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R Rosmond

Publications and source records attributed to R Rosmond.

53 records · Page 3Linked to original sources

Hypothalamic origin of the metabolic syndrome X.

The conspicuous similarities between Cushing's syndrome and the Metabolic Syndrome X open up the possibility that hypercortisolemia is involved also in the latter. Salivary cortisol is possible to measure during undisturbed conditions including perceived stressful events during everyday life. Such measurements clearly show that normally regulated cortisol secretion is associated with excellent health in anthropometric, metabolic, and hemodynamic variables. Upon perceived stress cortisol secretion is increased and followed by the Metabolic Syndrome X (insulin resistance, abdominal obesity, elevated lipids, and blood pressure). In a minor part of the population a defect, "burned-out" cortisol secretion, occurs with decreased sex steroid and growth hormone secretions, and strong, consistent associations with the Metabolic Syndrome X. Psychosocial and socioeconomic handicaps with tendencies to abuse and depressive-anxious mood changes are consistently associated. The feedback control of cortisol secretion by central glucocorticoid receptors (GR) is blunted, and the function of the GR is abnormal. This corresponds to a polymorphism early in the GR gene locus, which is also associated with abdominal obesity and insulin resistance and is found in 14% of the Swedish male population. We suggest that the Metabolic Syndrome X is due to a discretely elevated cortisol secretion, discoverable during reactions to perceived stress in everyday life. This is based on environmental factors and expressed with different impact depending on genetic susceptibility.

Diabetes Mellitus, Type 2↗

[Neuroendocrine disorders cause stress-related disease. "Civilization syndrome" is a growing health problem].

Although the relationship between stress and serious diseases, such as ischaemic heart disease, is well known, the underlying mechanisms have proved difficult to identify. With a new technique available today, the hypothalamic-pituitary-adrenocortical axis can be shown to constitute a central physiological factor in the interplay between stress and disease. This technique opens up new diagnostic possibilities, and thus therapeutic and preventive options, in stress-related diseases which represent a growing health problem in modern society.

Environmental Illness↗

Personality disorders in relation to anthropometric, endocrine and metabolic factors.

Subjects with abdominal obesity show several signs of a perturbed regulation of the hypothalamic-pituitary-adrenal (HPA) axis. This is known to occur after chronic, submissive stress. Perceived environmental stress is depending on personality characteristics. Therefore, personality disorders (PD:s) were examined in relation to HPA axis status, other endocrine and metabolic variables as well as anthropometry. Men (no.=284) aged 51 years, recruited in similar subgroups of low, median and high waist/hip circumference ratio (WHR) from a sample of 1302 men. Measurements of personality disorders by Structured Clinical Interview for DSM-III-R, Axis II (SCID II), body mass index (BMI, weight, kg/height2, m2), WHR and abdominal sagittal diameter (D), dexamethasone suppression test (0.5 mg, salivary measurements of cortisol), insulin-like growth factor I (IGF-I), testosterone and metabolic variables. Men with cluster A (paranoid, schizotypal, schizoid) PD showed an increased BMI, WHR and D, independent of dexamethasone suppression. Testosterone was decreased in these men in relation to a blunted dexamethasone suppression. BMI, WHR and D were increased in men with cluster B (borderline, histrionic, narcissistic) and cluster C (avoidant, dependent, obsessive compulsive, passive aggressive) PD, only in relation to a blunted dexamethasone suppression. Furthermore, IGF-I was low in cluster B. Metabolic variables were differently associated to clusters of PD but generally followed obesity. Path-analytic models suggested that cluster B and C PD were followed by blunted dexamethasone suppression and obesity. Men with cluster A PD showed centralized body fat distribution, independently of dexamethasone suppression. In contrast, men with impulsive (cluster B) and anxious (cluster C) personality disorders seem often to have abdominal obesity only in combination with a blunted dexamethasone suppression test, suggesting a HPA axis disturbance. These results suggest that PD:s are involved in the development of abdominal obesity in men, with different endocrine and metabolic profiles depending on the type of PD. This might hypothetically be due to frequent exposure and/or an increased sensitivity to environmental stress factors, caused by aberrant personalities.

Anthropometry↗

Psychosocial and socio-economic factors in women and their relationship to obesity and regional body fat distribution.

BACKGROUND: Abdominal obesity, as well as psychosocial and socio-economic handicaps are risk factors for serious, prevalent diseases. Connections between these variables have been found in men. OBJECTIVE: The principal aim of the present study was to analyse the associations between psychosocial and socioeconomic factors with body mass index (BMI) and the waist-to-hip circumference ratio (WHR) in women. DESIGN: A cohort study of data derived from questionnaires. SUBJECTS: 1137 women from a population sample of 1464 women born in 1956. MEASUREMENTS: Occupational, social and leisure time conditions, smoking and alcohol habits, as well as height, weight and waist and hip circumferences. RESULTS: BMI was associated with teetotalism and negatively to wine drinking. WHR correlated directly with cigarette smoking and negatively with consumption of wine and beer. Both BMI and WHR, adjusted for each other and for smoking and alcohol, showed independent associations with low education, unemployment and problems at work when employed, as well as with little physical activity and much TV-watching. In addition, the WHR showed a negative, independent relationship to housing conditions. CONCLUSION: These observations suggest psychosocial and socio-economic handicaps as well as a low physical activity in abdominally obese women. Similar observations have been made previously in men, but only with the WHR, suggesting an influence of obesity in these relationships in women only. Another interesting gender difference is the positive relationship between being married with BMI in men, as well as being divorced and living alone with the WHR in men only.

Adipose Tissue↗

Hypothalamic arousal, insulin resistance and Type 2 diabetes mellitus.

AIMS: Type 2 diabetes mellitus (DM) develops when insulin resistance overcomes the capacity of compensatory insulin secretion. Insulin resistance may be induced via psychoneuroendocrine pathways, a possibility which has received little previous attention. METHODS: We have used salivary cortisol measurements to monitor the activity of the hypothalamic-pituitary-adrenal (HPA) axis, the major controller of hormones involved in the regulation of peripheral insulin sensitivity under everyday conditions. The influence of external challenges, as well as the sensitivity of feedback regulation, were followed in randomly selected middle-aged population samples. RESULTS: In health there is a rhythmicity of cortisol secretion, with a high plasticity and efficient feedback control. In contrast, a group of subjects were identified with a flat, rigid day curve and poor feedback control, who showed consistent abnormalities in stress-related cortisol secretion, including inhibited secretions of sex steroids and growth hormone; insulin resistance; abdominal obesity; elevated leptin levels; hyperglycaemia; dyslipidaemia and hypertension with elevated heart rate. The endocrine abnormalities are probably responsible for the anthropometric and metabolic abnormalities. The circulatory perturbations seem to be induced by a parallel activation of the central sympathetic nervous system suggesting an 'hypothalamic arousal syndrome', gradually developing into an independent risk for disease. An associated cluster of environmental factors, including psychosocial and socio-economic stress, traits of depression and anxiety, alcohol consumption and smoking, all factors known to activate hypothalamic centres, has been identified. A polymorphism of the glucocorticoid receptor gene, with 13.7% homozygotes in the male Swedish population, parallels receptor dysfunction, and may be responsible for the associated insulin resistance, central obesity and hypertension. CONCLUSIONS: This is the first detailed examination of psychoneuroendocrinological processes in the natural environment on a population basis in relation to somatic health. The results suggest that an hypothalamic arousal syndrome, with parallel activation of the HPA axis and the central sympathetic nervous system, is responsible for development of endocrine abnormalities, insulin resistance, central obesity, dyslipidaemia and hypertension, leading to frank disease, including Type 2 DM. We suggest that this syndrome is probably based on environmental pressures in genetically susceptible individuals.

Adult↗

Visceral obesity and diabetes.

Visceral obesity is a strong predictor of type 2 (non-insulin-dependent) diabetes and is associated with insulin resistance. In addition, research has indicated that the accumulation of visceral fat is regulated by endocrine mechanisms. Data suggest that progressive malfunction of the hypothalamic-pituitary-adrenal (HPA) axis, with elevation of levels of cortisol and reductions in levels of sex steroids and growth hormone, is associated with visceral accumulation of fat that contributes to circulating levels of free fatty acids, and that these factors are implicated in the development of insulin resistance. Furthermore, failure of central feedback control of the HPA axis by glucocorticoid receptors (GR) appears to be correlated with polymorphisms near the first exons of the GR gene. The HPA axis disturbances are similar to those seen after prolonged exposure to environmental stress. Psychosocial and socioeconomic factors, alcohol, depressive traits and anxiety are linked to HPA axis abnormalities.

Adipose Tissue↗

Psychiatric ill-health of women and its relationship to obesity and body fat distribution.

OBJECTIVE: Abdominal obesity is associated with serious, prevalent diseases. Previously, psychiatric symptoms and ill-health has been found in this condition in men. The results of a similar study in women is reported herein. RESEARCH METHODS AND PROCEDURES: A cohort of 1464 women, aged 40 years and recruited by systematic sampling, was examined (77.7% participation rate). Items regarding use of anxiolytics, hypnotics, and antidepressive drugs were registered, as well as symptoms of dyspepsia, sleeping disturbances, melancholy, and degree of life satisfaction. Smoking and alcohol consumption, as well as self-measured weight, height, waist, and hip circumferences, were reported, from which body mass index [BMI; weight (kg)/height2 (m2), kg/m2] and the waist/hip circumference ratio (WHR) were calculated. RESULTS: In bivariate analyses, BMI was associated with use of anxiolytics, antidepressive drugs, various sleeping disturbances, and a low degree of life satisfaction. After controlling for the WHR, alcohol, and tobacco use in multivariate analysis, the associations between BMI and use of anxiolytics and sleeping disturbances remained significant. The WHR correlated with dyspepsia, sleeping problems, and use of antidepressive drugs. After adjustments for BMI, smoking, and alcohol, the relationship to dyspepsia and antidepressants remained significant. DISCUSSION: The results suggest that elevated BMI (obesity) and elevated WHR (central fat distribution) are associated in different ways with symptoms of psychiatric ill-health in women. Obesity alone shows no such relationships to psychiatric ill-health in men, whereas central fat distribution shows independent associations to all of the measured variables studied in this report in women, suggesting gender differences in these associations.

Adult↗

Endocrine and metabolic aberrations in men with abdominal obesity in relation to anxio-depressive infirmity.

Abdominal obesity, anxiety, and depression have been found to cluster in several studies. To further characterize these associations, the following study was performed. In a population of 51-year-old men (N = 284), measurements of obesity (body mass index [BMI]) and body fat distribution (waist to hip ratio [WHR] and sagittal trunk recumbent diameter [D]) were analyzed in relation to dexamethasone (0.5 mg) inhibition of cortisol secretion, measured as salivary cortisol. Symptoms of anxiety and depression were defined by a validated questionnaire. Furthermore, testosterone, insulin-like growth factor-I (IGF-I), insulin, glucose, and serum lipid levels were measured. Twenty-five men (8.8%) had symptoms of anxiety and depression. BMI, WHR, and D correlated negatively with testosterone, except for BMI in the anxio-depressive (ADP) group. IGF-I showed no significant relationship. Furthermore, fasting insulin and the insulin to glucose ratio correlated positively and high-density lipoprotein (HDL) cholesterol correlated negatively with BMI, WHR, and D in the total study population and in the subgroups. Total and low-density lipoprotein (LDL) cholesterol showed no significant relationships. Correlation coefficients tended to be higher in ADP men. Dexamethasone inhibition showed a negative significant relationship with BMI (rho = -.47, P = .025), WHR (borderline, rho = -.37, P = .086), and D (rho = -.43, P = .046) only in the ADP group. Comparing the ADP group versus the group without anxio-depression (ADO) and high or low BMI (P = .008), WHR (P = .026), and D (P = .012) showed blunted dexamethasone inhibition only in ADP men with high anthropometric measurements. These findings suggest there is a subgroup with elevated BMI, WHR, and D in whom a blunted dexamethasone response is found associated with traits of anxiety and depression, conditions characterized by such an abnormality. The reason for the association might be insufficient control of cortisol secretion, followed by visceral fat accumulation.

Anxiety↗

The interactions between hypothalamic-pituitary-adrenal axis activity, testosterone, insulin-like growth factor I and abdominal obesity with metabolism and blood pressure in men.

OBJECTIVE: To examine potential interactions between abdominal obesity, endocrine, metabolic and hemodynamic perturbations. SUBJECTS: A subgroup of 284 men from a population sample of 1040 at the age of 51 y. MEASUREMENTS: Anthropometric measurements included body mass index (BMI, kg/m2), waist/hip circumference ratio (WHR) and abdominal sagittal diameter (D). Endocrine measurements were a modified, low dose (0.5 mg) dexamethasone suppression test (Dex), testosterone (T) and insulin-like growth factor I (IGF-I). Overnight fasting values of blood glucose, serum insulin, triglycerides, total, low and high density lipoprotein cholesterol, as well as resting heart rate and blood pressure were also determined. RESULTS: Arbitrary subdivisions of the men were performed to obtain subgroups of low T and IGF-I values (lowest decile, borderlines < or =13.13 nmol/I and < or =128.80 microg/l, respectively) and normal or blunted Dex. Significant relationships with BMI, WHR or D, and abnormal metabolic and hemodynamic factors, usually with the exception of total and low density lipoprotein cholesterol, were then found in subgroups with different endocrine profiles. These included men with a blunted Dex test with low T or IGF-I values, as well as men with a normal Dex test and low or normal T or IGF-I values. In addition, a group with isolated low Dex suppression, as well as another group without endocrine abnormalities, showed such relationships. These findings suggest that, in men, obesity factors are associated with metabolic and hemodynamic complications with or without the presence of perturbations of hypothalamic-pituitary-adrenal axis (HPA) regulation or low T or growth hormone secretion. In order to generate hypotheses concerning the nature of the impact of the endocrine perturbations in abdominal obesity and its metabolic complications, path analyses were performed, testing different models. These models included the endocrine measurements (Dex test, T and IGF-I), the WHR and D (representing abdominal distribution of fat), BMI (representing obesity), as well as insulin and triglyceride values (representing metabolic perturbations). The results showed a satisfactory fit (goodness-of-fit index: 0.945 - 1.0) for the path diagrams: Dex --> T/IGF-I --> WHR or D --> insulin --> triglycerides with additional direct input of blunted Dex on insulin values (see Figure 1). With BMI as determinant, essentially the same results were found with the addition of a direct pathway between Dex and BMI as well as between IGF-I-T and insulin (Figure 2). There was no evidence for pathways where WHR or BMI determined endocrine variables. CONCLUSIONS: The results suggest that abdominal obesity with or without endocrine abnormalities exerts a major impact on abnormalities in metabolic and hemodynamic variables. Abdominal obesity seems to be dependent on endocrine abnormalities, which in turn show direct or indirect relationships to the metabolic and circulatory variables, including a direct pathway between HPA-axis perturbations and accumulation of total body fat as indicated by the BMI. It is therefore suggested that endocrine perturbations are followed by obesity and by storage of an elevated proportion of fat in visceral depots, followed by metabolic and hemodynamic abnormalities. This is statistical evidence which is supported by evidence of mechanistic links in previous studies, suggesting the possibility of causal relationships. The results also indicate subgroups of abdominal obesity and its associated metabolic and hemodynamic abnormalities, which might be due to the input of different pathogenetic factors.

Abdomen↗

A cross-sectional study of self-reported work conditions and psychiatric health in native Swedes and immigrants.

Several studies have demonstrated that immigrants in Scandinavian countries are more affected by psychosocial disabilities than the native-born population. The aim of the study was to evaluate the possible impact of work-related stressors on psychiatric health in immigrants compared to native Swedes. The study included a cluster selected cohort of 1,040 men born in 1944 (participation ratio = 79.9%), living in Gothenburg, Sweden. Of these, 182 (18.0%) were immigrants, defined as being born outside Sweden. Information on work conditions and psychiatric health were obtained by self-administered questionnaires. Employment in native Swedes showed inverse associations to frequent use of anxiolytics [relative risk (RR) = 0.2; 95% confidence interval (CI) = 0.06-0.4], frequent use of hypnotics (RR = 0.1; CI = 0.02-0.2) and use of antidepressants (RR = 0.3; CI = 0.2-0.5). None of the employed immigrants used anxiolytics or hypnotics frequently. Swedes seemed to display a number of psychiatric ill-health factors related to working conditions. These factors included frequent use of hypnotics, frequent insomnia, use of antidepressants, a high degree of melancholy, and were related to shift work, dissatisfaction with current work and management and a low degree of influence on work situation, often related to a high degree of stress at work and a frequent desire to change type of work. These associations were not seen in immigrants, apart from the risk of frequent insomnia (RR = 4.7; CI = 1.2-18.3) and dissatisfaction with colleagues (RR = 10.4; CI = 2.2-48.8) when working in shift. With a few exceptions, non-optimal working environment was associated with a low degree of life satisfaction in both groups. It was hypothesized that optimal working conditions are important for maintaining psychiatric health, and that immigrants, when employed, seem less affected by impaired working conditions than native Swedes.

Anti-Anxiety Agents↗

Blood pressure in relation to obesity, insulin and the hypothalamic-pituitary-adrenal axis in Swedish men.

OBJECTIVE: Some studies have shown a clustering of obesity, insulin and hypertension. The present study was performed to further characterize these associations. SUBJECTS AND METHODS: In a population of 51-year-old men (n=284), measurements of systolic and diastolic blood pressure were analyzed in relation to general obesity (body mass index) and central obesity (waist: hip circumference ratio and abdominal sagittal diameter), and to the fasting insulin and insulin: glucose ratio as an approximation of insulin sensitivity. The regulation of diurnal cortisol secretion was examined in repeated salivary samples. RESULTS: Linear regression analysis showed that all three parameters of obesity were significantly and strongly related to both systolic and diastolic blood pressure, more powerfully than insulin, glucose and insulin sensitivity (insulin: glucose ratio). Stepwise multiple regression showed that only central obesity, measured as the abdominal sagittal diameter, remained significantly (P< 0.001), and independently of insulin and insulin sensitivity, associated with both systolic and diastolic blood pressure (beta=7.5 and 4.2, respectively). A diurnal cortisol curve with normal rhythm was associated with lower than average blood pressures (P< 0.001) but not with insulin levels or the heart rate. In contrast, a flattened diurnal cortisol curve, indicating perturbations in the activity of the hypothalamic-pituitary-adrenal axis, was directly related to blood pressures, heart rate and insulin (P<0.001), and has previously been found to be strongly associated with abdominal obesity. CONCLUSIONS: These findings suggest that general and central obesity is independently related to blood pressure, and that insulin may account for only part of this association. The activity of the hypothalamic-pituitary-adrenal axis is apparently important for blood pressure regulation, suggesting that mechanisms of the central nervous system have an impact.

Abdomen↗

Stress-related cortisol secretion in men: relationships with abdominal obesity and endocrine, metabolic and hemodynamic abnormalities.

Abdominal obesity has been suggested to be associated with perturbations of the regulation of the hypothalamic-pituitary-adrenal (HPA) axis. In a population of 51-yr-old men (n = 284) salivary cortisol concentrations were determined on repeated (n = 7) occasions over a random working day, and perceived stress was reported in parallel. Cortisol values were then related to reported stress (stress-related cortisol). A standardized lunch was used as a physiological challenge. A low dose (0.5 mg) dexamethasone suppression test was also performed as well as determinations of testosterone and insulin-like growth factor I (IGF-I). Body mass index [weight (kilograms)/height (meters)2]; waist/hip circumference ratio (WHR); sagittal trunk recumbent diameter (D); fasting insulin; blood glucose; triglycerides; and total, low density (LDL), and high density (HDL) lipoprotein cholesterol were also determined. Cortisol concentrations were highest in the morning, and lunch was followed by a peak (P = 0.044). Two types of diurnal cortisol curves were identified, one characterized by a high variability with high morning values, and another with low variability and low morning values. Both correlated strongly with suppression of salivary cortisol by dexamethasone (P < 0.001). Stress-related cortisol secretion was associated with D (P = 0.051), low IGF-I (P = 0.006), and diastolic blood pressure (P = 0.078). When the type of diurnal cortisol curve was taken into consideration by statistical weighting, stress-related cortisol secretion in subjects with high variability showed associations with testosterone (P < 0.001), D, total and LDL cholesterol, diastolic blood pressure (P < 0.001), fasting insulin (P = 0.039), and glucose (P = 0.030) as well as, negatively, triglycerides (P < 0.001). When weighted for a low variability of diurnal cortisol secretion, stress-related cortisol secretion showed strong negative relationships with IGF-I, testosterone, and HDL. Furthermore, strong, consistent relationships (all P < 0.001) were found with obesity factors (body mass index, WHR, and D), and with metabolic (insulin, glucose, triglycerides, and total and LDL cholesterol) as well as hemodynamic variables (systolic and diastolic blood pressure and heart rate). These results clearly show interactions between diurnal cortisol secretion related to perceived stress and anthropometric, endocrine, metabolic, and hemodynamic variables. This seems to occur with apparently normal regulation of the HPA axis (high morning peaks and variability as well as dexamethasone suppression of cortisol), where other endocrine variables are not affected. With a low diurnal cortisol variation and blunted dexamethasone suppression, indicating abnormal regulation of the HPA axis, perceived stress-dependent cortisol values were strongly related to perturbations of other endocrine axes as well as abdominal obesity with metabolic and hemodynamic abnormalities. Perturbations of the regulations of the HPA axis such as those described in combination with low dexamethasone suppressibility are known to follow long term overactivation of the axis by factors such as environmental stress.

Abdomen↗

Mental distress, obesity and body fat distribution in middle-aged men.

Previous epidemiological studies have suggested that psychiatric symptoms are associated with obesity and abdominal distribution of body fat in women. The aim of the present study was to examine this in middle-aged men. In 1992 a cluster selected cohort of 1040 men born in 1944 (participation rate 79.9%) was examined. Registrations of symptoms of depression and anxiety, sleep disturbances, psychosomatic disease as well as degree of life satisfaction were analyzed in relation to body mass index (BMI) and the waist/hip circumference ratio (WHR). In univariate analyses both BMI and WHR correlated with these factors. BMI and WHR were, however, closely interrelated (p = 0.61), necessitating analyses of separate, independent relationships in multivariate analyses. When adjusted for WHR all the significant relationships with BMI disappeared. In contrast the WHR, adjusted for BMI, showed remaining significant associations with the use of anxiolytics (p = 0.018), hypnotics (p = 0.029), antidepressive drugs (p = 0.008), degree of melancholy (p = 0.002), and life satisfaction (p = 0.002, negative), difficulties to sleep (p = 0.014) and fall asleep (p = 0.047), tendency to wake up from sleep (borderline, p = 0.070) and dyspepsia (p < 0.001). Since smoking and alcohol are known to influence on the WHR, these factors were, in addition to BMI, entered into the analyses as confounding variables. The mentioned associations then remained statistical significant (use of hypnotics borderline, p = 0.074) except difficulties to fall asleep and tendency to wake up. It was concluded that in contrast to BMI, the WHR is associated with symptoms of depression and anxiety with associated sleep disturbances, as well as psychosomatic symptoms and dissatisfaction. It was hypothesized that the mechanism involved might be increased secretion of cortisol, directing storage fat to central adipose tissue depots.

Adipose Tissue↗

A comparative review of psychosocial and occupational environment in native Swedes and immigrants.

The aim of the present study was to evaluate potential differences in psychosocial status and work environment between native Swedes and immigrants living in Gothenburg, Sweden. A number of psychiatric, occupational and socio-economic factors were analysed by questionnaire in 1040 men born in 1944 out of 1302 selected. The immigrants (n = 182) who participated in the study used psychopharmacological drugs more extensively than native Swedes. They were more dissatisfied, had traits of depression, frequent sleeping problems, dyspepsia and headaches compared with the native Swedes. The immigrants were more often out of work, and those who were gainfully employed were more dissatisfied with their current work and their colleagues, had a lower influence on the work situation, felt a lower degree of work demands, more seldom attempted to alter their work situation when having problems, and had a more frequent desire to change their type of work. Furthermore, immigrants more often than Swedes were living under poor housing standards, indicating a low socio-economic status. They felt a low degree of time pressure and had more often experienced a serious life event compared to native Swedes. It was concluded that immigrants were more affected by psychiatric, occupational and socio-economic disabilities and handicaps than native Swedes, indicating that immigrants are a vulnerable group in Swedish society.

Adjustment Disorders↗

The influence of occupational and social factors on obesity and body fat distribution in middle-aged men.

OBJECTIVE: The principal aim of the present study was to analyse possible associations between psychosocial and occupational factors with body mass index (BMI) and the waist-to-hip circumference ratio (WHR). DESIGN: A cohort study of data derived from questionnaires. SUBJECTS: 1040 men from a population sample of 1302 men born 1944. MEASUREMENTS: Occupational, social and leisure time conditions, smoking and alcohol habits as well as height, weight and waist-to-hip circumferences. RESULTS: In multivariate analyses, the BMI, when adjusted for the WHR, smoking and alcohol, was marginally associated with shift work and, negatively, with influence on the work situation. Such men were often married or cohabited, had a low educational level, felt little time pressure and watched TV frequently. In contrast men with elevated WHR, when adjusted for BMI, alcohol and smoking, seemed to be more often out of work, and to be less satisfied with work management. They were frequently divorced and lived under relatively poorer housing conditions, indicating a low socio-economic status, exercised seldom and had little leisure time activities. CONCLUSION: It was concluded that obesity (BMI) and centralisation of body fat stores (WHR) are differently associated to occupational and social factors as well as leisure time activities.

Adipose Tissue↗

Growth hormone secretion after testosterone administration to men with visceral obesity.

Visceral obesity in men has been reported to be characterized by low testosterone (T) and insulin-like growth factor I (IGF-I) concentrations, the latter suggesting a relative growth hormone (GH) deficiency. Since T and GH-secretions are interrelated, men with visceral obesity were substituted with T for 14 days, and diurnal secretion pattern of GH as well as IGF-I concentrations, and metabolic variables were followed. Visceral obese men were characterized by a decreased total GH secretion and diminished peak amplitude, size, and number. T-substitution was followed by elevation of IGF-I levels. The IGF-I increase correlated with the elevation of T-concentration, and was most pronounced in men with the lowest concentrations of free T from the outset. There were no detectable changes in total quantity, amplitude, size or number of peaks of GH secretion. Glucose, chlolesterol and triglycerides as well as diastolic blood pressure decreased. There were no changes in thyroid or hematology variables. T-substitution of visceral obese men is followed by an elevation of IGF-I concentrations. It is suggested that this might be due either to minor, non-detectable increases in GH secretion, or to direct effects of T on IGF-I concentrations. The regulatory mechanisms by which T-administration are leading to metabolic and anthropometric improvements, might be direct effects of T, with or without mediation via GH secretion.

Abdominal Fat↗