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PubMed2002

Adiposity, central body fat distribution and blood pressure among young Bengalee adults of Kolkata, India: sexual dimorphism.

A cross-sectional study of 174 men and 153 women of Bengalee ethnicity was undertaken to compare levels of adiposity, central body fat distribution and blood pressure. The mean age of both the sexes were similar (men = 20.1 years; women = 20.0 years). Significantly more women (n = 42, 27.5%) were overweight (body mass index, BMI > or = 25.0 kg/m2) as compared with men (19, 10.9%). Men were significantly taller and heavier. They also had significantly greater mean waist (WC) and mid upper arm (MUAC) circumferences compared with women. On the other hand, women had significantly (p < 0.001) greater mean BMI, biceps (BSF), triceps (TSF) and subscapular (SSF) skinfolds. The mean values of systolic (SBP), diastolic (DBP) and mean arterial (MAP) blood pressure were significantly greater among men. These significant differences existed even after controlling for BMI. Regression analyses revealed that sex had significant effect on all these variables even after controlling for BMI. Correlation studies showed that WC was found to be much more strongly correlated than BMI with SBP, DBP and MAP, in both sexes. However, when the effect of WC (along with BMI) was also controlled for, there was no significant sex difference in blood pressure.

Adipose Tissue↗
PubMed1996

Body fat distribution and non-insulin-dependent diabetes: comparison of a fiber-rich, high-carbohydrate, low-fat (23%) diet and a 35% fat diet high in monounsaturated fat.

The effects of a fiber-rich, high-carbohydrate, low-fat (HCLF) diet and a modified-fat (MF) diet high in monounsaturated fat on body fat distribution were examined by dual-energy X-ray absorptiometry (DXA) in 16 subjects with non-insulin-dependent diabetes (NIDDM) during a randomized crossover study. Subjects lost similar amounts of body fat consuming the HCLF and MF diets (-0.83 +/- 0.37 and -0.87 +/- 0.40 kg, respectively) despite a marked difference in total fat consumption. With the MF diet, the ratio of upper- to lower-body fat (UF:LF) remained unchanged because fat was lost proportionately from the upper and lower body. In contrast, with the HCLF diet, a disproportionate loss of lower-body fat caused the UF:LF to increase. The effects of diet on regional body fat loss were significant (P < 0.05, two-factor repeated-measures ANOVA).

Absorptiometry, Photon↗
PubMed1993

Beta-endorphin response to exogenous corticotrophin-releasing hormone in obese women with different patterns of body fat distribution.

Obese individuals may be characterized by higher than normal basal and stimulated beta-endorphin plasma concentrations, which suggests an increased activity of the opioid system. This study was carried out to investigate whether the regulation of beta-endorphin secretion may be different in different phenotypes of obesity. Twenty-two obese women (body mass index greater than 30 kg/m2) without other endocrine and metabolic abnormalities were investigated. A group of seven normal weight healthy women matched for age served as controls. According to the protocol, obese women included in the study had a waist-to-hip ratio higher than 0.85 (n = 9) or lower than 0.80 (n = 13). The former were defined as having abdominal type and the latter peripheral type body fat distribution. Both groups were matched for body mass index. All women randomly underwent a corticotrophin-releasing hormone test (human CRF, 1 microgram/kg body weight) and a control saline study, with blood samples for beta-endorphin determination taken at regular intervals. Basal beta-endorphin levels were not significantly different between the three groups. No significant variation in the hormone levels occurred during the control study in either group. After CRF injection, however, beta-endorphin rose significantly in all women, but the hormone concentrations were significantly higher in obese women with abdominal fat distribution than in those with peripheral fat distribution and in controls. These results indicate that, among obese women, only those with the abdominal phenotype seem to have increased opioid activity.

Abdomen↗
PubMed1993

Body fat distribution, blood pressure and blood glucose in Egyptian obese women undergoing a weight control program.

In a sample of 92 obese healthy women, 35 of them were chosen to follow a weight control program comprising both caloric restriction and exercise for three months. They were matched for age and weight with the remaining 57 women who also served as a control group. The entire sample was further stratified according to age into two categories of 20-34 and 35-50 years. The caloric supply was restricted to about 1000 kcal/day, in addition to a 1-h session of mild exercise which was performed twice weekly; the subjects' energy expenditure was 2200 kcal/day. Only the mean values of the biceps, triceps, and supra-iliac skinfold measurements were significantly decreased (p < 0.05) in the younger trained dieters when compared to their counterpart sedentary controls. On the other hand, obvious group variations appeared between body fat distribution when related to body weight and to blood pressure. Blood glucose revealed normal levels in the whole sample. Mean values were numerically lower in the older trained dieters than their matched sedentary controls, while they were significantly lower (p < 0.05) in the younger trained dieters. Although blood pressure was in the normal range for all participants, a nonsignificant decrease was recorded for both age groups of the obese trained dieters upon completion of the program. The systolic blood pressure decreased by 5.4% and the diastolic by 6.7% regarding the younger age, while the decrease in the older age was 3.5% for the systolic and 4.8% for the diastolic blood pressure. It was concluded that, although the trained dieters were still obese, the caloric restriction was promoted synergistically by exercise, leading to a more harmonious fat distribution and to lower normal levels of blood pressure and blood glucose.

Adipose Tissue↗
PubMed1993

Body fat distribution and left ventricular morphology and function in obese females.

OBJECTIVE: To study left ventricular function and morphology in non-hypertensive obese females and to relate the findings to body mass index (BMI) and to an index of body fat distribution (waist:hip ratio). DESIGN: Cross-sectional study. SETTING: Obesity unit in city hospital. SUBJECTS: Healthy obese females (n = 22) with BMI > 25 and < 40 kg/m2 and a non-obese, age-matched control group (n = 20) with BMI < 25 kg/m2. MAIN OUTCOME MEASURES: Blood pressure and non-invasive indices of left ventricular morphology and diastolic and systolic function. RESULTS: The obese group had significantly higher blood pressure, larger left ventricular end-diastolic diameter, greater left ventricular mass; larger left atrial size, signs of decreased left ventricular distensibility and prolonged left ventricular relaxation time index, and signs of supernormal systolic left ventricular function (as judged from the relationship between fractional shortening and end-systolic wall stress) than the non-obese controls. The results also indicated that left ventricular wall thickness and mass were well adapted to the increase in afterload, as judged by analyses of end-systolic wall tension and end-systolic wall stress. CONCLUSION: In confirmation of several previous studies, obesity was closely associated with an increase in blood pressure and left ventricular mass, and with early signs of disturbed left ventricular diastolic function. Left ventricular wall thickness and mass were well adapted to the increase in afterload; thus, we could not identify any non-afterload-dependent effect of an increase in BMI or waist:hip ratio on left ventricular hypertrophy.

Adipose Tissue↗
PubMed1991

Impact of pubertal development on body fat distribution among white, Hispanic, and Asian female adolescents.

Variation in the waist/hip ratio (WHR) may be related to changes in hormonal secretion associated with pubertal maturation. We therefore studied the effects of race, pubertal development, and body fatness on WHR during adolescence in a multiethnic population. A total of 688 white, Asian, and Hispanic female adolescents (mean (+/- SD) 12.4 +/- 0.7 years), participating in the evaluation of a multisite school-based health education program, were included in these analyses. Self-assessed stage of puberty and measurements of height, weight, waist circumference, and hip circumference were obtained from each participant. The WHR and age-adjusted body mass index were calculated. Analysis of covariance demonstrated that puberty significantly affects hip circumference and WHR but not waist circumference among female adolescents. Age and fatness, as reflected by age-adjusted body mass index, contributed significantly to both circumferences and to the WHR. There was a significant effect of ethnicity on hip circumference but not on waist circumference or the WHR. These results confirm that pubertal stage exerts a significant effect on the hip circumference and WHR in female adolescents, even after the effects of fatness and age are controlled. Studies of body fat distribution during late childhood and adolescence should include assessments of pubertal maturation.

Adipose Tissue↗
PubMed1989

Body fat distribution and self-reported prevalence of hypertension, heart attack, and other heart disease in older women.

The associations of self-reported body mass and fat distribution with self-reported prevalence rates of hypertension, heart attack, and other heart disease were examined in a sample of 40,000 women, aged 55-69 years. Fat distribution was measured by the waist-to-hip circumference ratio (WHR), which had a mean +/- SD of 0.838 +/- 0.085. Prevalence of hypertension was significantly and positively associated with both body mass index (BMI) and waist-to-hip ratio. The prevalence rate ratio for hypertension in the highest versus the lowest tertile of body mass index and waist-to-hip ratio (considered jointly) was 2.7. Prevalence rates of heart attack and other heart disease were significantly and positively associated with waist-to-hip ratio but not with body mass index. The prevalence rate ratios were 2.2 for heart attack and 1.4 for other heart disease in the highest versus the lowest tertile of body mass index and waist-to-hip ratio. Findings were substantiated using multiple logistic regression. These results support the hypothesis that a significant relationship exists between body fat distribution and the occurrence of cardiovascular disease in older women.

Adipose Tissue↗
PubMed1996

Regional body fat distribution in New Zealand girls aged 4-16 years: a cross-sectional study by dual energy X-ray absorptiometry.

OBJECTIVE: To measure total body fat content and its regional distribution within the body (head, arms, legs and trunk) in young girls and adolescents in relation to age and body mass index (BMI). DESIGN: Cross-sectional observational study. SUBJECTS: 196 healthy Caucasian girls aged 4-16 years living in an urban town in the South Island of New Zealand. MEASUREMENTS: Body weight, height and BMI. Total body fat mass (kg) and the regional distribution of this fat (measured by dual energy X-ray absorptiometry). RESULTS: All the measured variables, including total and % fat mass were higher in older age groups. Regional distribution of fat differed, with older girls having a higher proportion of their body fat in the trunk and a smaller proportion of their body fat in the heat than younger girls. BMI was positively correlated with % trunk fat (r = 0.700) and negatively correlated with % leg fat (r = -0.465). Girls with higher levels of adiposity (> 75th percentile for BMI) stored more fat in the trunk and correspondingly less in the legs than girls with lower adiposity (< or = 75th percentile for BMI) at five of the six age groups (P < 0.05). CONCLUSION: It is concluded that body fat mass increases and shows a more central distribution in young girls as they grow older. Increasing adiposity as determined by BMI is associated with an increase in fat deposition in the trunk and a decrease in the legs.

Absorptiometry, Photon↗
PubMed1999

Influence of obesity and body fat distribution on growth hormone kinetics in humans.

We studied the kinetics of exogenous recombinant 22-kDa human growth hormone (rhGH) in premenopausal women with upper body obesity (UBO), lower body obesity (LBO), or normal body weight. A bolus of 100 mU rhGH was administered during a continuous infusion of somatostatin to suppress endogenous GH secretion. GH kinetics were investigated with noncompartmental analysis of plasma GH curves. GH peak values in response to GH infusion and plasma half-life of GH were not significantly different between normal weight and obese subjects. In contrast, GH clearance was 33% higher in LBO women and 51% higher in UBO women compared with clearance in normal weight controls. The difference in clearance between LBO and UBO was not statistically significant. Altered GH clearance characteristics contribute to low circulating GH levels in obese humans. Body fat distribution does not appear to affect GH kinetics.

Adipose Tissue↗
PubMed2000

Critical value for the index of body fat distribution based on waist and hip circumferences and stature in obese girls.

OBJECTIVE: To determine the critical value for the standard deviation score (SDS) of waist-hip ratio (WHR)/height (Ht), as an age-adjusted measure of body fat distribution, in relation to occurrence of biochemical complications in obese girls. DESIGN: Cross-sectional, clinical study. The (WHR/Ht)-SDS was calculated as described previously. Obese girls were classified into two groups according to the occurrence of abnormal values in either serum triglyceride, alanine aminotransferase or insulin level. The criteria for obesity were subjected to the receiver operating characteristic (ROC) analysis. SUBJECTS: One-hundred and twenty-four outpatient Japanese obese girls, ranging in age from 9 to 15 y. MEASUREMENTS: Height, body weight, waist girth and hip girth as anthropometric measures. Percentage overweight, waist girth, WHR and (WHR/Ht)-SDS as criteria for obesity. Clinical laboratory analysis for fasting blood samples of obese children. RESULTS: Fifty-nine girls were classified into the no complication group, and 65 girls into the complication group. Those with complications were older, more obese, and their waist girth and WHR were larger, than the girls without complications. The (WHR/Ht)-SDS was >2-fold higher and lipoprotein profile was more atherogenic in the complication group than in the no complication group. Among the four criteria of obesity, (WHR/Ht)-SDS gave the ROC curve skewed furthest into the top left corner of the diagram. Both sensitivity and specificity for (WHR/Ht)-SDS were >80% at the critical value of 2.00. The sensitivity for waist girth was as high as that for specificity for the rest of the criteria were <80%. CONCLUSION: Only (WHR/Ht)-SDS showed high enough sensitivity and specificity to predict metabolic derangement in the present obese girls. (WHR/Ht)-SDS can serve as the diagnostic criterion that classifies obesity in Japanese adolescent girls into two types.

Adipose Tissue↗
PubMed1996

Leptin concentrations in relation to overall adiposity and regional body fat distribution in Mexican Americans.

OBJECTIVE: Leptin, the product of the human OB gene is increased in obese individuals suggesting resistance to its effect. However, there is variability in leptin levels at each level of body mass index suggesting that genetic and environmental factors other than overall adiposity may regulate leptin concentrations. Moreover, the relation of leptin to various adipose depots may differ. Upper body (or central adiposity) is more metabolically active than peripheral adiposity. METHODS: We examined the relation of serum leptin levels to body fat distribution in 147 non-diabetic subjects from the San Antonio Heart Study. RESULTS: Leptin concentrations in men were significantly correlated with body mass index (BMI) (r = 0.741), waist-to-hip ratio (WHR) (r = 0.567), waist circumference (r = 0.840), hips circumference (r = 0.842) triceps skinfold (r = 0.520) and subscapular skinfold (r = 0.668) but not with subscapular to triceps skinfold (r = 0.185). Leptin concentrations in women were significantly correlated with BMI (r = 0.814), WHR (r = 0.377), waist circumference (r = 0.718), hips circumference (r = 0.779), subscapular skinfolds (r = 0.636) and triceps skinfolds (r = 0.587) but not with the ratio of subscapular to triceps skinfolds (r = 0.184) in women. CONCLUSIONS: Since the associations of leptin with body mass index (a surrogate for overall adiposity), waist circumference (a surrogate for upper body) and hips circumference (a surrogate for lower body adiposity) are similar, we conclude that leptin concentrations are associated with all adipose tissue depots and not disproportionately with upper body or central adiposity.

Adipose Tissue↗
PubMed1988

Relationship of body fat distribution pattern to atherogenic risk factors in NIDDM. Preliminary results.

Because recent knowledge indicates that the distribution of fat deposits in men may be a better predictor of cardiovascular disease than the degree of obesity alone, some risk factors for atherosclerosis were evaluated in 51 middle-aged men with non-insulin-dependent diabetes mellitus. Abdominal adiposity (waist/hip ratio, WHR) was related to parameters of metabolic control, lipid parameters, and known vascular complications in three different groups. In groups with abdominal obesity, mean annual hemoglobin A1 was significantly (P less than .01) higher than in patients without an abdominal fat distribution. Atherogenic index was significantly increased in the group with the highest WHR and high-density lipoprotein cholesterol (HDL-chol) levels were significantly decreased in both groups with upper-body fat distribution. The frequency of peripheral vascular disease, coronary ischemic heart disease, and hypertension was most prominent in diabetic subjects with an abdominal fat mass distribution. A highly significant (P less than .001) correlation was present between WHR and HDL-chol and WHR and the total-cholesterol/HDL-chol ratio; this significant correlation remains after correction for body mass index. A similar correlation could be found between WHR and systolic and diastolic blood pressures. These results demonstrate an association of excess abdominal fat, even without manifest obesity, with worse diabetes metabolic control, cardiovascular complications, and blood lipid levels actually considered to play an important role in atherogenesis.

Abdomen↗
PubMed1994

Relationship of body fat distribution with cardiovascular risk factors in healthy Chinese.

The relationships between six body girths (shoulder, midarm, waist, hip, thigh, and calf) and cardiovascular risk factors (systolic and diastolic blood pressures and glucose, triglyceride, lipoprotein cholesterol, and apolipoprotein levels) were examined in 407 healthy Chinese urban workers in Taipei, Taiwan who were between 40 to 59 years old. Canonical correlation analysis revealed significant associations of upper body adiposity (shoulder, midarm, and waist girths) with cardiovascular risk factors in all subgroups assessed: men, premenopausal women, and postmenopausal women. Waist girth and hip girth were consistent and important variables, and weighted in the opposite direction. Waist-hip ratio (WHR) was the best descriptor of centralized adiposity. Centralized fat distribution was positively associated with blood pressure and glucose, triglyceride, and apolipoprotein (apo) B levels, and negatively associated with high-density-lipoprotein (HDL) cholesterol and apo A-I levels in this population. Body fat distribution had an effect independent of body mass index and accounted for some of the differences in triglyceride, HDL cholesterol, apo A-I, and apo B concentrations among men, premenopausal women, and postmenopausal women. Our findings in a Chinese population are similar to data from other studies in Western populations, and are consistent with the hypothesis that centralized adiposity is related to cardiovascular risk factors independent of general obesity.

Adipose Tissue↗
PubMed2002

Insulin resistance and androgens in healthy women with different body fat distributions.

OBJECTIVE: To compare androgens and sex hormone-binding globulin (SHBG) levels, and indices of insulin sensitivity (the response of plasma insulin and C-peptide in OGTT, insulin resistance and beta-cell activity estimated with the homeostasis assessment model (HOMA model) in healthy obese premenopausal women with different body fat distributions. PATIENTS AND METHODS: Free testosterone, androstenedione, SHBG levels and responses of plasma glucose, insulin and C-peptide in OGTT were examined in 74 healthy premenopausal women (19 with lower-body obesity (WHR < 0.80), 20 with pure abdominal obesity (WHR > 0.85), 19 with predominant abdominal obesity (WHR 0.81-0.85) and 18 normal-weight women). Insulin resistance and beta-cell function were estimated with the HOMA model. RESULTS: Both fasting and glucose-induced insulin levels were higher in women with pure abdominal obesity than in the controls (p < 0.001) and in those with lower-body obesity (P < 0.01). Insulin resistance was also higher in women with pure abdominal obesity than in the controls (p < 0.01) and those with lower-body obesity (p < 0.05). Free testosterone (p < 0.01) was higher and SHBG (p < 0.001) was lower in women with abdominal obesity than in the control group and those with lower-body obesity. Insulin significantly correlated with SHBG, and this correlation was independent of androgens, obesity and obesity type. Beta-cell function positively correlated with free testosterone, whereas insulin resistance negatively correlated with SHBG, and was independent of obesity and obesity type. CONCLUSIONS: In healthy premenopausal women, increased BMI and more pronounced abdominal fat accumulation was associated with increased androgenic activity (higher free testosterone and lower SHBG levels) and with insulin resistance estimated using the HOMA model, as well as with increasing basal and glucose-induced insulin levels. SHBG levels correlated with insulin and insulin resistance independently of the degree of obesity, obesity type and androgens, whereas beta-cell function correlated only with free testosterone.

Adult↗
PubMed2006

Muscle adiposity and body fat distribution in type 1 and type 2 diabetes: varying relationships according to diabetes type.

OBJECTIVE: To compare the relationships between markers of total and regional adiposity with muscle fat infiltration in type 1 diabetic and type 2 diabetic subjects and their respective nondiabetic controls, and to document these relationships in type 1 diabetic subjects. DESIGN: Cross-sectional study. SUBJECTS: In total, 86 healthy, with type 1 diabetes, type 2 diabetes or control subjects. Each diabetic group was matched for age, sex and body mass index with its respective nondiabetic control group. MEASUREMENTS: Measures of body composition (hydrodensitometry), fat distribution (waist circumference, abdominal and mid-thigh computed tomography scans) and blood lipid profiles were assessed. RESULTS: Low attenuation mid-thigh muscle surface correlated similarly with markers of adiposity and body composition in all groups, regardless of diabetes status, except for visceral adipose tissue and waist circumference. Indeed, relationships between visceral adiposity and muscle adiposity were significantly stronger in type 2 vs type 1 diabetic subjects (P<0.05 for comparison of slopes). In addition, in well-controlled type 1 diabetic subjects (mean HbA(1c) of 6.8%), daily insulin requirements tended to correlate with low attenuation mid-thigh muscle surface, a specific component of fat-rich muscle (r=0.36, P=0.08), but not with glycemic control (HbA(1c)). CONCLUSION: This study suggests that the relationship of central adiposity and muscle adiposity is modulated by diabetes status and is stronger in the insulin resistant diabetes type (type 2 diabetes). In well-controlled nonobese type 1 diabetic subjects, the relationship between muscle fat accumulation and insulin sensitivity was also maintained.

Adiposity↗
PubMed1984

Quantification of body fat distribution in the abdomen using computed tomography.

A computed tomographic method was used to assess the pattern of abdominal fat distribution in normal males and females at different abdominal levels. The method permitted site specific calculations of total body volume (TA), total fat volume (TF), subcutaneous fat volume (SF), and intraabdominal fat volume (IF) in each computed tomography scan. The ratio of TF/TA, SF/TF and IF/TF were calculated for the L1, L3, and L5 vertebral levels. Regression analysis of IF versus SF, SF versus TF, IF versus TF, TF versus TA, and TF versus body mass index and age were calculated. A significant linear correlation between the measured variables TA, SF, IF, and TF and between TF and body mass index was found for virtually all correlations attempted at all scanned levels. Females had a higher total fat volume and greater percentage of subcutaneous fat at all levels. Males accumulated more fat intraabdominally than subcutaneously at the L1 and L3 levels. The male-female differences were greatest at L1 and the ratio SF/IF statistically significant at the L1 and L5 levels. Our results demonstrate that computed tomography can noninvasively quantify abdominal fat distribution at various sites. There is an inherent difference in abdominal fat distribution between males and females that is not related to weight. The distribution of body fat in males and females varies markedly from level to level.

Adipose Tissue↗
PubMed1998

Measurement issues related to studies of childhood obesity: assessment of body composition, body fat distribution, physical activity, and food intake.

This article reviews the current status of various methodologies used in obesity and nutrition research in children, with particular emphasis on identifying priorities for research needs. The focus of the article is 1) to review methodologic aspects involved with measurement of body composition, body-fat distribution, energy expenditure and substrate use, physical activity, and food intake in children; and 2) to present an inventory of research priorities.

Absorptiometry, Photon↗
PubMed1997

Body fat distribution before and after weight gain in anorexia nervosa.

OBJECTIVE: To study abdominal fat distribution in anorexia nervosa subjects and to assess the effects of initial weight regain on abdominal fat distribution. DESIGN: Longitudinal, clinical study. The baseline measurement was acquired within four days of admission to the eating disorders clinic. All patients were treated by re-feeding, reinforced by psychotherapy. Following weight regain of at least 5 kg, a second body fat distribution evaluation was performed. Of the 21 subjects evaluated at baseline, 14 achieved the goal of body weight regain and were retested. PATIENTS: Fourteen subjects (age: 18-38 y; body mass index: 11.5-18.3; relative body weight: 54.9-88.3%). MEASUREMENTS: Total, subcutaneous and visceral abdominal adipose tissue areas at the L4-L5 level were evaluated by computed tomography. RESULTS: At baseline the subjects showed a higher proportion of visceral adipose tissue (% visceral adipose tissue = 55.3 +/- 26.1). A significant association was observed between body weight and both subcutaneous adipose tissue and total adipose tissue. A regain of body weight of 7.3 +/- 1.6 kg was accompanied by a significant increase in total adipose tissue, comprising both subcutaneous and visceral adipose tissue. The increase observed in subcutaneous adipose tissue, however, was significantly greater than for visceral adipose tissue (212.6% vs 116.8%, respectively, P < 0.01). CONCLUSION: The results of the current study show a higher proportion of visceral adipose tissue than subcutaneous adipose tissue in anorexia nervosa subjects. With regain of body weight there is a preferential regain of subcutaneous adipose tissue. These data demonstrate a redistribution of abdominal adipose tissue with weight regain in anorexia nervosa subjects.

Abdomen↗