Central Body Fat Distribution Research Articles

Central Body Fat Distribution Research and Kidney Function: The Potential to Advance Safety in Living Kidney Donors.

Central Body Fat Distribution Research and Kidney Function: The Potential to Advance Safety in Living Kidney Donors.

Central Body Fat Distribution and Kidney Function after Living Kidney Donation.

In most screening guidelines, high body mass index (BMI) is considered a contraindication for kidney donation. New insights suggest that central body fat distribution might provide greater power in assessing kidney risk. This study aimed to determine whether BMI and central body fat distribution measures are associated with long-term kidney function after donor nephrectomy. We hypothesized that higher BMI, waist circumference (WC), and waist-to-height ratio (WHtR) were associated with lower kidney function long term after donation. The study population consisted of living kidney donors. BMI, WC, and WHtR were measured during donor screening. The outcome postdonation kidney function was assessed using measured GFR (mGFR) (mGFR, 125 I-iothalamate infusion) at 3 months ( n =1042), 5 years ( n =556), and 10 years ( n =210) of follow-up. Primary multivariable linear regression analyses were performed with BMI and WC and secondary analyses with WHtR. Linear mixed models were performed to investigate change in postdonation eGFR. The donor age was 52±11 years, and 48% were male. The mean BMI was 26.1±3.6 kg/m 2 , and WC was 91±11 cm. Higher predonation BMI was associated with lower mGFR throughout follow-up: -1.35 (95% confidence interval [CI], -1.95 to -0.80), -1.55 (95% CI, -2.50 to -0.65), and -2.35 (95% CI, -4.10 to -0.60) ml/min per m 2 per 5 kg/m 2 higher BMI at 3 months, 5, and 10 years after donation, respectively, adjusted for sex, age, and predonation GFR. For WC, differences in mGFR were -1.30 (95% CI, -1.70 to -0.90), -1.50 (95% CI, -2.20 to -0.80), and -1.70 (95% CI, -3.00 to -0.50) ml/min per m 2 per 10 cm higher WC at 3 months, 5, and 10 years after donation, respectively. In male donors, BMI and WC were significantly associated with a negative postdonation change in eGFR. Higher BMI and WC were independently associated with lower GFR (long term) after living kidney donation.

Circulating GDF15 concentrations in girls with low birth weight: effects of prolonged metformin treatment.

Low birth weight (LBW) followed by a rapid postnatal catch-up in weight predisposes individuals to a central distribution of body fat, which is reverted by metformin. Growth-and-differentiation-factor-15 (GDF15) plays an important role in the regulation of energy homeostasis, reducing food intake and body weight. We assessed whether GDF15 concentrations are raised by long-term metformin treatment in LBW/catch-up girls with precocious pubarche (PP, pubic hair <8 years), and whether they relate to changes in endocrine-metabolic variables, body composition, and abdominal fat partitioning. Circulating GDF15 was determined in 30 LBW/catch-up girls with PP randomly assigned to receive metformin for 4 years (n = 15; 425 mg/d for 2 years, then 850 mg/d for 2 years) or to remain untreated (n = 15). Endocrine-metabolic variables, body composition (by absorptiometry), and abdominal fat partitioning (by MRI) were assessed at the start and yearly during follow-up. Circulating GDF15 concentrations increased significantly in LBW-PP girls only after 3 and 4 years on metformin. GDF15 levels associated negatively with insulin, HOMA-IR, androgens, body fat, and visceral fat. Prepubertal intervention with metformin reduces central adiposity and insulin resistance in girls with reduced prenatal growth. GDF15 could be among the mediators of such effects, especially over the long term. Low birth weight followed by a rapid postnatal catch-up in weight predisposes individuals to a central distribution of body fat, which is reverted by metformin. Growth-and-differentiation-factor-15 (GDF15) is a peptide hormone that reduces food intake and lowers body weight; metformin is an exogenous GDF15 secretagogue. Serum GDF15 concentrations increase after 3 and 4 years on metformin and associate negatively with insulin, androgens, body fat, and visceral fat. Prepubertal intervention with metformin reduces central adiposity and insulin resistance in girls with low birth weight. GDF15 could mediate these effects, especially over the long term.

Relative Body Fat Distribution in Preadolescent Indian Children Exposed to a Natural Disaster during Early Development.

Fetal life and infancy are critical periods when adverse environmental conditions, such as natural disasters, may alter a developing organism, leading to life-lasting unfavorable health outcomes, such as central body fat distribution. Therefore, the aim of this study was to assess the effect of the exposure to cyclone Aila in utero or during infancy on the relative subcutaneous adiposity distribution in preadolescent Indian children. The study included children prenatally (N = 336) or postnatally (during infancy, N = 212) exposed to Aila and a non-affected group (N = 284). Anthropometric indices involved, i.e., subscapular, suprailiac, triceps, and biceps skinfolds. The relative adiposity distribution (PC1) and socioeconomic status (SES) were assessed using principal component analysis. An analysis of covariance and Tukey’s post hoc test for unequal samples were performed to assess the effect of exposure to a natural disaster on the PC1, controlling for age, sex, Z-BMI, and SES. Prenatally and postnatally Aila-exposed children revealed a significantly more central-oriented pattern of relative subcutaneous fat distribution compared to the controls (p < 0.05). Early-life exposure to a natural disaster was related to an adverse pattern of relative adipose tissue distribution in preadolescent children.

General and Central Obesity Are Associated With Increased Severity of the VMS and Sexual Symptoms of Menopause Among Chinese Women: A Longitudinal Study.

BackgroundStrong evidence has linked overweight and obesity to increased risks of cardiovascular disease and all-cause mortality in Chinese populations. Menopause is considered associated with increased obesity and central body fat distribution. However, the correlation between obesity and menopausal symptoms has not been well studied.ObjectiveTo examine the associations between obesity or abdominal obesity and menopausal symptoms as women progressed from premenopausal to postmenopausal status.DesignThis study included 430 midlife Chinese women who had experienced natural menopause and were followed up for 10 years. Physical examinations and questionnaires should be completed annually. The questionnaires include the Menopause-Specific Quality of Life questionnaire, the Hospital Anxiety and Depression Scale, and other physical and behavioral factors.ResultsAmong women who were not obese (n=345) or not abdominal obese (n=372) at baseline, 5.8% and 31.7% became obese or abdominal obese at the recent follow-up visit, respectively. Women at the recent follow-up visit had an increased body mass index (BMI) by 0.14%, and the waist-to-hip ratio (WHR) increased by 5.2% compared with the data at baseline. In multivariate analysis, more frequent hot flashes, moderate/severe bothered vasomotor symptoms (VMS), mild bothered sexual functioning, and less anxiety symptoms were significantly associated with obesity. Increasing age, moderate/severe bothered VMS, and less anxiety symptoms were independently associated with abdominal obesity. Multivariable analysis also showed that less education level is independently associated with both obesity and abdominal obesity.ConclusionOur findings suggest that the proportion of obesity and abdominal obesity increased gradually during menopause. The increase of abdominal obesity is more rapidly than obesity in middle-aged women. Both obesity and abdominal obesity are related with severe or frequent VMS and anxiety symptoms in Chinese women. Although the proportion of obese women in China is lower than in western countries, the problem of abdominal obesity and related complications cannot be ignored.

Aberrant overexpression of HOTAIR inhibits abdominal adipogenesis through remodelling of genome-wide DNA methylation and transcription

ObjectiveAbdominal adiposity is strongly associated with diabetic and cardiovascular comorbidities. The long noncoding RNA HOTAIR (HOX Transcript Antisense Intergenic RNA) is an important epigenetic regulator with fat depot-specific expression. Its functional roles and epigenetic regulation in abdominal adipogenesis remain uncertain. MethodsWe collected different fat depots from healthy, severely obese, and uraemic subjects to measure fat-depot specific gene expression and quantify regional adiposity via dual-energy X-ray absorptiometry (DXA). HOTAIR was overexpressed to evaluate its functional roles. Reduced representation bisulfite sequencing (RRBS), RNA-sequencing, real-time qPCR and RNA/chromatin immunoprecipitation were performed to analyse HOTAIR-mediated epigenetic regulation. ResultsA negative correlation between adipose tissue HOTAIR expression (arm or abdominal subcutaneous fat depots) and regional adiposity under the status of severe obesity or uraemia was observed. HOTAIR overexpression using human immortalized abdominal preadipocytes further revealed its anti-adipogenic effects. Integrative analysis of genome-wide DNA methylation by reduced representation bisulfite sequencing (RRBS) and gene expression was performed. Overall, the differentially methylated genes were functionally enriched for nervous system development, suggesting that HOTAIR may be epigenetically associated with cell lineage commitment. We specifically found that HOTAIR-mediated genes showed strong changes in both DNA methylation and gene expression during abdominal adipogenesis. We observed that two HOTAIR-repressed genes, SLITRK4 and PITPNC1, present an obesity-driven fat-depot specific expression pattern that is positively correlated with the central body fat distribution. ConclusionsOur study indicated that HOTAIR is a key regulator of abdominal adipogenesis via intricate DNA methylation and is likely to be associated with the transcriptional regulation of genes involved in nervous system development and lipid metabolism, such as SLITRK4 and PITPNC1.

Effect of General Adiposity and Central Body Fat Distribution on the Circulating Metabolome: A Multicohort Nontargeted Metabolomics Observational and Mendelian Randomization Study.

Obesity is associated with adverse health outcomes, but the metabolic effects have not yet been fully elucidated. We aimed to investigate the association between adiposity and circulating metabolites and to address causality with Mendelian randomization (MR). Metabolomics data were generated with nontargeted ultraperformance liquid chromatography coupled to time-of-flight mass spectrometry in plasma and serum from three population-based Swedish cohorts: ULSAM (N = 1,135), PIVUS (N = 970), and TwinGene (N = 2,059). We assessed associations of general adiposity measured as BMI and central body fat distribution measured as waist-to-hip ratio adjusted for BMI (WHRadjBMI) with 210 annotated metabolites. We used MR analysis to assess causal effects. Lastly, we attempted to replicate the MR findings in the KORA and TwinsUK cohorts (N = 7,373), the CHARGE Consortium (N = 8,631), the Framingham Heart Study (N = 2,076), and the DIRECT Consortium (N = 3,029). BMI was associated with 77 metabolites, while WHRadjBMI was associated with 11 and 3 metabolites in women and men, respectively. The MR analyses in the Swedish cohorts suggested a causal association (P value <0.05) of increased general adiposity and reduced levels of arachidonic acid, dodecanedioic acid, and lysophosphatidylcholine (P-16:0) as well as with increased creatine levels. The results of the replication effort provided support for a causal association of adiposity with reduced levels of arachidonic acid (P value = 0.03). Adiposity is associated with variation of large parts of the circulating metabolome; however, further investigation of causality is required in well-powered cohorts.

Pain sensitivity does not differ between obese and healthy weight individuals.

There is emerging evidence suggesting a relationship between obesity and chronic pain. The aim of this study was to determine whether pain-free obese individuals display altered pain responses to acute noxious stimuli, thus raising the possibility of greater pain sensitivity and potential susceptibility for chronic pain development. Psychophysical and anthropometric data were collected from 38 individuals with an obese body mass index (BMI) classification (BMI ≥ 30) and 41 age/sex-matched individuals of a healthy BMI (BMI < 24.9). Because BMI may be an inaccurate index of obesity, additional anthropometric parameters of central adiposity and percent body fat were examined. Pain responses to suprathreshold noxious heat and cold stimuli were examined. Subjects provided pain intensity and unpleasantness ratings to noxious heat (49°C) applied at varying durations and locations (ventral forearm/lower leg). Cold pain ratings, thresholds, and tolerances were obtained after immersion of the hand in a cold-water bath (0-2°C). Between-group differences in pain responses, as well as relationships between pain responses and obesity parameters, were examined. Importantly, confounds that may influence pain such as anxiety, depression, impulsivity, sleepiness, and quality of life were assessed. No between-group differences in pain sensitivity to noxious heat and cold stimuli were found. No relationships were found between central adiposity or body fat (percentage or distribution) and pain responses to noxious heat or cold stimuli. Obesity has minimal influence on pain sensitivity. Accordingly, it is unlikely that obesity alone increases susceptibility for chronic pain development through amplification of nociceptive processes.

Genomics of body fat distribution

Central obesity and body fat distribution measured by waist circumference (WC) and waist hip ratio (WHR) are good predictors of cardio metabolic adversities independent of overall adiposity. There are substantial evidence that body fat distribution is controlled by genetic factors. Even after accounting for body mass index (BMI), individual variation in body fat distribution is heritable, with estimates ranging from 31-76%. Individuals genetically predisposed to store more fat in visceral depots are at higher risk of developing metabolic complications. Several linkage and genomewide association studies (GWAS) for measures of body fat distribution uncovered numerous loci harbouring genes potentially regulating body fat distribution. Additionally, genes with fat depot specific expression patterns (especially, subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT)) have provided plausible candidate genes involved in body fat regulation. Further, sexual dimorphism have revealed a remarkable heterogeneity in the genetic regulation of body fat distribution. More than hundred loci have been identified through GWAS, displaying more pronounced effect in females than males, suggesting that both sexes share potentially different biological architecture in traits related to body fat distribution. Moreover, the handful of genes identified by GWAS have been validated in different population groups. This article aims at reviewing the current knowledge of genomic basis of body fat distribution.

Adverse Effects of Refeeding on the Plasma Lipidome in Young Individuals With Anorexia Nervosa?

Refeeding is the cornerstone of anorexia nervosa (AN) treatment, but little is known regarding the optimal pace and dietary composition or possible adverse effects of current clinical practices. Plasma lipids may be a moderating factor underlying unfavorable refeeding effects in AN, such as an abnormal central body fat distribution. The objective of this study was to analyze the plasma lipidome in the acutely underweight state of AN before and after refeeding. Using high-throughput quantitative mass spectrometry-based shotgun lipidomics, we measured 13 lipid classes and 204 lipid species or subspecies in the plasma of young female patients with acute AN, before (n= 39) and after (n= 23) short-term weight restoration during an intensive inpatient refeeding program (median body mass index [BMI] increase= 26.4%), in comparison to those in healthy control participants (n= 37). Before inpatient treatment, patients with AN exhibited increased concentrations of cholesterol and several other lipid classes. After refeeding, multiple lipid classes including cholesterol and ceramides, as well as certain ceramide species previously associated with obesity or overfeeding, showed increased concentrations, and a pattern of shorter and more saturated triacylgycerides emerged. A machine learning model trained to predict BMI based on the lipidomic profiles revealed a sizable overprediction in patients with AN after weight restoration. The results point toward a profound lipid dysregulation with similarities to obesity and other features of the metabolic syndrome after short-term weight restoration. Thus, this study provides evidence for possible short-term adverse effects of current refeeding practices on the metabolic state and should inspire more research on nutritional interventions in AN.

Methylome-wide association study of central adiposity implicates genes involved in immune and endocrine systems.

Aim: We conducted a methylome-wide association study to examine associations between DNA methylation in whole blood and central adiposity and body fat distribution, measured as waist circumference, waist-to-hip ratio and waist-to-height ratio adjusted for body mass index, in 2684 African-American adults in the Atherosclerosis Risk in Communities study. Materials & methods: We validated significantly associated cytosine-phosphate-guanine methylation sites (CpGs) among adults using the Women's Health Initiative and Framingham Heart Study participants (combined n=5743) and generalized associations in adolescents from The Raine Study (n=820). Results & conclusion: We identified 11 CpGs that were robustly associated with one or more central adiposity trait in adults and two in adolescents, including CpG site associations near TXNIP, ADCY7, SREBF1and RAP1GAP2 that had not previously been associated with obesity-related traits.

&lt;p&gt;Correlation Between Serum Uric Acid Level and Central Body Fat Distribution in Patients with Type 2 Diabetes&lt;/p&gt;

BackgroundThe aim of this study was to investigate the correlation between serum uric acid level and central body fat distribution in patients with type 2 diabetes (T2DM).MethodsA total of 867 patients with T2DM were enrolled. Measurements of central fat distribution were obtained by dual energy X-ray absorptiometry. Patients were stratified into three groups according to their levels of serum uric acid (SUA). Multiple linear regression analysis was used to determine the association between SUA and central body fat distribution. Logistic regression analysis was used to estimate the risk factors for hyperuricemia (HUA). Mediation analysis was applied to assess the overall, direct, and indirect mediators of SUA levels.ResultsMultiple linear regression analysis showed that SUA levels were significantly positively correlated with waist circumference (WC), body mass index (BMI), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), Android fat mass, Gynoid fat mass, fasting c-peptide (F-CP), and area under the curve of C-peptide (P < 0.05 for all). VAT [odds ratio (OR), 2.367; 95% confidence interval (CI), 1.078–5.197; P < 0.001)], WC (OR, 1.041; 95% CI, 1.011–1.072; P < 0.001), high-density lipoprotein (OR, 0.274; 95% CI, 0.104–0.727; P < 0.001), and estimated glomerular filtration rate (OR, 0.966; 95% CI, 0.959–0.973; P < 0.001) were found to be independent risk factors for T2DM patients with HUA. After mediation analysis, BMI and central obesity were found to have different partial effects on the association between SUA and F-CP (P < 0.001).ConclusionIn patients with T2DM, HUA was positively correlated with F-CP and central body fat distribution, especially VAT. These results suggest that central obesity may play a role in the positive correlation between HUA and insulin resistance (IR).

Increase in adiposity from childhood to adulthood predicts a metabolically obese phenotype in normal-weight adults.

Normal weight is associated with a favorable cardiometabolic risk profile and low risk of type 2 diabetes and cardiovascular disease. However, some normal-weight individuals-the "metabolically obese normal weight" (MONW)-show a cardiometabolic risk profile similar to the obese. Previous studies have shown that older age, central body fat distribution, and unfavorable lifestyle increase the risk of MONW. However, the role of early-life factors in MONW remains unknown. We examined the associations of early-life factors with adult MONW in 1178 individuals from the Cardiovascular Risk in Young Finns study who were followed up from childhood to adulthood. The strongest early predictor for adult MONW was an increase in BMI from childhood to adulthood (p = 3.1 × 10-11); each 1 SD increase in BMI z-score from childhood to adulthood led to a 2.56-fold increase in the risk of adult MONW (CI 95% = 1.94-3.38). Other significant predictors of adult MONW were male sex (OR = 2.38, 95% = 1.63-3.47, p = 7.0 × 10-6), higher childhood LDL cholesterol (OR = 1.41 per 1 SD increase in LDL cholesterol, CI 95% = 1.14-1.73, p = 0.001), and lower HDL cholesterol (OR = 1.51 per 1 SD decrease in HDL cholesterol, CI 95% = 1.23-1.85, p = 5.4 × 10-5). Our results suggest that an increase in adiposity from childhood to adulthood is detrimental to cardiometabolic health, even among individuals remaining normal weight.

ESTIMATED CENTRAL OBESITY INDEX – WORTHWHILE SCREENING TEST PROCEDURE OF ABDOMINAL OBESITY

Central obesity index (COI) is an indicator of central, abdominal obesity, which is the main characteristic of the metabolic syndrome. Dual-energy x-ray absorptiometric (DXA) assessment of the body fat distribution was performed through the COI values determined with a scan of the entire body in comparison to estimated COI values (eCOI) on spine and hip performed scans. COI was determined as a ratio of android (A) tissue percent fat (A-Tf%) and gynoid (G)-Tf% (COI=A/G-Tf%) as well as eCOI=eA/eG-Tf% in 3 groups of women: 1st group of women with Cushing’s syndrome (CS) (n=14), 2nd group of obese (O) women (n=21), 3rd group of non obese healthy women (C) (n=22). The examinees were not different according to their age, which was 44.32±13.83 years in the 1st group, 43.33±12.58 years in the 2nd group and 42.56±14.67 years in the 3rd group, as well as according to their BMI, which was 30.02±5.02 kg/m2 in CS, 29.66±4.88 kg/m2 in O, but it was in normal range 21.76±1.43 kg/m2 in non obese control group of healthy women.The values of eA, eG and eA/еG were not significantly different compared to the correspondent values A-Tf%, G-Tf% and A/G-Tf% in all examined groups (p&gt;0.05). The values of eA and A-Tf% in CS were significantly higher compared to O (P&lt;0.05), as well as compared to C and O+C and in O compared to C (p&lt;0.0001). COI value (1.05±0.15) and eCOI (1.04±0.1) in CS were significantly higher compared to O (p&lt;0.006 and p&lt;0.008) and highly significantly higher compared to C, O+C and in O compared to C (p&lt;0.0001). Estimated values eA, eG and eA/eG correlated highly significantly positively with the correspondent values A-Tf%, G-Tf% and A/G-Tf% (p&lt;0.0001) and COI values correlated highly significantly with eCOI, eA and A-Tf% (p&lt;0.0001) and not significantly with G-Tf% and eG (p&gt;0.05) in O confirming COI positive association with central, abdominal fat distribution.Conclusion: DXA indexes COI and eCOI discovered extreme central body fat distribution in CS women, differentiated them significantly and precisely from C and CO, and could be used as diagnostic DXA indexes of extreme central, abdominal obesity in CS and non CS abdominal obese women in DXA body composition and fat distribution assessment. Determination of eCOI is reliable, more practical and faster, with lower radiation and is more acceptable compared to COI, and it can be a routine screening procedure for body composition and body fat distribution assessment, during regular spine and hip scans for osteoporotic risk assessment instead of COI body fat distribution determination with total body composition measured scans which are used in scientific studies and are not necessary to be performed in clinical body fat distribution examinations.

P3823Body mass index or waist and hip circumference as predictors of outcome in the UK biobank

Abstract Background Controversies exist about the relationship between body habitus and mortality, especially for patients with cardiovascular disease. Purpose We evaluated the relations between different anthropometric indices and mortality amongst participants with and without cardiovascular (CV) risk factors, or established CV disease (stroke, myocardial infarction and/or heart failure), enrolled in the UK Biobank. Methods The UK Biobank is a large prospective study which, between 2006 and 2010, enrolled 502,620 participants aged 38–73 years. Participants filled questionnaires and had a medical history recorded, physical measurements done and biological samples taken. The UK Biobank is routinely linked to national death registries and updated on a quarterly basis. Data on death were coded according to the International Classification of Diseases, 10th Revision (ICD-10). The primary end-point was all-cause mortality (ACM) across three subgroups of men and women: those with, or without, one or more CV risk factors (smoking, diabetes and/or hypertension), and those with CV disease (history of stroke, myocardial infarction and/or heart failure) at recruitment. Presence, or absence, of CV risk factors and diagnoses of CV disease were self-reported by participants at enrolment. Associations between anthropometric indices (body mass index (BMI), waist circumference (WC), waist to hip ratio (WHiR), and waist to height ratio (WHeR)) and the risk of all-cause mortality were analysed using Cox regression models. Results After excluding those with history of cancer at baseline (n=45,222), 453,046 participants were included (median age: 58 (interquartile range: 50 - 63) years; 53% women), of whom 150,732 had at least one CV risk factor, and 17,884 established CV disease. During a median follow-up of 5 years, 6,319 participants died. Baseline BMI had a U-shaped relationship with ACM, with higher nadir-values for those with CV risk factors or CV disease, for both sexes (figure). WC, WHiR and WHeR (measures of central distribution of body fat) had more linear associations with ACM, regardless of CV risk factors, CV disease and sex. Conclusions For adults with or without CV risk factors or established CV disease, measures of central distribution of body fat are more strongly and more linearly associated with ACM than BMI. WC, or WHiR, rather than BMI, appear to be more appropriate variables for risk stratification.

Central and peripheral body fat distribution: Different associations with low-grade inflammation in young adults?

Background and aimsEvidence regarding the impact of regional body fat distribution on low-grade inflammation is limited. The current study examined the association of central and peripheral body fat distribution and low-grade inflammation levels in young adults, considering collinearity between variables. Methods and resultsA cross-sectional analysis of 809 adults (aged 27 years) was conducted as part of the EPITeen cohort, Porto, Portugal. Regional body fat was measured by dual-energy X-ray absorptiometry scan (DXA) and serum high-sensitivity C-reactive protein (hsCRP) was measured in a fasting blood sample. OLS (ordinary least squares) and LASSO (least absolute shrinkage and selection operator) regression models were fitted to estimate the association of trunk and peripheral fat with hsCRP, stratified by sex. Using OLS regression, trunk fat in females was positively associated with ln(hsCRP) (β1 = 0.064, 95% CI 0.018; 0.109). The effect of peripheral fat on ln(hsCRP) was shown not to be significantly different from trunk fat (β2 = −0.011, 95% CI −0.110; 0.089), but no statistically significant association was observed (β3 = 0.053, 95% CI −0.004; 0.110) between peripheral fat and ln(hsCRP). In males, trunk fat also showed a positive association with ln(hsCRP) (β1 = 0.104, 95% CI 0.055; 0.154), and the effect of peripheral fat on ln(hsCRP) was shown to be significantly different from trunk fat (β2 = −0.124, 95% CI −0.237;−0.011). However, the association between peripheral fat and ln(hsCRP) did not reach statistical significance (β3 = −0.020, 95% CI −0.086; 0.046). The results of OLS were confirmed by LASSO regression. ConclusionA higher fat deposited in the trunk was positively associated with hsCRP, whereas no statistically significant effect was observed for peripheral fat.

Subtle metabolic alterations in adolescents with obesity and polycystic ovarian syndrome.

To evaluate the frequency of some subtle metabolic alterations in a group of adolescents with obesity and polycystic ovary syndrome (PCOS). A cross-sectional, comparative study was conducted in a group of adolescents with obesity, and characterized as with or without PCOS according with the Rotterdam Consensus. Medical history, anthropometry, gynecologic pelvic ultrasound (to evaluate ovarian volumes, number of antral follicles and endometrial width), as well as serum glucose, insulin, lipoproteins, interleukin-6, tumor necrosis factor alpha, total testosterone, dehydroepiandrosterone, sexual hormones binding globulin, leptin, adiponectin and insulin-like growth factor 1, the free-androgen index, free and available testosterone, and homeostatic model assessment index were calculated. For statistics, mean and standard deviation, or median and ranges were used for description as appropriate. Likewise, Student t-test or Mann-Whitney test were used for comparisons. From a sample of 180 adolescents, 47 attached to selection criteria. Mean age was 13.5 year and Z-score 2.5. Eighty percent of adolescents presented central distribution of body fat and 95% hyperinsulinemia. The more frequent dyslipidemias were hypertriglyceridemia in 57% and hypercholesterolemia in 12.8%; 25.5% of adolescents presented two out of three criteria for polycystic ovary syndrome (PCOS). Body mass index and insulin were correlated with free testosterone, but the multivariate analysis demonstrated that the magnitude of the association was significantly higher in SOP patients. The metabolic alterations detected in obese adolescents with SOP suggest that the clinical manifestations that accompany the syndrome characterize the PCOS as a metabolic disease, which carry important health risks at short, medium and long term. Therefore, they merit intervening actions to prevent, diagnose and provide timing treatment in order to limit the damage in the course of the natural history of PCOS.

Long-Term Weight-Loss Lifestyle Modification Programme in a Patient with Severe Lumbar Intervertebral Disc Degeneration and Obesity: A Case Report

Obesity is a growing health problem worldwide, associated with serious medical and psychosocial comorbidities that increase the risk of mortality. Strong evidence confirms lifestyle modification programmes as the cornerstone of its treatment. However, the available long-term lifestyle modification programmes for weight management delivered in Arabic-speaking countries seem to be lacking in effectiveness in terms of weight-loss maintenance and do not conform to the standard for clinical significance. Factors such as methodological weaknesses in programme transcultural adaptation and the lack of expert clinical supervision before and during implementation seem to underlie this discrepancy. In this case report, we describe for the first time an Arabic-speaking patient with obesity and severe lumbar intervertebral disc degeneration, who successfully underwent weight management by means of a new, well-adapted and well-implemented personalized cognitive behavioural programme for obesity (CBT-OB). After eighteen months, the patient displayed significant weight-loss maintenance (~16% weight-loss), improvement in total and central body fat distribution, reduced pain from disc degeneration, and an increase in high-density lipoprotein (HDL). The CBT-OB programme may be a feasible approach to managing Arab patients with obesity, producing long-lasting weight-loss maintenance improvements in the obesity-related profile.

Dietary weight loss in insulin-resistant non-obese humans: Metabolic benefits and relationship to adipose cell size

Background and AimsOverweight and obesity increase risk for diabetes and cardiovascular disease, largely through development of insulin resistance. Benefits of dietary weight loss are documented for obese individuals with insulin resistance. Similar benefits have not been shown in overweight individuals. We sought to quantify whether dietary weight loss improves metabolic risk profile in overweight insulin-resistant individuals, and evaluated potential mediators between weight loss and metabolic response. Methods and ResultsHealthy volunteers with BMI 25–29.9 kg/m2 underwent detailed metabolic phenotyping including insulin-mediated-glucose disposal, fasting/daylong glucose, insulin, triglycerides, FFA, and cholesterol. Subcutaneous fat biopsies were performed for measurement of adipose cell size. After 14 weeks of hypocaloric diet and 2 weeks of weight maintenance, cardiometabolic measures and biopsies were repeated. Changes in weight, % body fat, waist circumference, adipose cell size and FFA were evaluated as predictors of change in insulin resistance.Weight loss (4.3 kg) yielded significant improvements in insulin resistance and all cardiovascular risk markers except glucose, HDL-C, and LDL-C. Improvement in insulin sensitivity was greater among those with <2 vs >2 cardiovascular risk factors at baseline. Decrease in adipose cell size and waist circumference, but not weight or body fat, independently predicted improvement in insulin resistance. ConclusionsWeight loss yields metabolic health benefits in insulin-resistant overweight adults, even in the absence of classic cardiovascular risk factors. Weight loss-related improvement in insulin sensitivity may be mediated through changes in adipose cell size and/or central distribution of body fat. The insulin-resistant subgroup of overweight individuals should be identified and targeted for dietary weight loss. Clinical trials identifierNCT00186459.

Central and Peripheral Body Fat Distribution on Insulin Resistance of Young Obese Women

Studies have shown that excess of fat in central region is the main substrate for pathophysiological alterations that leads obesity‐associated insulin resistance. Lately, in the medical practice the use of the waist circumference (WC) instead waist‐to‐hip ratio (WHR) is more usual. We hypothesized that WHR is a better tool to infer insulin resistance in young obese women. The aim of this study was to evaluate the insulin‐sensitive/insulin‐resistant in young obese women within central and peripheral body fat distribution. We studied 61 young obese women (BMI 30 to 40 kg/m2) with WC ≥ 88 cm and without comorbidities. They were divided into: with central fat distribution (CF), defined as waist‐to‐hip ratio (WHR) ≥ 0.85 cm (n=30, 33±7 y), and with peripheral fat distribution (PF) with WHR &lt; 0.85 cm (n=31, 33±6 y). All volunteers were submitted to anthropometric, glycemic and insulin measurements and indexes: fasting, HOMA‐IR, QUICKI and area under the curve (AUC) during the Oral Glucose Tolerance Test (OGTT) to assess the insulin sensitivity. Despite the fat distribution, CF and PF shown similar anthropometric measures (weight= 86.8±8.5 vs.87.6±8.3 kg, WC= 109±6 vs.106±8 cm, BMI= 33.2±2.7 vs. 33.7±2.4 kg/m2; respectively, p&gt;0.05). Also, both obese groups, CF and PF, showed normal fasting glucose (84±10 vs. 82±10 mg/dL, p=0.420), based in the IDF criteria (&lt;100mg/dL). However, the group CF compared with PF presented elevated fasting insulin (17.8±8.2 vs. 12.6±6.8 uUI/mL, p=0.008), HOMA‐IR (3.7±1.9 vs. 2.6±1.6 uUI/mL, p=0.011), reduced QUICKI (0.322±0.025 vs. 0.340±0.025, p=0.007). Furthermore, the group CF compared with PF had lower insulin sensitivity as AUCglucose/AUCinsulin ratio from OGTT (1.42±0.67 vs. 2.12±0.86, p=0.001). In conclusion, our data demonstrated that in young obese women with similar WC and fasting glucose, the central body fat distribution increase insulin‐resistant, emphasizing the importance in used the waist‐to‐hip ratio as important tool for identify the additional risk factor in obesity young women.Support or Funding Information#Universidade Nove de Julho (UNINOVE), SP ‐ Brazil.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.