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PubMed2002

Menopause-related differences in inflammation markers and their relationship to body fat distribution and insulin-stimulated glucose disposal.

OBJECTIVE: To determine whether postmenopausal status is associated with elevated plasma inflammation markers compared to premenopausal status, and how this explains differences in fat distribution and insulin-stimulated glucose disposal. DESIGN: Cross-sectional. SETTING: Clinical research center. PATIENT(S): Forty-five premenopausal women and 44 postmenopausal women. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) were measured by ELISA. Intraabdominal, subcutaneous abdominal, and total fat were measured by computed tomographic scan and dual-photon x-ray absorptiometry. Insulin-stimulated glucose disposal was measured by euglycemic clamp. RESULT(S): The TNF-alpha was higher in postmenopausal compared to premenopausal women (4.81 +/- 1.99 vs. 3.54 +/- 0.85 pg/mL). Interleukin-6 and CRP did not differ by menopausal status. In both premenopausal and postmenopausal women, CRP was related positively to total fat. The CRP was related to intraabdominal fat only in postmenopausal women and was negatively related to insulin-stimulated glucose disposal in both premenopausal and postmenopausal women. CONCLUSION(S): Postmenopausal status is characterized by higher TNF-alpha. The CRP may be associated with increased cardiovascular risk in postmenopausal women by its association with higher intraabdominal fat. Higher CRP is associated with lower insulin-stimulated glucose disposal in both premenopausal and postmenopausal women.

Absorptiometry, Photon↗
PubMed1993

Association between blood lipids and different measures of body fat distribution: effects of BMI and age.

The waist-to-hip ratio (WHR) and the waist circumference have been correlated with blood lipid parameters. However, both the WHR and the waist circumference have been measured in numerous ways by researchers, and it appears that standardization of the anatomical sites used in this measurement is necessary. The present study investigated the associations between five different WHR measurements and blood lipid parameters across age and BMI. Three hundred and twenty-four (324) males were assessed for cholesterol, HDL, LDL, VLDL, cholesterol/HDL ratio, and triglycerides. The waist was identified by three different sites which included the midpoint between the lower rib and iliac crest (ABAB), level of the umbilicus (UMB), and iliac crest (IC). The hip was measured at both the iliac crest (IC) and the greatest girth at the gluteus (GL). A total of five WHRs were calculated from these anatomical measurements. Partial correlation coefficients, controlling for age and BMI, indicated that the ABAB/GL, UMB/GL, ABAB and UMB have the greatest association with all of the blood lipid parameters examined (P < 0.05). However, after stratifying by BMI, partial correlations controlling for age indicated that these significant relationships are only present in the upper quartile of the BMI distribution, indicating that obesity is necessary for these relationships to exist. In addition, risk classification varied according to the WHR which was used. The results indicate that the ABAB/GL, UMB/GL, ABAB and UMB are similar for the prediction of blood lipid parameters. However, the ABAB/GL and ABAB may be the preferred methods because of the consistency in locating the necessary anatomical landmarks.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMed1992

Smoking in aborigines and persons of European descent in southeastern Australia: prevalence and associations with food habits, body fat distribution and other cardiovascular risk factors.

As part of a population-base study of risk factors for heart disease, we aimed to establish the prevalence of smoking and to identify associations between smoking and other risk factors in Australian Aborigines (n = 306) and persons of European descent (n = 553) in two country towns. Smoking prevalence was first analysed as a dichotomy (current smokers compared with nonsmokers), and according to three levels of exposure (< 10, 10-20 and > 20 cigarettes per day), and two levels of nonexposure (never and former smoker). Other behavioural, biochemical and physical variables were included in multivariable analyses. Of the Aborigines, 64.4 per cent (95 per cent confidence interval (CI) 59.0 per cent to 69.8 per cent) were current cigarette smokers, compared with 22.8 per cent of non-Aborigines (CI 19.3 per cent to 26.3 per cent). For persons aged 13 to 54 years, using the five categories of exposure, smoking in Aborigines again far exceeded that in non-Aborigines in all age groups (for males chi 2 = 72.8, for females chi 2 = 94.6, 4 df, P = < 0.0001 for both sexes). In non-Aboriginal females, the highest prevalence was in the youngest group (56 per cent of those aged 13 to 17 years). Food habit was associated with smoking. Subjects who ate meat without trimming the fat were more likely to smoke. In Australian country towns, Aborigines and all young women need smoking cessation programs. The nutritional status of smokers requires further study.

Adolescent↗
PubMed1993

Association of body fat distribution and family histories of breast and ovarian cancer with risk of postmenopausal breast cancer.

The authors recently published data from a prospective cohort study of postmenopausal women (N Engl J Med 1992;326:1323-9) which suggested that a high waist/hip ratio was associated with a significantly increased risk of breast cancer in women with a positive family history of breast cancer. Since families with aggregations of breast and ovarian cancer demonstrate more consistent genetic linkage to markers on chromosome 17q than do families with breast cancer alone, the authors performed additional analyses to examine whether the previously observed associations with waist/hip ratio differed when family history of breast cancer was partitioned according to whether or not ovarian cancer was also present in a close relative. Between 1986 and 1990, 620 incident cases of breast cancer were identified in a cohort of 37,105 postmenopausal Iowa women. A family history of breast cancer in first-degree relatives was associated with a relative risk of 1.34 (95% confidence interval (CI) 1.07-1.69); a family history of both breast cancer and ovarian cancer was associated with a relative risk of 2.36 (95% CI 1.12-4.98). Consistent with the authors' findings after 4 years of follow-up, a high waist/hip ratio (> or = 80th percentile vs. < 80th percentile) was associated with increased risk of breast cancer in the presence of a family history of breast cancer (relative risk (RR) = 2.10, 95% CI 1.43-3.09) but not in the absence of a family history of breast cancer (RR = 1.12). The combination of a high waist/hip ratio with a family history of breast and ovarian cancer was associated with 4.83-fold increased risk (95% CI 1.55-15.1). Neither a family history of breast cancer nor a family history of ovarian cancer was associated with significantly increased risk in the absence of a high waist/hip ratio.

Adipose Tissue↗
PubMed1986

Socioeconomic status, sex, age, and ethnicity as determinants of body fat distribution for Guatemalan children.

The distribution of subcutaneous fat at the triceps and subscapular skinfold sites is described for four groups of children living in Guatemala. These groups are high socioeconomic status (SES) children of Ladino (mixed Spanish and Indian) ancestry, high SES children of European ancestry, low SES Ladino children, and very low SES Indian children. The method of Healy and Tanner (1981) is used, employing regression and principal components analysis of log transformed skinfold values to divide "fatness" into two uncorrelated variables: size (amount of fat) and shape (fat pattern). Significant differences exist between groups in size, with lower SES groups having less fat than higher SES groups. No significant difference in fat pattern exists between the high SES Ladino and high SES European children. Significant differences do exist between the high SES groups and the low SES groups. The relative amount of subscapular fat increases from the high SES Ladinos and high SES Europeans, to the low SES Ladinos, to the very low SES Indians. In the high SES European and high SES Ladino samples, girls have significantly more arm fat than boys. There is no significant difference in fat patterning between boys and girls in the two low SES samples. Finally, the relative amount of subscapular fat tends to increase with age in all four samples. These results indicate that fatness and fat patterning are independent anatomical characteristics, SES influences fat patterning; low SES children of both Ladino and Indian ancestry show greater reductions in arm fat than in trunk fat compared to high SES children, sexual dimorphism in fat patterning is SES dependent.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMed2006

Plasma pancreatic polypeptide levels are associated with differences in body fat distribution in human subjects.

AIMS/HYPOTHESIS: Pancreatic polypeptide (PP) is produced by the F-cells of the pancreas, and its plasma concentration has been used as a marker of parasympathetic activity. Recent work in rodents suggests that there is both sympathetic and parasympathetic innervation of white adipose tissue and that parasympathetic activity is anabolic resulting in lipid accumulation. We have examined whether in humans increased PP levels are associated with increased intra-abdominal fat (IAF), and thereby insulin resistance. MATERIALS AND METHODS: We measured PP levels in 177 non-diabetic subjects (75 male/102 female; age 32-75 years) 3 min after an i.v. glucose bolus during a frequently sampled intravenous glucose tolerance test. IAF and s.c. fat (SCF) areas were measured by CT scan. The insulin sensitivity index (S (I)) was quantified using Bergman's minimal model. RESULTS: PP levels were higher in men than in women (96.2 +/- 72.2 vs 76.1 +/- 55.0 pg/ml, mean +/- SD, p = 0.037), as was IAF area (124.7 +/- 67.4 vs 83.0 +/- 57.7 cm(2), p < 0.001). While PP levels were significantly associated with IAF (r = 0.16, p = 0.031), WHR (r = 0.30, p < 0.001) and age (r = 0.37, p < 0.01), they were not associated with SCF (r = 0.02, p = 0.829). The association between PP and IAF was not independent of age and/or sex. S(I) was negatively associated with PP levels (r = -0.17, p = 0.026) and IAF area (r = -0.65, p < 0.001). The association between S(I) and PP disappeared after adjusting for IAF area, indicating that S(I) was not a major determinant of PP levels. CONCLUSIONS/INTERPRETATION: In humans, age and sex may modulate the association between plasma PP level and IAF area, suggesting that they may be determinants of parasympathetic activity and thus IAF accumulation.

Abdomen↗
PubMed1992

Effect of family history, body-fat distribution, and reproductive factors on the risk of postmenopausal breast cancer.

BACKGROUND: A family history of breast cancer reflects shared cultural factors, genetic predisposition, or both. There is evidence that the estimated risk associated with a family history of breast cancer increases multiplicatively in combination with other risk factors. We examined the combined effect of family history and anthropometric and reproductive factors on the risk of breast cancer in postmenopausal women. METHODS: Using data from a prospective cohort study, we studied 37,105 women 55 to 69 years of age to determine whether known risk factors for breast cancer are modified by a reported family history at the time of entry into the study. RESULTS: During the first 4 years of follow-up, 493 new breast cancers were diagnosed. The association of the waist-to-hip ratio (the circumference of the waist divided by that of the hips) with the risk of breast cancer was limited predominantly to women with a family history of breast cancer; the age-adjusted relative risk of breast cancer for the women above the fourth quintile for waist-to-hip ratio as compared with those below the first quintile was 3.2 in women with a family history of breast cancer and 1.2 for women without such a family history. An interaction was observed between a family history of breast cancer and the number of live-born children; the protective effect of higher parity was observed primarily among women with a family history of breast cancer. Similarly, the age-adjusted relative risk of breast cancer associated with a late age at first pregnancy (i.e., greater than or equal to 30 years) was 5.8 for women with a family history of breast cancer and 2.0 for women without such a family history. CONCLUSIONS: The increase in the risk of breast cancer associated with a high waist-to-hip ratio, low parity, or greater age at first pregnancy is more pronounced among women with a family history of breast cancer. These findings suggest etiologic differences between familial breast cancer and the sporadic form.

Adipose Tissue↗
PubMed2004

Effect of central and peripheral body fat distribution on sympathetic and baroreflex function in obese normotensives.

BACKGROUND: Previous studies have shown that obesity is characterized by a sympathetic overactivity coupled with an insulin resistance state and a baroreflex impairment. The present study was set out to compare the effects of peripheral versus central obesity on sympathetic, metabolic and reflex function. METHODS: In 36 lean subjects (age 35.8 +/- 1.4 years, mean +/- SEM), 20 subjects with peripheral obesity (PO) and 26 subjects with central obesity (CO), all age-matched and with normal blood pressure values, we measured beat-to-beat arterial blood pressure (Finapres), heart rate (HR, ECG), homeostasis model assessment (HOMA) index, plasma norepinephrine (NE, high-performance liquid chromatography) and postganglionic muscle sympathetic nerve traffic (MSNA, microneurography) at rest and during baroreceptor stimulation and deactivation induced by stepwise intravenous infusions of phenylephrine and nitroprusside, respectively. RESULTS: Both HOMA index, NE and MSNA values were significantly increased (P < 0.01) in obese as compared with lean individuals. Subjects with CO displayed MSNA and HOMA values significantly greater than those found in individuals with PO (65.4 +/- 2.0 versus 47.9 +/- 1.9 bs/100hb and 2.85 +/- 0.10 versus 2.43 +/- 0.11 a.u., respectively, P < 0.05 for both). Both in male and female subjects with CO or PO, MSNA, HOMA index and waist-to-hip ratio were significantly related to each other. Baroreceptor-HR and -MSNA control was significantly (P < 0.01) impaired in obese as compared with lean subjects, the degree of impairment being similar in CO and PO. CONCLUSIONS: These data suggest that CO is characterized by a sympathetic activation greater for magnitude than that detectable in PO. This appears not to be related to gender or to baroreflex mechanisms but rather to metabolic factors, i.e. to the greater insulin resistance characterizing CO.

Adult↗
PubMed1967

Serum lipid levels and body fat distribution in obese females.

Serum triglyceride levels were significantly raised in 37 markedly obese females, especially in the younger subjects; cholesterol and phospholipid levels were normal. Considerable variation in triglyceride levels of equally obese subjects was observed. No relationship was noted between triglyceride levels and the pattern of subcutaneous fat distribution. It is suggested that the high triglyceride levels of obese subjects may explain their predisposition to ischaemic heart disease.

Adipose Tissue↗
PubMed1994

Human HDL cholesterol levels are determined by apoA-I fractional catabolic rate, which correlates inversely with estimates of HDL particle size. Effects of gender, hepatic and lipoprotein lipases, triglyceride and insulin levels, and body fat distribution.

High-density lipoprotein (HDL) cholesterol (HDL-C) levels are a strong inverse predictor of atherosclerosis risk, but the physiological determinants of HDL-C levels are poorly understood. We selected 57 human subjects (30 women and 27 men) with a broad range of HDL-C levels and performed turnover studies of apolipoprotein (apo)A-I and apoA-II, the two major apolipoproteins of HDL, to measure the fractional catabolic rate (FCR) and production or transport rate (TR) of these proteins. We also measured several other parameters known to correlate with HDL-C levels to test for their interrelations and to postulate mechanisms of regulation of HDL-C levels. As expected, the women had higher levels of HDL-C (56.7 +/- 21.4 versus 45.1 +/- 16.3 mg/dL, mean +/- SD; P = .03) and apoA-I (147 +/- 32 versus 126 +/- 29 mg/dL, P = .01) than men and did not differ in apoA-II levels (34.5 +/- 7.4 versus 33.3 +/- 7.5 mg/dL, P > .2). The FCR of apoA-I tended to be lower in the women (0.248 +/- 0.077 versus 0.277 +/- 0.069 pools/d, P = .1), although the difference was not statistically significant. The FCR of apoA-II was also lower (0.184 +/- 0.043 versus 0.216 +/- 0.056 pools/d, P = .02). In contrast, the apoA-I TR was equal in women and men (12.0 +/- 1.6 versus 12.1 +/- 2.8 mg/kg per day, P > .2), and there was a trend toward lower apoA-II TR in women (2.19 +/- .62 versus 2.61 +/- 1.06 mg/kg per day, P = .07). Linear regression analysis revealed a strong inverse correlation between HDL-C levels and the FCRs of apoA-I and apoA-II (r = -.81 and -.76, respectively; P < .0001 for both). In contrast, there was little or no association between HDL-C and the TRs of apoA-I and apoA-II (r = .06 and -.35, P = not significant and .01, respectively). In stepwise multiple linear regression analysis, apoA-I FCR alone accounted for 66% of the variability in HDL-C; two other variables accounted for an additional 7%. Due to the importance of apoA-I FCR, its determinants were sought among the remaining variables.(ABSTRACT TRUNCATED AT 400 WORDS)

Adipose Tissue↗