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PubMedDate not supplied

The effects of sequential combined oral 17beta-estradiol norethisterone acetate on insulin sensitivity and body composition in healthy postmenopausal women: a randomized single blind placebo-controlled study.

OBJECTIVE: The androgenic effect of progestogen, necessary in early postmenopausal hormone replacement therapy (HRT), may adversely affect insulin sensitivity as well as body fat distribution and thereby increase the cardiovascular risk profile. The impact of HRT with sequential combined oral 17beta-estradiol and norethisterone acetate on insulin sensitivity and body composition in early menopause has not been studied. DESIGN: A randomized single blind placebo-controlled 6-month study of sequential combined 17beta-estradiol norethisterone acetate on insulin sensitivity and body composition was carried out. Thirty fit healthy postmenopausal women were enrolled and completed this 6-month study. Body composition was measured by dual-energy x-ray absorptiometry scanning, and insulin sensitivity was measured using the euglycemic hyperinsulinemic clamp. Studies were undertaken at baseline and after 6 months of therapy. The studies were performed during the estrogen-only phase of therapy. RESULTS: All women demonstrated a degree of decreased insulin sensitivity that was not modified by 6 months of hormone replacement therapy. Body composition remained unchanged over 6 months. There was no alteration in total body fat or the distribution of body fat. The percentage of central abdominal fat (android) was not altered. CONCLUSION: Six months of HRT with sequential combined oral 17beta-estradiol norethisterone acetate does not have an adverse effect on insulin sensitivity and does not promote an increase in weight or the more android distribution of body fat, which could contribute to the increased cardiovascular risk profile that is evident in postmenopausal women.

Absorptiometry, Photon↗
PubMed1989

Apolipoprotein concentrations in obese subjects with upper and lower body fat mass distribution.

In order to assess the relationship between obesity and serum lipids, a homogenous group of adult men and premenopausal women is assessed for body mass index, body fat distribution reflected by the waist/hip ratio (WHR), serum lipid parameters and apolipoproteins. Body fat distribution is distinguished in an abdominal and gluteal-femoral type using a cut-off point of 1.00 for the ratio of waist-to-hips girth for men. In women the cut-off value is considered as 0.80 but was also evaluated when considered as 0.85. In the next step tertiles for WHR are created to show a graded relationship between WHR and lipoprotein fraction. The results indicate that WHR is an important determinant for most atherosclerosis-related lipids and apoproteins: in both men (P less than 0.05) and women (P less than 0.005) WHR is significantly correlated with apolipoprotein B. Using multiple regression analysis, in women WHR seems to be the most important dependent variable, where body mass index is not significantly contributing to the explained variance. In men, however, besides WHR age is the most significant variable, although age distribution is similar in men and women. Using tertiles of WHR, we show a clear graded relationship with most lipids and lipoproteins; this gives additionally an argument to confirm that in women WHR = 0.80 is the most accurate cut-off value for abdominal obesity. This study demonstrates that both obese men and women with an abdominal fat mass distribution show a lipid and apoprotein profile that is less favorable than that seen in gluteal-femoral obese subjects insofar as the risk of coronary artery disease is concerned.

Abdomen↗
PubMed1990

[Anatomical distribution of subcutaneous body fat in a sample of school children of Los Teques: absolute patterns and familial aggregation].

The absolute patterns of subcutaneous body fat distribution were studied in a sample of school children from Los Teques, Miranda, formed by 222 females and 216 males, with ages between 6 and 17 years. These patterns were obtained based on the means by age and sex of the measurements expressed in millimeters, of 5 skinfolds: tríceps, subscapular, suprailiac, thigh and medial calf. Resemblance between sibs for height, weight and these 5 skinfolds was estimated through an intraclass correlation coefficient based on 100 pairs of sibs. Correlations between 100 random pairs of unrelated subjects were also estimated for these same variables in order to make comparisons between the correlation values obtained when biological relationship exists and when it is absent. The absolute patterns show that females are fatter than males, and that a redistribution of fat from extremities to trunk occurs from adolescence up to adulthood, more evident and taking place earlier in males. The intraclass correlation coefficients between sibs were higher than those between unrelated pairs, for all variables except for medial calf; these tendencies suggest the presence of genetic and/or common environmental factors on the determination of these variables. The highest correlation between sibs was obtained for height; within the five skinfolds, thigh is the one with the highest correlation value, whereas medial calf shows the lowest, suggesting that this is the skinfold with the smallest genetic component in its determination.

Adipose Tissue↗
PubMed2005

Short-term predictors of abdominal obesity in children.

BACKGROUND: The aim of this study was to examine the short-term tracking of abdominal adiposity in children. METHODS: A total of 918 children (477 boys) aged 6-12 years at baseline were followed-up for 2 years. Central obesity was assessed by waist circumference (WaistC), whereas body fat distribution by waist-to-hip ratio. Maturity was assessed by the Khamis-Roche method. Parental fatness and children's cardiorespiratory fitness (CRF) were also evaluated. Multiple and logistic regressions were employed to identify the predictors of BMI and WaistC. RESULTS: Tracking of body fatness and body fat distribution was high (r = 0.69-0.86, P < 0.01). More boys remained obese than girls (P < 0.05), whereas a greater percentage of boys moved to a higher quartile of WaistC after the 2-year follow-up (22.0 vs 14.1%, P < 0.01). Sex, child's maturity and WaistC at baseline, CRF, and maternal BMI explained 76% of the variability in BMI and WaistC at the follow-up (n = 290). Children with high WaistC at baseline and low CRF presented 1.9- and 4.3-fold increased risk of remaining in the upper quartile of WaistC at the follow-up (P < 0.01; n = 552). CONCLUSION: Youth with increased WaistC at baseline and low CRF presented an increased chance of maintaining central obesity at the follow-up. More boys than girls moved into a higher quartile of abdominal obesity during the 2-year follow-up period and this should be taken into account in designing programmes for childhood obesity.

Abdominal Fat↗
PubMed1987

[Influence of the distribution of body fat on vascular risk].

The metabolic and cardiovascular complications of obesity are dependent upon the distribution of body fat excess: predominantly abdominal or "android" obesity is more pathogenic than "gynoid" obesity which predominates in the lower part of the body. Adipose tissue overloads localized to the abdomen are associated with hypermortality from vascular diseases, even in patients who are not overweight. The metabolic characteristics of abdominal adipocytes, which have increased lipolytic capacity, might account for this situation, as they would facilitate hyperinsulinism, insulin resistance and such-metabolic disturbances as arterial hypertension, diabetes mellitus and dyslipidemia. Androgens seem to play a key role in the development of obesity morphotypes. These notions have important practical applications: an excess of body fat is not necessarily pathogenic; as regards vascular and metabolic risks, body fat distribution seems to be more important than overweight.

Abdominal Muscles↗
PubMed2001

Relation between body composition, fat distribution, and lung function in elderly men.

BACKGROUND: Body composition changes with age, with increases in fat mass and visceral fat and declines in skeletal muscle mass; lung function also declines with age. Age-related changes in body composition and fat distribution may be associated with the pulmonary impairment observed in the elderly. OBJECTIVE: Our goal was to evaluate the relations between body composition, fat distribution, and lung function in elderly men. DESIGN: We studied 97 men aged 67-78 y with body mass indexes (BMIs; in kg/m2) ranging from 19.8 to 37.1. Body composition was evaluated by using dual-energy X-ray absorptiometry and fat distribution was evaluated by using waist and hip circumferences, waist-to-hip ratio, and sagittal abdominal diameter (SAD). Spirometry was done in all subjects and the distance walked by each subject during a 6-min walking test was evaluated as was leg strength. RESULTS: A significant negative correlation was found between adiposity, fat distribution indexes, forced vital capacity (FVC), and forced expiratory volume in 1 s (FEV1). A positive correlation was found between fat-free mass and FVC. After adjustment for age, height, and weight, SAD still correlated negatively with FVC and FEV1 (r = -0.367 and -0.348, respectively; P < 0.01), whereas percentage body fat and fat mass correlated negatively and fat-free mass correlated positively with FVC (r = -0.313, -0.323, and 0.299, respectively; all P < 0.01). After the sample was subdivided by tertile of fat-free mass adjusted for age and BMI, FVC and FEV1 were significantly lower in the lowest fat-free mass tertile (P < 0.01). Stepwise multiple regression analysis performed with use of lung function variables as the dependent variables and age, height, fat mass, fat-free mass, waist circumference, and SAD as the independent variables showed that 3 variables entered the regression for predicting FVC: height, which entered the regression first; SAD, which entered second; and fat-free mass, which entered third. Only 2 variables entered the regression for predicting FEV1: height, which entered the regression first, and SAD, which entered second. CONCLUSION: Our cross-sectional data show a significant association between body composition, fat distribution, and lung function in elderly men.

Absorptiometry, Photon↗
PubMed2002

[Evaluation of leptin levels in plasma and their reliance on other hormonal factors affecting tissue fat levels in people with various levels of endogenous cotisol].

The discovery of leptin (LEP) shed new light on mechanisms regulating body fat mass (BFM). In this aspect, interactions between LEP and glucocorticoids at hypothalamic level may be of great importance. Factors that influence plasma LEP levels have not been fully recognized and available data on LEP levels are often inconsistent. The aim of this study was to evaluate absolute and BFM-corrected plasma LEP levels and their diurnal variation, as well as to assess the relationship between LEP levels, body fat distribution, and hormones influencing body fat in subjects with various levels of endogenous cortisol and different nutritional status. Group I was composed of 14 women aged 14-58 yrs, BMI of 23.9-37.1 kg/m2, with hypercortisolism due to ACTH-dependent and ACTH-independent Cushing's syndrome (CUS). 17 women with visceral obesity (OTY) and normal or disturbed carbohydrate metabolism, i.e. impaired glucose tolerance (IGT) and diabetes mellitus (DM), aged 24 do 50 yrs, BMI 30.0-46.1 kg/m2, were included in group II. Group III consisted of 14 women with Addison's disease (AD), aged 18 do 63 yrs, BMI 15.4-31.6 kg/m2. The control group IV (KON) included 17 healthy women with normal BMI. BMI, WHR, body composition, and body fat distribution (DEXA method) were assessed in all subjects. Basal plasma levels of LEP, beta-endorphin (B-EP), cortisol (F), insulin-like growth factor-1 (IGF-1) were measured with RIA test kits. Plasma adrenocorticotrophin (ACTH) levels, serum levels of insulin (IRI) and growth hormone (GH) were measured with IRMA test kits. Blood glucose (G) concentration was determined with an enzymatic method. Adiposity-corrected LEP levels were expressed as LEP/BFM and LEP/%BF indices. Fasting insulin resistance index (FIRI) was also calculated. Higher BFM and %BF values were found in the OTY group as compared with CUS KON and AD groups. BFM distribution did not differ in KON and AD groups whereas CUS subjects exhibited a higher accumulation of fat in the trunk when compared to OTY subjects. Absolute LEP levels were correlated with trunk BF in CUS patients whereas in KON and AD groups these levels were correlated only with limb fat. Absolute LEP levels in CUS and OTY groups were comparable, whereas LEP/BFM and LEP/%BF indices were higher in the CUS group (Table 1) reflecting upregulation of LEP levels (Figs. 1, 2). BFM-corrected LEP levels were comparable in groups with normal cortisolemia, i.e. in OTY and KON groups, whereas in the AD group both absolute and BFM-corrected LEP levels were lower than in controls. No correlation was found between plasma levels of F and LEP in CUS and AD groups. This correlation was negative in KON (Fig. 3) and positive in OTY groups (Fig. 4). Moreover, KON and AD groups demonstrated a negative correlation between plasma ACTH and LEP levels. CUS patients showed positive, BFM-independent correlations between LEP levels, FIRI and G values, and a positive, BFM-dependent correlation between IRI and LEP levels. OTY patients exhibited a BFM-dependent positive correlation between FIRI and LEP levels. In these and in AD patients, a positive, BFM-independent correlation between IRI and LEP levels was found. Moreover, a negative, BFM-dependent correlation between GH and LEP levels was found in OTY patients. In this group, B-EP levels were positively correlated with LEP/BFM and LEP/%BF indices (Fig. 5). A negative correlation between LEP levels, LEP/BFM and LEP/%BF indices was ascertained in the AD group. In CUS, OTY, and KON groups, but not in the AD group, a midnight increase in leptin levels was observed. In conclusion, upregulation of leptin levels in relation to body fat in Cushing's syndrome is independent of the source of hypercortisolism. Apparently, it results from insulin resistance and hyperglycaemia and contributes to coexisting metabolic abnormalities. In Addison's disease, downregulation of leptin may reflect an adaptation mechanism to cortisol deficiency and result from low insulin and extremely high adrenocorticotrophin levels. In women with normal cortisol levels, irrespectively of nutritional status; leptin levels reflect body fat content. In obese subjects, leptin levels may be influenced by cortisol levels, high levels of insulin, IGF-1, and beta-endorphin as well as low levels of growth hormone. Disturbed function of hypothalamic-pituitary-adrenal axis (CUS, AD) does not directly influence diurnal variation in plasma leptin levels. In Cushing's syndrome, visceral fat may be a predominant source of leptin, whereas in women with normal or low cortisol levels peripherally accumulated fat may determine leptin secretion.

Addison Disease↗
PubMed1991

Body fat in the adult Danish population aged 35-65 years: an epidemiological study.

The purpose of the study was: (1) to estimate body fat and body fat distribution in the general population of Danes aged 35-65 years and thus provide tables of normal values for adult Danes in these age groups; and (2) to assess the effects of age and gender on relations between measures of obesity and of fat distribution. Hitherto, the only available results from the Danish population have been on BMI. Of the 3608 invited subjects 2987 (83 per cent) attended the examination. Body fat and fat distribution were estimated from measurements of electrical impedance and from circumference measurements. The study showed large differences in body fat and fat distribution between men and women. There was a difference in total body fat of 4.5 and 6.9 kg in men and women respectively between the groups aged 35 and 65 years. Fat percentage increased 36 per cent in women and 30 per cent in men between the groups aged 35 and 65 years. There was a difference in waist/hip ratio (WH ratio) between men and women at all age groups. Of the women 46 per cent had WH ratios above 0.8 and 14 per cent of the men had WH ratios above 1.0, suggesting that cut-off points for WH ratio as an indicator of cardiovascular risk are population specific. This may be caused by a different distribution of other cardiovascular risk factors in the Danish population than in other populations. Men had larger WH ratios per body fat mass with age, whereas in women there was no effect of age on this relation. Furthermore the WH ratio increments in this population took place before the age of 55 years in men, but after 55 years in women. The results may contribute to explain gender differences in morbidity and mortality with increasing age.

Adipose Tissue↗
PubMed1997

Prevalence of diabetes and impaired glucose tolerance in Aragón, Spain.

OBJECTIVE: To determine the prevalence of diabetes and impaired glucose tolerance (IGT) and to investigate their associated cardiovascular risk factors in Aragón, Spain. RESEARCH DESIGN AND METHODS: We performed a population-based cross-sectional study with stratified and purposive sampling of residents aged 10-74 years. A sample of 935 subjects (427 men and 508 women) was selected. All except those with a previous history of diabetes underwent an oral glucose tolerance test (OGTT), and World Health Organization (WHO) criteria were used for diagnosis of undiagnosed diabetes and IGT. Plasma lipid levels, blood pressure, BMI, and waist-to-hip ratio were also measured. RESULTS: The prevalence of diagnosed and undiagnosed diabetes and IGT was 3.1, 3.0, and 7.2%, respectively. In the age range of 30-64 years, the age-adjusted prevalence of diabetes (using the world population of Segi) was 7.1% in men and 5.6% in women. Both diabetes and IGT were associated with high blood pressure, high triglyceride levels, low HDL cholesterol levels, and overweight and upper-body fat distribution. Only upper-body fat distribution in women was significantly higher in subjects with diabetes than in subjects with IGT. CONCLUSIONS: The prevalence of diabetes in Aragón was moderately high (6.1%) and comparable with that reported in other white populations around the world. The proportion of unknown cases of diabetes was nearly 50%. Cardiovascular risk factors associated with diabetes and IGT supported the existence of an insulin resistance or metabolic syndrome, but there were not sufficient differences between diabetes and IGT to suggest a possible pathogenetic relation of hyperinsulinemia and associated risk factors.

Adolescent↗
PubMed2000

Fat redistribution in HIV disease.

BACKGROUND: Abnormal distributions of body fat have been reported in association with HIV infection, including cases of both regional loss and gain of fat. OBJECTIVE: We describe the spectrum of abnormal fat distribution in HIV-positive patients. METHODS: Patients were included if they demonstrated a lack of subcutaneous fat in the cheeks in the absence of generalized wasting. Patients were examined fully and photographed, and medical records were reviewed. RESULTS: Fourteen patients were seen. Further abnormalities of body fat distribution were noted in all patients. We found a consistent pattern of fat loss in the cheeks, temples, and extremities as well as fat gain over the neck, upper back, mastoid processes, chest, and visceral abdomen. CONCLUSION: A consistent syndrome of body fat redistribution is seen in HIV-positive patients. A characteristic pattern of fat loss in the cheeks may serve as a specific marker of HIV-related fat redistribution.

Adipose Tissue↗
PubMed1998

Alterations in growth and body composition during puberty: III. Influence of maturation, gender, body composition, fat distribution, aerobic fitness, and energy expenditure on nocturnal growth hormone release.

We examined the relationships among gender, sexual maturation, four-compartment model estimates of body composition, body fat distribution (magnetic resonance imaging for abdominal visceral fat and anthropometrics), aerobic fitness, basal and total energy expenditure, and overnight GH release in an ultrasensitive chemiluminescence assay in healthy prepubertal and pubertal boys (n = 18 and 11, respectively) and girls (n = 12 and 18, respectively). Blood samples were withdrawn every 10 min from 1800-0600 h to determine the area under the serum GH-time curve (AUC), sum of the GH peak heights (sigma GH peak heights), and the mean nadir GH concentration. GH release was greater in the pubertal than prepubertal subjects due to an increase in sigma GH peak heights (43.8 +/- 3.6 vs. 24.1 +/- 3.5 ng.mL-1, P = 0.0002) and mean nadir (1.7 +/- 0.2 vs. 0.7 +/- 0.2 ng.mL-1, P = 0.0002), but not peak number (4.3 +/- 0.2 vs. 4.5 +/- 0.2). The girls had a greater sigma GH peak heights (39.0 +/- 3.5 vs. 28.8 +/- 3.6 ng.mL-1, P = 0.05) and mean nadir concentration (1.4 +/- 0.2 vs. 0.9 +/- 0.2 ng.mL-1, P = 0.05) than the boys. Significant inverse relationships existed between sigma GH peak heights (r = -0.35, P = 0.06) or mean nadir (r = -0.39, P = 0.04) and four-compartment percent body fat for all boys but not for all girls or when combining all subjects. For all girls, significant inverse relationships existed between sigma GH peak heights (r = -0.39, P = 0.03) or mean nadir (r = -0.37, P = 0.04) and waist/hip ratio. Similar inverse relationships in all boys or all subjects were not significant. Forward stepwise regression analysis determined that bone age (i.e. maturation, primary factor) and gender were the significant predictors of AUC, sigma GH peak heights, and mean nadir. The influence of maturation reflects rising sex steroid concentrations, and the gender differences appear to be because of differences in estradiol concentrations rather than to body composition or body fat distribution.

Adipose Tissue↗
PubMed2004

Prevalence of obstructive sleep apnoea in a sample of obese women: effect of menopause.

BACKGROUND: Obesity is a well known risk factor for obstructive sleep apnoea (OSA). Previous studies have investigated the prevalence of OSA among obese people, but a sample of women was rarely studied. OBJECTIVE: To describe the anthropometric and polysomnographic characteristics of a sample of obese women and investigate the effect of menopause on the prevalence of OSA. MATERIALS AND METHODS: Using a full-night polysomnography we studied a sample of 133 obese women with a body mass index (BMI) > or = 30 kg/m2. RESULTS: About 44% of our sample had a respiratory disturbance index (RDI) > or = 10. Neck circumference, BMI and age resulted the strongest predictors of RDI value. We also found that the prevalence of OSA was higher among post-menopausal women (67%) in comparison with pre-menopausal women (31%). Moreover, post-menopausal women had larger neck circumference and higher waist-to-hip circumference ratio (WHR). CONCLUSIONS: Among post-menopausal obese women the prevalence of OSA increases. We suggest that menopause could cause a different body fat distribution with an increase of fat in upper parts of the body and, consequently, with an increase of neck circumference.

Adolescent↗
PubMed1999

[Distribution of adipose tissue and insulin serum levels in women with gestational diabetes].

Obesity has been mentioned as a major risk factor to develop gestational diabetes mellitus (GDM). In this work the main purpose was to compare the distribution of body fat tissue and insulin serum levels in obese women suffering GDM. Twenty obese pregnant patients, ten with GDM and ten non-diabetic control subjects were selected. To define the body fat distribution the following anthropometric indexes were performed: subscapular/triceps skinfold index (STI) during pregnancy (24-28 weeks) and STI plus waist/hip ratio (WHR) in postpartum (6 weeks). The two obese groups were evaluated through an oral glucose tolerance test, taking blood at 0, 60, 120 and 180 minutes; after centrifugation glucose serum levels were measured immediately by the glucose oxidase technique and the rest of the sample was kept frozen at -20 degrees C until insulin determinations by radioimmunoassay. The ten patients with GDM presented upper body fat, segment distribution, while among those without GDM, only six had this last feature and four were found with lower body fat segment distribution (p < 0.047). Insulin serum levels in GDM group were higher than in women without GDM (p < 0.01). The STI during and after pregnancy correlated positively (r = 0.77, p < 0.00003) and also with WHR (r = 0.61, p < 0.0001). There was correlation between STI and WHR both measured in postpartum (r = 0.52, p < 0.0007).

Adipose Tissue↗
PubMed1985

HLA system, body fat and fat distribution in children and adults.

The association between the genotypes and the alleles at the A, B or C locus of the HLA system and body fat was studied in a total of 1578 individuals subdivided in four cohorts: adult males (n greater than or equal to 204), adult females (n greater than or equal to 184), boys and male adolescents (n greater than or equal to 282), and girls and female adolescents (n greater than or equal to 257). None of these subjects were grossly obese or had known metabolic disorders. Percent body fat from underwater weighing, subcutaneous fat from 6 skinfold measurements, trunk fat (3 skinfolds) and extremity fat (3 skinfolds) were considered in the analysis. Although a few significant associations were encountered, the lack of consistency across samples suggested that they were probably random and biologically not meaningful. The same negative findings were found for the ratio of trunk subcutaneous fat to extremity subcutaneous fat and the ratio of subcutaneous fat (6 skinfolds) to total fat mass. Earlier reports indicating a significant association between high body fat content and antigens B18, Bw35 or Cw4 were not supported by the results of this study. It was concluded that no consistent pattern of association emerged between genotypes or alleles of the HLA system and percent body fat, subcutaneous fat or fat distribution in children and adults of both sexes.

ABO Blood-Group System↗
PubMedDate not supplied

Usual dietary isoflavone intake and body composition in postmenopausal women.

OBJECTIVE: Previous studies suggest an association between isoflavone supplementation and improved body composition. The purpose of this study was to investigate the cross-sectional association between isoflavone consumption from a typical Western diet and measures of total body fat, body fat distribution and lean body mass. DESIGN: This study examined 208 healthy, postmenopausal women, aged 45 to 74 years. At screening, demographic and behavioral characteristics and medical history were obtained. One month later, dietary intake for the past year was assessed with a standardized questionnaire. Anthropometric measurements were obtained, and bioelectric impedance was used to measure total body fat (lb) and lean body mass (lb). Isoflavone consumption did not vary by age, smoking, exercise, or daily alcohol intake. RESULTS: A significant inverse relation was shown between genistein consumption and weight, body mass index, waist circumference, and total body fat mass by bioelectric impedance analysis (P < 0.05). These findings remained significant after adjustment for potential confounders. No association was seen, however, between genistein, daidzein, or total isoflavone intake and body fat distribution or lean body mass. CONCLUSION: This study suggests that usual dietary isoflavone intake is associated with reduced total body fat and may consequently have a role in the prevention of chronic disease.

Aged↗
PubMed1986

Upper body and centralized adiposity in Mexican Americans and non-Hispanic whites: relationship to body mass index and other behavioral and demographic variables.

Mexican Americans have a higher prevalence of NIDDM, more overall obesity and more centralized adiposity than non-Hispanic whites, but have thus far not been characterized as to whether they have greater upper body adiposity. Waist-to-hip circumferences (WHR, a measure of upper body adiposity) and subscapular-to-triceps skinfold ratios (centrality index, a measure of centralized adiposity) were determined in 725 Mexican Americans and 226 non-Hispanic whites as part of the San Antonio Heart Study, a population-based study of diabetes and cardiovascular risk factors. Mexican American females had higher centrality indices and WHRs than non-Hispanic white females, even after adjustment for demographic (age, menopausal status) and behavioral variables (body mass index, parity, cigarette smoking, alcohol consumption, exercise, and oral contraceptive and estrogen use). Mexican American males had higher centrality indices than non-Hispanic white males, but differences in WHR disappeared after adjustment for overall adiposity (body mass index). Of the demographic and behavioral variables, only age and body mass index were consistently related to regional body fat distribution. The lack of an association between body fat distribution and behavioral variables suggests that genetic factors may play the principal role in determining body fat distribution. Surprisingly, the distributions of centrality index and WHR were relatively independent of one another suggesting that they may be used as distinct, independent predictors of metabolic diseases.

Adipose Tissue↗
PubMed1994

Abdominal obesity and mortality risk among men in nineteenth-century North America.

The health consequences of an adverse body-fat distribution (e.g., android, upper-body, visceral) have only recently concerned the medical community. Ninety years ago, however, actuarial study demonstrated the relationship of body-fat distribution to the mortality experience of insured, North American men. Thirty-four insurance companies pooled their data on males issued life policies between 1870 and 1899. Special classes of risk were defined by weight for height at baseline or by the observation that abdominal girth exceeded the girth of the expanded chest (abdominal obesity). The mortality experience of each risk class was compared to an age-stratified, actuarial table of the period. We present new analyses of these historical data relating specifically to the mortality impact of abdominal obesity. Among 163,567 overweight men, the prevalence of abdominal obesity increased with age and with degree of overweight. Among moderately overweight men, those with abdominal obesity experienced 133% of the expected mortality rate compared to 112% of the expected mortality for those who were not abdominally obese. Severely overweight men with abdominal obesity experienced 152% of the expected mortality compared to 135% of the expected mortality for severely overweight men who were not abdominally obese. We believe this nineteenth-century, acturial study of waist and chest girths was the first demonstration that body-fat distribution can influence longevity. These early actuarial findings, taken with more recent reports, establish that abdominal enlargement, but not necessarily an 'upper-body' fat distribution, constitutes a major health hazard. Future research must establish which abdominal-obesity index best predicts disease outcomes.

Abdomen↗
PubMed1987

Obesity and serum lipids: an evaluation of the relative contribution of body fat and fat distribution to lipid levels.

The association of obesity and hyperlipidemia does not mean that fatness per se is the primary determinant of the lipid abnormality. To evaluate the contribution of fatness to fasting levels of serum triglycerides (TG), LDL cholesterol (LDL-C), and HDL cholesterol (HDL-C), we analyzed data on 368 caucasian adults (286 women, 82 men) consecutively entering a weight control program. Although most subjects were overweight, the population represented a wide spectrum of body weights and lipid levels. Study variables included body fat mass (by total body water), fat free mass (FFM), body build (chest to height ratio), fat cell size and number (from bilateral buttock biopsy specimens), upper-lower body fat pattern by arm to thigh circumference ratio, central-peripheral fat pattern by subcapsular to triceps skinfold ratio, waist to hip ratio, and the presence or absence of diabetes. Our results concurred with previously noted correlations of body weight with TG (r = 0.29, P less than 0.0001) and with HDL-C (r = -0.28, P less than 0.0001) at least in the larger sample of women, but there was no significant correlation with LDL-C (r = -0.06). In order to evaluate the relative contribution of the various components of body composition and fat distribution to lipid levels, stepwise regression analyses were performed on the subgroups of women and men. Among women: TG level was predicted best by FFM, upper body fat pattern, age, and diabetes (explaining 30 percent of TG variance); LDL-C level was predicted by age only (explaining 12 percent of variance); and HDL-C level was predicted by body build only (8 percent). Among men: TG level was predicted best by central and upper body fat patterns and diabetes (31 percent of variance); LDL-C and HDL-C levels were not significantly predicted by any of the 11 study variables. These results, obtained from cross-sectional analysis of a predominantly obese sample, suggest that lipid levels may be more directly related to body fat pattern, fat free mass and body build than to body fatness itself.

Adipose Tissue↗