Upper-body Adipose Research Articles

Pulmonary Function Abnormalities in Heart Failure Subtypes: Impact of Upper Body Adiposity

Study objective: Heart failure (HF) syndrome is associated with pulmonary system abnormalities that have a direct impact on mortality. Heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) are distinct subtypes of HF with different pathophysiologies, clinical presentations, and treatment approaches. Obesity is highly prevalent in HFpEF and significantly contributes to its development. Importantly, obesity and high abdominal adiposity can have significant effects on pulmonary function. Therefore, HFpEF patients may have more pronounced pulmonary function impairment than HFrEF patients in part due to higher prevalence of upper body adiposity. Hypothesis: We hypothesized that lung volumes would be lower in patients with HFpEF compared to those with HFrEF and CTL. Further, we hypothesized that higher upper body adiposity (measured as trunk fat by dual-energy X-ray absorptiometry) would be associated with lower lung volumes in patients with HFpEF. Methods: HFpEF patients (n=26), HFrEF patients (n=26) and CTL (n=36) performed pulmonary function tests according to ATS/ERS guidelines. Total lung capacity (TLC), residual volume (RV), forced vital capacity (FVC), and forced expiratory volume in one second (FEV1) were measured and absolute and % predicted values are reported. Dual-energy X-ray absorptiometry scans quantified % trunk fat. Absolute lung volumes were compared across groups using ANCOVA with age as a covariate and % predicted lung volumes were compared using one-way ANOVA. Results: HFpEF patients were older than HFrEF patients and CTL (HFpEF: 71±9 vs. HFrEF: 65±9 vs. CTL: 63±11 yrs, both p<0.05) while no differences were present among groups for sex, height, or BMI (all, p>0.05). HFpEF patients had higher % trunk fat than CTL (p<0.01), while no differences were present between HFrEF and HFpEF or CTL (p>0.05) (HFpEF: 46±11 vs. HFrEF: 42±8 vs. CTL: 38±11%). HFpEF patients had lower FVC (HFpEF: 3.0±0.7 vs. HFrEF: 3.7±1.0 vs. CTL: 3.8±0.8 L), FEV1 (HFpEF: 2.3±0.5 vs. HFrEF: 2.8±0.8 vs. CTL: 2.9±0.6 L), TLC (HFpEF: 5.5±1.3 vs. HFrEF: 6.3±1.4 vs. CTL: 6.4±1.1 L), and % predicted TLC than CTL (all, p<0.05). HFpEF and HFrEF patients had lower % predicted FVC and % predicted FEV1 than CTL (p<0.05). All other pulmonary function parameters were not different among groups (p>0.05). There was a negative relationship between % trunk fat and TLC for HFpEF patients (r= -0.51, p<0.05). There were negative relationships between % trunk fat and FVC for CTL (r= -0.37) and HFpEF patients (r= -0.50) (both, p<0.05), with statistically different y-intercepts (p<0.01). There were no other significant relationships (all, p>0.05). Conclusion: These findings demonstrate that patients with HF have smaller lung volumes than CTL. Further, our findings suggest that upper body adiposity may be an important contributing factor to these pulmonary system abnormalities in HFpEF. None. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

The value of neck adipose tissue as a predictor for metabolic risk in health and type 2 diabetes

Upper-body adiposity is adversely associated with metabolic health whereas the opposite is observed for the lower-body. The neck is a unique upper-body fat depot in adult humans, housing thermogenic brown adipose tissue (BAT), which is increasingly recognised to influence whole-body metabolic health. Loss of BAT, concurrent with replacement by white adipose tissue (WAT), may contribute to metabolic disease, and specific accumulation of neck fat is seen in certain conditions accompanied by adverse metabolic consequences. Yet, few studies have investigated the relationships between neck fat mass (NFM) and cardiometabolic risk, and the influence of sex and metabolic status. Typically, neck circumference (NC) is used as a proxy for neck fat, without considering other determinants of NC, including variability in neck lean mass. In this study we develop and validate novel methods to quantify NFM using dual x-ray absorptiometry (DEXA) imaging, and subsequently investigate the associations of NFM with metabolic biomarkers across approximately 7000 subjects from the Oxford BioBank. NFM correlated with systemic insulin resistance (Homeostatic Model Assessment for Insulin Resistance; HOMA-IR), low-grade inflammation (plasma high-sensitivity C-Reactive Protein; hsCRP), and metabolic markers of adipose tissue function (plasma triglycerides and non-esterified fatty acids; NEFA). NFM was higher in men than women, higher in type 2 diabetes mellitus compared with non-diabetes, after adjustment for total body fat, and also associated with overall cardiovascular disease risk (calculated QRISK3 score). This study describes the development of methods for accurate determination of NFM at scale and suggests a specific relationship between NFM and adverse metabolic health.

Impaired mitochondrial respiration in upper compared to lower body differentiated human adipocytes and adipose tissue.

Abdominal obesity is associated with increased cardiometabolic disease risk, while lower body fat seems to confer protection against obesity-related complications. The functional differences between upper and lower body adipose tissue (AT) remain poorly understood. We aimed to examine whether mitochondrial respiration is impaired in abdominal as compared to femoral differentiated human multipotent adipose-derived stem cells (hMADS; primary outcome) and AT in postmenopausal women. In this cross-sectional study, 23 postmenopausal women with normal weight or obesity were recruited at the University of Birmingham/Queen Elizabeth Hospital Birmingham (Birmingham, UK). We collected abdominal and femoral subcutaneous AT biopsies to determine mitochondrial oxygen consumption rates in differentiated abdominal and femoral hMADS. Furthermore, we assessed OXPHOS protein expression and mtDNA content in abdominal and femoral AT as well as hMADS. Finally, we explored in vivo fractional oxygen extraction and carbon dioxide release across abdominal and femoral subcutaneous AT in a subgroup of the same individuals with normal weight or obesity. We found lower basal and maximal uncoupled mitochondrial oxygen consumption rates in abdominal compared to femoral hMADS. In line, in vivo fractional oxygen extraction and carbon dioxide release were lower across abdominal than femoral AT. OXPHOS protein expression and mtDNA content did not significantly differ between abdominal and femoral differentiated hMADS and AT. The present findings demonstrate that in vitro mitochondrial respiration and in vivo oxygen fractional extraction are lower in upper compared to lower body differentiated hMADS and AT, respectively, in postmenopausal women.

Distinct inflammatory signatures of upper and lower body adipose tissue and adipocytes in women with normal weight or obesity.

Upper and lower body fat accumulation poses an opposing obesity-related cardiometabolic disease risk. Depot-differences in subcutaneous adipose tissue (SAT) function may underlie these associations. We aimed to investigate the inflammatory signatures of abdominal (ABD) and femoral (FEM) SAT in postmenopausal women with normal weight or obesity. We included 23 postmenopausal women with normal weight (n = 13) or obesity (n = 10). In vivo secretion of adipokines from ABD and FEM SAT was measured using the arterio-venous balance technique. Adipokine gene expression and adipocyte morphology were examined in ABD and FEM SAT. Furthermore, adipokine expression and secretion were investigated in vitro using differentiated human primary ABD and FEM subcutaneous adipocytes derived from the study participants. Plasma leptin and plasminogen activator inhibitor (PAI)-1 concentrations were higher, and ABD and FEM adipocytes were larger in women with obesity than normal weight. No differences in adipocyte size and blood flow were apparent between ABD and FEM SAT. We found significant release of leptin and monocyte chemoattractant protein (MCP)-1 from ABD and FEM SAT, with higher fractional release of MCP-1 from ABD than FEM SAT. Gene expression of leptin, PAI-1, and tumor necrosis factor-α was lower in ABD than FEM SAT and higher in women with obesity than normal weight. In ABD adipocytes, interleukin-6, PAI-1, and leptin gene expression were higher, while adiponectin and dipeptidyl-peptidase-4 gene expression were lower than in FEM adipocytes. Finally, ABD adipocytes secreted less MCP-1 compared to FEM adipocytes. These findings demonstrate that upper and lower body SAT and adipocytes are characterized by distinct inflammatory signatures in postmenopausal women, which seem independent of adipocyte size.

A mouse model of human mitofusin-2-related lipodystrophy exhibits adipose-specific mitochondrial stress and reduced leptin secretion.

Mitochondrial dysfunction has been reported in obesity and insulin resistance, but primary genetic mitochondrial dysfunction is generally not associated with these, arguing against a straightforward causal relationship. A rare exception, recently identified in humans, is a syndrome of lower body adipose loss, leptin-deficient severe upper body adipose overgrowth, and insulin resistance caused by the p.Arg707Trp mutation in MFN2, encoding mitofusin 2. How the resulting selective form of mitochondrial dysfunction leads to tissue- and adipose depot-specific growth abnormalities and systemic biochemical perturbation is unknown. To address this, Mfn2R707W/R707W knock-in mice were generated and phenotyped on chow and high fat diets. Electron microscopy revealed adipose-specific mitochondrial morphological abnormalities. Oxidative phosphorylation measured in isolated mitochondria was unperturbed, but the cellular integrated stress response was activated in adipose tissue. Fat mass and distribution, body weight, and systemic glucose and lipid metabolism were unchanged, however serum leptin and adiponectin concentrations, and their secretion from adipose explants were reduced. Pharmacological induction of the integrated stress response in wild-type adipocytes also reduced secretion of leptin and adiponectin, suggesting an explanation for the in vivo findings. These data suggest that the p.Arg707Trp MFN2 mutation selectively perturbs mitochondrial morphology and activates the integrated stress response in adipose tissue. In mice, this does not disrupt most adipocyte functions or systemic metabolism, whereas in humans it is associated with pathological adipose remodelling and metabolic disease. In both species, disproportionate effects on leptin secretion may relate to cell autonomous induction of the integrated stress response.

The interplay between diabetes mellitus and menopause: clinical implications.

The menopausal transition is an impactful period in women's lives, when the risk of cardiovascular disease is accelerated. Similarly, diabetes mellitus profoundly impacts cardiovascular risk. However, the interplay between menopause and diabetes mellitus has not been adequately studied. The menopausal transition is accompanied by metabolic changes that predispose to diabetes mellitus, particularly type 2 diabetes mellitus (T2DM), as menopause results in increased risk of upper body adipose tissue accumulation and increased incidence of insulin resistance. Equally, diabetes mellitus can affect ovarian ageing, potentially causing women with type 1 diabetes mellitus and early-onset T2DM to experience menopause earlier than women without diabetes mellitus. Earlier age at menopause has been associated with a higher risk of T2DM later in life. Menopausal hormone therapy can reduce the risk of T2DM and improve glycaemic control in women with pre-existing diabetes mellitus; however, there is not enough evidence to support the administration of menopausal hormone therapy for diabetes mellitus prevention or control. This Review critically appraises studies published within the past few years on the interaction between diabetes mellitus and menopause and addresses all clinically relevant issues, such as the effect of menopause on the development of T2DM, and the management of both menopause and diabetes mellitus.

Association of Neck Circumference with Body Composition and Cardiovascular Parameters in Young Healthy Adult Males

Background and Aim: Increased Neck circumference is the marker of upper body obesity and identified as an indicator of future cardiovascular disease risk (CVD). Hence, in this study, we assessed the relationship of Neck circumference (NC) with basal cardiovascular and body composition (BC) parameter in young adult males. Methods: Sixty three healthy young adult male volunteers of age between 18 to 25 years were enrolled for this study and they were divided into two groups based on neck circumference (NC). Control group (n = 32) comprises of individuals with normal neck circumference of ≤ 35.5 cm and study group (n = 31) includes individuals with increased neck circumference of ≥ 35.5 cm. The, BC parameters was assessed by Bioimpedance Analysis (BIA) method using Quadscan 4000. And the basal cardiovascular parameters such as systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) was measured by automated sphygmomanometer and the pulse pressure (PP), mean arterial pressure (MAP) and the rate pressure product (RPP) were derived. Results: Data was expressed in Mean ± SD. The groups were compared using Independent Student’s t test. The association between NC and various study parameters were assessed by Pearson’s correlation analysis. Our study, revealed increased body fat and reduced muscle mass in individuals with increased NC. Further, we observed a positive correlation of NC with body fat (%) and negative correlation with Lean Body Mass. Cardiovascular parameters SBP, DBP, MAP and PP were elevated in subjects with increased NC. Further, positive correlation is seen with SBP, DBP, RPP and NC. Conclusion: Neck circumference is a readily measurable screening tool of upper-body adiposity and increased NC is associated with CVD risk.

Neck circumference as a marker of body adiposity in young to middle-aged adults

ObjectiveNeck circumference (NC) is a straightforward method for quantifying upper body adiposity without the limitations that other indices can have. Thus, this study aimed to analyze the relationship between NC, overall (body mass index [BMI]) and central obesity (waist circumference [WC]), and percentage of body fat (BF%) in men and women. MethodsThe associations with NC quartiles (first quartile: reference group), BMI ≥30 kg/m2, WC (>102 cm for men and >88 cm for women), and high BF% (≥21 for men and ≥29 for women) were compared and analyzed by logistic regression models adjusted for demographic characteristics, cardiovascular risk factors, and lean mass. ResultsIn 4283 adults (mean age: 44 y, 71.8% of men), the mean NC was higher in men (40.5 cm, range: 32–55 cm) than women (34.5 cm, range: 28.5–46 cm). Among men, the fourth quartile of NC (42.5–55 cm) was positively associated with obesity (multivariable odds ratio [OR]: 2.28, 95% confidence interval [CI]: 1.1–4.48). Among women, the fourth quartile of NC (36.5–46 cm) was associated with increased WC (multivariable OR: 2.98; 95% CI: 1.59–5.60). Progressive increases in the ORs were noticed across the associations between NC quartiles (second to fourth) and high BF% in men and women. The highest ORs were observed for the associations between high BF% and the fourth quartiles of NC in men (multivariable OR: 2.42; 95% CI: 1.49–3.93) and in women (multivariable OR: 29.19; 95% CI: 14.01–60.84). ConclusionsThe utility of NC as a measurement of obesity in clinical practice was demonstrated in this large sample of young to middle-aged adults. The highest NC values were positively associated with overall obesity in men and central obesity in women. Moreover, NC was closely associated with high BF% in both sexes, particularly in women.

The Association of Upper Body Obesity with Insulin Resistance in the Newfoundland Population.

Body-fat distribution is a primary risk factor for insulin resistance and cardiovascular disease. Visceral fat explains only a portion of this risk. The link between upper-body fat and insulin resistance is uncertain. Furthermore, upper-body fat is not clearly defined. Dual-energy X-ray absorptiometry (DXA) can accurately quantify body fat. In this study, we explored the relationship between non-visceral upper-body adiposity and insulin resistance and other markers of metabolic syndrome. Fat proportions in the upper body, leg, and visceral regions were quantified by using DXA in 2547 adult Newfoundlanders aged 19 and older. Adjusting for remaining fat regions, we performed partial correlation analysis for each body region and insulin resistance defined by the Homeostatic Model of Assessment (HOMA). Similarly, partial correlation analysis was also performed between each fat region and other markers of metabolic syndrome, including high-density lipoprotein cholesterol (HDL), triglycerides (TG), body mass index (BMI), and blood pressure. Major confounding factors, including age, caloric intake, and physical activity, were statistically controlled by using partial correlation analysis. Interactions between sex, menopausal status, and medication status were also tested. Arm adiposity was correlated with HOMA-IR (R = 0.132, p < 0.001) and HOMA-β (R = 0.134, p < 0.001). Visceral adiposity was correlated with HOMA-IR (R = 0.230, p < 0.001) and HOMA-β (R = 0.160, p < 0.001). No significant correlation between non-visceral trunk adiposity and insulin resistance was found. Non-visceral trunk adiposity was negatively correlated with HDL in men (R = −0.110, p < 0.001) and women (R = −0.117, p < 0.001). Non-visceral trunk adiposity was correlated with TG (total: R = 0.079, p < 0.001; men: R = 0.105, p = 0.012; women: R = 0.078, p = 0.001). In menopausal women, leg adiposity was negatively correlated with HOMA-IR (R = −0.196, p < 0.001) and HOMA-β (R = −0.101, p = 0.012). Upper-body adiposity in the arms is an independent contributor to insulin resistance. Upper-body adiposity in the non-visceral trunk region is an independent contributor to metabolic syndrome. Leg adiposity is protective against metabolic syndrome in women.

Neck circumference, visceral adiposity, and hypertension: does upper body adiposity outperforms visceral adiposity in terms of hypertension predictions?

Background: This study set up to determine which of the neck circumference (NC), as a predictor of upper body sub-cutaneous fat, or visceral adipose tissue, as an indicator of intra-abdominal fat mass, can be the better predictor of hypertension. Material and methods: 130 overweight/obese women took part in this cross-sectional study conducted in November 2017. Blood pressure, anthropometric measurements, and body composition were determined. Pearson’s correlation coefficients, multivariate logistic regression, and the area under the curve of the receiver operator characteristic curves analyses were performed. Results: Mean age, weight, and neck circumference were 39.93 ± 8.71 years, 74.26 ± 9.86 Kg, and 35.06 ± 1.74 cm, respectively. There was a significant correlation between neck circumference and visceral adipose tissue with systolic blood pressure (r = 0.32, p = 0.001) (r = 0.57, p < 0.001) and diastolic blood pressure (r = 0.23, p = 0.008) (r = 0.45, p < 0.001), in the respective order. According to the results of the ROC curve analysis, visceral adipose tissue and neck circumference predicted hypertension with an accuracy of 81 and 65 percent, respectively. In addition, the probability of having increased blood pressure increased with higher visceral adipose tissue (OR = 1.22, p < 0.001). Conclusions: According to our findings, abdominal obesity and high NC in implication with overweight or obesity can more exactly evaluate hypertension risk.

Association between Neck Circumference and the Risk of Decreased Estimated Glomerular Filtration Rate in the General Population of China: A Cross-Sectional Study.

Background The burden of chronic kidney disease is increasing substantially worldwide. Neck circumference (NC), an anthropometric index for upper-body adiposity, has been recognized as an indicator of cardiometabolic diseases. However, the association between NC and renal dysfunction has not been fully disclosed. Objectives The aim of this study was to investigate the association between NC and estimated glomerular filtration rate (eGFR) in the general population in China. Methods A total of 8805 participants (3322 men and 5483 women) were enrolled in this study. Logistic regression analysis was conducted to examine the association between NC and eGFR. The male and female subjects were divided into four groups according to the NC quartiles. The primary outcome was defined as an eGFR ≤ 90 mL/min/1.73 m2. Results Logistic regression analysis revealed that in both sexes, higher NC was significantly associated with a higher risk of decreased eGFR even after fully adjusting for age, other anthropometric indexes, traditional risk factors for chronic kidney diseases, and sociologic risk factors (quartile 1 as a reference; the odds ratios [95% confidence intervals] were as follows: quartile 2, 1.26 [0.99-1.59]; quartile 3, 1.40 [1.07-1.83]; and quartile 4, 1.71 [1.22-2.38], in men; quartile 2, 1.14 [0.95-1.37]; quartile 3, 1.31 [1.03-1.66]; and quartile 4, 1.32 [1.04-1.68], in women). Stratified analyses suggested that the association was significant among subjects with prediabetes or normal serum uric acid levels and those without cardiovascular diseases (CVD). Among subjects with CVD, the association persisted only in males. When the subjects were stratified according to blood pressure or BMI, the association persisted among male subjects with abnormal blood pressure and was strengthened among male subjects who were overweight/obese, while the association disappeared among female subjects. Conclusions NC is independently associated with the risk of decreased eGFR in the general population in China, indicating that NC could contribute to renal dysfunction risk assessment.

Branched-chain amino acid metabolism, insulin sensitivity and liver fat response to exercise training in sedentary dysglycaemic and normoglycaemic men

Aims/hypothesisObesity and insulin resistance may be associated with elevated plasma concentration of branched-chain amino acids (BCAAs) and impaired BCAA metabolism. However, it is unknown whether the insulin-sensitising effect of long-term exercise can be explained by concomitant change in BCAAs and their metabolism.MethodsWe included 26 sedentary overweight and normal-weight middle-aged men from the MyoGlu clinical trial, with or without dysglycaemia, for 12 weeks of supervised intensive exercise intervention, including two endurance and two resistance sessions weekly. Insulin sensitivity was measured as the glucose infusion rate (GIR) from a hyperinsulinaemic−euglycaemic clamp. In addition, maximum oxygen uptake, upper and lower body strength and adipose tissue depots (using MRI and spectroscopy) were measured, and subcutaneous white adipose tissue (ScWAT) and skeletal muscle (SkM) biopsies were harvested both before and after the 12 week intervention. In the present study we have measured plasma BCAAs and related metabolites using CG-MS/MS and HPLC-MS/MS, and performed global mRNA-sequencing pathway analysis on ScWAT and SkM.ResultsIn MyoGlu, men with dysglycaemia displayed lower GIR, more fat mass and higher liver fat content than normoglycaemic men at baseline, and 12 weeks of exercise increased GIR, improved body composition and reduced liver fat content similarly for both groups. In our current study we observed higher plasma concentrations of BCAAs (14.4%, p = 0.01) and related metabolites, such as 3-hydroxyisobutyrate (19.4%, p = 0.034) in dysglycaemic vs normoglycaemic men at baseline. Baseline plasma BCAA levels correlated negatively to the change in GIR (ρ = −0.41, p = 0.037) and dot{V}{mathrm{O}}_{2max } (ρ = −0.47, p = 0.015) after 12 weeks of exercise and positively to amounts of intraperitoneal fat (ρ = 0.40, p = 0.044) and liver fat (ρ = 0.58, p = 0.01). However, circulating BCAAs and related metabolites did not respond to 12 weeks of exercise, with the exception of isoleucine, which increased in normoglycaemic men (10 μmol/l, p = 0.01). Pathway analyses of mRNA-sequencing data implied reduced BCAA catabolism in both SkM and ScWAT in men with dysglycaemia compared with men with normoglycaemia at baseline. Gene expression levels related to BCAA metabolism correlated positively with GIR and markers of mitochondrial content in both SkM and ScWAT, and negatively with fat mass generally, and particularly with intraperitoneal fat mass. mRNA-sequencing pathway analysis also implied increased BCAA metabolism after 12 weeks of exercise in both groups and in both tissues, including enhanced expression of the gene encoding branched-chain α-ketoacid dehydrogenase (BCKDH) and reduced expression of the BCKDH phosphatase in both groups and tissues. Gene expression of SLC25A44, which encodes a mitochondrial BCAA transporter, was increased in SkM in both groups, and gene expression of BCKDK, which encodes BCKDH kinase, was reduced in ScWAT in dysglycaemic men. Mediation analyses indicated a pronounced effect of enhanced SkM (~53%, p = 0.022), and a moderate effect of enhanced ScWAT (~18%, p = 0.018) BCAA metabolism on improved insulin sensitivity after 12 weeks of exercise, based on mRNA sequencing. In comparison, plasma concentration of BCAAs did not mediate any effect in this regard.Conclusion/interpretationPlasma BCAA concentration was largely unresponsive to long-term exercise and unrelated to exercise-induced insulin sensitivity. On the other hand, the insulin-sensitising effect of long-term exercise in men may be explained by enhanced SkM and, to a lesser degree, also by enhanced ScWAT BCAA catabolism.Graphical abstract

Associations of Added Sugar from All Sources and Sugar-Sweetened Beverages with Regional Fat Deposition in US Adolescents: NHANES 1999–2006

ABSTRACTBackgroundThe relative distribution of upper- versus lower-body fat may be an important determinant of cardiometabolic disease risk in youths. Dietary components associated with adolescent regional body fat distribution require further investigation.ObjectiveTo evaluate associations of added sugar intake overall and from sugar-sweetened beverages (SSBs) with relative upper-body fat deposition in US adolescents.MethodsThis was a cross-sectional analysis of data from 6585 adolescents (aged 12–19 y) in the NHANES cycles 1999–2006. Trunk, leg, and total fat mass were assessed by DXA. Participants were grouped into categories of total and SSB added sugar intake as a percentage of total energy intake (TEI) in 5% increments. Stepwise multivariable linear regression was used to examine associations of added sugar intake with truncal-to-leg fat ratio (TLR) and truncal-to-total fat ratio (TTR).ResultsThere were no associations of total added sugar intake with TLR or TTR. For SSB added sugar, compared with the lowest category of intake (<2% TEI), the highest category (>22% TEI) was associated with higher log-TLR [β (95% CI): >22% TEI versus <2% TEI: 0.05 (0.01, 0.09)] and TTR [1.30 (0.53, 2.07)] in the partially adjusted model with sex, age, race/ethnicity, income, physical activity, and smoking status as covariates (P-trend = 0.0001 for both). When BMI z-score and TEI were added as covariates, the magnitude of the associations were attenuated, but remained significant [log-TLR β (95% CI): 0.03 (0.005, 0.06), P-trend = 0.0018; TTR β (95% CI): 0.75 (0.27, 1.23), P-trend = 0.0004].ConclusionsThese findings support that added sugar from beverages is associated with higher upper-body adiposity, though the magnitude and clinical significance of the associations may be small, especially when adjusted for BMI and TEI. Additional studies are needed to elucidate the underlying biological mechanisms to explain these findings.

Neck Circumference as a Novel Measure of Central Obesity in Young Adults: Correlation with other Anthropometric Indices

Background&#x0D; Obesity is an important yet the most neglected public health problem that has assumed epidemic proportions even in developing countries. Many simple anthropometric indices, including the body mass index (BMI), waist circumference (WC) are being widely used as markers to reflect obesity. In recent years, there has been growing interest in the utility of neck circumference (NC) in identifying people with obesity. This new index of upper body adiposity is quite easy to determine, does not require much body exposure, and is believed to correlate with other obesity indices.&#x0D; Objectives&#x0D; This study was undertaken with the purpose to find out the relationship of neck circumference (NC) with other anthropometrical indices.&#x0D; Materials and Method&#x0D; This cross sectional study was carried out over a period of six months among 192 medical students. The participants were examined for various anthropometric parameters such as height, weight, and NC. BMI was calculated. The correlation between NC and other indices (BMI, weight WC) was assessed by calculating the Pearson's correlation coefficient (r) and P &gt; 0.05 was taken as statistically significant.&#x0D; Results&#x0D; Neck circumference (NC) positively correlated with BMI, weight and WC. The correlation was statistically significant (P &lt; 0.001).&#x0D; Conclusion&#x0D; Our study revealed a positive and significant correlation between neck circumference (NC)and other anthropometric indices like BMI, weight and waist circumference (WC) in young medical students, indicating an increase in BMI, weight and waist circumference (WC) with an increase in neck circumference (NC) or vice versa

Abstract P255: Central Fat Distribution and Metabolic Health in Normoglycemic Young Women

Purpose: The purpose of this pilot study is to test the hypothesis that fat distribution, rather than overall obesity, is strongly related to insulin sensitivity in young, normoglycemic women. Methods: Thirty-eight non-diabetic young women completed the study (ages 20.7 ±2.8 years; BMI 27.6 ±3.6; 44% Caucasian (17 of 38). Matsuda Insulin Sensitivity Index was calculated from plasma glucose and insulin at 0, 30, 60, and 90 minutes after ingestion of 75g glucose, using established formula, to estimate whole body insulin sensitivity. Whole body and regional adipose tissue was assessed via DXA, abdominal ultrasound of intra-abdominal and pre-peritoneal adipose depots, circumference measures, and skinfold measures. ANOVA was used to assess mean differences among tertiles of Matsuda Index. Partial correlations were controlled for age and race, then additionally controlled for DXA percent body fat to assess associations of fat distribution independent of overall obesity. Results: ANOVA revealed a higher waist circumference (83.8 ±7.8cm vs. 75.6 ±7.2), waist/hip ratio (0.777 ±0.48 vs. 0.716 ±0.05 ), waist/height ratio (0.524 ±0.028 vs. 0.468 ±0.043), ultrasound intra-abdominal thickness (3.57 ±1.3 vs. 2.48 ±1.1) in the least insulin-sensitive tertile, when compared to the most insulin-sensitive tertile, while age, BMI, and other measures of adiposity were comparable among the three groups. Partial correlations controlled for age and race revealed strong negative relationships between Matsuda Index and measures of upper-body and central adiposity, including waist circumference ( r =-.416, p &lt;0.05), waist/hip ratio ( r = -0.500, p &lt;0.01), waist/height ratio ( r =-0.431, p &lt;0.05), IAAT ( r = -0.412, p &lt;0.05), PPAT ( r =-0.381, p &lt;0.05), but not BMI ( r = -0.173, p =ns) or overall percent fat ( r =-0.132 , p =ns). When further controlled for percent body fat, correlations persisted between Matsuda and waist circumference ( r =-.433, p &lt;0.05), waist/hip ratio ( r =-0.488, p &lt;0.01), waist/height ratio (r= -.470, p &lt;0.01), intra-abdominal fat thickness ( r =-0.394, p &lt;0.05) and pre-peritoneal fat thickness ( r =-0.361, p =0.05). Conclusions: Central and upper-body fat distribution, independent of overall obesity, is strongly associated with metabolic health in young non-diabetic women. These data underscore the clinical utility of central adiposity as an marker of metabolic health.

Correlations of neck circumference with body composition and cardiometabolic risk factors in Arab women.

Neck circumference (NC) is a relatively unused index of upper body adiposity. The present study aims to analyze the associations of NC with anthropometric measures of obesity, as well as cardiovascular and metabolic risks in Arab women. This cross-sectional study included 623 women (aged 18-70years) recruited from different primary care centers in Riyadh, Saudi Arabia. NC, waist circumference (WC), body mass index (BMI), blood pressure, and metabolic and serological markers were measured in all participants. Covariance and regression analyses were used to evaluate the associations between NC and cardiometabolic risk factors. The correlation coefficients of NC and WC with the clinical indices were highly significant (p < 0.01). Overall, the NC was positively correlated with all cardiometabolic markers except total cholesterol and LDLc (p < 0.001). Interestingly, NC was associated with cardiometabolic risk factors independent of other anthropometric indices. NC is significantly and independently associated with cardiometabolic risk factors in Arab women. V, cross-sectional descriptive study.

Neck Circumference as a Novel Measure of Central Obesity in Young Adults: Correlation with other Anthropometric Indices

Background Obesity is an important yet the most neglected public health problem that has assumed epidemic proportions even in developing countries. Many simple anthropometric indices, including the body mass index (BMI), waist circumference (WC) are being widely used as markers to reflect obesity. In recent years, there has been growing interest in the utility of neck circumference (NC) in identifying people with obesity. This new index of upper body adiposity is quite easy to determine, does not require much body exposure, and is believed to correlate with other obesity indices. Objectives This study was undertaken with the purpose to find out the relationship of neck circumference (NC) with other anthropometrical indices. Materials and Method This cross sectional study was carried out over a period of six months among 192 medical students. The participants were examined for various anthropometric parameters such as height, weight, and NC. BMI was calculated. The correlation between NC and other indices (BMI, weight WC) was assessed by calculating the Pearson's correlation coefficient (r) and P > 0.05 was taken as statistically significant. Results Neck circumference (NC) positively correlated with BMI, weight and WC. The correlation was statistically significant (P < 0.001). Conclusion Our study revealed a positive and significant correlation between neck circumference (NC)and other anthropometric indices like BMI, weight and waist circumference (WC) in young medical students, indicating an increase in BMI, weight and waist circumference (WC) with an increase in neck circumference (NC) or vice versa

Differences in Upper and Lower Body Adipose Tissue Oxygen Tension Contribute to the Adipose Tissue Phenotype in Humans.

Upper and lower body adipose tissue (AT) exhibits opposing associations with obesity-related cardiometabolic diseases. Recent studies have suggested that altered AT oxygen tension (pO2) may contribute to AT dysfunction. Here, we compared in vivo abdominal (ABD) and femoral (FEM) subcutaneous AT pO2 in women who are overweight and have obesity, and investigated the effects of physiological AT pO2 on human adipocyte function. ABD and FEM subcutaneous AT pO2 and AT blood flow (ATBF) were assessed in eight [BMI (body mass index) 34.4 ± 1.6 kg/m2] postmenopausal women who were overweight with obesity and impaired glucose metabolism. ABD and FEM AT biopsy specimens were collected to determine adipocyte morphology and AT gene expression. Moreover, the effects of prolonged exposure (14 days) to physiological AT pO2 on adipokine expression/secretion, mitochondrial respiration, and glucose uptake were investigated in differentiated human multipotent adipose-derived stem cells. AT pO2 was higher in ABD than FEM AT (62.7 ± 6.6 vs 50.0 ± 4.5 mm Hg, P = 0.013), whereas ATBF was comparable between depots. Maximal uncoupled oxygen consumption rates were substantially lower in ABD than FEM adipocytes for all pO2 conditions. Low physiological pO2 (5% O2) decreased proinflammatory gene expression, increased basal glucose uptake, and altered adipokine secretion in ABD and FEM adipocytes. We demonstrated for the first time, to our knowledge, that AT pO2 is higher in ABD than FEM subcutaneous AT in women who are overweight/with obesity, partly due to a lower oxygen consumption rate in ABD adipocytes. Moreover, low physiological pO2 decreased proinflammatory gene expression and improved the metabolic phenotype in differentiated human adipocytes, whereas more heterogeneous effects on adipokine secretion were found.

Obstructive sleep apnea in non-dialyzed chronic kidney disease patients: Association with body adiposity and sarcopenia.

Obstructive sleep apnea (OSA) is a risk factor for cardiovascular disease (CVD), the main cause of mortality in chronic kidney disease (CKD). Although the prevalence of OSA in patients with CKD has not been established, a few studies suggest that it is higher than in the general population, potentially increasing the risk for CVD. Obesity increases the risk, whereas sarcopenia has been suggested as a consequence of OSA in the general population. To our knowledge, these associations have not been adequately evaluated in patients with CKD. The aim of this study was to evaluate OSA frequency and its association with total and upper body adiposity and sarcopenia in non-dialyzed CKD patients. This cross-sectional study included 73 patients with stages 3b-4 CKD (42 men, 62.9 ± 1.1 y of age). Glomerular filtration rate was estimated by the CKD-Epidemiology Collaboration equation. Patients were assessed for OSA by Watch-PAT200 (apnea-hypopnea index ≥5 events hourly; Itamar Medical), total body adiposity by dual-energy x-ray absorptiometry (DXA) and body mass index (BMI), upper body adiposity by anthropometric parameters and by trunk and visceral fat by DXA, and sarcopenia. OSA frequency was 67% (N = 49). Both total and upper body adiposity were associated with the presence and severity of OSA. In non-obese patients (BMI <30 kg/m2), upper body obesity increased significantly the frequency of OSA. OSA association with sarcopenia was blunted when BMI was included in regression model. Results from the present study suggest that in non-dialyzed CKD patients OSA is very common and associated with total and upper body obesity, but not with sarcopenia.

Cross-Validation of Anthropometric Measures against Body Mass Index for the Assessment of Obesity in Children

Background: It goes without saying that central or upper body adiposity leads to increased risks of obesity-associated metabolic complications. Direct methods of measurement of central obesity are not practical for field studies due to technical difficulties and cost. Thus, the urge to depend on anthropometry is going larger. The purposes of the study were to evaluate the relations between different anthropometry and to predict and cross-validate these measures. Methods: Subjects participating in the study included only 71 boys from different grades (aged 6-12 years). The following anthropometric measurements were measured and calculated: body mass index(BMI), waist circumference(WC), waist to hip ratio(WHR), and waist to height ratio(WHtR). Results: WC was the best single predictor of obesity, explaining 67.4% (r=0.67)of its variance while WHR explained 0.6% (r=0.006)and WHtR explained 7.3%.(r=0.07) Following quadratic regression and cross-validation techniques, it was obvious that WC better explained 77.3%(r=0.77) with p&lt;0.05 of the variance of BMI, while WHtR explained 11.5% (r=0.11) with p&lt;0.961, and WHR explained 16.7% (r=0.16)with p&lt;0.546. Conclusion: Collinearity between body mass index(BMI) and waist circumference (WC) does exist, but it is recommended to use Waist circumference associated with body mass index at a young age due to the period of intense growth.