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Effects of peroxisome proliferator-activated receptor-gamma 2 Pro12Ala polymorphism on body fat distribution in female Korean subjects.

The effects of peroxisome proliferator-activated receptor gamma 2 (PPAR gamma 2) Pro12Ala (P12A) polymorphism on body mass index (BMI) and type 2 diabetes are well documented; however, until now, only a few studies have evaluated the effects of this polymorphism on body fat distribution. This study was conducted to elucidate the effects of this polymorphism on computed tomography (CT)-measured body fat distribution and other obesity-related parameters in Korean female subjects. The frequencies of PPAR gamma 2 genotypes were: PP type, 93.0%; PA type, 6.8%; and AA type, 0.2%. The frequency of the A allele was 0.035. Body weight (P = .012), BMI (P = .012), and waist-to-hip ratio (WHR) (P = .001) were significantly higher in subjects with PA/AA compared with subjects with PP. When body composition was analyzed by bioimpedance analysis, lean body mass and body water content were similar between the 2 groups. However, body fat mass (P = .003) and body fat percent (P = .025) were significantly higher in subjects with PA/AA compared with subjects with PP. Among overweight subjects with BMI of greater than 25, PA/AA was associated with significantly higher abdominal subcutaneous fat (P = .000), abdominal visceral fat (P = .031), and subcutaneous upper and lower thigh adipose tissue (P = .010 and .013). However, among lean subjects with BMI of less than 25, no significant differences associated with PPAR gamma 2 genotype were found, suggesting that the fat-accumulating effects of the PA/AA genotype were evident only among overweight subjects, but not among lean subjects. When serum lipid profiles, glucose, and liver function indicators were compared among overweight subjects, no significant difference associated with PPAR gamma 2 genotype was found. Changes in body weight, BMI, WHR, and body fat mass were measured among overweight subjects who finished a 1-month weight lose program of a hypocaloric diet and exercise; no significant differences associated with PPAR gamma 2 genotype were found. The results of this study suggest that the PPAR gamma 2 PA/AA genotype is associated with increased subcutaneous and visceral fat areas in overweight Korean female subjects, but does not significantly affect serum biochemical parameters and outcomes of weight loss programs.

Adipose Tissue↗

Absolute fat mass, percent body fat, and body-fat distribution: which is the real determinant of blood pressure and serum glucose?

Associations of body mass index (BMI), absolute fat mass, percent body fat, and regional fat distribution with concentrations of fasting blood glucose and blood pressure were examined cross-sectionally in 1551 men and women aged 15-79 y from two study centers. Measurements included height, weight, multiple skinfold thicknesses, body density by underwater weighing, and waist and hip girths. Three principal findings emerged: 1) Absolute overall body mass and fat mass were stronger predictors of blood pressure and blood glucose than were relative fat mass, after age, height, and current cigarette-smoking status were adjusted for; 2) when diastolic blood pressure and serum glucose were used as the external validity criteria, densitometry was not a "gold standard" for body composition associated with risk for increased blood pressure and serum glucose; and 3) BMI was as good a predictor of blood pressure and glucose as was any other measure of body fat in nearly all analyses.

Adipose Tissue↗

Hormonal influences on the relationships between body fatness, body fat distribution, lipids, lipoproteins, glucose and blood pressure in French working women.

The independent associations between overall obesity, body fat distribution, lipids, lipoproteins, glucose, blood pressure and some hormonal factors (sex hormone-binding globulin (SHBG), corticosteroid binding globulin (CBG) and fasting insulin) were cross-sectionally examined in 205 French working women. After adjustment for age, overall adiposity assessed by body mass index (BMI) was significantly associated with most metabolic parameters, whereas regional adiposity assessed by the waist-hip ratio (WHR) was significantly associated only with triglyceride, systolic and diastolic blood pressure. Blood pressure, glucose but not triglyceride, were also negatively and significantly correlated with SHBG and positively with fasting insulin. Negative independent associations were found between SHBG and both BMI and WHR, whereas CBG was positively associated only with WHR. Fasting insulin was no longer related to WHR after adjustment for BMI. After controlling for the effect of SHBG or insulin, the associations between triglyceride, blood pressure and both BMI and WHR were not substantially modified. After adjustment for BMI and WHR, fasting insulin was independently associated with both HDL cholesterol and diastolic blood pressure. In conclusion, in these French women, hormonal factors under study appeared to have little influence on the relationships between body fatness, body fat distribution, metabolic variables and blood pressure.

Adipose Tissue↗

The differential effects of body fat distribution on insulin and glucose metabolism during pregnancy.

OBJECTIVE: Our purpose was to investigate whether maternal obesity, or more specifically body fat distribution, is associated with alterations in carbohydrate metabolism during pregnancy. STUDY DESIGN: A longitudinal study of oral glucose tolerance tests, insulin, C peptide, and glucagon levels during each trimester and post partum was undertaken in nine lean and 14 obese women. Obese women were divided into lower body obese (n = 6, waist/hip ratio < 0.9) and upper body obese (n = 8, waist/hip ratio > or = 0.9). RESULTS: Fasting blood glucose levels declined with advancing gestation only in lean subjects. Upper body obese women demonstrated maximal glucose response and insulin area under the curve by the second trimester, whereas lean and lower body obese women did not until the third trimester. Insulin areas were significantly elevated in upper body obese compared with lower body obese women (second trimester, p < 0.01; third trimester, p < 0.03; post partum p < 0.05). In contrast, C peptide levels were similar in obese subgroups and were significantly elevated only when compared with those of lean women. C peptide/insulin molar ratios were lower in upper body obese women during the second trimester (4.3 +/- 0.8) and third trimester (4.2 +/- 0.7) compared with lean (6.5 +/- 1.3, 6.7 +/- 0.5) and lower body obese women (7.9 +/- 1.4, 6.5 +/- 1.4) (p < 0.01). A significant relationship between waist/hip ratio and glucose level (r = 0.70, p < 0.004) and insulin areas (r = 0.76, p < 0.001) was present in late pregnancy in obese subjects. CONCLUSIONS: Relative hyperinsulinemia and earlier maximal glucose response in upper body obese women suggests that body fat distribution may explain the metabolic heterogeneity present in obese women during pregnancy. Body fat topography may serve as a potential marker for the early development of carbohydrate intolerance during pregnancy.

Adipose Tissue↗

Relationship of body fat distribution by waist circumference, dual-energy X-ray absorptiometry and ultrasonography to insulin resistance by homeostasis model assessment and lipid profile in obese and non-obese postmenopausal women.

OBJECTIVE: To correlate body fat distribution evaluated by waist circumference, dual-energy X-ray absorptiometry and ultrasonography to insulin resistance and lipid profile in obese and non-obese postmenopausal women. METHODS: We studied 40 obese and 47 non-obese postmenopausal women, assessing obesity by measuring waist circumference and fat tissue using dual-energy X-ray absorptiometry and ultrasonography, and examining their correlation with metabolic parameters: insulin resistance as determined by the homeostasis model assessment technique (HOMA-IR) and lipid profile including triglycerides (TG), total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), very-low-density lipoprotein, lipoprotein(a) (Lp(a)) and apoplipoprotein A-I (Apo A-I). RESULTS: There was no difference in lipid profile between the two groups. Insulin resistance was the metabolic disturbance of highest prevalence in the obese group, evaluated by HOMA-IR (obese: 3.38 +/- 2.2; non-obese: 1.20 +/- 0.7; p < 0.001). Obesity was not a confounding factor in linear regression analyses among HOMA-IR, HDL-C, TG, Lp(a), Apo A-I and the methods used to measure body fat distribution. Waist circumference was the method that best explained HOMA-IR (R(2) = 34.9%, p < 0.001) and TG concentration (R(2) = 10.9%, p = 0.002). HDL-C presented a positive association with subcutaneous fat evaluated by ultrasonography (R(2) = 12.5%, p < 0.001). Obesity was a confounding factor in multiple regression analyses between TC and LDL-C, when related to abdominal fat evaluated by ultrasonography, and resulted in a positive association among the obese and a negative association among the non-obese women. The sensibility of this method was related to the quantity of fat in the visceral region. CONCLUSIONS: Waist circumference showed the highest association with insulin resistance. Fat distribution evaluated by dual-energy X-ray absorptiometry and ultrasound was also associated with insulin resistance, but with lower intensity. The relationship of visceral fat distribution evaluated by ultrasound to TC cholesterol and LDL-C showed opposed results between obese and non-obese menopausal women.

Absorptiometry, Photon↗

Effects of fat mass and body fat distribution on resting metabolic rate in the elderly.

The aim of the present study was to investigate the relationship between resting metabolic rate (RMR) and fat-free mass, fat mass, and body fat distribution in 164 women (age 60 to 85 years; body mass index [BMI], 18.5 to 35.6 kg/m(2)) and 98 men (age 60 to 85 years; BMI, 18.3 to 36.5 kg/m(2)). After an overnight fast, RMR was assessed by indirect calorimetry and body composition by bioelectrical impedance analysis. Waist-to-hip ratio (WHR) was used to determine fat distribution. Results from linear regression analysis showed that most of the variance in RMR could be attributed to fat-free mass in women (R(2) = 0.54) and men (R(2) = 0.44), respectively. Fat mass explained an additional 3% and 2% of the variability in RMR in women and men, respectively. In stepwise multiple regression analysis, considering body composition and fat distribution, only fat-free mass and WHR were significant predictors of RMR in both sexes. In addition to fat-free mass, in women 6% and in men 8% of the variability in RMR was attributable to WHR. Grouping subjects according to their WHR, RMR, and RMR adjusted for fat-free mass and fat mass showed a significant increase with increasing WHR in both sexes. Results indicate that RMR not only depends on fat-free mass but also is influenced by fat mass, especially by fat distribution. These findings support our hypothesis of an elevated RMR with increasing abdominal body fat as a direct consequence of its greater metabolic activity.

Adipose Tissue↗

Relationship between insulin sensitivity, obesity, body fat distribution and beta-endorphinaemia in obese women.

OBJECTIVE: To study the associations of obesity (as body mass index (BMI)), of body fat distribution (as waist to hip ratio (WHR)) and of beta-endorphinaemia (beta-EP-aemia) with fasting insulin and glucose concentrations, with insulin secretion (as first phase insulin response (FPIR)) and with insulin sensitivity (SI) in obese women. DESIGN: a cross-sectional study of insulin sensitivity in obese women. SUBJECTS: 45 obese women (age: 20-70 y, BMI: 27-50). MEASUREMENTS: Frequently sampled intravenous glucose tolerance test (FSIGTT), FPIR, fasting glucose, fasting insulin, BMI, body fat topography (WHR), beta-EP-aemia, plasma ACTH. RESULTS: In univariate analysis the following positive associations were observed: fasting glucose with age and WHR, fasting insulin with BMI and WHR, beta-EP plasma concentration with WHR; SI was negatively associated with BMI, WHR and beta-EP plasma concentrations. This pattern of associations remained unaltered in multivariate analysis including age, BMI and WHR as independent variables. The contribution of beta-EP plasma concentrations to SI variability was corroborated by a stepwise multiple regression analysis: 53.8% of SI variation could be explained by BMI (30.7%), by beta-EP plasma concentrations (17.2%) and by WHR (5.9%). Finally, women were divided into two groups according to whether they had a peripheral (P-BFD, WHR < or = 0.80, n = 24) or an abdominal (A-BFD, WHR > or = 0.85, n = 16) body fat distribution. After adjustment for age and BMI, SI values were lower while beta-EP and ACTH plasma concentrations were higher in the A-BFD compared to the P-BFD group. In this latter group, 54.8% of SI variation was explained by the same variables as in the whole group. In the A-BFD group, higher WHR was associated with lower FPIR. CONCLUSIONS: 1) The major finding of this study is that, in non-diabetic obese women (especially those with a P-BFD), higher beta-EP plasma concentrations are associated with lower insulin sensitivity. This association is independent of both the magnitude of obesity and the pattern of fat distribution, although these two parameters are strong predictors of SI. 2) The major reduction in SI observed in women with A-BFD probably results from the additive effects of obesity, of elevated beta-EP plasma concentrations and of metabolic and endocrine alterations in relation with the central pattern of fat distribution.

Adult↗

Changes in body weight and body fat distribution as risk factors for clinical diabetes in US men.

Although previous studies have linked obesity to diabetes, the risks associated with weight gain or changes in body fat distribution have not been fully elucidated. The authors therefore prospectively examined the relations between changes in body weight and body fat distribution (1986-1996) and the subsequent risk of diabetes (1996-2000) among 22,171 men in the Health Professionals Follow-up Study. Weight gain was monotonically related to risk, and for every kilogram of weight gained, risk increased by 7.3%. A gain in abdominal fat was positively associated with risk, independent of the risk associated with weight change. Compared with men who had a stable waist, men who increased waist circumference by 14.6 cm or more had 1.7 (95% confidence interval: 1.0, 2.8) times the risk of diabetes after controlling for weight gain. In contrast, men who lost more than 4.1 cm in hip girth had 1.5 (95% confidence interval: 1.0, 2.3) times the risk of diabetes compared with men with stable hip circumference. Fifty-six percent of the cases of diabetes in this cohort could be attributed to weight gain greater than 7 kg, and 20 percent of the cases could be attributed to a waist gain exceeding 2.5 cm. Our findings underscore the critical importance of maintaining weight and waist to reduce the risk of diabetes.

Adipose Tissue↗

Upper-body fat distribution and endometrial cancer risk.

STUDY OBJECTIVE: --To determine if body fat distribution affected endometrial cancer risk. DESIGN: --Case-control study. SETTING: --This study was carried out at the H. Lee Moffitt Cancer Center at the University of South Florida, Tampa, where all patients in the case group received their diagnoses and histological confirmations. PATIENTS: --Forty consecutive women newly diagnosed with endometrial cancer and 40 controls matched for age and Quetelet index. MAIN OUTCOME MEASURES: --Anthropometric measurements were taken for the abdomen, thigh, suprailiac, subscapular, biceps, and triceps skin fold thicknesses; waist and hip circumferences, weight, and height. Relative risks for endometrial cancer were calculated according to these anthropometric measurements. RESULTS: --Case patients with endometrial cancer had significantly greater waist-to-hip circumference ratios (P less than .001), abdomen-to-thigh skin fold ratios (P less than .01), and suprailiac-to-thigh skin fold ratios (P = .02) compared with control subjects matched for age and Quetelet index. The relative risk for endometrial cancer increased with an increasing waist-to-hip circumference ratio (less than or equal to 1.14 = 1.0; greater than 1.14 = 15.0), with an increasing abdomen-to-thigh skin fold ratio (less than or equal to 0.82 = 1.0; greater than 0.82 = 5.0), and with an increasing suprailiac to-thigh skin fold thickness ratio (less than or equal to 0.67 = 1.0; greater than 0.67 = 3.50). CONCLUSION: --Upper-body fat localization is a significant risk factor for endometrial cancer in women matched for age and Quetelet index.

Adult↗

Impact of obesity and body fat distribution on cardiovascular risk factors in Hong Kong Chinese.

OBJECTIVE: Body fat distribution has been reported to differentially contribute to the development of cardiovascular risk. We report the relative associations between general and central obesity and risk factors in 2893 Chinese subjects recruited from the Hong Kong population. RESEARCH METHODS AND PROCEDURES: Anthropometric parameters [waist circumference (WC) and BMI], surrogate measures of insulin resistance (fasting plasma glucose and insulin, oral glucose tolerance test, 2 hours glucose and insulin), fasting lipids (total, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, and triglycerides) and systolic and diastolic blood pressure were measured. General obesity was classified as BMI > or =25.0 kg/m(2) and central obesity as a WC > or =80 or > or =90 cm in women and men, respectively. RESULTS: A total of 39.2% of the population was found to be obese. Obesity per se increased the levels of the risk factors, but central adiposity contributed to a greater extent to adverse high-density lipoprotein-cholesterol, triglyceride, and insulin resistance levels. There was a continuous relationship between increasing obesity, both general and central, and cardiovascular risk, with lowest risk associated with the lowest indices of obesity. In the 1759 nonobese subjects divided into quartiles of BMI or WC, the levels of the cardiovascular risk factors still significantly increased with increasing quartiles of adiposity. DISCUSSION: Central adiposity appears to contribute to a greater extent than general adiposity to the development of cardiovascular risk in this population. The relationship between obesity parameters and risk is a continuum, with risk factors significantly increasing even at levels usually considered nonobese. These observations support the proposed redefinition of overweight and obesity in Asian populations using lower cut-off points.

Adipose Tissue↗

Body fat distribution and serum lipoproteins in relation to age and body weight.

Android obesity is reported to be a risk factor for coronary heart disease and aberrations in lipid metabolism, but so far its association with other risk factors such as age and overweight has not been clearly analyzed. We therefore investigated the relationship between the waist-to-hip ratio, age, body mass index and serum lipoproteins in 305 probands (158 men, 147 women), while body mass index was kept constant in all age groups. Waist-to-hip ratio correlated with both age (r = 0.441) and body mass index (r = 0.532) in simple linear correlation analysis (P less than 0.001). In stepwise multiple regression analysis we found in both sexes a first step dependence on age for total and LDL-cholesterol (P less than 0.001), a first step dependence on waist-to-hip ratio for triglycerides (P less than 0.001), VLDL-triglycerides (P less than 0.001) and VLDL-cholesterol (P less than 0.001 for men, P less than 0.05 for women), and an inverse first step dependence on body mass index for HDL-cholesterol (P less than 0.05 for men, P less than 0.001 for women). From these results we propose an independent association between waist-to-hip ratio and triglycerides while the relation to total and LDL-cholesterol is determined by age. HDL-cholesterol, on the other hand, is influenced by body fat mass and independent from age or body fat distribution.

Adipose Tissue↗

Are there any sex differences in fatty liver? A study of glucose metabolism and body fat distribution.

BACKGROUND AND AIMS: Fatty liver is a common condition found more often in males. Whether sex differences affect its development is presently unknown. The hypothesis that glucose metabolism alterations or central body fat distribution are gender-related in fatty liver was investigated. METHODS: Overall 199 consecutive subjects seen in the Division of Internal Medicine and Gastroenterology, Modena City Hospital, were enrolled. In the main arm of the present study, 44 men with sonographic fatty liver and 47 controls without, and 18 women with and 19 without fatty liver had their body mass index (an index of overall adiposity), hepatobiliary serum enzymes, serum cholesterol and triglycerides determined. All underwent oral glucose tolerance tests (estimated through the glucose area under the curve with the trapezoidal method). In the ancillary arm study, 17 other men with and 14 without, and 11 other women with and 29 without fatty liver had anthropometric measurements of body fat distribution (waist/hip, waist/height and skinfold thickness). RESULTS: Following statistical evaluation including univariate and multivariate analyses (main study), elevated body mass index was found to be an independent predictor of fatty liver in either sex. Glucose area under the curve and a central-type body fat distribution (ancillary study) predicted FL only in women. CONCLUSIONS: Fatty liver could be gender-related in the present series.

Body Mass Index↗

Reliability of body fat distribution measurements. The ARIC Study baseline cohort results. Atherosclerosis Risk in Communities Study.

OBJECTIVE: To estimate the reliability of skinfold and girth measurements, and ratios involving these measurements, commonly used in epidemiological and clinical studies as measures of body fat distribution. DESIGN: Repeated measurements of body fat distribution measures were scheduled on randomly selected participants at the baseline clinical examination of the ARIC Cohort Study, by the same or by different technicians. SETTING: Probability sample of 45-65 year old residents selected from four US communities. MEASUREMENTS: Subscapular and triceps skinfolds were taken twice using a Lange caliper on standardized right-side locations. Waist and hip girths were measured using an anthropometric tape applied at the level of umbilicus and of the maximal protrusion of the gluteal muscles, respectively. Repeated measurements were taken 1-2 h apart. RESULTS: Inter-technician measurements of triceps skinfolds, subscapular skinfolds, waist girth, hip girth, and waist/hip ratio each had high reliability (R > 0.91). The reliability coefficient for triceps/subscapular ratio (R = 0.81) was somewhat lower. For skinfold measures, intra-observer coefficient of variations are lower than the ones observed in previous studies, and inter-technician coefficient of variations are comparable. CONCLUSIONS: These results confirm previous findings which indicate that the reliability of girth measurements is greater than for skinfold measurements. As a consequence, the waist to hip ratio is less affected by measurement error than the skinfold ratio. Moreover, the expected gain in reliability from using the average of two skinfold measures, taken in succession, was not realized, indicating that when measurements are taken in rapid succession by the same technician, statistical independence between measures is questionable.

Analysis of Variance↗

Body fat distribution in pubertal girls quantified by magnetic resonance imaging.

We examined body fat distribution in relation to anthropometrically derived variables in 24 girls in early and late stages of puberty. The amounts of subcutaneous and intra-abdominal body fat were derived from transverse slices at the levels of the waist, hip and trochanter using magnetic resonance imaging (MRI), and were compared to the related circumferences, the circumference ratios and the trunk-to-extremity skinfold ratios. Waist, hip and trochanter circumferences were highly correlated to the respective related MRI total fat surface area both in early and late pubertal girls (r = 0.79-0.97), while waist circumference, and waist-hip, waist-thigh or skinfold ratios were not significantly correlated to intra-abdominal fat areas. Late pubertal girls (n = 11) were significantly taller, heavier and fatter compared to early pubertal girls (n = 13), yet their anthropometric waist-to-hip or waist-to-trochanter circumference ratios were significantly lower. The intra-abdominal fat area measured in a transverse MRI section at the level of the waist was 24.1 +/- 4.1 cm2 in early pubertal girls and 25.7 +/- 4.1 cm2 in late pubertal girls (mean +/- s.e.m.). As compared to early pubertal girls, the MRI derived amount of subcutaneous fat in late pubertal girls was significantly higher at the trochanter level (142.1 +/- 12.7 vs. 201.3 +/- 26.3 cm2; P less than 0.05). We conclude that circumferences at the trunk are good measures for the related amounts of fat in pubertal girls. In contrast conventional anthropometric measurements, such as trunk-to-extremity skinfold ratio or waist-to-hip circumference ratio, cannot be used to predict the amount of intra-abdominal fat in pubertal girls.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗

Quality of life, overweight, and body fat distribution in middle-aged men.

Measurements of obesity [body mass index (BMI)] and body fat distribution [waist-to-hip ratio (WHR)] were analyzed in 284 51-year-old men in relation to items about social, mental, and physical well-being from the Göteborg Quality of Life Instrument. Overweight participants (BMI > or = 25) reported a better home-family situation, appetite, and self-esteem, but decreased physical fitness and more pain in the legs compared with their leaner counterparts. Men with abdominal obesity (WHR > or = 1.0) experienced impaired health and physical fitness and lower self-esteem compared with those with WHR < 1.0. The abdominally obese participants were more often exhausted and experienced depressive symptoms. Abdominal pain was more frequent among those with WHR > or = 1.0. Overweight and abdominal obesity seem differently associated with social, mental, and physical well-being in men. Impaired quality of life may be causally related to the development of abdominal obesity; the mechanism involved might be increased cortisol secretion, which can redistribute body fat to central adipose tissue depots.

Body Constitution↗

Body fat distribution in pre- and post-menopausal women: metabolic and anthropometric variables and their inter-relationships.

The aim of the study was to compare body fat distribution and metabolic variables in pre- and post-menopausal women. Body fat distribution was measured using abdominal circumference and computerized tomography. No significant differences were found between the two groups as regards body weight, body mass index, waist-hip ratio and total abdominal adipose tissue areas. Subcutaneous abdominal adipose tissue areas were significantly higher in premenopausal women whereas visceral abdominal adipose tissue areas and the subcutaneous to visceral abdominal adipose tissue area ratios were significantly higher in post-menopausal subjects. After adjusting for body mass index, no significant differences emerged between the two groups as regards total abdominal adipose tissue areas, waist circumference, hip circumference and waist-hip circumference ratio; subcutaneous abdominal adipose tissue areas were significantly lower and both visceral abdominal adipose tissue areas and visceral to subcutaneous abdominal adipose tissue area ratios significantly higher in post-menopausal women (P less than 0.01). Basal glucose, sum of blood glucose values during oral glucose tolerance test and blood cholesterol values were significantly higher in the post-menopausal group (P less than 0.05), while no significant difference was observed in sum of blood insulin values during oral glucose tolerance test. Basal plasma insulin values, systolic blood pressure and diastolic blood pressure were higher in post-menopausal women, though the differences were not significant. Only blood cholesterol was significantly higher in post-menopausal women after adjusting for visceral abdominal adipose tissue areas. Positive correlations emerged between age and waist-hip ratio (P less than 0.05), visceral abdominal adipose tissue areas and the visceral to subcutaneous abdominal adipose tissue area ratio (P less than 0.001). A negative correlation was established between age and subcutaneous abdominal adipose tissue areas (P less than 0.01). There was a significant correlation between visceral abdominal adipose tissue areas and metabolic and haemodynamic variables in both pre- and post-menopausal women. In pre-menopausal women, body mass index correlated with basal glucose, basal insulin, sum of glucose during oral glucose tolerance test and systolic and diastolic blood pressure (P less than 0.05). When stepwise multiple regression analysis was used to evaluate the joint effect of anthropometric variables on metabolic variables, visceral abdominal adipose tissue area proved to be the most powerful variable for predicting metabolic disorders. Our data suggest that visceral abdominal adipose tissue areas and visceral to subcutaneous abdominal adipose tissue area ratios increase with age. Obesity correlates directly with the amount of subcutaneous fat, but not with the distribution pattern.(ABSTRACT TRUNCATED AT 400 WORDS)

Adipose Tissue↗

Body-fat distribution and serum lipids during the long-term follow-up of obese patients treated initially with a very-low-calorie diet.

To evaluate a long-term efficacy of very-low-calorie-diet (VLCD) treatment, 42 obese patients were reexamined 1 y after the initiation of the weight reduction by VLCD treatment for 1 mo. All the subjects participating in the long-term outpatient weight-reduction regime were divided into weight losers and regainers according to the weight change achieved at the end of 1-y follow-up. A final body weight decrease in weight losers was followed by a significant decline of total cholesterol-high-density-lipoprotein (HDL) cholesterol ratio together with significant rise of serum HDL cholesterol whereas almost all skinfold thicknesses declined. In weight regainers the sum of 10 skinfold thicknesses was the same at the end of follow-up as at the beginning of VLCD treatment, but body fat distribution was shifted towards the gynoid type when individual skinfold thicknesses were assessed. However, among the generally employed indexes of body fat distribution only waist-thigh ratio significantly decreased in weight losers. Nonsignificant differences in serum concentrations of total cholesterol, HDL cholesterol, and triglycerides between weight regainers and weight losers at the end of long-term follow-up suggest that some kind of adherence to weight reduction regime including physical exercise may favorably affect the lipid profile as well as body fat distribution independently on the body weight regained.

Adipose Tissue↗

Estradiol and progesterone endometrial receptors and body fat distribution in obese women.

The content of endometrial receptors for estradiol (ER) and progesterone (PR) was determined in three groups (10 women each) classified with respect to body fat distribution: (1) normal, nonobese; (2) lower body segment obesity and (3) upper body segment obesity. The ER in group 3 were significantly (p < 0.05) higher than those of group 1. As regards PR, no statistical differences were found among the three groups. These findings demonstrate different endometrial ER concentrations in obese women according to body fat distribution, greater in upper segment obesity. Probably the lack of progesterone as well as other factors in the endocrine milieu of these patients may determine the differences found; therefore, future research on this matter should be carried out.

Adult↗