Upper-body Obesity Research Articles

Neck circumference and clustered cardiovascular risk factors in children and adolescents: cross-sectional study

ObjectiveEarly detection of cardiovascular disease (CVD) risk factors, such as obesity, is crucial to prevent adverse long-term effects on individuals’ health. Therefore, the aims were: (1) to explore the robustness...

Obstructive sleep apnoea: is it moving into primary care?

Periods of obstructive sleep apnoea (OSA), first properly described in 1965,1 have been shown to occur in around 25% of males and 10% of females.2 But only about a fifth will need or benefit from treatment. OSA is due to excessive collapsing forces around the pharynx that overpower the decreased muscle tone during sleep. Snoring is an early marker of this collapse, and is either partial (causing hypopnoea) or complete (causing apnoea). To prevent asphyxia such events are terminated by a brief awakening after 20 to 40 seconds or so, restoring muscle tone and airflow, but of which the patient is rarely aware. A few such events during sleep are regarded as within the normal range, but there is a continuum of severity, with the most severe cases experiencing apnoeic events every minute across the whole night, with gross sleep fragmentation and recurrent hypoxic events. The dominant risk factor is upper-body obesity, mainly around the neck, although jaw shapes that reduce pharyngeal volume are important. In children, enlarged tonsils are the main risk factor and tonsillectomy is usually curative. Excessive daytime sleepiness is the main symptom of OSA, usually then called OSA syndrome (OSAS). This may be described as tiredness or fatigue, but closer questioning usually reveals it to be more sleepiness (though in women tiredness may be the main complaint). OSAS usually develops over several years, thus the patient may not be fully aware of just how symptomatic they are. Talking to a close relative can be useful, particularly regarding any sleepiness while driving. However, many people with OSA are not sleepy and do not need treatment. The main reason for any referral will be excessive sleepiness that interferes with quality of life, or impairs a vigilance-critical activity such as …

실버 의류산업 활성화를 위한 노년 비만여성의 체형연구

Abstract This study analyzed the body-type characteristics of 340 old-aged obese women that had been on the rise as a part of efforts to activate the silver clothing industry. The subjects were in the age range of 60-79 and met some obesity requirements, including a Rohrer Index of 1.6 or higher, a BMI of 25 or higher, and a WHR of 0.85 or higher. Old-aged obese women showed increased thickness of the torso with age, which suggests that they revealed the characteristics of regardless of gender. In other words, they became bigger in the waist and abdomen, shorter in height, slimmer in the lower body, and thicker in the torso. There are three types of obesity: Type 1 is lower-body obesity with a higher degree of obesity in the abdomen than the upper body. Type 2 is abdominal obesity with a higher degree of obesity in the upper body than in the lower body. Type 3 is whole-body obesity with balanced obesity of the whole body. As for changes to the types of obesity according to age, those who are in their sixties usually fall into the categories of upper-body and whole-body obesity, and those who are in their seventies are much more concentrated in the categories of abdominal obesity and upper-body obesity with a decreased percentage of whole-body obesity. It is apparent that the percentage of abdominal and upper-body obesity rises with age due to fat accumulation in the abdomen. Key word: old aged obese women(), factor analysis( ), BMI( ), silber clothing industry( !), obesity body type(#)

Testosterone Supplementation Improves Carbohydrate and Lipid Metabolism in Some Older Men with Abdominal Obesity.

Background/ObjectivesThe effects of testosterone supplementation on carbohydrate and lipid metabolism in obese older men are uncertain. We conducted a single-arm open-label prospective pilot study to investigate the effects of testosterone supplementation on central and peripheral insulin sensitivity in older men with upper body obesity and insulin resistance.Subjects/MethodsTwenty men (62–78 years-old) with morning testosterone levels <13.9 nmol/L (400 ng/dL), waist circumference ≥ 102 cm, and HOMA-IR ≥ 4.0 or HgbA1C 5.7–6.4% applied transdermal testosterone (10 mg) daily for 20 weeks. Insulin sensitivity (Si) was determined by a 2-stage glucose clamp, liver and intramyocellular lipid by 1H-MR spectroscopy and body composition by DEXA.ResultsTestosterone supplementation significantly reduced total fat (−.9 ± 2.4 kg, p=0.002), trunk fat (−1.3 ± 1.4 kg, p=0.0007) and extremity fat (−0.7 ± 1.1 kg, p=0.01), and increased extremity lean tissue (+1.3 ± 1.4 kg, p=0.0006). Whole body (WB) Si improved by 21% (0.76 ± 1.57 dL/min per µU/mL, p=0.04) and insulin-stimulated glucose uptake (Rd) by 24% (0.91 ± 1.74 dL/min per µU/mL, p=0.03). Improvements in glucose kinetics were limited to men with reductions in trunk and extremity fat greater than median declines for the entire group. Reductions in intramyocellular lipid were associated with improvements in WB Si (p=0.04) and Rd (p=0.03). Change in Rd accounted for 90% of the change in WB Si. Hepatic glucose output and liver lipid/H2O were unchanged (p>0.05). Multivariable analyses revealed that reductions in extremity fat, trunk fat, and FFA levels during the clamp accounted for 45% (p=0.004), 31% (p=0.002) and 8% (p=0.04) of respective changes in Rd. Triglycerides decreased by −0.40 ± 0.67mmol/L (p=0.02), LDL-C by-0.35 ± 0.57 mmol/L (p=0.02), and HDL-C by −0.14 ± 0.19 mmol/L (p=0.004).ConclusionsTestosterone supplementation that resulted in greater reductions in regional adiposity was associated with improved insulin sensitivity, lower LDL-C and fasting triglycerides, but lower HDL-C. Placebo controlled trials need to further examine the potential cardiometabolic risks/benefits of androgen supplementation for older men with low testosterone levels, central obesity, and insulin resistance.

Association of neck circumference as an indicator of upper body obesity with cardio-metabolic risk factors among first degree relatives of diabetes patients.

Background:The aim of the present study was to determine the relation between neck circumferences (NC), as an indicator of upper body obesity, with anthropometric and cardio-metabolic factors among the first degree relatives of diabetes patients.Materials and Methods:This cross-sectional study was performed on first degree relatives of diabetes patients (n = 213). Weight, height, waist circumference (WC), hip circumference (HC), systolic blood pressure (SBP), diastolic blood pressure (DBP) and NC were measured. Laboratory data included oral glucose tolerance test (OGTT) results, high density lipoprotein (HDL), low density lipoprotein, triglyceride (TG) and total cholesterol.Results:There was no difference in NC among different results of OGTT in men or women. Factors including weight, body mass index (BMI), WC and HC were strongly associated with NC in both genders (r = 0.420-0.711). NC was weakly associated with SBP in women (r = 0.195) and moderately with DBP in men (r = 0.314). Regarding lipid profile, HDL and TG were associated with NC only in women (r = −0.268-0.325).Conclusions:NC has a significant correlation with gender and anthropometric variables including BMI, weight and waist and HCs in both men and women but it does not differ significantly in patients with different status in OGTT.

The “New Deadly Quartet” for Cardiovascular Disease in the 21st Century: Obesity, Metabolic Syndrome, Inflammation and Climate Change: How Does Statin Therapy Fit into this Equation?

Despite population-based improvements in cardiovascular risk factors, such as blood pressure, cholesterol and smoking, cardiovascular disease still remains the number-one cause of mortality in the United States. In 1989, Kaplan coined the term "Deadly Quartet" to represent a combination of risk factors that included upper body obesity, glucose intolerance, hypertriglyceridemia and hypertension [Kaplan in Arch Int Med 7:1514-1520, 1989]. In 2002, the third report of the National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP III) essentially added low HDL-C criteria and renamed this the "metabolic syndrome." [The National Cholesterol Education Program (NCEP) in JAMA 285:2486-2497, 2001] However, often forgotten was that a pro-inflammatory state and pro-thrombotic state were also considered components of the syndrome, albeit the panel did not find enough evidence at the time to recommend routine screening for these risk factors [The National Cholesterol Education Program (NCEP) in JAMA 285:2486-2497, 2001]. Now over a decade later, it may be time to reconsider this deadly quartet by reevaluating the roles of obesity and subclinical inflammation as they relate to the metabolic syndrome. To complete this new quartet, the addition of increased exposure to elevated levels of particulate matter in the atmosphere may help elucidate why this cardiovascular pandemic continues, despite our concerted efforts. In this article, we will summarize the evidence, focusing on how statin therapy may further impact this new version of the "deadly quartet".

Biochemical and molecular mechanisms for the association between obesity, chronic Inflammation, and breast cancer

Upper body obesity is a risk factor for postmenopausal breast cancer and is related to an aggressive tumor phenotype and a poor prognosis regardless of menopausal status. After the menopause, the major mechanism for the association with disease risk is elevated estrogen production by adipose tissue, due to a high level of aromatase activity: these hormone-dependent tumors express both estrogen and progesterone receptors. Other important biological factors of risk include leptin and adiponectin, adipokines with opposing endocrine and paracrine activities, and obesity-related hyperinsulinemia. Chronic inflammation of the breast adipose tissue, which occurs in some obese women and is indicated by the accumulation of macrophages around dead adipocytes ("crown-like structures"), rather than adiposity per se, may prove to be the pathological lesion responsible for both local aromatase induction, and enhanced invasiveness and metastatic capacity through biological mechanisms that involve leptin, tumor necrosis factor-α, and insulin. A causal association between obesity in premenopausal women and breast cell epithelial-mesenchymal transition, perhaps with the participation of the Wnt signaling pathway, and aggressive hormone-independent breast cancer is suggested by a number of experimental and clinical studies.

Cardiometabolic risks during anabolic hormone supplementation in older men

There is little prospective information on the cardiometabolic risks of testosterone and growth hormone (GH) replacement therapy to youthful levels during aging. We conducted a double-masked, partially placebo controlled study in 112 men 65–90 years-old. Transdermal testosterone (5g-vs-10g/day) using a Leydig Cell Clamp and subcutaneous recombinant GH (rhGH) (0-vs-3-vs-5ug/kg/day) were administered for 16-weeks. Measurements included testosterone and IGF-1 levels, body composition by DEXA, and cardiometabolic risk factors (upper body fat, blood pressure, insulin sensitivity, fasting triglycerides, HDL-cholesterol, and serum adiponectin) at baseline and after 16 weeks of treatment. Some cardiometabolic factors improved (total and trunk fat, triglycerides, HDL-cholesterol) and others worsened (systolic blood pressure, insulin sensitivity index [QUICKI], adiponectin). Cardiometabolic risk composite scores (CRCS) improved (−0.69±1.55, p<0.001). In multivariate analyses, QUICKI, triglycerides, and HDL-cholesterol contributed 33%, 16%, and 14% of the variance in CRCS, respectively. Pathway analyses indicated that changes in fat and lean mass were related to individual cardiometabolic variables and CRCS in a complex manner. Changes in BMI, reflecting composite effects of changes in fat and lean mass, were more robustly associated with cardiometabolic risks than changes in fat mass or LBM individually. In conclusion, testosterone and rhGH administration was associated with diverse changes in individual cardiometabolic risk factors, but in aggregate appeared not to worsen cardiometabolic risk in healthy older men after 4-months. The long term effects of these and similar anabolic therapies on cardiovascular events should be investigated in populations with greater funtional limitations along with important health disabilities including upper body obesity and other cardiometabolic risks.

Plus-size 성인여성의 의복패턴 설계를 위한 상반신 체형 연구

The percentage of overweight people has increased in older people due to the change of body shape (including pregnancy and giving birth for women). Obesity is accompanied by body shape changes; subsequently, there are more pattern design considerations compared to standard body shapes. This paper classifies the upper body shape of overweight women in Korea, analyzes features by body shape and proposes basic pattern design data that reflects the features of plus-size women body shapes. The data on 540 subjects in the overweight group (from 20 to 69 years old)whose BMI was over 25 was selected. The following features by shape were identified in accordance with the upper body shape classification of overweight women. Body Shape1 had lower body obesity with long stature and arms in proportion to the trunk length and represented 22.2% of the subjects. Body Shape2 had most parts near average sizes for overweight body shapes with short height and arms that represented 37.6% of the subjects (the highest ratio). Body Shape3 was the smallest body shape in the four groups with the most distinct body figure and represented 30.7% of the subjects. Body Shape4 (9.4% of the subjects)was the upper body obesity type (the fattest group)and with of the waist bigger abdominal obesity type.

Fat Depots, Free Fatty Acids, and Dyslipidemia

Body fat deposition and excess free fatty acid (FFA) metabolism contribute to dyslipidemia and the adverse health consequences of obesity. Individuals with upper body obesity have impaired functioning of adipocytes, the primary fatty acid storage site. Excess visceral fat is strongly associated with impaired suppression of FFA release in response to insulin, as well as with hypertriglyceridemia and low concentrations of high density lipoprotein (HDL) cholesterol. High FFA concentrations can induce insulin resistance in muscle and liver. Furthermore, failure of hyperinsulinemia to normally suppress FFA is associated with impaired carbohydrate oxidation and muscle glucose storage, reduced hepatic insulin clearance and elevated triglycerides. Understanding the impact of body fat distribution on FFA metabolism and dyslipidemia is critical for determining the link between overweight and obesity and cardiovascular disease risk. In the current review, we will explore the relationship between adipose tissue, body fat depots, and FFA metabolism.

Superior vena cava syndrome as a rare complication to lipomatous atrial septal hypertrophy (LASH)

A 66-year-old woman with a history of breast cancer was admitted due to dyspnoea and excessive weight gain. Severe oedema of the upper body, resting dyspnoea, and extreme obesity (BMI 40 kg/m2) was noted ( Panel A ) . Superior vena cava syndrome (SVCS) was suspected. A contrasted computer tomography …

An Evidence-Based Review of Exercise and Metabolic Syndrome

An Evidence-Based Review of Exercise and Metabolic Syndrome

Abdominal Obesity and Endometrial Cancer in Egyptian Females With Postmenopausal Bleeding

Endometrial cancer is the most common type of female genital tract malignancies. We intended to assess the relation between different measures of obesity and the risk to develop endometrial cancer in Egyptian females with postmenopausal bleeding (PMB). The study was conducted in Alexandria, Egypt and included all postmenopausal females presenting to the University Hospital of Gynecology and Obstetrics with PMB within the study period (from January 1 to September 30). A questionnaire was completed, and data about anthropometric measurements including weight, height, and waist circumference were collected. Vaginal sonography, dilatation and curettage, and pathological examination were done by experts for all participants. Endometrial cancer was diagnosed in 38% of females presenting with PMB. Using ROC curve analysis, only the measure of abdominal obesity (waist circumference) showed significant accuracy in predicting endometrial cancer (area = 0.63, P < .05). The best cutoff point that maximizes accuracy was 88 cm. Body mass index (≥30 vs. ≤30) showed no significant relation (OR = 1.1, 95%CI 0.5–2.3), and the ratio between upper and lower body obesity (W/H ratio) showed border line significant relation (OR = 2, 95% CI 1–4.1), whereas waist circumference (≥88 vs. ≤88 cm) showed strikingly high OR (OR = 13.6, 95%CI 4–46.6). The risk of abdominal obesity on endometrial cancer remains very high (OR = 15.8, 95%CI 4.1–60.9) even after adjustment, in a logistic model, for other risk factors such as age at presentation, age at menarche, age at menopause, family history of malignancy, and gravidity. Abdominal obesity (waist circumference >88 cm) is the best measure of obesity to be used in predicting the risk of endometrial cancer in Egyptian females with PMB.

Addictive Genes and the Relationship to Obesity and Inflammation

There is increasing evidence that the same brain reward circuits involved in perpetuating drug abuse are involved in the hedonic urges and food cravings observed clinically in overweight and obese subjects. A polymorphism of the D2 dopamine receptor which renders it less sensitive to dopamine stimulation has been proposed to promote self-stimulatory behavior such as consuming alcohol, abusing drugs, or binging on foods. It is important to determine how this polymorphism may interact with other well-known candidate genes for obesity including polymorphisms of the leptin receptor gene and the opiomelanocortin gene. Leptin is a proinflammatory cytokine as well as a long-term signal maintaining body fat. Upper-body obesity stimulates systemic inflammation through the action of multiple cytokines including leptin throughout many organs including the brain. The association of numerous diseases including diabetes mellitus, heart disease, as well as depression with chronic low-grade inflammation due to abdominal obesity has raised the possibility that obesity-associated inflammation affecting the brain may promote addictive behaviors leading to a self-perpetuating cycle that may affect not only foods but addictions to drugs, alcohol, and gambling. This new area of interdisciplinary research holds the promise of developing new approaches to treating drug abuse and obesity.

Pathways regulated by glucocorticoids in omental and subcutaneous human adipose tissues: a microarray study

Glucocorticoids (GC) are powerful regulators of adipocyte differentiation, metabolism, and endocrine function and promote the development of upper body obesity, especially visceral fat stores. To provide a comprehensive understanding of how GC affect adipose tissue and adipocyte function, we analyzed patterns of gene expression (HG U95 Affymetrix arrays) after culture of abdominal subcutaneous (Abd sc) and omental (Om) adipose tissues from severely obese subjects (3 F, 1 M) in the presence of insulin or insulin (7 nM) plus dexamethasone (Dex, 25 nM) for 7 days. About 20% (561 genes in Om and 569 genes in sc) of 2,803 adipose expressed genes were affected by long-term GC. While most of the genes (90%) were commonly regulated by Dex in both depots, 26 in Om and 34 in Abd sc were affected by Dex in only one depot. 60% of the commonly upregulated genes were involved in metabolic pathways and were expressed mainly in adipocytes. Dex suppressed genes in immune/inflammatory (IL-6, IL-8, and MCP-1, expressed in nonadipocytes) and proapoptotic pathways, yet induced genes related to the acute-phase response (SAA, factor D, haptoglobin, and RBP4, expressed in adipocytes) and stress/defense response. Functional classification analysis showed that Dex also induced expression levels of 22 transcription factors related to insulin action and lipogenesis (LXRα, STAT5α, SREBP1, and FoxO1) and immunity/adipogenesis (TSC22D3) while suppressing 17 transcription factors in both depots. Overall, these studies reveal the powerful effects of GC on gene networks that regulate many key functions in human adipose tissue.

Targeting metabolic syndrome: Candidate natural agents

Following on from impressive economic development and urbanization, China is currently experiencing a high prevalence of metabolic syndrome. Patients with metabolic syndrome suffer from the "The Deadly Quartet" of hyperglycemia, hypertriglyceridemia, hypertension, and central (or upper body) obesity. Current treatment strategies directed towards metabolic syndrome tend to be limited to just one of these four conditions, so developing novel drugs to target multiple metabolic abnormalities could be preferable to current approaches. New insights suggest benefits of natural agents as treatments for metabolic syndrome. Herein, we review the evidence for using nine such agents developed on the basis of traditional medicine or herbal preparations.

Commentary on “Behavior of Visfatin in Nonobese Women Undergoing Liposuction: A Pilot Study”

In their article, “Behavior of Visfatin in Nonobese Women Undergoing Liposuction: A Pilot Study,” the authors investigate the change in serum visfatin levels in 33 women who underwent elective abdominal subcutaneous liposuction with an average volume of 4400 mL removed. They demonstrated a statistically-significant rise in visfatin levels, from an average of 51.9 ng/mL preoperatively to 76.3 ng/mL one month postoperatively. The authors are to be commended for incorporating basic science research into their elective cosmetic surgical treatment. Over recent years, adipose tissue has been extensively investigated for its metabolic properties, along with its reservoir of mesenchymal stem cells. As well as storing and secreting lipid, adipose tissue has been found to be a highly secretory organ.1 Hormones secreted by adipose tissue include leptin and adiponectin, whereas adipose-derived cytokines (adipocytokines) include interleukin-6 (IL-6) and tumor necrosis factor α (TNFα). Visfatin is an adipose cell-derived protein that is so named because it is predominantly found in visceral fat. Upper body obesity is a well-recognized risk factor for disorders of insulin resistance, such as …

비만에 따른 여성 연령대별 인체비례의 탐색적 연구

The objectives of this study were to investigate the progress of obesity in women from childhood to adulthood and to analyze the characteristics of obese figures through comparing their body proportions to normal-weight people, to provide a basic reference for development of new size categories and improved pattern grading. Body measurement was made on 6,704 women age between 7-39 in Sizekorea 2004 database. The age range was divided into three groups: children(7-12), teenagers(13-18) and adults(19-39). The result of research into the characteristics of body proportions of obese figures and the classification of different figure groups of obese people are as follows: The ratio between width and circumference for each part of the body was investigated according to body weight which was grouped into three different weights of low, normal and obese body weights. And the result demonstrated that in all the ranges of age, the obese groups had the lowest ratio between width and circumference, having a thick body shape. And according to the result of comparing the ratio of the circumference of each body part divided by the waist circumference, the obese group also showed a low ratio, indicating that they have bigger waist circumference than any other body parts. By analyzing the ratio of circumference of body parts divided by waist circumference, three factors were identified as contributing to obesity. Using the factor loadings of the upper, distal and lower body obesity, a cluster analysis was carried out and three different categories of obesity were defined; abdominal obesity, distal obesity and proximal obesity.

Stress and obesity: the role of the hypothalamic–pituitary–adrenal axis in metabolic disease

Chronic stress, combined with positive energy balance, may be a contributor to the increased risk for obesity, especially upper body obesity, and other metabolic diseases. This association may be mediated by alterations in the hypothalamic-pituitary-adrenal (HPA) axis. In this review, we summarize the major research that has been conducted on the role of the HPA axis in obesity and metabolic disease. Dysregulation in the HPA axis has been associated with upper body obesity, but data are inconsistent, possibly due to methodological differences across studies. In addition to systemic effects, changes in local cortisol metabolism in adipose tissue may also influence the risk for obesity. HPA axis dysregulation may be the causal link between conditions such as maternal malnutrition and sleep deprivation with metabolic disease. The present review provides evidence for the relationship between chronic stress, alterations in HPA activity, and obesity. Understanding these associations and its interactions with other factors will be important in developing effective treatments for obesity and related metabolic diseases.

연령대 변화에 따른 비만 남성 체형 특성 연구

This study investigates the progress of obesity in men from childhood to adulthood, by analyzing the measurement references from the 5th Size Korea. It also seeks to analyze the characteristics of obese figures through the comparison of body proportions to normal-weight people, to provide a basic reference for the development of new size categories and improved pattern grading. The age range is divided into three groups: children (2-7), teenagers (13-18), and adults (19-39). The results of research into the characteristics of body proportions of obese figures and the classification of different figure groups of obese people are as follows. The ratio between width and circumference for each part of the body was investigated according to body weight that was grouped into three different categories of low, normal, and obese body weights. The result demonstrated that in all the ranges of age, the obese groups had the lowest ratio between width and circumference in having a thick body shape. According to the results that compared the ratio of the circumference of each body part divided by the waist circumference, the obese group showed a low ratio that indicates that they have a bigger waist circumference than other parts of the body. Two factors are identified as contributing to obesity in analyzing the ratio of the circumference of body parts divided by waist circumference. Using the factor loadings of the upper and lower body obesity, a cluster analysis was carried out and three different categories of obesity were defined; lower body obesity, abdominal obesity, and upper body obesity. The obese groups of children and teenagers were mostly in body shape with lower obesity and abdominal obesity, whereas the adults group showed the obesity present in the upper body obesity that have fewer cases in lower body obesity.