Central Pattern Of Fat Distribution Research Articles

Pattern of body fat distribution in patients of PCOS using DEXA-based indices

BackgroundConsidering the close link between polycystic ovary syndrome (PCOS) and metabolic syndrome considerable research has been devoted to studying the pattern of fat distribution in PCOS.ObjectivesThe study aims to assess the usefulness of dual-energy X-ray absorptiometry (DEXA) based regional fat distribution indices as a predictor of the development of PCOS.MethodsThis case–control study recruited diagnosed cases of PCOS using Rotterdam Criteria (cases n = 86) and healthy age-matched controls (n = 90). DEXA was performed in both groups for assessment of total and regional body fat distribution after undergoing ultrasonography (USG) and baseline/biochemical evaluation.ResultsThe study revealed a significant difference between cases and controls in trunk fat percentage (40.2% ± 9.1% vs 26.5% ± 9.1%; p < 0.001), android fat percentage (42.4% ± 41%vs 27.8% ± 1.51%; p < 0.001), total fat percentage (43.8% ± 8% vs28.5% ± 1.6%; p < 0.001), fat mass/ht2 (fat mass index) (8.82 ± 3% vs 4.8 ± 1.7%; p < 0.001), android/gynoid ratio (1.05 ± 0.1 vs 0.7 ± 0.2; p < 0.001), and trunk/limb fat mass ratio (1.06 ± 0.3 vs 0.69 ± 0.3; p 0.001). Multivariate analysis revealed a significant relation of trunk fat mass with android % fat, gynoid fat mass, and android-gynoid ratio.ConclusionsThe study demonstrates that there is a central pattern of fat distribution in patients with PCOS while the overall fat might not be increased which is well analyzed by DEXA. Hence, we suggest its use in the initial diagnostic workup and follow-up of PCOS patients for their body fat distribution and content.

A Study to Correlate Waist Circumference (WC) and Peak Expiratory Flow Rate (PEFR) in Overweight Women: A Correlational Study

Background and objective:Obesity is a major health issue and there is steady trend of increasing obesity over the pastseveral decades. Obesity can alter the respiratory function and may impair the health of an individual. Althoughseveral factors such as respiratory muscle strength, lung compliance, resistance to airflow and even obesity affectthe lung functions, the nature of relationship with markers of adiposity, the role of body fat distribution hasreceived limited attention. So the objective of this study was to correlate PEFR and WC in overweight women.Methods: 100 overweight women whose BMI was 25-29.9 kg/m2, who fulfill the inclusion and exclusion criteria,aged between 20-50 years were selected for the study. Waist circumference (WC) and Peak expiratory flow rate(PEFR) of all the subjects were measured. Results: Data were analyzed using Spearman’s correlation coefficient.The result showed non- significant correlation (p=0.057) (r = -0.057) between PEFR and WC in overweight women.Conclusion: The study concluded that obesity, measured as WC did not significantly affect the PEFR in youngoverweight females in the age group of 20 to 50 years. A central pattern of fat distribution, as measured by WCalone was not associated with lower values for PEFR in young female overweight adults.

Adiposity: Determinant of Peak Expiratory Flow Rate in Young Indian Adults Male

Although several factors such as respiratory muscle strength, lung compliance, resistance to airflow, and even obesity affect the lung functions, the nature of relationship with markers of adiposity is not clear. We hypothesised that central pattern of fat distribution is a significant predictor of decreased peak expiratory flow rate (PEFR). The present study was designed with the aim to examine the effects of adiposity on PEFR in males. One hundred young healthy male volunteers were analysed in the study. They were classified into non-obese, and obese groups based on body mass index (BMI) (obese > or = 30 Kg/m2 and non-obese < 30 Kg/m2). The PEFR was measured by using Wright's peak flow meter. Data was analysed using unpaired 't' test for statistical significance of differences between the non-obese and the obese, stratified into age groups of 20 to 30 years and 30 to 40 years. A partial correlation adjusted to age, height and BMI followed by regression analysis was conducted using adiposity markers as a predictor of PEFR. The model adjusted to age, height, weight and BMI revealed waist hip ratio (WHR) as the only parameter which shows significant variance in PEFR with a Pearson's r=-0.59, F (1, 100)=12.23, p=0.04. The resulting linear regression equation is y=-388.72xWHR+850.68. Our findings suggest that obesity itself and especially the pattern of body fat distribution have independent effects on PEFR. These results suggest that abdominal adiposity, measured as WHR, is a better predictor of expiratory flow than weight or BMI.

Body fat distribution in Italian, Spanish and Estonian children

Obesity, and especially abdominal obesity, is associated with increased risk of a number of cardiovascular and metabolic diseases. Many disturbances related to abdominal obesity show their onset in the childhood years. Thus, during these years, it’s important to properly monitor body fat and its distribution. The aim of this study was to investigate the fat patterning in Italian, Estonian and Spanish schoolchildren. The sample consisted of 2024 children (1005 boys and 1019 girls) aged 6 to 11 years. Anthropometric measurements included triceps, biceps, subscapular, supraspinal, suprailiac, thigh, medial and lateral calf skinfold thicknesses, height and humerus width. Two indices of central adiposity and one frame index were calculated. Italian children of both sexes showed higher values of skinfold thicknesses than Estonian and Spanish children, while Spanish children showed overall higher values of central adiposity indexes, followed by Italian children. On the contrary, Estonian children showed higher values of the frame index and lower central adiposity. From a public health perspective, a priority will be the development of programs aiming to prevent obesity, in particular when a central pattern of fat distribution emerges during childhood.

Impact of adiposity markers on Peak expiratory flow rate in young adult South Indian females

Background: Even though several factors like respiratory muscle strength, lung compliance, resistance to airflow, and elastic recoil of lungs determine lung functions, physical factors such as height, weight and central pattern of fat distribution also affect the pulmonary functions. Objective: The present study was done to assess the impact of both general as well as central adiposity markers on PEFR in young adult females. Materials and Methods: The study was conducted on 186 healthy young female medical students in the age group of 18-22 years. The study group was divided into three groups based on BMI (as per WHO Asian guidelines). Those with BMI between 18.5 to 22.9 kg/m 2 were considered as normal weight individuals, those having a BMI of 23-24.9 kg/m 2 were taken as overweight individuals and those with a BMI more than 25 were considered as obese. Waist circumference (WC), Waist to hip ratio (WHR) and waist to height ratio were also calculated; these serve as measures for central pattern of fat distribution. PEFR was recorded with Wright's peak flow meter and the best of three readings was considered. The data obtained was statistically analyzed using one way ANOVA and Pearson's correlation tests. A P-value less than 0.05 was considered as significant. Results: Mean value of PEFR did not show significant differences when compared between three groups. On correlation a negative association of various adiposity markers with PEFR was observed and was more related with central adiposity markers than BMI. Conclusion: Our findings suggest that obesity itself and especially the pattern of body fat distribution have independent effects on PEFR in young adult females. Abdominal adiposity may influence pulmonary functions by restricting the descent of the diaphragm and limiting lung expansion as compared to overall adiposity which may compress the chest wall.

The Relationship of Body Fatness and Body Fat Distribution with Microvascular Recruitment: The Amsterdam Growth and Health Longitudinal Study

Microvascular function has been proposed to link body fatness to CVD and DM2. Current knowledge of these relationships is mainly based on studies in selected populations of extreme phenotypes. Whether these findings can be translated to the general population remains to be investigated. To assess the relationship of body fatness and body fat distribution with microvascular function in a healthy population-based cohort. Body fatness parameters were obtained by anthropometry and whole-body dual-X-ray absorptiometry (DEXA) in 2000 and 2006. Microvascular recruitment (i.e., absolute increase in perfused capillaries after arterial occlusion, using nailfold capillaroscopy) was measured in 2006. Linear regression analysis was used to examine the relationship of (changes in) body fatness and body fat distribution with microvascular recruitment. RESULTS Data were available for 259 participants (116 men). Capillary density was higher in women than in men (difference 7.3/ mm(2); p < 0.05). In the total population, the relationship between total body fatness and microvascular recruitment was positive (β = 0.43; p = 0.002), whereas a central pattern of fat distribution (trunk-over-total fatness) showed a negative relationship (β = -26.2; p = 0.032) with microvascular recruitment. However, no association remained apparent after adjustment for gender. In addition, there was no relationship between 6-year changes in body fatness or fat distribution and microvascular recruitment. Women show higher capillary recruitment values than men. This study does not support a linear relationship between microvascular function and body fatness or body fat distribution within a population-based normal range.

Body Composition as Determinant of Thrombin Generation in Plasma

The association between obesity and cardiovascular disease and venous thromboembolism might, at least partially, be explained by a hypercoagulable state. The extent to which body fat mass and its distribution contribute to a hypercoagulable state is unknown. In this study, we investigated the association between body composition and thrombin generation and evaluated the potential mediating role of low-grade inflammation. We studied 586 individuals from the Hoorn Study (mean age, 69.7 ± 6.5 years, 298 women) in whom body composition was assessed by whole body dual-energy absorptiometry. Thrombin generation was measured using the calibrated automated thrombogram. Multiple regression analyses showed a positive association between total body fat and thrombin generation in women but not in men. In addition, detailed analyses of regional body composition showed that central but not peripheral fat mass was associated with greater thrombin generation and that there was a trend toward an inverse association with peripheral lean mass. The reported positive associations were partially attenuated by low-grade inflammation, however. Body fat mass, in particular a central pattern of fat distribution, is associated with higher levels of thrombin generation in elderly women but not in men. This association may partially be explained by adiposity-related low-grade inflammation, but this hypothesis needs to be further investigated in mechanistic/prospective studies.

Body fat distribution and C-reactive protein – a principal component analysis

Background and Aims To assess, using principal component analysis, the independent associations of general, central and peripheral subcutaneous fat with high-sensitivity C-reactive protein (hs-CRP), in men and women from the general population. Methods and results We studied 833 women and 486 men, randomly selected from the non-institutionalized population of Porto, Portugal, with information on hs-CRP (≤10 mg/l) and anthropometrics (1999–2003). Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and a skinfold composite index to estimate the proportion of arm subcutaneous fat (PSFA), were ascertained by trained personnel. Beta regression coefficients were obtained from generalized linear models with adjustment for the main confounders. Direct associations were found between BMI, WC, WHR and hs-CRP. PSFA was inversely associated with hs-CRP in women ( β ˆ = −0.080, p-trend = 0.010). Since the anthropometric measures were strongly correlated, we used principal component analysis to identify new independent anthropometric factors. The first one, representing a generalized fat distribution (high BMI and WC), was directly associated with hs-CRP ( β ˆ = 0.226, p-trend < 0.001 in women; β ˆ = 0.138, p-trend = 0.002 in men). The second factor, characterized by a high PSFA, showed an inverse association with hs-CRP in women ( β ˆ = −0.071, p-trend = 0.048). The third factor, representing a central pattern of fat distribution (low BMI, but high WC and high WHR), was directly associated with hs-CRP in men ( β ˆ = 0.090, p-trend = 0.005). Conclusion A central pattern of fat distribution is directly associated with hs-CRP levels in men, while a high proportion of peripheral subcutaneous fat seems to be inversely associated with hs-CRP, but only in women.

Postnatal growth in children born small and appropriate for gestational age during the first years of life

The aim of the study was to evaluate growth pattern of small- and appropriate-for-gestational-age children and to identify prenatal and postnatal risk factors for short stature and development of components of metabolic syndrome. A total of 109 small- and 239 appropriate-for-gestational-age infants were enrolled in the study. Within 24 hours after birth and at 2, 5, 9, 12, 18, 24 months, and 6 years of age, anthropometric data were recorded for study children. Cord blood samples from study infants were collected, and insulin-like growth factor-1 (IGF), IGF-binding protein-3, and leptin levels were measured. Birth weight and height (P<0.001) and insulin-like growth factor-1, IGF-binding protein-3, and leptin levels (P<0.05) were lower in children born small for gestational age vs. children born appropriate for gestational age. At 2, 5, 12, 18, and 24 months and 6 years of age, children born small for gestational age remained shorter and weighed less (P<0.001). Waist-to-hip ratio, heart rate at 6 years of age and gain in body mass index from birth up to 6 years of age was higher in children born small for gestational age. Height gain during the first year of life was mainly influenced by birth length and target height. Maternal weight before pregnancy and cord leptin levels were the most significant factors influencing postnatal weight gain during the first years of life. During the first 6 years of life, children born small for gestational age remained shorter and lighter. A greater catch-up in body mass index and tendency towards central pattern of fat distribution during the first years of life might be predisposing factors for the development of long-term metabolic complications in these individuals.

The influence of birthweight and intrauterine environment on adiposity and fat distribution in later life.

To review the literature on the association between birthweight and body mass index (BMI) and obesity in later life. Included in the review were papers appearing in Medline since 1966 and identified using the search terms obesity, body fat, waist, body constitution, birthweight and birth weight. Further papers were identified by examining bibliographies. There is good evidence that there is an association between birthweight and subsequent BMI and overweight in young adults and children, which is linear and positive in some studies and J- or U-shaped in others. The evidence is less strong for middle-aged subjects. Studies that have assessed lean body mass (LBM) and fat body mass have tended to find that birthweight is positively associated with LBM and negatively associated with relative adiposity. This suggests that the association between birthweight and BMI/overweight does not necessarily reflect increased adiposity at higher birthweights. On controlling for current body mass there is fairly consistent evidence of a negative association between birthweight and a central pattern of fat distribution as measured by central:peripheral skinfold ratios. It has been suggested that the prenatal period is a 'critical' period for the development of adiposity, but it is unclear how far associations between birthweight and subsequent body habitus are genetic in origin and how far they result from intrauterine 'programming'. Two lines of evidence would suggest that the association is predominantly genetic. Studies of monozygotic twins have found environmentally determined differences in birthweight to be unrelated to subsequent BMI, and the association between birthweight and BMI is substantially reduced on controlling for parental BMI. However, some evidence of an influence of intrauterine environment on later obesity comes from studies of subjects who were exposed in utero to the effects of diabetes, famine conditions or smoking. The reasons for the positive association between birthweight and BMI remain unclear. More studies including accurate measurement of body composition are needed to assess how far this relation is accounted for by changes in fat mass or by changes in lean mass. Studies with accurate measures of parental BMI would also be useful in assessing the importance of this confounder.

A central body fat distribution is related to renal function impairment, even in lean subjects

Background: Overweight and obesity are believed to be associated with renal damage. Whether this depends on fat distribution is not known. We hypothesize that in addition to overweight, fat distribution may be associated with renal function abnormalities. Methods: We studied the relation between body weight and fat distribution and microalbuminuria and elevated or diminished filtration in 7,676 subjects without diabetes. Microalbuminuria is defined as urinary albumin excretion (UAE) of 30 to 300 mg/24 h. Elevated and diminished filtration are defined as filtration plus or minus 2 SDs of a nondiabetic lean group with a peripheral fat distribution and UAE of 0 to 15 mg/24 h, corrected for age and sex. The total population was divided into six groups according to body weight (overweight is defined as body mass index [BMI] > 25 and ≤ 30 kg/m2; obesity, as BMI > 30 kg/m2) and fat distribution. Results: In logistic regression analysis, obese subjects with central fat distribution had a greater risk for microalbuminuria (relative risk, 1.7; 95% confidence interval, 1.19 to 2.35). Obese subjects with either peripheral or central fat distribution had a greater risk for elevated filtration (relative risk, 3.2; 95% confidence interval, 1.19 to 8.47; relative risk, 2.6; 95% confidence interval, 1.59 to 4.28, respectively). Furthermore, subjects with central fat distribution, either lean, overweight, or obese, had a greater risk for diminished filtration (relative risk, 1.9; 95% confidence interval, 1.19 to 3.12; relative risk, 2.0; 95% confidence interval, 1.19 to 3.19; and relative risk, 2.7; 95% confidence interval, 1.46 to 4.85, respectively). Finally, by dividing waist-hip ratio (WHR) into quartiles, greater WHR was associated with a greater risk for diminished filtration, even when corrected for BMI. Conclusion: Not only overweight and obese subjects, but also lean subjects with central fat distribution are at risk for diminished filtration. Therefore, a central pattern of fat distribution, not overweight or obesity by itself, seems to be important for renal impairment.

Secular changes in body fat patterning in children and adolescents of Zaragoza (Spain), 1980-1995.

To examine whether children and adolescents of Zaragoza (Spain) are becoming centrally obese to a greater extent than would be predicted by their relative body weights. Two cross-sectional surveys conducted in 1980 and 1995. The samples selected for the 1980 and 1995 surveys comprised 1553 and 701 male children, and 1311 and 659 female children, respectively, with ages ranging from 6.0 to 14.9 y. We measured four skinfold thicknesses (biceps, triceps, subscapular, suprailiac) and calculated some indices of fat patterning: triceps/subscapular skinfolds (T/SS), biceps+triceps/subscapular+suprailiac skinfolds (B+T/SS+SI), and (subscapular+suprailiac/biceps+triceps+subscapular+suprailiac skinfolds)x100 (trunk-to-total skinfolds %). In males, B+T/SS+SI, and trunk-to-total skinfolds % showed a significant trend to a central pattern of fat distribution from 1980 to 1995, at the ages of 6.5-11.5 y. In females, B+T/SS+SI and trunk-to-total skinfolds % showed a significant trend to a central pattern of fat distribution from 1980 to 1995, at the ages of 6.5 and 7.5 y. Similar results were obtained when we adjusted for BMI values. We have observed a trend to a central pattern of adipose tissue distribution, especially in males and at the youngest ages studied (6-11 y in males, and 6-7 y in females). These observations were independent of trends in BMI.

Fat distribution and plasma lipid-lipoprotein concentrations in pre- and postmenopausal women.

In the postmenopausal years, women develop a central pattern of fat distribution and an increased risk of developing cardiovascular disease (CVD). The possibility that these events are related has not been extensively investigated. The object of the present study was to test the hypotheses that, 1) menopause-related differences in lipids are associated with greater estimated intra-abdominal adiposity, and 2) the relationship between individual adipose depots and plasma lipids differs with menopausal status. Cross-sectional. 141 healthy pre- and postmenopausal women aged 35-65 y. Total body fat by hydrodensitometry was used as an index of whole-body adiposity, the sum of five central skinfold measurements as an index of subcutaneous upper-body adiposity, and estimated intra-abdominal adipose tissue (IAF) as an index of visceral adiposity. Fasting plasma concentrations of total cholesterol (total-C), high- and low-density-lipoprotein cholesterol (HDL-C, LDL-C), and triglycerides were used as indices of CVD risk. Postmenopausal women had greater total body fat (P < 0.001), summed central skinfolds (P < 0.01), estimated IAF (P < 0.001), higher plasma concentrations of total-C (P < 0.001), LDL-C (P < 0.001) and triglycerides (P < 0.001), than premenopausal women. The relationship between central skinfolds and LDL-C differed with menopausal status, being significant in pre- but not postmenopausal women. Adjustment for estimated IAF with analysis of covariance decreased menopause-related differences in levels of total-C, LDL-C and triglycerides by approx 40-70%. These observations suggest that, 1) menopause-related changes in IAF may adversely affect the plasma lipid profile, and 2) menopausal status affects the relationship between central subcutaneous fat and LDL-C. Studies with measured IAF are needed to confirm present results.

Visceral adipose tissue impairs insulin secretion and insulin sensitivity but not energy expenditure in obesity

In obesity, a central pattern of fat distribution is mostly associated with hyperinsulinemia, insulin resistance, and hyperlipemia, thus promoting the development of non-insulin-dependent diabetes mellitus and cardiovascular disease. In addition, in obesity, changes in energy expenditure are hypothesized to be involved in the development or maintenance of excessive body fat storage. In this study, abdominal fat distribution by computed tomographic (CT) scan was used to study the relation between the visceral fat depot, insulin secretion, and insulin sensitivity in a group of obese subjects with normal glucose tolerance (n = 26; body mass index [BMI], 39 ± 1 kg/m 2) and a group of normal-weight control subjects (n = 9; BMI, 23 ± 1 kg/m 2). The minimal model method was used to assess insulin sensitivity, S I, and first-phase (Φ1) and second-phase (Φ2) β-cell sensitivity from plasma glucose, insulin, and C-peptide concentrations measured during an intravenous glucose tolerance test ([IVGTT] 0.33 g/kg body weight). Moreover, we evaluated the relationships between these parameters and the resting metabolic rate (RMR) and glucose-induced thermogenesis (GIT) measured by indirect calorimetry. The data show the following: (1) in obese subjects, (Φ1) is greater but not statistically different from the value in control subjects (252 ± 41 v 157 ± 25 dimensionless 10 9); (2) Φ2 is significantly higher in obese subjects (27 ± 4 v 14 ± 2 min −1 × 10 9, P < .05), with a positive correlation between the amount of visceral adipose tissue (VAT) and Φ2 ( r = .49, P < .05); (3) S l is decreased in the obese group (2.8 ± 0.3 v 9.7 ± 1.6 10 −4 · min −1/(μU · mL −1), P < .0001), with a negative correlation of S l, with the adiposity index BMI ( r = −.67, P < .0001) and VAT ( r = −.56, P < .05); (4) RMR, expressed in absolute terms, was significantly increased in obese versus lean subjects (5.9 ± 0.2 v 4.6 ± 0.3 kJ/min, P < .01), whereas when RMR was adjusted for fat-free mass (FFM), the difference between the two groups disappeared (0.09 ± 0.003 v 0.09 ± 0.002 kJ/min · kg FFM). We did not observe any difference in GIT between lean and obese subjects. Moreover, GIT was significantly correlated with FFM ( r = .69, P < .005), but not with BMI. The amount of VAT did not correlate with RMR or GIT. In conclusion, these results suggest that in obese subjects with normal glucose tolerance, insulin sensitivity is impaired and the β-cell hyperresponse to glucose is mainly due to an enhanced second-phase β-cell secretion. The degree of visceral fat deposition seems to affect insulin secretion and worsens insulin sensitivity, but does not influence energy expenditure.

Diabetes mellitus and macrovascular complications. An epidemiological perspective.

It is clearly recognized that patients with NIDDM have an increased risk for CHD. Recent data indicate that persons with glucose concentrations in the nondiabetic range also may be at higher risk for CHD. These associations may not represent cause and effect, however. Emerging data suggest that hyperglycemia and CHD may both arise from hyperinsulinemia/insulin resistance. In support of this hypothesis are studies showing that NIDDM and CHD have many risk factors in common, including age, elevated blood pressure, dyslipidemia, adiposity, and a central pattern of fat distribution. Moreover, these risk factors are frequent concomitants of hyperinsulinemia, itself a risk factor for CHD and perhaps for NIDDM. Although the duration of NIDDM has been infrequently related to risk of CHD, the authors hypothesize that duration of hyperinsulinemia/insulin resistance would be a more sensitive marker for risk of CHD. The relation of IDDM to CHD is a different situation. The etiological process leading to IDDM, namely the destruction of beta-cells in genetically predisposed persons, is not related to cardiovascular risk. However, IDDM patients still have an excess of CVD, the risk factors for which may vary according to the location of the diseases (e.g., LEAD vs. CHD). There is a strong relationship between proteinuria and CVD, which has led to a general theory of vascular complications in IDDM based on defective heparan sulfate metabolism (Steno hypothesis). Recent evidence challenges parts of this hypothesis, and the possibility is raised that a higher case-fatality rate in a subgroup of patients with both renal and CVD explains part of the renal connection, as does the general worsening of CVD risk factors.