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PubMed2005

[Serum adiponectin concentration in relation to body fat distribution and tissue insulin sensitivity in the glucose clamp study].

OBJECTIVE: To study serum adiponectin level in relation to body fat distribution and tissue insulin sensitivity by using the extended hyperinsulinemic euglycemic clamp technique. METHODS: Extended hyperinsulinemic euglycemic clamp was performed in 44 Chinese individuals with normal glucose tolerance from Shanghai area, including 12 subjects with normal weight [body mass index (BMI) < 25 kg/m(2)], 19 with overweight (25 kg/m(2) < or = BMI < 30 kg/m(2)), and 13 with obesity (BMI > or = 30 kg/m(2)). The rate of insulin-mediated glucose disposal (Rd) during the steady state of glucose clamp was used to assess the peripheral tissue insulin sensitivity. Total body fat depots [BMI, percentage of body fat (FAT%), and body fat mass (FM)], regional body fat depots [waist circumference (W), hip circumference (H), W and H ratio (WHR), abdominal subcutaneous fat area (SA), intra-abdominal fat area (VA), and femoral subcutaneous fat area (FA)] were measured on all subjects. Fasting serum adiponectin level was determined by radioimmunoassay. RESULTS: (1) After the adjustment for age and sex, the serum adiponectin concentrations in the overweight and obesity groups were (8.7 +/- 4.8) mg/L and (6.7 +/- 0.8) mg/L, both significantly lower than that in the normal weight group [(15.7 +/- 1.8) mg/L, both P < 0.01]. (2) Serum adiponectin concentration was negatively correlated with BMI, W, WHR, FAT%, FM and VA, especially with W and VA (r = -0.46, P < 0.01, and r = -0.53, P < 0.01). (3) Serum adiponectin concentration was positively correlated with Rd (r = 0.52, P < 0.01) and the rate of glycogen synthesis (r = 0.36, P < 0.05), and was negatively correlated with free fatty acid level (r = -0.41, P < 0.05). (4) Stepwise regression analysis indicated that in addition to sex, BMI, WHR or VA and SA, serum adiponectin level was also the independent contributing factor for Rd, which explains 3.52% and 4.84% of the variance respectively (P all < 0.05). CONCLUSION: (1) The decrease in serum adiponectin level is associated with the increase of total body fat depot, especially the increase of total body fat depot in intra-abdominal fat area. (2) Serum adiponectin level is an independent contributing factor for insulin sensitivity.

Adiponectin↗
PubMed1991

Obesity, body fat distribution, and sex hormones in breast cancer patients.

This study addresses the relationship between female sex hormones, obesity, body fat distribution, and breast cancer. Increasing obesity correlated with a progressive fall in sex hormone-binding globulin (SHBG) level and an increase in testosterone level. Premenopausal breast cancer patients were found to have significantly lower levels of SHBG compared with age-matched and weight-matched controls. This difference in SHBG level was not noted in postmenopausal breast cancer patients. The SHBG level decreased with increasing upper body fat localization in breast cancer patients and controls. This effect was more marked in breast cancer patients which may explain our earlier finding that women with upper body fat localization are at increased risk for developing breast cancer.

Adult↗
PubMed1999

Environmental contaminants and body fat distribution.

The effect of body mass index (BMI) and waist:hip ratio (WHR) on plasma levels of organochlorines [i.e., 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (DDE)] was investigated in a sample of black and white women drawn from a population-based study in North Carolina. Organochlorine levels were determined in plasma samples from 99 women selected on the basis of race (black versus white) and quartile of the WHR (1st versus 4th). Of a panel of 20 organochlorine compounds tested, only DDE was detectable in most study subjects. Measurements of height, weight, and waist and hip circumferences were taken during an in-person interview. Information was elicited regarding dietary, residential, and breast-feeding histories. Results of multiple regression analyses indicate that black women had significantly higher plasma levels of DDE than white women. These levels were independent of BMI and WHR. BMI but not WHR was also found to be an independent predictor of DDE plasma level. These results suggest that black/white differences should be considered in studies that explore the relationship between environmental contaminants and various disease outcomes, such as breast cancer risk. In addition, BMI may affect circulating levels of contaminants and should also be considered a potentially important modifying factor for exposure to lipophilic substances.

Aged↗
PubMedDate not supplied

Is body fat distribution associated with cardiovascular risk factors in childhood?

The authors studied the association of cardiovascular risk variables with body fat distribution (BFD) in a cross-sectional sample of 743 Texas schoolchildren of both sexes ages 6-14 years. This association is well known in adults and several useful indices of BFD are available. Whether they are applicable to children remains a question of importance for epidemiological investigations in this age group. Canonical correlations between anthropometric (five skinfolds, four circumferences) and risk (blood pressures, cholesterol, pulse) variables ranged from 0.37 to 0.82 depending on sex/age group (p < 0.01). The skinfold vector suggested an association of risk with central fat at most but not all ages. The circumference vectors, on the other hand, suggest that size or fatness, not BFD, was related to risk. Partial correlation and stepwise regression of fatness and BFD indices with cardiovascular risk factors as dependent variables, showed that 'fatness' or 'size' was more clearly associated with risk factors than BFD. The variables most consistently entering the regression were hip circumference and sum of skinfolds. These results contrast with studies of adults or sexually mature adolescents, in which BFD is more clearly related to CV risk variables and the hip circumference is a 'low-risk' variable.

Adipose Tissue↗
PubMedDate not supplied

Relation of endometrial cancer risk to past and contemporary body size and body fat distribution.

In a multicenter case-control study that included 403 cases and 297 controls, we examined the relation of past and contemporary body size, including body fat distribution, to the risk of endometrial cancer. The relative contributions of past and contemporary body size were assessed by examining weight and height histories provided by the subjects. Anthropometric indicators thought to reflect early environmental influences (e.g., height and sitting height), current weight, and fat distribution patterns were measured directly. Height was not a risk factor for endometrial cancer, but inexplicably, sitting height was inversely associated with risk. Weight during early adulthood appeared to be directly related to disease risk, but the association was explained by contemporary weight and thus weight gain during adulthood. While contemporary weight was associated with risk of endometrial cancer, the effect was restricted to those in the top quartile. Women whose measured weight at interview exceeded 78 kg had 2.3 times the risk of those weighing less than 58 kg (95% confidence interval, 1.4 to 3.7). Upper-body obesity (waist-to-thigh circumference ratio) was a risk factor independent of body weight. After adjustment for weight, the relative risks of endometrial cancer across increasing quartiles of upper-body obesity were 1.0, 1.5, 1.8, and 2.6 (P for trend < 0.001). These data indicate that both obesity and the distribution of adipose tissue accumulated during adult life increase endometrial cancer risk substantially.

Adipose Tissue↗
PubMed1987

Endogenous estrogens and breast cancer a possible relationship between body fat distribution and estrogen availability.

The growth of hormone-dependent human breast cancer is related to the activity of endogenous estrogens. The evidence for an etiological role of endogenous estrogens is still circumstantial. Life style and in particular dietary factors are held responsible for large geographic differences and time-trends in breast cancer incidence. The measurement of urinary estrogen metabolites and plasma estrogens has given no satisfactory explanation for the latter. The newly developed interest in the bioavailability of plasma sex steroids may offer a better understanding of the biology and epidemiology of breast cancer. Based on our observations on the relationship between plasma free fatty acids and estrogen-protein-binding and recently gained insight in the metabolic consequences of different types of body fat distribution we postulate that Western life style may act on breast cancer incidence through an influence on body fat distribution and resulting changes in sex steroid availability.

Abdomen↗
PubMed1992

Body fat distribution and coronary heart disease mortality in subjects with impaired glucose tolerance or diabetes mellitus: the Paris Prospective Study, 15-year follow-up.

The Paris Prospective Study is a long-term, large-scale study of the factors predicting coronary heart disease in healthy middle-aged men. Subjects with impaired glucose tolerance or diabetes (not treated by insulin) at the first follow-up examination (n = 973) were selected from the total cohort for a separate analysis of the predictors of death from coronary heart disease. An index of body fat distribution, the iliac to thigh ratio, was entered into the list of potentially predictive variables, despite the fact that it had been measured one year before the first follow-up examination. After 15 years of mean follow-up, 41 of the selected subjects had died from coronary heart disease. Univariate analysis showed that these subjects differed from the subjects who died of another cause or who were alive at 15 years on the following variables: iliac to thigh ratio (p less than 0.0005), plasma triglyceride level (p less than 0.006), systolic blood pressure (p less than 0.01), and body mass index (p less than 0.04). In multivariate regression analysis using the Cox model, only iliac to thigh ratio and triglyceride plasma level achieved statistical significance as independent predictors. This result supports the current hypothesis that upper-body fat distribution, a characteristic trait of subjects with diabetes of glucose intolerance, plays an important role towards their high cardiovascular risk. However, it is unlikely that this role would be mediated through the lipid abnormalities that have been described as associated with upper-body fat deposition.

Adipose Tissue↗
PubMed1997

Coronary atherosclerosis and myocardial hypertrophy in relation to body fat distribution in healthy women: an autopsy study on 33 violent deaths.

OBJECTIVE: To determine the relationship between cardiovascular pathology and body fat distribution in healthy women with no ante mortem clinical evidence of cardiovascular disease. SUBJECTS: Thirty-three female forensic autopsy cases of sudden death from violent causes. METHODS: Body height and weight, the circumferences of the waist and hip and the thicknesses of the subscapular and abdominal subcutaneous fat were measured, and Body Mass Index (BMI) and Waist-to-Hip ratio (WHR) were calculated. Omental, mesenterial and perirenal fat deposits were weighted. Heart weight was indexed to height (2.7), the degree of coronary narrowing was determined in each artery, and myocardial collagen volume fraction and myocyte cross-sectional area were measured. RESULTS: The degree of coronary narrowing, heart weight in absolute terms and indexed to height (2.7), myocyte cross-sectional area and all the measures of obesity were significantly positively correlated with age. Regression of coronary narrowing on measures of obesity indicated that a quadratic model fitted the data for BMI, waist circumference and intra-abdominal fat better than a linear one. After adjusting for age, the degree of coronary narrowing was related to tertiles of BMI, waist circumference, WHR and intra-abdominal fat, the severity of the narrowing being most marked in the second tertile of BMI (24.0-31.0), waist circumference (80-96 cm) and intra-abdominal fat (500-1700 g), but in the third tertile of WHR (over 0.92). Regression on heart weight/height (2.7) on the aforementioned measures of obesity indicated a clearly linear association and heart weight indexed to height (2.7) was related to tertiles of BMI, waist circumference and WHR, and also to tertiles of intra-abdominal fat. CONCLUSIONS: The results suggest that body fatness and abdominal accumulation of fat are associated with the severity of coronary atherosclerosis and myocardial hypertrophy in women with no clinical evidence of cardiovascular disease, but the relationship between coronary lesions and BMI is not linear. Both coronary lesions and myocardial hypertrophy are more advanced as the numerical value for WHR increases in women. Future autopsy studies should be directed at young women with increased WHR in order to determine their risk of developing life-threatening lesions in the atherosclerosis-prone regions of the coronary tree.

Adult↗
PubMed2006

Evidence for a role of developmental genes in the origin of obesity and body fat distribution.

Obesity, especially central obesity, is a hereditable trait associated with a high risk for development of diabetes and metabolic disorders. Combined gene expression analysis of adipocyte- and preadipocyte-containing fractions from intraabdominal and subcutaneous adipose tissue of mice revealed coordinated depot-specific differences in expression of multiple genes involved in embryonic development and pattern specification. These differences were intrinsic and persisted during in vitro culture and differentiation. Similar depot-specific differences in expression of developmental genes were observed in human subcutaneous versus visceral adipose tissue. Furthermore, in humans, several genes exhibited changes in expression that correlated closely with body mass index and/or waist/hip ratio. Together, these data suggest that genetically programmed developmental differences in adipocytes and their precursors in different regions of the body play an important role in obesity, body fat distribution, and potential functional differences between internal and subcutaneous adipose tissue.

Adipocytes↗
PubMed2001

Obesity, body fat distribution and coronary atherosclerosis among Japanese men and women.

OBJECTIVE: To investigate the relation of the obesity and body-fat distribution with angiographically defined coronary atherosclerosis. DESIGN: Cross-sectional study in a clinical setting. SUBJECTS: Three hundred and twenty men (median age, 59 y) and 212 women (median age, 67 y) who underwent coronary angiography for suspected or known coronary heart disease at 5 cardiology departments between September 1996 and August 1997. Patients with disease duration >1 y were excluded. MEASUREMENTS: The body mass index (BMI) and the waist to hip circumference ratio (WHR) were used as main exposure variables, and either the presence of significant coronary stenosis or the Gensini's score (> or =10 vs<10) as an outcome variable, in a sex-specific multiple logistic regression analysis controlling for age, hospital, and other coronary risk factors. RESULTS: Among male patients, BMI was progressively higher with an increasing number of vessels involved (P trend=0.05); the adjusted odds ratios for the presence of significant stenosis across quartiles of BMI were 1.0 (reference), 1.1, 1.9 and 2.5 (P trend=0.02), and the positive association was more pronounced for younger patients. Among females, however, such associations were not evident. Employing the Gensini's score as an outcome gave similar results. WHR was not significantly associated with either outcome regardless of sex. CONCLUSION: These results suggested that BMI was predictive of coronary stenosis among male patients, but not among female patients. Unlike most previous studies, this study failed to detect a positive association with WHR.

Adipose Tissue↗
PubMed1986

Body fat distribution and cardiovascular risk in middle-aged people in southern Italy.

Skinfold thickness, % body fat content, body mass index, systolic and diastolic blood pressure, plasma glucose, serum cholesterol and triglycerides have been measured in 132 middle-aged men (mean age 39.8 +/- 9.9, range 20-59 yr) and in 114 middle-aged women (mean age 39.1 +/- 9.3, range 20-59 yr). Anthropometric data were related to blood pressure and biochemical parameters by using a straight-line regression analysis. Body mass index, % body fat content, subscapular and suprailiac skinfold thickness, consideral as indicative of splanchnic fat distribution, were positively correlated to blood pressure, plasma glucose, cholesterol and triglycerides. Triceps skinfold thickness, an index of peripheral fat distribution, showed weaker or no correlation with these parameters. These preliminary observations in the Neapolitan area support the hypothesis that, in addition to body mass index and % body fat content, preferential splanchnic fat distribution is associated with cardiovascular risk factors.

Adipose Tissue↗
PubMed1991

Insulin sensitivity, glucose effectiveness, and body fat distribution pattern in nondiabetic offspring of patients with NIDDM.

OBJECTIVE: To determine the relationship of insulin sensitivity (SI), glucose effectiveness (glucose-dependent glucose transport [SG]), and body fat distribution patterns in glucose-tolerant offspring of patients with non-insulin-dependent diabetes mellitus (NIDDM). RESEARCH DESIGN AND METHODS: Ten glucose-tolerant offspring of patients with NIDDM and 10 age-, sex-, and weight-matched healthy control subjects without family history of diabetes were studied with the minimal model method of Bergman et al. Body fat composition and distribution pattern were assessed by the bioelectrical impedance analyzer and waist-hip circumference ratios (WHR), respectively, in each subject. RESULTS: Mean fasting serum glucose (4.39 +/- 0.17 vs. 3.94 +/- 0.17 mM) and postglucose peak (18.50 +/- 1.50 vs. 13.20 +/- 1.06 mM) levels were significantly greater (P less than 0.05) in the offspring than in the control subjects. Mean fasting serum insulin levels were slightly greater but not significantly different in the offspring versus control subjects (64 +/- 14 vs. 29 +/- 7 pM). After intravenous stimulation with glucose and tolbutamide, the mean serum insulin rose to significantly greater (P less than 0.05) levels at t = 5 and 25 min in the offspring compared with the control subjects. Mean SI was significantly reduced by 45% in the offspring compared with the control subjects (4.77 +/- 0.67 vs. 8.37 +/- 1.24 x 10(-4) min-1.mU-1.L-1). However, SG was not different in the offspring versus control subjects (1.92 +/- 0.12 vs. 2.10 +/- 0.17 x 10(-2) min-1). SI correlated significantly and inversely with the percentage of body fat mass (r = -0.580, P less than 0.05) but not with the WHR (r = -0.019) in the offspring. We found a negative association between SI and basal serum insulin (r = -0.798, P less than 0.01) but not with the poststimulation incremental insulin responses in the offspring. Family history of diabetes independently accounted for at least 27% of variance in the SI in our subjects. CONCLUSIONS: Our study confirmed that insulin insensitivity but not a reduced glucose effectiveness exists in young glucose-tolerant offspring of patients with NIDDM. The reduced S1 appears to be causally related to the total body fat content and may be a familial and/or genetic trait in the offspring.

Adipose Tissue↗
PubMed1995

Body fat distribution and steroid hormone concentrations in obese adolescent girls before and after weight reduction.

The aim of this study was to investigate the role of body fat distribution on steroid hormone serum concentrations in obese adolescent girls before and after weight reduction. Ninety-two girls (age, 15.1 +/- 0.7 yr) with a mean body mass index of 31.2 +/- 4.6 kg/m2 participated in this 6-week intervention study. Initially, girls with abdominal obesity (waist to hip ratio, > 0.86; n = 30) had higher levels of total and free testosterone and lower levels of sex hormone-binding globulin as well as lower morning levels of total and free cortisol than girls with gluteal-femoral obesity (waist to hip ratio, < 0.80; n = 31) independent of their body mass index. After a mean weight loss of 8.3 +/- 2.6 kg by a standardized weight loss program, significant reductions were observed in estradiol, total and free testosterone, dehydroepiandrosterone sulfate, and the ratio of LH to FSH, whereas sex hormone-binding globulin and free cortisol levels increased significantly. Decreases in total and free testosterone and increases in total and free cortisol were significantly greater in the girls with abdominal obesity than in the girls with gluteal-femoral obesity. Our results suggest that obese girls with an abdominal pattern of fat distribution exhibit more pronounced steroid hormone aberrations, in particular a high androgenic activity, than girls with a gluteal-femoral pattern of fat distribution. The reduction of excess body weight by a conventional treatment regimen is associated with a remarkable improvement of steroid hormone abnormalities in this particular subtype of obese adolescent girls.

Adipose Tissue↗
PubMed1989

Indices of body fat distribution and adiposity in Dutch children from birth to 18 years of age.

Skinfold thicknesses, Quetelet index and waist-to-hip circumference ratio (WHR) were measured in 2285 Dutch children aged 0-17 years. Skinfold thicknesses, Quetelet index and WHR were significantly influenced by age. No significant differences were found between the sexes in Quetelet index. Skinfolds were generally higher in older girls compared to older boys. WHR and the trunk-to-total skinfolds percentage were used as possible indicators of body fat distribution. On average, boys had higher WHR and trunk-to-total skinfolds percentage than girls, especially in the older age groups. The WHR decreased from about 1.1 in the youngest children to about 0.8 in pubertal children. The trunk-to-total skinfolds percentage increased from about 42 per cent in both sexes at younger ages to about 60 per cent in pubertal boys and to about 52 per cent in pubertal girls. Several correlations were calculated controlled for age. Low but significant correlations were found between WHR and skinfold thicknesses or the Quetelet index. WHR was strongly inversely related to body height. In girls 58 per cent of the variation in skinfold thicknesses was associated with the Quetelet index, in boys this was 42 per cent. The prevalence of obesity in the studied population varied between 0.5 and 10 per cent according to the reference standard chosen to assess obesity. It is concluded that more research is necessary to assess whether the WHR in children is a valid indicator of body fat distribution, especially in prepubertal children. It is also concluded that more research is needed to develop a method for assessing childhood obesity in an objective way.

Adipose Tissue↗
PubMed2005

Regional adiposity, body composition and central body fat distribution of 10-16 years old Bengalee boys of Nimta, North 24 Parganas, West Bengal, India.

A cross-sectional study of 502 Bengalee boys aged 10-16 years of Nimta, North 24 Parganas, West Bengal, India, was undertaken to study regional adiposity, body composition and central body fat distribution. The subjects were classified into seven age groups: 10-10.9 years (n = 74), 11-11.9 (n = 53), 12-12.9 (n = 87), 13-13.9 (n = 116), 14-14.9 (n = 58), 15-15.9 (n = 57), 16-16.9 (n = 57). In general, there was a significant linear increasing trend from 10 to 16 years for all the anthropometric variables. There was a net increase of 30.5 cm and 22.8 kg in mean height and weight, respectively, between 10 and 16 years of age. Mean BMI increased by 3.7 kg/m2 during the same period. Among circumferences, the largest increase was in hip followed by chest while the smallest increase was in mid upper arm, between 10 and 16 years of age. Subscapular skinfold showed the largest increase followed by abdomen and suprailiac skinfolds, while the increase was least in forearm skinfold. Significant linear increasing trend was observed for all the body composition measures. The largest increase in percent of body fat (PBF) was observed between ages 10 and 11 years while mean fat mass (FM), fat free mass (FFM) and fat mass index (FMI) increased the most between 14 to 15 years. However, an overall decreasing trend was observed, in mean waist-to-hip ratio (WHR) from 10 to 16 years. Boys aged 10 years had the highest mean WHR while those aged 15 years had the lowest mean WHR. There was an increase in mean WHR among 16 years old boys.

Adiposity↗
PubMed2001

The G-308A variant of the Tumor Necrosis Factor-alpha (TNF-alpha) gene is not associated with obesity, insulin resistance and body fat distribution.

BACKGROUND: Tumor Necrosis Factor-alpha (TNF-alpha) has been implicated in the pathogenesis of insulin resistance and obesity. The increased expression of TNF-alpha in adipose tissue has been shown to induce insulin resistance, and a polymorphism at position -308 in the promoter region ofTNF-alpha has been shown to increase transcription of the gene in adipocytes. Aim of this study is to investigate the role of the G-308A TNFalpha variant in obesity and to study the possible influence of this mutation on body fat distribution and on measures of obesity (including Fat Free Mass, Fat Mass, basal metabolic rate), insulin resistance (measured as HOMAIR), and lipid abnormalities. The G-308A TNFalpha polymorphism has been studied in 115 patients with obesity (mean BMI 33.9 +/- 0.5) and in 79 normal lean subjects (mean BMI 24.3 +/- 0.3). METHODS: The G-308A variant, detected by PCR amplification and Nco-1 digestion, determines the loss of a restriction site resulting in a single band of 107 bp [the (A) allele]. RESULTS: The (A) allele frequencies of the G-308A TNFalpha polymorphism were 13.1% in the obese group and 14.6% in the lean subjects, with no significant difference between the two groups. Furthermore, no association was found with BMI classes, body fat distribution, HOMAIR, and metabolic abnormalities. CONCLUSIONS: Our study did not detect any significant association of the G-308A TNFalpha polymorphism with obesity or with its clinical and metabolic abnormalities in this population. Our data suggests that, in our population, the G-308A TNFalpha polymorphism is unlikely to play a major role in the pathogenesis of these conditions.

Journal Article↗
PubMed2002

Serum cortisol and sex hormone binding globulin (SHBG) levels, body fat distribution and the role of genetic factors in obese females.

Fasting plasma levels of both cortisol and sex hormone binding globulin (SHBG) in obese women were significantly inversely related to anthropometric characteristics of body fat distribution. It means that a central accumulation of body fat might be partly mediated by cortisol and SHBG levels. Significant within-pair resemblance observed in plasma cortisol level in obese female monozygotic twins suggests an important role of genetic factors in determination of cortisol secretion. However, no within-pair similarities revealed in plasma SHBG concentrations favour a major role of environmental factors in the regulation of plasma SHBG level. On the other hand the twin study supported the role of genetic determinants in changes of both cortisol and SHBG levels in response to energy deficit induced by very low calorie diet (VLCD). The mechanisms controlling baseline levels of cortisol and SHBG apparently differ from those controlling their responses to energy restriction.

Adipose Tissue↗
PubMed1996

Association of body mass and body fat distribution with serum melatonin levels in obese women either non-operated or after jejunoileostomy.

The association of body mass index (BMI) and body fat distribution (as measured by waist-to-hip circumference ratio; WHR) with serum melatonin (MEL) levels determined at 02 and 14 h were examined in 22 non-operated obese women and 21 obese women who underwent jejunoileostomy for morbid obesity 2 to 6 years earlier as well as in 20 gender and age-matched healthy controls with normal body weight. All non-operated obese women either with moderate or morbid obesity had significantly higher MEL concentration at 14 h compared with controls, whereas the amount of MEL secreted at 02 h was elevated only in morbidly obese women. The mean differences between serum MEL levels at 14 h and 02 h (delta MEL) was reduced in morbidly obese women - it may be due to desynchronisation of its circadian rhythmicity. Among women who underwent jejunoileostomy for morbid obesity the values of MEL were normalized only in those with a noted body mass reduction and with BMI and WHR indexes less than 28 kg/m² and 0.83, respectively. MEL correlated positively with BMI and WHR indexes at 14 h in all subjects studied. Negative correlation was noted between the relative values of delta MEL and BMI in both non-operated and operated obese women with BMI indexes >31 kg/m².

Journal Article↗