Excess Of Abdominal Fat Research Articles

A-FABP and E-FABP as cutaneous biomarkers of Metabolic Syndrome

Introduction: In Metabolic syndrome (MetS), tissues such as adipose, liver, and skin with very active lipid metabolism are dysfunctional, making it diffcult to store the excess fat. Fatty acid binding proteins (FABPs) are cytosolic proteins that can reversibly bind to lipids and transport them to different cell organelles. In this work, we focus on adipocyte (A-FABP) and epidermal (E-FABP) FABPs, which have been proposed as potential biomarkers of MetS due to their different tissue expression patterns. When MetS impacts the skin, the integrity of the barrier is affected, such as changes in the structure and function of collagen fibers, changes in microcirculation and macrocirculation, damage to lymphatic vessels, diffculty in wound healing, increased production of sebum and sweat. All those changes seem to depend on the abnormal function of lipids and FABPs. In MetS, E-FABP and A-FABP increase significantly in serum and probably in the skin in order to facilitate lipid transport. For this reason, they can be considered a molecular sensors of the inflammation induced in the skin by MetS. Objective: Analyze the concentrations of A-FABP and E-FABP in the skin of a MetS model to determine their value as biomarkers. Methods: We used a Wistar rat model (N=32) of MetS with a 41% extra fat diet during 8, 18, 28, and 52 weeks. The protocol was approved by the "Internal Committee for the Care and Use of Laboratory Animals of the Faculty of Medicine of the Autonomous University of San Luis Potosí" (assigned code: BGFMUASLP -07-19). At the end of every period of time (8, 18, etc) a biopsy of the skin (1 cm2) was took and cleaned from connective and subcutaneous adipose tissue. For Western Blot (WB) experiments the protein extraction was performed using cell lysis and homogenization, and 50 μg of protein of each sample was used. The WB was performed following the supplier's specifications and the standardized protocol in our laboratory. The primary antibodies used for incubation were rat A-FABP antibody (R&D Systems, AF1443) and rat E-FABP antibody (R&D Systems, AF1476). The secondary antibody was Goat IgG HRP-conjugated Antibody (R&D Systems, HAF017). As a control gene, GAPDH reconstituted as indicated by the supplier. Bands were visualized using chemiluminescent detection, and their density in each group was analyzed using ImageJ software. Results: animals developed MetS after being 28 weeks in high fat diet showing excess of abdominal fat, hypertension, high triglycerides, and low cholesterol-HDL. At 52 weeks, we observed an increase in total cholesterol and in the severity of the blood lipids mentioned. Also, 40% of the animals showed visible skin lesions characterized by redness, eruptions, scratching marks, and wounds that do not heal, mainly in the cervical region, suggesting an inflammatory process. A-FABP expression was increased in MetS rats at 8 and 18 weeks and remained high at 28 and 52 weeks, although the increase was not significant. On the other hand E-FABP expression increased in MetS rats from week 18 and 28 but decreasing at 52. It suggests a greater presence of the protein and a probable participation of it in the inflammatory processes and skin lesions observed. Conclusions: E-FABP and A-FABP, increase significantly in the skin of MetS rats, mainly in the in the initial stages of MetS. E-FABP can considered a molecular sensor of skin inflammation induced by obesity. We also observed the presence of A-FABP in the skin, probably from subcutaneous adipose tissue. We propose the feasibility of both FABPs as early markers of MetS. This work has been supported by the National Council of Science and Technology (CONAHCYT) Project No. 320024. GE Donjuán-Loredo thanks CONAHCYT CVU 775467. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Excessive generalized and visceral adiposity is associated with a higher prevalence of diabetic retinopathy in Caucasian patients with type 2 diabetes

Background and aimsType 2 Diabetes Mellitus (T2D) has heterogeneous clinical phenotypes related to different risk of developing diabetes complications. We investigated the correlation between generalized and abdominal adiposity and the prevalence of both micro- and macrovascular complications in Caucasian patients with T2D. Methods and resultsWe evaluated 769 individuals with T2D consecutively referred to our diabetes center. Body mass index (BMI), waist circumference (WC), waist to hip (W/H) ratio, glycated hemoglobin (HbA1c), systolic and diastolic blood pressure, lipid profile, smoking habit, diabetes therapy, and micro- and macrovascular complications were recorded. Patients were divided into three groups based on BMI and WC: non-obese with normal WC (nWC, n = 220), non-obese with excess of abdominal fat (AF, n = 260) and obese (Ob, n = 289). We found that nWC, compared with AF and Ob individuals, were predominantly males (p<0.01), had lower HbA1c (p<0.01), diastolic blood pressure (p<0.01), triglycerides (p<0.01), and showed a significantly lower prevalence of diabetic retinopathy (DR) (p = 0.01). The rate of proliferative DR was significantly higher in Ob (13.2 %) compared to the other groups (p = 0.03). Multivariate analyses showed a significantly decreased prevalence of DR in nWC compared to both AF (OR 0.58, 95 CI 0.34–0.96; p = 0.03) and Ob (OR 0.57, 95 CI 0.33–0.98; p = 0.04) individuals. Conversely, DR was associated, mainly in women, to higher WC and W/H ratio. The prevalence of the other diabetes-related complications was similar among the studied groups. ConclusionsIn our population, nWC subjects showed a lower prevalence of DR. An increased generalized and abdominal adiposity was associated to a higher prevalence of DR, especially among females.

Interactions between dietary inflammatory index, nutritional state and Multiple Sclerosis clinical condition

The Dietary Inflammatory Index (DII) consists of a tool that assesses dietary inflammatory potential based on the assignment of an inflammatory score to a variety of nutrients, seasonings and bioactive compounds. Pro-inflammatory diets are associated to weight and abdominal fat excess. High Body Mass Index (BMI) and Waist Circumference (WC) seem to contribute to a worse prognosis in Multiple Sclerosis (MS) patients. Therefore, this study seeks to investigate the relation between anthropometric indexes and body adiposity with the clinical condition and the Dietary Inflammatory Index of MS individuals. This is a cross-sectional, analytical study that included 137 MS patients residing in the Brazilian northeast. Through a structured questionnaire and medical records consultation, we collected data on demographics, nutritional state, arterial pressure, clinical and dietary variables. Clinical variables included the MS type, number of pulse therapies and attack rate in the last two years, number of days of most recent pulse therapy and muscular strength assessment scores (MRC) and most recent disability level (EDSS). The nutritional state was evaluated based on BMI, WC, waist-hip ratio (WHR), Body Roundness Index (BRI), Body Shape z score Index (ABSIz) and body fat percentage (%BF). The DII was calculated according to a validated methodology. The ABSIz presented a positive correlation with regards to the EDSS score (r=0.294. p=0.001). WC and WHR presented a negative correlation in relation to the number of pulse therapy days (r=-0.255. p=0.022 and r=-0.251. p=0.024). BMI and %BF were not correlated to clinical variables (p>0.05). The DII was positively correlated to the BMI in people with progressive MS (r=0.556. p=0.025). The DII may interfere in the nutritional state of MS patients and the nutritional state may affect disability levels but it is necessary to establish which nutritional indicator can better predict the relation between DII and the clinical condition of MS patients.

DIEP flap for breast reconstruction: Is abdominal fat thickness associated with post-operative complications?

Some surgeons consider a high body mass index (BMI) or important abdominal fat excess as contraindications for breast reconstruction with free deep inferior epigastric perforator (DIEP) flap. This study aimed to identify factors associated with post-operative complications by using this type of flap, with an emphasis on BMI and abdominal subcutaneous fat thickness. A retrospective chart review of 105 consecutive patients who underwent DIEP flap breast reconstruction at our institution was performed to assess post-operative complications. Among other risk factors, we specifically studied the influence of BMI and abdominal wall thickness on complication occurrence. Abdominal wall thickness was measured at 10 different points on the angio-computed tomography scan performed pre-operatively. Median age was 49.8 years (range, 27-69); average BMI was 25.57kg/m2 (range, 18.07-41.91). Immediate breast reconstruction was performed for 35% of patients, and five patients (4.7%) underwent bilateral reconstruction. Twenty-six patients (24.8%) presented 29 post-operative complications; 12 concerned abdominal complications (delayed wound healing [n=6] and seroma [n=6]) and 17 were related to complications of the reconstructed breast (six minimal necrosis treated conservatively, eight minor necrosis requiring surgical debridement and three total flap loss). The complication rate was not correlated with increased BMI or abdominal wall thickness. The only factor that significantly predicts DIEP flap complications was pre-operative radiotherapy (odds ratio=4.05; p=0.03). No significant correlation was observed between BMI of 25-35kg/m2 or abdominal wall thickness and post-operative complications of the donor site or DIEP flap. Therefore, these factors should not be considered as contraindication criteria.

Body composition and frailty profiles in Brazilian older people: Frailty in Brazilian Older People Study-FIBRA-BR

ObjectiveTo determine the association between body composition and frailty in older Brazilian subjects. Material and methodsThis is a Cross-sectional study called FIBRA-BR and developed in community Brazilian aged ≥65 (n=5638). Frailty was assessed according to Fried et al. definition and body composition was determined by BMI, waist circumference and waist-hip ratio. ResultsThe lowest prevalence of frailty was observed in subjects with BMI between 25.0 and 29.9kg/m2. Subjects with a BMI <18.5 and those with elevated WC presented a higher risk of frailty compared to eutrophic subjects (odds ratio (OR)=3.10; 95% CI: 2.06–4.67) and (OR=1.15; 95% CI: 1.03–1.27), respectively. Being overweight was protective for pre-frailty (OR=0.48; 95% CI: 0.4–0.58) and frailty (OR=0.77; 95% CI: 0.67–0.9). Obese older people presented a higher risk of pre-frailty only (OR=1.29; 95% CI: 1.09–1.51). Older people with high WC showed a greater proportion of frailty regardless of the BMI range. ConclusionUndernutrition is associated with pre-frailty and frailty in Brazilian elderly subjects, whereas obesity is associated only with pre-frailty. Overweight seems to have a protective effect against the syndrome. The excess of abdominal fat is associated with both profiles independent of the BMI.

Prevalence of general and abdominal obesity and overweight among adults in Poland. Results of the WOBASZ II study (2013-2014) and comparison with the WOBASZ study (2003-2005).

INTRODUCTION There are limited data on the current prevalence of overweight and obesity as well asits changes with time in Poland. OBJECTIVES The aim of the study was to assess the prevalence of general and abdominal obesity andoverweight in Polish adults in the years 2013-2014, and to compare it with the prevalence in the years2003-2005. PATIENTS AND METHODS The study was conducted in 2 independent, representative samples of thePolish population, comprising 14 537 persons (aged 20-74 years) examined in the years 2003-2005and 6164 persons (aged ≥20 years) examined in the years 2013-2014. Anthropometric measurementswere done by trained nurses. RESULTS In the years 2013-2014, the age-standardized prevalence of obesity (body mass index [BMI]≥30 kg/m2) was 24.4% in men and 25.0% in women. The prevalence of overweight (BMI, 25.0-29.9kg/m2) was 43.2% in men and 30.5% in women. Abdominal obesity (waist circumference ≥102 cm inmen or ≥88 cm in women) was noted in 32.2% of men and 45.7% of women. Abdominal overweight(waist circumference, 94-101.9 cm in men or 80-87.9 cm in women) was present in 27.2% of menand 21.7% of women. Since the years 2003-2005, the distribution of body mass according to the BMIcategory had shifted to higher values, and an increase in the prevalence of obesity was observed inmen. The percentage of adults with normal waist circumference decreased significantly in both sexes. CONCLUSIONS Every fourth inhabitant of Poland is obese, and during the last decade, the prevalence ofobesity has increased, particularly in men. Abdominal obesity is observed in every third man and nearlyevery second woman, and an excess of abdominal fat has increased in both sexes.

Hypovitaminosis D Is Associated With Visceral Adiposity, High Levels of Low-Density Lipoprotein and Triglycerides in Alternating Shift Workers

Background: Studies suggest that there is a strong association between low vitamin D levels and cardiovascular disease (CVD) and its risk factors (RFs). Hypovitaminosis D (25(OH)D < 30 ng/mL or 75 nmol/L) is a recent public health problem that has reached different populations. The objective of the study was to investigate whether hypovitaminosis D is an additional mechanism to explain the disturbances in the lipid profile as well as the excess of abdominal fat presented by alternating shift workers of a mining company in the region of Inconfidentes, Minas Gerais, Brazil. Methods: A cross-sectional study was conducted in a sample of 391 adult males, aged 20 - 57 years old and working alternating shifts, who had at least one risk criterion for CVD. Demographic, behavioral, clinical, and anthropometric and body composition variables were obtained. A blood sample was drawn for determining 25(OH)D, parathyroid hormone intact molecule, lipid profile, blood glucose, insulin, C-reactive protein, and adipokines. Results: The average age of the 391 study participants was 36.1 ± 7.3 years. The percentage of hypovitaminosis D and dyslipidemia was 73% and 74.2%, respectively. Excess visceral fat was significant in the hypovitaminosis D group, with an odds ratio (OR) of 2.4 (95% confidence interval (CI): 1.1 - 5.2). Dyslipidemia showed 25(OH)D levels significantly lower (OR: 2.7, 95% CI: 1.6 - 4.3) than in individuals with normal levels of cholesterol and fractions, and triglycerides. After adjusted the analysis by age and seasonality, the vitamin levels had a significant inverse association and dose-dependent with low-density lipoprotein (OR: 5.9), triglycerides (OR: 2.3) and visceral fat area (OR: 2.4). Conclusion: Hypovitaminosis D and dyslipidemia were found in the majority of our mining company shift workers. Furthermore, excess visceral adiposity, hypertriglyceridemia and high low-density lipoprotein cholesterol levels are strong predictors of hypovitaminosis D. J Endocrinol Metab. 2016;6(3):80-89 doi: http://dx.doi.org/10.14740/jem340w

Hypovitaminosis D Is Associated With Visceral Adiposity, High Levels of Low-Density Lipoprotein and Triglycerides in Alternating Shift Workers

Background: Studies suggest that there is a strong association between low vitamin D levels and cardiovascular disease (CVD) and its risk factors (RFs). Hypovitaminosis D (25(OH)D < 30 ng/mL or 75 nmol/L) is a recent public health problem that has reached different populations. The objective of the study was to investigate whether hypovitaminosis D is an additional mechanism to explain the disturbances in the lipid profile as well as the excess of abdominal fat presented by alternating shift workers of a mining company in the region of Inconfidentes, Minas Gerais, Brazil. Methods: A cross-sectional study was conducted in a sample of 391 adult males, aged 20 - 57 years old and working alternating shifts, who had at least one risk criterion for CVD. Demographic, behavioral, clinical, and anthropometric and body composition variables were obtained. A blood sample was drawn for determining 25(OH)D, parathyroid hormone intact molecule, lipid profile, blood glucose, insulin, C-reactive protein, and adipokines. Results: The average age of the 391 study participants was 36.1 ± 7.3 years. The percentage of hypovitaminosis D and dyslipidemia was 73% and 74.2%, respectively. Excess visceral fat was significant in the hypovitaminosis D group, with an odds ratio (OR) of 2.4 (95% confidence interval (CI): 1.1 - 5.2). Dyslipidemia showed 25(OH)D levels significantly lower (OR: 2.7, 95% CI: 1.6 - 4.3) than in individuals with normal levels of cholesterol and fractions, and triglycerides. After adjusted the analysis by age and seasonality, the vitamin levels had a significant inverse association and dose-dependent with low-density lipoprotein (OR: 5.9), triglycerides (OR: 2.3) and visceral fat area (OR: 2.4). Conclusion: Hypovitaminosis D and dyslipidemia were found in the majority of our mining company shift workers. Furthermore, excess visceral adiposity, hypertriglyceridemia and high low-density lipoprotein cholesterol levels are strong predictors of hypovitaminosis D. J Endocrinol Metab. 2016;6(3):80-89 doi: http://dx.doi.org/10.14740/jem340w

ASSOCIATION OF THE NUTRITIONAL PROFILE WITH HISTOLOGICAL FINDINGS OF PATIENTS WITH GENOTYPE 1 CHRONIC HEPATITIS C INFECTION.

Different factors are responsible for the progression of hepatic fibrosis in chronic infection with hepatitis C virus, but the role of nutritional factors in the progression of the disease is not clearly defined. This study aimed to evaluate the nutritional status and dietary profile among patients with chronic hepatitis C who were candidates for treatment and its association with histopathological features. A crossectional study was conducted on treatment-naïve patients with chronic hepatitis C genotype 1, between 2011 and 2013. The following assessments were performed before treatment: liver biopsy, anthropometric measurements and qualitative/quantitative analysis of food intake. Seventy patients were studied. The majority of patients was classified as obese (34%) or overweight (20%) according to body mass index [BMI] and as at risk for cardiovascular diseases by waist circumference (79%). Unhealthy food intake was presented by 59% according to qualitative parameters and several patients showed an insufficient intake of calories (59%), excessive intake of protein (36%) and of saturated fat (63%), according to quantitative analysis. With respect to histology, 68% presented activity grade ≥2, 65% had steatosis and 25% exhibited fibrosis stage >2. Comparative analysis between anthropometric parameters and histological features showed that elevated waist circumference was the only variable associated to hepatic steatosis ( P =0.05). There was no association between qualitative and quantitative food intake parameters with histological findings. In this study, most of the patients with hepatitis C presented inadequate qualitative food intake and excessive consumption of saturated fat; in addition, excess of abdominal fat was associated to hepatic steatosis. Therefore, nutritional guidance should be implemented prior to treatment in patients with chronic hepatitis C, in order to avoid nutritional disorders and negative impact on the management of patients.

NUTRITIONAL STATUS, DIET AND NON-ALCOHOLIC FATTY LIVER DISEASE IN ELDERS.

evaluate the inter-relations between non-alcoholic fatty liver disease (NAFLD) and dietary factors in a population of hypertensive elders. 229 hypertensive elder patients were evaluated, from June to December 2009. All the patients that accepted to participate in the study signed a free consent term. An anthropometric evaluation was carried out and the body composition was evaluated. The diagnosis of NAFLD was determined by the American guidelines. The regular food intake was estimated through a 24 hour questionnaire. the weighted excess, by the body mass index and excess of abdominal fat, were associated with NAFLD (p < 0.001). An inverse profile was found with the diet variables. the studied group presents a health risk situation, considering the nutritional status markers. The regular diet appeared to be inadequate, showing excess of sodium and low fiber and vegetables intake.

Cardiovascular autonomic dysfunction and oxidative stress induced by fructose overload in an experimental model of hypertension and menopause.

BackgroundMetabolic syndrome is characterized by the association of 3 or more risk factors, including: abdominal obesity associated with an excess of abdominal fat, insulin resistance, type 2 diabetes, dyslipidemia and hypertension. Moreover, the prevalence of hypertension and metabolic dysfunctions sharply increases after the menopause. However, the mechanisms involved in these changes are not well understood. Thus, the aim of this study was to assess the effects of fructose overload on cardiovascular autonomic modulation, inflammation and cardiac oxidative stress in an experimental model of hypertension and menopause.MethodsFemale SHR rats were divided into (n = 8/group): hypertensive (H), hypertensive ovariectomized (HO) and hypertensive ovariectomized undergoing fructose overload (100 g/L in drinking water) (FHO). Arterial pressure (AP) signals were directly recorded. Cardiac autonomic modulation was evaluated by spectral analysis. Oxidative stress was evaluated in cardiac tissue.ResultsAP was higher in the FHO group when compared to the other groups. Fructose overload promoted an increase in body and fat weight, triglyceride concentration and a reduction in insulin sensitivity. IL-10 was reduced in the FHO group when compared to the H group. TNF-α was higher in the FHO when compared to all other groups. Lipoperoxidation was higher and glutathione redox balance was reduced in the FHO group when compared to other groups, an indication of increased oxidative stress. A negative correlation was found between IL-10 and adipose tissue.ConclusionFructose overload promoted an impairment in cardiac autonomic modulation associated with inflammation and oxidative stress in hypertensive rats undergoing ovarian hormone deprivation.

Chirurgie bariatrique et esthétique de l’adolescent obèse : une thérapeutique alternative

The increased frequency of extreme forms of obesity in adolescents and the disappointing results of conventional treatments are now leading pediatricians to consider bariatric or cosmetic surgery as the only real long-term effective therapeutic alternative. The two main techniques currently used for bariatric surgery in adolescents are gastric bypass and adjustable gastric banding. Whatever the technique, weight loss is significant with improvement of comorbidities and quality of life. In addition, the complications are identical to those in adults and equally frequent. However, because of the particularities of this age, caution is still required. Adolescence is indeed characterized by specific nutritional needs, but also changes in body image in which surgery could have a negative effect. Currently, all obese teenagers making a request for bariatric surgery should have a comprehensive assessment with global care for at least 6 months. The indication is then discussed on a case-by-case basis by multidisciplinary teams and experts. To date, the type of surgery (gastric banding, gastric sleeve, or bypass) is still widely discussed. Based on experience with adults, we believe that gastric sleeve and bypass should be preferred. In addition, obesity in adolescents almost always involves psychosocial consequences, while somatic complications are rare. Thus, the care of adipo- or gynecomastia, abdominal fat excess, and concealed penis is essential and therefore justifies cosmetic surgery.

Dietary, Anthropometric, and Biochemical Determinants of Plasma High-Density Lipoprotein-Cholesterol in Free-Living Adults

The level of high-density lipoprotein is thought to be critical in inhibiting lesion formation as well as reducing the lipid load of preexisting atherosclerotic lesions. With the aim of determining the main determinants of plasma HDL-cholesterol (HDL-c) in free-living adults, 997 individuals (52.3 ± 10 years, 67% females) were selected for a descriptive cross-sectional study. The used data corresponded to the baseline obtained from participants clinically selected for a lifestyle modification program. Covariables of clinical, anthropometry, food intake, aerobic fitness, and plasma biochemistry were analyzed against plasma HDL-c either as continuous or categorized variables. After adjustments for age, gender, and BMI the excess of abdominal fat along with high carbohydrate-energy intake and altered plasma triglycerides were the stronger predictors of reduced plasma HDL-c. In conclusion lifestyle interventions aiming to normalize abdominal fatness and plasma triglycerides are recommended to restore normal levels of HDL-c in these free-living adults.

Abdominal Fat Quantity and Distribution in Women with Polycystic Ovary Syndrome and Extent of Its Relation to Insulin Resistance

Increased abdominal fat has been linked to insulin resistance and increased cardiovascular risk. Because many patients with polycystic ovary syndrome (PCOS) present abdominal obesity, it may be the cause of insulin resistance in this disorder. Fat quantity and distribution were evaluated by dual x-ray absorptiometry at the Departments of Clinical Medicine at the University of Palermo and the University of Naples, Italy. A total of 110 patients with PCOS and 112 weight-matched controls were studied. Anthropometric data, blood glucose, serum insulin, and testosterone were evaluated. Total, trunk, and central abdominal fat quantity were measured by total-body dual x-ray absorptiometry. Compared with weight-matched controls, patients with PCOS had similar quantity of total and trunk fat but higher quantity of central abdominal fat. This difference was not observed when comparing obese PCOS and obese controls but depended on differences between overweight and normoweight patients and controls. All obese subjects, independently of having PCOS or not, had increased central abdominal fat. The same parameter was increased in 71% of overweight PCOS, 50% of overweight controls, and 30% of normoweight PCOS patients. PCOS patients with increased central abdominal fat had significantly higher (P < 0.01) insulin levels and significantly reduced (P < 0.01) insulin sensitivity than controls with similar quantities of central abdominal fat. Overweight PCOS patients with normal abdominal fat had significantly higher (P < 0.05) insulin levels and significantly reduced (P < 0.05) insulin sensitivity than overweight controls with normal abdominal fat. Most obese subjects, independent of being affected by PCOS, have an abdominal form of obesity. However, abdominal fat excess may not be the only determinant of insulin resistance in PCOS.

Hypergonadotrophinaemia with reduced uterine and ovarian size in women born small-for-gestational-age.

Fetal growth restraint has been associated with FSH hypersecretion in early infancy and in early post-menarche, and with reduced uterine and ovarian size in adolescence. It is unknown whether these reproductive anomalies persist, respectively, into late infancy and into the reproductive age range. We report follow-up findings in two age groups of girls. A cohort of infants [n=26; n=10 born appropriate-for-gestational-age (AGA) and n=16 born small-for-gestational-age (SGA)], who had been studied at the age of approximately 4 months, was assessed again at the age of 12 months. A cohort of teenagers (n=28), who had been studied at the age of approximately 14 years, was assessed again at the age of approximately 18 years; this group was complemented by a transversal cohort of similar age (n=19) for a total of 47 young women (n=27 AGA; n=20 SGA). In infants, only serum FSH was measured; adolescents underwent endocrine-metabolic screening, ultrasound assessment of uterine-ovarian size, and evaluation of body composition by dual X-ray absorptiometry. Serum FSH levels were higher in SGA than AGA infant girls at 4 and 12 months, and higher in SGA than AGA adolescents at 14 and 18 years (all P<0.01). Longitudinal ultrasound assessments disclosed a late-adolescent increment of uterine size that was less obvious in SGA than AGA girls. In contrast, ovarian volume remained stable in both subgroups. Compilation of longitudinal and transversal results at 18 years of age corroborated the persistent reduction in the uterine size of SGA girls (by approximately 20%; P<0.005) and in their ovarian volume (by approximately 40%; P<0.0001); moreover, SGA girls displayed not only a persistent elevation of FSH (by approximately 50%; P<0.001), but also a rise of LH and fasting insulin, as well as an excess of abdominal fat (all P<0.01). The gynaecology of young women born SGA was found to be characterized by hypergonadotrophinaemia and by a reduced uterine and ovarian size.

Anovulation in eumenorrheic, nonobese adolescent girls born small for gestational age: insulin sensitization induces ovulation, increases lean body mass, and reduces abdominal fat excess, dyslipidemia, and subclinical hyperandrogenism.

Adolescent girls born small for gestational age (SGA) are at risk for anovulation, hyperinsulinism, subclinical hyperandrogenism, dyslipidemia, and central adiposity. Hyperinsulinemic insulin resistance has been proposed as a key pathogenetic factor underpinning these associations. We have tested this hypothesis in an intervention study by assessing the effects of insulin sensitization (metformin treatment, 850 mg/d for 3 months) in eumenorrheic, nonobese, anovulatory SGA adolescents [n = 13; mean birth weight, 2.3 kg; age, 15 yr; body mass index (BMI), 20.5 kg/m(2); >or=3 yr post-menarche] who were in a steady state (over approximately 6 months) for BMI, hyperinsulinism, subclinical hyperandrogenism, and dyslipidemia, and who presented a deficit of lean body mass and an excess of (truncal and abdominal) fat mass. Metformin treatment was accompanied by a drop in fasting insulin and serum androgens and by a less atherogenic lipid profile (all P <or= 0.01). After 3 months on metformin, all identified aberrations in body composition were attenuated, the most marked changes (P < 0.0001) being a reduction of the excess in abdominal fat and of the deficit in lean body mass; BMI remained unaltered. Finally, 6 of 13 girls became ovulatory after about 6 wk on metformin, and 9 of 13 (69%) ovulated within 11 wk on metformin. In conclusion, these observations corroborate the notion that anovulation, an excess of abdominal fat mass, and a deficit of lean mass in nonobese SGA adolescents are essentially underpinned by hyperinsulinemic insulin resistance, and that sensitization to insulin is an effective approach to correct these abnormalities and, conceivably, to prevent them.

Race-Dependent Health Risks of Upper Body Obesity

For Caucasian women, an excess of abdominal fat is a potent risk factor for the development of diabetes and cardiovascular disease. However, there is limited information regarding the health risks of upper body obesity for African-American women despite a higher prevalence of obesity and obesity-related diseases and a reportedly higher prevalence of abdominal fat accumulation. This study aimed to determine whether UBO, independent of total body fatness, is as potent a diabetic and CVD risk factor for black women as has been confirmed for white women. Diabetes and CVD risks and androgenic status were assessed in nondiabetic, premenopausal women of similar body fatness who differed by race (black or white) and body fat distribution (UBO or lower body obesity). In black women, high-density lipoprotein cholesterol was the only measurement adversely affected by abdominal fat; HDL cholesterol was significantly lower in the black UBO group (1.14 +/- 0.05 mM) compared with the black LBO group (1.37 +/- 0.08 mM). This contrasts markedly with our findings in white women. In confirmation of previous reports, white UBO women, compared with white LBO counterparts, had significantly higher glucose (967.6 vs. 709.2 mM/2 h) and insulin (120.5 vs. 52.1 pM/2 h) areas and significantly lower peripheral insulin sensitivities (0.99 vs. 2.95 x 10(-4) min-1/microU/ml). In addition, HDL cholesterol levels were significantly lower in the white UBO group (1.03 mM) compared with the white LBO group (1.49 mM), whereas plasma TG levels (white UBO, 1.72 vs. white LBO, 0.88 mM) and dBPs (white UBO, 84 vs. white LBO, 75 mmHg) were significantly higher.(ABSTRACT TRUNCATED AT 250 WORDS)