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[Assessment of fat tissue distribution impact on selected prothrombin and fibrinolytic factors in pre- and postmenopausal women].

OBJECTIVES: Objective was to examine the relationship of obesity, body fat distribution fasting plasma insulin concentrations and triglycerides of pro-thrombotic and fibrinolitics factors in pre and postmenopausal women. MATERIAL AND METHODS: We assessed 24 (13 nonobese and 11 obese) postmenopausal and 44 (15 obese and 29 non obese) premenopausal women. Plasma concentration of PAI-1 ag,PAI-1 activity, fibrinogen, tPA-1 akt, tPA ag, von Willebrand factor, fasting plasma insulin, and the lipid pattern (cholesterol, TG, HDL, LDL) was measured. The body fat distribution was assessed by waist-to-hip circumference measuring. RESULTS: Postmenopausal subjects had higher PAI-1 act. and PAI-1 ag (p < 0.05 and 0.001 respectively), vWf and lower ATIII. There was direct correlation between PAI-1 act., Fibrinogen and BMI in both groups of patients together and in premenopausal group PAI-1 act correlated directly and tPA ag/act. indirectly with plasma insulin concentrations. CONCLUSIONS: Plasma concentrations of the pro-thrombotic factors are increased in obese and postmenopausal women and correlate directly with BMI and indirectly with plasma insulin concentrations. Plasma concentrations of anti thrombotic factors indirectly correlated with WHR and with plasma insulin concentrations.

Adipose Tissue↗

Adipocyte diameter distributions and body fat contents of sedentary and exercised female Zucker rats.

The objective was to determine whether adipocyte diameter distributions were asymmetric in lean and obese female Zucker rats under conditions of ordinary activity (sedentary controls) as well as under conditions of enforced treadmill exercise. In sedentary animals, adipocyte diameter distributions were asymmetric in both lean and obese rats. Exercise abolished the asymmetry and markedly reduced body fat content of lean rats but had no such effects in obese ones. In contrast, exercise had no effect on average adipocyte diameter in either lean or obese rats. Results suggest that ability of exercise to reduce body fat content is more closely related to a decreased proportion of small adipocytes than to decreased average adipocyte diameter in female Zucker rats.

Adipose Tissue↗

Studies in the distribution of body fat. III. Effects of cigarette smoking.

Cross-sectional associations between smoking habits, body mass index, and waist-hip ratio (WHR) were examined in 1122 men aged 19 to 102 years. Weight and body mass index were significantly lower in cigarette smokers than in nonsmokers when age was taken into account. The WHR in smokers was significantly higher than in nonsmokers. A graded dose-response relationship was found between the number of cigarettes smoked and the WHR. Longitudinal associations between changes in smoking habits and changes in the WHR were examined during follow-up visits. In the period between these pairs of visits, weight increased when subjects quit smoking and decreased when they started smoking, as expected. The increase in WHR among those who quit smoking was, however, significantly less than the expected increase if smoking had continued. The WHR in those who started smoking actually increased despite their loss of weight. These paradoxical changes in WHR indicate that there are harmful effects of cigarette smoking on the pattern of distribution of body fat. These facts introduce still another reason to suggest that the decision to initiate or to continue smoking to control body weight is unwise.

Adult↗

[Abdominal adipose tissue--significance and methods of detection].

INTRODUCTION: The presence of excess fat in the abdomen, out of proportion to total body fat, is associated with increased risk for cardiovascular and metabolic diseases and other complications of obesity. HISTOANATOMICAL CHARACTERISTICS OF THE ABDOMINAL ADIPOSE TISSUE: In regard to subcutaneous fat, accumulation of visceral abdominal adipose tissue is more associated with increased metabolic risk However, men have more visceral fat than premeno-pausal women. Compared with premenopausal women, postmenopausal women have 49% more intra-abdominal fat, regardless of age and total fat mass. MEASUREMENT OF ABDOMINAL FAT DEPOTS: Various anthropometric indicators have been suggested for measuring body fat distribution. All of them have advantages and disadvantages, in relation to their interpretation and use. Many are specified as ratios and are difficult to interpret biologically, whereas a change in body fat distribution may exhibit little or no change in the ratios. Waist circumference and sagittal abdominal diameter are good predictors of visceral fat. But, extreme individual variations in visceral to subcutaneous ratio demonstrate the limitations of external anthropometry. The best methods to estimate the amount of visceral fat are imaging techniques like computed tomography or magnetic resonance, but they are expensive and inconvenient in routine practice. CONCLUSION: Further investigations should provide a simple and optimal indicator of abdominal obesity which should correlate with the amount of viscelar fat and the risk.

Abdomen↗

Normal weight obese (NWO) women: an evaluation of a candidate new syndrome.

BACKGROUND AND AIMS: Obesity, an independent risk factor for cardiovascular disease (CVD), has been associated with the early development of coronary atherosclerosis in adolescents and young men. A subset of metabolically obese but normal weight individuals was identified, with potentially increased risks for development of the metabolic syndrome despite their normal body mass index. We determined the relationship among body fat distribution and selected CVD risk factors to distinguish normal weight obese from controls with normal metabolic profiles. METHODS AND RESULTS: We analysed anthropometric variables, body composition by DXA, RMR by indirect calorimetry and bioumoral variables of 74 clinically healthy Caucasian Italian women. Significant differences were observed in the biochemical HDL-chol values between NWO and controls and pre-obese-obese. Significant correlations were found among cardiovascular risk indexes, LEAN of the right part of the trunk and TC/HDL (R=-0.69, p<0.001) and LDL/HDL (R=-0.72, p<0.001), and LEAN and RMR (R=0.44, p=0.022) of NWO women. CONCLUSIONS: In normal weight obese women the cardiovascular risk indexes are related to metabolic variables and to body fat mass distribution. NWO individuals showed a relationship between the decrease in LEAN of the left leg and an increase in CVD risk factors. We suggest that LEAN distribution seems to be a potential predictor of CVD.

Adolescent↗

Effects of a thiazolidinedione compound on body fat and fat distribution of patients with type 2 diabetes.

OBJECTIVE: To examine the effects of a thiazolidinedione (600 mg troglitazone) insulin-sensitizing treatment on total body fat measured by underwater weighing, on intra- and extra-abdominal fat mass using magnetic resonance imaging (MRI), and on anthropometric measures. RESEARCH DESIGN AND METHODS: Type 2 diabetic outpatients were studied in a double-blind randomized trial carried out at Glasgow Royal Infirmary, Scotland. RESULTS: Groups who received troglitazone (8 men, 3 women) and placebo (8 men, 2 women) were well matched for age, BMI, total body fat percentage by underwater weighing, and intra-abdominal fat (kilograms) by MRI. After 12 weeks, body weight changes in the troglitazone group (mean +0.66 kg [95% CI -0.71 to 2.04], P = 0.31) and the placebo group (mean +0.25 kg [-0.64 to 1.13], P = 0.55) were not statistically different. Changes in total body fat with troglitazone (mean +1.02% body wt [-1.13 to 3.17], P = 0.32) and placebo (mean -0.54% body wt [-1.68 to 0.59], P = 0.31) were not significantly different. There was, however, a decrease in intra-abdominal fat mass in the troglitazone-treated group (mean -0.47 kg [-0.79 to -0.13], P = 0.01), and this was significantly different (P = 0.03) from placebo treatment (mean -0.41 kg [-0.77 to -0.05]). CONCLUSIONS: Treatment with the thiazolidinedione troglitazone in human patients with type 2 diabetes decreases intra-abdominal fat mass but does not affect total body fat or weight. This potentially valuable effect points to a differential action on insulin sensitivity in different adipose tissue depots.

Abdomen↗

Abdominal obesity increases overnight cortisol excretion.

Although plasma and 24 h urinary free cortisol (UFC) levels are normal in obese subjects, pharmacological investigations have identified minor hypothalamo-pituitary-adrenal axis differences in patients with abdominal body fat distribution (A-BFD) vs peripheral BFD (P-BFD). Using recent tools such as saliva cortisol or overnight urinary free cortisol upon creatinine ratio (UFC/UC) determinations, we have investigated a population of obese females according to their body fat distribution. In-patients subjects (no.=82) were subjected to routine biochemical testing, 24 h and overnight UFC/UC, basal and post-1 mg overnight dexamethasone-suppressing test plasma and saliva cortisol determinations. Central obesity defined by a waist-to-hip ratio (WHR) >0.85 was found in 64% of the subjects vs 87% when defined by waist girth (WG) corrected for age. Despite identical body mass index, A-BFD subjects were more prone to hypertension using both classifications and had higher triglycerides (WHR classification) or higher triglycerides, cholesterol and glycemia (WG classification). Plasma cortisol levels were similar but saliva cortisol levels were lower in the A-BFD group using the WG classification. The 24 h UFC/UC were similar but the overnight UFC/UC were higher in the A-BFD group using the WHR classification. These mild differences in cortisol nocturnal secretion and free cortisol indexes in subjects with different body fat mass distribution suggest that their hypothalamo-pituitary-adrenal axis has a spontaneously subtly different regulation.

Abdomen↗

Serum leptin in obese women with polycystic ovary syndrome is correlated with body weight and fat distribution but not with androgen and insulin levels.

Leptin is a hormone produced in the adipose tissue and its concentrations in peripheral blood are significantly correlated with the amount of body fat. Whether other factors, including the pattern of body fat distribution and several hormones (such as insulin, sex steroids, and glucocorticoids), may be involved in the regulation of circulating blood leptin levels is controversial. Women with the polycystic ovary syndrome (PCOS) are hyperandrogenic and most of them are characterized by hyperinsulinemia, insulin resistance, and obesity, particularly the visceral phenotype. To assess the potential contribution of anthropometric factors, androgens, and insulin in determining leptin levels, we examined their relationship with body-mass index (BMI), visceral (VAT) and subcutaneous (SAT) adipose tissue areas, basal androgen levels, and fasting and glucose-stimulated (AUC) insulin in different groups of obese women with PCOS (n = 23) and of age-matched obese (n = 16) and non-obese (n = 10) otherwise healthy controls. The VAT/SAT ratio was measured as a parameter of body fat distribution. Serum leptin levels were significantly higher in obese PCOS women than in obese and normal-weight healthy controls and, within the controls, in the obese than in the non-obese group. In all women considered together, and in each group separately, leptin concentrations were highly significantly correlated with BMI. In addition, after adjusting for BMI, both VAT and the VAT/SAT ratio were positively and significantly correlated with leptin. Partial correlations with the VAT/SAT ratio remained significant in both the obese PCOS group and in controls considered separately, whereas the correlation with the SAT value was significant only in the control group. After adjusting for BMI, no correlation between leptin, androgens and fasting or stimulated (like AUC) insulin was found. These findings indicate that leptin levels in obese women with PCOS are higher than those observed in obese and non-obese controls. Moreover, they suggest that, other than BMI, the pattern of body fat distribution may be an independent factor related to circulating leptin levels, which, on the contrary, do not appear to be related to either androgen or insulin concentrations.

Adipose Tissue↗

Pituitary desensitization to gonadotropin-releasing hormone increases abdominal adiposity in hyperandrogenic anovulatory women.

OBJECTIVE: To determine whether hyperandrogenism in anovulatory women affects body fat distribution. DESIGN: Prospective nonrandomized study. SETTING: An academic research environment. PATIENT(S): Ten hyperandrogenic anovulatory patients and 10 healthy women matched by body mass index. INTERVENTION(S): Regional body fat analysis was performed before and after 3 months of GnRH analogue (GnRH-a) therapy. MAIN OUTCOME MEASURE(S): Body fat distribution was measured by waist-to-hip circumference ratio, single-slice computed tomography imaging (L2-3 interspace), and total body dual-energy x-ray absorptiometry. RESULT(S): Weight, body mass index, waist-to-hip circumference ratio, total body and leg fat mass, and subcutaneous adipose area were unaffected by the presence of hyperandrogenism or the use of GnRH-a therapy. Basal abdominal fat mass, abdomen-to-leg fat mass ratio, visceral adipose area, and total visceral adipose volume were comparable in both study groups. The abdominal fat mass increased in both groups during GnRH-a therapy, whereas the abdomen-to-leg fat mass ratio rose significantly only in the hyperandrogenic patients. During GnRH-a therapy, the hyperandrogenic patients demonstrated a significant increase in visceral adipose area compared with the healthy women so that total visceral adipose volume increased significantly in the former but not the latter. CONCLUSION(S): Three months of GnRH-a administration preferentially increased abdominal fat, as measured by single-slice computed tomography imaging and total body dual-energy x-ray absorptiometry, in hyperandrogenic anovulatory women.

Abdomen↗

Normal Weight Obese syndrome: role of single nucleotide polymorphism of IL-1 5Ralpha and MTHFR 677C-->T genes in the relationship between body composition and resting metabolic rate.

We have identified a subset of metabolically obese, but normal weight individuals, with potentially increased risks of developing the metabolic syndrome, despite their normal body mass index. We determined the relationship among body fat distribution, resting metabolic rate (RMR), total body water amount (%TBW), selected gene polymorphism on interleukin-15 receptor-alpha (IL-15Ralpha) and methylenetetrahydrofolate reductase 677C-->T (MTHFR 677C-->T), to distinguish normal weight obese (NWO) from nonobese with a normal metabolic profile and obese individuals. We analysed anthropometric variables, body composition by Dual energy X-ray Absorptiometry (DXA), RMR by indirect calorimetry, %TBW by bioimpedence analysis (BIA), MTHFR 677C-->T and IL-15Ralpha genotypes of 128 clinically healthy Caucasian individuals. We compared a group of female, defined as NWO and characterised by a BMI < or = 25 kg/m(2) and FM > or = 30% with groups of others female, and males, represented by nonobese with a BMI < or = 25 kg/m(2) and FM < or = 30%, and preobese-obese individuals with BMI > or = 25 kg/m(2) and %FM > or = 30%; none of the males was classified as NWO. Significant correlations were found among body fat mass distribution, metabolic variables, percentage of total body water distribution and selected genetic variations. The variables that contributed significantly to the separation of classes were body tissue (Tissue), %TBW, RMR, the volumes of both oxygen (VO2) and carbon dioxide (VCO2). The distribution of MTHFR 677C-->T and IL-15 genotypes was significantly different between classes. Our data highlight that NWO individuals showed a significant relationship between the decrease in the basal metabolism (RMR), body fat mass increasing and total water amount. Possession of wild type homozygotes genotypes regarding IL-15Ralpha cytokine and 677C-->T MTHFR enzyme characterised NWO individuals.

Adult↗

[Relationship between abdominal fat distribution assessed by computed tomography and serum lipids in the elderly].

A nutritional assessment is necessary to evaluate the pathophysiological state of patients, and serum lipids are one of the factors which must be evaluated. Body fat distribution is considered to be associated with cardiac diseases, metabolic diseases and hypertension. In this study, we performed quantitative measurements of fat distribution by X-ray computed tomography (CT) in 31 elderly outpatients. Thirteen males (mean age 74.8 years) and 18 females (mean age 75.4 years) were examined by abdominal CT. All subjects had body mass indices within the normal range and did not have malignant disease, hyperlipidemia, liver dysfunction or diabetes mellitus. CT scans were carried out at the level of the middle abdomen; these scan slices included intraabdominal fat which consisted of omental, retroperitoneal and perirenal adipose tissues. Subcutaneous fat areas and intraabdominal fat areas were measured from six 10-mm-thick slice films using a 2-dimensional computerized calculator. The relationship between serum lipids and fat distribution was also examined. The ratio of intraabdominal adipose tissue area to subcutaneous adipose tissue area (V/S) was higher in males than in females. V/S correlated positively with serum triacylglycerol and correlated negatively with serum HDL-Ch. These results suggest that the measurement of body fat distribution is important to evaluate lipid metabolism and nutritional states in the elderly.

Adipose Tissue↗

Low-grade inflammation and estimates of insulin resistance during the menstrual cycle in lean and overweight women.

BACKGROUND: Inflammatory markers and insulin resistance are independent cardiovascular risk factors and are thought to be influenced by sex steroids. We investigated changes of inflammatory markers and estimates of insulin resistance during the menstrual cycle, their variances, and their relationship to each other, sex steroids, and regional body fat distribution. METHODS: Eight normal weight (body mass index, 21.6 +/- 1.9 kg/m(2)) and nine overweight (body mass index, 30 +/- 2.4 kg/m(2)) young women with normal ovarian function were assessed 15 times throughout the menstrual cycle. Regional fat distribution was assessed using dual x-ray absorptiometry. RESULTS: Concentrations of highly sensitive C-reactive protein (hs-CRP) changed significantly during the menstrual cycle and were highest in the early follicular phase (P < 0.00001). SHBG concentrations were stable in the follicular phase but increased in the luteal phase (P < 0.00001). During the follicular phase, estimates of insulin resistance had a higher within-subject variance when determined by the homeostasis model assessment index (42%) than when estimated by SHBG concentrations (5%, P < 0.05). During the menstrual cycle, using repeated measurements, hs-CRP correlated inversely to estradiol (beta-coefficient, -0.23, P < 0.0001) and SHBG concentrations (beta-coefficient, -0.83, P = 0.004). Central accumulation of body fat correlated to the mean hs-CRP concentration (r = 0.63, P = 0.007) and the mean homeostasis model assessment index for insulin resistance (r = 0.75, P = 0.001). CONCLUSION: We demonstrate that serum concentrations of hs-CRP and SHBG significantly change during the menstrual cycle. We reveal a close link between sex steroids, subclinical inflammation, insulin resistance, and body fat distribution in regularly menstruating women.

Absorptiometry, Photon↗

Body mass, fat distribution and cardiovascular risk factors in a lean population of south China.

The associations of body mass index and abdominal adiposity, represented by an elevated waist/hip circumference ratio, with cardiovascular risk factors were examined in men and women, aged 28-69 years, from urban and rural areas of Guangzhou, China. Mean body mass index ranged from 20.1 to 21.9 kg/m2 across the four sex- and area-groups. Mean waist/hip ratio was 0.84 in men and 0.80 in women. After accounting for age and body mass index, waist/hip ratio was associated negatively (p < 0.05) with fasting serum HDL cholesterol (both sexes), and positively with serum triglycerides (both sexes), total and LDL cholesterol (men only), uric acid (both sexes), glucose (women only), and mean systolic blood pressure (women only). Body mass index was associated in a similar direction with most of these risk factors. These data confirm that abdominal adiposity is independently associated with cardiovascular disease risk factors, even in a lean Asian population.

Abdomen↗

Autonomic activity assessed by heart rate spectral analysis varies with fat distribution in obese women.

Obesity in humans has been associated with altered autonomic nervous system activity. The objective of this study was to examine the relationship between autonomic function and body fat distribution in 16 obese, postmenopausal women using power spectrum analysis of heart rate variability. Using this technique, a low frequency peak (0.04-0.12 Hz) reflecting mixed sympathetic and parasympathetic activity, and a high frequency peak (0.22-0.28 Hz) reflecting parasympathetic activity, were identified from 5-minute consecutive heart rate data (both supine and standing). Autonomic activity in upper body (UBO) vs. lower body obesity (LBO)(by waist-to-hip ratio) and subcutaneous vs. visceral obesity (by CT scan) was evaluated. Power spectrum data were log transformed to normalize the data. The results showed that standing, low-frequency power (reflecting sympathetic activity) and supine, high-frequency power (reflecting parasympathetic activity) were significantly greater in UBO than in LBO, and in visceral compared to subcutaneous obesity. Women with combined UBO and visceral obesity had significantly higher cardiac sympathetic and parasympathetic activity than any other subgroup. We conclude that cardiac autonomic function as assessed by heart rate spectral analysis varies in women depending on their regional body fat distribution.

Adipose Tissue↗

Effects of isoenergetic, low-fat diets on energy metabolism in lean and obese women.

Whether changing from a high-fat diet to an isoenergetic, low-fat, high-complex-carbohydrate diet results in thermogenic benefits is controversial. Brief dietary interventions and failure to account for the potential influence of body-fat distribution on energy metabolism could have confounded the interpretation of previous studies. To address these issues, eight upper-body obese, seven lower-body obese, and eight non-obese premenopausal women underwent measurements of body composition, resting energy expenditure, overnight energy expenditure, and meal fat oxidation at the end of a weight-stabilizing, high-fat (42%) diet, and after 4 wk of an isoenergetic, low-fat (27%) diet. No change in body composition, resting energy expenditure, overnight energy expenditure, or meal fat oxidation occurred. We conclude that isoenergetic shifts from dietary fat to dietary carbohydrate within the generally recommended range have little or no effect on energy metabolism, and that body-fat distribution does not predict differences in energy expenditure.

Adipose Tissue↗

Body weight and fat cell size in young men with mild blood pressure elevation.

The aim of the study was to assess the relationship between body fat distribution and blood pressure. Forty-four men, aged 19-22 years, with mild blood pressure elevation (MBPE) and 29 normotensive controls (NC) were investigated. Body fat distribution was assessed by calculating fat cell size in biopsy samples of adipose tissue from different subcutaneous depots. The subjects in MBPE group were heavier than those in NC group (79.7 +/- 2.7 and 71.5 +/- 1.6 kg, p < 0.05). Total body fat was also significantly higher in the MBPE group (12.5 +/- 1.6 and 8.1 +/- 1.3 kg, p < 0.05) but not the lean body cell mass (36.8 +/- 1.1 and 34.7 +/- 0.9 kg, n.s.). Fat cell size (microgram/cell) in the lower abdominal area were significantly bigger in MBPE than in NC (respectively 40.9 +/- 4.4 and 28.0 +/- 3.1, p < 0.05). The same differences applied for fat cell size in the upper abdominal (respectively 43.1 +/- 3.0 and 26.8 +/- 3.0, p < 0.001) and averaged abdominal areas (respectively 40.1 +/- 3.4 and 26.8 +/- 2.8; p < 0.05). Fat cell size in gluteal, femoral and averaged gluteofemoral areas did not differ between MBPE and NC. Therefore, the abdominal/gluteofemoral ratio was significantly higher in MBPE than in NC (respectively 1.1 +/- 0.1 and 0.7 +/- 0.1; p < 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

Adipocytes↗

Relationship of body fat topography to insulin sensitivity and metabolic profiles in premenopausal women.

The relationship of body fat distribution to metabolic profiles was determined in 80 healthy premenopausal white women of a wide range of obesity levels [percentage of ideal body weight (% IBW) 92-251]. Distribution of fat between the upper and lower body was assessed from the waist/hips girth ratio (WHR), which varied from 0.64 to 1.02. In 23 women, in vivo insulin sensitivity was also determined from the steady-state plasma glucose (SSPG) level at comparable insulin levels of approximately 100 microU/mL attained by the intravenous infusion of somatostatin, glucose, and insulin. Increasing WHR was accompanied by progressively increasing fasting plasma insulin levels (r = 0.47, P less than 0.001), insulin and glucose areas after glucose challenge (r = 0.53, P less than 0.001; r = 0.50, P less than 0.001, respectively) and fasting plasma triglyceride concentrations (r = 0.48, P less than 0.001). Obesity level was similarly correlated with these metabolic indices. Partial and multiple regression analysis and analysis of variance with a linear contrast model revealed that the effects of body fat topography were independent of, and additive to, those of obesity level. Within obese subjects alone (%IBW: 130), %IBW had no predictive value, but WHR remained a significant predictor of plasma glucose, insulin, and triglyceride concentrations. The WHR also correlated with the plasma cholesterol level, but this association was largely dependent on its relationship to %IBW. Both WHR and %IBW correlated with the insulin resistance index, SSPG (r = 0.60, P less than 0.01; r = 0.61, P less than 0.01, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗