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PubMed1990

Effect of intensity of physical activity on body fatness and fat distribution.

To evaluate the effect of intensity of physical activity on body fatness and fat distribution, observations of 1366 women and 1257 men who participated in the 1981 Canada Fitness Survey were analyzed. Subjects were tested for energy expenditure of leisure-time activities and estimated maximal oxygen uptake (VO2max), body fatness was measured by subcutaneous skinfold thicknesses, and anthropometric measurements were made. Subjects of both sexes were categorized into four subgroups on the basis of their participation in leisure-time activities of various intensities. In general, subjects practicing vigorous activities on a regular basis had lower subcutaneous skinfold thicknesses and waist-to-hip ratios (WHRs) than those not performing these activities. These differences remained statistically significant after a covariance analysis was used to remove the effect of total energy expenditure of leisure-time activities on subcutaneous fat and fat distribution. Moreover, the WHR remained significantly lower in subjects performing high-intensity exercise after the effect of subcutaneous fat on fat distribution was adjusted for.

Adipose Tissue↗
PubMed2002

Sex and race differences in fat distribution among Asian, African-American, and Caucasian prepubertal children.

Sexual dimorphism in fat distribution is thought to emerge during puberty. Truncal or android body fat distribution is characteristic of adult males but is also recognized as a human cardiovascular risk factor. Race differences in truncal fat are clearly evident in adults and have been described in prepubertal children but not between Asians and other race groups. The aim of this study in African-American, Asian, and Caucasian prepubertal children was to evaluate sex differences and race differences in body fat distribution. Analysis of covariance was used to explore fat distribution in 358 prepubertal children (176 girls and 182 boys; 143 Asians, 95 African-Americans, and 120 Caucasians), measured by skinfold thickness and dual-energy x-ray absorptiometry (DXA) in a cross-sectional study. Extremity and gynoid fat masses were evaluated after adjustment for trunk or android fat, respectively, and for covariates including age, weight, height, and interactions. In Asian children, sex differences were present in models for gynoid fat by DXA only (P < 0.001), with girls having greater gynoid fat than boys. In African-American and Caucasian children, sex differences were present in models for extremity and gynoid fat masses, measured by both methods. Among girls, Asians had generally lower adjusted extremity and gynoid fat than Caucasians and African-Americans. Among boys, Asians had lower adjusted extremity fat by DXA than Caucasians (P < 0.01) but greater gynoid fat by skinfolds than African-Americans (P < 0.01). This study of prepubertal children demonstrates that: 1) sex differences in body fat distribution are present in prepubertal children but that the specific characteristics for Asians differ from African-Americans and Caucasians, and 2) differences in body fat distribution in Asian children, compared with African-Americans and Caucasians, are present but vary by sex. This comparison of African-American, Asian, and Caucasian prepubertal children suggests phenotypic differences. Additional studies are needed to explore the metabolic and health risk implications of these findings.

Abdomen↗
PubMed2005

Lack of age-related increase in average glycemia in a non-Westernized sample of rural Yucatec Maya females.

Age-related decline in glucose processing and the associated progressively higher circulating glucose levels are considered well-established biological aging phenomena. However, their occurrence in non-Westernized populations characterized by less mechanization and dietary processing has not been well-studied. This research extends evaluation of lifestyle conditions of diet and physical activity beyond those of Westernized areas and examines aging patterns in blood glucose among rural Yucatec Maya. The purpose is to investigate whether deteriorating glucose processing is intrinsic to human aging, while controlling for body composition in a non-Westernized setting. Data were gathered from 60 nondiabetic Maya women, 40-85 years of age, living in 16 rural villages around Merida, Yucatan. Information regarding personal history, diet, and physical activity was collected through interviews. Body composition was assessed through anthropometric and derived indicators of body size, fat distribution, body mass index, intra-abdominal fat, and total fat and fat-free masses. Glycemia was measured through microvenous samples analyzed for glycated hemoglobin (HbA(1c)) and fructosamine, to demonstrate average circulating glucose under customary living conditions. As indicated by glycation, average glycemia is not higher in older Maya females (age group F for HbA(1c) = 0.88, P > 0.05; age group F for fructosamine = 0.38, P > 0.05). Further, correlations between age and HbA(1c) (r = -0.13, P > 0.05) and fructosamine (r = -0.10, P > 0.05) are negative and not significant. The absence of significant, positive age associations with HbA(1c) and fructosamine persists when effects of body composition are taken into account. Thus, decline in glucose regulation does not appear to be a feature of aging in this non-Westernized sample, suggesting that age-related deterioration in glucose processing is not universal among human populations. Results suggest that relationships of age with glycemia are linked to lifestyle differences.

Adult↗
PubMed1990

Cigarette smoking, adiposity, non-insulin-dependent diabetes, and coronary heart disease in Japanese-American men.

PURPOSE: Coronary heart disease has been described to be increased with both glucose intolerance and cigarette smoking. All three of these have also been reported to be associated with central adiposity (disproportionate deposition of fat on the trunk compared to the extremities). The purpose of this analysis was to determine the relationship of cigarette smoking to glucose intolerance and coronary heart disease, the relationship of cigarette smoking to risk factors such as adiposity, body fat distribution, and plasma lipoprotein and insulin levels, the relationship of cigarette smoking to these risk factors independent of disease status, and whether these risk factors could account for any of the relationship between cigarette smoking and disease status. PATIENTS AND METHODS: The study design was cross-sectional. The study sample contained 219 middle-aged and elderly Japanese-American men: 77 with normal and 74 with impaired glucose tolerance and 68 with type II diabetes. There were 54 men with coronary heart disease. A detailed smoking history was obtained. Glucose tolerance status was established by medical history and a 75-g oral glucose tolerance test. Coronary heart disease was determined by medical history and a resting electrocardiogram. Adiposity and fat distribution measurements were body mass index (kg/m2), skinfold thicknesses, body circumferences, and cross-sectional fat areas by computed tomography. Levels of insulin, C-peptide, cholesterol (total, low-density lipoprotein [LDL], high-density lipoprotein [HDL], HDL2, HDL3, very-low-density lipoprotein [VLDL]), and triglyceride (total, VLDL) were measured in fasting blood specimens. RESULTS: A central pattern of body fat was associated with both non-insulin-dependent diabetes mellitus and coronary heart disease. Smoking history was related to both adiposity and body fat distribution, and was strongly related to coronary heart disease but not to diabetes. Past smokers who had smoked up to a month ago were the heaviest while present smokers who were currently smoking or had smoked within the past month were the leanest. However, although present smokers had reduced amounts of fat, this was attributable to those present smokers without heart disease. Present smokers with heart disease were not as lean and had increased amounts of intra-abdominal fat. Past smokers had the greatest amount of central fat and this was attributable to those with heart disease. By two-way (smoking history and coronary heart disease status) analysis of covariance, smoking history was significantly related only to subcutaneous fat disposition on the chest and abdomen independent of coronary heart disease, while coronary heart disease status was strongly related to plasma levels of insulin C-peptide, VLDL, HDL, HDL2, and HDL3 cholesterol, and total and VLDL triglyceride, independent of smoking history. Further analysis showed that none of the body fat variables could account for the risk of coronary heart disease associated with smoking history. Higher fasting plasma C-peptide levels in past smokers accounted statistically for part of the risk of coronary heart disease associated with cigarette smoking. However, this effect was not mediated by any of the body fat measurements. CONCLUSIONS: Disproportionately increased intra-abdominal fat is related to coronary heart disease but not to smoking history. Smoking history is related to coronary heart disease but not to diabetes. Weight gain is associated with smoking cessation and appears to be concentrated in the central subcutaneous regions, especially for those who have coronary heart disease. Weight gain associated with cessation of smoking appears to be unrelated to atherogenic changes in lipids, lipoproteins, or insulin. Other pathogenic processes must be considered in the association between smoking and coronary heart disease.

Adipose Tissue↗
PubMed2002

Ultrasound measurement of visceral and subcutaneous fat in morbidly obese patients before and after laparoscopic adjustable gastric banding: comparison with computerized tomography and with anthropometric measurements.

BACKGROUND: There are now a variety of methods to assess body fat distribution, anthropometric (waist circumference and waist/hip W/H ratio), computed tomography (CT), and ultrasound (US) measurements, with CT considered as the reference method. Bariatric surgery leads to a significant and usually durable weight loss in morbidly obese patients; when assessing its results, it is of interest to measure changes of total fat tissue and of body fat distribution. METHODS: In this study, we compared anthropometric, US, and CT measurements of body fat distribution under basal conditions and 1 year after laparoscopic adjustable gastric banding (LAGB); 120 morbidly obese patients were considered at baseline, and 40 patients were re-evaluated 1 year after LAGB. RESULTS: Thickness of visceral and subcutaneous fat measured through CT and US methods was superimposable both under basal conditions and 1 year after LAGB, and the highest correlation was found between CT and US data on visceral fat, followed by CT and US data on subcutaneous fat; a fair correlation was also found between CT and US data on visceral fat and waist circumference. CONCLUSION: We suggest that evaluation of body fat distribution is accomplished by US instead of CT measurement, because of its lower cost and low exposure risk. Waist circumference stands as a reasonable surrogate of both methods, while W/H ratio is poorly correlated with other measures of body fat distribution.

Adipose Tissue↗
PubMed2005

Prediction of segmental percent fat using anthropometric variables.

AIM: This study aimed to develop a prediction equation for segmental percent fat from anthropometric measurements. METHODS: The subjects were 107 adults, consisting of 77 males and 30 females, aged from 21 to 82 years. Height, weight, waist circumference, hip circumference, body mass index, waist hip ratio and subcutaneous fat thickness (SFT) were used as anthropometric measurements. The SFTs were measured at 14 sites. Segmental percent fats in both arms (%SF(arms)), both legs (%SF(legs)) and trunk (%SF(trunk)) were measured by dual-energy absorptiometry (DXA) method, and these values were used as references. To predict the segmental percent fat measured by DXA, stepwise multiple regression analysis was conducted using sex, age and the anthropometric measurements as predictors. To examine the systematic error between the observed and predicted values, the error and the observed values were plotted based on Bland-Altman technique, and limits of agreement (LA) were also calculated. RESULTS: The R, SEE and range of LA values in each prediction equation was as follows: %SF(arms): R=0.919, SEE=3.333%, LA=6.5%; %SF(legs): R=0.915, SEE=3.468, LA=6.5%; %SF(trunk): R=0.858, SEE=4.944, LA=9.7%. These prediction equations used 5 to 7 predictors and met the necessary standards for predicting body fat. Although the prediction accuracy of %SF(trunk) was inferior than those of %SF(arms) and %SF(legs), it was superior to those found in previous study reports predicting abdominal visceral fat mass and fat mass at the trunk from anthropometric measurements. CONCLUSIONS: These prediction equations can be considered useful and practical for predicting segmental percent fat and assessing body fat distribution.

Abdominal Fat↗
PubMed2000

Comparison of anthropometric characteristics between normotensive and hypertensive individuals among a population of Bengalee Hindu elderly men in Calcutta, India.

A comparative investigation of 99 normotensive and 111 hypertensive Bengalee Hindu elderly men (aged 55 years and above) of Kalighat, South Calcutta, India, was undertaken to study differences in levels of adiposity, body fat distribution and body composition between these two groups. Results revealed that there were significant differences between normotensive (NT) and hypertensive (HT) subjects in the mean values for weight (p < 0.05), body mass index (BMI, p < 0.01); waist (p < 0.001) and hip circumferences (p < 0.05); waist-hip ratio (WHR, p < 0.001), conicity index (CI, p < 0.01) and fat free mass (FFM, p < 0.001). Percentile distributions for all these variables and indices showed consistently higher values among the HT patients as compared with NT subjects. However, the frequency of obesity (BMI > or = 25) was similar (NT = 6.1%, HT = 11.7%) in both groups. Thus, these results indicated that there existed significant differences in central adiposity and FFM between NT and HT subjects although their level of obesity was similar. Hypertensive individuals have significantly enhanced levels of central body fat distribution.

Aged↗
PubMed2005

Body composition and fat distribution influence systemic hemodynamics in the absence of obesity: the HyperGEN Study.

BACKGROUND: We have shown that increased cardiac output is related to both fat-free mass and fat mass in obesity. OBJECTIVE: We studied the association of body fat distribution and body composition with flow-resistance relations in overweight. DESIGN: We studied 521 overweight, nonobese participants in the Hypertension Genetic Epidemiology Network (HyperGEN) Study-a component of the National Heart, Lung, and Blood Institute Family Blood Pressure Program, designed to assess the genetic basis of hypertension. Participants had normal ventricular function and no cardiovascular disease: 261 with central fat distribution (CFD) (waist girth >88 cm in women and >102 cm in men) and 260 with peripheral fat distribution (PFD). Fat-free mass (FFM) and fat mass (FM) were measured by bioelectric impedance. Body composition was estimated as FM/FFM. Echocardiographic stroke volume (SV) and cardiac output (CO) were measured. RESULTS: Hypertension was present in 73% of the subjects with PFD and in 78% with CFD. Overweight with CFD was associated with greater FM/FFM in both normotensive and hypertensive participants. After FFM, age, sex, and race were controlled for, SV and CO were higher in subjects overweight with CFD than in those with PFD, whereas peripheral resistance was not significantly different. Differences in CO between CFD and PFD were reduced after further adjustment for FM. After the covariates were controlled for, hypertensive subjects had higher peripheral resistance and lower arterial compliance than did normotensive participants, but cardiac output was not significantly different. CONCLUSION: CFD is associated with more severe abnormalities in body composition and with higher CO independently of FFM in overweight, nonobese subjects.

Adipose Tissue↗
PubMed1997

Gender differences in resting metabolic rate and noradrenaline kinetics in older individuals.

The physiological factors mediating gender differences in resting metabolic rate (RMR) in older individuals are presently unclear. We examined the contribution of sympathetic nervous system activity to gender differences in resting metabolic rate in older men and women and its relation to body fat distribution. We performed measurements of noradrenaline (NA) kinetics from infusions of [3H]-NA, RMR, body fat distribution, body composition, peak Vo2 and dietary intake in 29 older men (69 +/- 6 years) and 26 older women (65 +/- 5 years). Older men weighed more (P < 0.01) and had a greater fat-free mass (P < 0.01) and a larger waist circumference (P < 0.01) than older women. Older men had a higher RMR (P < 0.05) than older women, which persisted after controlling for differences in fat-free mass and fat mass. Older men also showed a greater NA appearance rate (P < 0.01) at rest than older women. The higher NA appearance rate in older men was partly related to their greater waist circumference (r = 0.50, P < 0.01). We explored the sympathetic contribution to gender differences in RMR by statistically controlling for differences in body composition and NA appearance rate. After this procedure, we found no gender differences in adjusted RMR between older men (4.3 +/- 0.5 kJ min(-1)) and older women (4.3 +/- 0.4 kJ min(-1)). Our results suggest that: (a) older men have a higher RMR than older women independent of differences in body composition; (b) the higher RMR in older men may be partly due to higher levels of sympathetic nervous system activity; (c) the higher sympathetic nervous system activity in older men is partly related to their greater waist circumference, a proxy measure of central body fatness.

Aged↗
PubMed2006

Relationship between fat cell size and number and fatty acid composition in adipose tissue from different fat depots in overweight/obese humans.

OBJECTIVE: To evaluate the body fat distribution and fat cell size and number in an overweight/obese population from both genders, and to determine the possible relationship between fat cell data from three different adipose tissue localizations (subcutaneous (SA), perivisceral and omental) and adipose tissue composition and dietary fatty acid. DESIGN: The sample consisted of 84 overweight/obese patients (29 men and 55 women) who have undergone abdominal surgery. The adipocyte size and total fat cell number was studied. Fat cell data were related with anthropometric, adipose tissue and subject's habitual diet fatty acid composition. MEASUREMENTS: Fat cell size was measured according to a Sjöström method from the three adipose depots. Total fat cell number was also calculated. The fatty acid composition of adipose tissue was examined by gas chromatography. The subjects diet was studied by a 7 days dietary record. RESULTS: Our data showed a negative relationship between the adipocyte size and the n-6 and n-3 fatty acids content of the SA adipose tissue (r=-0.286, P=0,040; r=-0.300, P=0.030) respectively, and the n-6 in the omental depots (r=-0.407, P=0.049) in the total population. Positive associations with the total of saturated (r=0.357, P=0.045) and negative (r=-0.544, P=0.001) with the n-9 fatty acids were observed when the relationship between the adipocyte number and the fatty acid composition of the different anatomical fat regions was studied. Dietary fatty acids composition positively correlated with fat cell size for the myristic acid (14:0) in men in the visceral depot (r=0.822, P=0.023), and for the saturated fatty acids (SFAs) in women in the omental depot (r=0.486, P=0.035). CONCLUSION: In the present study, for the first time in humans we found that n-3 and n-6 fatty acids are related to a reduced adipocyte size according to the depot localization. In contrast, adipose tissue and dietary SFAs significantly correlated with an increase in fat cell size and number. No significant associations were found between n-9 acids content and adipocyte size. However, n-9 adipose tissue fatty acids content was inversely associated with fat cell number showing that this type of fatty acid could limit hyperplasia in obese populations. The differences observed in the three different regions, perivisceral, omental and SA fat, indicate that this population adipose tissue have depot-specific differences.

Adipocytes↗
PubMed2005

The implication of obesity and central fat on markers of chronic inflammation: The ATTICA study.

OBJECTIVE: We evaluated the association of obesity with various markers of chronic inflammation, in a population-based sample of 3,042 adults. METHODS: During 2001-2002, we randomly enrolled 1,514 men (18-87 years old) and 1,528 women (18-89 years old), from the Attica area, Greece; the sampling was stratified by the age-sex distribution of the region (census 2001). Among several variables, we also measured various inflammatory markers (C-reactive protein, tumor necrosis factor alpha, amyloid A, white blood cells and interleukin-6) and anthropometric variables (weight, height, waist and hip circumferences). Central fat was defined as waist-to-hip ratio>or=0.95 in men and>or=0.8 in women, while obesity as body mass index (BMI)>29.9 kg/m(2). RESULTS: Central fat prevailed in 36% of men and 43% of women (p<0.001), while obesity prevailed in 20% of men and 15% of women, respectively. Compared to participants with normal body fat distribution, those with central fat exhibited 53% higher C-reactive protein levels, 30% higher tumor necrosis factor, alpha levels, 26% higher amyloid A levels, 17% higher white blood cell counts and 42% higher interleukin-6 levels (all p<0.05). We observed that all inflammation markers were related to BMI (index for obesity), waist and to waist-to-hip ratio (indices for central fat), in both genders. Moreover, the models that included waist or waist-to-hip ratio as independent variable had higher explanatory ability (i.e. R(2)) than the models included BMI, especially in women, even after adjusting for age and various other potential confounders. CONCLUSION: Our results suggest a relationship between central adiposity and inflammation process, irrespective of age and other potential confounders. This association was more prominent than the relationship between total obesity and inflammation. It could be hypothesized that a disproportionate accumulation of visceral fat mass could be partially associated with increased coronary risk, through inflammation process.

Adolescent↗
PubMed1989

Body fat mass distribution. Influence on metabolic and atherosclerotic parameters in non-insulin dependent diabetics and obese subjects with and without impaired glucose tolerance. Influence of weight reduction.

Due to the recent knowledge that the distribution of fat deposits would be a better predictor of cardiovascular disease than the degree of obesity, some risk factors for atherosclerosis were evaluated in middle age type II male diabetics and in obese subjects with and without glucose intolerance. In non-insulin dependent diabetes, abdominal adiposity reflected by the waist/hip-circumference (WHR) was related to parameters of metabolic control, lipid parameters, blood rheology, insulin status, hypertension and known vascular complications in three different groups. In the groups with abdominal obesity, the mean annual HbA1 is significantly (p less than 0.01) higher than the group without an abdominal fat mass distribution. Atherogenic index is significantly increased in the group with the highest WHR. HDL-cholesterol levels are significantly decreased in both groups with upper body fat distribution. A highly significant (p less than 0.001) correlation was present between WHR and HDL-cholesterol and WHR and total/HDL-cholesterol ratio; this significant correlation remains after correction for body mass index. Whole blood and plasma viscosity and fibrinogen levels are significantly (p less than 0.05) increased in diabetics with upper body fat accumulation and could be compared to patients with proven coronary ischemic heart disease. The frequency of peripheral vascular disease, coronary ischemic heart disease and hypertension is most prominent in diabetics with an abdominal fat mass distribution. Systolic blood pressure even seems to be increased in non-obese diabetics with the highest WHR. A correlation could be found between WHR and both systolic and diastolic blood pressure. When corrected for body mass index the same significant correlation between WHR and blood pressure remained. Both fasting and postprandial insulin and C-peptide values may be the link between abdominal fat deposits and all metabolic disturbances. These results confirm the negative effect of an excess of abdominally located fat cells, even without manifest obesity, on diabetes metabolic control, lipid fractions, hypertension, insulin behaviour, blood rheology and cardiovascular complications. In obese patients with upper body fat accumulation a higher prevalence of glucose intolerance and diabetes is present, in contrast to their counterparts with lower body fat deposit. Both fasting glycemia, insulin and insulin area are significantly (p less than 0.005) increased in the group with the greatest WHR.(ABSTRACT TRUNCATED AT 400 WORDS)

Adipose Tissue↗
PubMed1989

Ethnic differences in anthropometric characteristics of young children and their parents.

The distribution of body fat, or fat patterning, is an important risk factor for cardiovascular disease and diabetes, independent of obesity. Furthermore, the incidence of cardiovascular disease and diabetes varies by ethnicity. We documented ethnic differences in anthropometric characteristics and body fat distribution between Anglo, Black, and Mexican American men (n = 101), women (n = 245), boys (n = 111), and girls (n = 111). We used aggregates of skinfold measures to examine ethnic differences in the deposition of fat in body compartments (body, trunk, leg, and arm) and analyzed trunk-extremity skinfold ratios to determine which best reflected ethnic differences in fat distribution. The results show that Mexican American mothers have larger skinfold ratios and more body fat (as determined by skinfold aggregates) than either Anglo or Black American mothers, whereas Black American mothers have larger ratios than Anglo American mothers. Mexican American fathers also have larger skinfold ratios but not more body fat (skinfold aggregates) than Anglo American fathers. Mexican American fathers have more body fat than Black American fathers, but we found no differences between skinfold ratios. The ethnic differences among children in skinfold ratios and aggregates are similar to those found among fathers, with more differences among girls than boys. Fat patterning differences do exist among the three ethnicities, with greater trunk fat among Mexican and Black Americans. Those ethnicities are known to be at higher risk for cardiovascular disease and diabetes.

Adult↗
PubMed2005

Resistin is not associated with insulin sensitivity or the metabolic syndrome in humans.

AIMS/HYPOTHESIS: The aim of this study was to further elucidate the relationship between resistin and insulin sensitivity, body fat distribution and the metabolic syndrome in humans. METHODS: We measured plasma resistin levels in 177 non-diabetic subjects (75 male, 102 female; age 32-75 years). BMI, waist circumference, blood pressure, lipids, glucose, plasminogen-activator inhibitor 1 (PAI-1), adiponectin and leptin levels were also measured. The insulin sensitivity index (S(I)) was quantified using Bergman's minimal model. Intra-abdominal fat (IAF) and subcutaneous fat (SQF) areas were quantified by CT scan. Presence of metabolic syndrome criteria was determined using the National Cholesterol Education Program Adult Treatment Panel III guidelines. RESULTS: When subjects were divided into categories based on BMI (< or > or =27.5 kg/m(2)) and S(I) (< or > or = 7 x 10(-5) min(-1) [pmol/l](-1)), resistin levels did not differ between the lean, insulin-sensitive (n=53, 5.36+/-0.3 ng/ml), lean, insulin-resistant (n=67, 5.70+/-0.4 ng/ml) and obese, insulin-resistant groups (n=48, 5.94+/-0.4 ng/ml; ANOVA p=0.65). Resistin correlated with age (r=-0.22, p<0.01), BMI (r=0.16, p=0.03) and SQF (r=0.19, p=0.01) but not with S(I) (p=0.31) or IAF (p=0.52). Resistin did not correlate with the number of metabolic syndrome criteria or any of the individual metabolic syndrome criteria. In contrast, adiponectin, PAI-1 and leptin each correlated with IAF, SQF and S(I). Additionally, the number of metabolic syndrome criteria correlated with adiponectin (r=-0.32, p<0.001), leptin (r=0.31, p<0.001) and PAI-1 (r=0.26, p=0.001). CONCLUSIONS/INTERPRETATION: In contrast to other adipokines, resistin is only weakly associated with body fat and is unlikely to be a major mediator of insulin resistance or the metabolic syndrome in humans.

Adiponectin↗
PubMed2001

Fat distribution in obese women is associated with subtle alterations of the hypothalamic-pituitary-adrenal axis activity and sensitivity to glucocorticoids.

OBJECTIVES: Obesity with abdominal body fat distribution (A-BFD) and hypothalamic-pituitary-adrenal (HPA) axis activity are somehow linked, but the exact interactions still need clarification. Obese subjects display normal circulating plasma cortisol concentrations with normal circadian rhythms. However, when the HPA axis is pharmacologically challenged, body fat distribution matters and then A-BFD obese women differ from those with subcutaneous body fat distribution (P-BFD). We hypothesized that lower dose provocative and suppressive tests than those used to diagnose hypercortisolism of tumour origin or adrenal insufficiency would shed some light on the characteristics of the HPA axis activity in relation with body fat distribution. PATIENTS AND METHODS: Fifty premenopausal obese women were grouped according to their body fat mass distribution. Their plasma cortisol responses to (i) two low doses of dexamethasone (0.25 and 0.5 mg) with (ii) low dose of the ACTH analogue tetracosactrin (1 microg) were assessed. Salivary cortisol was also determined during the ACTH test. RESULTS: A-BFD differed from P-BFD women in terms of HPA axis responsiveness. They had comparatively: (i) increased nocturnal cortisol excretion (9.38 +/- 2.2 vs. 6.82 +/- 0.91 nmol/micromol creatinine, A-BFD vs. P-BFD, respectively, P = 0.03); (ii) increased salivary cortisol response to ACTH stimulation (1 microg) [salivary cortisol peak: 33.4 (14.1-129) vs. 28.5 (13.2-42.8) nmol/l; salivary AUC: 825 (235-44738) vs. 537 (69-1420) nmol/min/l; A-BFD vs. P-BFD, P = 0.04 for both]; and (iii) increased pituitary sensitivity to dexamethasone testing [postdexamethasone (0.25 mg) plasma cortisol levels: 163 (26-472) vs. 318 (26-652) nmol/l and postdexamethasone (0.5 mg) plasma cortisol levels: 26 (26-79) vs. 33 (26-402) nmol/l; A-BFD vs. P-BFD, P = 0.01 for both). CONCLUSIONS: These data demonstrate differences in the HPA axis activity and sensitivity to glucocorticoids between obese women differing in their body fat distribution, with both enhanced negative and positive feedback in those with abdominal obesity. Several mechanisms may explain these differences: central vs. peripheral hypotheses. Thus, abdominal obesity does not appear to be linked solely to one pathophysiological hypothesis.

Adolescent↗
PubMed1997

Genetic susceptibility to visceral obesity and related clinical implications.

This paper reviews evidence supporting the notion that genetic factors may have an influence on the determination of body fat distribution, particularly emphasizing the genetic susceptibility of visceral adipose tissue (AT) accumulation. The potential contribution of genetic susceptibility to the development of metabolic alterations in visceral obese individuals will also be reviewed. The contribution of genetic factors to the variation in body fat distribution is supported by studies in which racial differences in body fat distribution were reported. These ethnic differences suggest that body fat distribution may be influenced by some components of the genetic background which are shared among individuals of a given race. Furthermore, the familial aggregation and the resemblance between monozygotic twins that have been observed for anthropometric measurements of body fat distribution and for visceral AT accumulation measured by computed tomography, also suggest that genetic factors are involved in the determination of body fat distribution. Genetic susceptibility may also influence the relationship between visceral AT accumulation and the development of metabolic alterations. In this regard, it has been reported that the polymorphism of some genes (for example, the apolipoprotein (apo) E, apo B100 and lipoprotein lipase genes) is altering the relationship between visceral obesity and plasma lipoprotein-lipid levels. In conclusion, results presented in this paper suggest that genetic factors seem to have a significant influence on the propensity to accumulate AT in the visceral depot and that genetic factors also seem to affect the associations commonly reported between visceral obesity and the development of metabolic alterations.

Adult↗
PubMed1988

Body fat deposition in adult obese women. II. Changes in fat distribution accompanying weight reduction.

This study examined changes in body fat distribution in 68 women who lost an average of 12.3 kg from an initial weight of 103.6 kg. Weight reduction was accompanied by a small but statistically significant reduction of 1.2% in the waist-to-hip ratio, suggestive of a reduction in upper-body obesity. Subjects with greater upper-body obesity tended to achieve greater reductions in the waist-to-hip ratio. Changes in five circumference measures were highly correlated with losses of fat and showed that subjects with lower-body obesity tended to lose large amounts of fat from both their upper and lower fat depots while subjects with upper-body obesity lost fat primarily from their upper depots. Women with lower-body obesity tended to lose more total body fat than did women with upper body obesity (r = -0.26, p less than 0.04).

Adipose Tissue↗
PubMed1986

Muscle tissue in obesity with different distribution of adipose tissue. Effects of physical training.

Obese men and women with the same body fat mass, as well as obese women in another study, were divided into groups with male or female type of body fat distribution, but again with similar body fat mass. The participants were examined with measurements of body composition, including muscle fiber distribution, as well as circulatory and metabolic variables before and after physical training under controlled conditions. Obese men had higher lean body mass, blood pressure, blood glucose and plasma insulin, C-peptide, cholesterol and triglyceride concentrations than age- and body fat-matched obese women. Obese women with male type of adipose tissue distribution showed the same differences (except cholesterol) in comparisons with women with female type of adipose tissue distribution. The women with male type obesity were also more insulin resistant in glucose clamp measurements, and had male type of muscle fiber distribution. Physical training in the group of obese men resulted in a decrease of body fat, a further increase of lean body mass, an increase of fast twitch, aerobic type, muscle fibres as well as lower plasma insulin, cholesterol and triglyceride concentrations and lower blood pressure. Obese women with male type distribution of adipose tissue responded to physical training essentially like men. The insulin sensitivity was improved to the same level as in obese women with female type of adipose tissue distribution. In contrast, the latter women showed an increase of body fat and no metabolic improvements after training. These results show that obese women with male type of body fat distribution also have male characteristics of muscle mass, morphology and function. It is suggested that the obesity complications associated with this condition are improved by physical training because of an adaptation to a negative energy balance, in combination with an improvement of insulin sensitivity of the muscle mass. In contrast, the failure of obese women with female type of adipose tissue distribution to adapt to a negative energy balance during physical training is probably explaining their failure to decrease body fat and to improve metabolism during physical training.

Adipose Tissue↗