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PubMed2004

Anthropometry of women of childbearing age in Morocco: body composition and prevalence of overweight and obesity.

OBJECTIVE: To determine the prevalence of obesity and body fat distribution of Moroccan women of childbearing age, using a panel of anthropometric measurements. DESIGN AND SETTING: A cross-sectional survey conducted in 1995 in an agricultural community, El Jadida province of Morocco. Weight, height, waist and hip circumferences and triceps, biceps, subscapular and supra-iliac skinfold thicknesses were measured. Body mass index (BMI), waist/hip ratio (WHR), sum of all and sum of trunk skinfold thicknesses were determined. SUBJECTS: In total, 1269 women aged 15-49 years from urban and rural areas were surveyed. RESULTS: The means of all anthropometric measurements including body fat were higher in urban than in rural women and increased with age. Trunk fat contributed 50% of total fat. Globally, 4.7% of women were underweight (BMI<18.5 kg m(-2)), 35.2% were overweight or obese (BMI> or =25 kg m(-2)), 10.1% were obese (BMI> or =30 kg m(-2)) and 16.8% had central obesity (WHR>0.85). The prevalence of overweight and obesity was higher in the urban than in the rural area. Underweight prevalence decreased with age, whereas that of overweight and obesity increased. All anthropometric parameters adjusted for age increased with the increase of BMI and WHR. CONCLUSIONS: Although undernutrition is still prevalent, there is an alarming prevalence of overweight and obesity in Moroccan women of childbearing age. The results indicate a shift in this country from the problem of dietary deficiency to the problem of dietary excess, and alert one to the necessity of establishing an intervention to prevent obesity-related diseases. It is necessary to address which of the anthropometric variables studied here is the best predictor of obesity-related diseases in this population.

Adipose Tissue↗
PubMed1990

Increased prevalence of clinical gallbladder disease in subjects with non-insulin-dependent diabetes mellitus.

The association between non-insulin-dependent diabetes mellitus (NIDDM) and the prevalence of gallbladder disease remains controversial. The authors investigated this association in 1,250 men and 1,656 women from the San Antonio Heart Study (1984-1988) a population-based study of diabetes and cardiovascular disease. A total of 68% of the subjects were Mexican American, a population at high risk for both gallbladder disease and NIDDM. Gallbladder disease was assessed by self-report, and the prevalence of diabetes was determined using National Diabetes Data Group criteria. NIDDM was significantly associated with gallbladder disease in Mexican-American men and women and in non-Hispanic white women. After adjustment for age, body mass index, ratio of waist-to-hip circumference, and ethnicity, using multiple logistic regression, the odds of gallbladder disease in women was 1.6 times higher if NIDDM was present (odds ratio = 1.60, 95% confidence interval 1.08-2.37). Mexican-American women also had a significantly increased prevalence of gallbladder disease relative to non-Hispanic white women (odds ratio = 2.21, 95% confidence interval 1.50-3.28). In nondiabetic women, fasting insulin was significantly related to prevalence of gallbladder disease in univariate analyses, but not in multivariate analyses. The authors conclude that women with diabetes have an increased prevalence of gallbladder disease relative to nondiabetic women and that this association is not explained by the greater adiposity or unfavorable body fat distribution of the diabetic subjects.

Adult↗
PubMed2005

Histological changes in the liver of morbidly obese patients: correlation with metabolic parameters.

BACKGROUND: Obesity is a major risk factor for fatty liver disease. The purpose of this study was: 1) to determine the degree of steatosis, inflammation and fibrosis in liver biopsies of morbidly obese patients in relation to their body fat distribution and metabolic status, and 2) to examine the course of liver enzyme changes with surgically-induced weight loss. METHODS: The study population included 179 morbidly obese bariatric surgical patients (82% female, 18% male, mean age 39+/-0.7 (SEM) years, BMI 52+/-0.6 kg/m2, excess body weight 80+/-1.8 kg). All patients tested negative for hepatitis and HIV. Liver biopsies were taken intra-operatively. Hepatic enzyme activities were measured along with lipid parameters, fasting glucose, insulin and leptin. RESULTS: Liver biopsies showed that 47% of morbidly obese females and 85% of males had >30% of hepatocytes filled with fat droplets. Clinically significant hepatic steatosis was associated (P<0.01) with: a) metabolic aberrations, i.e.hyperlipidemia, hyperglycemia, b) male gender, c) abdominal adiposity, and d) elevated hepatic aminotransferase activities. Hepatic inflammation was found in 47% of females and 55% of males, and 'moderate' fibrosis occurred in 12% of males and 6% of females. Postoperatively, the activity of hepatic aminotransferases declined after an initial increase in response to weight loss, with normalization of values occurring at an excess weight loss of 50% (P<0.0001). CONCLUSION: The majority of morbidly obese patients have >30% steatosis of the liver. The incidence of steatosis is higher for males than females, possibly due to their visceral obesity and associated metabolic aberrations.

Adult↗
PubMed2000

Anthropometric, computed tomography and fat cell data in an obese population: relationship with insulin, leptin, tumor necrosis factor-alpha, sex hormone-binding globulin and sex hormones.

OBJECTIVE: To correlate anthropometric, computed tomography and fat cell data from abdominal regions with the levels of serum insulin, C-peptide, leptin, tumor necrosis factor-alpha (TNF-alpha), testosterone, 17beta-estradiol, androstenedione, dehydroepiandrosterone sulphate (DHEA-S) and sex hormone-binding globulin (SHBG). DESIGN AND METHODS: The sample consisted of 84 obese patients (29 men, 22 premenopausal women and 33 postmenopausal women) who had undergone abdominal surgery. Weight, height, percentage of body fat by skinfolds, waist, hip and thigh circumferences, sagittal and coronal diameters, visceral and subcutaneous area, serum hormones and fat cell data were studied. RESULTS AND CONCLUSIONS: Premenopausal women showed the lowest values in most abdominal distribution parameters, although, depending on the waist circumference criteria at the umbilicus level perimeter (W1) or midway between lower rib margin and iliac crest perimeter (W2), the population was classified differently, as gynoid or android. Although there were no differences in fat cell size between genders, gynoid women had smaller and more numerous fat cells than the android type. Perivisceral fat cell size was significantly smaller than subcutaneous fat cell size. In women, central obesity was significantly correlated with an increase in serum insulin, leptin, TNF-alpha, testosterone and androstenedione levels, and a decrease in 17beta-estradiol and DHEA-S, while in men significant correlations were positive with insulin and negative with testosterone and androstenedione. Fat cell size was positively correlated with serum levels of leptin, insulin, DHEA-S, androstenedione and inversely correlated with SHBG. These data indicate that hormones seem to interact not only with body fat distribution but also with fat cell size. This interaction differs between genders and between the different abdominal adipose tissue regions.

Adipocytes↗
PubMed2000

[Lipodystrophy and hyperglycemia produced by protease inhibitors].

BACKGROUND: HIV-1 protease inhibitors (PI) have been recently associated with a syndrome of anomalous body fat distribution or lipodystrophy (LD), which sometimes is associated to hyperglycemia. Many aspects of this syndrome remain obscure. The objective of the study is to describe the prevalence, clinical patterns, derangement of glucose metabolism associated and follow-up. METHODS: Patients taking at least one PI during January 1998 were asked a questionnaire about any body change, and a physical exam looking for fat changes was performed. In patients found to have LD, basal plasma glucose, cholesterol, triglycerides and cortisol were studied, and an oral glucose tolerance test (OGTT) was performed. In those cases with breast enlargement, prolactin and estradiol were measured. RESULTS: Among 272 patients, five cases (1.8%) of LD were detected. The syndrome appeared associated with all the IP available at the time of the study, a medium of 4.2 months after the introduction of the drug. The most common pattern was fat accumulation in abdomen and breast, and fat loss in arms, legs and face. Basal glycemia was normal in all 5 patients, but OGTT showed carbohydrate intolerance in two (both of them had family antecedents of type 2 diabetes mellitus). Only one patient need treatment withdrawal because of progressive deforming changes. CONCLUSIONS: The LD can appear in patients taking any IP. Body changes are usually self limited and in many patients PI don't need to be stopped.

Adult↗
PubMed2001

Gender differences in fat metabolism.

Women generally have a higher percentage of body fat than men. Also, women store more fat in the gluteal-femoral region, whereas men store more fat in the visceral (abdominal) depot. This review focuses on differences in regional fatty acid storage, mobilization and oxidation that may contribute to gender-related differences in body fat distribution. There are pronounced regional differences in the regulation of regional fatty acid metabolism between men and women. Firstly, there is evidence that in vivo, catecholamine mediated leg free fatty acid release is lower in women than in men, whereas free fatty acid release from the upper body depots is comparable. These data correspond to in-vitro adipose tissue biopsy data, which indicate a more pronounced difference in catecholamine mediated lipolysis between upper body and lower body fat depots in women than in men. Secondly, free fatty acid release by the upper body subcutaneous fat depots is higher in men than in women, indicating a higher resistance to the antilipolytic effect of meal ingestion in the upper body fat depots in men. Thirdly, there are indications that basal fat oxidation (adjusted for fat free mass) is lower in females as compared to males, thereby contributing to a higher fat storage in women. Finally, postprandial fat storage may be higher in subcutaneous adipose tissue in women than in men, whereas storage in visceral adipose tissue has been hypothesized to be higher in men. All the above differences may play a role in the variation in net regional fat storage between men and women, but the number of in-vivo studies on gender-related differences in fatty acid metabolism is very limited and most findings require confirmation. Furthermore, there is abundant evidence that the proportion of energy derived from fat during exercise is higher in women than in men. With respect to total body fat, this finding seems counterintuitive, as percentage body fat is increased in women. Further studies are necessary to investigate the significance of differences in exercise-induced fat oxidation on 24-h fat balance.

Adipose Tissue↗
PubMed2003

Sex steroids and body composition in men with cystic fibrosis.

OBJECTIVE: Delayed sexual maturation and low body weight is common in cystic fibrosis (CF). Concomitant data on sex hormones and concomitant body composition are lacking in men with CF. DESIGN: Cross-sectional study. SUBJECTS AND METHODS: Serum levels of testosterone, 17beta-oestradiol (E(2)), 25-hydroxyvitamin D (25(OH)D), sex hormone-binding globulin (SHBG) and LH were measured by RIA and total and regional lean body mass (LBM), fat body mass (FBM), bone mineral content and bone mineral density (BMD) were assessed by dual-energy X-ray absorptiometry, in men with CF (n=40; age 24.7+/-5.4 years) and age-matched healthy controls (n=28; age 25.7+/-3.7). Only men without acute disease exacerbation or systemic glucocorticoid treatment were included. RESULTS: Mean levels of hormonal serum parameters differed significantly between healthy controls (testosterone=20.2+/-5.5 nmol/l; E(2)=95.0+/-20.2 pmol/l; 25(OH)D=62.8+/-28.3 nmol/l) and patients (testosterone=15.9+/-4.1 nmol/l; E(2)=60.7+/-19.4 pmol/l; 25(OH)D=39.5+/-17.8 nmol/l; P<0.001) while no difference was found for SHBG or LH. Eleven (for E(2), 19 of 40, for 25(OH)D, 20 of 40) out of 40 patients had serum testosterone levels 2 s.d. below the mean of normal. Men with CF showed a relative shift from FBM to LBM and a different body fat distribution compared with healthy controls (P<0.01). Testosterone was not correlated with weight, total or regional LBM or FBM, but significantly with BMD (r=0.32; P<0.05) independently from body height and 25(OH)D levels. E(2) was correlated with regional and total FBM (r=0.48; P<0.05). In a multiple regression analysis of the joint effect of testosterone and body components on E(2), a testosterone-independent effect was found for FBM. CONCLUSIONS: CF patients with stable disease have moderately reduced serum testosterone levels. This might already imply detrimental effects on bone. The change in LBM of patients appears to have no direct association with sex hormone levels while low FBM might cause reduced net conversion of serum testosterone to E(2) with possible effects on FBM distribution.

Absorptiometry, Photon↗
PubMed1989

Cigarette smoking and increased central adiposity.

STUDY OBJECTIVE: To determine whether cigarette smoking is associated with central obesity in men and women. DESIGN: A cross-sectional survey. SETTING: A geographically defined population of older white adults. PARTICIPANTS: Men (836) and women (1112) ages 50 to 79. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Waist-hip circumference ratio and body mass index (weight in kg/height in m2) were measured in participants wearing light clothing without shoes. Past and current cigarette smoking habits were ascertained by a standard self-administered questionnaire. Cigarette smokers had higher waist-hip ratios than non-smokers. We observed a dose-response relation of increasing waist-hip ratio with increasing number of cigarettes smoked. Although smokers were leaner than nonsmokers, the increased waist-hip ratio in smokers was independent of body mass index and was consistent within body-mass index tertiles. The associations, seen in both sexes, were stronger in women. CONCLUSIONS: Cigarette smokers have more central obesity than nonsmokers. These results suggest that body fat distribution can be modified by behavioral factors such as smoking.

Abdomen↗
PubMed2004

Insulin resistance and vascular dysfunction in nondiabetic Asian Indians.

Asian Indians are at higher risk for diabetes and cardiovascular disease than European Caucasians. To examine the pathophysiology of this increased risk, we measured insulin sensitivity, cardiovascular risk factors, fat distribution, and endothelium-dependent (reactive hyperemia) and -independent (nitroglycerin) vasodilation before and after a 2-h hyperinsulinemic clamp (40 mU/m(2).min) in 25 nondiabetic Asian Indians and 15 Caucasians with similar age and body mass index. Asian Indians had higher fasting insulin than Caucasians (6.7 +/- 0.8 vs. 3.7 +/- 0.3 microU/ml, P = 0.007) but similar FPG (90 +/- 2 vs. 88 +/- 2 mg/dl). Glucose uptake during the clamp was markedly reduced in Asian Indians vs. Caucasians (4.5 +/- 0.3 vs. 7.5 +/- 0.4 mg/kg x min, P < 0.0001). During the clamp, basal brachial artery diameter increased less in Asian Indians vs. Caucasians (2.6 +/- 1.0 vs. 5.7 +/- 1.0%, P = 0.04), and the reduction was correlated with the impairment in insulin sensitivity (r = 0.38, P = 0.04). In contrast, vasodilatory responses to reactive hyperemia and nitroglycerin were similar in Asian Indians and Caucasians both before and during hyperinsulinemia. Plasminogen activator inhibitor-1 and FFA were significantly elevated and adiponectin was significantly lower in Asian Indians vs. Caucasians, and there were trends toward higher low-density lipoprotein and triglycerides, lower high-density lipoprotein, and increased total, sc, and visceral fat. These risk factors were all significantly correlated with insulin sensitivity. Thus, apparently healthy Asian Indians have severe insulin resistance, dyslipidemia, elevated plasminogen activator inhibitor-1, impaired insulin-mediated vasodilation, and trends toward altered body fat distribution. These abnormalities may contribute to the increased risk of diabetes and cardiovascular disease in this population.

Abdomen↗
PubMed2003

Influence of adiposity on tonic sympathetic support of resting metabolism in healthy adults.

BACKGROUND: beta-Adrenergic receptor sympathetic nervous system (beta-AR SNS) support of resting metabolic rate (RMR) is attenuated with older age, female sex, and a sedentary lifestyle. Total and abdominal adiposity and/or body fat pattern modulate some SNS-mediated physiological functions. OBJECTIVE: To determine if total and abdominal adiposity and/or body fat distribution are independently related to SNS support of RMR. DESIGN: Cross-sectional comparison of beta-AR SNS support of RMR. SUBJECTS: A total of 54 healthy male and female subjects aged 18-75 y. MEASUREMENTS: RMR (ventilated hood, indirect calorimetry) before (baseline) and during complete beta-AR blockade; body composition by dual energy X-ray absorptiometry. RESULTS: Forward stepwise multiple regression analysis using sex, exercise status, age group, %body fat, total adiposity, abdominal adiposity, and the ratio of abdominal adiposity to hip adiposity as variables revealed sex to be the strongest predictor, explaining 21% of the variability in beta-AR SNS support of RMR (P=0.0006). Age group explained an additional 4% and exercise status a further 4% (both P=0.10). %Body fat, total adiposity, abdominal adiposity, and the ratio of abdominal adiposity to hip adiposity did not enter the equation. CONCLUSION: Total and abdominal adiposity and body fat pattern are not independent physiological determinants of beta-AR SNS support of RMR among healthy men and women. Moreover, further support is provided for our previous finding of attenuated beta-AR SNS support of RMR with age, female sex, and sedentary lifestyle.

Abdomen↗
PubMed2003

Effect of shift work on body mass index: results of a study performed in 319 glucose-tolerant men working in a Southern Italian industry.

OBJECTIVE: To examine the influence of shift work on metabolic and cardiovascular risk factors in subjects working in an industry sited in Apulia, Southern Italy. DESIGN: Cross-sectional study of metabolic effects of shift work in glucose tolerant workers in a chemical industry in southern Italy. SUBJECTS: The subjects included 319 glucose tolerant male individuals, aged 35-60 y. MEASUREMENTS: Anthropometric parameters (body mass index (BMI) and waist-to-hip ratio (WHR)), fasting concentrations of glucose, insulin, and lipids (total cholesterol, HDL-cholesterol, triglycerides), the sum of glucose levels during 75 g-oral glucose tolerance test (Sigma-OGTT), and systolic and diastolic blood pressure (SBP and DBP, respectively). RESULTS: The prevalence of obesity was higher among shift workers compared to day workers, whereas body fat distribution was not different between the two groups. Shift workers had higher BMI than day workers, and shift working was associated with BMI, independently of age and work duration. Shift workers had significantly higher SBP levels, which were independently influenced by BMI, but not by shift work, thus suggesting that the difference in SBP may well be mediated by the increased body fatness. CONCLUSION: In workers of an industry sited in Southern Italy, shift work may be directly responsible for increased body fatness and is indirectly associated with higher blood pressure levels and some features of metabolic syndrome.

Adult↗
PubMed1993

Nutritional assessment in Duchenne muscular dystrophy.

A specific-weight chart and simple clinical tools are sufficient to obtain an accurate diagnosis of undernutrition or obesity among patients with Duchenne muscular dystrophy (DMD). The authors collected weight-for-age measures from a sample of 252 boys and anthropometric data from 109 of those boys with DMD. The data confirm the accuracy of the DMD ideal-weight chart previously proposed by Griffiths and Edwards (1988). Obesity may occur from the age of seven years; its prevalence seems to reach 54 per cent by the age of 13 years. Undernutrition occurs after the age of 14 years, involving 54 per cent of boys at about 18 years of age. Obese boys show a centralized body-fat distribution, in agreement with other obese populations.

Adipose Tissue↗
PubMed2003

Validity of body composition methods across ethnic population groups.

Body composition methods can be classified into direct, indirect and doubly indirect methods. In vivo direct methods use neutron activation analysis to get information on body composition. Indirect methods rely on rules and constants derived from direct methods. Most basic research, especially the development of rules and models has been done in Caucasian subjects in Europe or USA. The critical use of more advanced body composition methodologies in various ethnic groups has shown that assumptions may differ between ethnic groups, an example being the assumption of constant density of the fat free mass. Indirect or predictive methods rely on statistical relationships between body parameters and components of body composition. Subcutaneous fat patterning differs among ethnic groups, and this may have consequences for the validity of body fat predicted from skinfold thickness. Relative leg length and relative arm length also differ between ethnic groups. As a result the body mass index (weight/height squared, BMI), often used as surrogate for body fat percent, and formulas based on bioelectrical impedance measurement show different validity among ethnic groups. Less information is available about the validity of indicators for body fat distribution. There are indications that the relationship between the amount of visceral adipose tissue and waist circumference or waist-hip circumference ratio also differs among ethnic groups. Ethnic differences in body composition rules and constants are important and challenging to investigate, especially in relation to overweight and obesity.

Anthropometry↗
PubMed1989

[Basal lipid energy utilization in obese women and men].

In 16 abdominal type obese males, in 16 gluteal-femoral type obese females and in 10 nonobese males and 9 nonobese females, as controls, the influence of body fat distribution on basal lipid oxidation was evaluated by indirect calorimetry. Basal lipid oxidation was significantly higher in the obese males (1.21 +/- 0.12 g/kg-FFM.die) than in the nonobese males (0.47 +/- 0.13 g/kg-FFM.die; p less than 0.001), but not significantly different between obese and nonobese females (0.98 +/- 0.16 and 0.89 +/- 0.13 g/kg-FFM.die; p ns). A significant correlation between basal lipid oxidation and percentage of body fat was found only in the male subjects (r = 0.51; p less than 0.01). These results suggest that basal lipid oxidation differs in the two sexes according to adipose tissue anatomic location.

Adipose Tissue↗
PubMed1996

Education, health behaviors, and the black-white difference in waist-to-hip ratio.

Few epidemiologic studies have investigated the impact of body mass index, low educational attainment, cigarette smoking, and physical activity on the considerable black-white difference in waist-to-hip ratio. These relationships were assessed with multivariable linear regression among 3,094 adults (24% black) who were examined in 1987 in South Carolina. The unadjusted mean waist-to-hip ratio was lower for black men than for white men (-0.03 units) and higher for black women than for white women (+0.03 units). After adjustment for age, body mass index, education, smoking, and physical activity, the black-white difference in mean waist-to-hip ratio was -0.02 units (p < 0.001) among men and +0.01 units (p < 0.01) among women. Although differing distributions of age, body mass index, and educational attainment accounted for a 59% reduction in the black-white difference among women, these factors did not explain the difference among men. Thus, these results suggest that other environmental or biologic factors may also play an important role in the marked variation in body fat distribution between the two ethnic groups. The results also support the importance of the prevention of cigarette smoking and overweight in potentially preventing abdominal obesity in both black adults and white adults.

Adult↗
PubMed1989

Health risks of obesity.

Evidence implicating obesity as a risk-factor disease is critically reviewed. Possible reasons for the many conflicting findings are addressed. The classification of obesity, based upon the site of body fat distribution, and possible biologic mechanisms associating regional adiposity with morbidity, are discussed.

Adipose Tissue↗
PubMed1991

The influence of regional adiposity on atherogenic risk factors in men and women with type 2 diabetes.

To determine firstly whether body fat distribution could predict the presence of atherogenic risk factors better than overall adiposity in Type 2 diabetes, and secondly whether sex differences in these risk factors could be explained by sex differences in fat distribution, waist-to-hip girth ratio (WHR), serum lipids, lipoproteins, apolipoproteins, plasma lipolytic activity, and blood pressure were assessed in 47 patients with Type 2 diabetes, 21 women matched for age, body mass index (BMI) and blood glucose control with 26 men. The men had higher WHR (0.95 (range 0.83-1.07) vs 0.82 (0.74-0.94), p less than 0.001), lower HDL-cholesterol (1.03 +/- 0.05 vs 1.38 +/- 0.06 mmol l-1, p less than 0.001) and apolipoprotein A1 (1.40 +/- 0.06 vs 1.76 +/- 0.06 gl-1, p less than 0.001) concentrations, and higher hepatic lipase activities (16.2 (6.4-38.0) vs 8.6 (2.3-23.1) mmol h-1 l-1, p less than 0.01). In both men and women, BMI and WHR were positively related to serum triglyceride, insulin and C-peptide concentrations. In women, HDL-cholesterol was negatively related to BMI (r = -0.45, p less than 0.05) but only possibly related to WHR (r = -0.33, NS). In men, by contrast, WHR was related negatively to HDL-cholesterol (r = -0.60, p less than 0.005), HDL2-cholesterol (r = -0.43, p less than 0.05), and apolipoprotein A1 (r = -0.70, p less than 0.001) and positively to hepatic lipase activity (r = 0.65, p less than 0.001), whereas the same relationships with BMI were not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMed1983

Clinical features of diabetogenic and atherogenic obesity.

Fat mass per se has little effect on the progression of obesity towards diabetes. Predominance of fat in the upper part of the body resulting in android obesity is at least the clinical reflection of factors which lead obesity to progress towards diabetes and atherosclerosis. Therefore, this type of obesity may be termed diabetogenic and atherogenic obesity. Insulin and cortisol secretion in obesity are not correlated with body fat but with the predominance of fat in the upper part of the body. Diabetogenic obesity may evolve through 5 stages from initial obesity without diabetes to insulin dependent diabetes in previously obese subjects. Aside from the characteristics of body fat distribution, the mechanisms which induce or interrupt this progression remain unknown.

Adolescent↗