Ratio Of Trunk Fat Research Articles

Changes in Physical Fitness Parameters with Increasing Age

It is inevitable to see changes in physical fitness parameters with age. This study compares the physical fitness parameters, body composition, laxity, balance, proprioception, and muscle strength between different age groups. The study comprised 44 individuals in good health, divided into two age groups: 20-39 and 40-65.Body composition was measured with Tanita BC 418; balance was measured with a Biodex Biosway stabilometer device, and laxity was measured with a GNRB knee arthrometer. The isokinetic system (Cybex NORM, Humac, CA, USA) was used for strength and proprioception measurements. Anteroposterior, mediolateral, and overall stability index among the balance parameters between the two groups was significant. Among the groups, a statistically significant difference was observed in terms of body mass index (BMI), total body fat ratio, trunk fat ratio, and dominant leg fat ratio (p 0.05).With increasing age, it is essential to be aware of the negatively changing body composition and deteriorating balance and encourage participation in physical activity and exercise to prevent physical fitness loss, especially from 40.

Impaired Sensitivity to Thyroid Hormones is Associatedwith Central Obesity in Euthyroid Type 2 Diabetes Mellitus Patients with Overweight and Obesity.

Thyroid hormone levels are associated with the distribution of body components in humans. This study aimed to investigate the associations between thyroid hormone (TH) levels, central sensitivity to THs, and body composition in overweight and obese patients with euthyroid type 2 diabetes mellitus (T2DM). This cross-sectional study included 1215 euthyroid T2DM patients (721 men and 494 women) aged 20-80 years. The thyroid hormone sensitivity indices included the thyroid feedback quartile-based index (TFQI), thyrotroph T3 resistance index (TT3RI), thyrotroph T4 resistance index (TT4RI), and thyroid-stimulating hormone index (TSHI). The appendicular fat ratio, trunk fat ratio, android fat ratio, gynoid fat ratio, and appendicular skeletal muscle mass (ASM) were measured via dual-energy X-ray absorptiometry. The data revealed a greater proportion of subjects with impaired central sensitivity to THs in the obese group. TFQIFT4 and TFQIFT3 levels were positively correlated with the upper limb fat ratio, lower limb fat ratio, gynoid fat ratio, and total fat ratio. TSHI was positively correlated with body mass index (BMI), upper limb fat ratio, lower limb fat ratio, trunk fat ratio, android fat ratio, gynoid fat ratio, total fat ratio, and appendicular skeletal muscle mass index (ASMI) in women. In men, TSHI was only positively correlated with upper limb fat ratio, lower limb fat ratio, and total fat ratio. Logistic regression analysis indicated that TT3RI and TFQIFT3 were independently and positively associated with central obesity and low muscle mass in overweight and obese men. No significant differences were found among the women. THs central sensitivity is related to the body composition of euthyroid T2DM patients. Specifically, high levels of TT3RI and TFQIFT3 are associated with central obesity and low muscle mass in T2DM men with overweight and obesity.

Dietary and Exercise Interventions for Perimenopausal Women: A Health Status Impact Study.

PurposeTo explore the impact of different intervention methods on physical health indexes of perimenopausal women.MethodsSeventy-eight perimenopausal women were divided into three groups. Group A received routine gynecological diagnosis and treatment and participated in centralized lifestyle health education. Group B was required to participate in all intensive education content, and professional dietitians gave individualized dietary guidance. Group C received intensive education, individualized diet intervention and intensified resistance exercise. Dietary scores, exercise habits, waist circumference, body mass index, fat and muscle mass were observed after three months.ResultsAfter the intervention, the total diet score of group C was higher than groups A and B, and the red meat score was significantly reduced. The number of patients in groups B and C who exercised >3 times per week and the number of resistance exercises were significantly increased, while the number of aerobic exercises per week in group C was significantly increased. The body fat and waist circumference were significantly reduced, and skeletal muscle weight was significantly increased. Body mass index, trunk fat ratio and waist-to-hip ratio were significantly decreased in groups B and C, while trunk muscle was significantly increased in group C.ConclusionThe combined intervention of the three methods can give full play to the synergistic effect of various interventions. The improvement effect of increasing the appropriate amount of resistance exercise is more obvious, which is worthy of further promotion and application.

Body fat distribution and its risk for cardiovascular events in 10 years: Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Body fat distribution seems to have different effects in cardiovascular diseases (CVD). We aimed to estimate the associations between lower limbs and trunk fat ratio and the 10-year CVD risk, and isolated risk factors in men and women. A total of 10,917 participants from ELSA-Brasil were eligible for this cross-sectional study. Associations between lower limb/trunk fat ratio with the percentage of 10-year CVD risk - according to the Framingham Risk Score - and its risk factors (systolic blood pressure, total cholesterol and HDL-cholesterol, diabetes, and use of antihypertensive medication) were performed using generalized linear models, linear and logistic regressions. All analyses were stratified by gender and adjustments were made by age, self-reported skin color, educational attainment, alcohol consumption, leisure physical activity, hypolipidemic drug use and, for women, menopausal status. In this study, 55.91% were women, with a mean age of 52.68 (SD = 6.57) years. A higher lower limb/trunk fat ratio was related to lower 10-year CVD risk, as well as a reduction in systolic blood pressure, total cholesterol, and antihypertensive drug use, also an increasing HDL-cholesterol in both genders, but this relationship was stronger in women. Besides, a protective relationship to diabetes was observed in women. Higher fat accumulation in the lower body, when compared to the trunk, seems to have a lower risk of CVD and associated risk factors - even in the presence of fat in the abdominal region - with women presenting lower risks than men.

Association of Appendicular Skeletal Muscle to Trunk Fat Ratio with Type 2 Diabetes Mellitus in Older Adults

Introduction: Mounting evidence has demonstrated that skeletal muscle and visceral adiposity play crucial roles in glucose metabolism. The purpose of this study was to investigate whether the appendicular skeletal muscle mass index (ASMI) to trunk fat mass (TFM) ratio (ASMI/TFM) is a more specific and identifiable factor for type 2 diabetes mellitus (T2DM) in older adults than conventional anthropometric measures. Methods: This cross-sectional study included 1,370 older adults from the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) cohort. ASMI and TFM were measured by using a bioelectrical impedance analyzer, and T2DM was defined with the criteria of the American Diabetes Association. Odds ratios (ORs) were evaluated using multivariable logistic analysis. Results: The prevalence of T2DM is 20.0% in this study. The multivariable-adjusted ORs (95% confidence interval) of T2DM for increasing categories of ASMI/TFM, BMI, and waist circumference (WC) were 1.00 (reference), 0.70 (0.49, 1.02), 0.61 (0.42, 0.89), and 0.45 (0.30, 0.67; p for trend <0.0001); 1.00 (reference), 1.15 (0.83, 1.60), and 1.37 (0.94, 2.01; p for trend = 0.10); and 1.00 (reference) and 1.78 (1.19, 2.74; p < 0.01), respectively. Conclusions: Higher ASMI/TFM was associated with a lower prevalence of T2DM in this study of older adults. The T2DM predictive value of ASMI/TFM may be stronger than BMI and WC in this population.

Impact of body composition on COVID-19 susceptibility and severity: A two-sample multivariable Mendelian randomization study

ObjectivesRecent studies suggested obesity to be a possible risk factor for COVID-19 disease in the wake of the coronavirus (SARS-CoV-2) infection. However, the causality and especially the role of body fat distribution in this context is still unclear. Thus, using a univariable as well as multivariable two-sample Mendelian randomization (MR) approach, we investigated for the first time the causal impact of body composition on the susceptibility and severity of COVID-19. MethodsAs indicators of overall and abdominal obesity we considered the measures body mass index (BMI), waist circumference (WC), and trunk fat ratio (TFR). Summary statistics of genome-wide association studies (GWASs) for these body composition measures were drawn from the GIANT consortium and UK Biobank, while for susceptibility and severity due to COVID-19 disease data from the COVID-19 Host Genetics Initiative was used. For the COVID-19 cohort neither age nor gender was available. Total and direct causal effect estimates were calculated using Single Nucleotide Polymorphisms (SNPs), sensitivity analyses were done applying several robust MR techniques and mediation effects of type 2 diabetes (T2D) and cardiovascular diseases (CVD) were investigated within multivariable MR analyses. ResultsGenetically predicted BMI was strongly associated with both, susceptibility (OR = 1.31 per 1 SD increase; 95% CI: 1.15–1.50; P-value = 7.3·10−5) and hospitalization (OR = 1.62 per 1 SD increase; 95% CI: 1.33–1.99; P-value = 2.8·10−6) even after adjustment for genetically predicted visceral obesity traits. These associations were neither mediated substantially by T2D nor by CVD. Finally, total but not direct effects of visceral body fat on outcomes could be detected. ConclusionsThis study provides strong evidence for a causal impact of overall obesity on the susceptibility and severity of COVID-19 disease. The impact of abdominal obesity was weaker and disappeared after adjustment for BMI. Therefore, obese people should be regarded as a high-risk group. Future research is necessary to investigate the underlying mechanisms linking obesity with COVID-19.

Abstract 3483: Measures of overall and central adiposity in relation to risk of obesity-related cancers among normal weight men and women in the UK Biobank

Abstract Background: Within the normal BMI (body mass index (BMI) of 18.5-24.9kg/m2) category, some individuals may be at increased risk of developing obesity-related cancers. Towards this end, studies have shown positive associations between body fat, particularly in the abdominal region, and cancer-associated metabolic disturbances among normal weight individuals. However, little is known about the association between body fat distribution and risk of obesity-related cancers among normal weight individuals. Thus, in this study, we examined the association of overall and central adiposity, assessed using bioelectrical impedance (BIA)-derived and anthropometric measures, with risk of selected obesity-related cancers among normal weight persons. Methods: The study included normal weight individuals aged 40-70 years who were enrolled in the UK Biobank cohort between 2006 and 2010. BIA-derived and anthropometric body fat measures were taken at baseline by trained staff. Incident tumors were ascertained via linkage to UK cancer registries. Multivariable Cox proportional hazards regression models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI) for the associations of the body fat measures with risk of cancers of the breast, endometrium, ovary, colorectum, pancreas, and kidney, and with multiple myeloma. Results: The overall incidence of obesity-related cancers was 2.2 per 1000 person-years of follow-up (N= 2364 incident obesity-related cases among 152,489 subjects with a median follow-up time of 7 years). All measures of central and peripheral adiposity demonstrated linear positive dose-response relationships with risk of postmenopausal invasive breast cancer and with endometrial cancer. For all of the body fat measures, postmenopausal women in the highest quartile showed increased invasive breast cancer risk, after adjusting for potential confounders, compared to women in the lowest quartile, with hazard ratios ranging from 1.29 (95% CI: 1.11-1.50) for the ratio of trunk fat to leg fat mass to 1.59 (95% CI: 1.31-1.93) for trunk fat mass index (TFMI; calculated as trunk fat mass (kg)/height (m)2). For endometrial cancer, only the TFMI (HR: 1.80, 95% CI:1.12-2.88) and waist circumference (HR: 1.70, 95% CI: 1.04-2.80) were positively associated with risk. A waist-to-hip ratio in the highest quartile was also positively associated with colorectal cancer risk among males (HR: 1.56, 95% CI: 1.03-2.37). None of the body fat measures were associated with risk colorectal cancer risk among women or with risk of the remaining cancers. Conclusion: The findings of this study suggest that elevated levels of central and/or overall adiposity may be associated with increased risk of postmenopausal breast cancer, endometrial cancer and probably colorectal cancer (males), among normal weight individuals. Evaluating body composition in those with a normal BMI can potentially identify individuals at increased risk for cancer providing an opportunity for interventions to reduce risk. Citation Format: Rhonda S. Arthur, Mimi Kim, Andrew Dannenberg, Thomas Rohan. Measures of overall and central adiposity in relation to risk of obesity-related cancers among normal weight men and women in the UK Biobank [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 3483.

2002-P: Waist-Hip Ratio: A Better Obesity Measure Index Represents Insulin Secretion among Obese Women with Different Glucose Metabolism Status

Objective: To investigate the association of simple obesity measures (BMI, WC and WHR) with insulin secretion in obese subjects with normal glucose metabolism (NGM), prediabetes, and T2DM. Research Design and Methods: 848 obese patients were recruited and divided into three groups (428 NGM, 248 prediabetes, and 172 T2DM). BMI, WC, and WHR were obtained. Insulin secretion was described by three beta cell function indices (HOMA-β, ΔI30/ΔG30 and AUCI60-120). Pearson correlation analysis and multiple linear regression analysis were used. In addition, 284 subjects estimated their body fat by dual x-ray absorptiometry. The joint relationship between obesity measures, body fat and insulin secretion were studied. Results: As glucose metabolism spectrum changed from NGM to prediabetes and to T2DM, the correlation between WHR and insulin secretion declined (from r=0.286**, r=0.081, r=0.2** to r=-0.012, r=-0.072, r=-0.074 and to r=-0.173*, r=-0.175*, r=-0.171*; *P &amp;lt; 0.05, **P &amp;lt; 0.01). In contrast, BMI and WC showed a consistent association with insulin secretion (r&amp;gt;0). Similar relevant reversal was only found in female subjects. There were significant interactions of WHR and glucose status on insulin secretion in female subjects, in this adjusted model, WHR was associated with higher insulin secretion in NGM group (1.19±0.23**, 0.58±0.32, 0.82±0.26**) and lower in T2DM group (-0.77±0.34*, -1.78±0.47**, -1.36±0.39), not prediabetes (0.15±0.27, 0.08±0.38, 0.28±0.31). Adding HOMA-IR to the core model can increase the inverse associations. Elevated limb fat to trunk fat ratio had significantly lower insulin secretion levels, and the relationship between this fat ratio and WHR was considerably strong in female. Conclusions: WHR and insulin secretion relationship is dependent on glucose status among obese women. As diabetes developed, higher WHR revealed lower insulin secretion, which may be attributed to more fat distributed in extremities. Disclosure J. Wu: None. B. Wang: None.

Effects of Moderate Consumption of Non-Nutritive Sweeteners on Glucose Tolerance and Body Composition in Rats

INTRODUCTION: To combat the effects of excess energy intake on obesity and glucose intolerance, non-nutritive sweeteners (NNS) have been used as a replacement for more energy dense traditional sweeteners. However, limited research has been completed regarding the metabolic effects of moderate consumption of non-nutritive sweeteners. PURPOSE: The purpose of this study was to determine the effect of moderate consumption of NNS (aspartame and sucrose) on glucose tolerance and the insulin response to an oral glucose load, and on body composition in an animal model. METHODS: Male Sprague-Dawley rats (N=30) were given aspartame (ASP, n=10, 8.5 mg/kg/day) or sucralose (SUC, n=10, 2.6 mg/kg/day) in drinking water, or untreated water as a control (n=10) for 6 weeks. In the morning, after overnight fasting, rats underwent an oral glucose tolerance test (2g/kg 50% dextrose w/v by gavage). Blood was obtained by tail clip; glucose was measured by glucose meter and insulin was measured by radioimmunoassay. Following euthanasia, lean mass and fat mass were determined by dual energy x-ray absorptiometry; epididymal fat pads were removed and weighed. RESULTS: No significant differences were found between groups in area under the curve for glucose or insulin response to an oral glucose load. Significant differences in serum insulin were seen 15 minutes after the glucose load between both the ASP (0.72 ± 0.06 ng/mL vs 0.94 ± 0.08 ng/mL, p=0.035) and SUC group (0.72 ± 0.07 ng/mL vs 0.94 ± 0.08 ng/mL, p=0.048) compared with the control. While percent body fat was not different between groups, epididymal fat pad mass was significantly higher in the ASP group compared with the control group (5.50 ± 0.34 g vs 4.55 ± 0.19 g, p=0.042), while the ratio of trunk fat to total fat was significantly lower in the SUC group compared with controls (0.49 ± .02 vs 0.60 ± .14, p< 0.01). CONCLUSION: Moderate consumption of aspartame or sucralose had no effect on percent body fat. Fifteen minutes following a glucose load, serum insulin was significantly lower in both NNS groups compared with the control, suggesting a potential suppression in insulin response. Both aspartame and sucralose altered body fat distribution. These results may have implications for addressing abdominal obesity.

Effect of elevated physical activity on changes in body composition and subcutaneous fat distribution in boys aged 10 to 16 years: a longitudinal study

The study is aimed at evaluation of the effect of regular physical activity on total and subcutaneous body fat and its distribution in boys aged 10 to 16 years. A three-year longitudinal study was carried out in order to monitor physical development in 237 boys from sports schools and regular schools in Warsaw, Poland. The boys were selected so that their rate of puberty changes was similar based on evaluation of voice and facial hair. The authors measured 5 skinfolds in the following sites: triceps, calf, subscapular, suprailiac, and abdominal skinfolds. The percentage fraction of total body fat in body mass was measured by means of Tanita TBF 300 electronic body composition analyser. A limb fat to trunk fat ratio (LF/TF) was also calculated in order to evaluate the type of distribution of subcutaneous fat in boys and monitor its changes as affected by regular high physical activity throughout puberty. Lower total body fat and subcutaneous fat in boys from sports schools was the effect of considerably higher physical activity. It was demonstrated that with some minimal values of total body fat and subcutaneous fat, physical activity did not cause a reduction in body fat. It was found that elevated physical activity in boys is conducive to development of a more limb-oriented (peripheral) fatness, which is more favourable to human health.

Small-Dense LDL Cholesterol/Large-Buoyant LDL Cholesterol Ratio as an Excellent Marker for Indicating Lipodystrophy in HIV-Infected Patients

To examine whether the lipid parameters are predicting factors for human immunodeficiency virus (HIV)-associated lipodystrophy. Whole-body fat compositions of HIV-positive patients receiving stavudine-containing antiretroviral regimens (n = 79) were determined. Lipodystrophy was defined as a ratio of trunk fat mass/lower limb fat mass greater than 2.28. Blood samples were analyzed for total cholesterol (TC), triglycerides, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), small-dense LDL-C (sdLDL-C), apoAI, apoB, lipoprotein(a), and CD4 cell counts. Large-buoyant LDL-C (lbLDL-C) was calculated (LDL-C minus sdLDL-C). Twenty-six patients were classified as having lipodystrophy. The mean values of triglycerides, HDL-C, sdLDL-C, apoB, TC/HDL-C, apolipoprotein (apo) B/apoAI, and sdLDL-C/lbLDL-C showed significant differences between patients with and without lipodystrophy (P < .02). Using logistic regression analysis, sdLDL-C/lbLDL-C was identified as a significant predictor of lipodystrophy (P < .001). At a ratio of 0.554, the odds ratio was 17.8 with a likelihood ratio of 5.5. The sdLDL-C/lbLDL-C ratio is an excellent marker for indicating lipodystrophy in HIV-infected patients.

Increase in subcutaneous adipose tissue and fat free mass in women with polycystic ovary syndrome is related to impaired insulin sensitivity

Objectives: The present study was performed to search whether subcutaneous and whole body adipose tissue increase and they relate to measures of insulin sensitivity in women with polycystic ovary syndrome (PCOS).Materials and methods: 52 women with PCOS and 53 healthy controls, all with similar age and body mass index participated in the study. A skinfold caliper device was used to measure biceps, triceps, subscapular and suprailiac skinfold thickness (SFT). Mid-upper arm circumference (MUAC) was measured using a tape measure. Body fat distributions were determined by bioelectrical impedance analysis. Insulin resistance score was computed with the HOMA formula. Plasma adiponectin was measured by EIA.Results: SFT in all defined areas, MUAC, total body and trunk fat free mass, and HOMA score were higher in women with PCOS compared with healthy women, while adiponectin level was significantly lower. SFT values correlated positively with HOMA score, and negatively with blood adiponectin level. Regression analysis indicated, SFT in triceps and supscapular areas, trunk fat mass, trunk fat ratio, fat free mass and trunk fat free mass values as the most powerful predictors of HOMA score.Conclusions: The present study showed that SFT in different body regions and fat-free tissue mass are increased in women with PCOS, with a significant relation to impaired insulin sensitivity.

Associations between weight-related eating behaviors and adiposity in postmenopausal Japanese American and white women

The purpose of this study was to test the associations between cognitive and psychological eating behavior traits and detailed measures of adiposity and body fat distribution using imaging-based methods in a cross-sectional study. Eating behavior traits (compensatory and routine restraint, external eating, and emotional eating) were assessed using the validated Weight-Related Eating Questionnaire, and measures of adiposity using anthropometry, dual energy X-ray absorptiometry (DXA), and magnetic resonance imaging (MRI). Each adiposity outcome of interest (total fat, ratio of trunk fat to periphery fat, visceral and subcutaneous fats as % of abdominal area, and % liver fat) was regressed on the four eating behaviors while adjusting for age and race/ethnicity. This study included a total of 60 postmenopausal Japanese American (n=30) and white (n=30) women (age: 60–65years, BMI: 18.8–39.6kg/m2). Weight-related eating behavior traits did not differ by ethnicity. Higher external eating scores were associated with measures of total adiposity, including higher BMI (β=0.36, p=0.02) and DXA total fat mass (β=0.41, p=0.001), and with MRI abdominal subcutaneous fat (β=0.55, p=0.001). Higher routine restraint scores were associated with visceral adiposity (β=0.42, p=0.04). Our findings suggest that different weight-related eating behavior traits might increase not only total adiposity but also abdominal and visceral fat deposition associated with higher metabolic risks. Future research, preferably in a prospective study of men and women and including biomarkers related to psychological stress, will be needed to explore potential underlying biological mechanisms.

Leptin, Fat Mass, and Bone Mineral Density in Healthy Pre- and Postmenopausal Women

The purpose was to examine relationships between age, fat mass, and bone mineral density (BMD) with resting leptin levels in premenopausal and postmenopausal women. Young (aged 18–30 yr, n = 30) and estrogen-deficient postmenopausal (aged 55–75 yr, n = 43) women were recruited. Total body and segmental fat mass and bone-free lean body mass (BFLBM) and total body, lumbar spine, and proximal femur BMD were assessed using dual-energy X-ray absorptiometry. Serum-resting, fasted leptin levels were measured by Immunoradiometric Assay (IRMA), and leptin-to-fat mass ratios were calculated. Young and older women had similar amounts of BFLBM, but older women had greater ( p < 0.05) amounts of fat mass and 35% higher leptin levels. Age differences in leptin concentrations were no longer significant after controlling for fat mass. Older women had significantly ( p < 0.05) lower hip BMD values. Age was negatively related ( r = −0.29, p < 0.05) to leptin:trunk fat ratio. Increases in fat mass, not menopause per se, contributes to higher leptin levels in older women. Relationships between leptin and BMD may be age dependent.

Associations of the Limb Fat to Trunk Fat Ratio With Markers of Cardiometabolic Risk in Elderly Men and Women

The ratio of limb fat to trunk fat (LF/TF) is associated with markers of cardiometabolic risk in elderly men and women. It is unknown if LF/TF is associated with cardiometabolic risk beyond that explained by LF and TF independently. Participants included abdominally obese men (n = 58) and women (n = 78) between 60 and 80 years of age. Regional adiposity was quantified using magnetic resonance imaging. Insulin resistance, fasting glucose, high-density lipoprotein (HDL) cholesterol, plasma triglycerides, and adiponectin were determined using standard procedures. After control for potential confounders, TF was positively associated with fasting glucose, insulin resistance, and plasma triglycerides and negatively associated with HDL cholesterol and adiponectin (p < or = .05). These associations were strengthened after further control for LF (p < .05), with the exception of adiponectin in men (p > .05). After control for potential confounders, LF was negatively associated with adiponectin in men (p < .05) but not with any other marker of cardiometabolic risk (p > .05). After further control for TF, LF was negatively associated with plasma triglycerides and positively associated with HDL cholesterol in both genders combined (p < .05) and with adiponectin in women (p < .05) but not in men (p > .05). LF/TF was not associated with any marker of cardiometabolic risk after control for LF and TF. These results suggest that it is the absolute, rather than relative, amounts of LF and TF that have the greatest influence on cardiometabolic risk in elderly men and women.

Growth Hormone Treatment and Fat Redistribution in Children Born Small for Gestational Age

To determine whether in children born small for gestational age (SGA) high-dose growth hormone (GH) treatment is not only associated with catch-up of growth and with gain of lean mass, but also with a more central fat distribution. Short children who were SGA (n = 25; age [mean +/- SD], 5.3 +/- 1.5 years) were randomly assigned to remain untreated (n = 14) or to receive GH (n = 11; sc 66 mug/Kg/d). Growth status and body composition were assessed at the study's start, after 1 year, and after 2 years with anthropometry and absorptiometry. Children who were treated with GH gained more height and weight than children who were untreated and developed a less adipose body composition (all P < .0001), as expected. However, these changes were also accompanied by a relatively more centripetal distribution of fat mass (0-2 year change in ratio of trunk fat to limb fat; 0.26 +/- 0.23 versus 0.02 +/- 0.15; P < .0001). In children who are SGA, catch-up growth induced by exogenous GH in high doses is accompanied by a less adipose body composition and a more central fat distribution.

Limb Fat to Trunk Fat Ratio in Elderly Persons Is a Strong Determinant of Insulin Resistance and Adiponectin Levels

Similar to lipodystrophy syndromes, aging results in increased visceral adiposity with loss of subcutaneous adipose tissue in the extremities. The hypothesis of this study is that the distribution of limb fat to trunk fat (LF/TF) ratio in elderly persons has a stronger correlation than trunk fat alone to insulin resistance and adiponectin levels. Thirty-eight elderly participants were divided into an insulin-resistant (IR) group and an insulin-sensitive (IS) group. Limb fat and trunk fat were measured by dual-energy x-ray absorptiometry. Insulin resistance was measured by a hyperinsulinemic-euglycemic clamp. There was no significant difference between the IS and IR groups with respect to body mass index, body fat index, absolute amount of trunk fat, or percent body fat. However, the difference in LF/TF ratio between the IS (1.02 +/- 0.05) and the IR groups (0.77 +/- 0.05) was highly significantly different (p <.001). Insulin resistance had a stronger correlation to the LF/TF ratio (r = 0.61, p <.001) than to absolute trunk fat (r = -0.32, p =.051). Adiponectin levels had a strong association with the LF/TF ratio (r = 0.63, p <.001), but did not correlate to absolute trunk fat (r = -0.24, p =.18). The distribution of body fat (LF/TF ratio) in elderly persons is a stronger determinant of insulin resistance and adiponectin levels than is trunk fat alone. The LF/TF ratio can be a useful tool to assess insulin sensitivity in the elderly population.

Body fat patterning in polycystic ovary syndrome women as a predictor of the response to clomiphene

Background. To investigate the difference in the response to clomiphene citrate (CC) based on body fat distribution in women with polycystic ovary syndrome (PCOS). Methods. Ninety anovulatory PCOS women were divided into two subgroups based on treatment response: women who ovulated with CC (CC responders, n = 49) and those who did not ovulate with CC (CC nonresponders, n = 41). Baseline characteristics included age, age at menarche, height, weight and body mass index [BMI; weight/(height)2]. Percentage of body fat, body fat mass and the ratio of trunk fat to leg fat mass amount (trunk–leg fat ratio) were measured by dual-energy X-ray absorptiometry (DEXA). Results. Age, age at menarche and height did not differ between the two groups. However, trunk–leg fat ratio in CC responders (0.9 ± 0.4) was significantly lower than that in CC nonresponders (1.3 ± 0.4) (p < 0.001). Percentage of body fat, body fat mass and BMI were also lower in CC responders (p < 0.01). On multiple regression analysis, however, trunk–leg fat ratio proved to be a superior predictor of CC responder to percentage of body fat, BMI or body fat mass (standardized regression coefficient ≥ 0.510; t-values ≥ 3.432; p < 0.001). Conclusions. Response to CC in anovulatory PCOS women differs with body fat distribution.

Regional body composition in adolescents with anorexia nervosa and changes with weight recovery

Studies of regional fat distribution in adults with anorexia nervosa (AN) have shown decreased extremity fat at baseline and increased trunk fat with weight recovery, resulting in truncal adiposity. Little is known about fat distribution in adolescents with AN, especially with weight recovery. We sought to determine whether regional fat distribution in adolescents with AN is comparable with that in healthy adolescents and whether weight recovery results in increased trunk fat and truncal adiposity. In 21 adolescent girls with AN and 21 control subjects matched for age and pubertal stage, we measured body-composition variables with dual-energy X-ray absorptiometry at baseline, 6 mo, and 12 mo. Weight recovery was defined as a > or = 10% increase in body mass index. At baseline, the girls with AN had a lower percentage of trunk fat than did the control subjects, whereas the percentage of extremity fat was not significantly different between the groups. Weight recovery in 13 subjects with AN resulted in an increased percentage of trunk fat and an increased ratio of trunk fat to extremity fat; however, this ratio did not exceed that of control subjects. In adolescents with AN, trunk fat rather than extremity fat is reduced. Weight recovery is associated with increased trunk fat and an increased ratio of trunk fat to extremity fat. In contrast with previous findings in adults, this most likely represents normalization of fat distribution rather than development of truncal adiposity.

Altered fat distribution in HIV-positive men on nucleoside analog reverse transcriptase inhibitor therapy.

To determine whether HIV infection, the wasting syndrome, or nucleoside analog reverse transcriptase inhibitor (NRTI) or protease inhibitor (PI) therapy uniquely affect fat distribution in men, we performed manual regional analysis of total, appendicular, trunk, and central abdominal fat measured by dual-energy X-ray absorptiometry (DEXA). Five groups of study subjects were identified for this cross-sectional analysis: HIV-negative controls (HIV-; N = 44) and four groups of HIV-positive subjects: antiretroviral (ARV)-naive or with limited prior use of NRTIs (ARV-; N = 23); on NRTIs for > or =6 months but PI-naive (NRTI; N = 30); on an NRTI/PI regimen for > or =6 months but with no complaints of abnormal fat distribution (NRTI/PI; N = 26); and those on NRTIs but PI-naive with the wasting syndrome (NRTI/WS; N = 40). Total, appendicular, trunk, and central abdominal fat was significantly lower in NRTI/WS. The ratio of trunk fat to appendicular fat was virtually identical in HIV- and ARV-. This ratio was significantly higher in the NRTI, NRTI/PI, and NRTI/WS groups, and values in these three groups were similar. These cross-sectional data suggest that HIV-infected men receiving NRTIs have an altered pattern of fat distribution, compared with HIV-negative men and HIV-positive men who are not receiving antiretroviral therapy. This effect was independent of the concomitant use of a PI or a diagnosis of the wasting syndrome. We saw no evidence of a unique effect of HIV infection per se on regional fat distribution. Although the fat ratio is increasingly employed, its physiologic significance is unclear. Our results, which have been obtained retrospectively, are intended to provide the impetus for prospective, controlled studies of the interactions among drug and host factors in the development of fat distribution abnormalities.