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PubMed1998

Effects of the menopause transition on body fatness and body fat distribution.

OBJECTIVE: The menopause transition increases cardiovascular and metabolic disease risk, partly because of the adverse effects of estrogen deficiency on the plasma lipid-lipoprotein profile and cardiovascular function. This increased cardiovascular and metabolic disease risk may also be partially mediated by increased body fat, increased intra-abdominal adipose tissue accumulation, or both. The objective of this mini-review is to summarize studies that have investigated the relationships among the menopause transition, body fatness, and body fat distribution. RESEARCH METHODS AND PROCEDURES: A review of cross-sectional and longitudinal studies on menopause that examined body fatness and body fat distribution. RESULTS: Cross-sectional reports show that the menopause transition is related to modest increases in body mass index or total fatness, although not all studies found significant effects. Increased central adiposity appears to be related to menopause, independent of advancing age, but these results are methodology dependent. An independent effect of menopause on central body fatness was noted by the use of techniques such as DEXA or computed tomography, whereas studies using circumference measures showed discrepant results. Longitudinal studies showed that the menopause transition accelerated the increase in central adiposity, although no studies quantified changes in intra-abdominal fat by imaging techniques. DISCUSSION: Thus, additional longitudinal studies using more accurate measures of adiposity are needed to critically examine the effects of the menopause transition on total and central body fatness. Collectively, previous studies suggest that menopause is related to modest increase in total fatness and accelerated accumulation of central body fat that exceeds changes normally attributed to the aging process. These changes may increase the risk for cardiovascular and metabolic disease in aging women.

Abdomen↗
PubMed2003

Acculturation and psychosocial stress show differential relationships to insulin resistance (HOMA) and body fat distribution in two groups of blacks living in the US Virgin Islands.

The objective of this study was to determine whether acculturation and psychosocial stress exert differential effects on body fat distribution and insulin resistance among native-born African Americans and African-Caribbean immigrants living in the US Virgin Islands (USVI). Data collected from a non-diabetic sample of 183 USVI-born African Americans and 296 African-Caribbean immigrants age > 20 on the island of St. Croix, USVI were studied. Information on demographic characteristics, acculturation and psychosocial stress was collected by questionnaire. Anthropometric measurements were taken, and serum glucose and insulin were measured from fasting blood samples. Insulin resistance was estimated by the homeostasis model assessment (HOMA) method. The results showed that in multivariate regression analyses, controlling for age, education, gender, BMI, waist circumference, family history of diabetes, smoking and alcohol consumption, acculturation was independently related to logarithm of HOMA (InHOMA) scores among USVI-born African Americans, but not among African-Caribbean immigrants. In contrast, among USVI-born African Americans psychosocial stress was not significantly related to InHOMA, while among African-Caribbean immigrants psychosocial stress was independently related to InHOMA in models that included BMI, but not in those which included waist circumference. This study suggests that acculturation and psychosocial stress may have a differential effect on body fat distribution and insulin resistance among native-born and immigrant blacks living in the US Virgin Islands.

Acculturation↗
PubMed1990

[Obesity, body fat distribution and the incidence of breast, cervical, endometrial and ovarian carcinomas].

The connection of body fat distribution (BFD) and the risk of developing mammary, cervical, endometrial or ovarian carcinoma was ascertained for 163 patients with carcinoma (mean age 49.9 [19-78] years) and 489 controls of comparable age and body-mass index. BFD was expressed as the ratio of waist and hip circumference (T/H ratio of 0.822 vs 0.781 and 0.826 vs 0.789, respectively; P less than 0.01). In premenopausal women with mammary or cervical carcinoma and in all postmenopausal women BFD was similar to that in the control subjects. A common cause of android obesity and ovarian or endometrial carcinoma may be a reduction of sex-hormone-binding globulins with an elevated serum level of free androgens and oestrogens.

Adult↗
PubMed1993

Effect of weight loss on regional body fat distribution in premenopausal women.

This study evaluates effects of weight loss on regional fat distribution and compares waist-to-hip ratio (WHR) and computed tomography (CT) as methods of assessing body fat distribution in 16 premenopausal obese women (body weight 104.3 +/- 18.1 kg, WHR 0.84 +/- 0.08). Mean weight loss was 6.6 kg after 2 wk on a very-low-energy diet (VLED) and 16 kg after 14 additional weeks on a low-energy diet (LED). Visceral abdominal fat and sagittal diameter significantly decreased after both the VLED and LED. Subcutaneous abdominal fat decreased significantly only after the LED. WHR showed no significant reduction over the entire study period. The decrease in visceral fat after both the VLED and LED was greater than the decrease in subcutaneous fat. Changes in body weight over the entire study period correlated with initial body weight and with total and subcutaneous abdominal fat, but not with visceral abdominal fat. They also correlated with changes in subcutaneous abdominal fat, visceral abdominal fat, sagittal diameter, and WHR. In conclusion, weight loss is associated with changes in regional fat distribution. In premenopausal subjects weight loss correlates more closely with the amount of subcutaneous than visceral fat.

Adipose Tissue↗
PubMed1993

The hypothalamic-pituitary-adrenal axis in obese women with different patterns of body fat distribution.

To investigate whether obese subjects with abdominal obesity may be characterized by hyperactivity of the hypothalamic-pituitary-adrenal axis, we examined two groups of obese women with a waist to hip ratio (WHR) lower than 0.80 (n = 13), therefore having peripheral body fat distribution (P-BFD), or a WHR higher than 0.85 (n = 12), thus having abdominal body fat distribution (A-BFD). A group of seven normal weight healthy women served as controls. All subjects underwent the following protocol study that included 1) measurement of daily urinary free cortisol excretion rate; 2) a CRF test (human CRF, 1 microgram/kg BW, as iv bolus), with blood samples taken at regular intervals for ACTH and cortisol determination; and 3) an ACTH test, performed by administering two boli of ACTH (Synacthen, 0.2 microgram/kg BW, iv), at 90-min intervals, with blood samples taken for cortisol determination. Each woman also had a control saline study. Basal levels of both ACTH and cortisol rose significantly after CRF administration in all groups, but this increase was significantly higher in A-BFD than in P-BFD and control women. A significant correlation was found between the incremental area of cortisol and that of ACTH during the CRF test (r = 0.502), but not between these parameters and WHR values. Although the cortisol increase after the ACTH test was higher in A-BFD than in the other groups, these differences were only significant at 60 min during the test and when the analysis for repeated measures was applied. On the contrary, the incremental cortisol area after the ACTH test was not significantly different in the three groups. Moreover, it was not significantly correlated with the incremental cortisol area after CRF test or WHR values. Daily urinary free cortisol excretion rates (per g creatinine), however, were significantly higher in A-BFD than in P-BFD and control women. These results, therefore, suggest that obese women with A-BFD may have hyperactivity of the hypothalamic-pituitary-adrenal axis. This abnormality could be central in origin, due to hypersecretion of CRF or ACTH; alternatively, it could represent an adaptive phenomenon secondary to a state of functional cortisol resistance.

Abdomen↗
PubMed1992

Familial resemblance of body fat distribution: the Minneapolis Children's Blood Pressure Study.

Although many reports have shown that obesity (as defined by weight for height indices) tends to run in families, considerably fewer data are available concerning the familial resemblance of body fat distribution as defined by the waist to hip ratio (WHR), which is a risk factor for coronary heart disease. This question was examined among 712 participants of the Minneapolis Children's Blood Pressure Study. For each family member separately (son, daughter, father and mother) the distribution of the WHR was divided into quintiles. Quintiles of WHR were cross-classified between child and parent to examine the proportion of subjects clustering in each quintile. A significantly higher than expected proportion of parent-child WHRs clustered in the top quintile. For example, 42.5% of sones were placed in the top quintile of their father's WHR (P less than 0.001) and 36.7% of daughters were placed in the top quintile of their mother's WHR (P less than 0.001). Multiple linear regression analyses revealed that these findings were independent of parent and child body mass indices and other covariates. These results indicate significant familial aggregation of body fat distribution and may aid in suggesting specific primary preventive strategies targetted at appropriate families to reduce the risk of cardiovascular disease.

Adipose Tissue↗
PubMed1992

Is abdominal body fat distribution a major explanation for the sex difference in the incidence of myocardial infarction? The study of men born in 1913 and the study of women, Göteborg, Sweden.

The authors considered whether the difference in body fat distribution between men and women, measured as waist:hip ratio, might explain part of the sex difference in coronary heart disease incidence in prospective population studies of 1,462 women and 792 men. In these studies, conducted in Sweden, men were found to have about four times higher odds for coronary heart disease than women during a 12-year follow-up period (men, 1967 to 1979; women, 1968-1969 to 1980-1981). Controlling for differences in blood pressure, serum cholesterol, smoking, and body mass index only marginally altered the magnitude of the male-female difference. When waist:hip ratio, which predicted coronary heart disease rates in both sexes, was also considered, the sex difference in coronary heart disease risk was significantly reduced and virtually disappeared (odds ratios = 1.0-1.1; nonsignificant). The findings suggest that body fat distribution or a factor highly correlated with waist:hip ratio (genetic, hormonal, or behavioral) may help to explain the sex differences in coronary heart disease.

Abdomen↗
PubMed1994

Body fat distribution and its association with metabolic and hormonal risk factors in women with angiographically assessed coronary artery disease. Evidence for the presence of a metabolic syndrome.

The aim of this study was to investigate the pattern of body fat distribution and its association with metabolic and hormonal cardiovascular risk factors in women undergoing coronary angiography. Thirty of the 51 women exhibited significant coronary artery disease (CAD) (group A), whereas the remaining 21 subjects were free of major coronary stenoses (group B). Twenty-five healthy women without clinical signs of CAD served as a control group (group C). Despite comparable age and body mass index the women of group A had a significantly higher waist-to-hip ratio (WHR), a measure of the pattern of body fat distribution, than those of group C (0.88 +/- 0.07 vs. 0.78 +/- 0.06, P < 0.01). In an oral glucose tolerance test a high prevalence of impaired glucose tolerance or diabetes was found in groups A and B (53% and 63%, respectively) compared with group C (4%, each P < 0.01). The women of groups A and B showed significantly higher blood pressure and triglyceride levels as well as lower HDL-cholesterol than those of group C, whereas total and LDL-cholesterol were not different between the groups. The serum concentrations of testosterone, sex-hormone-binding globulin (SHBG) and cortisol were comparable between the three groups and correlation analysis revealed positive associations between androgens and WHR (r = 0.36, P < 0.01) and serum insulin (r = 0.34, P < 0.01) respectively. These findings indicate that women with angiographically confirmed CAD, and those with clinical signs of CAD but without significant stenosis, frequently exhibit a metabolic syndrome characterized by a cluster of metabolic abnormalities which may underlie the atherosclerotic process.

Adipose Tissue↗
PubMed1991

Cigarette smoking, dietary intake, and physical activity: effects on body fat distribution--the Normative Aging Study.

Studies have indicated that although smokers weigh less than nonsmokers, smokers have greater waist-to-hip circumference ratios after adjustment for age and body mass index (BMI). The purpose of this investigation was to determine whether factors associated with smoking, such as dietary intake, alcohol intake, and physical activity, modified or confounded the relationship between smoking and body fat distribution. The study used cross-sectional data for 765 men aged 43-85 y from the Normative Aging Study. Current smokers were found to have a greater amount of central adiposity, as represented by the abdomen-to-hip circumference ratio (abdomen-hip ratio), than did former smokers and people who never smoked after adjustment for age, BMI, dietary and alcohol intakes, and physical activity. Multiple-linear-regression analysis revealed that physical activity was negatively associated with and alcohol intake was positively associated with the abdomen-hip ratio. These results suggest a direct effect of smoking on body fat distribution, independent of other smoking-related behaviors.

Adipose Tissue↗
PubMedDate not supplied

[Obesity, central body fat distribution and ischemic cardiopathy in the Mexican population].

An age- and sex-matched case-control study was conducted to evaluate the relation of obesity and body fat distribution with the occurrence of coronary heart disease in mexicans. Obesity was measured in 150 couples by bioelectrical impedance with an EZ comp 1000 computer (body composition), and by estimating the body mass index. Skinfold anthropometry was used to assess central fat distribution. Two fat distribution indices were calculated, a ratio of central to peripheral skinfolds (central pattern) and a ratio of upper to lower body skinfolds (android pattern). Those subjects who had a percentage of body fat, by bioelectrical impedance, greater than 20%, had a 20 fold higher risk to develop acute myocardial infarction. The risk of coronary heart disease was also high in those with a central fat distribution and even higher in those with an android pattern. Both obesity and abdominal fat distribution are closely related to coronary heart disease. There is a need to promote life-styles changes and to reduce obesity, to prevent the occurrence of coronary heart disease in Mexico.

Aged↗
PubMed2006

Comparison of body fat distribution and blood lipid profiles according to Trp64Arg polymorphism for the beta 3-adrenergic receptor gene in Korean middle-aged women.

The aim of this study was to determine whether there was an association between body fat distribution, blood lipid profiles, and beta 3-adrenergic receptor gene polymorphism in Korean middle-aged women. Subjects were grouped according to BMI as obese (> or = 5 BMI, n = 95) or non-obese (BMI<25, n = 93). The Trp64Arg mutation of the beta 3-adrenergic receptor gene was detected by PCR-RFLP. Skinfold thickness, body circumference, intra-abdominal fat area by CT, and blood lipid profiles were also measured. Data were compared using ANOVA, Bonferroni t-test, and Chi-square. Significance for statistical analyses were set at p<0.05. In the obese group, 63.16% were Trp64Trp homozygotes and 36.84% were Trp64Arg heterozygotes, compared to 80.65% who were Trp64Trp homozygotes and 19.35% who were Trp64Arg heterozygotes in the non-obese group. These results indicated a significant (chi-square = 4.943, p<0.05) difference between the two groups. Frequency of the Arg64 allele in the obese group (16.84%) showed a significant (chi-square = 4.185, p<0.05) difference as compared to the non-obese group (9.68%). Skinfold thickness and body circumference of the Trp64Arg heterozygote group showed a consistent increase as compared to the Trp64Trp homozygote group. Visceral fat area and VSR of Trp64Arg heterozygote group showed a higher tendency than Trp64Trp homozygotes in the obese group, but these differences were not statistically significant. In conclusion, the Trp64Arg polymorphism of the beta 3-adrenergic receptor gene is associated with obesity in middle-aged Korean women, but it is difficult to suggest the prominent association of the Trp64Arg polymorphism of the beta 3-adrenergic receptor gene with prevalence of abdominal obesity or dyslipidemia in Korean middle-aged women.

Arginine↗
PubMed1989

Biology of regional body fat distribution: relationship to non-insulin-dependent diabetes mellitus.

Our studies support the view that body fat distribution and the accompanying metabolic abnormalities could be exacerabated by variability in the androgenic/estrogenic balance. Sensitivity to the androgenic milieu might be initiated by an early developmental aberration in sexual dimorphism. The possible direct and indirect sites of interaction between androgenic activity and the abnormal metabolic pathways in upper body obesity are summarized in Figure 19.

Adipose Tissue↗
PubMed1993

Insulin and androgen relationships with abdominal body fat distribution in women with and without hyperandrogenism.

This retrospective study was carried out to investigate, in a large group of hyperandrogenized women with polycystic ovary syndrome (PCOS) and nonhyperandrogenized control women, the interrelationships between sex steroids and indices of body fat distribution. Moreover, we investigated the relationships between these parameters and insulin blood levels, since obese women with abdominal pattern of fat distribution (A-BFD), as well as those with PCOS (either obese and nonobese) are characterized by moderate to severe hyperinsulinemia. A sample of 100 women with PCOS and that of 138 women without clinical signs of hyperandrogenism, who served as a control group, were investigated. The waist to hip circumference ratio (WHR) which was used to define different patterns of fat topography was significantly (p < 0.05) higher in PCOS (0.84 +/- 0.10) than in control women (0.81 +/- 0.08). In both groups, women with WHR values lower than or equal to 0.85 were considered as having a peripheral pattern of body fat distribution (P-BFD) whereas those having WHR values higher than 0.85 had A-BFD. Compared to controls, women with PCOS had higher LH, androgen and estrogen concentrations. In both PCOS and controls there were no differences in sex hormone levels between women with different patterns of fat distribution, except androstenedione, which levels were significantly higher in women with A-BFD than with P-BFD. Women with PCOS showed significantly higher insulin levels than controls. Moreover, in both groups fasting and stimulated insulin were significantly higher in women with A-BFD than in those with P-BFD.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗
PubMed1999

Body fat distribution and obesity in pre- and postmenopausal breast cancer.

BACKGROUND: Excessive body weight is known to increase the risk of postmenopausal, but not premenopausal breast cancer. Some studies have suggested that being overweight is protective against premenopausal breast cancer, but the evidence is not compelling. Much less is known about the role of body fat distribution in either pre- or postmenopausal breast cancer. METHODS: Breast cancer risk was examined in relation to body weight, height, Quetelet index (kg/m2), and waist/hip ratio (WHR) in the New York University Women's Health Study, a prospective cohort study. Cases were 109 premenopausal and 150 postmenopausal women diagnosed with breast cancer between 1985 and 1994. Non-cases were 8,157 cohort members free of breast cancer. RESULTS: Among premenopausal women, there was an increasing risk of breast cancer with increasing WHR. The relative risk (RR) of breast cancer increased to 1.72 (95% confidence interval [CI]: 1.0-3.1) in the upper quartile of WHR. The association was limited to subjects who had elevated Quetelet index, but not among those with lower weight. Overall, Quetelet index itself was not related to breast cancer risk in the premenopausal group, but there was a protective association among those ranking below the median WHR. In postmenopausal women, the RR for breast cancer increased to 2.36 (95% CI: 1.4-3.9) in the upper quartile of Quetelet index, but there was no association with WHR. Height was not associated with breast cancer in this study. CONCLUSIONS: The study confirms that excessive body weight increases breast cancer risk in postmenopausal women. On the contrary, in premenopausal women, excessive body weight may be protective among women who have a lower-body type of fat accumulation (low WHR). An upper-body fat accumulation (high WHR) is a predictor of breast cancer risk in premenopausal women, and this effect is especially pronounced among subjects who are overweight.

Adipose Tissue↗
PubMed1997

Total and sports activity in older men and women: relation with body fat distribution.

Physical activity is reported to be inversely associated with abdominal fat in young and middle-aged populations, which may in part explain its beneficial effect on health. However, it is unclear whether this inverse association exists in older people. The authors investigated the relation of total and sports activity with fat distribution in a population-based sample of 1,163 men and 1,154 women aged 55-85 years, representative of the Dutch elderly population in 1992-1993. Waist and hip circumference and their ratio (WHR) were used as indicators of fat distribution. Physical activity of the previous 2 weeks was obtained by questionnaire. Among men, total physical activity time was negatively associated with waist (98.3 +/- 0.4 cm in the most active quartile vs. 100.5 +/- 0.4 cm in the least active quartile, p = 0.0001 (mean +/- standard error)) and WHR (0.98 +/- 0.00 vs. 0.99 +/- 0.00, p = 0.005) after adjustment for age, education level, body mass index, smoking, and season of the year. This association was not observed among women. Men and women who participated in sports activity had a smaller waist and WHR than those who did not. After adjustment, the time spent on sports activity was negatively associated with waist (p = 0.004 for men and p = 0.07 for women) and WHR (p = 0.03 for men and p = 0.09 for women) in both sexes. No relation between total physical activity time and body fat distribution was observed among respondents who were not participating in any sports activity (p > or = 0.17), suggesting that performance of activities of low/moderate intensity has no effect on body fat distribution. No associations with hip circumference were observed. The results did not change after additional adjustment for chronic illness. The results of this large-scale study show that physical activity, and specifically intensive activity, is negatively associated with abdominal fat in older people.

Adipose Tissue↗
PubMed1989

Influence of body fat distribution on free fatty acid metabolism in obesity.

UNLABELLED: In order to determine whether differences in body fat distribution result in specific abnormalities of free fatty acid (FFA) metabolism, palmitate turnover, a measure of systemic adipose tissue lipolysis, was measured in 10 women with upper body obesity, 9 women with lower body obesity, and 8 nonobese women under overnight postabsorptive (basal), epinephrine stimulated and insulin suppressed conditions. RESULTS: Upper body obese women had greater (P less than 0.005) basal palmitate turnover than lower body obese or nonobese women (2.8 +/- 0.2 vs. 2.1 +/- 0.2 vs. 1.8 +/- 0.2 mumol.kg lean body mass (LBM)-1.min-1, respectively), but a reduced (P less than 0.05) net lipolytic response to epinephrine (59 +/- 7 vs. 79 +/- 5 vs. 81 +/- 7 mumol palmitate/kg LBM, respectively). Both types of obesity were associated with impaired suppression of FFA turnover in response to euglycemic hyperinsulinemia compared to nonobese women (P less than 0.005). These specific differences in FFA metabolism may reflect adipocyte heterogeneity, which may in turn affect the metabolic aberrations associated with different types of obesity. These findings emphasize the need to characterize obese subjects before studies.

Adipose Tissue↗
PubMed2001

A comparative study of adiposity and central body fat distribution of normotensive and hypertensive older Bengalee Hindu women of Calcutta, India.

A comparative investigation of 134 normotensive and 145 hypertensive Bengalee Hindu older women (aged 50 years and above) of Kalighat, South Calcutta, India, was undertaken to study differences in levels of adiposity and central body fat distribution between the two groups. Results revealed that hypertensive (HT) subjects had significantly (p < 0.05) greater (age controlled) mean values of weight, body mass index (BMI), minimum waist circumference (MWC) and waist-hip ratio (WHR) compared with normotensive (NT) subjects. Percentile distributions for all these variables and index showed consistently higher values among the HT patients as compared with NT subjects. The frequency of central obesity (WHR > 0.85) was significantly higher (chi2 = 5.16178, p < 0.025) among HT (62.8%) patients compared with NT (49.3%) subjects. Multiple regression analyses revealed that BMI and WHR had significant effect (age controlled) on SBP (BMI: p < 0.01; WHR: p < 0.005) and DBP (BMI: p < 0.05; WHR: p < 0.005). The significant impact (p < 0.05) of WHR on SBP and DBP remained even after controlling for BMI. Thus, these results indicated that hypertensive individuals have significantly enhanced levels of central body fat distribution (WHR), irrespective of their age and level of generalized adiposity (BMI), compared with normotensive subjects.

Abdomen↗
PubMed1993

Obesity and body fat distribution in New Zealanders: a pattern of coronary heart disease risk.

AIMS: To describe the prevalence of obesity and the body fat distribution of New Zealanders. To discuss this in the context of the coronary heart disease risk. METHODS: Body weight and height, body mass index (BMI), waist:hip ratio (WHR) and six skinfold measurements were determined for 3204 randomly selected New Zealanders who responded to an invitation to a health check (response rate 56%). RESULTS: In the study sample BMI generally increased with age. Fifty five percent of men and 38 per cent of women aged 18-64 had a BMI exceeding 25, and of these 13 per cent and 10 per cent were obese (BMI > 30). WHR was greater in men than in women of all ages, and a third of the men and a quarter of the women had values exceeding 0.9 and 0.8 respectively. Central skinfold measurements (subscapular, suprailiac and abdominal) were lowest in young men, but rose markedly with age and were similar to women above age 35. Limb skinfolds were lower in men. CONCLUSIONS: This survey indicates that a large percentage of New Zealanders are overweight or obese and their excess body fat tends to be centrally distributed, especially in men. Obesity is thus a significant health problem in New Zealand.

Adipose Tissue↗