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PubMed1991

Contribution of glucose tolerance and plasma insulin levels to the relationships between body fat distribution and plasma lipoprotein levels in women.

Numerous interrelated metabolic and morphological variables such as plasma insulin levels, glucose tolerance and abdominal obesity are associated with changes in plasma lipoprotein levels. The present study was undertaken to differentiate, using a multivariate approach, the respective contributions of plasma glucose and insulin levels, obesity and regional adipose tissue distribution to the variance in plasma lipoproteins. The study group was composed of 69 healthy premenopausal women (age 35.4 +/- 5.0 years (mean +/- s.d.); percent body fat 40.7 +/- 10.1). Indices of carbohydrate metabolism showed significant univariate correlations with triglyceride (TG) and/or cholesterol (CHOL) content of plasma VLDL, LDL and HDL (P less than 0.05). Multivariate analyses indicated that the explained variance in plasma VLDL-TG (R2 x 100 = 44 percent, P less than 0.05) and LDL-apoprotein (apo) B levels (R2 x 100 = 33.1 percent, P less than 0.08) was entirely accounted for by indices of carbohydrate metabolism and body fat distribution, whereas total body fatness added no significant contribution to these models. Multivariate analyses also revealed that the best possible regression model to predict the variation in plasma HDL2-CHOL levels only included computed tomography-derived deep abdominal adipose tissue area (P less than 0.0001). All other variables were unable to further improve the explained variance in plasma HDL2-CHOL levels. In partial correlation analyses, indices of carbohydrate metabolism and the waist-to-hip circumference ratio (WHR) remained significantly correlated with plasma VLDL-TG and LDL-apo B levels after adjustment of VLDL-TG and LDL-apo B for either insulin and glucose levels, or for the WHR (P less than 0.08). After correcting for deep abdominal fat accumulation, no significant correlation was observed between indices of carbohydrate metabolism and plasma HDL2-CHOL levels whereas deep abdominal fat showed significant correlations with HDL2-CHOL levels (P less than 0.05) after correction for indices of carbohydrate metabolism. These results suggest that both disturbances in glucose-insulin homeostasis and abdominal obesity are significantly associated with changes in plasma VLDL-TG and LDL-apo B levels and that these associations are partly independent from each other. These results also indicate that mechanisms other than disturbances in glucose homeostasis and hyperinsulinemia are responsible for the association between the level of deep abdominal fat and plasma HDL2-CHOL levels.

Abdomen↗
PubMed1991

Endometrial cancer, obesity, and body fat distribution.

A case-control study was undertaken to evaluate the roles of obesity and body fat distribution in the etiology of endometrial cancer. The study also included an evaluation of the associations of serum estrone, estradiol, and androstenedione with obesity, body fat distribution, and endometrial cancer risk. The study included 168 cases and 334 control subjects identified at an optometry clinic. A strong, positive relationship between overall obesity and endometrial cancer was found. The relative rate of endometrial cancer for women in the upper 90th percentile of a body mass index compared to those below the median was estimated as 5.5 with 95% confidence limits of 3.2-9.6. There was no association between endometrial cancer and the waist to hip ratio, an index of upper versus lower body fat distribution. A statistical test of trend across the four quartiles of the waist to hip ratio yielded a P value of 0.45 after adjustment for confounding by the body mass index. On the other hand, there was a statistically significant, independent positive effect of a high subscapular to tricep skinfold ratio, a measure of central versus peripheral obesity, on endometrial cancer risk. The relative rates of endometrial cancer for the second, third, or fourth quartile compared to the first quartile of this index were 1.5, 1.9, and 2.7, respectively (P = 0.007), after adjustment for the body mass index. Serum estrone and estradiol, but not androstenedione, were statistically significantly correlated with the body mass index among control subjects (r = 0.37 and 0.40 for estrone and estradiol, respectively). On the other hand, each of the sex hormones was uncorrelated with the waist to hip ratio after adjustment for body mass. The correlations between each of the three hormones and the subscapular to tricep skinfold ratio among controls were weak and were not statistically significant (0.10, 0.10, and 0.14 for estrone, estradiol and androstenedione, respectively). Cases had statistically significantly higher mean serum estrogen and androstenedione levels than did controls and these elevations did not simply reflect a higher prevalence of obesity among them. The findings are equivocal with respect to fat patterns and endometrial cancer. We suggest that future epidemiological studies of cancer and body fat distribution more carefully distinguish among the various types of fat patterns.

Adipose Tissue↗
PubMed1990

Body fat mass, body fat distribution, and plasma hormones in early puberty in females.

We examined whether there is a relationship between body fat mass or body fat distribution and hormonal profiles in the plasma of early pubertal girls. Thirty-five apparently healthy caucasian schoolgirls were selected for Tanner's breast development stage M2; they had all been classified as being stage M1 6 months earlier. Body fat mass had no relationship with the total plasma sex steroid concentration or gonadotropins. However, body fat mass was correlated with the fraction of testosterone that was not bound to sex hormone-binding globulin and considered the fraction available for biological activity. Body fat distribution, rather than body fat mass, was different in relation to the total concentrations of estrone, estradiol (E2), and testosterone as well as the percentage of available E2 or testosterone. Girls with fat localized predominantly on the hips had the highest levels of sex steroids and gonadotropins. It seems likely that this type of fat distribution is a result of ovarian activity. Girls with predominantly abdominal fat were also more obese and showed increased plasma levels of total E2 and a lower androgen/estrogen ratio in plasma, possibly due to increased aromatization, especially in abdominal adipose tissue. The findings suggest a reciprocal relationship among body fat distribution, plasma sex hormone levels, and availability of sex steroids in early female puberty.

Adipose Tissue↗
PubMed2003

[Plasma leptin levels in relation to body composition and body fat distribution in patients with Cushing's syndrome].

It is known that body composition, especially body fat content, determines plasma leptin (LEP) levels. Clinical observation confirms that glucocorticoids (GS) have a considerable impact on body composition and body fat distribution which leads to visceral fat accumulation and a decrease in muscle mass in limbs. On the other hand, in experimental models GS stimulate ob mRNA expression in adipose tissue and LEP secretion into bloodstream. The aim of the study was to evaluate changes in body composition and fat and fat-free mass distribution in the conditions of endogenous hypercortisolism as well as to determine whether changes in body composition parameters may influence plasma LEP levels in patients with Cushing's syndrome (CUS). The study group was composed of 14 patients (12 F, 2 M) with ACTH-dependent and ACTH-independent CUS (BMI 29,5 +/- 1,0 kg/m2, aged 41,6 +/- 2,9 yrs.). The control group (KON) included 14 overweight/obese subjects (12 F, 2 M; WHR>0.8) matched for age, height, weight, and BMI with CUS group. Basal plasma LEP levels were measured by RIA kit. Total fat mass (BFM), fat-free mass (FFM), their regional depots (arms, legs, trunk) as well as bone mineral content (BMC) were determined by DEXA method (Lunar Co., USA). Values of BFM and %BF were comparable in both groups whereas the amount of FFM was lower in CUS group than in controls. Patients with CUS had less BF in limbs than controls whereas the difference in the amount of trunk BF in favour of CUS reached a borderline significance. Moreover, subjects with CUS exhibited decreased amount of FFM both in arms and legs when compared to controls, which may be explained by limb muscle and connective tissue wasting observed clinically. However, the amount of trunk FFM did not differ between both groups. Eventually, subjects with CUS had lower BMC values than controls. Absolute plasma LEP levels were 2-fold higher in CUS group than those in KON group (34,03 +/- 4,45 vs. 17,04 +/- 1,88, ng/ml; p=0.006), however, in both groups they were highly correlated with BFM and %BF. Multiple linear regression analysis revealed that in CUS group 64% of the variation of plasma LEP levels is explained by trunk BF and in KON group 92% of the variation of LEP levels is dependent of arms BF (+, 18%) and legs BF (+, 69%) and arms FFM (-, 5%). In conclusion, endogenous hypercortisolismus leads to the augmentation of truncal (visceral) fat accumulation as well as to a marked decrease in fat-free mass in limbs and in bone mineral content. In Cushing's syndrome, irrespectively of its cause (pituitary gland, adrenal glands), plasma LEP levels are elevated in relation to body fat content. Truncal (visceral) fat may have a relatively stronger influence on plasma LEP in Cushing's syndrome than in subjects with normal cortisolaemia, however, changes in body composition and tissue distribution do not fully account for the presence of markedly elevated LEP levels in this syndrome.

Adipose Tissue↗
PubMedDate not supplied

Body fat distribution in men and women of the Hispanic health and nutrition examination survey of the United States: associations with behavioural variables.

Body fat distribution is a biological risk factor for cardiovascular disease and diabetes. There are known genetic factors influencing body fat distribution, but variation in this characteristic is also attributable to human behavioural and socioeconomic variables such as social class. Björntorp has proposed that these associations may be due to a series of physiological responses to psychosocial stress, most prominently chronic stimulation of the adrenal-cortical system. This system is known to affect body fat distribution. Elsewhere we have shown that general socioeconomic status is related to body fat distribution in men and women of the Hispanic Health and Nutrition Examination Survey (HHANES) of the United States. In this paper we explore the relationship with those behavioural variables available from the HHANES which could hypothetically serve as indicators of psychosocial stress: smoking, drinking and depression. For both sexes in all Hispanic ethnic groups except Puerto Rican men, as socioeconomic status declined, subcutaneous fat became more centrally distributed. This relationship continued to be significant after controlling for the behavioural variables. A positive relationship was also found between smoking and central body fat distribution which was independent of socioeconomic status. This relationship was statistically significant for all subsamples except Cuban-American women. No consistent relationships were found between body fat distribution, drinking and depression. The data support the hypothesis that body fat distribution may be linked to the social stress of low socioeconomic status, independent of the behavioural factors tested.

Adipose Tissue↗
PubMedDate not supplied

Correlation of Kupperman's index with estrogen and androgen levels, according to weight and body fat distribution in postmenopausal women from Mexico City.

OBJECTIVES: To establish the differences in Kupperman's index (KI) and hormone levels according to weight and body fat distribution in postmenopausal women, since obesity and fat distribution affect hormone levels. MATERIAL AND METHODS: One hundred and twenty-five postmenopausal women were studied and divided according to body mass index (BMI) and waist-hip ratio (WHR): normal weight (BMI < or = 27), obesity (BMI > 27); lower-level body fat distribution (WHR < or = 0.85) and upper-level body fat distribution (WHR >0.85). Afterwards four subgroups were created: (I) BMI < or = 27 and WHR < or = 0.85, (II) BMI < or = 27 and WHR > 0.85, (III) BMI > 27 and WHR < or = 0.85, and (IV) BMI >27 and WHR > 0.85. Climacteric symptoms were analyzed with Kupperman's index. Estrone, estradiol, testosterone, androstenedione, and dehydroepiandrosterone sulfate determinations were done by radioimmunoassay and verified by chemoluminescence. The androstenedione-estrone and testosterone-estradiol ratios were calculated. Statistical analysis was by Student's t test for independent samples, plus Pearson's correlation analysis. RESULTS: Average age was 53.0 +/- 6.5 years, time since menopause 74.2 +/- 64.3 months. When comparing those with lower-level body fat distribution and those with upper-level body fat distribution, the A levels were significantly lower (P < 0.04) in those with upper-level distribution. Kupperman's index was significantly lower in subgroup I when compared with subgroups III and IV. The androstenedione level was lower in subgroup IV compared with subgroup III. In the whole sample, there was a correlation of the WHR with testosterone (0.297, P < .004) and the testosterone-estradiol ratio (0.209, P < .04). CONCLUSION: It was shown that the testosterone-estradiol ratio has a better correlation with the symptoms, so it can be used to evaluate climacteric patients when they complain of menopausal symptoms.

Androgens↗
PubMed1995

Insulin resistance in adipocytes of obese women: effects of body fat distribution and race.

Upper-body obesity (UBO) in white women is associated with increased fatty acid turnover and resistance to the effects of insulin on systemic glucose metabolism. The present study determined whether the abilities of insulin to stimulate glucose transport and suppress lipolysis are impaired in adipocytes from white UBO (W-UBO) women. Because the clinical risks associated with UBO are attenuated in black women, the effects of race on adipocyte insulin sensitivity were assessed. Forty-two healthy, equally obese women were selected for study on the basis of race (black or white) and body fat distribution (UBO or lower-body obesity [LBO]). In white women, both abdominal and gluteal fat cells from the UBO versus LBO group were less responsive to the stimulatory effects of insulin on glucose uptake and less sensitive to the antilipolytic effects of insulin and the adenosine analog, phenylisopropyladenosine (PIA). In contrast, in black women, fat cells from UBO and LBO groups were equally sensitive to the stimulatory effects of insulin on glucose transport and the suppressive effects of insulin and PIA on lipolysis. These in vitro data correlate well with previous clinical findings that UBO in white women but not in black women is associated with insulin resistance and dyslipidemia. Thus, resistance to the antilipolytic effects of insulin and adenosine at the level of adipose tissue may increase systemic lipolysis and play a role in the development or maintenance of peripheral insulin resistance associated with UBO in white women, but not in black women.

Abdomen↗
PubMedDate not supplied

The precision of anthropometric assessment of body fat distribution in children.

Precision estimates are given for indices of body mass, fatness and body fat distribution in a sample of n = 19 subjects selected at random from a larger study of cardiovascular disease risk in school-aged children. The value of this study is that little is known about the measurement precision of ratio indices and multivariate constructs of body fat distribution in children or any other age group. Intra- and inter-observer precisions were highest for weight, height, body mass index and six body circumferences (0.95-0.99), and were lower and more variable for five skinfold thicknesses (0.80-0.99). The measurement precision of ratio indices derived from the circumferences (waist/hip and waist/thigh) and the skinfolds (subscapular/thigh and triceps/subscapular) were lower and more variable than precisions of the single variables. Circumference ratio precisions varied from 0.81 to 0.96 and skinfold ratios varied from 0.28 to 0.94. Precisions of a multivariate construct of central fat distribution from five skinfold measures were better (0.77-0.95), suggesting its greater efficacy. Inter-examiner precisions tended to be significantly lower than intra-examiner precisions for skinfold thicknesses and all composite indices. The lower precisions of ratio indices, compared to the measurement accuracy of the variables which make them up, needs to be considered in epidemiological studies of body fat distribution.

Adipose Tissue↗
PubMed1995

Relation of body fat distribution to reproductive factors in pre- and postmenopausal women.

The cross-sectional relations of several reproductive characteristics with self-reported waist-to-hip circumference ratio were evaluated in 44,487 pre- and postmenopausal women 40 to 65 years of age who were free of cancer, cardiovascular disease, and diabetes. All results were adjusted for age, body mass index, cigarette smoking, physical activity, and alcohol intake. Current use of postmenopausal hormones was associated with a significantly lower waist-to-hip ratio than either past or never use independent of type of menopause (0.778 versus 0.784, p = 0.0001 and 0.787, p = 0.0001, respectively), although associations with type (unopposed estrogens versus combined estrogen and progesterone) and duration of hormone therapy were not noted. Waist-to-hip ratio did not differ between pre- and postmenopausal women, but demonstrated weak positive associations with age at menarche, parity, and age at first birth, and a weak inverse association with past duration of breast-feeding. These data confirm relations of several reproductive factors and use of hormone replacement therapy with body fat distribution. Epidemiologic studies relating body fat distribution to disease outcomes in women should consider these factors as potential confounders.

Adipose Tissue↗
PubMed2001

Prospective evaluation of body weight and body fat distribution in early postmenopausal women with and without hormonal replacement therapy.

AIMS: In order to assess the effects of menopause and hormonal replacement therapy (HRT) on body weight and body fat distribution (determined by dual energy X-ray), early postmenopausal women were given either oral calcium (500 mg/day, control group, n=13) or HRT, a combination of estradiol valerate (EV, 2 mg/day for 21 days) with cyproterone acetate (CPA, 1 mg/day in the last 10 days of the treatment cycle, n=18; Climen, Schering). RESULTS: There were no differences in basal body weight and body fat distribution in the two groups before the study. In control group, a significant (P<0.05) increase in body weight (from 63.5+/-2.0 to 68.7+/-2.0 kg after 36 months) paralleled a shift to a prevalent central, android fat distribution with a slight but significant (P<0.05) increase in total body fat mass (from 23.4+/-2.1 to 29.1+/-2.1 kg), an increase in trunk (from 10.1+/-0.4 to 12.7+/-0.4 kg, P<0.05), arms (from 2.4+/-0.2 to 2.9+/-0.2 kg, P<0.05) and legs (from 6.5+/-0.4 to 7.8+/-0.4 kg, P<0.05) fat. In the HRT group total body bone mineral showed a significant increase (from 1086+/-21 to 1128+/-19 mg/cm(2), P<0.05) increase after 36 months, with no significant increase in body weight (from 62.6+/-1.8 to 65.0+/-1.9 kg), and no modifications in trunk (from 10.0+/-0.2 to 10.1+/-0.2 kg) and arms (from 2.4+/-0.1 to 2.6+/-0.1 kg) fat, but a significant increase in legs fat (from 6.9+/-0.3 to 9.9+/-0.4 kg, P<0.05). CONCLUSION: Present results demonstrate that menopause is associated with an accelerated increase in body weight and body fat, with a prevalent central, android fat distribution, that can be counteracted at least in part by oral HRT.

Absorptiometry, Photon↗
PubMed1985

A prospective study of body fat distribution and weight loss.

Previous studies have suggested an association between adipose tissue cellularity and body fat distribution, and between adipose tissue cellularity and ability to lose weight. To determine whether there was an association between body fat distribution and ability to lose weight, we prospectively studied 187 severely obese women. The women were all 50 percent or more above ideal body weight, with personal physician documentation of no known major illnesses. Weights were recorded at the beginning and end of a 3-week hospitalization and every 3 months following hospitalization, for up to 2 years. The ratio of waist girth to hip girth (WHR) was used as an index of body fat distribution. A statistical analysis which adjusted for age and weight on admission did not find any association between WHR and weight loss during hospitalization, or at any time up to 2 years after hospital discharge. We conclude that the WHR index of body fat distribution is not a useful prognostic indicator of weight change for severely obese women with refractory obesity.

Adipose Tissue↗
PubMed1982

Relation of body fat distribution to metabolic complications of obesity.

The importance of body fat distribution as a predictor of metabolic aberrations was evaluated in 9 nonobese and 25 obese, apparently healthy women. Plasma glucose and insulin levels during oral glucose loading were significantly higher in women with predominantly upper body segment obesity than in women with lower body segment obesity. Of the former group, 10 of 16 subjects had diabetic glucose tolerance results, while none of the latter group was diabetic. Fasting plasma triglyceride levels were also significantly higher in the upper body segment obese women. The site of adiposity in the upper body segment obese women was comprised of large fat cells, while in the lower body segment obese subjects, it was formed of normal size cells. In both types of obesity, abdominal fat cell size correlated significantly with postprandial plasma glucose and insulin levels. Thigh fat cell size gave no indication as to the presence of metabolic complications. Thigh adipocytes were also resistant to epinephrine-stimulated lipolysis, presumably due to an increase in alpha-adrenergic receptors. Thus, in women, the sites of fat predominance offer an important prognostic marker for glucose intolerance, hyperinsulinemia, and hypertriglyceridemia. This association may be related to the disparate morphology and metabolic behavior of fat cells associated with different body fat distributions.

Adipose Tissue↗
PubMed1997

Correlation of body fat distribution with grade of endometrial cancer.

To elucidate whether body fat distribution correlates with the grade of endometrial cancer, we studied 74 postmenopausal women with endometrial cancer (mean age 62.4 +/- 6.6 years, range 49-78 years). The subjects were divided into three groups as follows: well-differentiated adenocarcinoma (G1 group; N = 53), moderately differentiated adenocarcinoma (G2 group; N = 11), and poorly differentiated adenocarcinoma (G3 group; N = 10). Four body fat indices [total fat weight (g), body fat ratio (%), trunk fat weight (g), and weight ratio of trunk fat to leg fat (trunk/leg ratio)] were measured by dual-energy X-ray absorptiometry. Baseline characteristics and body fat indices in the three groups were compared. In all subjects, the correlations of these variables with the grade of adenocarcinoma were investigated using single and stepwise regression analyses. Total fat weight, body fat ratio, and trunk fat weight showed slight increases with the grade of differentiation. The trunk/leg ratio in G1 group was significantly higher than in G2 and G3 groups. The trunk/leg ratio was significantly correlated with the grade in stepwise regression analysis. Body fat distribution in women with endometrial cancer may correlate with the grade of the adenocarcinoma.

Absorptiometry, Photon↗
PubMed1983

Relationship of obesity to diabetes: influence of obesity level and body fat distribution.

The relationship of clinical diabetes to body fat distribution and obesity level was examined in 15,532 women. After adjusting for relative weight, all upper body segment girth measurements (neck, bust, and waist) had strong positive associations with diabetes. In contrast, the lower body segment girth measurement (hips) had an equally strong but inverse association with diabetes. Based upon waist-to-hip girth ratio, women were divided into four subgroups. The prevalence of diabetes increased with increasing values of this ratio. Women in the upper quartile had about three times the prevalence of diabetes as women of comparable obesity level in the lowest quartile. Women with both upper body fat predominance and severe obesity had a relative risk of diabetes 10.3 times as great as nonobese subjects with lower body fat predominance. The results suggest that localization of fat in the upper body segment and severe obesity are two distinct additive risks for diabetes.

Adipose Tissue↗
PubMed1998

Relationship between glycosylated hemoglobin, blood pressure, serum lipid profiles and body fat distribution in healthy Chinese.

Obesity-related metabolic disorders have not been adequately addressed due to a failure to distinguish the importance of general obesity or body fat distribution in relation to atherosclerotic risk factors, especially in the less obese populations. To assess the relationship between general obesity (reflected by BMI, total body fat percentage and total adiposity), body fat distribution (reflected by WHR, default regions and ROIs of DEXA) and atherosclerotic risk factors in the Chinese population, a total of 872 healthy subjects (477 male and 395 female) were enrolled in the study. The results indicated that the android pattern of fat distribution, independent of general obesity, was positively correlated with blood pressure, atherogenic indices, fasting and OGTT 2-h plasma glucose, glycosylated hemoglobin (HbA1c), serum concentration of cholesterol, triglyceride, LDL cholesterol and negatively correlated with HDL cholesterol in both genders. The gender differences in patterns of body fat distribution and atherosclerotic risk factors remained significant after adjustments were made for age, BMI and total adiposity, although diminished after further adjustments for body fat distribution. In conclusion, body fat distribution, rather than general obesity, is more correlated with obesity-related atherosclerotic risk factors and sex-associated differences. ROIs measured by DEXA may be a useful method to evaluate sex-associated changes in body fat distribution and atherosclerotic risk factors in the healthy Chinese population.

Adipose Tissue↗
PubMed1997

Effects of age on body fat distribution and cardiovascular risk factors in women.

We conducted a cross-sectional study of body fat distribution and metabolic variables and the interrelations among these factors in 134 women aged 18-71.9 y. Body fat distribution was measured with use of computerized tomography. A significant positive correlation was observed between age and visceral adipose tissue (VAT) and between VAT and body weight. When subjects were divided into five age groups, VAT values were significantly higher in older groups. Values for triacylglycerols, cholesterol, fasting glucose, 2-h glucose, and the sum of glucose values during an oral-glucose-tolerance test were significantly higher in older subjects. After adjustment for visceral fat, no significant differences in any metabolic variable studied, except cholesterol, were found across the five age groups. In conclusion, we found that regional body fat distribution in older women was different from that in younger subjects: older women had larger amounts o visceral fat. Values for metabolic variables were also higher in older subjects. Our data suggest that redistribution of body fat in older subjects is associated with changes in metabolic variables.

Adipose Tissue↗
PubMed2000

Efficacy of troglitazone on body fat distribution in type 2 diabetes.

OBJECTIVE: The insulin-sensitizing action of troglitazone may be mediated through the activation of peroxisome proliferator-activated receptor-gamma (PPAR-gamma) and the promotion of preadipocyte differentiation in adipose tissue on which troglitazone has depot-specific effects. We investigated the relationship between efficacy of the drug and body fat distribution. Changes in body fat distribution were also investigated by long-term administration of the drug. RESEARCH DESIGN AND METHODS: Troglitazone was given at a dose of 400 mg/day to 20 patients with type 2 diabetes whose diet and sulfonylurea therapy produced unsatisfactory glycemic control (HbA(1c) >7.8%) and whose insulin secretory capacity was found to be preserved (postprandial C-peptide >3 ng/ml). HbA(1c) values, serum lipid levels, and body weight were measured monthly Body fat distribution was evaluated in subcutaneous (SC) and visceral fat using a computed tomography scan at umbilical levels before and after troglitazone therapy RESULTS: During the 1-year troglitazone treatment, HbA(1c) was significantly decreased (from 9.2 +/- 0.2 to 7.1 +/- 0.2%, P < 0.01), showing lowest values at 4-6 months, whereas body weight was significantly increased (BMI 24.6 +/- 0.6 to 25.7 +/- 0.6 kg/m2, P < 0.01). Reduction of HbA(1c) (deltaHbA(1c)) from the baseline value during treatment was significantly greater in obese patients (BMI >26 kg/m2) than in nonobese patients (-3.2 +/- 0.4 vs. -2.1 +/- 0.3%, P < 0.05) and was more significant in women than in men (-3.2 +/- 0.2 vs. - 1.4 +/- 0.2%, P < 0.01). The level of deltaHbA(1c) during treatment showed a significant negative correlation with SC fat area (r = -0.742, P < 0.01) but not with visceral fat area. Weight gain during troglitazone treatment resulted in increased accumulation of SC fat without a change in visceral fat area and, consequently. in a significant decrease in the visceral-to-SC fat ratio. CONCLUSIONS: Predominant accumulation of SC fat for the visceral fat tissue was an important predictor of the efficacy of troglitazone therapy in patients with type 2 diabetes. Greater efficacy of troglitazone was observed in women who were characterized by more accumulation of SC adipose tissue than men. Long-term administration of the drug resulted in weight gain with increased accumulation of SC adipose tissue, probably because of the activation of PPAR-gamma in the region.

Adipose Tissue↗
PubMed2003

Relationship of serum adiponectin and leptin concentrations with body fat distribution in humans.

OBJECTIVE: We investigated whether serum concentrations of adiponectin are determined by body fat distribution and compared the findings with leptin. RESEARCH METHODS AND PROCEDURES: Serum concentrations of adiponectin and leptin were measured by radioimmunoassay (n = 394) and analyzed for correlation with sex, age, and body fat distribution, i.e., waist-to-hip ratio, waist and hip circumference, and subcutaneous adipose tissue area of the lower leg as assessed by magnetic resonance imaging. RESULTS: After adjusting for sex and percentage of body fat, adiponectin was negatively (r = -0.17, p < 0.001) and leptin was positively (r = 0.22, p < 0.001) correlated with waist-to-hip ratio. Leptin, but not adiponectin, correlated with both waist (r = 0.49, p < 0.001) and hip circumference (r = 0.46, p < 0.001). Furthermore, leptin, but not adiponectin, correlated with the proportion of subcutaneous fat of the lower leg cross-sectional area (r = 0.37, p < 0.001). DISCUSSION: These data suggest that both adipocytokines are associated with central body fat distribution, and serum adiponectin concentrations are determined predominantly by the visceral fat compartment.

Adiponectin↗