Regional Fat Distribution Research Articles

Regional thickness of facial skin and superficial fat: Application to the minimally invasive procedures

Various recently introduced minimally invasive treatment modalities are now widely used for enhancing the aging face. In a special, filler is used to increase the volume of tissue, and so understanding the regional thickness and distribution of the facial superficial fat is essential for optimizing minimally invasive procedures. The aim of this study was to establish the overall facial skin and superficial fat thicknesses using a three-dimensional (3D) scanning system. From 53 adult Korean and Thai embalmed adult cadavers, the undissected and serially-dissected facial specimens were scanned and reconstructed. The facial skin and superficial fat thicknesses on seven facial regions were calculated from the superimposed images. The facial skin tended to become thicker in the order of the radix and dorsum, and the temple, supraorbital, forehead, perioral, cheek, and infraorbital areas. The skin was thinnest at radix and dorsum (1.51 ± 0.55 mm), and thickest in infraorbital region (1.97 ± 0.84 mm). The facial superficial fat thickness tended to increase in the order of the radix and dorsum, supraorbital, forehead, temple, cheek, infraorbital, and perioral regions. The superficial fat was thinnest at the radix and dorsum (1.61 ± 1.07 mm), and thickest in the perioral region (5.14 ± 3.31 mm). The facial superficial fat thickness tended to increase in the order of the radix and dorsum, supraorbital, forehead, temple, cheek, infraorbital, and perioral regions. The present findings indicate that 3D scanning system can yield crucial anatomical information about depths of the facial skin and superficial fat layers for utilization in various clinical procedures. Clin. Anat. 32:1008-1018, 2019. © 2019 Wiley Periodicals, Inc.

Relationship between regional hepatic glucose metabolism and regional distribution of hepatic fat.

Hepatic steatosis is associated with insulin resistance and hyperinsulinaemia. Insulin stimulates hepatic glucokinase, even in insulin resistance, so hepatic glucose uptake is increased in hepatic steatosis. The study hypothesis was that hepatic glucose uptake is also influenced locally by fat, the hepatic distribution of which is heterogeneous. Sixty patients undergoing PET/CT using fluorine-18-fluorodeoxyglucose (F-FDG) had dynamic imaging of the liver for 30 min after injection before undergoing whole-body PET/CT at 60 min after injection. Hepatic F-FDG uptake was measured using Gjedde-Patlak-Rutland graphical analysis. Plot gradient (Ki), which represents hepatic blood clearance of F-FDG to phosphorylation, was normalized to intercept [V(0)], which represents the hepatic F-FDG distribution volume. The 60 min computed tomography (CT) was co-registered on to each of the 30 dynamic PET frames. This failed in 20 patients. A further seven patients with lymphoma and three with hepatic metastases were excluded. Within transaxial sections, the liver was divided into small regions of interest (ROIs) of 5×5 pixels each in sections of 5 mm (range: 118-586 ROIs/liver). CT density and Ki/V(0) were measured in each ROI. Throughout the 25-pixel ROIs in the individual liver, CT density and Ki/V(0) showed a significant negative correlation in 15/30 patients. It was significantly positive in only three (P=0.01). In some patients, parametric imaging showed regional concordance between Ki/V(0) and hepatic fat, identified as reduced CT density. In addition to systemic influences, hepatic glucose uptake is regionally linked to the distribution of hepatic fat. Increased metabolism could be the cause or result of local fat deposition.

Integrative Analysis Revealing Human Adipose-Specific Genes and Consolidating Obesity Loci

Identification of adipose-specific genes has contributed to an understanding of mechanisms underlying adipocyte development and obesity. Herein, our analyses of the recent Genotype-Tissue Expression (GTEx) database revealed 38 adipose-specific/enhanced protein coding genes, among which 3 genes were novel adipose-specific, and 414 highly differentially expressed genes (DEGs) between subcutaneous and omental adipose depots. By integrative analyses of genome-wide association studies (GWASs), 14 adipose-specific/enhanced genes and 60 DEGs were found to be associated with obesity-related traits and diseases, consolidating evidence for contribution of these genes to the regional fat distribution and obesity phenotypes. In addition, expression of HOXC cluster was up-regulated in subcutaneous adipose tissue, and the majority of the HOXB cluster was expressed highly in omental adipose tissue, indicating differential expression patterns of HOX clusters in adipose depots. Our findings on the distinct gene expression profiles in adipose tissue and their relation to obesity provide an important foundation for future functional biological studies and therapeutic targets in obesity and associated diseases.

Volumes of coronary plaque disease in relation to body mass index, waist circumference, truncal fat mass and epicardial adipose tissue in patients with type 2 diabetes mellitus and controls.

Coronary atherosclerosis in patients with type 2 diabetes mellitus may be promoted by regional fat distribution. We investigated the association between anthropometric measures of obesity, truncal fat mass, epicardial adipose tissue and coronary atherosclerosis in asymptomatic patients and matched controls. We examined 44 patients and 59 controls [mean (standard deviation) age 64.4 ± 9.9 vs 61.8 ± 9.7, male 50% vs 47%, diabetes duration mean (standard deviation) 7.7 ± 1.5] with coronary computed tomography angiography. Coronary plaques were quantified as total, calcified, non-calcified and low-density non-calcified plaque volumes (mm3). Regional fat distribution was assessed by dual-energy X-ray absorptiometry, body mass index (kg/m2), waist circumference (cm) and epicardial fat volume (mm3). Endothelial function and systemic inflammation were evaluated by peripheral arterial tonometry (log transformed Reactive Hyperemia Index) and C-reactive protein (mg/L). Body mass index and waist circumference (p < 0.02) were associated with coronary plaque volumes. Body mass index was associated with low-density non-calcified plaque volume after adjustment for age, sex and diabetes status (p < 0.01). Truncal fat mass (p > 0.51), waist circumference (p > 0.06) and epicardial adipose tissue (p > 0.17) were not associated with coronary plaque volumes in adjusted analyses. Body mass index is associated with coronary plaque volumes in diabetic as well as non-diabetic individuals.

Effects of a Hypocaloric, Nutritionally Complete, Higher Protein Meal Plan on Regional Body Fat and Cardiometabolic Biomarkers in Older Adults with Obesity

Background: Whether improvements in cardiometabolic health following weight loss (WL) are associated with changes in regional body fat distribution (gluteal vs. ­android) is not well documented. Methods: Older (age: 70 ± 4 years; mean ± SD) adults with obesity were randomized to a 6-month WL program (WL; n = 47), accomplished using a hypocaloric, nutritionally complete, higher protein ­(targeting ≥1.0 g/kg/day) meal plan, or a weight stability (WS; n = 49) program. Android, gynoid, visceral, and subcutaneous abdominal fat masses (via dual energy X-ray absorptiometry ) and fasting glucose and lipid profiles were assessed at baseline and 6 months. Results: The WL group lost more body weight (WL: –8.6% vs. WS: –1.7%, p < 0.01), resulting in a reduction in fat mass at each region only following WL (all p < 0.05). The decline in the ratio of android/gynoid fat mass also was significant only following WL, resulting in greater declines than WS (mean [95% CI]; WL: –0.026 [–0.040 to –0.011] vs. WS: 0.003 [–0.012 to 0.019] g, p < 0.01). The change in the ratio of visceral/subcutaneous abdominal fat mass was not significant in either group and did not differ between groups (WL: 0.65 [–0.38 to 1.68] vs. WS: 0.05 [–1.00 to 1.10] g, p = 0.42). In general, the improvements in glucose and lipid profiles were associated with declines in fat mass at the gynoid and android regions (r’s = 0.20–0.42, all p < 0.05), particularly the visceral depot but not the ratios. Conclusion: WL achieved via a hypocaloric, nutritionally complete, higher protein meal plan is effective in reducing body fat in the android, gynoid, and visceral depots, which relate to cardiometabolic improvements.

Influence of Sex on the Changes in Regional Fat and Skeletal Muscle Mass in Response to Exercise Training in Adolescents with Obesity.

We retrospectively examined the sex differences in the changes in (1) total fat, total and regional subcutaneous adipose tissue (SAT), visceral fat, and intermuscular fat and (2) total and regional skeletal muscle distribution in response to aerobic exercise (AE) or resistance exercise (RE) in adolescents with obesity. Twenty-eight boys and 27 girls with obesity (BMI ≥95th percentile, 12-18 years) were randomly assigned to 3-month interventions (180 minutes per week) of AE or RE. Changes in total and regional fat and skeletal muscle distribution were assessed by a whole-body magnetic resonance imaging. After controlling for corresponding baseline values, age, and race, changes in body weight, BMI, BMI z-score, and waist circumference were similar between exercise groups (p > 0.05) and sexes (p > 0.05). There were no sex or exercise group differences in the reductions in total fat, total SAT, visceral fat, or intermuscular fat. With AE, boys had greater (p < 0.05) reductions in abdominal SAT as compared with girls. With RE, boys had greater (p < 0.05) increases in total, upper body, and abdominal skeletal muscle as compared with girls. Independent of exercise modality, the improvement in VO2max was greater (p < 0.05) in boys than in girls. Independent of sex, the increase in muscular strength index was higher (p < 0.05) in the RE vs. AE group. With the exception of abdominal SAT, there were no sex or exercise treatment differences in the reductions in total and regional fat. In response to RE, the increases in total and regional skeletal muscle were significantly greater in boys than in girls.

Liver Fat Content and Body Fat Distribution in Youths with Excess Adiposity.

This study had two main objectives: To examine the association between body fat distribution and non-alcoholic fatty liver disease (NAFLD) and liver fat content, and to determine whether the relationship between NAFLD and regional body fat distribution, with respect to liver fat content in youths with excess adiposity, is independent of cardiorespiratory fitness (CRF) and a healthy diet. Liver fat content (controlled attenuation parameter (CAP)), body fat distribution (body mass index (BMI) z-score, waist circumference, waist-to-height ratio, fat mass/height, body fat percentage, total fat mass, android-to-gynoid fat mass ratio, visceral adipose tissue (VAT), and lean mass index, determined by dual-energy X-ray absorptiometry (DXA)), CRF (20-m shuttle-run test), and healthy diet (adherence to the Mediterranean diet by KIDMED questionnaire) were measured in 126 adolescents (66% girls) aged between 11 and 17 years. Participants were assigned to two groups according to the presence or absence of hepatic steatosis (CAP values ≥225 dB/m or <225 dB/m of liver fat, respectively). Considering the similar total fat values for the two groups (>30% by DXA), youths with NAFLD had higher fat distribution parameters than those without NAFLD, regardless of sex, age, puberty stage, lean mass index, CRF, and healthy diet (p < 0.01). In the non-NAFLD group, the association between hepatic fat and fat distribution parameters presented a similar pattern, although the association was statistically insignificant after adjusting for a potential confounding variable (ps > 0.05), except for the case of VAT. Body fat distribution parameters were higher in youths with NAFLD compared to those without NAFLD. Additionally, body fat distribution showed a significant association with liver fat content as assessed by CAP in youths with NAFLD independent of CRF and adherence to the Mediterranean diet, supporting the notion that upper body fat distribution might play a pivotal role in the development of NAFLD in adolescents. These results may have implications for the clinical management of youths with excess adiposity given the high prevalence of NAFLD in children and young adults.

Age-associated changes of resting energy expenditure, body composition and fat distribution in Chinese Han males.

Age‐related alterations in whole body composition, particularly, reduced fat free mass (FFM) and increased fat mass (FM), lead to a progressive decline in resting energy expenditure (REE). Similarly, regional body composition and fat distribution changes with age might also contribute to an overall lower REE. This study investigated the influence of age on REE, regional body composition and fat distribution, including subcutaneous fat (SF) and visceral fat (VF), in a Chinese Han population as well as their contributions to age‐related changes in REE. One hundred and two males aged 31–83 years old underwent dual‐energy X‐ray absorptiometry (DXA) which measured whole body and regional FM and FFM. SF and VF were measured by magnetic resonance imaging (MRI) and REE by indirect calorimetry. Age was significantly negatively correlated with REE (r = −0.37), total FFM (r = −0.25), upper limbs FFM (r = −0.32), lower limbs FFM (r = −0.34) and showed positive association with trunk FFM (β=0.926). FM, SF and VF decreased in older age groups after an initial rise up to 55–65 years. REE correlated positively to FM, FFM, SF, VF and showed significant association with age (β = −0.254) independent of age‐associated changes in body composition. The regional alterations in body composition with age were explained by changes in trunk FFM (β = 0.926). Age‐related decline in REE were not solely due to alterations in FM and FFM. Therefore, the changes in regional body composition, fat distribution and REE which occur during aging could be explained by disparities in race, ethnicity, diet, physical activity, and lower specific metabolic rates of FFM components.

Longitudinal Changes in Body Composition by Dual-energy Radiograph Absorptiometry Among Perinatally HIV-infected and HIV-uninfected Youth: Increased Risk of Adiposity Among HIV-infected Female Youth.

Combination antiretroviral therapy has allowed youth with perinatal HIV infection (PHIV+) to live into adulthood, but many youth may experience metabolic and body composition changes that predispose to greater cardiovascular disease (CVD) risk. This longitudinal study evaluated changes in body composition measured by dual-energy radiograph absorptiometry (DXA) in a cohort of PHIV+ youth compared with HIV- controls over a 7-year period. PHIV+ youth and HIV- controls were prospectively enrolled in a single-site study to assess nutrition and CVD risk. Anthropometrics and DXA scans were longitudinally obtained to assess percent body fat and regional fat distribution. Using general linear models, we analyzed differences in body composition and anthropometric measures by sex between PHIV+ youth and controls over time. Two hundred thirty-five participants (156 PHIV+ and 79 HIV- controls) with at least 1 DXA performed since study enrollment were included for analysis. During the study period, 471 DXAs were obtained in the PHIV+ group and 95 in HIV- controls. PHIV+ females demonstrated greater increase in weight and body mass index over time compared with HIV- females, and significant increases in total percent body fat [estimate = 1.212 (95% confidence interval: 0.837-1.587) percent per year; P < 0.001) and percent trunk fat [1.3818 (95% confidence interval: 0.922-1.84); P < 0.001] compared with HIV- females and PHIV+ males. PHIV+ females demonstrate an unfavorable change in fat redistribution and percent body fat over time that exceeds the pattern seen in PHIV+ males or HIV- females. Providers should have heightened awareness of body composition changes of PHIV+ females that may eventually lead to increased CVD risk.

A17462 Association of DXA-derived indices of fat distribution with cardiometabolic risk in Chinese children and adolescents

Objectives: Regional fat distribution is an important determinant of cardiometabolic risk in both adult and children and adolescents. The aim of this study was to investigate the association between the indices of fat distribution derived by Dual-energy X-ray Absorptionmetry (DXA) with cardiometabolic risk factors in obese and nonobese children and adolescents. Methods: A total of 1983 children and adolescents aged 6–18 years underwent a comprehensive assessment of cardiometabolic risk factors. Body composition was measured by Dual-energy X-ray Absorptiometry (DXA). Results: After adjusting for age and height, almost indices of fat distribution derived by DXA presented positive relationship with the examined cardimetabolic risk factors, but displayed the negative associations with HDL cholesterol. Moreover, these significant correlations differed with age and sex. VFM was an independent predictor of TG among children aged 6–9 years (P < 0.001), and HDL cholesterol for adolescent boys (P = 0.001). AFM/GFM ratio was an independent predictor of HDL cholesterol and TG for adolescent girls (both P < 0.001). TrFM was the most important determinant of MS in boys (OR = 8.46, 95%CI:3.52–20.32, P < 0.001). For girls, VFM was the most important determinant of MS (OR = 1.01, 95%CI:1.00–1.02, P = 0.017). Conclusion: Among children and adolescents, almost indices of fat distribution derived by DXA presented positive versus negative associations with the examined cardimetabolic risk factors, but with significant differences seen by age and sex. The indices of fat distribution may serve as clinically useful tools for evaluating cardiometabolic risk in children and adolescents, but dependent of age and sex.

Prevalence and characteristics of metabolic phenotypes: The Rhineland study, Germany

Background Body mass index (BMI) is a commonly used yet crude indicator of obesity as it does not provide any information about body composition or metabolic characteristics. The definition of obesity needs to be improved and is still a matter of on-going debate. Other single body measures and/or metabolic characteristics perform better at capturing adiposity-related health risk. Percentage of body fat (PBF) is an indicator of risk for several comorbidities related to obesity. Nevertheless, obese individuals differ not only in the amount of excess fat mass but also in regional fat distribution. Thus, waist circumference (WC) and waist to hip ratio (WHR) have been used as a proxy measures for body fat distribution and identifying individuals at-risk. More recently, metabolically healthy (MH) and metabolically unhealthy (MU) phenotypes based on several metabolic profiles have been suggested as a clinically more relevant classification for obesity. Objective To estimate (a) the prevalence of metabolic healthy and unhealthy phenotypes and (b) the prevalence of individuals at-risk defined by PBF, WC and WHR in German adults aged 30–93 years and (c) the proportion of overlap between these two risk assessments. Method We used cross-sectional data on anthropometric measures, body composition and clinical characteristics from the Rhineland Study, Germany. Metabolically healthy and unhealthy phenotypes were defined by a pre-established classification combining the following clinical criteria: blood pressure ≥ 130/85 mmHg, triglycerides ≥ 150 mg/dL, HDL cholesterol 0.1 mg/L, glycated haemoglobin (HbA1c) ≥ 6.5%. Study participants having two or more of these cardio metabolic abnormalities were considered as MU. We identified 6 metabolic phenotypes: normal weight (BMI Results Based on data from the first 990 participants (440 M and 550 W), overall prevalence of MU phenotype was 13.3%, with higher prevalence in men (7.8%) than in women (5.5%). The mean (± SD) age for the MH group was 55.8 ± 14.0 y and for the MU group 62.5 ± 12.2 y. According to BMI groups, the prevalence of MU for normal weight, overweight and obese participants were 4.3%, 16.9% and 33.5%, respectively. The prevalence of individuals at-risk identified by PBF was 46.8% of which 6.3% were classified as MU; for WC the prevalence was 52.4% of which 11.6% were categorized as MU. The prevalence of individuals at-risk based on WHR was 50.2%; 12.2% of those were categorized as MU. Conclusion Adiposity indicators, specifically WC and WHR that classify abdominal fat, identified the higher prevalence of individuals at metabolic risk than the classification of MU phenotypes. Adiposity indicators, specifically WC and WHR that classify abdominal fat, identified the higher prevalence of individuals at metabolic risk than the classification of MU phenotypes. These classification schemes slightly overlap and seem to identify partly different people. Therefore, a stratification of metabolic phenotypes including metabolic profile and indicators of abdominal obesity could improve the identification of individuals at metabolic risk.

Impact of body fat distribution on long-term clinical outcomes after drug-eluting stent implantation.

Background and objectiveThe distribution of body fat is closely related to cardiovascular disease and outcomes, although its impact on patient prognosis after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) has not been evaluated. We investigated the impact of truncal fat distribution on long-term clinical outcomes after DES treatment.MethodsIn 441 DES-treated patients, dual energy X-ray absorptiometry was performed to assess total and regional body fat distribution after index PCI. The ratio of truncal fat to total body fat mass (%FMtrunk/FMtotal) was calculated as a representative parameter for truncal fat distribution. The primary endpoint was major adverse cardiac events (MACE), a composite of ischemia-driven target vessel revascularization (TVR), non-procedural myocardial infarction, cardiac death at 5 years.ResultsDuring the median follow-up duration of 1780 days, MACE occurred in 22.0% of patients, with the highest-quartile group of %FMtrunk/FMtotal having a higher rate than the lowest quartile group (27.8% vs. 15.3%; log rank p = 0.026). The difference was driven by a higher rate of ischemia-driven TVR (25.9% vs. 9.9%; log rank p = 0.008). In multivariable Cox regression analyses, %FMtrunk/FMtotal was independently associated with MACE (hazard ratio: 1.075; 95% CI: 1.022–1.131; p = 0.005), but body mass index (BMI) was not.ConclusionsIn DES-treated patients, truncal fat distribution is associated with unfavorable clinical outcomes and is more clinically relevant than BMI.

Experimental Weight Gain Increases Ambulatory Blood Pressure in Healthy Subjects: Implications of Visceral Fat Accumulation

ObjectiveTo examine whether experimentally induced weight gain raises ambulatory blood pressure (BP) in healthy subjects and identify any relationship between changes in BP and changes in regional fat distribution. Patients and MethodsTwenty-six normal weight subjects were randomized to 8 weeks of weight gain through overfeeding (n=16; age, 30.4±6.6 years) or to weight maintenance (controls; n=10; age, 27.1±7.7 years) between July 2004 and August 2010. Measures of body composition via dual energy X-ray absorptiometry and computed tomography, circulating biomarkers, and 24-hour ambulatory BP were obtained at baseline and after the 8-week experimental phase. ResultsOverfeeding resulted in 3.7 kg (95% CI, 2.9-4.5) increase in body weight in weight gainers, with increments in total (46.2 cm2; 95% CI, 27.6-64.9), visceral (13.8 cm2; 95% CI, 5.8-21.9), and subcutaneous fat (32.4 cm2; 95% CI, 13.5-51.3). No changes occurred in the maintenance group. Increases in 24-hour systolic BP (4 mm Hg; 95% CI, 1.6-6.3), mean BP (1.7 mm Hg; 95% CI, 0.3-3.3), and pulse pressure (2.8 mm Hg; 95% CI, 1.1-4.4) were evident after weight gain in the experimental group, whereas BP remained unchanged in controls. Changes in mean BP correlated only with changes in visceral fat (ρ=0.45; P=.02), but not with changes in other body composition measures. ConclusionModest weight gain causes elevation in 24-hour BP in healthy subjects. The association between increased BP and abdominal visceral fat accumulation suggests that visceral deposition of adipose tissue may contribute specifically to the enhanced risk of hypertension associated with weight gain.

Regional body fat distribution assessment by bioelectrical impedance analysis and its correlation with anthropometric indices

ObjectiveThe purpose of this study is to assess the validity of Bioelectrical Impedance Analysis (BIA) to characterize the regional fat distribution among female and its correlation with anthropometric indices. Materials and methodsThe following indices were carried out: weight, height, body mass index (BMI), waist circumference (WC), hip circumference (HC), waist hip index (WC + HC) of random samples (209) of women (age, 32–85 years). The segmental body fat percentages were assessed by bioelectrical impedance analysis. Hand-to-Hand and Foot-to-Foot Body Analyzer devices were used to estimate upper and lower body fat percent (BF %), respectively. Upper and lower body fat measurements were used to calculate total body fat. Agreement between the variables was assessed by scatter plots. ResultsThe plots of upper and lower percent body fat (BF %) against waist and hip circumferences revealed significant correlation values of (r = 0.949) and (r = 0.942), respectively. The total of upper and lower body fat ratios showed a stronger correlation with the BMI than those of severally. Weak to fear correlations between upper and lower body fat percent, with BMI were observed. ConclusionThe results indicated that the BIA technique of estimating segmental body fat percent associated with the anthropometrical indices (WC, HC) has the potential to determine adiposity risk available for use in large epidemiological studies.

Correction: Long-Term Changes of Subcutaneous Fat Mass in HIV-Infected Children on Antiretroviral Therapy: A Retrospective Analysis of Longitudinal Data from Two Pediatric HIV-Cohorts.

[This corrects the article DOI: 10.1371/journal.pone.0120927.].

Body Adiposity Index is Worse than Body Mass Index when Evaluating the Factors Associated with Adiposity in Elderly People

Body Mass Index (BMI) is an easily measurable indicator of body fat and with low cost. However, as an indicator of risk of development of chronic diseases in the elderly, it has limitations, as it does not reflect mainly the regional distribution of fat that occurs with the aging process. As an alternative to BMI, the Body Adiposity Index (BAI) has been proposed. This index showed a high correlation with the measurement of body fat in adults indicating that it could replace BMI. However, BAI is still understudied in the elderly.

A Prevalence Study Based on Relationship of Obesity Indices with Different Anthropometric Parametrs in Two Communities

Overweight refers to an excess body weight compared to set standards. Obesity specially refers to having an abnormally high proportion of total body fat. Most health providers agree that men with more than 25% total body fat and women with more than 30% total body fat should be considered obese [1]. A more important aspect of obesity is the regional distribution of excess body fat. Our research is a prevalence study to find out the distribution of obese and overweight girls from two different communities distributing them according to different anthropometric parameters. The 1001 girls residing in different hostels from different colleges were selected for the study. Two groups were made and the total girls were categorized into Gujarati and Non Gujarati groups respectively. They were further classified according to categories like waist circumference, hip circumference, waist hip ratio, obesity indices, body fat percent, total body fat, lean body mass, skinfold thickness, family history and blood pressure. Fourteen percent were overweight and eleven percent girls were obese according to waist circumference. Seventy one percent had hip circumference of more than 36 inches; waist hip ratio of more than 0.85 was observed in 47% girls; Twenty four percent had high waist circumference, waist hip ratio and BMI&gt;25 kg/m2; Eighty percent had body fat percent &lt; 33%, 27% had total body fat &gt; 20 kg; Fifty six percent had lean body mass &gt; 42 kg and sixty nine percent had skinfold thickness &gt; 50 mm. Seventy eight percent girls were without any family history of disease and 53%/46% had high normal systolic and diastolic blood pressure.

Relationships between MRI fat distributions and sleep apnea and obesity hypoventilation syndrome in very obese patients

PurposeObesity is associated with both obstructive sleep apnea (OSA) and obesity hypoventilation. Differences in adipose tissue distribution are thought to underlie the development of both OSA and hypoventilation. We explored the relationships between the distribution of upper airway, neck, chest, abdominal and muscle fat in very obese individuals.MethodsWe conducted a cross-sectional cohort study of individuals presenting to a tertiary sleep clinic or for assessment for bariatric surgery. Individuals underwent magnetic resonance (MR) imaging of their upper airway, neck, chest, abdomen and thighs; respiratory polygraphy; 1 week of autotitrating CPAP; and morning arterial blood gas to determine carbon dioxide partial pressure and base excess.ResultsFifty-three individuals were included, with mean age of 51.6 ± 8.4 years and mean BMI of 44.3 ± 7.9 kg/m2; there were 27 males (51%). Soft palate, tongue and lateral wall volumes were significantly associated with the AHI in univariable analyses (p < 0.001). Gender was a significant confounder in these associations. No significant associations were found between MRI measures of adiposity and hypoventilation.ConclusionsIn very obese individuals, our results indicate that increased volumes of upper airway structures are associated with increased severity of OSA, as previously reported in less obese individuals. Increasingly large upper airway structures that reduce pharyngeal lumen size are likely to lead to OSA by increasing the collapsibility of the upper airway. However, we did not show any significant association between regional fat distribution and propensity for hypoventilation, in this population.

Low Plasma Adiponectin Concentrations Predict Increases in Visceral Adiposity and Insulin Resistance.

Context:Plasma adiponectin concentration has been shown to be inversely associated with body mass index (BMI) and insulin resistance in cross-sectional research. However, it is unclear whether adiponectin predicts future body composition and insulin resistance.Objective:We aimed to investigate the potential relationship between adiponectin concentration and future regional body fat distribution and insulin resistance.Design and Setting:This was a community-based prospective cohort study with 5 years of follow-up.Participants:A total of 218 Japanese Americans without diabetes (79 men, 139 women, mean age 51.7 ± 10.1 years) were assessed at baseline and after 5 years of follow-up.Main Outcome Measures:Abdominal visceral and subcutaneous fat area and thigh subcutaneous fat area were measured by computed tomography (CT). Insulin resistance was evaluated by homeostasis model assessment 2 of insulin resistance (HOMA2-IR). Plasma total adiponectin was measured by radioimmunoassay.Results:Baseline adiponectin was inversely associated with abdominal visceral fat area (P = 0.037) and HOMA2-IR (P = 0.002) at 5 years in a multiple linear regression model after adjustment for baseline traits (including age, sex, BMI, abdominal visceral fat area, abdominal subcutaneous fat area, thigh subcutaneous fat area, HOMA2-IR) and weight change. However, no association was seen between baseline adiponectin concentration and BMI or other CT-measured regional fat depots at 5 years.Conclusions:Low plasma adiponectin concentration independently predicted future abdominal visceral fat accumulation and increased insulin resistance in Japanese Americans.

Eating frequency predicts changes in regional body fat distribution in healthy adults.

Eating frequency (EF) has been associated with generalized obesity. We aimed to prospectively investigate potential associations of frequency of eating episodes with regional fat layers. EF was evaluated at baseline in 115 subjects free of clinically overt cardiovascular disease (54 ± 9.1 years, 70 women) in a prospective, observational study. Metabolic parameters known to be associated with dietary factors and anthropometric markers including ultrasound assessment of subcutaneous (Smin) and pre-peritoneal (Pmax) fat and their ratio Smin/Pmax (AFI) were evaluated at baseline and at follow-up, 5 years later. EF at baseline positively correlated with Pmax, even after adjustment for potential confounders. EF above median was also an independent predictor for Pmax (beta coefficient = -0.192, P = 0.037) and AFI (beta coefficient = 0.199, P = 0.049) at follow up. Multivariable linear mixed models analysis demonstrated that subjects with increased EF presented a lower progression rate of Pmax (beta = -0.452, P = 0.006) and a higher progression rate of AFI (beta = 0.563, P = 0.003) over time, independently of age, sex, progression of BMI, energy intake, smoking and changes in parameters of glucose metabolism. High EF is associated with lower progression rate of pre-peritoneal fat accumulation. Future interventional studies should further investigate the clinical utility of these findings.