence of the reduction in body weight. Measured RMR values, on the contrary, did not show any significant decline. In conclusion our study showed that high altitude trekking induced a weight loss due approximately 2/3rds to fat mass and 1/3rd to lean body mass. Decreased energy efficiency, which was still present several days after returning to sea level, may have helped contribute to weight loss due to reduced energy intake.
Adult↗
Effects of age on body fat distribution and cardiovascular risk factors in women.
We conducted a cross-sectional study of body fat distribution and metabolic variables and the interrelations among these factors in 134 women aged 18-71.9 y. Body fat distribution was measured with use of computerized tomography. A significant positive correlation was observed between age and visceral adipose tissue (VAT) and between VAT and body weight. When subjects were divided into five age groups, VAT values were significantly higher in older groups. Values for triacylglycerols, cholesterol, fasting glucose, 2-h glucose, and the sum of glucose values during an oral-glucose-tolerance test were significantly higher in older subjects. After adjustment for visceral fat, no significant differences in any metabolic variable studied, except cholesterol, were found across the five age groups. In conclusion, we found that regional body fat distribution in older women was different from that in younger subjects: older women had larger amounts o visceral fat. Values for metabolic variables were also higher in older subjects. Our data suggest that redistribution of body fat in older subjects is associated with changes in metabolic variables.
Adipose Tissue↗
The benefits of modest weight loss in type II diabetes.
Obesity increases the risk of developing type II diabetes. However, the link between the two remains unclear, although insulin resistance and visceral adiposity are dominant risk factors. A study with CT scanning confirmed that the degree of visceral adiposity had a significant positive correlation with insulinaemia, and was negatively associated with insulin sensitivity. A 48 month retrospective study in patients with type II diabetes, who had received dietary therapy, identified a 'responder' group in whom metabolic improvements accompanied weight loss. Preferential loss of visceral fat may be an important factor in these 'responders'. Patients losing > 6.9 kg (or at least 10% mean baseline body weight) have demonstrated significant improvements in their glucose, HbA1 and lipid profiles. Modest weight loss by patients with type II diabetes therefore improves glycaemic control, insulin sensitivity and cardiovascular risk factors; and the risk of developing long-term diabetes-related complications may also be reduced by such metabolic improvements.
Blood Glucose↗
Effect of regain of body weight on regional body fat distribution: comparison between pre- and postmenopausal obese women.
The aim of our study was to determine if regain of body weight increases visceral fat in obese women and if regain of weight has a different effect upon pre- and postmenopausal women. Twenty obese women (11 pre- and 9 postmenopausal) underwent a very low energy diet (VLED) for 2 weeks to lose weight. They then regained body weight in spite of the recommended hypocalorie diet. No significant modifications in body fat distribution indexes were found by computed tomography between VLED and after regain of weight. No significant changes were found in metabolic variables. No interactions between menopausal status and regain of body weight were observed. In conclusion, regain of weight does not seem to cause an increase in visceral fat; both pre- and postmenopausal women showed the same body fat distribution before weight loss and after regain of weight.
Adipose Tissue↗
Effect of altitude on body composition during mountaineering expeditions: interrelationships with changes in dietary habits.
Loss of body weight occurs during high mountain expeditions but whether it is due to inadequate diet or other factors is unknown. Moreover the composition of the weight loss is unclear. The aim of our study was to compare the nutritional, anthropometric and metabolic changes during a mountaineering expedition in two groups of climbers, whose dietary energy intake was ad libitum, one given a lacto-fish-ovo-vegetarian diet and one an omnivorous diet. The intake of various nutrients, body weight, body composition and metabolic variables were evaluated before and during high altitude exposure and after the return to low altitude. The two groups were matched for age, body mass index and gender. No significant differences were found for nutritional variables between the two groups. Energy, animal and vegetable protein and fiber intake were significantly lower at climbing quote than before the beginning of the expedition. Significant differences between before the beginning and base camp in all variables were found. Energy and animal protein intake, but not vegetable protein and fiber intake, were significantly lower at climbing quote than at base camp. All subjects significantly reduced body weight, body mass index, waist and hip circumferences but not fat-free mass and fat mass. Metabolic variables significantly improved after the mountaineering expedition. Our study seems to confirm that a mountaineering expedition decreases energy and protein intake, reduces body weight and improves metabolic variables. Because our subjects spontaneously tended to have the same food intake despite the different dietary recommendations, our study failed to observe any differences between the two groups. However, our study shows that a low protein diet, in which the type of protein is mostly vegetable protein, could be adapted for climbers determining only a small decrease of fat-free mass.
Altitude↗
Computed tomography visceral adipose tissue volume measurements of Italians. Predictive equations.
OBJECTIVES: To evaluate total visceral adipose tissue (AT) volumes in relation to single slices of visceral AT area measured at different levels and to other simple anthropometric measurements. DESIGN: Only outpatients examined in a metabolic unit were considered; subjects without conditions known to affect AT distribution who gave their informed consent were recruited. SETTING: All subjects were hospitalized in the Department of Internal Medicine of the University of Messina. SUBJECTS: 90 adult subjects of which 18 men and 42 pre- and 30 post-menopausal women. Ages ranged from 18 to 69 years and body mass indexes ranged from 22 to 50. INTERVENTIONS: The AT volume was calculated by computed tomography from the AT area of five scans and from the distances between these scans. RESULTS: AT area at the level of the 2nd-3rd lumbar vertebra had by itself the highest predictive power in men (s.e. = 6.8%), in post-menopausal women (s.e. = 7.4%) and, together with age, in pre-menopausal women (s.e. = 14%). Of the non-radiological parameters it was waist circumference, together with age, which showed the highest predictive power in men (s.e. = 21%), pre-menopausal women (s.e. = 25%) and, together with height, in post-menopausal women (s.e. = 33%). CONCLUSIONS: A single scan measurement at the lumbar level was confirmed to be representative of total visceral AT volume. Waist circumference was the non-radiological parameter that best correlated with volume.
Adipose Tissue↗
Relationship between hydration of lean body mass and visceral adipose tissue. A clinical study of women.
OBJECT: To study the relationship between hydration of lean body mass and adipose tissue location. DESIGN: Cross-sectional, clinical study of visceral adipose tissue area and total body water as a percentage of lean body mass. PATIENTS: Seventy-two adult, overweight, women, 52 pre- and 20 post-menopausal (age: 18-72 years, body mass index: 26-52). MEASUREMENTS: Total body water was obtained by electrical impedance measurement; visceral adipose tissue and lean body mass were obtained by computed tomography measurement of visceral adipose tissue area at the level of the 4th-5th lumbar vertebra. RESULTS: Visceral adipose tissue was found, by multiple regression analysis, to be the only predictor of the hydration of the lean body mass. The other independent variables: age, menopausal status, body mass index, glucose and insulin both fasting and after glucose load were not able to significantly improve the predictive power. CONCLUSION: Results of this study confirm the existence of a relationship between visceral adipose tissue content and hydration of the lean body mass.
Abdomen↗
Body fat accumulation is possibly responsible for lower dehydroepiandrosterone circulating levels in premenopausal obese women.
OBJECTIVE: To determine whether any androgen is independently related with parameters of body fat accumulation and distribution in obese women. DESIGN: Circulating insulin and androgen levels (total testosterone (T), free testosterone (FT), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), androstenedione, sex hormone binding globulin (SHBG)) and the parameters of body fat accumulation and distribution (body mass index, waist-to-hip ratio, total body fat volume (TBF), visceral adipose tissue area (VAT) and subcutaneous adipose tissue area (SAT) were determined in a population of non-diabetic obese women. SUBJECTS: 28 premenopausal obese women, recruited at the Verona University Hospital Outpatient Clinic. MEASUREMENTS: TBF, VAT and SAT area were quantified by computed tomography. Hormone levels were measured by RIA. RESULTS: SHBG showed an inverse correlation with BMI (r: -0.452, P < 0.05), WHR (r: -0.388, P < 0.05), TBF (r: -0.509, P < 0.01), VAT (r: -0.378, P < 0.05) and SAT (r: -0.449, P < 0.05). DHEA was negatively associated with BMI (r: -0.376, P < 0.05), TBF (r: -0 < 0.05), VAT (r: -0.662, P < 0.001) and SAT (r: -0.401, p < 0.05). T was found to be inversely related with VAT (r: -0.401, P < 0.05). Androstenedione was positively correlated with WHR (r: 0.383, P < 0.05). DHEAS and FT did not show significant associations with BMI, WHR, or any CT-parameters. Stepwise multiple regressions were performed for all androgens: one of the age-adjusted androgens was considered as the dependent variable for each analysis, and insulin, VAT, SAT and all other androgens were entered into the regression model. DHEA was the only hormone to show an independent association (negative) with both SAT (t-value: -3.683, P < 0.01) and VAT (t-value: -2.252, P < 0.05), whereas DHEAS showed an independent positive correlation with SAT (t-value: -2.241, P < 0.05). CONCLUSIONS: Among the androgens, DHEA seems to be the most sensitive to body fat accumulation in premenopausal obese women.
Adipose Tissue↗
Lipoprotein(a) and general risk factors in patients with angiographically assessed peripheral arterial disease.
High lipoprotein(a) [Lp(a)] has been observed in patients with ischemic heart disease and cerebrovascular disease. Lp(a) is actually thought to be an independent risk factor for coronary disease. We therefore carried out a case-control study, evaluating plasma Lp(a) in 61 patients with angiographically documented peripheral arterial disease (PAD) and in 61 age- and sex-matched patients with no cardiovascular disease. General risk factors for vascular disease were also taken into account. Lp(a) was significantly higher in patients than controls (257.0 +/- 34.8 vs 146.5 +/- 23.5 mg/l p < 0.05), as were cigarette smoking, diabetes, cholesterolemia, fibrinogenemia and the waist-to-hip circumference ratio. Stepwise logistic regression analysis showed that, in addition to cigarette smoking, diabetes, cholesterol and fibrinogen, Lp(a) is a significant independent risk indicator for PAD. This result suggests that high plasma Lp(a) is associated with enhanced risk of PAD and must therefore be evaluated alongside traditional risk factors.
Adult↗
Body fat distribution and whole blood viscosity in a sample of Italian men and women.
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Adipose Tissue↗