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PubMed1990

[Effect of sports on the distribution of body fat].

The pathogenetic effectiveness of the risk factor overweight is essentially modified by the distribution of the fatty depot. The form of obesity, the primary obesity, which above all is to be found in men is connected with a relatively high risk for the appearance and progression of several chronic diseases which at present determine morbidity. An only two-hour sports activity per week has a great influence on the size and the distribution of the lipopexia. Sporting persons have less body fat than inactive ones. In particular in sporting males the deposition of fat in the abdominal region is much limited.

Adipose Tissue↗
PubMed1999

Early postpartum metabolic assessment in women with prior gestational diabetes.

OBJECTIVE: To present the results of early postpartum metabolic assessment in women with gestational diabetes mellitus (GDM), to determine predictive factors for subsequent diabetes, and to investigate the association of postpartum glucose tolerance with other components of the metabolic syndrome. RESEARCH DESIGN AND METHODS: A total of 788 women were evaluated 3-6 months after a GDM pregnancy. A 75-g oral glucose tolerance test (OGTT) was performed. Cholesterol, HDL cholesterol, triglycerides, blood pressure, BMI, and body fat distribution were assessed. Clinical and obstetric history, baseline variables at the diagnosis of GDM, metabolic control during pregnancy, and index pregnancy outcome were compared in women with diabetes and women without diabetes (American Diabetes Association [ADA] criteria) after pregnancy. Multivariate logistic regression analysis was used to ascertain independent predictors of subsequent diabetes. Correlation coefficients were assessed between postpartum glucose tolerance and lipid levels, blood pressure, BMI, and body fat distribution. RESULTS: According to ADA criteria, 588 (74.6%) women were normal, 46 (5.8%) had impaired fasting glucose, 82 (10.4%) had impaired glucose tolerance, 29 (3.7%) had both impaired fasting glucose and impaired glucose tolerance, and 43 (5.4%) had diabetes. Prepregnancy obesity, recurrence of GDM, gestational age at diagnosis of GDM, glucose values in the 100-g OGTT, number of abnormal values in the 100-g OGTT, fasting C-peptide levels in pregnancy, C-peptide/glucose score in pregnancy, insulin requirement in pregnancy, 3rd trimester HbA1c levels, and macrosomia differed significantly in women with subsequent diabetes. Independent predictors of postpartum diabetes were prepregnancy obesity, C-peptide/glucose score during pregnancy, and the number of abnormal values in the 100-g diagnostic OGTT. The area under the postpartum glucose curve was positively associated with BMI, waist circumference, waist-to-hip ratio, triglycerides, and systolic and diastolic blood pressures. CONCLUSIONS: Low C-peptide/glucose score during pregnancy together with prepregnancy obesity and severity of GDM (number of abnormal values in the 100-g diagnostic OGTT) are independent predictors of subsequent diabetes. Our data suggest that regardless of obesity and severity of GDM, a beta-cell defect increases the risk of postpartum diabetes. The association of postpartum glucose tolerance with triglyceride levels, blood pressure, obesity, and regional distribution of body fat suggests that postpartum glucose intolerance anticipates a high-risk cardiovascular profile that comprises other risk factors besides diabetes.

Adult↗
PubMed1999

Determinants of postprandial lipemia in obese women.

OBJECTIVE: To quantify the effects of fasting lipids, age, apolipoprotein (apo) E polymorphism, insulin resistance, body fat and abdominal fat distribution, on postprandial lipemia (PPL) in non-diabetic obese women. DESIGN: Cross-sectional, prospective. SUBJECTS: A total of 93 obese women (mean +/- s.d. age 39+/-13y; body mass index (BMI) 38.3+/-4.9 kg/m2) and 16 nonobese women (25+/-8y; BMI 22.7+/-3.2 kg/m2). MEASUREMENTS: Body fat distribution was determined by the ratio of waist-to-hip circumferences (WHR) and by computed tomography (CT) at the L4-L5 level. Apo E genotyping was performed by restriction isotyping. Insulin resistance was calculated from fasting glucose and insulin concentrations. PPL was evaluated using the vitamin A-fat tolerance test (1.0 g fat/kg body weight and 7.0 mg cholesterol/kg body weight+300000 IU vitamin A palmitate). Blood samples were drawn before, and every 1.5 h for 7.5 h plus 24 h after ingestion of the fat meal. Areas under the response curves (AUC) for triglycerides (TG) and retinyl palmitate (RP) were calculated using the geometrical method for two time intervals, that is, 0-7.5 h and 0-24 h. RESULTS: Incremental AUCs TG, but not AUCs RP, were increased in the obese women. Apo E polymorphism, BMI, WHR and menopausal state did not influence PPL in the obese women. Fasting TG, age, the intra-abdominal to subcutaneous abdominal fat ratio (IA/SC ratio) and insulin resistance were independent determinants of PPL. Together, fasting TG, IA/SC ratio and insulin resistance, explained 38% of the variance in AUC TG 0-7.5 h (P = 0.0001). CONCLUSION: Alterations in PPL are to be added to the increasing number of components of the plurimetabolic syndrome.

Adolescent↗
PubMed2005

Estimation accuracy of percent total body fat and percent segmental fat measured by single-frequency bioelectrical impedance analysis with 8 electrodes: the effect of difference in adiposity.

AIM: This study aimed to compare the accuracy of percent total body fat (%TBF) and percent segmental fat (%SF) measurements of new automatic single-frequency bioelectrical impedance analysis with 8 electrodes (SF-BIA8), referenced to the dual-energy X-ray absorptiometry (DXA), between different fatness level female groups. METHODS: Subjects were 34 overweight females (OWG) and 24 normal females (NG). This study used the BIA analyzer of Tanita BC-118 which is a commercially available single frequency bioelectrical impedance analysis system with 8 tactile electrodes. RESULTS: Test-retest reliability in each method was high (intra-class correlations > or =0.96). The SF-BIA8 tends to overestimate %TBF and %SF in the lower extremities and trunk compared with DXA, and consistency with DXA was especially low in %SFs in the lower extremities (left leg: r=0.475, SEE=4.673, right leg: r=0.494, SEE=4.772). Systematic errors regarding to the difference in fatness were found in %TBF and %SFs in lower extremities in OWG, and were found in %SF in upper extremities in NG. Furthermore, systematic errors regarding to the difference in body fat distribution were found in %SFs in lower extremities in OWG, and found in %SFs in upper extremities and trunk in NG. CONCLUSIONS: SF-BIA can provide highly reproducible measurements of %TBF and %SF, but systematic errors based on the differences in fatness and body fat distribution were found. An improved prediction equation considering a variety in fat and body fat distribution will be needed in further investigations.

Absorptiometry, Photon↗
PubMed1994

Relation between weight and body fat's distribution and ambulatory blood pressure in Chinese elderly.

Ninety-five subjects aged 60 years and over underwent casual and ambulatory blood pressure (BP) measurements as well as weight, height, both waist and hip circumferences and both upper arm and thigh circumferences. Most anthropometric variables were significantly correlated with measures of BP. One stepwise regression analysis was applied to reveal that among measures of BP, 24-hour systolic BP had the strongest correlation with waist/hip ratio and awaking diastolic BP the strongest correlation with weight, both waist and hip circumferences and body mass index. Another was used to show that waist/hip ratio was the best overall predictor of systolic BP and weight the best overall predictor of diastolic BP. We suggest that (1) ambulatory BP be superior to casual BP in evaluating effect of weight and body fat's distribution on BP and (2) waist/hip ratio more important than weight in the hypertensive target organ damage and the prognosis of hypertension in Chinese elderly population.

Adipose Tissue↗
PubMed2006

Body mass, fat distribution and blood pressure in Southern Italian children: results of the ARCA project.

OBJECTIVE: To investigate the association between the degree of adiposity, assessed using the international reference values for body mass index (BMI) of the International Obesity Task Force (IOTF), the fat distribution pattern and the blood pressure (BP) profile in children. METHODS: Anthropometric indices and blood pressure were measured in 3923 children aged 6-11 years in southern Italy. RESULTS: The prevalence of overweight and obesity (by IOTF references) and pediatric hypertension was, respectively: 27, 21 and 10% for boys; 25, 21 and 14% for girls. Body mass index and waist z-scores were the strongest determinants of BP by regression analysis. Overweight and obesity were associated with a greater tendency for central fat deposition and higher BP (waist, cm; boys: 59.2+/-6.0, 69.5+/-7.9, 79.0+/-9.7; girls: 58.8+/-6.5, 68.2+/-7.4, 75.3+/-8.9; SBP/DBP, mmHg; boys: 94/60+/-12/9, 99/62+/-13/8, 103/64+/-15/10; girls: 93/59+/-12/9, 99/62+/-14/9, 101/63+/-14/9; normal weight, overweight and obese, respectively; P<0.0001; M+/-SD), and a higher risk of hypertension (overweight: RR=2.33; 95% CI 1.76-3.08; obesity: RR=3.69; 95% CI 2.78-4.90), independent of age, physical activity, birth weight, parental adiposity and education. Among normal weight children, 99% had waist <85th percentile and 93% were normotensive. CONCLUSIONS: Overweight and obese children, identified according to the IOTF growth charts, are characterized by a central fat distribution pattern and higher BP.

Abdominal Fat↗
PubMed2001

Polymorphisms in the leptin receptor gene, body composition and fat distribution in overweight and obese women.

OBJECTIVE: Leptin is an adipocyte-secreted hormone involved in body weight regulation, acting through the leptin receptor, localised centrally in the hypothalamus as well as peripherally, amongst others on adipose tissue. The aim of this study was to evaluate whether polymorphisms in the leptin receptor (LEPR) gene were related to obesity and body fat distribution phenotypes, such as waist and hip circumferences and the amount of visceral and subcutaneous fat. METHODS: Three known LEPR polymorphisms, Lys109Arg, Gln223Arg and Lys656Asn, were typed on genomic DNA of 280 overweight and obese women (body mass index (BMI)>25), aged 18-60 y. General linear model (GLM) analyses were performed in 198 pre- and 82 postmenopausal women, adjusting the data for age and menopausal state, plus fat mass for the fat distribution phenotypes. RESULTS: No associations were found between the LEPR polymorphisms and BMI or fat mass. In postmenopausal women, carriers of the Asn656 allele had increased hip circumference (P=0.03), total abdominal fat (P=0.03) and subcutaneous fat (P=0.04) measured by CT scan. Total abdominal fat was also higher in Gln223Gln homozygotes (P=0.04). Also in postmenopausal women, leptin levels were higher in Lys109Lys homozygotes (P=0.02). CONCLUSION: In conclusion, polymorphisms in the leptin receptor gene are associated with levels of abdominal fat in postmenopausal overweight women. Since body fat distribution variables were adjusted for fat mass, these results suggest that DNA sequence variations in the leptin receptor gene play a role in fat topography and may be involved in the predisposition to abdominal obesity.

Adipose Tissue↗
PubMed2000

Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome.

Methods for assessment, e.g., anthropometric indicators and imaging techniques, of several phenotypes of human obesity, with special reference to abdominal fat content, have been evaluated. The correlation of fat distribution with age, gender, total body fat, energy balance, adipose tissue lipoprotein lipase and lipolytic activity, adipose tissue receptors, and genetic characteristics are discussed. Several secreted or expressed factors in the adipocyte are evaluated in the context of fat tissue localization. The body fat distribution and the metabolic profile in nonobese and obese individuals is discussed relative to lipolysis, antilypolysis and lipogenesis, insulin sensitivity, and glucose, lipid, and protein metabolism. Finally, the endocrine regulation of abdominal visceral fat in comparison with the adipose tissue localized in other areas is presented.

Abdomen↗
PubMed1990

Population study on the adipose tissue distribution in Japanese women born in 1948.

We examined the relationship between body fat distribution and glucose metabolism and sex hormones in Japanese premenopausal women born in 1948. 1. There was a significant positive correlation shown between the waist circumference or skinfolds of the upper body, and the fasting insulin and C-peptide levels. 2. A positive correlation was seen between W2-3/H, and both insulin (r = 0.29, 0.30, P less than 0.05) and C-peptide levels (r = 0.40, 0.33, P less than 0.01, 0.05). 3. A significant negative correlation was seen between the SHBG level, and BMI (r = -0.39, p less than 0.01), W3/H (r = -0.46, P, 0.01), insulin (r = -0.28, P less than 0.05), and C-peptide (r = -0.46, P less than 0.01). 4. A significant negative correlation was seen between SHBG and W3/H (r = -0.31, P less than 0.05) after adjustment for BMI. These results suggest that the association of body fat distribution and glucose metabolism and androgeneity even if taking account of BMI, exists in non-obese women.

Adipose Tissue↗
PubMed1996

Nutrition and endometrial cancer.

Epidemiologic evidence on the relation between nutrition and endometrial cancer (EC) is reviewed. Obesity is an important determinant of EC, probably because of its effect on the hormonal milieu of both pre- and postmenopausal women. However, epidemiologic studies of body fat distribution and EC are inconsistent, as are the data pertaining to the relation between body fat distribution and sex hormones. Randomized and observational studies of diet and sex hormones indicate that low fat diets may be associated weakly with decreased estrogen levels, and thus a lowering of EC risk. Only ecologic and case-control studies of diet and EC have been reported. These findings as well as the methodologic limitations of these study designs are discussed. Both types of studies implicate fat as a potential risk factor, while the case-control studies suggest that carotene may lower risk of EC. Epidemiologic studies of alcohol and EC also are inconsistent, but generally indicate no association, or a weak protective effect. The role of diet in the etiology of EC is unresolved. The conduct of cohort and intervention studies, which can avoid many of the methodologic shortcomings of ecologic and case-control studies, would improve our understanding of diet and EC.

Adipose Tissue↗
PubMed2000

Androgen effect on body composition and fat metabolism.

Recognizing the adverse metabolic effects of predominantly visceral body fat distribution associated with low testosterone levels, researchers have investigated the effects of androgen treatment on body fat distribution in men. This presentation reviews the results of research on acute and longer-term effects of treatment with testosterone and dihydrotestosterone. Methods for investigating these results, including measurement of lipoprotein lipase activity and of radiolabeled fat uptake and turnover, are described and discussed.

Adipose Tissue↗
PubMed1993

[Cardiovascular risk factors and treatment with insulin in type II diabetic patients in whom oral hypoglycemic drugs have failed].

BACKGROUND: To find whether insulin treatment in type II diabetic patients in whom treatment with oral hypoglycemic treatment has failed changes body fat distribution or modifies cardiovascular risk factors. METHODS: Twenty-six patients (16 women and 10 men with a mean age of 62.3 +/- 9.8 years and 12.8 +/- 8.5 years of evolution) were studied before and 3 months after starting insulin treatment at a daily dose of 0.3 IU/kg of body weight. RESULTS: HbA1c decreased from 9.9 +/- 2.1 to 8.2 +/- 1.6% (p < 0.001) similar to fructosamine (from 407 +/- 86 to 350 +/- 71 mumol/l; p < 0.001) following treatment with insulin, but a increase in body weight, body mass index, blood pressure and a decrease in the concentration of HDL-cholesterol (p < 0.05) were observed. Weight was gained in 21 patients (80%) (3.7 +/- 1.9 kg), increasing body fat of central distribution in 13 (50%) and of peripheral distribution in 8 (30%). The patients in whom body fat of central distribution was increased fundamentally differentiated from the remaining patients by having a greater body mass index (p < 0.01), in all cases greater than 25 kg/m2 upon initiation of the insulin treatment, and by a significantly greater increase in body weight, blood pressure and total cholesterol after the insulin treatment. Patients who increased body fat of peripheral distribution or who did not gain weight did not present these changes in cardiovascular risk factors and were characterized by an increase of at least 500 kcal/week consumed by physical exercise. CONCLUSIONS: Treatment with insulin in type 2 diabetic patients in whom oral hypoglycemic drugs have failed improves glycemic control, but induces an increase in weight and worsens cardiovascular risk factors in patients with a CMI greater than 25 kg/m2. This change may be prevented by an increase in physical activity.

Adipose Tissue↗
PubMed2002

Differences of subcutaneous adipose tissue topography between type-2 diabetic men and healthy controls.

Men with noninsulin-dependent diabetes mellitus (type 2 DM) provide a different subcutaneous body fat distribution and a concentration of fatness on the upper trunk compared with healthy subjects. However, subcutaneous fat distribution is always measured in an inaccurate and/or very simplified way (e.g., by caliper), and to date, there exists no study reporting on the exact and complete subcutaneous adipose tissue distribution of type 2 DM men. A new optical device, the LIPOMETER, enables the nonivasive, quick, and safe determination of the thickness of subcutaneous adipose tissue layers at any given site of the human body. The specification of 15 evenly distributed body sites allows the precise measurement of subcutaneous body fat distribution, so-called subcutaneous adipose tissue topography (SAT-Top). SAT-Tops of 21 men with clinically proven type 2 DM (mean age of 57.5 +/- 6.7 years) and 111 healthy controls of similar age (mean age 59.0 +/- 5.4 years) were measured. In this paper, we describe the precise SAT-Top differences of these two groups and we present the multidimensional SAT-Top information condensed in a two-dimensional factor value plot. In type 2 DM men, especially in the upper trunk, SAT-Top is significantly increased (up to +50.7% at the neck) compared with their healthy controls. One hundred eleven of the 132 individuals (84.1%) are correctly classified (healthy or type 2 DM) by their subcutaneous fat pattern by stepwise discriminant analysis.

Adipose Tissue↗
PubMed1993

[Obese children and adolescents. Waist-hip ratio and cardiovascular risk].

In obese adults body fat distribution is more closely associated with cardiovascular risk factors and cardiovascular disease, type II diabetes and gout than the degree of obesity; the android, abdominal body fat pattern carrying more risk than the gynoid, femoral form. For characterizing the different types of fat distribution the ratio of waist to hip girth (WHR) is commonly used. The question was whether these facts can already be demonstrated in obese children. In the studied group of 69 obese children, aged between 3-16 years (mean = 10.8 years) with a mean of 47% overweight no correlations between percentage overweight and waist hip ratio could be found. Better correlations of serum triglycerides, total- and LDL-cholesterol, the atherogenic index LDL/HDL-cholesterol, fasting insulin level, oral glucose tolerance and blood pressure were obtained with percentage overweight than with waist-hip-ratio. HDL-cholesterol was the only parameter showing better and significant correlation with waist-hip-ratio than with percentage overweight. These results are in contrast to the situation in adults but are comparable with other studies in normal weighed and obese children, where correlations of waist hip ratio with body fat and risk factors were low in childhood, becoming higher in adolescence. Only after onset of puberty does waist hip ratio seem to be an indicator for body fat distribution and for possibly associated additional risk factors as in adults. For estimation of the cardiovascular risk in obese children, determination of WHR need not to be recommended.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2006

Comparison of body fat composition and serum adiponectin levels in diabetic obesity and non-diabetic obesity.

OBJECTIVE: Clinical aspects of diabetes and obesity are somewhat different, even at similar levels of insulin resistance. The purpose of this study was to determine differences in body fat distribution and serum adiponectin concentrations in diabetic and non-diabetic obese participants. We were also interested in identifying the characteristics of insulin resistance in these two groups, particularly from the standpoint of adiponectin. RESEARCH METHODS AND PROCEDURES: Adiponectin concentrations of 112 type 2 diabetic obese participants and 124 non-diabetic obese participants were determined. Abdominal adipose tissue areas and midthigh skeletal muscle areas were measured by computed tomography. A homeostasis model assessment of the insulin resistance score was calculated to assess insulin sensitivity. The relationships among serum adiponectin, body fat distribution, and clinical characteristics were also analyzed. RESULTS: Both abdominal subcutaneous and visceral fat areas were higher in the non-diabetic obese group, whereas midthigh low-density muscle area was higher in the diabetic obese group. The homeostasis model assessment of the insulin resistance score was similar between groups, whereas serum adiponectin was lower in the diabetic obese group. Abdominal visceral fat (beta = -0.381, p = 0.012) was a more important predictor of adiponectin concentration than low-density muscle (beta = -0.218, p = 0.026) in cases of non-diabetic obesity, whereas low-density muscle (beta = -0.413, p = 0.013) was a better predictor of adiponectin level than abdominal visceral fat (beta = - 0.228, p = 0.044) in diabetic obese patients. DISCUSSION: Therefore, factors involved in pathophysiology, including different serum adiponectin levels and body fat distributions, are believed to be responsible for differences in clinical characteristics, even at similar levels of insulin resistance in both diseases.

Adiponectin↗
PubMed1999

Adipose tissue distribution in postmenopausal women with adenomatous hyperplasia of the endometrium.

OBJECTIVE: To investigate body fat distribution in postmenopausal women with adenomatous and atypical hyperplasia of the endometrium. METHODS: A prospective population-based case control study was performed in a health care county in Sweden. General obesity, as reflected by body mass index (BMI), and adipose tissue distribution, expressed as waist to hip circumference ratio (WHR), were evaluated in a cohort of 367 postmenopausal women who underwent dilatation and curettage because of uterine bleeding. The study group consisted of 29 women with adenomatous or atypical hyperplasia of the endometrium. The controls consisted of 49 age-matched postmenopausal women randomly selected from the computerized population register of the same region. RESULTS: The frequency of endometrial adenomatous and atypical hyperplasia in postmenopausal women with bleeding was 7.2%. In the total population of postmenopausal women the incidence of these endometrial lesions was 44 per 100,000 per year. Body weight (P = 0.039), BMI (P = 0.007), and WHR (P = 0.022) were higher in postmenopausal women with endometrial adenomatous and atypical hyperplasia than in controls. In multivariate analysis only BMI remained statistically associated with adenomatous hyperplasia (P = 0.012). CONCLUSIONS: General obesity, but neither upper nor lower body fat distribution, was characteristic of postmenopausal women with adenomatous and atypical hyperplasia of the endometrium. Overall obesity is a risk factor for these endometrial precancerous lesions, as it is also claimed to be for endometrial cancer.

Adipose Tissue↗
PubMed2006

Index of central obesity - A novel parameter.

Waist circumference (WC) is globally used as a parameter to quantify central obesity, the key culprit in insulin resistance and related disorders. Hitherto globally in various definitions of metabolic syndrome and risk scores, WC is used to quantify central obesity. For defining central obesity, which is a single entity numerous WC cutoffs have been suggested, separately for males and females and various races. We believe that this difference is amenable to differences in their average heights. To quantify proportion of visceral fat in the total body fat, WC alone is not sufficient. We hereby hypothesize that Index of central obesity (ICO) defined by us, as a ratio of WC and height is a better parameter of central obesity. If ICO is used in place of WC we may do away with various WC cutoffs and may have a single cutoff applicable to all races and both genders. Using average heights of various countries and their respective WC cutoffs suggested by IDF consensus definition for defining metabolic syndrome (MS) we derived their ICO cutoffs mathematically. The ICO cutoffs obtained ranged from 0.51 to 0.58 among males and 0.47 to 0.54 among females. The range has narrowed down compared to wide range of cutoffs for WC i.e. 90-102 cm for males and 80-88 cm for females. To test superiority of ICO over WC even among people of same race and same gender we conducted a pilot study in which, we compared two subjects with same WC and body mass index (BMI), though they differed in their stature. Body fat distribution was compared on DEXA and oral glucose tolerance was tested. Percentage of total body fat contributed by truncal fat was 36.11% in taller subject (Dr. P) and 46.31% in the shorter one (Mr. P). On investigation Dr P had normal glucose tolerance while Mr. P was diagnosed to be diabetic. These differences unexplained by identical WC and BMI could be explained by difference in their ICO (0.557 vs 0.645). ICO has a potential to be a better parameter of central obesity. It may obviate the need for numerous WC cutoffs and may even be applicable to children where existing parameters are not useful.

Absorptiometry, Photon↗
PubMed2001

Increased visceral adipose tissue is associated with increased circulating insulin and decreased sex hormone binding globulin levels in massively obese adolescent girls.

The current study was designed to examine the relationship between body fat distribution, as evaluated by anthropometry and magnetic resonance imaging (MRI), and circulating insulin, sex hormone and SHBG levels in obese adolescent girls. Twenty-nine obese adolescent girls, aged 12.6-16.9 years with a mean BMI of 30.51+/-1.86 participated in this study. All girls had breast stage B4-5 and pubic hair stage P4-5. Percent obesity and BMI as indices of being overweight were calculated; the waist-to-hip ratio (WHR) and the waist-to-thigh ratio (WTR) were calculated to obtain two anthropometric indices for the pattern of body fat distribution. The areas of visceral (VAT) and subcutaneous adipose tissue (SAT) were evaluated by MRI at the L4-L5 level. Serum concentrations of total T, DHEAS, 17beta-estradiol, progesterone and SHBG were measured. Plasma glucose and insulin concentrations were evaluated during an oral glucose tolerance test. WHR was the only anthropometric parameter that was significantly associated with the area of VAT. Insulin level showed correlation with both WHR and the area of VAT; no correlation was found between insulin levels and WTR. Both WHR and VAT were negatively correlated with serum DHEAS level and positively correlated with T level. There were strong negative correlations between serum SHBG level and the area of VAT and WHR. Inverse correlation was found between serum SHBG level and insulin. Serum 17beta-estradiol and progesterone levels showed no significant correlation with all the patterns of body fat distribution. SAT was not significantly correlated with both anthropometric parameters and any of the sex hormones evaluated. We can draw two main conclusions. Firstly, in massively obese adolescent girls, the WHR seems to be a good indicator for the accumulation of VAT, and abdominal obesity, rather than adiposity per se, appears to be related to biochemical complications. Secondly, increased upper body adiposity and, in particular, the intra-abdominal fat area are associated with increased insulin levels in massively obese adolescent girls. The associated reductions in SHBG and DHEAS levels represent an early general risk factor for the development of metabolic and cardiovascular diseases in this population, as previously described for obese adult women.

Adipose Tissue↗