Abdominal Subcutaneous Fat Mass Research Articles

THU115 Sex-Specific And Shared Associations Between Vasopressin Levels And Body Composition In Adults With Obesity

Abstract Disclosure: F. Galbiati: None. M. Wronski: None. A. Aulinas Maso: None. M. Muhammed: None. R. Boutin: None. K. Liya: None. S. Carter: None. H. Nazarloo: None. J.M. Davis: None. K. Holman: None. J. Gydus: None. S. Smith: None. E. Asanza: None. M. Bredella: None. M. Torriani: None. F. Plessow: None. E.A. Lawson: Advisory Board Member; Self; OXT Therapeutics. Grant Recipient; Self; Tonix Pharmaceuticals. Background: Arginine-vasopressin (AVP) is a sexually dimorphic neurohormone shown in preclinical studies to have relevant metabolic effects, including reducing food intake, inducing lipolysis, and promoting muscle regeneration in male mice. However, findings are inconsistent, possibly due to the opposing effects of AVP at different receptor subtypes, and little is known about the effects of AVP on metabolism in humans. We hypothesized that AVP may act as signal of energy availability, such that in adults with obesity, integrated AVP levels around a standardized meal would be positively associated with BMI, adiposity, and lean mass. We also predicted that relationships between AVP and body composition measures would differ by sex. Methods: We performed a cross-sectional study of 53 adults with obesity (56% females; age [mean±SD] 33.7±6.2 years; BMI 36.9±4.9 kg/m2). We obtained plasma AVP levels fasting and 30, 60, and 120 minutes after a standardized meal. We computed area under the curve with respect to ground (AUC) for an integrated measure of AVP levels around the meal. Participants underwent body composition assessment by dual-energy X-ray absorptiometry (total fat, truncal fat, and lean mass) and magnetic resonance imaging (abdominal visceral and subcutaneous fat). We performed Pearson’s correlation (normally distributed variables) and Spearman’s correlation (non-normally distributed variables) to investigate the relationship between AVP levels and body composition parameters. Fisher’s Z test was performed to analyze the difference between correlation coefficients across sexes. Results: Age and AVP AUC did not differ based on sex (p=0.300). Total fat mass (p=0.013) was higher while total lean mass (p<0.0001) and abdominal visceral fat (p=0.001) were lower in females than males; BMI, truncal fat, and abdominal subcutaneous fat did not differ by sex (p’s≥0.09). Across all participants, AVP AUC levels were positively correlated with BMI (rs=0.36, p=0.008), total fat mass (r=0.33, p=0.013), truncal fat (r=0.35; p=0.010), abdominal subcutaneous fat (r=0.30, p=0.028), and total lean mass (r=0.38, p=0.005), but not with abdominal visceral fat (p=0.331). Within sex-based group, a robust positive correlation between AVP AUC and abdominal subcutaneous fat mass was present in males (r=0.56, p=0.004), but not females (r=0.04, p=0.592) [(by Fisher’s Z test, p=0.024). There were no other sex differences in correlations (by Fisher’s Z test, p≥0.108). Conclusions: Our data in humans showing a link between integrated AVP and body composition support preclinical data indicating that AVP is a metabolically active hormone. Additionally, we identified sex differences in the relationship between AVP and subcutaneous fat mass. Further investigation of sex-specific and shared metabolic effects of AVP in humans will be important. Presentation: Thursday, June 15, 2023

Association Between Fat Mass in Early Life and Later Fat Mass Trajectories

A rapid increase in weight in early life is associated with an increased risk for adiposity and cardiovascular diseases at age 21 years and beyond. However, data on associations of early change in measured fat mass percentage (FM%) with adiposity development are lacking. To investigate whether a rapid increase in FM% in the first months of life is associated with higher trajectories of body fat mass during the first 2 years of life. A birth cohort consisting of 401 healthy, term-born infants of the Sophia Pluto Cohort Study was analyzed. Participants were born between January 7, 2013, and October 13, 2017. Data were analyzed from February 1, 2020, to May 20, 2020. Longitudinal measurements of FM% by air-displacement plethysmography and dual-energy x-ray absorptiometry, and abdominal subcutaneous and visceral fat mass (FM) by ultrasonography in infants at ages 1, 3, 6, 9, 12, 18, and 24 months. A rapid increase in FM% was defined as a change in FM% of greater than 0.67 standard deviation scores (SDS). Associations between change in FM% SDS in the first and second 6-month period of life with body composition at age 2 years and whether a rapid increase in FM% SDS during the first 6 months leads to higher body FM and abdominal FM trajectories during the first 2 years of life. Of the 401 participants, 228 infants (57%) were male. Change in FM% SDS from age 1 to 6 months was positively associated with FM% (β, 0.044; 95% CI, 0.017-0.068), FMI (β, 0.061; 95% CI, 0.032-0.091), and abdominal subcutaneous FM (β, 0.064; 95% CI, 0.036-0.092) at age 2 years, but not with visceral FM. In contrast, no associations were found within the 6- to 12-month period. Infants with a rapid increase in FM% of greater than 0.67 SDS in the first 6 months of life had higher trajectories of FM%, FM index, and subcutaneous FM during the first 2 years of life (all P≤.001), but visceral FM index was not significantly different compared with infants without a rapid increase (P = .12). In this study, only the change in FM% in the first 6 months of life was associated with more adiposity at age 2 years. Infants with a rapid increase in FM% had higher trajectories of FM% and FM index during the first 2 years of life. These findings appear to support a critical window for adiposity programming in early life.

Comparison of Age-Related Anthropometric Changes Among Elderly Punjabi Males Residing in Old-Age Homes with Those Residing with Their Families

The present study was conducted to find out the changes in anthropometric measurements with advancing age among elderly males living in old-age homes and those living in family. Cross-sectional data on anthropometric measurements and other general information were obtained for 400 male subjects (200 living in old-age homes and 200 living with family) ageing 60 years and above, and data were collected from various districts in Punjab. Height decreased non-significantly and sitting height decreased significantly ( p = 0.03) from 60 years to ≥80 years of age in both the groups of elderly males. Weight decreased significantly among the elderly males residing in old-age homes ( p < 0.001). Biceps ( p = 0.03) and thigh skinfold ( p = 0.009) thicknesses decreased significantly only among elderly residing in old-age homes. Abdominal ( p = 0.01) and supra-iliac ( p = 0.01) skinfold thickness measurements decreased significantly among elderly residing with their families. Circumference measurements on limbs decreased significantly ( p < 0.01) among both the groups of elderly (except upper arm circumference among elderly residing with their families). Abdominal circumference decreased significantly ( p = 0.04) among the elderly males residing with their families. Elderly residing in old-age homes retained more abdominal subcutaneous fat mass and lost more appendicular fat mass as compared with those residing with their families. Elderly residing with their families lost lesser appendicular muscle mass as compared with their counterpart’s elderly residing in old-age homes.

Normalizing Ovulation Rate by Preferential Reduction of Hepato-Visceral Fat in Adolescent Girls With Polycystic Ovary Syndrome

PurposePolycystic ovary syndrome (PCOS) is an increasingly prevalent disorder in adolescent girls, commonly presenting with hirsutism/oligomenorrhea, commonly treated with an oral contraceptive (OC), and commonly followed by oligoanovulatory subfertility. We tested whether an intervention targeting the reduction of hepato-visceral adiposity is followed by a higher ovulation rate than OC treatment. MethodsThis randomized, open-label, single-center, pilot proof-of-concept study (12 months on treatment, then 12 months off) was performed in adolescent girls with hirsutism and oligomenorrhea (PCOS by National Institutes of Health; no sexual activity; N = 36; mean age 16 years, body mass index 23.5 kg/m2; 94% study completion). Compared treatments were OC (ethinylestradiol–levonorgestrel) versus low-dose combination of spironolactone 50 mg/d, pioglitazone 7.5 mg/d, and metformin 850 mg/d (SPIOMET). Primary outcome was post-treatment ovulation rate inferred from menstrual diaries and salivary progesterone (12 + 12 weeks). Secondary outcomes included body composition (dual X-ray absorptiometry), abdominal fat (magnetic resonance imaging), insulinemia (oral glucose tolerance test), and androgenemia (liquid chromatography – tandem mass spectrometry). ResultsSPIOMET was followed by a 2.5-fold higher ovulation rate than OC (p ≤ .001) and by a 6-fold higher normovulatory fraction (71% vs. 12%; p ≤ .001); oligoanovulation risk after SPIOMET was 65% lower (95% confidence interval, 40%–89%) than after OC. Higher post-treatment ovulation rates related to more on-treatment loss of hepatic fat (r2 = .27; p < .005). Visceral fat and insulinemia normalized only with SPIOMET; androgenemia normalized faster with OC but rebounded more thereafter. Body weight, lean mass, and abdominal subcutaneous fat mass remained stable in both groups. ConclusionsEarly SPIOMET treatment for PCOS normalized post-treatment ovulation rates more than OC. Focusing PCOS treatment on early reduction of hepato-visceral fat may prevent part of later oligoanovulatory subfertility.

Visceral adiposity and metabolic syndrome after very high–fat and low-fat isocaloric diets: a randomized controlled trial

Background: Different aspects of dietary pattern, including macronutrient and food profiles, may affect visceral fat mass and metabolic syndrome.Objective: We hypothesized that consuming energy primarily from carbohydrate or fat in diets with similar food profiles would differentially affect the ability to reverse visceral adiposity and metabolic syndrome.Design: Forty-six men (aged 30–50 y) with body mass index (in kg/m2) >29 and waist circumference >98 cm were randomly assigned to a very high–fat, low-carbohydrate (VHFLC; 73% of energy fat and 10% of energy carbohydrate) or low-fat, high-carbohydrate (LFHC; 30% of energy fat and 53% of energy carbohydrate) diet for 12 wk. The diets were equal in energy (8750 kJ/d), protein (17% of energy), and food profile, emphasizing low-processed, lower-glycemic foods. Fat mass was quantified with computed tomography imaging.Results: Recorded intake of carbohydrate and total and saturated fat in the LFHC and VHFLC groups were 51% and 11% of energy, 29% and 71% of energy, and 12% and 34% of energy, respectively, with no difference in protein and polyunsaturated fatty acids. Mean energy intake decreased by 22% and 14% in the LFHC and VHFLC groups. The diets similarly reduced waist circumference (11–13 cm), abdominal subcutaneous fat mass (1650–1850 cm3), visceral fat mass (1350–1650 cm3), and total body weight (11–12 kg). Both groups improved dyslipidemia, with reduced circulating triglycerides, but showed differential responses in total and low-density lipoprotein cholesterol (decreased in LFHC group only), and high-density lipoprotein cholesterol (increased in VHFLC group only). The groups showed similar reductions in insulin, insulin C-peptide, glycated hemoglobin, and homeostasis model assessment of insulin resistance. Notably, improvements in circulating metabolic markers in the VHFLC group mainly were observed first after 8 wk, in contrast to more acute and gradual effects in the LFHC group.Conclusions: Consuming energy primarily as carbohydrate or fat for 3 mo did not differentially influence visceral fat and metabolic syndrome in a low-processed, lower-glycemic dietary context. Our data do not support the idea that dietary fat per se promotes ectopic adiposity and cardiometabolic syndrome in humans. This study was registered at clinicaltrials.gov as NCT01750021.

Abdominal visceral adiposity influences CD4+ T cell cytokine production in pregnancy

Women with pre-gravid obesity are at risk for pregnancy complications. While the macrophage response of obese pregnant women categorized by body mass index (BMI) has been documented, the relationship between the peripheral CD4+ T cell cytokine profile and body fat compartments during pregnancy is unknown. In this study, third trimester peripheral CD4+ T cell cytokine profiles were measured in healthy pregnant women [n=35; pre-pregnancy BMI: 18.5–40]. CD4+ T cells were isolated from peripheral blood mononuclear cells and stimulated to examine their capacity to generate cytokines. Between 1 and 3weeks postpartum, total body fat was determined by dual-energy X-ray absorptiometry and abdominal subcutaneous and visceral fat masses were determined by magnetic resonance imaging. Pearson’s correlation was performed to assess relationships between cytokines and fat mass. Results showed that greater abdominal visceral fat mass was associated with a decrease in stimulated CD4+ T cell cytokine expression. IFN-gamma, TNF-alpha, IL-12p70, IL-10 and IL-17A were inversely related to visceral fat mass. Chemokines CCL3 and IL-8 and growth factors G-CSF and FLT-3L were also inversely correlated. Additionally, total body fat mass was inversely correlated with FGF-2 while abdominal subcutaneous fat mass and BMI were unrelated to any CD4+ T cell cytokine. In conclusion, lower responsiveness of CD4+ T cell cytokines associated with abdominal visceral fat mass is a novel finding late in gestation.

Maternal weight gain in different periods of pregnancy and childhood cardio-metabolic outcomes. The Generation R Study.

Excessive gestational weight gain seems to be associated with offspring cardio-metabolic risk factors. Little is known about the critical periods of gestational weight gain. We examined the associations of maternal weight gain in different periods of pregnancy with childhood cardio-metabolic risk factors. In a population-based prospective cohort study from early pregnancy onwards among 5908 mothers and their children, we obtained maternal prepregnancy weight and weight in early, mid and late pregnancy. At the age of 6 years (median: 72.6 months; 95% range: 67.9, 95.8), we measured childhood body mass index (BMI), total body and abdominal fat distribution, blood pressure and blood levels of lipids, insulin and c-peptide. Overall, the associations of maternal prepregnancy weight with childhood outcomes were stronger than the associations of maternal gestational weight gain. Independent from maternal prepregnancy weight and weight gain in other periods, higher weight gain in early pregnancy was associated with higher childhood BMI, total fat mass, android/gynoid fat mass ratio, abdominal subcutaneous fat mass and systolic blood pressure (P-values<0.05). Independent associations of maternal weight gain in early pregnancy with childhood abdominal preperitoneal fat mass, insulin and c-peptide were of borderline significance. Higher weight gain in mid pregnancy was independently associated with higher childhood BMI, total and abdominal subcutaneous fat mass and systolic blood pressure (P-values<0.05). The associations for childhood cardio-metabolic outcomes attenuated after adjustment for childhood BMI. Weight gain in late pregnancy was not associated with childhood outcomes. Higher weight gain in early, but not in mid or late pregnancy, was associated with increased risks of childhood overweight and clustering of cardio-metabolic risk factors (odds ratio (OR) 1.19 (95% confidence interval (CI): 1.10, 1.29) and OR 1.20 (95% CI: 1.07, 1.35) per standard deviation increase in early gestational weight gain, respectively). Higher weight gain in early pregnancy is associated with an adverse cardio-metabolic profile in offspring. This association is largely mediated by childhood adiposity.

Relationship between arterial stiffening and skeletal muscle atrophy in hemodialysis patients: a gender comparative study.

Dear Editor, Composition of regional muscle and fat masses are related to arteriosclerotic changes in the general population [1]. This study was aimed to clarify the association of muscle mass in the lower limbs and abdominal fat mass with arteriosclerotic parameters in patients on chronic hemodialysis (HD). We measured abdominal subcutaneous fat mass area (ASFA), abdominal visceral fat mass area (AVFA), and thigh muscle area (TMA) from computed tomography (CT) images and adjusted those by body mass index (BMI) in 124 HD patients (age 61 ± 11 [37–79] years, time on HD 11 ± 10 [0–36] years, male/female = 84/40). Brachial-ankle pulse wave velocity (baPWV) and ankle brachial pressure index (ABI) were also measured together and automatically in CAVI-VaSera VS-1000 (Fukuda Denshi Co, Ltd, Tokyo, Japan) just before HD session. A significant association was found between baPWV and TMA/BMI ratio in male (r = −0.32, p < 0.01). Male patients in the top tertile of baPWV had a significantly lower TMA/BMI ratio when compared with those in the middle tertile and those in the bottom tertile (Table 1). Table 1 Baseline characteristics according to the baPWV tertile TMA/BMI ratio was also correlated with ABI (r = 0.46, p < 0.01) in female patients. There was a significantly lower TMA/BMI ratio in patients with the lowest ABI compared to those with the second and with the highest tertile (Table 2). There was rather an inverse association between AVFA/BMI ratio with baPWV in women (r = −0.38, p < 0.05). Table 2 Baseline characteristics according to the ABI tertile A multiple linear regression analysis adjusted by conventional, nutritional, and anthropometric parameters revealed that TMA/BMI was independently associated with baPWV in male, while with ABI in female (Table 3). In contrast, there was no relationship between AVFA/BMI and ASFA/BMI ratios and arteriosclerotic parameters in men. Table 3 Independent determinants of baPWV and ABI in male and female patients It has been demonstrated that skeletal muscle atrophy is associated with accelerated arteriosclerosis. TMA is inversely associated with baPWV in general subjects [2, 3]. A higher PWV is related to a more profound decline in sarcopenic index in older men [4]. Skeletal muscle mass to visceral fat area ratio is also inversely associated with baPWV [5]. In this study, we showed that TMA/BMI ratio was independently associated with baPWV in male, while with ABI in female HD patients, suggesting a possible association of muscle wasting with arteriosclerotic changes in HD patients. Visceral adiposity is linked to arteriosclerosis. AVFA is positively correlated with baPWV and carotid-femoral PWV in general subjects [2, 6]. Visceral fat level was a predictor of carotid-femoral PWV in peritoneal dialysis patients [7]. A positive relationship between AVFA and baPWV was also observed in diabetic HD patients [8]. In this study, however, AVFA/BMI was rather negatively associated with baPWV in female HD patients. The reasons for this discrepancy are not known, but may be due to a well-preserved nutritional status in female patients with abdominal adiposity. An increased body fat mass volume is paradoxically associated with better outcomes in HD patients [9]. The protective role of accumulated trunk fat on subclinical vascular damage, assessed by carotid-radial PWV, was also observed in the elderly women [10]. In summary, we found that reduced TMA/BMI ratio was independently associated with increased baPWV in male, while with decreased ABI in female patients. The findings support a possible relationship between arteriosclerosis and thigh muscle atrophy even in the dialysis population.

Maternal thyroid hormones during pregnancy, childhood adiposity and cardiovascular risk factors: the Generation R Study

Variation in maternal thyroid function during early pregnancy may permanently affect childhood growth and cardiovascular development. We examined the associations of early pregnancy maternal TSH and free T4 (FT4) levels with childhood growth, body composition and cardiovascular characteristics. We performed a population-based prospective cohort study among 5646 mothers and their children. Maternal thyroid parameters were assessed in early pregnancy (median: 13·2 weeks; 95% range: 9·7-17·6 weeks). Childhood growth was repeatedly measured from birth to 6 years. At the age of 6 years, childhood body mass index (BMI), total body and abdominal fat distribution, blood pressure and left ventricular mass were measured. Maternal thyroid parameters were not consistently associated with childhood length and weight growth characteristics. Lower maternal TSH levels were associated with lower childhood BMI, total fat mass, abdominal subcutaneous fat mass area and diastolic blood pressure (P-values <0·05), but not with preperitoneal abdominal fat mass area, systolic blood pressure or left ventricular mass. Higher maternal FT4 levels were associated with lower childhood BMI, abdominal subcutaneous and preperitoneal fat mass area (P for trends <0·05), but not with other cardiovascular characteristics. Clinically maternal hypothyroid or hyperthyroid statuses were not associated with childhood growth, body fat or cardiovascular outcomes. Maternal thyroid function during early pregnancy may influence childhood body composition and cardiovascular development. Further studies are needed to replicate these findings and to examine the influence of maternal thyroid hormone levels during pregnancy on long-term growth and cardiovascular development in the offspring.

Waist Circumference Adjusted for Body Mass Index and Intra-Abdominal Fat Mass

BackgroundThe association between waist circumference (WC) and mortality is particularly strong and direct when adjusted for body mass index (BMI). One conceivable explanation for this association is that WC adjusted for BMI is a better predictor of the presumably most harmful intra-abdominal fat mass (IAFM) than WC alone. We studied the prediction of abdominal subcutaneous fat mass (ASFM) and IAFM by WC alone and by addition of BMI as an explanatory factor.Methodology/Principal FindingsWC, BMI and magnetic resonance imaging data from 742 men and women who participated in clinical studies in Canada and Finland were pooled. Total adjusted squared multiple correlation coefficients (R2) of ASFM and IAFM were calculated from multiple linear regression models with WC and BMI as explanatory variables. Mean BMI and WC of the participants in the pooled sample were 30 kg/m2 and 102 cm, respectively. WC explained 29% of the variance in ASFM and 51% of the variance in IAFM. Addition of BMI to WC added 28% to the variance explained in ASFM, but only 1% to the variance explained in IAFM. Results in subgroups stratified by study center, sex, age, obesity level and type 2 diabetes status were not systematically different.Conclusion/SignificanceThe prediction of IAFM by WC is not improved by addition of BMI.

Association of abdominal visceral adiposity and thigh sarcopenia with changes of arteriosclerosis in haemodialysis patients

In haemodialysis (HD) patients, abdominal visceral fat is accumulated while lean body mass is decreased irrespective of their body mass indexes (BMI). However, it is poorly understood which changes of fat and muscle masses are more associated with changes of arteriosclerosis. We aimed at examining the associations of abdominal visceral fat and thigh muscle masses with markers of arteriosclerosis in chronic HD patients in a cross-sectional fashion. We measured abdominal visceral fat mass area (AVFA), abdominal subcutaneous fat mass area (ASFA), thigh muscle area (TMA) and TMA standardized for femoral shaft area (TMA/FSA) by computed tomography (CT) in 161 HD patients (age: 61 ± 11 years, time on HD: 12 ± 10 years, male/female = 113/48, non-diabetes/diabetes = 127/34). We also investigated carotid artery intima-media thickness (CA-IMT) using the ultrasound instrument, and brachial-ankle pulse wave velocity (baPWV), cardio-ankle vascular index (CAVI) and ankle-brachial pressure index (ABI) using the waveform device (CAVI-VaSera VS-1000). AVFA was significantly and positively related to CA-IMT in both non-diabetic (r = 0.23, P < 0.05) and diabetic HD patients (r = 0.38, P < 0.05). There was a significant and positive correlation between AVFA and hs-CRP in all patients (r = 0.26, P < 0.01). ASFA was also significantly correlated with CA-IMT (r = 0.53, P < 0.01) in diabetic HD patients. TMA/SFA ratio was negatively associated with CA-IMT (r = - 0.21, P < 0.05), while positively with ABI (r = 0.28, P < 0.01) in non-diabetic patients. TMA/SFA ratio was inversely related to baPWV (r = - 0.41, P < 0.01) and CAVI (r = - 0.41, P < 0.05) in diabetic HD patients. Multiple regression analysis revealed that AVFA was a significant determinant of CA-IMT. TMA/AFA was also significantly associated with CA-IMT, baPWV, CAVI and ABI. Accumulated abdominal visceral fat is associated with CA-IMT. In addition, reduced thigh muscle mass area is independently related to CA-IMT, baPWV, CAVI and ABI, suggesting that sarcopenia in the leg is closely associated with systemic changes of arteriosclerosis in HD patients.

Vitamin D status and PTH in young men: a cross‐sectional study on associations with bone mineral density, body composition and glucose metabolism

Although vitamin D and bone metabolism are closely related, few studies have addressed the effects of vitamin D status on bone in men at time of peak bone mass. The objectives of this study were to evaluate the prevalence of vitamin D inadequacy in a cross-sectional study in young men and the effects of vitamin D and parathyroid hormone (PTH) on bone mass, bone markers and metabolic function. The study population consisted of 783 men aged 20-29 years. Bone mineral density (BMD) of the total hip, femoral neck and lumbar spine was measured. dual-energy X-ray absorptiometry was used to evaluate total body fat mass (BFAT). Visceral fat mass and abdominal subcutaneous fat mass (ViFM and ScFM) were assessed using magnetic resonance imaging. A radioimmunoassay was used to measure the level of 25-hydroxy vitamin D (25OHD). The prevalence of vitamin deficiency (serum 25OHD < 50 nm) was 6·3% during summer and 43·6% during winter. Serum 25OHD was associated with BMD at all sites and inversely associated with bone-specific alkaline phosphatase and directly with carboxyterminal telopeptide of type-1-collagen. 25OHD and PTH were inversely associated with BFAT, whereas 25OHD also was inversely associated with body mass index, waist-hip ratio, ViFM and ScFM after adjustment for confounders. The associations were found only to be present in participants with insufficient levels of 25OHD. 25-Hydroxy vitamin D and PTH were inversely related to insulin resistance in vitamin-insufficient participants only. No associations between PTH or 25OHD and blood pressure were noted. The study showed a high prevalence of 25OHD deficiency in young, northern European men, which was significantly associated with decreased BMD. PTH and 25OHD were found to be inversely related to the markers of insulin resistance.

Growth in foetal life and infancy is associated with abdominal adiposity at the age of 2 years: The Generation R Study

Early weight gain is associated with an increased risk of obesity. It is not known whether rapid weight gain in foetal life and infancy is also associated with increased abdominal adiposity. We examined the associations of foetal and postnatal growth characteristics with abdominal fat mass at the age of 2 years. This study was performed in 481 children participating in a prospective cohort study from early foetal life onward. Foetal and postnatal growth characteristics in second and third trimester, at birth and at the age of 2 years were related to abdominal fat mass (subcutaneous distance and area, preperitoneal distance and area) measured by ultrasound at the age of 2 years. Foetal and birth weight were not associated with abdominal subcutaneous fat mass. Estimated foetal weight in second trimester of pregnancy was inversely associated with preperitoneal fat area [-3.73% (95% confidence interval -7.23, -0.10)] per standard deviation score increase in weight. Weight gain from birth to the age of 2 years was positively associated with preperitoneal fat mass measures. These associations remained significant after adjustment for age, sex, breastfeeding and body mass index. Positive associations were found between catch-up growth in weight and abdominal fat mass measures. Our results suggest that rapid growth rates during foetal life and infancy are associated with increased abdominal subcutaneous and preperitoneal fat mass in healthy children. Further studies need to explore whether these associations persist in later life and are related to metabolic syndrome outcomes.

Serum brain-derived neurotrophic factor level is increased and associated with obesity in newly diagnosed female patients with type 2 diabetes mellitus

Previous studies have demonstrated that brain-derived neurotrophic factor (BDNF) played a role in the eating behavior and glucose and lipid metabolism. In this study we measured the serum BDNF levels in newly diagnosed female patients with type 2 diabetes mellitus (n = 24, aged 34-59 years) and female subjects with normal glucose tolerance (n = 7, aged 34-56 years). The serum BDNF level was found to significantly increase in diabetic patients in comparison to that in healthy subjects ( P < .05). In these patients, the serum BDNF level showed positive correlation with the body mass index ( r = 0.535, P < .01), the percentage of body fat ( r = 0.552, P < .01), the subcutaneous fat area based on computed tomography scan ( r = 0.480, P < .05), the triglyceride level ( r = 0.470, P < .05), the fasting blood glucose level ( r = 0.437, P < .05), and the homeostasis model assessment of insulin resistance score ( r = 0.506, P < .05), whereas it showed a negative correlation with age ( r = −0.486, P < .05). The partial correlation coefficients adjusted by age showed significant differences regarding the body mass index ( r = 0.423, P < .05), percentage of body fat ( r = 0.504, P < .05), and triglyceride level ( r = 0.426, P < .05). These results provide the first evidence that an increased BDNF is associated with a prevalence of type 2 diabetes mellitus. In addition, the BDNF is related to the total and abdominal subcutaneous fat mass and energy metabolism in the newly diagnosed female patients with type 2 diabetes mellitus.

Assessment of skeletal muscle triglyceride content by (1)H nuclear magnetic resonance spectroscopy in lean and obese adolescents: relationships to insulin sensitivity, total body fat, and central adiposity.

The metabolism and composition of skeletal muscle tissue is of special interest because it is a primary site of insulin action and plays a key role in the pathogenesis of insulin resistance. Intramyocellular (IMCL) triglyceride stores are an accessible form of energy that may decrease skeletal muscle glucose utilization, thereby contributing to impaired glucose metabolism. Because of the invasive nature of muscle biopsies, there is limited, if any, information about intramuscular lipid stores in children. The development of (1)H nuclear magnetic resonance (NMR) spectroscopy provides a unique noninvasive alternative method that differentiates intracellular fat from intercellular fat in muscle tissue. The present study was performed to determine whether IMCL and extramyocellular (EMCL) lipid contents are increased early in the development of juvenile obesity and to explore the relationships between IMCL and EMCL to in vivo insulin sensitivity, independently of total body fat and central adiposity in obese and nonobese adolescents. Eight nonobese (BMI 21 kg/m(2), age 11-16 years) and 14 obese (BMI 35 +/- 1.5 kg/m(2), age 11-15 years) adolescents underwent 1) (1)H-NMR spectroscopy to noninvasively quantify IMCL and EMCL triglyceride content of the soleus muscle, 2) a 2-h euglycemic-hyperinsulinemic clamp (40 mU.m(-2).min(-1)) to assess insulin sensitivity, 3) a dual-energy X-ray absorptiometry scan to measure total percent body fat, and 4) magnetic resonance imaging to measure abdominal fat distribution. Both the IMCL and EMCL content of the soleus muscle were significantly greater in the obese adolescents than in the lean control subjects. A strong inverse correlation was found between IMCL and insulin sensitivity, which persisted and became even stronger after controlling for percent total body fat and abdominal subcutaneous fat mass (partial correlation r = -0.73, P < 0.01) but not when adjusting for visceral fat (r = - 0.54, P < 0.08). In obese adolescents, increase in total body fat and central adiposity were accompanied by higher IMCL and EMCL lipid stores. The striking relationships between both IMCL and EMCL with insulin sensitivity in childhood suggest that these findings are not a consequence of aging but occur early in the natural course of obesity.

Body fat distribution and cardiovascular risk in normal weight women. Associations with insulin resistance, lipids and plasma leptin.

To systematically examine the correlations between insulin resistance, plasma leptin concentration, obesity and the distribution of fat assessed by anthropometry and magnetic resonance imaging in Asian women. A cross sectional study of non-diabetic, normal weight women. Twenty-one healthy women aged 38.8 y (s.d. 11.7) and BMI 22.6 kg/m2 (s.d. 2.3). Intraperitoneal, retroperitoneal and subcutaneous abdominal fat volume was assessed by magnetic resonance imaging. Anthropometric data were collected. Total fat mass was assessed by bioelectric impedance analysis. Fasting serum lipids, insulin and plasma leptin were assayed. Generalized obesity correlated with subcutaneous abdominal fat mass (r=0.83, P<0.001), but not with intra-abdominal fat mass. Both intraperitoneal fat mass and retroperitoneal fat mass increased with age (r=0.58, P=0.005 and r=0. 612, P=0.003, respectively). Abdominal subcutaneous fat mass was the most important determinant of insulin resistance and plasma leptin. Of the serum lipids, only fasting triglyceride correlated significantly with the waist-to-hip ratio. It is possible that the large size of the subcutaneous depot compared to the intra-abdominal depot overwhelms any metabolic differences between adipose tissue from these two sites, resulting in the stronger correlation between insulin resistance and subcutaneous abdominal fat mass rather than intra-abdominal fat mass. On the other hand, the distribution of fat between subcutaneous fat depots may be important in the metabolic syndrome given the correlation of fasting triglyceride with waist to hip ratio but not with abdominal fat. However, the study population was small, younger and leaner compared to previous studies and we may not be able to generalize these results to all segments of the population. We confirm that subcutaneous fat mass is the major determinant of plasma leptin.