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PubMed2005

Bone mineral density among female sports participants.

Training for and participation in impact-loading sports are associated with alterations in bone strength which are specific to anatomical site and type of strain. The effect of exercise on bone mineral density (BMD) depends on the type of activity engaged in. Sports with high impact loading seem to have a positive effect in promoting bone mineralisation, whereas those with low impacts may have negative or no effects. The aims of the present study were to compare BMD and body composition measures among female participants in three distinctly different sports and investigate differences from sedentary control subjects. Participants were club and university level Rugby Union football players (n = 30, age: 21.4 +/- 1.9 years, height: 1.67 +/- 0.05 m, mass: 73.3 +/- 10.7 kg), netball players (n = 20, 20.7 +/- 1.3 years, 1.68 +/- 0.07 m, 64.3 +/- 7.2 kg), distance runners (n = 11, 21.5 +/- 2.6 years, 1.68 +/- 0.04 m, 57.1 +/- 6.1 kg), and sedentary controls (n = 25, 21.4 +/- 1.1 years; 1.64 +/- 0.07 m, 56.8 +/- 6.8 kg). With the exception of three distance runners, all participants were eumenorrhoeic. Bone mineral density scans were performed for whole-body, left proximal femur, and lumbar spine (L1-4) using dual-energy X-ray absorptiometry. Fat mass, percent body fat, and fat-free soft tissue mass were assessed from whole-body scans. Regional and segmental analysis was also carried out on whole-body BMD data using standard procedures. The runners had a lower fat mass and percent body fat compared to the other sports participants and the controls. All sports groups had higher BMD values than had the controls. Density of bone in the upper body was most pronounced in the rugby football players and least pronounced in the runners. Positive effects were evident at all sites for the rugby players. There were significant correlations between BMD and fat-free soft tissue mass, BMD and body mass, and BMD and training volume. It is concluded that sports participation has positive effects on BMD. The effects are site-specific and depend on the loading characteristics of the sport.

Absorptiometry, Photon↗
PubMed2003

Trends in incidence rates for obesity-associated cancers in the US.

The purpose of this study was to assess the possible impact of rising prevalence of obesity in US adults (since the late 1970s) on incidence rates (1973-1999) for cancers strongly associated with obesity, and to estimate the number of incident cancers (in 2002) potentially attributable to obesity. Data from a group of high-quality population-based cancer registries, regarded as generally representative of the unknown cancer rates in the entire US, were used to obtain average annual age-standardized incidence rates (ASIRs) per 100,000 from 1973 to 1975 through 1997-1999 for selected obesity-related cancers. Temporal increases in ASIRs were evident during the entire period for kidney and adenocarcinomas of the esophagus and gastric cardia, while during the 1990's the decline in ASIRs for adenocarcinoma of the uterine corpus was reversed and the ASIRs for breast cancer continued to increase for age 50+ years, suggesting a potential impact of rising obesity prevalence rates. An estimated 41,383 new cancers (about 3.2% of all cancers) diagnosed in the US in 2002 may be potentially attributable to obesity. Further analytic epidemiologic studies are needed to assess the risks of other cancers in relation to both obesity and body fat distribution.

Adult↗
PubMedDate not supplied

The nurse practitioner's role in managing dyslipidemia and other cardiovascular risk factors in HIV-infected patients: impact of antiretroviral therapy.

The beneficial effects of antiretroviral therapy (ART) for the treatment of HIV disease have been accompanied by metabolic changes associated with an increased risk of cardiovascular disease. These changes, which include dyslipidemia, change in body fat distribution, and insulin resistance, resemble the symptoms of metabolic syndrome. Protease inhibitors, nucleoside analogue reverse transcriptase inhibitors, and nonnucleoside reverse transcriptase inhibitors have all been associated with dyslipidemia to varying degrees. In addition, patients on ART show an increased risk of myocardial infarction and other cardiovascular events. According to the recommendations of the National Cholesterol Education Program and the Adult AIDS Clinical Trial Group, health care providers should assess cardiovascular risk before starting ART and then continue to monitor lipid levels. Treatment of ART-associated dyslipidemia should follow the following sequence: therapeutic lifestyle changes, lipid-lowering drug therapy, and finally, modifying ART if necessary. By providing education, support, and follow-up care, nurse practitioners can help to implement these steps.

Anti-HIV Agents↗
PubMed2006

Daily physical activity related to body fat in children aged 8-11 years.

OBJECTIVE: To evaluate the association between objectively measured daily physical activity and body fat. STUDY DESIGN: Cross-sectional, observational, study of 248 children aged 7.9 to 11.1 years. Abdominal fat mass and total body fat mass were measured by dual-energy X-ray absorptiometry. Daily physical activity was assessed by accelerometers for 4 days. RESULTS: Total body fat expressed as a percentage of body mass was inversely related to minutes of vigorous physical activity per day, for all children r = -0.38 (P < .05). Children, both boys and girls, in the highest quartile of body fat performed on average 12 minutes less vigorous activity per day compared with their counterparts in the lowest quartile. Multiple regression analysis revealed that independent factors for body fat were number of minutes of vigorous activity per day and sex. CONCLUSION: Low physical activity can be a contributing factor in childhood obesity. Only longitudinal studies, however, can give more definitive information about the relation between daily physical activity and obesity.

Absorptiometry, Photon↗
PubMed2006

Cross-sectional and longitudinal associations between TV viewing and girls' body mass index, overweight status, and percentage of body fat.

OBJECTIVE: To assess cross-sectional and longitudinal relations between television (TV) viewing and girls' body mass index (BMI), weight status, and percentage of body fat. STUDY DESIGN: Participants included 169 girls who were measured at ages 7, 9, and 11 years. Height and weight were measured and used to calculate girls' BMI and to classify their weight status. Girls' percentage of body fat was assessed with the use of dual-energy x-ray absorptiometry. Mothers reported the hours per day that girls watched TV on a typical day. RESULTS: No significant cross-sectional associations were identified. Results from longitudinal analyses showed that in comparison to girls who never exceeded the American Academy of Pediatrics TV viewing recommendations (ie, watched </= 2 hours of TV per day), girls who exceeded recommendations at ages 7, 9, and 11 years were 13.2 times more likely be overweight at age 11, were 4.7 times more likely to become overweight between ages 7 and 11, had significantly higher BMI and percentage body fat at age 11, and exhibited significantly greater increases in BMI between ages 7 and 11. CONCLUSIONS: Interventions that target reductions in TV viewing among 7- to 11-year-old girls may help to reduce their risk of weight gain during late childhood.

Absorptiometry, Photon↗
PubMed2006

Sex steroids and leptin regulate 11beta-hydroxysteroid dehydrogenase I and P450 aromatase expressions in human preadipocytes: Sex specificities.

Adipose tissue is an important site of steroid hormone biosynthesis, as type I 11beta-hydroxysteroid dehydrogenase (HSD1), the enzyme responsible for the conversion of cortisone into cortisol and the P450 aromatase, the enzyme catalysing androgens aromatization into estrogens, are both expressed in human adipose tissue. In the present report, we have investigated the possibility that sex steroids and leptin could regulate these two enzymes in cultured preadipocytes from men and women intra-abdominal fat depots. In women preadipocytes, human recombinant leptin down-regulates HSD1 mRNA expression (-58%) and P450 aromatase activity (-26%). Conversely, leptin up-regulates the HSD1 (2.4-fold) and the P450 aromatase (1.6-fold) mRNA expression in men preadipocytes. In women preadipocytes, 17beta-estradiol strongly stimulates HSD1 mRNA expression (10-fold) and, in contrast, decreases by half the P450 aromatase expression. In men, 17beta-estradiol has no influence on HSD1 expression but up-regulates P450 aromatase mRNA expression (2.4-fold). Finally, androgens increase by a factor of 2.5-5 the mRNA expression of both enzymes in men. These findings suggest that sex steroids and leptin either increase or decrease local cortisol and estrogens productions in men or in women preadipocytes, respectively. They also indicate that steroid metabolism in adipose tissue is controlled by a coordinated regulation of P450 aromatase and HSD1 expressions. Finally, the important sex-specific differences described herein may also contribute to explain the sexual dimorphism of body fat distribution in humans.

11-beta-Hydroxysteroid Dehydrogenase Type 1↗
PubMed2004

Comparison of proliferation and differentiation capacity of human adipocyte precursor cells from the omental and subcutaneous adipose tissue depot of obese subjects.

Upper body obesity is characterized by an expansion of the visceral adipose tissue and is associated with an increased susceptibility for type 2 diabetes and cardiovascular disease. In order to get a better understanding of the regulation of body fat distribution, the aim of the present study was to compare adipocyte development between the omental and subcutaneous adipose tissue region in obese subjects. Therefore, the proliferation and differentiation capacity in primary cultures of adipose tissue-derived stromal cells were compared between the 2 depots in a group of 29 obese individuals, of which 21 were women. Proliferation of the cells was stimulated using fetal calf serum (FCS) and assessed by counting the cell number in the culture dishes. Differentiation of preadipocytes was assessed in parallel by morphological criteria and determination of glycerol-3-phosphate dehydrogenase (GPDH) after stimulation by standardized adipogenic conditions. Stromal cells from the subcutaneous adipose tissue region proliferated faster (doubling time, 4 +/- 1 days) than those from the omental region (doubling time, 5 +/- 1 days), whereas there was no regional difference in adipose differentiation with any of the adipogenic media. The same findings were observed when men were excluded from the analysis. Interestingly, there were more endothelial cells in the cultures from the omental tissue as compared to those from the subcutaneous tissue, but there was no correlation between endothelial cell contamination and proliferation capacity, suggesting that the regional difference in proliferation capacity was not due to regional differences in the amount of endothelial cells. In addition, we found a negative correlation between donor age and proliferation of subcutaneous cells but not of omental cells, possibly explaining the greater capacity for adipose tissue growth in the omental as compared to the subcutaneous depot with aging. In conclusion, there may exist regional differences in adipose tissue growth with regard to proliferation capacity, whereas there are apparently no significant differences in in vitro differentiation capacity between subcutaneous and omental preadipocytes.

1-Methyl-3-isobutylxanthine↗
PubMed2005

Aerobic exercise training improves insulin sensitivity without changes in body weight, body fat, adiponectin, and inflammatory markers in overweight and obese girls.

The aim of this study was to examine the effect of aerobic exercise training on insulin sensitivity in overweight and obese girls. Nineteen overweight and obese girls (mean +/- SD: age, 13.1+/-1.8 years; body mass index, 26.8+/-3.9 kg/m(2)) volunteered for this study. Body composition (dual-energy x-ray absorptiometry), insulin sensitivity (oral glucose tolerance test and homeostasis model assessment estimate of insulin resistance; n=15), adiponectin, C-reactive protein (CRP), interleukin (IL) 6, insulin-like growth factor-1, soluble intercellular adhesion molecule-1 and soluble vascular cell adhesion molecule-1 serum levels, and blood lipids and lipoproteins were assessed before and after 12 weeks of aerobic training. Cardiorespiratory fitness increased by 18.8% (P<.05) as a result of training. The area under the insulin concentration curve (insulin area under the curve) decreased by 23.3% (12781.7+/-7454.2 vs 9799.0+/-4918.6 microU.min/mL before and after intervention, respectively; P=.03). Insulin sensitivity was improved without changes in body weight (pre-intervention, 67.9+/-14.5 kg; post-intervention, 68.3+/-14.0 kg) or percent body fat (pre-intervention, 41.4% +/- 4.8%; post-intervention, 40.7%+/-5.2%). The lower limb fat-free mass increased by 6.2% (P<.01) as a result of training, and changes in lower limb fat-free mass were correlated with changes in the insulin area under the curve (r= -.68; P< .01). Serum adiponectin, IL-6, and CRP concentrations did not change (pre-intervention vs post-intervention: adiponectin, 9.57+/-3.01 vs 9.08+/-2.32 microg/mL; IL-6, 1.67+/-1.29 vs 1.65+/-1.25 pg/mL, CRP, 3.21+/-2.48 vs 2.73+/-1.88 mg/L) whereas insulin-like growth factor-1 was lower after training (pre-intervention, 453.8 +/- 159.3 ng/mL; post-intervention, 403.2+/- 155.1 ng/mL; P<.05). In conclusion, 12 weeks of aerobic training improved insulin sensitivity in overweight and obese girls without change in body weight, percent body fat, and circulating concentrations of adiponectin, IL-6, CRP, and other inflammatory markers. These findings suggest that increased physical activity may ameliorate the metabolic abnormalities associated with obesity in children with a mechanism other than the parameters cited earlier.

Adiponectin↗
PubMed2006

Obesity, free testosterone, and cardiovascular risk factors in adolescents with polycystic ovary syndrome and regularly cycling adolescents.

Adolescent girls with polycystic ovary syndrome (PCOS) have increased levels of factors constituting the metabolic syndrome: centripetal obesity, hypertension, hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C), and hyperinsulinemia. Given the strong association reported between early, persistent obesity and development of metabolic syndrome 10 years later in girls, we speculated that if adolescent girls without PCOS had obesity measures similar to girls with PCOS, they would exhibit similar metabolic syndrome-cardiovascular disease risk factors. Within this context, we compared 37 adolescent girls with PCOS and 2 samples of normal, regularly cycling adolescent girls (controls) of similar ages, selected from the Cincinnati Clinic of the National Heart, Lung, and Blood Institute Growth and Health Study. The first sample included 157 controls selected using a stratified random sample based on age. As expected, girls with PCOS had higher body mass index (BMI), waist circumference, insulin, systolic blood pressure (SBP) and diastolic blood pressure, triglycerides (TGs), lower HDL-C, and higher low-density lipoprotein cholesterol (LDL-C) and free testosterone (FT) than controls. A second sample consisted of girls matched one to one with girls with PCOS for BMI and age. Comparisons of group differences were not significant for insulin, lipids, or blood pressure; girls with PCOS had a trend toward higher values for waist circumference (median, 92.7 vs 87.5 cm; P = .07) and much higher median FT (4.25 vs 1.42 ng/mL, P = .0001). After matching for BMI and age, by conditional regression analysis, we showed that the groups were not differentiated (P > .15) by insulin, HDL-C, LDL-C, TG, SBP, or diastolic blood pressure, but were differentiated by higher FT (P = .0024) and waist circumference (P = .0024) in PCOS than in controls. Prospective longitudinal analyses of NHGS controls showed that changes in BMI from ages 9 to 10 years to ages 15 to 16 years were positively associated with changes in waist circumference (P < .0001), LDL-C (P = .01), TG (P = .008), and SBP (P = .002). These findings suggest that if adolescent girls achieve adiposity equal to girls with PCOS, they then acquire major components of the metabolic syndrome, and excluding high FT and waist circumference, comparable increased cardiovascular disease risk.

Adolescent↗
PubMed2004

Circadian phase difference of leptin in android versus gynoid obesity.

A circadian rhythm in serum leptin, measured every 4 h for 24 h, characterizes normal-weight women (N = 14), and women with gynoid (N = 17) or android (N = 26) obesity, peaking around midnight (P < 0.05), but differing by about 3 h between android and gynoid women (P < 0.01). Obesity is associated with a higher MESOR (rhythm-adjusted mean; P < 0.001) and a smaller relative circadian amplitude (P < 0.05). Gynoid obesity is associated with a larger circadian amplitude of cortisol (P < 0.05), whereas android obesity is associated with a larger circadian amplitude and a higher MESOR of insulin (P < 0.05). Understanding putative mechanisms underlying different body fat distribution may lead to improved chronotherapeutic measures.

Adult↗
PubMed2005

Site-specific differences of insulin action in adipose tissue derived from normal prepubertal children.

Body fat distribution determines obesity-related morbidity in adults but little is known of the aetiology or pathophysiology in children. This study investigates differences in insulin-mediated metabolism in primary cell cultures of subcutaneous and visceral preadipocytes derived from prepubertal children. The impact of differentiation and responses to TNFalpha exposure was also investigated. Proliferation rates were greater in subcutaneous versus visceral preadipocytes (41 h3 versus 69 h4; P=0.008). Insulin caused a dose-dependent increase in GSK-3 phosphorylation and an increase in MAPK phosphorylation over time, with increased sensitivity in subcutaneous preadipocytes. Post-differentiation, dose-dependent increases in GSK-3 phosphorylation were maintained, while MAPK phosphorylation was identical in both subtypes. No changes were observed in insulin receptor abundance pre-/post-differentiation. GLUT4 abundance was significantly increased in visceral versus subcutaneous adipocytes by 76(4)%; P=0.03), coincidental with increased insulin-stimulated 2-deoxy-glucose transport (+150(26)% versus +79(10)%; P=0.014) and further elevated by acute exposure to TNFalpha (+230(52)%; P=0.019 versus +123(24)%; P=0.025, respectively). TNFalpha also significantly increased basal glucose transport rates (+44(14)%; P=0.006 versus +34(11)%; P=0.007) and GLUT1 localisation to the plasma membrane. These data establish site-specific differences in subcutaneous and visceral fat cells from children. Responses to insulin varied with differentiation and TNFalpha exposure in the two depots, consistent with parallel changes in GLUT1/4 abundance and localisation.

Adipocytes↗
PubMed2000

Stimulation of vitamin A(1) acid signaling by the HIV protease inhibitor indinavir.

HIV protease inhibitors (PIs) are effective drugs for the treatment of AIDS. However, PI therapy is sometimes associated with side-effects including increased plasma lipids and altered body fat distribution, although fat redistribution may occur in some patients not treated with PIs. Overdosage with vitamin A(1) acid (all-trans-retinoic acid, ATRA) or its metabolites may cause similar changes in lipid metabolism. Moreover, the PI indinavir and retinoids have been associated with nail, skin, and hair defects, suggesting that indinavir and retinoids may exert their effects through similar molecular mechanisms. This hypothesis was tested by examining the effects of PIs on retinoid signaling in vitro. Mesenchymal stem cells (C3H10T1/2) were cultured in the presence of various PIs (amprenavir, indinavir, nelfinavir, ritonavir, and saquinavir) and synthetic retinoids, and the metabolic response was assessed by measuring the activity of a retinoid-regulated protein, alkaline phosphatase (ALP). Of the PIs tested, only indinavir stimulated ATRA-dependent ALP activity and altered stem cell morphology; the effects of indinavir occurred in the presence of ATRA, but not in its absence. Moreover, indinavir increased the effects of ATRA on lipid accumulation during fat cell differentiation. AGN 193109 (4-[[5,6-dihydro-5, 5-dimethyl-8-(4-methylphenyl)-2-naphthalenyl]ethynyl]-benzoic acid), a retinoic acid receptor (RAR) antagonist, inhibited the synergistic effects of indinavir and ATRA, indicating that indinavir increases RAR signaling. However, indinavir did not potentiate ALP activity in the presence of the RAR agonist CH55 (3,5-di-tert-butylchalcone 4'-carboxylic acid). Unlike ATRA, CH55 does not bind to cytosolic retinoic acid binding protein (CRABP), suggesting that CRABP may regulate the effects of indinavir on RAR signaling. These observations support the proposal that altered retinoid signaling promotes some of the adverse reactions associated with indinavir therapy, such as altered lipid metabolism.

Animals↗
PubMed1997

Women at cardiac risk: is HRT the route to maintaining cardiovascular health?

Cardiovascular disease is the leading cause of death in women of postmenopausal age. Data from observational studies suggest that the risk of coronary heart disease in postmenopausal women can be reduced by 30-50% by estrogen replacement therapy. The protective effect of estrogen is multifactorial, affecting lipids, carbohydrate metabolism, hemostasis, body-fat distribution and blood pressure. Although the unopposed use of estrogen is associated with an increased risk of endometrial cancer, this risk can be reduced or even neutralized by the addition of progestogen. The protection against cardiovascular disease provided by combined estrogen/progestogen treatment has been the subject of much debate. However, results from epidemiological studies, intervention trials and animal experiments now suggest that the addition of progestogen does not attenuate the beneficial effects of estrogen. While secondary prevention studies are needed to evaluate the various hormone regimens, the use of combined estrogen/progestogen therapy can be supported.

Aged↗
PubMed1999

Changes in daily hassles and life events and the relationship with coronary heart disease risk factors: a 2-year longitudinal study in 27-29-year-old males and females.

To investigate the relationship between changes in daily hassles and life events and biological (lipoproteins, blood pressure, body fat, and body fat distribution) and lifestyle (physical activity, smoking and alcohol consumption) risk factors for coronary heart disease (CHD) 166 subjects were measured twice, at 27 and 29 years of age. The results showed that changes in daily hassles were positively related to changes in lipoprotein levels, daily physical activity, and to smoking behavior. These relationships were more pronounced for subjects with a "rigid" coping style and subjects with type A behavior. Changes in life events were also positively related to lipoprotein levels, but only for subjects with a "rigid" coping style and only when the subjective appraisal of life events was taken into account. It was concluded that the relationships seemed to be mediated by different coping styles and type A behavior, that daily hassles were more important in these relationships than life events, and that the relationships with biological CHD risk factors were not influenced by lifestyle.

Adaptation, Psychological↗
PubMed2002

[Cardiovascular risk factors in patients with morbid obesity: weight loss influence].

BACKGROUND: We studied the presence of cardiovascular risk factors in patients with morbid obesity and analyzed the influence of weight loss achieved through diet on these factors. We also evaluated the influence of gender on the presence of cardiovascular risk factors and on its response to diet. PATIENTS AND METHODS: An anthropometric evaluation was performed in patients with morbid obesity (23 men and 36 women). The presence of cardiovascular risk factors was evaluated (fibrinogen, blood pressure, glucose metabolism determination by means of oral glucose tolerance test, complete lipid profile, sleep apnea syndrome), before and after following, on an alternative fashion, very-low calorie and low-calorie diets. The comparison was made with the t-test for paired samples. RESULTS: A very significant weight loss was achieved in our patients, particularly in men (decrease of 33.4 kg, 95% CI: 26.9 to 39.8). This was accompanied by a reduction in the presence of cardiovascular risk factors, particularly in men, in whom the body fat distribution improved significantly (decrease in waist: 24.8 cm, 95% CI 18.4 to 36.5), as well as the lipid profile including triglycerides, VLDLc, HDLc and B100 apoprotein. CONCLUSIONS: Patients with morbid obesity have a high prevalence of cardiovascular risk factors. A significant reduction of this prevalence can be achieved with diet during one year. This improvement is particularly significant in men.

Adolescent↗
PubMed1996

Plasma high-density lipoprotein cholesterol but not apolipoprotein A-I is a good correlate of the visceral obesity-insulin resistance dyslipidemic syndrome.

Apolipoprotein (apo) A-I is a major component of high-density lipoproteins (HDLs), and it has been suggested that measurement of apo A-I may provide additional information in the assessment of coronary heart disease (CHD) risk. In the present study in a sample of 111 men (age [mean +/- SD], 35.3 +/- 6.6 years), we determined whether a low apo A-I concentration is associated with the cluster of metabolic abnormalities that characterize the visceral obesity-insulin resistance dyslipidemic syndrome. For this purpose, the first and fourth quartiles of apo A-I and HDL cholesterol (HDL-C) concentrations were compared in relation to body fat distribution, glucose tolerance, and plasma insulin and lipoprotein levels. Men in the first quartile (< the 25th percentile) of HDL-C, as compared with men in the fourth quartile (> the 75th percentile), were characterized by an elevated visceral adipose tissue (AT) accumulation (P < .05), as well as by increased plasma levels of triglycerides ([TGs] P < .0001), apo B (P < .0005), and insulin (P < .01). These differences were not found when the first and fourth quartiles of plasma apo A-I concentrations were compared. These results suggest that plasma levels of HDL-C are more closely associated with the various features of the visceral obesity-insulin resistance syndrome than plasma apo A-I.

Adipose Tissue↗
PubMed1996

Hypothalamic-pituitary-adrenal axis activity and its relationship to the autonomic nervous system in women with visceral and subcutaneous obesity: effects of the corticotropin-releasing factor/arginine-vasopressin test and of stress.

In a previous study, we demonstrated that premenopausal women with visceral obesity have hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis, characterized by an exaggerated hormone response to corticotropin-releasing factor (CRF) and corticotropin (ACTH) stimulation. The hypothalamic peptide flow that stimulates the pituitary, particularly after a physiological stress challenge, involves not only CRF, but also arginine-vasopressin (AVP), which synergizes the CRF capacity to stimulate pituitary hormone secretion. Previous studies in humans have demonstrated that combining AVP with CRF permits maximal stimulation of the pituitary, providing a more appropriate method of assessing pituitary hormone reserve. We therefore investigated the response of the HPA axis to combined CRF and AVP stimuli in obese women with different obesity phenotypes. Moreover, we examined hormonal and cardiovascular responses to several mental stress tasks, according to previously standardized procedures. Two groups of age-matched premenopausal eumenorrheic obese women with visceral (V-BFD) or subcutaneous (S-BFD) body fat distribution and a group of normal-weight healthy controls were investigated. All women randomly underwent the following protocol: (1) a combined CRF/AVP test (100 micrograms plus 0.3 IU intravenously [IV], respectively); (2) a standardized stress test, which consisted of completing two puzzles and a mental arithmetic test; and (3) a control saline test. Blood samples for ACTH and cortisol determinations were obtained before and during each test, and measurements of arterial blood pressure and pulse rate were made at regular intervals during the stress test. After combined CRF/AVP administration, ACTH and cortisol were significantly higher in V-BFD than in the other two groups. In contrast, no significant hormonal variation was found in either group during stress tasks. During the stress test, pulse rate (but not arterial blood pressure) significantly increased after 8 and 15 minutes in the V-BFD group, whereas no significant variation was found in S-BFD and control women. A significant correlation was present between the pulse rate and change in cortisol level during the stress test at minutes 8 (r=.54, P<.05) and 15 (r=.57, p<.01) in all women considered together. Subjective emotional involvement during stressful tasks was measured by a two-dimensional short verbal scale, which revealed that the stress section had a more significant impact in obese V-BFD than in S-BFD and control women. These data therefore confirm that women with visceral obesity have hyperactivity of the HPA axis, and that the combined CRF/AVP stimulation may offer a good tool for investigating pituitary reserve in this obesity phenotype. Moreover, the results indicate that these women probably have a hyperreactive sympathetic response to acute stress that seems interrelated to that of the HPA axis.

Adrenocorticotropic Hormone↗