Android Region Research Articles

Relationship between fat distribution and cardiometabolic risk in Hispanic girls.

In adults, certain body fat depots have greater impact on cardiometabolic risk than total adiposity. Whether similar relationships exist in children is uncertain. The aim of this study was to examine the relationships among dual x-ray absorptiometry (DXA) measures of body fat distribution and total body adiposity with cardiometabolic risk factors in Hispanic girls. Measures of total percent body fat, percent of total fat within the android, gynoid, leg, and trunk regions, and cardiometabolic biomarkers (insulin, glucose, homeostatic model assessment of insulin resistance (HOMA-IR), triglycerides (TG), low and high lipoprotein cholesterol (LDL-C, HDL-C)) were obtained from 232 Hispanic girls (age 10.7 ±1.1 years). Regression models for each metabolic parameter were run against adiposity measures. Partial correlations of the adiposity measures were used to compare associations between adiposity measures and the cardiometabolic risk factors, controlling for somatic maturation. Total and regional adiposity were significantly related with cardiometabolic risk factors (P < 0.05) except fasting glucose. The partial correlations of total and regional adiposity measures with each cardiometabolic biomarker were similar. More variance was explained for insulin and the HOMA-IR (33%-43%) than other risk factors. Partial correlations for the percentage of total fat in the gynoid and leg regions with insulin, HOMA-IR, TG, and LDL-C were negative, and positive with HDL-C. Measures of total and regional fat perform similarly in predicting cardiometabolic risk in Hispanic girls. A higher proportion of fat distributed in the gynoid or leg region is associated with lower cardiometabolic risk.

Comparing Time Efficiency of Sprint vs. High-Intensity Interval Training in Reducing Abdominal Visceral Fat in Obese Young Women: A Randomized, Controlled Trial.

Introduction: High-intensity interval training (HIIT) is an emerging lifestyle intervention strategy for controlling obesity. HIIT consisted of brief all-out supramaximal sprint intervals was termed as sprint interval training (SIT). This study was designed to examine the time-efficient characteristics of SIT in reducing abdominal visceral fat.Methods: A randomized controlled trial was conducted to compare the specific adaptations of SIT (80 × 6 s all-out cycle sprints interspersed with 9 s passive recovery) with those resulting from a HIIT regimen with training volume relatively higher (repeated 4 min bouts of cycling at 90% O2max alternated with 3 min rest, until the work of 400KJ was achieved), and with those of nonexercising control counterparts (CON). Forty-six obese young women (body fat percentage ≥30) received either SIT (n = 16), HIIT (n = 16), or no training (n = 14), 3–4 sessions per week, for 12 weeks. The abdominal visceral fat area (AVFA) and abdominal subcutaneous fat area (ASFA) of the participants were measured through computed tomography scans pre-intervention and post-intervention. Total fat mass and the fat mass of the android, gynoid, and trunk regions were assessed through dual-energy X-ray absorptiometry.Results: Following the intervention, abdominal visceral and subcutaneous fat were reduced markedly (p < 0.05). The reduction in AVFA (−6.31, −9.7 cm2) was not different between SIT and HIIT (p > 0.05), while the reduction in ASFA (−17.4, −40.7 cm2) in SIT was less than that in HIIT (p < 0.05). Less reduction in the fat mass of the trunk (−1.2, −2.0 kg) region was also found in SIT, while the reductions in fat percentage (−1.9%, −2.0%), total fat mass (−2.0, −2.8 kg), and fat mass of the android (−0.2, −0.2 kg), and gynoid (−0.4, −0.3 kg) regions did not differ between the two regimes (p > 0.05). In contrast, the increase in O2max was significant greater following the SIT than HIIT (p < 0.01). No variable changed in CON.Conclusion: Such findings suggest that the lower training load and exercise time commitments of the SIT regime could optimize the time-efficiency advantage of the traditional HIIT, facilitating the abdominal visceral fat reduction in obese young women.

Effect of combined training on body composition and metabolic variables in people living with HIV: A randomized clinical trial

PurposeThe aim of this study was to conduct a randomized clinical trial to assess the effects of 16 weeks of combined training on body composition, lipid profile, adiponectin, C-reactive protein (CRP), and leptin levels in people living with HIV/AIDS (PLWHA). MethodsFifty-eight HIV-infected individuals were randomized into a training group (T) or a control group (C). Combined training consisted of aerobic and resistance exercises performed at the same training session, applied at a frequency of three times a week for a total of 16 weeks. Waist circumference, body mass, body fat percentage (%fat), fat mass, lipid profile, adiponectin, CRP, and leptin levels were measured pre- and post-training in both groups. ResultsSixteen weeks of combined training decreased (P < 0.05) body fat in different body segments in PLWHA. Lipodystrophic PLWHA experienced greater reduction in body fat in the android region than non-lipodystrophic PLWHA after combined training. Lipid profile and circulating levels of adiponectin, leptin, and CRP remained unchanged. ConclusionsSixteen weeks of combined training was effective to reduce body fat in different body segments, without altering plasma lipid and cytokine levels.

Effects of Different Resistance Training Frequencies on Fat in Overweight/Obese Older Women.

This study compared the effect of different resistance training (RT) frequencies on total, android, gynoid and trunk body fat in overweight/obese older women. Fifty-seven overweight/obese older women (66.9±5.3 years and 39.9±4.9% body fat) were randomly assigned to one of three groups: a group performing RT twice a week (G2X), a group performing RT three times a week (G3X), or a non-exercise control group (CG). Both training groups performed the same 12-week RT program consisting of 8 exercises that trained all major muscle groups. Dual-energy X-ray absorptiometry was used to assess body composition. After the intervention period, both G2X and G3X demonstrated significant (P<0.05) reductions in adiposity compared to the CG for total body fat (G2X=-1.7%, G3X=-2.7%, CG=+2.1%), android fat (G2X=-6.2%, G3X=-7.0%, CG=+8.6%), gynoid fat (G2X=-2.5%, G3X=-2.9%, CG=+1.0%), and trunk fat (G2X=-2.5%, G3X=-3.0%, CG=+2.9%), with no significant differences between training groups. These results demonstrate that a low-volume 12-week RT program performed two or three times per week causes decreases in total and regional fat deposition with the greatest reductions occurring in the android region.

Correlation between changes of body fat distribution and insulin resistance after Roux-en-Y gastric bypass

Objective To investigate the effect of laparoscopic Roux-en-Y gastric bypass(LYGB) on body fat distribution, and relationship between the changes of body fat distribution and improvement of insulin resistance. Methods A total of 65 patients with type 2 diabetes who underwent LYGB were selected for a retrospective analysis.Metabolic parameters, anthropometric measurements, body composition and fat distribution measured by dual-energy X-ray absorptiometry(DEXA) were collected separately before and 6 months post LYGB. All data of pre- and postoperation were compared with pair t test, Pearson correlation analysis was used to evaluate correlation of two variables. Results Weight, body mass index, waist circumference, waist-to-hip ratio, triglyceride, fasting plasma glucose, fasting insulin and homeostatic model assessment for insulin resistance (HOMA-IR) were significantly decreased in 6 months after surgery (P<0.05). Total fat mass, body fat mass of trunk, upper and lower limbs decreased significantly (P<0.05). Percent fat mass at the whole body, Android region, upper and lower limbs decreased significantly (P<0.05). After 6 months postoperatively, abdominal obesity indices waist circumfernce decreased from (98.10±13.03) cm to (91.60±7.68) cm (P<0.01) and percent fat mass at the Android region decreased from (35.71±10.24)% to (29.44±12.11) % (P<0.05), HOMA-IR decreased from 3.62±5.18 to 1.79±1.52 (P<0.05). The improvement of postoperative insulin resistance is positively correlated with the changes in waist circumference (P<0.01) and percent fat mass of Android region (P<0.05). Conclusions The body fat distribution changes after LYGB, change of abdominal fat distribution is positively correlated to the improvement of insulin resistance. Key words: Gastric bypass; Diabetes mellitus, type 2; Body fat distribution; Insulin resistance

Estimates of the precision of regional and whole body composition by dual-energy x-ray absorptiometry in persons with chronic spinal cord injury.

Study DesignLongitudinal designObjectivesTo determine the reproducibility of total- and regional-body composition assessments from a total-body scan using dual-energy x-ray absorptiometry (DXA) in persons with spinal cord injury (SCI).MethodsTwenty-four individuals with SCI completed within-day short-term precision testing by repositioning study participants between scans. An additional and separate cohort of 22 individuals with SCI were scanned twice on a GE-Lunar DXA scanner separated by a 4-week interval to assess the long-term precision assessment. The root mean square coefficient of variation percent (RMS-CV%) values for the regional and total body composition was calculated.ResultsFor the same day, short-term precision assessment, the RMS-CV% for each region did not exceed 5.6%, 2.7%, 3.8%, 6.5%, 5.8% and 2.3% for arms, legs, trunk, android and gynoid regions and total body mass, respectively. In the long-term precision assessment, the RMS-CV% for each region did not exceed 6.0%, 3.0%, 4.4%, 8.2%, 3.4% and 2.0% for arms, legs, trunk, android, gynoid and total body mass. Moreover, the interclass-correlation coefficient in the long-term precision group demonstrated excellent linear agreement between repeat scans for all regions (r> 0.97).ConclusionThe precision error of the total body composition variables in our SCI cohort was similar to those reported in the literature for nondisabled individuals, and the precision errors of the regional body composition compartments were notably higher, but similar to the regional precision errors reported in the general population.

Changes in regional body fat, lean body mass and body shape in trans persons using cross-sex hormonal therapy: results from a multicenter prospective study.

Cross-sex hormonal therapy (CHT) in trans persons affects their total body fat and total lean body mass. However, it is unknown how separate body regions are affected and whether these changes alter body shape. Therefore, the aim of this study was to determine the effects on body fat and lean body mass in separate body regions and on body shape after one year of CHT. In a multicenter prospective study at university hospitals, 179 male-to-female gender dysphoric persons, referred to as transwomen, and 162 female-to-male gender dysphoric persons, referred to as transmen, were included. All underwent whole-body dual-energy X-ray absorptiometry and anthropometric measurements before and after one year of CHT. In transwomen, increases in body fat ranged from +18% (95% CI: 13%;23%) in the android region to +42% (95% CI: 37%;46%) in the leg region and +34% (95% CI: 29%;38%) in the gynoid region. In transmen, changes in body fat ranged from -16% (95% CI: -19;-14%) in the leg region and -14% in the gynoid region (95% CI: -16%;-12) to no change in the android region (+1%, 95% CI: -3%;5%). Waist-to-hip ratio (WHR) decreased in transwomen (-0.03, 95% CI: -0.04;-0.02) mainly due to an increase in hip circumference (+3.2 cm, 95% CI: 2.3;4.0). Transmen have a decrease in hip circumference (-1.9 cm, 95% CI: -3.1;-0.7) resulting in an increase in WHR (+0.01, 95% CI: 0.00;0.02). CHT causes a more feminine body fat distribution and a lower WHR in transwomen and a more masculine body fat distribution with a lower hip circumference in transmen.

Use of iDXA spine scans to evaluate total and visceral abdominal fat.

Abdominal fat may be a better predictor than body mass index (BMI) for risk of metabolically-related diseases, such as diabetes, cardiovascular disease, and some cancers. We sought to validate the percent fat reported on dual energy X-ray absorptiometry (DXA) regional spine scans (spine fat fraction, SFF) against abdominal fat obtained from total body scans using the iDXA machine (General Electric, Madison, WI), as previously done on the Prodigy model. Total body scans and regional spine scans were completed on the same day (N = 50). In alignment with the Prodigy-based study, the following regions of interest (ROI) were assessed from total body scans and compared to the SFF from regional spine scans: total abdominal fat at (1) lumbar vertebrae L2-L4 and (2) L2-Iliac Crest (L2-IC); (3) total trunk fat; and (4) visceral fat in the android region. Separate linear regression models were used to predict each total body scan ROI from SFF; models were validated by bootstrapping. The sample was 84% female, a mean age of 38.5 ± 17.4 years, and mean BMI of 23.0 ± 3.8 kg/m2 . The SFF, adjusted for BMI, predicted L2-L4 and L2-IC total abdominal fat (%; Adj. R2 : 0.90) and total trunk fat (%; Adj. R2 : 0.88) well; visceral fat (%) adjusted R2 was 0.83. Linear regression models adjusted for additional participant characteristics resulted in similar adjusted R2 values. This replication of the strong correlation between SFF and abdominal fat measures on the iDXA in a new population confirms the previous Prodigy model findings and improves generalizability.

Serum adipokines, adipose tissue measurements and metabolic parameters in patients with advanced radiographic knee osteoarthritis.

We conducted the present study to evaluate the serum levels of adipokines (leptin, total and high molecular adiponectin, resistin), a marker of cartilage breakdown (C2C), and ghrelin together with body composition in patients with knee osteoarthritis (OA). Fifty patients and 50 sex-matched healthy subjects (HS) were evaluated. Knee OA was scored according to the Kellgren-Lawrence (KL) grade. Body composition parameters including lean mass and measurements of fat mass (total fat, adiposity, fat in the android and gynoid regions, visceral fat and trunk/legs fat ratio) were obtained using dual energy X-ray absorptiometry. Most of the recruited patients (88%) had advanced knee OA with KL grade 3 or 4. The patients had higher body mass index than HS (p<0.0001). Serum leptin, high molecular adiponectin, resistin and ghrelin levels did not differ between patients and HS. Total adiponectin was higher in women with OA compared to women from the HS group (p=0.004). Total fat mass, adiposity and measurements of central adiposity (fat in the android region, trunk/lower limbs fat ratio and visceral fat) were increased in patients with knee OA (all p<0.05). Total adiponectin was borderline associated with the severity of OA. Our results show that total adiponectin is significantly increased in women with advanced knee OA. Independently of gender, patients with severe knee OA were characterized by a significant excess of fat with a distribution toward the visceral region. This abnormal body composition may contribute to the cardiometabolic profile that is described in patients with knee OA.

Differences in Adipose Tissue and Lean Mass Distribution in Patients with Collagen VI Related Myopathies Are Associated with Disease Severity and Physical Ability.

Mutations in human collagen VI genes cause a spectrum of musculoskeletal conditions in children and adults collectively termed collagen VI-related myopathies (COL6-RM) characterized by a varying degree of muscle weakness and joint contractures and which include Ullrich Congenital Muscular Dystrophy (UCMD) and Bethlem Myopathy (BM). Given that collagen VI is one of the most abundant extracellular matrix proteins in adipose tissue and its emerging role in energy metabolism we hypothesized that collagen VI deficiency might be associated with alterations in adipose tissue distribution and adipokines serum profile. We analyzed body composition by means of dual-energy X-ray absorptiometry in 30 pediatric and adult COL6-RM myopathy patients representing a range of severities (UCMD, intermediate-COL6-RM, and BM). We found a distinctive pattern of regional adipose tissue accumulation which was more evident in children at the most severe end of the spectrum. In particular, the accumulation of fat in the android region was a distinguishing feature of UCMD patients. In parallel, there was a decrease in lean mass compatible with a state of sarcopenia, particularly in ambulant children with an intermediate phenotype. All children and adult patients that were sarcopenic were also obese. These changes were significantly more pronounced in children with collagen VI deficiency than in children with Duchenne Muscular Dystrophy of the same ambulatory status. High molecular weight adiponectin and leptin were significantly increased in sera from children in the intermediate and BM group. Correlation analysis showed that the parameters of fat mass were negatively associated with motor function according to several validated outcome measures. In contrast, lean mass parameters correlated positively with physical performance and quality of life. Leptin and adiponectin circulating levels correlated positively with fat mass parameters and negatively with lean mass and thus may be relevant to the disease pathogenesis and as circulating markers. Taken together our results indicate that COL6-RM are characterized by specific changes in total fat mass and distribution which associate with disease severity, motor function, and quality of life and which are clinically meaningful and thus should be taken into consideration in the management of these patients.

Clinical value of dual-energy X-ray absorptiometry in evaluating the improvement of metabolic indexes after laparoscopic sleeve gastrectomy

Objective To observe the changes of pre- and post-operative body fats of obese patients undergoing laparoscopic sleeve gastrectomy which were evaluated by dual-energy X-ray absorptiometry (DEXA) and investigate the correlation of the changes between body fat and insulin resistance. Methods The cohort study was conducted. The clinical data of 10 obese patients who were admitted to the Fourth Affiliated Hospital of China Medical University from October 2015 to February 2017 were collected. Ten obese patients received laparoscopic sleeve gastrectomy (LSG). The pre- and post-operative body fat masses in the different parts and regions of the whole body [whole body, upper limbs, lower limbs, trunk, region of android (region A) and region of gynoid (region G)] were measured by DEXA and pre- and post-operative indexes of insulin resistance (HOMA-IR) were calculated. Observation indicators: (1) fat parameters evaluated by DEXA and test results of other obesity related indicators; (2) test results of insulin sensitivity index. The patients were followed up by the professional team of metabolic surgery using telephone interview, outpatient and inpatient examinations up to February 2017, and DEXA using outpatient and inpatient examinations was performed at 6 months postoperatively. The measurement data with normal distribution were represented as ±s, and repeated measurement data were analyzed by the repeated measures ANOVA. The correlation analysis was performed by the Pearson, and the degree of correlation was analyzed by the factor analysis and multiple linear regression. Results (1) Fat parameters evaluated by DEXA and test results of other obesity related indicators: all the 10 patients were followed up. The fat masses and percentages of the whole body, upper limbs, lower limbs, trunk, region A and region G, BMI, waist circum- ference and HOMA-IR were respectively (55.6±13.7)kg, (6.2±1.9)kg, (17.8±3.6)kg, (31.7±12.7)kg, (5.6±2.4)kg, (8.8±1.5)kg, 50%±3%, 54%±5%, 50%±4%, 52%±3%, 57%±4%, 52%±4%, (42±8)kg/m2, (123±23)cm, 8.7±5.6 before operation and (37.4±11.3)kg, (4.0±1.2)kg, (11.2±3.0)kg, (20.4±9.6)kg, (3.5±1.7)kg, (5.1±1.4)kg, 43%±5%, 46%±5%, 42%±5%, 46%±5%, 48%±6%, 46%±5%, (30±6)kg/m2, (101±20)cm, 3.5±2.4 at 6 months postoperatively, with statistically significant differences between pre-and post-operations (F=11.282, 6.308, 15.789, 6.083, 7.836, 9.027, 5.485, 7.743, 8.620, 3.743, 4.704, 5.421, 13.281, 14.258, 4.465, P 0.05). (2) Test results of insulin sensitivity index: there was a positive correlation in the fat masses of the whole body, trunk, region A and region G, BMI, waist circumference and HOMA-IR (r=0.873, 0.874, 0.894, 0.696, 0.843, 0.816, P 0.05). The principal component of F1 and F2 were constructed by the factor analysis, F1 (trunk for the most) reflected the fat mass of the different parts of the whole body and F2 reflected the fat mass of peripheral limbs, the model of F1 was reasonable (t=5.033, P<0.05). The contribution rate of the whole body, upper and lower limbs, trunk, region A, region G, BMI and waist circumference were respectively 0.994, 0.633, 0.487, 0.887, 0.900, 0.897, 0.959, 0.897 in the F1 and -0.030, 0.716, 0.829, -0.446, -0.405, 0.423, -0.201, -0.283 in the F2, and the whole body fat mass (BFM) made a largest contribution rate for the preoperative HOMA-IR (0.994). There was a positive correlation between decrease of fat mass in region G and improvement of HOMA-IR at 6 months postoperatively (r=0.717, P<0.05). Conclusion BFM is an important index to evaluate the insulin resistance in female patients, and the decrease of fat mass in the region G is an important factor for the early remission of insulin resistance in female patients after laparoscopic sleeve gastrectomy. Key words: Obesity; Sleeve gastrectomy; Insulin resistance; Dual-energy X-ray absorptiometry

Indian girls have higher bone mineral content per unit of lean body than boys through puberty.

Our aim is to describe changes in the muscle-bone unit assessed as a ratio of bone mineral content (BMC) to lean body mass (LBM) through puberty at total body and various skeletal sites in Indian boys and girls. A cross-sectional study was conducted (888 children, 480 boys, aged 5-17years) in Pune, India. Pubertal staging was assessed. BMC, LBM and fat percentage at the arms, legs, android, gynoid and total body (less the head) were assessed by dual energy X-ray absorptiometry. The amount of BMC per unit LBM (BMC/LBM) was computed. Changes in mean BMC/LBM at 5 Tanner (pubertal) stages after adjustment for age and fat percentage were calculated. In boys, adjusted BMC/LBM was significantly higher with successive Tanner stages [legs (TS-II vs TS-I), android (TS-III vs TS-II, TS-IV vs TS-III) and gynoid region (TS-III vs TS-II and TS-II vs TS-I) (p<0.05)]. In girls, adjusted BMC/LBM was significantly higher with successive Tanner stages at total body, legs and gynoid (TS-III vs TS-II; TS-II vs TS-I; TS-V vs TS-IV), arms (TS-I to TS-V) and android regions (TS-V vs TS-IV) (p<0.05). Boys had significantly higher adjusted BMC/LBM than girls at earlier Tanner stages (TS-I to TS-III), whereas girls had significantly higher adjusted BMC/LBM than boys at later Tanner stages (TS-IV, TS-V) (p<0.05). Indian boys and girls showed higher total and regional body, and age- and fat percentage-adjusted BMC/LBM with successive pubertal stages. Girls had higher BMC/LBM than boys which may possibly act as a reservoir for later demands of pregnancy and lactation.

Changes in Body Composition among Female College Basketball Players Pre and Post-Preseason Training

PURPOSE: To examine changes in area-specific lean mass and body fat among female, division I college basketball players before and after preseason training. METHODS: Body composition was measured before and after preseason training using a dual-energy x-ray absorptiometry (iDXA) scan. Total and area-specific (arms, trunk, legs, android, and gynoid) lean mass and body fat were analyzed. Preseason training lasted 1 month and consisted of 8 hours per week of a combination of weight training, high-intensity interval sprint training, and skill workouts. Paired-sample t-tests were used to examine change pre- and post-intervention. Pearson correlations were conducted to examine potential associations among variables. RESULTS: Female athletes (N=11) completed this study. Total body mass significantly increased (p = .001) after preseason training from 152.8 to 155.6 lbs. Total and area-specific fat mass did not significantly change after preseason training. Total lean mass significantly increased (p = .004) from 109.6 to 112.0 lbs. However, for area-specific lean mass, only lean mass in the trunk (p = .01) and in the android region (p = .013) significantly increased from 51.2 to 52.3 lbs. and from 6.8 to 6.9 lbs., respectively. Individual lean mass responses to training varied widely. Specifically, changes in total lean mass ranged from +.02 to +7.9 lbs. Changes in total fat mass also varied widely between individuals, ranging from a loss of 2.2 lbs. to a gain of 3.5 lbs. Change in total lean mass was not significantly correlated with baseline total lean mass, age, year in school, or position played. Change in total body fat was negatively correlated (r = -.82, p = .001) but not significantly correlated with age, year in school, or position played. One athlete experienced an ACL tear midway through the season. Although her data was not included in pre-post analysis, her iDXA scan indicated a loss of 11.3 lbs. in lean mass, with the majority of this reduction seen in the legs (-6.4 lbs.). CONCLUSIONS: Because there were significant increases in total body mass and lean mass but not body fat, it is important to directly measure body composition to examine effects of training. In addition, these data demonstrate that athletes’ responses to training can vary widely thus highlighting the potential use of individualized training programs.

Preliminary study on the assessment of visceral adipose tissue using dual-energy xray absorptiometry in chronic obstructive pulmonary disease

Background: Visceral adipose tissue (VAT) was shown to be increased in patients with chronic obstructive pulmonary disease (COPD) compared to control subjects with comparable body mass index (BMI). Our aim was to determine the relation of VAT by dual-energy x-ray absorptiometry (DEXA) in patients with COPD by disease severity, BMI, other indices of body composition and static lung volumes. Methods: 294 COPD patients admitted for rehabilitation were studied. Lung function, static lung volumes and body composition (i.e. BMI, waist circumference, fat-free mass, fat mass and fat distribution between android and gynoid fat mass) were assessed before entering pulmonary rehabilitation. VAT was estimated within the android region by using DEXA. Patients were stratified for gender, BMI (cut-off of 25 kg/m2) and GOLD stage. To assess the impact of VAT on lung volumes, patients were also stratified for VAT less and above 50th percentile. Results: Both male and female patients with more severe airflow limitation had significantly lower VAT values, but these differences disappeared after stratification for BMI. VAT was significantly and strongly correlated with other body composition parameters (all p &lt; 0.001). Patients with moderate to severe airflow limitation and lower VAT had increased static lung hyperinflation and lower diffusing capacity for carbon monoxide. Nevertheless, multivariate stepwise regression models including for BMI, age, gender and forced expiratory volume in 1 s (FEV1) as confounders did not confirm an independent role for VAT on static lung hyperinflation and diffusion capacity. Conclusion: After stratification for BMI, VAT is comparable in moderate to very severe COPD patients. Furthermore, BMI and demographics, but not VAT, were independent predictors of static lung hyperinflation and diffusing capacity in COPD.

Preliminary study on the assessment of visceral adipose tissue using dual-energy x-ray absorptiometry in chronic obstructive pulmonary disease.

BackgroundVisceral adipose tissue (VAT) was shown to be increased in patients with chronic obstructive pulmonary disease (COPD) compared to control subjects with comparable body mass index (BMI). Our aim was to determine the relation of VAT by dual-energy x-ray absorptiometry (DEXA) in patients with COPD by disease severity, BMI, other indices of body composition and static lung volumes.Methods294 COPD patients admitted for rehabilitation were studied. Lung function, static lung volumes and body composition (i.e. BMI, waist circumference, fat-free mass, fat mass and fat distribution between android and gynoid fat mass) were assessed before entering pulmonary rehabilitation. VAT was estimated within the android region by using DEXA. Patients were stratified for gender, BMI (cut-off of 25 kg/m2) and GOLD stage. To assess the impact of VAT on lung volumes, patients were also stratified for VAT less and above 50th percentile.ResultsBoth male and female patients with more severe airflow limitation had significantly lower VAT values, but these differences disappeared after stratification for BMI. VAT was significantly and strongly correlated with other body composition parameters (all p < 0.001). Patients with moderate to severe airflow limitation and lower VAT had increased static lung hyperinflation and lower diffusing capacity for carbon monoxide. Nevertheless, multivariate stepwise regression models including for BMI, age, gender and forced expiratory volume in 1 s (FEV1) as confounders did not confirm an independent role for VAT on static lung hyperinflation and diffusion capacity.ConclusionAfter stratification for BMI, VAT is comparable in moderate to very severe COPD patients. Furthermore, BMI and demographics, but not VAT, were independent predictors of static lung hyperinflation and diffusing capacity in COPD.

Role of heart rate in the relation between regional body fat and subendocardial viability ratio in women.

Subendocardial viability ratio (SEVR) is a measure of left ventricular function, specifically; it is an index of myocardial perfusion relative to left ventricular workload. Women have lower SEVR than men, partly due to a faster resting heart rate that reduces diastolic time (i.e., time for myocardial perfusion). It is unclear if body fat relates to SEVR, thus the purpose of this study was to examine the relation between body fat and SEVR in women. Twenty-eight middle-aged (31-45years) and 31 older (60-80years) women were examined. Radial artery applanation tonometry was used to calculate SEVR from a synthesized central aortic pressure wave. Dual-energy X-ray absorptiometry was used to assess body composition including fat in the trunk, legs, android and gynoid regions. Body fat was not related (P>.05) with SEVR in older women. In middle-aged women, all measures of regional fat were correlated with heart rate (range, r=.49-.59, P≤.01) and SEVR (range, r=.43-.53, P≤.01). Android-to-gynoid ratio was identified as the strongest predictor (r(2) =-.26, P<.01) of SEVR among measures of regional fat. Middle-aged women with lower android-to-gynoid fat ratio had higher SEVR (1.96±0.33 vs 1.66±0.20, P=.009) than women with higher fat ratio, even after adjusting for age, height, daily physical activity, and aortic mean pressure (P=.02). Adjusting for heart rate or diastolic time abolished the difference in SEVR between groups (1.80±0.09 vs 1.82±0.09, P=.56). These results suggest that middle-aged women with a greater distribution of fat in the abdomen have poorer left ventricular function that is dependent on the negative influence of heart rate on diastolic time.

Visceral fat measured by DXA is associated with increased risk of non-spine fractures in nonobese elderly women: a population-based prospective cohort analysis from the São Paulo Ageing & Health (SPAH) Study.

The protective effect of obesity on bone health has been questioned because visceral fat has been demonstrated to have a deleterious effect on bone. The aim of this study was to investigate the association of visceral fat measured by DXA with the incidence of non-spine fractures in community-dwelling elderly women. This longitudinal prospective population-based cohort study evaluated 433 community-dwelling women aged 65years or older. A specific clinical questionnaire, including personal history of a fragility fracture in non-spine osteoporotic sites, was administered at baseline and after an average of 4.3years. All incidences of fragility fractures during the study period were confirmed by affected-site radiography. Visceral adipose tissue (VAT) was measured in the android region of a whole-body DXA scan. The mean age was 72.8 ± 4.7years, and 28 incident non-spine osteoporotic fractures were identified after a mean follow-up time of 4.3 ± 0.8years. According to the Lipschitz classification for nutritional status in the elderly, 38.6% of women were nonobese (BMI ≤ 27kg/m2) and 61.4% were obese/overweight. Logistic regression models were used to estimate the relationship between VAT and non-spine fractures in elderly women. After adjusting for age, race, previous fractures, and BMD, VAT (mass, area, volume) had a significant association with the incidence of non-spine fractures only in nonobese elderly women (VAT mass: OR, 1.42 [95% CI, 1.09-1.85; p = 0.010]; VAT area: OR, 1.19 [95% CI, 1.05-1.36; p = 0.008]; VAT volume: OR, 1.40 [95% CI, 1.09-1.80; p = 0.009]). This study suggests a potential negative effect of visceral adiposity on bone health in nonobese women.

Associations Between Sedentary Time, Physical Activity, and Dual-Energy X-ray Absorptiometry Measures of Total Body, Android, and Gynoid Fat Mass in Children

Negative health outcomes are associated with excess body fat, low levels of physical activity (PA), and high sedentary time (ST). Relationships between PA, ST, and body fat distribution, including android and gynoid fat, assessed using dual-energy X-ray absorptiometry (DXA) have not been measured in children. The purpose of this study was to test associations between levels of activity and body composition in children and to evaluate if levels of activity predict body composition by DXA and by body mass index percentile in a similar manner. PA, ST, and body composition from 87 children (8.8–11.8 yr, grades 3–5, 44 boys) were used to test the association among study variables. Accelerometers measured PA and ST. Body composition measured by DXA included bone mineral content (BMC) and fat and lean mass of the total body (TB, less head), android, and gynoid regions. ST (range: 409–685 min/wk) was positively associated with TB percent fat (0.03, 95% confidence interval [CI]: 0.00–0.05) and android fat mass (1.5 g, 95% CI: 0.4–3.0), and inversely associated with the lean mass of the TB (−10.7 g, 95% CI: −20.8 to −0.63) and gynoid regions (−2.2 g, 95% CI: −4.3 to −0.2), and with BMC (−0.43 g, 95% CI: 0.77–0.09). Moderate-to-vigorous PA was associated with lower TB (−53 g, 95% CI: −87 to −18), android (−5 g, 95% CI: −8 to −2]), and gynoid fat (−6 g, 95% CI: −11 to −0.5). Vigorous activity results were similar. Light PA was associated with increased TB (17.1 g, 95% CI: 3.0–31.3) and gynoid lean mass (3.9 g, 95% CI: 1.0–6.8) and BMC (0.59 g, 95% CI: 0.10–1.07). In boys, there were significant associations between activity and DXA percent body fat measures that were not found with the body mass index percentile. Objective measures of PA were inversely associated with TB, android, and gynoid fat, whereas ST was directly associated with TB percent fat and, in particular, android fat. Activity levels predict body composition measures by DXA and, in particular, android fat distribution.

Quantification of Visceral Fat Using Dual-Energy X-Ray Absorptiometry and Its Reliability According to the Amount of Visceral Fat in Korean Adults

Recently, a fully automated method for segmenting abdominal fat into subcutaneous fat and visceral fat (VF) within the android region using dual-energy X-ray absorptiometry (DXA) has been newly developed. The purpose of this study was to validate a new DXA method by comparing it to the gold standard, computed tomography (CT), in the Korean population. Furthermore, we examined its reliability regarding VF and explored whether it is applicable to the Asian population, which has relatively larger amount of VF. We studied 123 adult men and women, aged 22–73 yr, representing a wide range of body mass index values (17.1–36.0 kg/m2), who underwent both DXA and CT in a fasting state within 1 h. The coefficient of determination (r2) for regression of the CT on DXA values was 0.892 for females, 0.838 for males, and 0.931 combined. Bland-Altman bias was −451.4 cm3 with 95% limits of agreement of 149.8 to −1052.6 cm3. The DXA-measured VF showed a better correlation with CT-measured VF volume than common indices for adiposity, including the body mass index and waist circumference. There was a lesser discrepancy ratio between DXA- and CT-measured VF with an increase of VF volume. DXA, a relatively convenient, inexpensive, and safe method with minimum radiation dosage, can be a reliable technique for VF assessment in the Asian population.

Higher serum concentrations of betaine rather than choline is associated with better profiles of DXA-derived body fat and fat distribution in Chinese adults.

Animal studies have suggested that betaine, but not choline, may improve body composition, but little evidence is available in humans. We examined the association of serum concentrations of choline and betaine with body composition and fat distribution in adults. This community-based study recruited 1996 adults (women/men: 1380/616) aged 40-75 years in urban Guangzhou, China. General information and anthropometric measurements were taken, and serum choline and betaine levels were assessed by high-performance liquid chromatography-tandem mass spectrometry between July 2008 and June 2010. After 3.2 years, 1623 of the 1996 participants were measured for fat mass (FM and %FM) over the total body (TB), trunk, limbs, android (A) and gynoid (G) regions. The %FM ratios of the A/G regions and the trunk and limbs were determined by dual energy X-ray absorptiometry. Univariate analyses showed that higher serum betaine levels were significantly associated with lower values of adiposity indices (all P-trends<0.05), except in the case of the %FM at the gynoid area. After adjusting for potential covariates, similar associations were observed. The mean percentage differences between quartiles 4 and 1 of the serum betaine levels were -4.9% (weight), -4.7% (body mass index, BMI), -2.5% (waist circumference), -7.9% (TB FM) and -3.4% (TB %FM). The mean differences in the FM and %FM were much more pronounced at the trunk (-10.0 and -4.5%) or android areas (-10.7 and -4.7%) than those at the limbs (-0.8 and -2.3%) or gynoid areas (-0.6 and -1.4%). Such favorable associations were stronger in men than in women. No significant associations between serum choline and the adiposity indices were observed, except in the cases of body weight and BMI. Greater circulating betaine, but not choline, was dose-dependently associated with better body composition and fat distribution due to a lower FM in the trunk regions in this population.