Subcutaneous Fat Distribution Research Articles

5-HT2CRs Expressed by Pro-Opiomelanocortin Neurons Regulate Energy Homeostasis

SummaryDrugs activating 5-hydroxytryptamine 2C receptors (5-HT2CRs) potently suppress appetite, but the underlying mechanisms for these effects are not fully understood. To tackle this issue, we generated mice with global 5-HT2CR deficiency (2C null) and mice with 5-HT2CRs re-expression only in pro-opiomelanocortin (POMC) neurons (2C/POMC mice). We show that 2C null mice predictably developed hyperphagia, hyperactivity, and obesity and showed attenuated responses to anorexigenic 5-HT drugs. Remarkably, all these deficiencies were normalized in 2C/POMC mice. These results demonstrate that 5-HT2CR expression solely in POMC neurons is sufficient to mediate effects of serotoninergic compounds on food intake. The findings also highlight the physiological relevance of the 5-HT2CR-melanocortin circuitry in the long-term regulation of energy balance.

Distribution of Subcutaneous Fat Predicts Insulin Action in Obesity in Sex‐specific Manner

The pattern of adipose tissue (AT) distribution is an important predictor of metabolic risk. The aim of this study was to analyze the association of peripheral (insulin-mediated glucose disposal--M) and hepatic (suppression of endogenous glucose production--EGP) insulin action with abdominal (subcutaneous abdominal AT-SAAT intraabdominal AT-IAAT) and thigh AT depots in obese individuals. Fifty-seven Pima Indians with normal glucose tolerance underwent magnetic resonance imaging (MRI) and euglycemic-hyperinsulinemic clamp. M was negatively related to intraperitoneal IAAT (P = 0.02) and deep SAAT (P = 0.03). Suppression of EGP was negatively related to total (P < 0.05) or deep SAAT (P < 0.05 and P = 0.01, respectively), and total or intraperitoneal IAAT (P = 0.009 and P = 0.002, respectively). A significant interaction with sex was found in the association between superficial SAAT and M, so that in women, but not men, M negatively correlated with superficial SAAT (P = 0.02). In stepwise regression analysis, both M (r2 = 0.09) and EGP suppression (r2 = 0.17) were associated only with intraperitoneal IAAT in the whole group. In the sex-specific analysis (because of the significant interaction), lower M was associated with higher deep SAAT (r2 = 0.15) in combination with lower superficial SAAT (r2 = 0.09) in men, and with higher superficial SAAT (r2 = 0.29) in combination with lower thigh subcutaneous AT (r2 = 0.16) in women. Although intraperitoneal IAAT and deep SAAT were major predictors of peripheral and hepatic insulin action in obese Pima Indians, the largest variance in M rate was explained in a sex-specific manner by relative size of subcutaneous AT depots.

Do Body Fat and Exercise Modulate Vitamin D Status?

Obesity has been associated with lower levels of serum 25-hydroxyvitamin D, abbreviated 25(OH)D, in several studies, including the third National Health and Nutrition Examination Survey (NHANES III). Body fat has been shown to be a storage site for vitamin D in humans, but the exact mechanism by which higher body fat results in lower serum 25(OH)D is not known for certain. Hypotheses include sequestration in fat, increased clearance by a larger body-fat pool, negative feedback from higher circulating 1,25(OH)2D levels in obesity, and decreased sun exposure due to limited mobility or avoidance of outdoor activity. Wortsman et al. found that the increase in serum vitamin D3 levels after UV exposure was 57% less in obese than nonobese subjects despite similar skin content of the vitamin D3 precursor, which supports the possibility of sequestration by fat. Other findings consistent with a possible role for sequestration include data in humans showing lower rates of lipolysis in the obese and data in rats showing an increasing accumulation of potentially less-available vitamin D esters in fat over time. There is mixed support for a role of negative feedback from 1,25(OH)2D in explaining lower levels of 25(OH)D in obesity, since higher levels of 1,25(OH)2 D in obese subjects have been seen in some, but not all, studies. Finally, data showing lower levels of physical activity in obese individuals are available, but they do not distinguish between indoor and outdoor activity. Data from NHANES III suggest that the body fatvitamin D relationship may be complex. For example, the relationship appears to vary by race, being weaker in African Americans than in Caucasians. Some, but not all, studies based on smaller samples of healthy volunteers have found similar results. Differences in dermal production of vitamin D or in body fat distribution could potentially contribute to a different relationship between body fat and vitamin D by race. Synthesis of vitamin D in the skin is reduced in blacks due to greater amounts of melanin, which absorbs the UV wavelengths needed to convert 7-dehydroxycholesterol to vitamin D3 in the skin. 27 If less vitamin D is formed, there may be less available to be sequestered in subcutaneous fat. Differences in the distribution of subcutaneous fat also exist, with blacks having less subcutaneous fat in the extremities and more in the trunk than whites. This could affect the body fat-vitamin D relationship by reducing the amount of fat present to sequester vitamin D in body areas that may be more important for dermal production of vitamin D, given the possibility that the extremities are less likely to be covered with clothing than the body trunk. Physical activity is also related to serum 25(OH)D, with higher self-reported activity linked with higher levels of 25(OH)D in NHANES III, as well as in other studies. Whether this reflects a direct relationship between activity and vitamin D metabolism or is a result of confounding due to the relationship between physical activity and body fat or sun exposure is not certain. There is conflicting evidence regarding a direct impact of physical activity on the metabolism of 25(OH)D. Results of these studies are difficult to interpret due to small sample sizes, lack of control groups, or failure to control for sun exposure. Confounding by body fat appears unlikely to fully explain the relationship between physical activity and serum 25(OH)D; although physical activity was associated with lower body fat in NHANES III, adjusting for body fat did not noticeably attenuate the relationship between physical activity and 25(OH)D. There are some data to support a role for confounding from sun exposure. For example, Scragg et al. reported significantly higher levels of 25(OH)D in those who exercised outdoors than in those who exercised indoors, and Rock et al. found no significant relationship between physical activity and serum 25(OH)D after controlling for hours of sun exposure. In NHANES III, the relationship between physical activity and serum 25(OH)D differs by race in a manner similar to that seen for body fat, with a weaker relationDr. Looker is with the National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA. Please address all correspondence to: Dr. Anne Looker, National Center for Health Statistics Centers for Disease Control and Prevention, 3311 Toledo Road, Room 4310, Hyattsville, MD 20782, USA; Phone: 301458-4352; Fax: 301-458-4029; E-mail: acl1@cdc.gov. doi: 10.1301/nr.2007.aug.S124–S126

Ontogenesis changes and sex dimorphism of subcutaneous fat distribution: 12‐Year longitudinal study of children and adolescents from Cracow, Poland

The aim of the work was to analyze the direction and tempo of subcutaneous fat redistribution during ontogenesis, appearing sex differences and relations to puberty on the basis of 12-year longitudinal data of 270 boys and 154 girls from Cracow, Poland. They all had complete data (from 7 to 18-years old) of three trunk (subscapular, abdominal, suprailiac) and three extremity (triceps, knee, medial calf) skinfold thicknesses. The type of subcutaneous adipose tissue distribution was determined based on trunk to extremity ratio to analyze the process of fat redistribution. The analysis included medians of extremity and trunk skinfolds and medians of their sums and age altered frequency of central and peripheral type of fat distribution. To present empirical values, the median variability of the sums of three trunk and extremity skinfolds was calculated using a third degree polynomial as an age function. Polynomial regression of extremity skinfolds median explained 88% of its variability (F = 71.2, P < 0.001) and for trunk skinfolds as far as 96% (F = 111.65, P < 0.001). The median variability curves of both types of distribution crossed at the age of 11.88 in girls and 13.45 in boys directly preceding puberty stage, which indicated clear dependencies between fat redistribution and puberty. The results showed a tight connection between the process of subcutaneous fat redistribution and puberty, and also sex dimorphism of the process. More dynamic fat redistribution in boys contrasted trunk and extremity fatness, while in girls less dynamic changes resulted in more even fatness.

Subcutaneous adipocyte size and body fat distribution

BackgroundBoth body fat distribution and adipocyte size are associated with metabolic abnormalities. ObjectiveWe defined the extent to which subcutaneous adipocyte size is related to regional fat mass and to the sizes of adipocytes in other subcutaneous depots independent of adiposity, age, and sex. DesignData collected from 188 women and 133 men who were 18–50 y old and who had a body mass index (in kg/m2) of 18 to 50 were analyzed. The mean size of isolated subcutaneous abdominal, femoral, and gluteal adipocytes was measured by direct microscopy or by automated analysis of digital images. Visceral fat area was measured with computed tomography. Dual-energy X-ray absorptiometry was used to calculate adiposity. ResultsStepwise multiple regression analyses showed that abdominal adipocyte size was associated positively with visceral and subcutaneous abdominal fat areas and negatively with lower-body fat mass as a percentage of total-body fat, after control for sex and percentage body fat. Femoral adipocyte size was related to percentage body fat (P < 0.0001), whereas gluteal adipocyte size was related to visceral fat area (P = 0.002), which suggests that these 2 lower-body fat depots are distinct. Analyses of data from a subset of volunteers (n = 99) for whom we had adipocyte size from all 3 depots showed that adipocyte size from 1 depot could be better predicted if adipocyte size from other depots were known. ConclusionsAbdominal adipocyte size is related to body fat distribution. Adipocyte size in a person seems to be globally regulated by factors independent of variations in body fat distribution.

Genetic and environmental determination of tracking in subcutaneous fat distribution during adolescence

Background: The distribution of fat and adipose tissue is an important predictor of disease risk. Variation in fat distribution during adolescence is correlated with fat distribution in adulthood.Objective: The objective was to gain insight into the relative contribution of genes and environment to the stability of subcutaneous fat distribution from early adolescence into young adulthood.Design: Ratio of trunk to extremity skinfold thickness (TER) data from the Leuven Longitudinal Twin Study (n = 105 Belgian twin pairs followed from 10 to 18 y of age) was entered into a longitudinal path analysis.Results: The best-fitting model included additive genetic sources of variance and nonshared environment. Heritabilities ranged between 84.3% (95% CI: 63.9–92.3%) and 88.6% (95% CI: 76.5–94.1%) in boys and between 78.4% (95% CI: 59.3–88.3%) and 88.3% (95% CI: 77.0–93.8%) in girls. The majority of the phenotypic tracking (boys: 0.40–0.78; girls: 0.38–0.72) could be attributed to the moderate-to-high genetic correlations (rG) (between 0.27–0.84 and 0.38–0.80 for the various age intervals in boys and girls, respectively). This rG could be attributed to both genetic sources of variance, which are the same throughout adolescence, as well as genetic sources of variance that are “switched-on” at a certain age, the effect of which is then transmitted to subsequent observations. Environmental correlations (rE) in boys ranged between 0.51 and 0.70 but contributed relatively little to phenotypic tracking because the amount of variance explained by the environment was low (11.4–15.7%). In girls rE was low to moderate at best (0.09–0.48).Conclusion: Phenotypic tracking in subcutaneous fat distribution during adolescence is predominantly explained by additive genetic sources of variance.

Do Body Fat and Exercise Modulate Vitamin D Status?

Obesity has been associated with lower levels of serum 25-hydroxyvitamin D, abbreviated 25(OH)D, in several studies, including the third National Health and Nutrition Examination Survey (NHANES III). Body fat has been shown to be a storage site for vitamin D in humans, but the exact mechanism by which higher body fat results in lower serum 25(OH)D is not known for certain. Hypotheses include sequestration in fat, increased clearance by a larger body-fat pool, negative feedback from higher circulating 1,25(OH)2D levels in obesity, and decreased sun exposure due to limited mobility or avoidance of outdoor activity. Wortsman et al. found that the increase in serum vitamin D3 levels after UV exposure was 57% less in obese than nonobese subjects despite similar skin content of the vitamin D3 precursor, which supports the possibility of sequestration by fat. Other findings consistent with a possible role for sequestration include data in humans showing lower rates of lipolysis in the obese and data in rats showing an increasing accumulation of potentially less-available vitamin D esters in fat over time. There is mixed support for a role of negative feedback from 1,25(OH)2D in explaining lower levels of 25(OH)D in obesity, since higher levels of 1,25(OH)2 D in obese subjects have been seen in some, but not all, studies. Finally, data showing lower levels of physical activity in obese individuals are available, but they do not distinguish between indoor and outdoor activity. Data from NHANES III suggest that the body fatvitamin D relationship may be complex. For example, the relationship appears to vary by race, being weaker in African Americans than in Caucasians. Some, but not all, studies based on smaller samples of healthy volunteers have found similar results. Differences in dermal production of vitamin D or in body fat distribution could potentially contribute to a different relationship between body fat and vitamin D by race. Synthesis of vitamin D in the skin is reduced in blacks due to greater amounts of melanin, which absorbs the UV wavelengths needed to convert 7-dehydroxycholesterol to vitamin D3 in the skin. 27 If less vitamin D is formed, there may be less available to be sequestered in subcutaneous fat. Differences in the distribution of subcutaneous fat also exist, with blacks having less subcutaneous fat in the extremities and more in the trunk than whites. This could affect the body fat-vitamin D relationship by reducing the amount of fat present to sequester vitamin D in body areas that may be more important for dermal production of vitamin D, given the possibility that the extremities are less likely to be covered with clothing than the body trunk. Physical activity is also related to serum 25(OH)D, with higher self-reported activity linked with higher levels of 25(OH)D in NHANES III, as well as in other studies. Whether this reflects a direct relationship between activity and vitamin D metabolism or is a result of confounding due to the relationship between physical activity and body fat or sun exposure is not certain. There is conflicting evidence regarding a direct impact of physical activity on the metabolism of 25(OH)D. Results of these studies are difficult to interpret due to small sample sizes, lack of control groups, or failure to control for sun exposure. Confounding by body fat appears unlikely to fully explain the relationship between physical activity and serum 25(OH)D; although physical activity was associated with lower body fat in NHANES III, adjusting for body fat did not noticeably attenuate the relationship between physical activity and 25(OH)D. There are some data to support a role for confounding from sun exposure. For example, Scragg et al. reported significantly higher levels of 25(OH)D in those who exercised outdoors than in those who exercised indoors, and Rock et al. found no significant relationship between physical activity and serum 25(OH)D after controlling for hours of sun exposure. In NHANES III, the relationship between physical activity and serum 25(OH)D differs by race in a manner similar to that seen for body fat, with a weaker relationDr. Looker is with the National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA. Please address all correspondence to: Dr. Anne Looker, National Center for Health Statistics Centers for Disease Control and Prevention, 3311 Toledo Road, Room 4310, Hyattsville, MD 20782, USA; Phone: 301458-4352; Fax: 301-458-4029; E-mail: acl1@cdc.gov. doi: 10.1301/nr.2007.aug.S124–S126

The influence of obesity on arterial compliance in adult men and women

The objective of this study was to determine whether differences in large and small arterial compliance existed among normal weight, overweight, and obese older men and women, and whether large and small arterial compliance were associated with abdominal, hip, and subcutaneous fat distribution. A total of 134 individuals who were 40 years of age and older (age = 62 +/- 11 years; mean +/- SD) were grouped into normal weight (BMI: 18.5-24.9 kg/m2; n = 33), overweight (BMI: 25.0-29.9 kg/m2; n = 48), or obese (BMI: > or =30.0 kg/m2; n = 53) categories. The hemodynamic and arterial compliance measurements were obtained using the HDI/PulseWave CR-2000 CardioVascular Profiling System (Hypertension Diagnostics, Inc). Body mass index, nine-site sum of skinfolds, and circumference measures around the hip and waist were used for analysis. Large and small arterial compliance was lower (p < 0.001) in the obese group (12.4 +/- 4.8 ml/mmHg x 10 vs 4.6 +/- 2.5 ml/mmHg x 100, respectively) than the normal weight (16.2 +/- 4.9 ml/mmHg x 10 vs 5.5 +/- 2.7 ml/mmHg x 100) and overweight (15.2 +/- 4.3 ml/mmHg x 10 vs 5.0 +/- 2.2 ml/mmHg x 100) groups. This difference remained (p < 0.001) after adjusting for body surface area, sex, hyperlipidemia, and hypertension. Additionally, large arterial compliance correlated (p < 0.05) with sum of skinfolds (r = - 0.209), while small arterial compliance correlated with hip circumference (r = - 0.189). Arterial compliance measures were not related (p > 0.05) to waist circumference or waist-to-hip ratio. In conclusion, obesity was associated with a decrease in large and small arterial compliance independent of conventional risk factors. Additionally, subcutaneous fat and fat around the hips were inversely related to arterial compliance.

Inherited lipodystrophies and the metabolic syndrome

Lipodystrophies represent a heterogeneous group of diseases characterized by an abnormal subcutaneous fat distribution, the extent of which can vary from localized, to partial, to generalized lipoatrophy. Whereas partial and generalized lipodystrophies are each associated with metabolic abnormalities, the localized form is not. These metabolic changes include insulin resistance with type 2 diabetes, acanthosis nigricans, dyslipidaemia predominantly consisting of hypertriglyceridaemia (associated with the onset of pancreatitis) and depressed HDL cholesterol, liver steatosis and hypertension. Affected women are often hirsute and this can be associated with the presence of polycystic ovarian syndrome (PCOS). Most of these clinical features are present to some extent in patients with the common metabolic syndrome. As the prevalence of metabolic syndrome far outweighs that of lipodystrophy, the diagnosis of this rare disorder may often be overlooked with the affected patient diagnosed as merely being 'yet' another case of metabolic syndrome. In this article, we draw attention to the importance of recognizing patients with lipodystrophy who present with metabolic abnormalities, as both the diagnostic as well as the therapeutic approach of these patients differ profoundly from patients with the metabolic syndrome.

Automated Quantification of Body Fat Distribution on Volumetric Computed Tomography

To develop a computerized method to automatically quantify visceral and subcutaneous fat distribution within the abdomen and pelvis on volumetric computed tomographic (CT) images. Given the slices of interest, the algorithm automatically delineates a contour that separates the visceral fat from the subcutaneous fat on each slice. Explicitly, starting with extraction of the body perimeter, radii at a fixed angle increment are drawn from the perimeter to the center of the body. Along each radius, intensity profile is analyzed to determine the point on the subcutaneous fat layer that is closest to the body center (inner point). All inner points are then connected to form an inner contour, and a specific smoothing algorithm is subsequently applied to correct suboptimal results. Pixels having HU values between -190 and -30 are considered fat pixels. This procedure is repeated on each of the slices of interest. The visceral and subcutaneous fat volumes computed automatically were compared with those after the radiologist's adjustments. Ratios of volumetric visceral fat-to-total fat and visceral fat-to-subcutaneous fat were compared on average and with single-slice measurements obtained at L4 and L5 vertebral body levels. Subcutaneous and visceral fat were automatically segmented using this algorithm on 419 axial CT slices in 9 CT scans (patients) within the abdomen and pelvis. The overall average percentage difference between the automated segmentation and the segmentation edited by the radiologist were 1.54% for the visceral fat and 0.65% for the subcutaneous fat. Preliminary results have shown that total compartmental fat, including visceral and subcutaneous fat, can be automatically and accurately segmented on volumetric CT.

Heart positive: Design of a randomized controlled clinical trial of intensive lifestyle intervention, niacin and fenofibrate for HIV lipodystrophy/dyslipidemia

Dyslipidemia and insulin resistance occur in a large proportion of HIV-infected patients treated with highly active antiretroviral therapy (HAART); anthropomorphic changes, such as lipoatrophy and central obesity, occur in a subset of patients. This cluster of clinical features, which is termed HIV lipodystrophy, places patients at increased risk for cardiovascular disease. Currently, there is no consensus on the appropriate therapy for the management of HIV lipodystrophy for which the underlying defects are enhanced lipolysis, impaired fat oxidation, increased hepatic VLDL-triglyceride synthesis and secretion, and impaired disposal of intestinally-derived lipoprotein-triglycerides. We describe the design of a randomized, placebo-controlled trial to compare the effects of usual care to diet, exercise and lipid-lowering drugs on lipid profiles of patients with HIV lipodystrophy. The trial will randomize 200 patients into five groups. Outcomes of usual care, diet and exercise alone or in combination with niacin, fenofibrate or both medications will be compared after six months. Unique aspects of the design include an interactive Internet Diet Management system to increase ATP-III recommended dietary compliance for metabolic syndrome, and a supervised program of aerobic and resistance exercises. The study is powered to detect a 20% decrease in triglycerides with the lifestyle intervention and an additional 20% improvement with the addition of niacin and/or fenofibrate. Secondary outcomes include assessment of lipid profile changes, LDL and HDL particle size, plasma cholesterol ester transport protein activity, visceral and subcutaneous fat distribution, glucose tolerance, insulin resistance, and leptin and adiponectin levels.

MEAT QUALITY, BACTERIOLOGY AND RETAIL CASE LIFE OF BISON LONGISSIMUS LUMBORUM FOLLOWING SPRAY CHILLING

ABSTRACT Spray chilling effectively controls shrink loss during cooling of beef and lamb carcasses. Because subcutaneous fat distribution in bison is nonuniform over the carcass surface, spray chilling may be beneficial for this species as well. We examined the effect of four 60‐s spray cycles/h for 8 h at 2C on bison carcass bacteriology and shrink loss. Longissimus muscles were removed 24 h postmortem and stored in vacuum packages for up to 6 weeks, with retail display for 0–9 days following each storage period. Spray chilling reduced (P &lt; 0.01) cooler shrink loss from bison carcasses. Meat quality, bacteriology and odor acceptability were not substantially affected by chilling treatment; however, retail display of aerobically packaged bison steaks was severely limited by early discoloration, an effect exaggerated where the meat was subject to any period of storage. Further investigation of suitable alternatives for handling and merchandising bison meat should be investigated.

Effects of growth hormone on insulin resistance and atherosclerotic risk factors in obese type 2 diabetic patients with poor glycaemic control

SummaryObjective We aimed to evaluate the combined effects of GH treatment and diet restriction on lipolysis and anabolism, insulin resistance and atherosclerotic risk factors in obese patients with type 2 diabetes mellitus (T2DM).Subjects This randomized, double‐blind, placebo‐controlled study included 24 obese T2DM patients (male : female = 12 : 12, mean age 53·7 ± 7·2 years) with poor glycaemic control (fasting plasma glucose 10·673 ± 1·121 mmol/l, HbA1C 9·9 ± 2·3%). Sixteen of these patients were treated with recombinant human GH (1–1·5 units/day, 5 days/week) while undergoing diet restriction and exercise for 12 weeks.Methods Anthropometric and bioelectrical impedance measurements were undertaken to determine the lean body mass and total body fat. Computed tomography (CT) was performed to estimate visceral and subcutaneous fat distribution at the umbilicus level and the muscle area of the midthigh. Insulin resistance was measured by the insulin tolerance test (ITT) and by the homeostasis model assessment of insulin resistance (HOMA‐IR).Results The ratios VSR (visceral fat area/subcutaneous fat area) and VMR (visceral fat area/thigh muscle area) were significantly decreased in the GH‐treated group compared to the control group. An increase in lean body mass was observed in the GH‐treated group. Levels of total cholesterol, triglyceride, free fatty acid (FFA), fibrinogen, and plasminogen activator inhibitor‐1 (PAI‐1) were significantly decreased after GH treatment. Fasting glucose levels decreased similarly (P &lt; 0·05 anova) in both groups during the treatment period. Fasting C‐peptide levels significantly increased, whereas insulin levels significantly decreased, in the GH‐treated group, but no changes were observed in the control group. The insulin sensitivity index (ISI) was significantly increased in the GH‐treated group (1·3 ± 1·4 vs. 1·9 ± 1·0%/min, P &lt; 0·05).Conclusions GH treatment in obese T2DM patients with poor glycaemic control is beneficial in decreasing the amount of visceral fats, and may therefore result in improvements in insulin resistance, atherosclerotic risk factors and dyslipidaemia.

Effect of a Conditioning Program on Subcutaneous Fat and LBM% in Males Aged 18-24 Years

This study examined the effect of a three-month conditioning program-consisting of exercises targeted to improve flexibility strength and cardiorespiratory endurance on Subcutaneous Fat and Lean Body Mass percent (LBM%) in fifty (N = 50) physically active males aged 18-24 years. Bioelectrical Impedance Analysis was used for total body composition assessment and subcutaneous fat distribution was measured with the help of skinfold thickness from selected body sites (Biceps Triceps Subscapular Suprailiac and Calf). On an average most deposition of fat was noticed in the Subscapular site followed by Calf Triceps Suprailiac and Biceps regions in that order before the start of a conditioning program. Conditioning program caused a significant reduction in the subcutaneous fat deposition at all sites after the completion of first mesocycle of 45 days as well as after the second mesocycle (next 45 days of conditioning). However the conditioning program of 90 days failed to change the distribution pattern of subcutaneous fat in the observed sites. On the body composition front the mean values of total body fat percent demonstrated a decrease after the conditioning program (before 19.83 ± 5.50 and after 17.7 ± 5.36) but this decrease was not statistical significant (P < 0.05). Similarly the mean values of total body LBM% demonstrated increase after a conditioning program (before 80.16 ± 5.50 and after 82.3 ± 5.44) but again this increase was also not statistically significant. These findings indicate that a conditioning program on the one hand statistically significant lowers skinfold thickness by mobilizing and using the stored fat (subcutaneous) from various sites and on the other hand although there was a difference in the mean values of total body Fat Percent and total LBM percent after a conditioning but that difference was not statistical significant. (authors)

Facial distribution of subcutaneous fat in women

女性の顔の形状に関しての美意識は高く, 形状を形づくるものとしては骨格や筋肉, 皮下脂肪が関わっていると考えられる。そこでわれわれは, MRI法 (核磁気共鳴映像法) を用いて女性の顔面における皮下脂肪を計測し, 皮下脂肪の分布と体型との関係について実態解析を行ったので報告する。健常女性38名を, 痩身体型10名・正常体型18名・肥満体型10名に分け, 頭部MRI撮影を行った。撮影条件は, 脂肪を映すのに適したT1強調で撮影した。MRI画像の顔面皮下脂肪面積は, 肥満体型, 正常体型, 痩身体型の順で多かった。さらに, 顔面45ヵ所の皮下脂肪厚を計測した結果, 頬部の鼻側は体型にかかわらず皮下脂肪量が多い部位であったが, 咬筋部と下顎骨部周辺の皮下脂肪量はBMI (Body Mass Index) が高くなるに伴い増大した。すなわち, 体型にかかわらず皮下脂肪が存在する部位と, BMIの増加に伴い蓄積していく部位があることが示唆された。

P0059 PP SUBCUTANEOUS FAT DISTRIBUTION IN PRETERM AND TERM NEWBORNS

Introduction: Assessment of subcutaneous fat tissue by skinfold thickness (ST) is a fast and noninvasive method that has shown good correlation with the amount of fat mass in newborns (1). A better knowledge of neonatal body mass composition could aid us to find relationships between perinatal body fatness and early infant outcome or later development of metabolic diseases. The aim of the study is to describe the normal pattern and distribution of subcutaneous fat assessed at birth, in term and pre-term newborn infants, and to analyze their gestational age and gender related variations. Methods: Data were obtained from 4634 singleton neonates, 2445 males and 2189 females, born in the University Clinical Hospital ‘Lozano Blesa’, Zaragoza (Spain), with a gestational age from 32 to 41 weeks. Infants from minority ethnical groups or with alterations that could affect body composition were excluded. Weight, length and ST (triceps, biceps, subscapular and suprailiac) were measured using standardized methodology (2). The sum of the four skinfolds (SS) (mm) and various ratios were calculated: central to total skinfold ratio (%) (CTS) [CTS = (tricepsST+bicepsST)/SS ×100], the sum of the four skinfolds per weight unit (SS/weight) and central skinfolds per weight unit [(tricepsST+bicepsST)/Weight]. Results: Skinfold thicknesses were greater in females than in males, particularly from 38 weeks. Females also had bigger values of CTS than males in every gestational age, and differences were significant from 35 week. All subcutaneous fat variables and ratios analyzed in this study significantly increased (each of ST, SS) or decreased (SS/weight, (tricepsST+bicepsST)/Weight) with gestational age (p<0.0001); except for CTS which did not show variations throughout the gestational period. Conclusion: Term and preterm female infants have more amount and a more centralized pattern of subcutaneous body fat than males. ST measurements increase with gestational age but CTS does not vary significantly from 32 to 41 weeks, neither in male nor in female newborns. Therefore, CTS must be considered as an index of centripetal fat store that is not gestational age dependent.

Gender differences in newborn subcutaneous fat distribution.

The pattern and distribution of subcutaneous fat in term and preterm newborns has been assessed by skinfold thicknesses (ST), describing gender and gestational age variations. Weight, length and ST (triceps, biceps, subscapular and suprailiac) were measured in 4634 neonates (2445 males and 2189 females) aged from 32 to 41 gestational weeks. Central to total skinfold ratio (CTS), (suprailiac + subscapular)/sum of 4 ST, was calculated. Males were heavier and longer than females. The sum of 4 ST and CTS was higher in females at every gestational age (with significant differences from 35 weeks) and also the sum of 4 ST per kg body weight (P < 0.05 from 32-33 weeks). Throughout the gestational period, ST increased significantly (P < 0.0001) but CTS did not show variations, neither in males nor in females. term and preterm females have a more centralised pattern and more amount of subcutaneous fat than males. Central to total skinfold ratio must be considered as an index of centripetal fat store which is independant of gestational age.

Benfluorex As a Therapeutic Option for Insulin Resistance in HIV Lipodystrophy Syndrome

Background: HIV lipodystrophy syndrome, characterized by a significant excess of visceral adiposity and a reduced subcutaneous fat mass in association with insulin resistance and dyslipidemia, still afffects the majority of antiretroviral-treated HIV-infected patients. The therapeutic management of this syndrome has not yet been well established. Benfluorex is known to decrease insulin resistance with no side effects on lactate levels in HIV-negative patients. Method: We conducted an open-label study of benfluorex (150 mg, 2-3 times a day) that was prescribed for 60 HIV-infected patients who were diagnosed with glucose metabolism abnormalities by oral glucose tolerance test (OGTT); 47 of these patients had visceral fat accumulation measured by computed tomography (VAT). Median follow-up was 12 months (interquartile range [IQR] = 6-12 months). The great majority of patients (90%) were treated with at least triple therapy (in 70% the therapy included at least one PI), with a nonsignificant change over the study period. Results: Added to antiretroviral therapy, benfluorex improved OGTT in 47/60 cases, including total normalization in 34/60 without lactate concentration modification. A trend toward a decrease in VAT distribution was observed (p = .06). No significant difference was observed in subcutaneous fat distribution, although an increase in subcutaneous thigh adipose tissue was observed in 17/47 (36.2%) cases and 6 patients (12.7%) presented both subcutaneous fat increase and VAT decrease.

女性の顔面部皮下脂肪の分布解析

女性の顔の形状に関しての美意識は高く, 形状を形づくるものとしては骨格や筋肉, 皮下脂肪が関わっていると考えられる。そこでわれわれは, MRI法 (核磁気共鳴映像法) を用いて女性の顔面における皮下脂肪を計測し, 皮下脂肪の分布と体型との関係について実態解析を行ったので報告する。健常女性38名を, 痩身体型10名・正常体型18名・肥満体型10名に分け, 頭部MRI撮影を行った。撮影条件は, 脂肪を映すのに適したT1強調で撮影した。MRI画像の顔面皮下脂肪面積は, 肥満体型, 正常体型, 痩身体型の順で多かった。さらに, 顔面45ヵ所の皮下脂肪厚を計測した結果, 頬部の鼻側は体型にかかわらず皮下脂肪量が多い部位であったが, 咬筋部と下顎骨部周辺の皮下脂肪量はBMI (Body Mass Index) が高くなるに伴い増大した。すなわち, 体型にかかわらず皮下脂肪が存在する部位と, BMIの増加に伴い蓄積していく部位があることが示唆された。

Size and Shape Modifications in Sardinian Adolescent Girls

In females, menarche is the defining moment of puberty, the period of life when the greatest body changes occur. In the present study, the metric and morphological variations associated with sexual maturation are defined in 155 Sardinian girls (10-17 years) and the role of some potentially influential variables is discussed: age, age at menarche and time since menarche. We studied thirty-eight anthropometric variables, the fat-free mass and the fat mass estimated by Bioelectrical Impedance Analysis. Statistical analyses were performed to evaluate the difference between pre- and post-menarcheal girls of the same age (Student's t-test) and to evaluate the different role played by the variables (principal components analysis, cluster analysis, multiple regression). The results demonstrate that the body dimensions of the adolescent girls mainly increase in concomitance with sexual maturation. The age at menarche influences the fat mass but not the distribution of visceral and subcutaneous fat. The time since menarche has also no effect on the distribution of subcutaneous fat.