Measures Of Abdominal Adiposity Research Articles

Determinants of the transition from a cardiometabolic normal to abnormal overweight/obese phenotype in a Spanish population

There is limited prospective evidence at population scale of the impacts of lifestyle and surrogate measures of general and abdominal adiposity on the transition of a metabolically healthy (absence of a metabolic disorder) overweight/obese (MHOO) phenotype to a metabolically abnormal overweight/obese (MAOO) phenotype. Therefore, we determined the relationship between 10-year body mass index (BMI), waist circumferences (WC), waist to height ratio (WHtR), and lifestyle changes and the transition of the MHOO phenotype. We conducted a prospective population-based study of 3,052 male and female Spaniards aged 25-74 years who were followed from 2000 through 2009. Diet and leisure-time physical activity were recorded on validated questionnaires. Weight, height, WC, blood lipids, glycemia, and blood pressure were measured. All variables were obtained at baseline (BL) and follow-up (FL). Participants with a BMI ≥ 25 kg/m(2) and free from hypercholesterolemia, hypertriglyceridemia, diabetes, hypertension, and low HDL and high LDL cholesterol levels were characterized as the MHOO phenotype. A composite healthy lifestyle index (HLI) was constructed by including temporary changes in 3 lifestyle variables (diet, leisure-time physical activity, and smoking). Initially, 20.8% of subjects had the MHOO phenotype; 49.2% of these shifted to MAOO phenotype. In multivariate analysis, changes in BMI, WC, WHtR were positively associated (p = 0.004, p = 0.018, and p = 0.016, respectively) with this transition. One unit increase in the HLI was associated with a 33% lower risk (p = 0.025) to the MAOO phenotype transition after adjusting for age, sex, educational level, and baseline energy intake, BMI, WC, and WHtR. The presence of metabolic disorders in the MHOO phenotype is predicted by an increase in anthropometric surrogate measures of general and abdominal adiposity. In contrast, a healthy lifestyle protects against a transition to the MAOO phenotype.

The Long-term impact of intrauterine growth restriction in a diverse US cohort of children: The EPOCH study

ObjectiveTo explore the long-term impact of intrauterine growth restriction (IUGR) among a diverse, contemporary cohort of U.S. children.Design and MethodsA retrospective cohort of 42 children exposed to IUGR and 464 unexposed who were members of Kaiser Permanente of Colorado. Height and weight measurements since birth and measures of abdominal adiposity and insulin-resistance were measured at an average age of 10.6 (±1.3) years.ResultsInfants born IUGR experienced ‘catch-up growth’ in the first 12 months of life at a rate of 3.58 kg/m2 compared to 2.36 kg/m2 in unexposed infants (p=0.01). However, after 1 year of age, no differences in BMI growth velocity were observed. Nevertheless children exposed to IUGR had higher waist circumference (67.0 vs. 65.3 cm, p=0.03), higher insulin (15.2 vs. 11.0 uU/ml, p=0.0002), higher HOMA-IR (2.8 vs. 2.3, p=0.03) and lower adiponectin levels (9.0 vs. 12.0 ug/ml, p=0.003) in adolescence, independent of other childhood and maternal factors.ConclusionsOur data from a contemporary U.S. cohort suggests that children exposed to IUGR have increased abdominal fat and increased insulin resistance biomarkers despite no differences in BMI growth patterns beyond 12 months of age. These data provide further support for the fetal programming hypothesis.

Influence of obesity on localized prostate cancer patients treated with radical prostatectomy

This study aimed to investigate the association between different anthropometric measures of obesity and clinicopathological characteristics in Chinese patients with clinically localized prostate cancer (PCa). A total of 734 patients with clinically localized PCa who underwent radical prostatectomy (RP) were included in this study. Clinical and pathological data from each patient were collected. Anthropometric measures of abdominal adiposity were measured from T2-weighted sagittal localisation images from magnetic resonance imaging (MRI) for 413 (56.3%) patients. Patient clinical and pathological characteristics were compared across body mass index (BMI) groups. Univariable and multivariable logistic regression models were used to address the influence of the preoperative total testosterone level and anthropometric measures of obesity on pathological outcomes. In the multivariate analysis, BMI was not significantly associated with any pathological outcomes. However, the percentage of visceral adipose tissue (VAT%) was an independent predictor of a pathological Gleason score ≥8 (P<0.001), extracapsular extension (ECE; P=0.002) and seminal vesicle invasion (SVI; P=0.007). More importantly, we found that the preoperative total testosterone level was significantly correlated with the VAT% (Pearson's correlation coefficient: -0.485, P<0.001) and subcutaneous adipose tissue (SAT; Pearson's correlation coefficient: 0.413, P<0.001). In conclusion, the results of this study suggest that abdominal fat distribution, and particularly VAT%, is associated with a risk of advanced PCa. Moreover, our present study confirms a significant inverse correlation between visceral adiposity and testosterone. Further studies are warranted to elucidate the biological mechanisms underlying the relationship between abdominal adiposity and the aggressiveness of PCa.

PP50 Body Mass Index, Waist Circumference and Incident Coronary Heart Disease in the Million Women Study

BackgroundBody mass index (BMI) and waist circumference are measures of total and abdominal adiposity, respectively, and both relate to coronary heart disease (CHD) risk. However, these measures are highly correlated,...

Dietary fructose and glucose alter measures of trabecular bone formation and architecture in growing male rats

This study investigated the effects of dietary glucose and fructose on bone formation, microarchitecture, and strength. Twenty‐four male Sprague‐Dawley rats (60 days old) were randomly assigned to consume a high fructose (n=9; 40% fructose, 10% glucose), high glucose (n=9; 50% glucose), or chow diet (n=6; 44% cornstarch) for 12 weeks. Bone measurements included histology and histomorphometry of trabecular bone in the distal femur and a three‐point bending test of the whole tibia. Epididymal and perirenal fat pads were weighed as a measure of abdominal adiposity. There were no differences in energy intake or body weight between groups. Mineral apposition rates (p=0.005), osteoblast surface (p=0.002), and osteoblast number (p=0.005) were higher in glucose and fructose‐fed rats compared to chow‐fed rats. Despite similar effects on bone formation, trabecular thickness was higher in the fructose group compared to the glucose group (p=0.0016). Differences in cortical bone strength among groups were not observed. Heavier epididymal fat pads (glucose vs. chow; p=0.003) and livers (fructose vs. glucose; p=0.000), combined with variations in bone outcomes with different sugar intakes, suggest a link between energy metabolism and bone that should be explored further as a potential explanation for these findings. This work was supported by Georgia Agricultural Experiment Stations grant GEO00663 Hatch 0217572.

Abstract MP64: Body Mass Index and Waist Circumference are More Strongly Associated with Abdominal Adiposity Compared to a Body Shape Index in Middle-aged Adults: The Cardia Study

Background: A Body Shape Index (ABSI) has been recently shown to better predict mortality when compared to BMI and waist circumference. Although individuals with higher abdominal adiposity generally exhibit greater mortality risk, the association between ABSI and imaging-based measures of abdominal adiposity has not been thoroughly explored. Objective: To quantify and compare associations between ABSI, BMI, and waist circumference with computed-tomography assessed measures of visceral (VAT), subcutaneous (SAT), and total (TAT) abdominal adipose tissue volumes in middle age adults according to race and sex. Methods: Coronary Artery Risk Development in Young Adults (CARDIA) is a community-based, prospective study of black and white men and women. Height (cm), weight (kg), and waist circumference (WC) were assessed during the year 25 exam (43-55 yrs), from which, BMI (kg/m 2 ) and A Body Shape Index (ABSI) were calculated. VAT, SAT, and TAT volumes (cm 3 ) were concurrently measured by computed tomography (n=3,155). Linear regression was used to assess the amount of variation in VAT, SAT and TAT explained by BMI, WC and ABSI composition measure accounting for age, sex, race, and study center Results: Height, weight, BMI, WC and ABSI were all univariately associated with VAT, SAT and TAT with significant interactions by race and sex. Across all race/sex groups, BMI, WC and weight explained greater variance in VAT, SAT and TAT compared to ABSI (Table 1). WC generally explained the most variance in abdominal adiposity measures (R 2 =0.56-0.74). BMI explained the largest amount of variance in SAT (R 2 = 0.74-0.78). ABSI and height explained the least variance in abdominal adiposity (range R 2 &lt; 0.29). Conclusions: Although ABSI may provide additional information related to mortality that is not explained by more simple anthropometric measurements, the associations reported may not be strongly mediated through abdominal adiposity. BMI and WC remain simple clinical measures that strongly account for variations in abdominal adiposity.

Does hypertension begin in adolescence?

Does hypertension begin in adolescence?

Obesity and abdominal aortic aneurysm

The relationship between obesity and abdominal aortic aneurysm (AAA) is unclear. An observational cohort study was undertaken to examine the associations between waist circumference as a measure of abdominal adiposity, and between body mass index (BMI) as a measure of total adiposity, and risk of AAA. Data were used from the population-based Swedish Mammography Cohort and the Cohort of Swedish Men, involving 63,655 men and women, aged 46-84 years. Between 1998 and 2009, 597 patients with incident AAA defined by relevant clinical events were identified by linkage to the Swedish Inpatient Register and the Swedish Vascular Registry. Cox proportional hazards models were used to estimate relative risks (RRs) with 95 per cent confidence intervals. In multivariable analysis, individuals with an increased waist circumference had a 30 per cent higher risk of AAA (RR 1·30, 95 per cent confidence interval 1·05 to 1·60) compared with those with a normal waist circumference. The risk of AAA increased by 15 per cent (RR 1·15, 1·05 to 1·26) per 5-cm increment of waist circumference up to the level 100 cm for men and 88 cm for women. There was no association between BMI and risk of AAA. Abdominal, but not total, adiposity was associated with an increased risk of incident AAA. A threshold was observed at a waist circumference of 100 cm for men and 88 cm for women.

Response to Letters Regarding Article, “Sweetened Beverage Consumption, Incident Coronary Heart Disease, and Biomarkers of Risk in Men”

We thank Malavazos et al for their interest in our article.1 Indeed, visceral fat is a potent source of inflammatory factors2 and may act as mediator between sugar-sweetened beverage (SSB) consumption and coronary heart disease (CHD) risk, particularly because fructose intake is associated with de novo lipogenesis.3 To test this hypothesis, we additionally adjusted our multivariate SSB–CHD and SSB–biomarker relationships for waist-to-hip ratio from 1987 onwards. We chose to adjust for waist-to-hip ratio because, unlike waist circumference, it has a relatively weak association with body mass index and can therefore be considered a measure of abdominal adiposity that is independent of general adiposity.4 However, even after adjusting for waist-to-hip …

Perinatal and early adulthood factors associated with adiposity

We used body mass index (BMI) and waist circumference (WC) as fat indicators to assess whether perinatal and early adulthood factors are associated with adiposity in early adulthood. We hypothesized that risk factors differ between men and women and are also different when WC is used for measuring adiposity as opposed to BMI. We conducted a longitudinal study based on a sample of 2,063 adults from the 1978/1979 Ribeirão Preto birth cohort. Adjustment was performed using four sequential multiple linear regression models stratified by sex. Both perinatal and early adulthood variables influenced adulthood BMI and WC. The associations differed between men and women and depending on the measure of abdominal adiposity (BMI or WC). Living with a partner, for both men and women, and high fat and alcohol intake in men were factors that were consistently associated with higher adulthood BMI and WC levels. The differences observed between sexes may point to different lifestyles of men and women, suggesting that prevention policies should consider gender specific strategies.

Sugar‐Sweetened and Diet Beverages in Relation to Visceral Adipose Tissue

Frequent sugar-sweetened beverage (SSB) intake has been consistently associated with increased adiposity and cardio-metabolic risk, whereas the association with diet beverages is more mixed. We examined how these beverages associate with regional abdominal adiposity measures, specifically visceral adipose tissue (VAT). In a cross-sectional analysis of 791 non-Hispanic white men and women aged 18-70 we examined how beverage consumption habits obtained from a food frequency questionnaire associate with overall and abdominal adiposity measures from MRI. With increasing frequency of SSB intake, we observed increases in waist circumference (WC) and the proportion of visceral to subcutaneous abdominal adipose tissue (VAT%), with no change in total body fat (TBF%) or BMI. Greater frequency of diet beverage intake was associated with greater WC, BMI, and TBF%, but was not associated with variation in visceral adiposity We conclude that increased frequency of SSB consumption is associated with a more adverse abdominal adipose tissue deposition pattern.

Socio-economic determinants of anthropometric measures of abdominal adiposity among older people in England

Abstract Objective: to look into the socio-economic determinants of levels of three anthropometric measures of abdominal adiposity among older people in England -body mass index, waist circumference (WC), and waist-hip ratio (WHR)- and of changes along two health risk classifications: the World Health Organisation classification based on BMI levels and the WHO combined classification based on BMI and waist circumference measurements. Design: quantile regression and multinomial analysis using data from the English Longitudinal Study of Ageing (ELSA), wave 2 (2004-05) and wave 4 (2008-09) Results: The quantile analysis on levels led to disparate results depending on the wave, which would question results previously published based on only one wave. However, we found that age tends to present an inverse U-shaped relationship with BMI and WC, smoking is negatively associated with BMI and positively with WC and WHR, alcohol consumption is negatively associated with BMI and WC levels, net total wealth is negatively related with the three anthropometric measures, educational attainment is negatively associated with each measure, and depression is positively associated with each measure. The multinomial analysis found that living in a larger household size increases the likelihood of becoming or remaining unhealthy irrespective of which classification we used. Furthermore, using the BMI-based categorisation, the initial category is highly relevant as a predictor of the category four years later and alcohol consumption would be positively associated with being or becoming obese. From the combined BMI-WC categorisation, we found that net total wealth would be negatively associated with becoming or remaining unhealthy whereas depression is a significant predictor of becoming or remaining unhealthy.

European adolescents’ level of perceived stress and its relationship with body adiposity—The HELENA Study

Since stress is hypothesized to be involved in the aetiology of obesity, the present study examined the current perception of stress in European adolescents and the association between adolescent perceived stress and their adiposity. Observational data from 1121 adolescents aged 12.5-17.5 years from six European cities involved in the Healthy Lifestyle in Europe by Nutrition in Adolescence cross-sectional study, was investigated. The adolescents completed the adolescent stress questionnaire, comprising 10 different stress dimensions. Anthropometric measurements (weight, height, skinfold thicknesses and circumferences) and bioelectrical impedance analysis were performed, and personal characteristics (age, pubertal stage and parental education) were collected. The measures of perceived stress were described for boys and girls separately and gender differences were investigated. Associations between the adolescents' perceived stress and indicators of general (body mass index z-score, sum of skinfold thicknesses and body fat%) and abdominal (waist and hip circumference, and waist/height ratio) adiposity were examined using hierarchical linear models. While girls reported systematically higher levels of stress compared with boys, their stress profiles were similar, with highest levels for school-related stress followed by future uncertainty. Only in girls, perceived stress was significantly associated with increased measures of general and abdominal adiposity. In boys, no relationship between perceived stress and adiposity measures was observed. School is reported to be an important source of adolescent stress and should be the focus of stress management campaigns. Only in girls, the hypothesis that stress might be involved in the aetiology of obesity during adolescence was supported.

Measures of Abdominal Adiposity and the Risk of Stroke

Excess fat accumulates in the subcutaneous and visceral adipose tissue compartments. We tested the hypothesis that indicators of visceral adiposity, namely, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR), are better predictors of stroke risk than body mass index (BMI). The association of BMI, WC, WHR, and WHtR with stroke was assessed in 31,201 men and 23,516 women, free of vascular disease at baseline, from the MOnica Risk, Genetics, Archiving and Monograph (MORGAM) study. During a mean follow-up of 11 years, 1130 strokes were recorded. Relative risks (95% CI) were calculated by Cox regression after stratification for center and adjustment for age, smoking, educational level, alcohol consumption, hypertension, diabetes, total cholesterol, high-density lipoprotein cholesterol, and BMI and model fit was assessed using log-likelihoods. BMI, WC, WHR, and WHtR were associated with the risk of stroke in men. After full adjustment including BMI, the relative risks for stroke remained significant for WC (1.19 [1.02 to 1.34] per 1 SD increase in WC), WHR (1.14 [1.03 to 1.26]), and WHtR (1.50 [1.28 to 1.77]). Among women, the extent of the associations with stroke risk was similar for WHtR (1.31 [1.04 to 1.65]), WC (1.19 [0.96 to 1.47]), and WHR (1.08 [0.97 to 1.22]). Further analyses by World Health Organization obesity categories showed that WC, WHR, and WHtR were associated with the risk of stroke also in lean men and women (BMI<25 kg/m2), independently of confounders, cardiovascular risk factors, and BMI. Indicators of abdominal adiposity, especially WHtR, are more strongly associated with stroke risk than BMI. These results emphasize the importance of measuring abdominal adiposity, especially in lean subjects.

Anthropometric factors, physical activity, and risk of Non-Hodgkin's lymphoma in the Women's Health Initiative

Background: Incidence rates of non-Hodgkin's lymphoma (NHL) increased substantially in the United States and worldwide during the latter part of the 20th century, but little is known about its etiology. Obesity is associated with impaired immune function through which it may influence the risk of NHL; other factors reflecting energy homeostasis (height, abdominal adiposity, and physical activity) may also be involved. Methods: We examined the association of anthropometric factors and physical activity with risk of NHL and its major subtypes in a large cohort of women aged 50–79 years old who were enrolled at 40 clinical centers in the United States between 1993 and 1998. Over a mean follow-up period of 11 years, 1123 cases of NHL were identified among 158,975 women. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Results: Height at baseline was positively associated with risk of all NHL and with that of diffuse large B-cell lymphoma (HRs q4vs.q1 1.19, 95% CI 1.00–1.43 and 1.43, 95% CI 1.01–2.03, respectively). Measures of obesity and abdominal adiposity at baseline were not associated with risk. Hazard ratios for NHL were increased for women in the highest quartile of weight and body mass index at age 18 (HRs q4vs.q1 1.29, 95% CI 1.01–1.65 and 1.27, 95% CI 1.01–1.59, respectively). Some measures of recreational physical activity were modestly associated with increased risk of NHL overall, but there were no clear associations with specific subtypes. Conclusion: Our findings regarding anthropometric measures are consistent with those of several previous reports, suggesting that early life influences on growth and immune function may influence the risk of NHL later in life.

P2-303 Development of predictive equations for DXA measures of adiposity in an Indian population

IntroductionPredictive equations for DXA measures of total and abdominal adiposity from simple anthropometry for an Indian population will enable more accurate estimates of adiposity to be derived in other studies.MethodsUsing...

The association of lifetime alcohol use with measures of abdominal and general adiposity in a large-scale European cohort

The relation between lifetime use of alcohol and measures of abdominal and general adiposity is unknown. Among 99,381 men and 158,796 women of the European Prospective Investigation into Cancer and Nutrition (EPIC) study, means of waist circumference (WC), waist-to-hip-ratio (WHR) and body mass index (BMI), and odds ratios (OR) for a larger WC than predicted for a given BMI (WClp=positive residuals of gender specific linear regression of BMI on WC) across categories of average lifetime use of alcohol (total, from wine and from beer) were calculated, all adjusted for socio-demographic, lifestyle and health factors. WC, WHR and BMI in men using lifetime ≤6 g/d alcohol were 95.1 cm, 0.942 and 27.3 kg/m(2), and 96.2 cm, 0.961 and 28.3 kg/m(2) when using >96 g/d. WC and WHR in women was 83.2 cm and 0.813 for ≤6 g/d, and 84.6 cm and 0.830 for >60 g/d, whereas BMI deviated only slightly with the lowest BMI (26.7 kg/m(2)) observed for >6-24 g/d. Compared with ≤6 g/d, OR for a WClp in both genders increased steadily across categories of alcohol use (up to 1.40 (95% confidence interval 1.32, 1.49) in men using >60 g/d and 1.63 (1.54, 1.73) in women using >24 g/d), though increase was higher for alcohol from beer than from wine (P for difference between beer and wine<0.001 (men) and=0.002 (women)). Lifetime alcohol use is positively related to abdominal and general adiposity in men, possibly following the male weight gain pattern; in women, it is positively related only to abdominal adiposity. In this context, beer may contribute additionally to abdominal adiposity.

Body mass index, waist circumference and waist–hip ratio: which is the better discriminator of cardiovascular disease mortality risk? Evidence from an individual‐participant meta‐analysis of 82 864 participants from nine cohort studies

Few studies have examined both the relative magnitude of association and the discriminative capability of multiple indicators of obesity with cardiovascular disease (CVD) mortality risk. We conducted an individual-participant meta-analysis of nine cohort studies of men and women drawn from the British general population resulting in sample of 82 864 individuals. Body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) were measured directly. There were 6641 deaths (1998 CVD) during a mean of 8.1 years of follow-up. After adjustment, a one SD higher in WHR and WC was related to a higher risk of CVD mortality (hazard ratio [95% CI]): 1.15 (1.05-1.25) and 1.15 (1.04-1.27), respectively. The risk of CVD mortality also increased linearly across quintiles of both these abdominal obesity markers with a 66% increased risk in the highest quintile of WHR. In age- and sex-adjusted models only, BMI was related to CVD mortality but not in any other analyses. No major differences were revealed in the discrimination capabilities of models with BMI, WC or WHR for cardiovascular or total mortality outcomes. In conclusion, measures of abdominal adiposity, but not BMI, were related to an increased risk of CVD mortality. No difference was observed in discrimination capacities between adiposity markers.

Associations of cardiovascular risk factors with two surrogate markers of subclinical atherosclerosis: Endothelial function and carotid intima media thickness

Objective Endothelial function and carotid intima media thickness (cIMT) were investigated in a cohort of 54 healthy adults without known cardiovascular disease. Methods Pulse wave amplitude was determined with peripheral arterial tonometry (PAT) to obtain the reactive hyperemia (RH)–PAT ratio. Ultrasound was used to determine cIMT. Results cIMT and RH–PAT were significantly associated (rho = −0.35, P = 0.02) in univariate analysis. RH–PAT was significantly associated with age, triglycerides, fasting glucose, HDL, WHR, waist circumference and VAT. cIMT was associated with age, smoking history, fasting glucose, systolic blood pressure, diastolic blood pressure and LDL. In multivariate regression analyses, triglyceride level ( P = 0.04) remained a significant determinant of RH–PAT whereas systolic blood pressure ( P = 0.02) and smoking pack-year history ( P = 0.046) were significant determinants of cIMT. Conclusion Determinants of cIMT and RH–PAT were different, dominated by triglyceride and abdominal adiposity measures for RH–PAT but traditional risk factors including blood pressure, glucose, smoking and LDL for cIMT.

Adverse Associations between Visceral Adiposity, Brain Structure, and Cognitive Performance in Healthy Elderly

The link between central adiposity and cognition has been established by indirect measures such as body mass index (BMI) or waist–hip ratio. Magnetic resonance imaging (MRI) quantification of central abdominal fat has been linked to elevated risk of cardiovascular and cerebro-vascular disease. However it is not known how quantification of visceral fat correlates with cognitive performance and measures of brain structure. We filled this gap by characterizing the relationships between MRI measures of abdominal adiposity, brain morphometry, and cognition, in healthy elderly. Methods: A total of 184 healthy community dwelling elderly subjects without cognitive impairment participated in this study. Anthropometric and biochemical markers of cardiovascular risk, neuropsychological measurements as well as MRI of the brain and abdomen fat were obtained. Abdominal images were segmented into subcutaneous adipose tissue and visceral adipose tissue (VAT) adipose tissue compartments. Brain MRI measures were analyzed quantitatively to determine total brain volume, hippocampal volume, ventricular volume, and cortical thickness. Results: VAT showed negative association with verbal memory (r = 0.21, p = 0.005) and attention (r = 0.18, p = 0.01). Higher VAT was associated with lower hippocampal volume (F = 5.39, p = 0.02) and larger ventricular volume (F = 6.07, p = 0.02). The participants in the upper quartile of VAT had the lowest hippocampal volume even after adjusting for age, gender, hypertension, and BMI (b = −0.28, p = 0.005). There was a significant age by VAT interaction for cortical thickness in the left prefrontal region. Conclusion: In healthy older adults, elevated VAT is associated with negative effects on cognition, and brain morphometry.