Upper-body Fat Research Articles

Bidirectional Mendelian randomization highlights causal relationships between circulating INHBC and multiple cardiometabolic diseases and traits.

Human genetic and transgenic mouse studies have highlighted a potential liver-adipose tissue endocrine axis, involving activin C (Act-C) and/or Act-E and ALK7, influencing fat distribution and systemic metabolism. We investigated the bidirectional effects between circulating INHBC, which homodimerizes into Act-C, and adiposity traits, insulin resistance, inflammation, and cardiometabolic disease risk. Additionally, we examined if Act-C is an ALK7 ligand in human adipocytes. We used Mendelian randomization and in vitro studies in immortalized human abdominal and gluteal adipocytes. Circulating INHBC was causally linked to reduced lower-body fat, dyslipidaemia, and increased risks of coronary artery disease (CAD) and non-alcoholic fatty liver disease (NAFLD). Conversely, upper-body fat distribution, obesity, hypertriglyceridemia, subclinical inflammation, and type 2 diabetes positively impacted plasma INHBC levels. Mechanistically, an atherogenic lipid profile may partly explain the INHBC-CAD link, while inflammation and hypertriglyceridemia may partly explain how adiposity traits affect circulating INHBC. Phenome-wide Mendelian randomization showed weak causal relationships between higher plasma INHBC and impaired kidney function and higher gout risk. In human adipocytes, recombinant Act-C activated SMAD2/3 signaling via ALK7 and suppressed lipolysis. In summary, INHBC influences systemic metabolism by activating ALK7 in adipose tissue and may serve as a drug target for atherogenic dyslipidemia, CAD, and NAFLD.

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.

Associations of Regional Body Fat with Risk of Cardiovascular Disease and Mortality among Individuals with Type 2 Diabetes.

We aimed to prospectively examine the association between regional body fat and risk of cardiovascular disease (CVD) in individuals with type 2 diabetes (T2D), who often exhibit changes in relative fat distribution and have increased CVD risk. The main analysis included 21,472 participants with T2D from the UK Biobank. Regional body fat was measured by bioelectric impedance assessment. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Over a median of 7.7 years of follow-up, 3,976 CVD events occurred. After multivariable adjustment, upper and lower body fat were independently and oppositely associated with CVD risk among patients with T2D. Higher arm fat percentage was linearly associated with increased CVD risk (P nonlinear >0.05), while higher trunk fat percentage was nonlinearly associated with increased CVD risk (P nonlinear <0.05). In contrast, higher leg fat percentage was nonlinearly associated with lower CVD risk (P nonlinear <0.05). When comparing extreme quartiles, the multivariable-adjusted HR (95% CI) of CVD was 0.72 (0.58, 0.90) for leg fat percentage, 1.63 (1.29, 2.05) for arm fat percentage, and 1.27 (1.06, 1.52) for trunk fat percentage. Similar patterns of associations were observed for all-cause and CVD mortality. In addition, leg fat percentage, but not other regional fat percentage, was associated with CVD risk independently of traditional measures of obesity. Among people with T2D, arm fat and trunk fat were positively, whereas leg fat was inversely, associated with the risk of CVD and mortality. These findings highlight the importance of considering both the amount and the location of body fat when assessing CVD and mortality risk among individuals with T2D.

FRI028 Multiple Symmetric Lipomatosis As A Model For Understanding The Importance Of Mitochondria Function On Adipose Tissue Biology

Abstract Disclosure: M.C. Foss de Freitas: Advisory Board Member; Self; PTC Therapeutics. A. DillGomes: None. F. Grissi: None. S. Imam: None. E.A. Oral: Consulting Fee; Self; Regeneron Pharmaceuticals, Aegerion Pharmaceuticals, receives payment, Ionis Pharmaceuticals Inc., Third Rock Ventures, Rejuvenate Inc. Grant Recipient; Self; Regeneron Pharmaceuticals, Ionis Pharmaceuticals Inc., Aegerion Pharmaceuticals, Novo Nordisk, Rhythm pharmaceuticals, Fractyl Laboratories, GID Dynamics. Other; Self; Aegerion Pharmaceuticals. Multiple symmetric lipomatosis (MSL) is a rare disease characterized by symmetrical deposition of adipose tissue (AT) in the neck and upper body, associated with lipoatrophy in the distal segments of arms and legs and has been recently associated with biallelic mitofusin (MFN) 2 pathogenic variants. We are currently following multiple pedigrees, some with two affected siblings with MFN2-associated MSL. Homozygous MFN2 R707W (c.2119C&amp;gt;T) pathogenic variant was detected in all but one patient. Briefly, patient 1 is a 43-year-old female who first reported increased head and neck adiposity with increased muscularity of her extremities around 13 years old. Her sister is also affected (patient 2). The father was confirmed to be heterozygous for the pathogenic variant R707W. Patient 3 (20-year-old male) and patient 4 (17-year-old male) are siblings from another pedigree. The older sibling in this pedigree has evidence of axonal neuropathy and feet deformities. Both parents are heterozygous for R707W. Patient 5 () is a 54-year-old female reporting face and upper body fat tissue expansion starting when she was 15 years old; she also presented with distal axonal neuropathy. Her sister (patient 6) has clinical manifestations compatible with MSL (patient 6). Patient 7, who is a compound heterozygote with the R707W and D536T variants, is a 59-year-old woman who started noticing unusual body fat distribution at age 17 and progressively developed myopathy and neuropathy associated with Charcot-Marie-Tooth disease, and she also developed acromegalic features and severe macroglossia. All patients share the phenotypic features of the disease characterized by the accumulation of fat in the upper part of the body and lipoatrophic upper and lower limbs. Although variable, all patients have some degree of insulin resistance, but none of them has crossed the clinical threshold of diabetes so far. Triglyceride levels are elevated, ranging from around 200mg/dL-1300mg/dL. Remarkably, all patients have very low leptin levels and an enlarged liver with mildly impaired liver function. Obstructive sleep apnea is diagnosed in four patients due to the accumulation of AT in the neck. All patients have enlarged tongues. Patient 7 has an elevated IGF-1 level. Interestingly, all patients have been noted to have elevated GDF-15 levels (ranging from 1662-2813pg/mL). Affected patients have variable degrees of scoliosis, likely a secondary effect of adipose tissue overgrowth during adolescence. Although the mechanism of disease is not clear, R707 is in the carboxy-terminal coiled-coil domain HR2 of MFN2 and may regulate mitochondrial membrane fusion. A better understanding of the metabolic impact of MFN2 R707W in lipolysis and energy expenditure will provide new insights into patient care, hopefully improving these patients' quality of life. Presentation: Friday, June 16, 2023

Novel Anthropometric Indices as Screening Tools for Obesity: A Study on Healthy Iranians.

Upper body fat distribution is more related to cardiometabolic diseases than central obesity. Neck circumference (NC) and neck-to-height ratio (NHtR) are two indicators of upper body obesity that are affordable, easy to obtain, highly reproducible, and more practical in the crowded health centers than the classic anthropometric indices. 18-65-year-old individuals with no past medical history were included. After obtaining written informed consent, they were screened for hypertension, high blood glucose, and other abnormal laboratory results. Data were analyzed using SPSS and Mann-Whitney U test, Chi square test, Spearman's correlation coefficient, and ROC curve. In our 2,812 participants, NC had the lowest area under the curve (AUC) in both male and female obese and overweight subjects. NHtR and hip circumference (HC) had the highest AUC in men and women with obesity, respectively. The highest sensitivity for overweight men and women belonged to waist circumference (WC) and waist-to-height ratio (WHtR), respectively, and for both males and females with obesity, NHtR had the highest sensitivity. The cutoff point of NHtR had the same value for males and females. HC and NHtR had the highest positive likelihood ratio (PLR) for obesity in men. In addition, HC and WC had the highest PLR for obesity in women. In this study, we revealed that NC had the lowest and NHtR and HC had the highest predictive value for obesity. Furthermore, for both males and females with obesity, NHtR had the highest sensitivity. HC had the highest PLR for obesity in both genders. Our results warrant prospective studies to evaluate the role of NHtR and other novel anthropometric indices in the risk of cardiometabolic diseases.

Interleukin-6 in Patients With Heart Failure and Preserved Ejection Fraction

BackgroundInterleukin (IL)-6 is a central inflammatory mediator and potential therapeutic target in heart failure (HF). Prior studies have shown that IL-6 concentrations are elevated in patients with HF, but much fewer data are available in heart failure with preserved ejection fraction (HFpEF). ObjectivesThis study aims to determine how IL-6 relates to changes in cardiac function, congestion, body composition, and exercise tolerance in HFpEF. MethodsClinical, laboratory, body composition, exercise capacity, physiologic and health status data across 4 National Heart, Lung, and Blood Institute–sponsored trials were analyzed according to the tertiles of IL-6. ResultsIL-6 was measured in 374 patients with HFpEF. Patients with highest IL-6 levels had greater body mass index; higher N-terminal pro–B-type natriuretic peptide, C-reactive protein, and tumor necrosis factor-α levels; worse renal function; and lower hemoglobin levels, and were more likely to have diabetes. Although cardiac structure and function measured at rest were similar, patients with HFpEF and highest IL-6 concentrations had more severely impaired peak oxygen consumption (12.3 ± 3.3 mL/kg/min 13.1 ± 3.1 mL/kg/min 14.4 ± 3.9 mL/kg/min, P < 0.0001) as well as 6-minute walk distance (276 ± 107 m vs 332 ± 106 m vs 352 ± 116 m, P < 0.0001), even after accounting for increases in IL-6 related to excess body mass. IL-6 concentrations were associated with increases in total body fat and trunk fat, more severe symptoms during submaximal exercise, and poorer patient-reported health status. ConclusionsIL-6 levels are commonly elevated in HFpEF, and are associated with greater symptom severity, poorer exercise capacity, and more upper body fat accumulation. These findings support testing the hypothesis that therapies that inhibit IL-6 in patients with HFpEF may improve clinical status. (Clinical Trial Registrations: Phosphodiesterase-5 Inhibition to Improve Clinical Status and Exercise Capacity in Diastolic Heart Failure [RELAX], NCT00763867; Nitrate’s Effect on Activity Tolerance in Heart Failure With Preserved Ejection Fraction, NCT02053493; Inorganic Nitrite Delivery to Improve Exercise Capacity in HFpEF, NCT02742129; Inorganic Nitrite to Enhance Benefits From Exercise Training in Heart Failure With Preserved Ejection Fraction [HFpEF], NCT02713126)

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.

Double-pyramid and Reverse step resistance training effectiveness on physical fitness factors among elite female athletes

Due to the necessity of resistance training for athletes conditioning, loading patterns in order to improve training outcomes have received more attention in recent decades. Accordingly, the purpose of this study was to assess the impact of 8-week resistance training performed with double pyramid (DP) and reverse step (RS) systems on some physical fitness components of elite female athletes. 30 young female handball players are randomly assigned to the three groups of DP (age: 17.43±1.63 year, weight: 70.28±10.14 kg, fat percentage: 15.60±1.17), RS (age: 17.13±1.32 year, weight: 67.80±7.78 kg, fat percentage: 15.40±1.69), and control groups (age: 17.33±1.71 year, weight: 61.04±6.61 kg, fat percentage: 16.50±1.43). Training programs was performed for an eight-week, 3 sessions per week with loading pattern of DP or RS. Measurements including fat percentage, anaerobic power (RAST), agility (Illinois), Speed (45 meter sprint), strength (1RM), and muscle endurance (60% 1RM) are taken before and after the training course.After the training period, DP and RS groups had significant effects on the mean power, upper and lower body muscular endurance, fat percentage, agility and speed (p&amp;lt;0.05). Also, DP showed a significantly more increase in upper body strength compared to RS groups and RS showed a significantly more increase in lower body strength compared to DP groups (p&amp;lt;0.05). Also, comparison of DP and RS groups showed a significant difference in lower and upper body muscle endurance between the two groups (P &amp;lt;0.05); While, there was not a significant difference in anaerobic power, upper and lower body strength, fat percentage, speed, and agility tests between training groups. DP resistance training appears that to have more impact in improving anaerobic power, upper body strength and speed. While, RS ones showed a greater effect on increasing the lower body strength, muscular endurance, agility and fat percentage of female handball players.

Evaluation of Association Between Obesity and Health of Periodontium in the Indian Population - A Randomized Cross-Sectional Study

Background Obesity is characterized by the abnormal or excessive deposition of fat in the adipose tissues. The recent rise in incidence of obesity in both developed as well as developing nations are a matter of grave concern due to the well-established association between obesity and several other chronic conditions.Aim The objective of the present study was to verify the potential association between obesity and periodontal disease among Indians.Methodology Using random sampling 200 subjects aged 20 to 60 years from the state of Punjab were evaluated at a given time using the Community Periodontal Index CPI and periodontitis was defined as ge ldquocode 3.rdquo Body mass index BMI and waist circumference WC were used to represent the measures of overall body fat and upper body fat respectively. BMI and WC cutoff points used in the present study are as established by the World Health Organization.Results There was a positive correlation between BMI and periodontitis in both males and females while WC was highly significantly associated with periodontitis only in females.Conclusion Within the limitations of this study it can be concluded that obese individuals are at a higher risk for developing periodontitis.

Neck Circumference is Associated with General and Central Obesity in Young Indian Adults.

Obesity has been a major concern due to its increasing prevalence and associated metabolic complications. Body mass index (BMI) assesses general obesity, but it does not distinguish between muscle and fat accumulations, so using only BMI can lead to an erroneous result. Waist circumference (WC), a marker of central obesity, predicted mortality risk better than BMI. However, WC can be affected by abdominal distension, is time-consuming, and may not be culture-sensitive. Neck circumference (NC) is devoid of these disadvantages and is believed to be an index of upper body fat distribution. This study aimed to assess the association of neck circumference with general and central obesity and to identify the cut-off points for evaluating obesity in young adults using NC. Height, weight, waist, and hip circumference were measured to determine BMI and waist-hip ratio. NC was measured at the level of the mid-cervical spine and mid-anterior neck in a standing position with the arms hanging freely. For males with a laryngeal prominence, NC was measured just below the prominence. In total, 357 (170 male and 187 female) young, healthy Indian adults aged 18-25 participated. Neck circumference (NC) is significantly associated with BMI and WC in both genders. We found the best cut-off for male and female participants to be ≥34 cm and ≥30.5 cm, with a sensitivity of 88.3% and 84.4% for assessing obesity. NC may be a better alternative to BMI and WC as a marker to assess obesity since it is more practical, simple, inexpensive, time-saving, and less invasive.

Obesity, Fat Distribution and Risk of Cancer in Women and Men: A Mendelian Randomisation Study.

Obesity and upper-body fat distribution are independent, cardiometabolic risk factors but whether they also display comparable associations with cancer risk is unknown. We investigated the causal relationships between body mass index (BMI) and BMI-adjusted waist-to-hip ratio (WHRadjBMI) and cancer risk and searched for potential drivers linking these traits to carcinogenesis using two-sample and multivariable Mendelian randomisation. In women, genetically instrumented higher BMI was associated with lower breast (OR = 0.87, 95% CI 0.81-0.93) and higher endometrial (OR = 1.75, 95% CI 1.55-1.96) cancer risk whilst WHRadjBMI was associated with higher colon cancer risk (OR = 1.22, 95% CI 1.07-1.42). In men, elevated BMI was associated with lower prostate cancer risk (OR = 0.91, 95% CI 0.85-0.98). Mechanistically, testosterone and insulin mediated 21% and 35%, respectively of the total, genetically determined association of BMI with endometrial cancer risk whilst HDL cholesterol and IGF-1 mediated 40% and 22%, respectively of the association between BMI and breast cancer risk. In men, testosterone mediated 21% of the association between BMI and prostate cancer risk. Colon cancer aside, the total amount of body fat might be more important than its location in modulating cancer susceptibility due to differential effects of obesity and fat distribution on adiposity-associated cancer drivers.

PSUN137 Suppression of endogenous insulin secretion during euglycemic hyperinsulinemia – effects of obesity

Abstract Hyperinsulinemia is strongly linked with excessive body fat. However, with the exception of plasma glucose concentrations, the other factors regulating insulin secretion are under-studied. We examined the effects of hyperinsulinemia itself on beta cell insulin secretion during exogenous insulin and glucose infusions in adults with insulin-resistant upper body (UBO), insulin-sensitive lower body obesity (LBO) and non-obese controls. Data from the euglycemic, hyperinsulinemic clamp studies of 33 volunteers (9 controls, 5 LBO, 19 UBO) was analyzed; basal and insulin-suppressed (residual) insulin secretion rates were determined using deconvolution of C-peptide concentrations. Obesity phenotype was determined using waist: hip ratio and body composition was assessed with dual-energy X-ray absorptiometry and abdominal computed tomography. Plasma insulin concentrations were log transformed to achieve a normal distribution before statistical analysis. The plasma glucose concentration change during the clamp was 0.3 (SD: 3) mg/dl, and similar among groups (p=0.7). Median, achieved serum insulin concentrations was 66 (IQR: 45-105) mIU/mL, and greater in participants with obesity. Fasting insulin secretion rates were 0.093 (SD: 0.029), 0.158 (SD: 0.036), and 0.216 (0.078) nmol/min in controls, LBO and UBO, respectively (UBO p&amp;lt;0.001 vs. other groups). Insulin secretion was suppressed by 28% during hyperinsulinemia with no between group differences (p= 0.69). The ratios of insulin secretion rate (from C-peptide deconvolution) to serum insulin concentration (nmol/min per mIU/mL) was 0.058 (SD: 0.015) in controls, 0.090 (SD: 0.016) in LBO and 0.111 (SD: 0.039) in UBO (UBO vs. other groups P = 0.001). The ratio of insulin secretion rates to plasma insulin concentrations was correlated with BMI (r=0.69, P &amp;lt;0.001). We conclude that adults with obesity have greater residual insulin secretion during an exogenous insulin infusion and that this is related to upper body fat distribution. However, because the proportional suppression of endogenous insulin secretion is similar in these groups, this could indicate the primary abnormality is fasting insulin secretion. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.

Lipoprotein profiles of fat distribution and its association with insulin sensitivity.

Fat deposition is associated with adverse outcomes. Waist-to-hip (WHR) ratio is a simple feasible index to assess fat distribution. Lipoprotein particle composition in relation to WHR and to what extent their association is mediated by insulin sensitivity are less investigated. In 504 randomly recruited Flemish (mean age: 48.9 years; women: 51.6%), we analyzed the lipoprotein particle constitutions using nuclear magnetic resonance spectroscopy. WHR obesity described a WHR of ≥ 0.85 for women or 0.9 for men. Insulin sensitivity was evaluated by the homeostasis model assessment-estimated insulin resistance (HOMA-IR). SCORE-2 risk algorithm was applied to estimate 10-year cardiovascular risk. Statistical methods included multivariable-adjusted linear regression analysis, logistic regression analysis, and mediation analysis. The prevalence of WHR obesity was 54.6%, approximately 3 times of BMI-determined obesity (19.1%). Individuals with WHR obesity had significantly higher metabolic complications, such as hypertension (57.1%), dyslipidemia (61.8%), and insulin resistance (14.2%). WHR and WHR obesity were positively associated with total very-low-density lipoprotein (VLDL) particle concentration, remnant cholesterol, and triglycerides, but were negatively associated with VLDL particle size (P ≤ 0.027), independent of body mass index and other covariates. WHR was inversely associated with total high-density lipoprotein (HDL) particle concentration, whereas WHR obesity was inversely associated with HDL cholesterol (P ≤ 0.039). Neither WHR nor WHR obesity was associated with the concentration of total low-density lipoprotein (LDL) particles, LDL particle size, and LDL cholesterol (P ≥ 0.089). In the mediation analysis, insulin sensitivity significantly mediated the effect of WHR on total VLDL particle concentration (mediation percentage: 37.0%), remnant cholesterol (47.7%), and HDL cholesterol (41.1%). Individuals with WHR obesity were at increased cardiovascular risk, regardless of LDL cholesterol (P ≤0.028). In WHR obesity, higher total VLDL particle concent36ration and remnant cholesterol, and lower HDL cholesterol were associated with an increased cardiovascular risk (P≤ 0.002). Upper-body fat deposition was independently associated with an unfavorable lipoprotein profile, and insulin sensitivity significantly mediated this association. LDL cholesterol might underestimate lipid abnormality for people with upper-body obesity and lowering VLDL particles and remnant cholesterol might potentially reduce the residual cardiovascular risk.

Study of prevalence of non- alcoholic fatty liver disease in type 2 diabetes and its correlation with liver function tests and fasting lipid profile

Introduction: NAFLD is the third leading indication for liver transplantation. The prevalence of NAFLD has been documented to be 15%-30% in general population and 70%-75% in type 2 diabetes population. Indian population has a higher body fat content and abdominal adiposity: the more upper body fat content is associated with insulin resistance causing more NAFLD. There is evidence that Type 2 DM patients with NAFLD are at higher risk of developing cirrhosis compared to non-diabetic patients. The present study was conducted in a tertiary care hospital from south India to know the Prevalence of Non -Alcoholic Fatty Liver Disease in persons with Type 2 Diabetes Mellitus and to correlate the results of Liver Function Tests and fasting Lipid Profile with NAFLD. Materials and Methods: This is an observational study done in patients attending OPDs in department of General Medicine during 1st January 2018 to 30th June 2019 in Maharajah’s Institute of Medical Sciences, Vizianagaram and Andhra Pradesh. Results: The prevalence of NAFLD, as assessed by ultrasound examination, was 67%, mean age of subjects in the NAFLD group was 53.06 ± 6.20 years. Prevalence in males was 45.2%. High BMI is associated with NAFLD (P&lt; 0.001).

Neck circumference predicts development of carotid intima-media thickness and carotid plaque: A community-based longitudinal study

Background and aimsCarotid intima-media thickness (C-IMT) is an important index for evaluating subclinical atherosclerosis. Neck circumference (NC), a new anthropometric index of the upper body fat, is closely related to cardiovascular disease (CVD) and CVD risk factors. This study investigated the relationship between NC, C-IMT, and carotid plaque in a community-based cohort. Methods and resultsParticipants recruited from Shanghai communities were followed up for 1.1–2.9 years. All participants underwent anthropometric and biochemical measurements. Elevated NC was defined as NC ≥ 38.5 cm and NC ≥ 34.5 cm in men and women, respectively. Elevated C-IMT, determined by ultrasound, was defined as a level higher than the 75th percentile in the study population (>0.75 mm). In total, 1189 participants without carotid plaque at baseline were included, with an average age of 59.6 ± 7.3 years. After a mean follow-up of 2.1 ± 0.2 years, 203 participants developed carotid plaques. After adjusting for various atherosclerosis risk factors, the logistic regression showed that the higher NC group had a significantly greater risk of developing carotid plaque than the lower NC group (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.12–2.14; P = 0.008). Of those without carotid plaque at follow-up, 495 participants developed elevated C-IMT. Compared to the lower NC group, the higher NC group had a significantly increased risk of elevated C-IMT (OR, 1.49; 95% CI, 1.14–1.95; P = 0.003). ConclusionHigher NC was significantly positively correlated with the risk of carotid plaque and elevated C-IMT.

Sex hormones, adiposity, and metabolic traits in men and women: a Mendelian randomisation study.

ObjectiveEpidemiological and clinical studies have highlighted important roles for sex hormones in the regulation of fat distribution and systemic metabolism. We investigated the bidirectional associations between bioavailable serum testosterone (BioT) in both sexes and oestradiol (E2) in men and adiposity and metabolic traits using Mendelian randomisation (MR).Design and MethodsAs genetic instruments for sex hormones, we selected all the genome-wide significant, independent signals from a genome-wide association studies (GWAS) in up to 425 097 European ancestry UK Biobank participants. European population-specific, summary-level data for adiposity, metabolic, and blood pressure traits were obtained from the largest publicly available GWAS. Sex-specific, two-sample MR analyses were used to estimate the associations of sex hormones with these traits and vice versa.ResultsIn women, higher BioT was associated with obesity, upper-body fat distribution, and low HDL-cholesterol although, based on analyses modelling the sex hormone-binding globulin-independent effects of BioT, the last two associations might be indirect. Conversely, obesity and android fat distribution were associated with elevated serum BioT. In men, higher BioT was associated with lower hip circumference and lower fasting glucose. Reciprocally, obesity was associated with lower BioT and higher E2, while upper-body fat distribution and raised triglycerides were associated with lower E2.ConclusionsAdipose tissue and metabolic dysfunction are associated with deranged sex hormone levels in both sexes. In women, elevated BioT might be a cause of obesity. Conversely, in men, higher BioT appears to have beneficial effects on adiposity and glucose metabolism.

Adiposity in adolescents with malignant neoplasms: is there a more suitable parameter for early identification?

Rationale: Evidence suggests that cytokine-induced lipolysis, through TLR-4 signaling, causes the release of pro-inflammatory mediators involved in chemoresistance in tumor cells. Upper subcutaneous body fat (USBF), which can be identified by neck circumference (NC), is strongly associated with these metabolic changes and may be increased in adolescence. The main objective of this study was to identify the assessment of adiposity in adolescents with malignant neoplasms.

Body Fat Distribution, Cardiometabolic Traits, and Risk of Major Lower-Extremity Arterial Disease in Postmenopausal Women.

To assess the relationship between body fat distribution and incident lower-extremity arterial disease (LEAD). We included 155,925 postmenopausal women with anthropometric measures from the Women's Health Initiative who had no known LEAD at recruitment. A subset of 10,894 participants had body composition data quantified by DXA. Incident cases of symptomatic LEAD were ascertained and adjudicated through medical record review. We identified 1,152 incident cases of LEAD during a median 18.8 years follow-up. After multivariable adjustment and mutual adjustment, waist and hip circumferences were positively and inversely associated with risk of LEAD, respectively (both P-trend < 0.0001). In a subset (n = 22,561) where various cardiometabolic biomarkers were quantified, a similar positive association of waist circumference with risk of LEAD was eliminated after adjustment for diabetes and HOMA of insulin resistance (P-trend = 0.89), whereas hip circumference remained inversely associated with the risk after adjustment for major cardiometabolic traits (P-trend = 0.0031). In the DXA subset, higher trunk fat (P-trend = 0.0081) and higher leg fat (P-trend < 0.0001) were associated with higher and lower risk of LEAD, respectively. Further adjustment for diabetes, dyslipidemia, and blood pressure diminished the association for trunk fat (P-trend = 0.49), yet the inverse association for leg fat persisted (P-trend = 0.0082). Among U.S. postmenopausal women, a positive association of upper-body fat with risk of LEAD appeared to be attributable to traditional risk factors, especially insulin resistance. Lower-body fat was inversely associated with risk of LEAD beyond known risk factors.

Performance of neck circumference to predict obesity and metabolic syndrome among adults in a tertiary care hospital in India: A prospective cross sectional study

Aims and Objectives: To explore performance of neck circumference to predict obesity and metabolic syndrome among adults. Materials & Methods: In this prospective study, totally Three hundred cases of both sexes, between 30 to 75 years old, were evaluated. A convenience sampling strategy was used. The sample comprised cases treated at an outpatient clinic for obese children and adolescents in the Hospital. The study included overweight, obese, and normal weight subjects, according to criteria from the Centers for Disease Control and Prevention (CDC). Exclusion criteria were: cervical lymph nodes or deformities, goitre, late neuropsychological and motor development, congenital syndromes, hepatopathy, nephropathy, metabolic disorders (such as type 1 diabetes, hypothyroidism, and hyperthyroidism) and use of systemic corticosteroids. Results: In the present study, 17 cases belongs to age group of less than 31 years, 70 cases belongs to 31 to 40 year group, 43 cases belongs to 41 to 50 year group and 170 cases belongs to more than 50 year age group, 159 cases were male and 131 cases were female, one case belongs to underweight category, 84 cases belongs to normal weight category, 152 cases belongs to overweight category and 63 cases belongs to obese category. In males, 32 cases NC was less than 37 cms and 127 cases was more than 37 cms and In females, 47 cases NC was less than 34 cms and 84 cases was more than 34 cms. 86 cases were suffering from diabetes, 135 cases were suffering from hyperlipidemia, 2 cases were suffering from chronic kidney disease, 4 cases were suffering from coronary artery disease, 29 cases were suffering from hypertension, 15 cases were suffering from hypothyroidism, FBS was normal in range in 174 cases and abnormal in 126 cases, HBA1C was normal in 174 cases and abnormal in 126 cases. Conclusion: Strength of the study is that it was community based, making it more precise in the results and wider age groups have been included in the study. In spite of all the limitations, measuring upper body fat by neck circumference is a reasonable method to evaluate the obesity status.

Distinct opposing associations of upper and lower body fat depots with metabolic and cardiovascular disease risk markers.

To examine the associations of total and regional adiposity with metabolic and cardiovascular disease (CVD) risk markers. This cross-sectional study included 1080 (53.8% men, aged 39-44 years) individuals from South India. Anthropometry (height, weight, waist and hip circumference), body composition assessment using dual-energy X-ray absorptiometry (DXA), blood pressure (BP), and plasma glucose, insulin and lipids were measured. Regression analysis was used to examine associations of standardized fat measurements with type 2 diabetes (T2D), insulin resistance (IR), hypertension and hypertriglyceridemia and continuous measurements of BP, glucose, insulin, HOMA-IR and lipids. Contour plots were constructed to visualize the differential effect of upper and lower fat depots. DXA-measured fat depots were positively associated with metabolic and CVD risk markers. After adjusting for fat mass index, upper body fat remained positively, while lower body fat was negatively associated with risk markers. A one standard deviation (SD) increase in android fat showed higher odds ratios (ORs) for T2D (6.59; 95% CI 3.17, 13.70), IR (4.68; 95% CI 2.31, 9.50), hypertension (2.57; 95% CI 1.56, 4.25) and hypertriglyceridemia (6.39; 95% CI 3.46, 11.90) in men. A 1 SD increase in leg fat showed a protective effect with ORs for T2D (0.42; 95% CI 0.24, 0.74), IR (0.31; 95% CI 0.17, 0.57) and hypertriglyceridemia (0.61; 95% CI 0.38, 0.98). The magnitude of the effect was greater with DXA-measured fat compared with anthropometry. At any level of total body fat, upper and lower body fat depots demonstrate opposite risk associations with metabolic and CVD risk markers in Asian Indians.