Waist-to-hip Circumference Ratio Research Articles

Leptin levels in obese children: effects of gender, weight reduction, and androgens.

Obesity in children is accompanied by increased circulating leptin concentrations. Girls have higher leptin concentrations than boys. The aim of our study was to compare serum leptin levels before and after a five-week weight reduction program and to study the relationship of leptin levels, serum total cholesterol, and androgens (testosterone, dehydroepiandrosterone, dehydroepiandrosterone sulphate) in 33 obese boys (age: 12.7+/-1.97 years, BMI: 30.46+/-4.54) and 66 obese girls (age: 12.7+/-2.51 years, BMI: 29.31+/-4.62). We found that serum leptin concentrations in obese children were significantly decreased after a weight reduction program (before 20.79+/-9.61 ng/ml, after 13.50+/-8.65 ng/ml in girls; before 12.25+/-10.09 ng/ml and after 5.18+/-3.56 ng/ml in boys, p<0.0001 in both genders). Leptin levels correlated positively with the body mass index before and after weight reduction. There was a positive association in obese boys and a negative one in obese girls between leptin levels and the WHR (waist to hip circumference ratio). Serum leptin also shows a strong relationship to fat distribution (p=0.02 in boys, p<0.0001 in girls). No significant correlation was found between leptin concentrations and total cholesterol or androgens. We confirmed that leptin is a sensitive parameter of body composition and weight reduction in obese children.

A Meta-Analysis of Published Literature on Waist-to-Hip Ratio and Risk of Breast Cancer

: Epidemiological studies have identified body weight as a risk factor for breast cancer. Beyond the amount of adipose tissue a woman has, its distribution, particularly abdominally, may be a risk factor in breast cancer etiology. Body fat distribution is commonly measured by a waist-to-hip circumference ratio (WHR). We performed a meta-analysis to summarize the published literature on WHR and breast cancer risk. After assembling all published studies, we extracted mean WHRs for study participants and adjusted risk estimates comparing highest with lowest partition of WHR and calculated weighted mean differences in WHR between cases and noncases and summary risk estimates based on study design and menopausal status. The weighted mean difference was 0.016 [95% confidence interval (CI) = 0.005-0.028] for all studies combined. The summary risk estimates were 1.80 (95% CI = 1.29-2.50) for case-control studies and 1.27 (95% CI = 1.07-1.51) for cohort studies. By menopausal status, the summary risks were 1.79 (95% CI = 1.22-2.62) for premenopausal women and 1.50 (95% CI = 1.10-2.04) for postmenopausal women. For all studies combined, the summary risk was 1.62 (95% CI = 1.28-2.04). This meta-analysis indicates that a greater WHR is associated with increased risk of breast cancer and suggests that the avoidance of abdominal obesity may reduce risk of the disease.

Waist-to-Hip Ratio, Body Mass Index and Sex Hormone Levels Associated with Breast Cancer Risk in Premenopausal Caucasian Women

Obese women and women with upper body fat distribution have been shown to have a hormonal profile associated with increased risk of breast cancer. This study examines the relationships between obesity and body fat distribution, and sex hormones. Data from 47 healthy nulliparous premenopausal Caucasian women were collected cross-sectionally. Eight were obese and 39 non-obese. Thirteen had normal body fat (NBF), while 34 lower body fat (LBF) phenotypes. The concentrations of serum estrone, estrone sulfate, estradiol, free estradiol (Free E2), %Free E2, androstenedione, testosterone, free testosterone (Free T), %Free T, prolactin and sex hormone-binding globulin (SHBG) levels were determined in the mid-follicular phase. Results showed that in multivariate regression analyses controlling for age, age at menarche and body mass index (BMI), a 0.1 unit increase in waist-to-hip circumference ratio (WHR) towards the normal range decreased %FreeT by 18% (p=0.03), %FreeE2 by 15% (p=0.07) and increased SHBG by 36% (p=0.07). In similar analyses controlling for WHR, a unit increase in BMI increased %FreeE2 by 0.25%(p=0.04), %FreeT by 0.23% (p=0.07), and decreased that SHBG by 0.52% (p=0.07). Multivariate comparison showed SHBG levels to be higher by 39% (p=0.02) and %FreeE2 lower by 13% (p=0.07) in NBF compared to LBF phenotype women. Multivariate comparison between obese and nonobese women, however, showed SHBG levels to be lower by 24% (p=0.04), and %FreeE2 higher by 18% (p=0.04) in obese women. Results suggested that obesity and increasing BMI are associated with a serum sex hormone profile that increases breast cancer risk; however, increasing WHR towards the normal range is not associated with a high risk sex hormone profile. WHR in the normal range appears to be associated with a sex hormone profile that is more protective compared to the lower range.

Weight excess and abdominal fat in the metabolic syndrome among Japanese-Brazilians

Obesity, especially abdominal, has been associated with cardiovascular risk factors such as dyslipidemia, hypertension and diabetes mellitus (DM). The importance of these risk factors among Japanese-Brazilians was previously shown, although obesity is not a typical characteristic of Japanese migrants. In this study the prevalence of weight excess and central adiposity (CA) among Japanese-Brazilians and their association with metabolic disorders was evaluated. A sample of 530 1st and 2nd generation Japanese-Brazilians (aged 40 - 79 years) went through anthropometric and blood pressure measurements, lipid profile and oral glucose tolerance tests. The prevalence rate (point and confidence interval) of overweight was calculated using a cut-off value of >26.4 kg/m2. CA diagnosis was based on waist-to-hip circumference ratio (WHR): greater-than-or-equal 0.85 and 0.95 in women and men, respectively. The prevalence of weight excess was 22.4% (CI 95% 20.6 - 28.1), and CA was 67.0% (95% CI 63.1 - 70.9). In addition to higher prevalence of DM, hypertension and dyslipidemia, stratifying by BMI and WHR, people with weight excess and CA revealed a poorer metabolic profile: blood pressure levels were significantly higher among those with weight excess with or without CA; CA individuals had higher glucose, triglycerides, total and LDL cholesterol, and lower HDL than those without weight excess or CA; fasting insulinemia was significantly higher among subjects with weight excess (with or without CA) than among those without weight excess or CA. Comparing subgroups with and without CA supports the hypothesis that abdominal fat accumulation represents a risk factor for insulin resistance-related diseases, even among Japanese descendants. The increased prevalence of metabolic syndrome among Japanese migrants could be attributed to visceral fat deposition, which has been implicated in the genesis of insulin resistance.

Body Fat Distribution and Resting Energy Expenditure in Obese Premenopausal Women

The purpose of this study was to assess the relationship between body fat distribution and resting energy expenditure (REE) in obese women. Abdominal adiposity was determined by six different methods: waist to hip circumference ratio (WHR), sagittal diameter (SD), waist circumference, sagittal diameter/height (SD/H), visceral adipose tissue (VAT), and the conicity index (CI). REE was determined by indirect calorimetry. When age, fat free mass, and fat mass were controlled for, SD and SD/H were the only anthropometric measures to correlate with REE at r = 0.63, P < .01 and r = 0.55, P < .05, respectively.

Microalbuminuria is associated with the insulin resistance syndrome independent of hypertension and type 2 diabetes in the Korean population

To investigate whether microalbuminuria is associated with the insulin resistance syndrome independent of hypertension and type 2 diabetes, we studied the association between microalbuminuria and features of insulin resistance syndrome in Korean general population. We selected 1006 subjects by a random cluster sampling among residents aged >40 years living in the Chung-Up district, a rural area of South Korea. Subjects were stratified by oral glucose tolerance status [normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and diabetes mellitus], and by the presence or absence of hypertension. Urinary albumin excretion rate (UAER) was determined using timed overnight urine collection. Various cardiovascular risk factors including anthropometric indices, serum lipid, true insulin and proinsulin concentrations were also measured. The prevalence of microalbuminuria (UAER between 20 and 200 μg/min) increased as the glucose tolerance worsened (6.0% in NGT, 11.8% in IGT, and 21.8% in diabetes; χ 2 trend=25.9, P<0.001). Subjects with microalbuminuria had a higher body mass index (BMI), waist-to-hip circumference ratio (WHR), systolic and diastolic blood pressure (BP), fasting and 2 h plasma glucose, fasting plasma insulin and proinsulin levels, and lower HDL-cholesterol level than subjects without microalbuminuria. In multiple regression analysis, BMI, diastolic BP, 2 h plasma glucose, and fasting plasma insulin levels were found to be independent factors associated with UAER. Multiple logistic regression analysis showed that not only diabetes mellitus and hypertension, but also fasting hyperinsulinemia and waist-to-hip ratio were independent factors associated with the presence of microalbuminuria. When the normotensive, non-diabetic subjects were analyzed separately, fasting hyperinsulinemia and impaired glucose tolerance remained independent variables associated with the presence of microalbuminuria. These results show that microalbuminuria in the Korean general population is associated with hyperinsulinemia and central obesity, and suggest that microalbuminuria is a feature of the insulin resistance syndrome independent of hypertension or type 2 diabetes.

Thinness and body shape of Playboy centerfolds from 1978 to 1998.

Changes in the body weight and shape of Playboy centerfolds over the past two decades (1978-1998) were examined. The body mass index (BMI) and waist-to-hip circumference ratio (WHR) were obtained from measurements reported by 240 centerfolds (ages 19-35 y). The 20-y averages (mean+/-s.d.) were 18.1+/-0.8 kg/m2 for BMI and 0.68+/-0.03 for WHR, and there has been no appreciable change in either BMI or WHR in centerfolds over the past 20 y. Based on current recommendations for the classification of underweight (BMI<18.5 kg/m2), 70% of the centerfolds were underweight. Further, 77.5% of the centerfolds were <85% of their ideal body weight. Given the perception of Playboy centerfolds as culturally 'ideal' women, the notion that 70% of them are underweight highlights the social pressures on women to be thin and helps to explain the high levels of body dissatisfaction and disordered eating among women.

Waist to hip circumference ratio as a significant predictor of preeclampsia, irrespective of overall adiposity.

To investigate whether abnormal body fat distribution is a significant predictor of the development of preeclampsia, irrespective of overall adiposity. Twenty-six women with preeclampsia and 198 control women were enrolled. Waist to hip circumference ratio (WHR), body weight (BW), and body mass index (BMI, wt/ht2) were measured early in pregnancy (< 9 weeks of gestational age). Age, height, parity, tobacco usage, education period, gestational duration, and weight gain during pregnancy were also recorded for each subject. WHR, BMI, and BW early in pregnancy were significantly higher in the preeclampsia group (p < 0.0001). WHR, BMI, and BW positively correlated with the development of preeclampsia on univariate regression analysis (Standardized regression coefficient = 0.410, 0.387, and 0.363, respectively, p < 0.0001). On stepwise multiple regression analysis, WHR still correlated with the development of preeclampsia irrespective of BMI and BW. When the WHR predictive of the development of preeclampsia was set at 0.9, the sensitivity was 46.2% (12/26), which was significantly better than that of 25 of BMI (19.2%, 5/26; p < 0.05). Higher WHR is a significant predictor of the development of preeclampsia. This relation is irrespective of overall adiposity.

Obesity, body fat distribution and coronary atherosclerosis among Japanese men and women.

To investigate the relation of the obesity and body-fat distribution with angiographically defined coronary atherosclerosis. Cross-sectional study in a clinical setting. Three hundred and twenty men (median age, 59 y) and 212 women (median age, 67 y) who underwent coronary angiography for suspected or known coronary heart disease at 5 cardiology departments between September 1996 and August 1997. Patients with disease duration >1 y were excluded. The body mass index (BMI) and the waist to hip circumference ratio (WHR) were used as main exposure variables, and either the presence of significant coronary stenosis or the Gensini's score (> or =10 vs<10) as an outcome variable, in a sex-specific multiple logistic regression analysis controlling for age, hospital, and other coronary risk factors. Among male patients, BMI was progressively higher with an increasing number of vessels involved (P trend=0.05); the adjusted odds ratios for the presence of significant stenosis across quartiles of BMI were 1.0 (reference), 1.1, 1.9 and 2.5 (P trend=0.02), and the positive association was more pronounced for younger patients. Among females, however, such associations were not evident. Employing the Gensini's score as an outcome gave similar results. WHR was not significantly associated with either outcome regardless of sex. These results suggested that BMI was predictive of coronary stenosis among male patients, but not among female patients. Unlike most previous studies, this study failed to detect a positive association with WHR.

Correlation between a liking for fat-rich foods and body fatness in adult Japanese: a gender difference

The aim of the present study was to test the hypothesis that Japanese adults who like fat-rich foods have more body fatness and higher serum lipid levels than those who do not. The subjects were 540 male and 492 female workers under 41 years of age. A self-administered questionnaire determined four levels of liking for fat-rich foods. Anthropometric measurements were employed yielding body mass index (BMI), waist to hip circumference ratio (WHR), and skinfold thickness. Anthropometric values were compared among the levels of liking for fat-rich foods using analysis of covariance. For males, a liking for fat-rich foods was associated with BMI, WHR, whole-body skinfold thickness, and abdominal skinfold thickness (p<0·0001). In particular, those who like fat-rich foods “quite a bit” or “very much” showed significantly higher values than those who answered “no” or “a little”. Multiple regression analysis showed that a liking for fat-rich foods explains 7–9% of the variation in the anthropometric indices, even when other lifestyles were taken into account. For females, such findings were not evident. There is a gender difference in the association between a liking for fat-rich foods and body fatness. The difference may be due to a female-specific attitude toward high-calorie foods.

Obesity, leptin and blood pressure among children in Taiwan: the Taipei children’s heart study

Background: Obesity is associated with the occurrence of hypertension; however, the mechanisms of obesity-induced high blood pressure (BP) remain unclear. Leptin, the obese ( ob) gene product, is associated with the occurrence of obesity and related disorders in humans. The purpose of this study was to evaluate the association between plasma leptin and BP among children. Methods: After multistage sampling, we randomly selected 1265 children (618 boys and 647 girls) with a mean age of 13.3 years (12 to 16 years old) in this cross-sectional survey. Obesity measurements included body mass index (BMI) and waist-to-hip circumference ratio (WHR). Plasma leptin levels were measured by radioimmunoassay. Results: The mean and median plasma leptin levels were 4.1 and 2.4 ng/mL among boys and 10.1 and 8.8 ng/mL among girls. Children in the highest quintile of leptin level (mean, 11.1 and 19.7 ng/mL for boys and girls, respectively) had higher body weight, BMI, WHR, BP, and insulin levels than children in the lowest quintile (mean, 1.1 and 3.9 ng/mL for boys and girls, respectively). Boys had a higher BMI, WHR, and BP levels, yet had lower leptin levels than girls. In both genders, BMI and plasma leptin levels were significantly positively correlated with BP. In multivariate regression analyses, plasma leptin levels were positively associated with BP; however, this association became insignificant among girls and even inversely associated with systolic BP among boys after adjusting for BMI. Conclusions: Obesity is positively associated with BP among school children in Taiwan; however, the role of plasma leptin on the development of obesity-related hypertension is still controversial among school children.Obesity, leptin, blood pressure, children.

Plasma leptin concentrations and obesity in relation to insulin resistance syndrome components among school children in Taiwan--The Taipei Children Heart Study.

Leptin, an adipose tissue-derived product of the obesity (OB) gene, is an important regulator of energy metabolism and may be associated with the occurrence of insulin resistance and diabetes in humans. The purpose of this study was to evaluate the association of plasma leptin concentration with obesity and the components of insulin resistance syndrome (IRS) among school children in Taiwan. After multistage sampling of 85 junior high schools in Taipei, we randomly selected 1,264 children (617 boys and 647 girls) aged 12-16y. Obesity measurements included body mass index (BMI) and waist-to-hip circumference ratio (WHR). We calculated an IRS summary score for each individual by adding the quartile ranks from the distribution of systolic blood pressure (BP), serum triglyceride (TG), HDL-cholesterol (inverse), and insulin levels. Boys had a higher BMI and WHR, BP and IRS score and lower leptin, insulin, TG and HDL-C levels than girls. BMI, WHR and plasma leptin levels were significantly associated with the IRS summary score and each of its components in both genders. Children with higher plasma leptin levels (> 75th percentiles) have significantly higher BP, TG, insulin levels and IRS score than children with low leptin levels. The associations between plasma leptin level and the IRS components and score were still significant after adjusting for BMI in boys, but less so in girls. In both genders, after adjusting for WHR, plasma leptin levels were still significantly associated with the IRS components and summary score (P< 0.001). The final model that included the standard covariates, BMI and leptin, but not WHR, was the most predictive of the IRS summary score among school children. Insulin resistance syndrome in childhood, characterized by high blood pressure, dyslipidemia, and hyperinsulinemia, may be an early marker of cardiovascular risk. From the present BMI and leptin in combination are the most predictive markers of insulin resistance syndrome among school children in Taiwan.

Preperitoneal fat thickness in childhood obesity: association with serum insulin concentration.

The clinical significance of visceral fat accumulation in childhood obesity has remained controversial. In 35 subjects (18 boys and 17 girls) aged 9-15 years, visceral and subcutaneous fat were estimated by measuring the maximum thickness of preperitoneal fat (Pmax) and the minimum thickness of subcutaneous fat (Smin) in the upper median abdomen, respectively, by ultrasonography. The associations with fasting serum insulin levels converted to logarithm (log(IRI)) were studied for six obesity-related indices, including the obesity index, body fat percentage, waist-to-hip circumference ratio (WHR), Pmax, Smin and the ratio of Pmax to Smin (abdominal wall fat index, AFI). In girls, the log(IRI) was positively correlated with the Pmax, obesity index, body fat percentage and Smin. In contrast, the log(IRI) was positively correlated only with the Pmax and Smin in boys. There were no significant correlations between the log(IRI) and the WHR or AFI in either sex. The Pmax revealed the highest correlation with the log(IRI) in both boys (r = 0.703, P < 0.001) and girls (r = 0.921, P < 0.0001). These results indicate the important contribution of visceral fat accumulation to the development of hyperinsulinemia, regardless of sex. Accordingly, it is suggested that evaluating Pmax by ultrasonography may be the most sensitive and reliable method of predicting insulin resistance-associated metabolic derangements in children, compared with other conventional indices of obesity.

Effects of electro‐acupuncture on anovulation in women with polycystic ovary syndrome

The present study was designed to evaluate if electro-acupuncture (EA) could affect oligo-/anovulation and related endocrine and neuroendocrine parameters in women with polycystic ovary syndrome (PCOS). Twenty-four women (between the ages of 24 and 40 years) with PCOS and oligo-/amenorrhea were included in this non-randomized, longitudinal, prospective study. The study period was defined as the period extending from 3 months before the first EA treatment, to 3 months after the last EA treatment (10-14 treatments), in total 8-9 months. The menstrual and ovulation patterns were confirmed by recording of vaginal bleedings and by daily registrations of the basal body temperature (BBT). Blood samples were collected within a week before the first EA, within a week after the last EA and 3 months after EA. Nine women (38%) experienced a good effect. They displayed a mean of 0.66 ovulations/woman and month in the period during and after the EA period compared to a mean of 0.15 before the EA period (p=0.004). Before EA, women with a good effect had a significantly lower body-mass index (BMI) (p<0.001), waist-to-hip circumference ratio (WHR) (p=0.0058), serum testosterone concentration (p=0.0098), serum testosterone/sex hormone binding globulin (SHBG) ratio (p=0.011) and serum basal insulin concentration (p=0.0054), and a significantly higher concentration of serum SHBG (p=0.040) than did those women with no effect. Repeated EA treatments induce regular ovulations in more than one third of the women with PCOS. The group of women with good effect had a less androgenic hormonal profile before treatment and a less pronounced metabolic disturbance compared with the group with no effect. For this selected group EA offers an alternative to pharmacological ovulation induction.

ACTH and cortisol response to combined corticotropin releasing hormone-arginine vasopressin stimulation in obese males and its relationship to body weight, fat distribution and parameters of the metabolic syndrome.

To investigate the activity of the hypothalamic-pituitary-adrenal (HPA) axis in male obesity and its relationship with several prominent parameters of the metabolic syndrome. A cross-sectional clinical study of the activity of the HPA axis in groups of obese males and normal-weight controls. Seventeen obese non-diabetic males with a body mass index (BMI) >28 and eight normal-weight controls were examined. Fat free mass (FFM) and fat mass (FM) were measured by bioelectrical impedance, and the waist-to-hip circumference ratio (WHR) was calculated in all subjects. Baseline samples were taken for sex hormone and lipid determination, and an oral glucose tolerance test (OGTT) was performed for glucose and insulin determination. The activity of the HPA axis was determined by the combined administration of human corticotropin releasing hormone (CRH) (100 microg) and arginine vasopressin (AVP) (0.3 IU). As expected, FFM and FM and the WHR were higher in obese men than in controls, as were fasting insulin and stimulated (as area under the curve (AUC)) glucose and insulin concentrations. Baseline adrenocorticotropin (ACTH) and cortisol concentrations were similar in both groups, but stimulated (as AUC), ACTH was higher (P < 0.05) in obese subjects than in controls, whereas no significant difference in cortisolAUC was present. Since the main differences between obese subjects and controls were present during the early 30 min of the test, the correlation coefficients between total and incremental ACTH(AUC 0-30 min) and CortisolAUC 0-30 min and all other variables were analyzed. A significant correlation coefficient was present between them and all anthropometric parameters, fasting insulin and insulinAUC, but not with androgens and gonadotrophins. In addition, a significant correlation was present between total and incremental ACTH(AUC 0-30 min) and triglyceride concentrations. However, after adjusting for BMI or FM values, all correlation coefficients became non-significant, except the one between incremental ACTH(AUC 0-30 min) and insulinAUC (P < 0.05). These findings indicate that obese men may also have an altered pituitary response to combined CRH/AVP stimulation, which appears to be predominantly related to body size and total body fat. ACTH hyperresponsiveness after CRH/AVP stimulation also appears to be related to hyperinsulinaemia, but underlying mechanisms of this relationship remain to be elucidated.

Psychosocial and socio-economic factors in women and their relationship to obesity and regional body fat distribution.

Abdominal obesity, as well as psychosocial and socio-economic handicaps are risk factors for serious, prevalent diseases. Connections between these variables have been found in men. The principal aim of the present study was to analyse the associations between psychosocial and socioeconomic factors with body mass index (BMI) and the waist-to-hip circumference ratio (WHR) in women. A cohort study of data derived from questionnaires. 1137 women from a population sample of 1464 women born in 1956. Occupational, social and leisure time conditions, smoking and alcohol habits, as well as height, weight and waist and hip circumferences. BMI was associated with teetotalism and negatively to wine drinking. WHR correlated directly with cigarette smoking and negatively with consumption of wine and beer. Both BMI and WHR, adjusted for each other and for smoking and alcohol, showed independent associations with low education, unemployment and problems at work when employed, as well as with little physical activity and much TV-watching. In addition, the WHR showed a negative, independent relationship to housing conditions. These observations suggest psychosocial and socio-economic handicaps as well as a low physical activity in abdominally obese women. Similar observations have been made previously in men, but only with the WHR, suggesting an influence of obesity in these relationships in women only. Another interesting gender difference is the positive relationship between being married with BMI in men, as well as being divorced and living alone with the WHR in men only.

Adipose Tissue Distribution in Postmenopausal Women with Adenomatous Hyperplasia of the Endometrium

Objective.To investigate body fat distribution in postmenopausal women with adenomatous and atypical hyperplasia of the endometrium.Methods.A prospective population-based case control study was performed in a health care county in Sweden. General obesity, as reflected by body mass index (BMI), and adipose tissue distribution, expressed as waist to hip circumference ratio (WHR), were evaluated in a cohort of 367 postmenopausal women who underwent dilatation and curettage because of uterine bleeding. The study group consisted of 29 women with adenomatous or atypical hyperplasia of the endometrium. The controls consisted of 49 age-matched postmenopausal women randomly selected from the computerized population register of the same region.Results.The frequency of endometrial adenomatous and atypical hyperplasia in postmenopausal women with bleeding was 7.2%. In the total population of postmenopausal women the incidence of these endometrial lesions was 44 per 100,000 per year. Body weight (P= 0.039), BMI (P= 0.007), and WHR (P= 0.022) were higher in postmenopausal women with endometrial adenomatous and atypical hyperplasia than in controls. In multivariate analysis only BMI remained statistically associated with adenomatous hyperplasia (P= 0.012).Conclusions.General obesity, but neither upper nor lower body fat distribution, was characteristic of postmenopausal women with adenomatous and atypical hyperplasia of the endometrium. Overall obesity is a risk factor for these endometrial precancerous lesions, as it is also claimed to be for endometrial cancer.

Body Fat Distribution and Basal Metabolic Rate in Obese Women

The purpose of this study was to assess body fat distribution and basal metabolic rate (BMR) in a group of 19 healthy premenopausal women, age 29.5±5.4 (mean±SD), >125% ideal body weight. Subjects completed a questionnaire detailing demographic information and medical history. Abdominal adiposity was determined by 6 different methods: waist to hip circumference ratio (WHR), sagittal diameter (SD), waist circumference, sagittal diameter/height (SD/H), visceral adipose tissue (VAT), and the conicity index (CI). All measures of abdominal adiposity were significantly correlated (p<0.005). BMR was determined by indirect calorimetry, and percent body fat was determined by bioelectrical impedance (BIA). Average BMR for the entire sample was 1359±252 kilocalories. The strongest correlation was between SD and BMR (r=0.70, p<0.001). When age, fat free mass (FFM), and fat mass (FM) were controlled for, SD and SD/H were the only anthropometric measures to correlate with BMR at r=0.63, p<0.01 and r=0.55, p<0.05, respectively. Subjects were divided into upper and lower body obese groups by each of the six anthropometric measures. Upper body obese were found to have a higher BMR (controlled for age, FFM, FM) when compared with lower body obese when determined by SD (p<0.01) and SD/H (p<0.05) but not when determined by WHR, waist circumference, CI, or VAT. Multiple regression determined SD and FM were the only significant predictors of BMR. These results indicate an increased BMR in upper body versus lower body premenopausal obese women when assessed by SD and SD/H. SD and FM were the most significant predictors of BMR, with FM having an inverse relationship. In conclusion, increasing abdominal adiposity as determined by SD and SD/H is associated with an increasing BMR in obese premenopausal women.

Perceived Social Support and Abdominal Fat Distribution in Adolescents and Young Adults: a Structural Equation Analysis of Prospective Data

We prospectively examined the relationship between perceived social support and abdominal fat distribution. A 3-year follow-up study of 235 randomly selected healthy adolescents and young adults was used. Abdominal fat distribution was measured by means of the waist to hip circumference ratio (WHR), and social support was measured by the Perceived Social Support Scale-Revised. Data were analysed using structural equation models. Changes in social support were inversely associated with changes in WHR, adjusted for body-mass index, among boys and men. This association was less evident among girls and women. The relationship of social support with WHR was independent of depression and hostility. The findings suggest that social support may protect against abdominal fat accumulation, thereby potentially decreasing the risk of coronary heart disease later in life.

EMPLOYING DUAL ENERGY X-RAY ABSORPTIOMETRY TO ASSESS CARDIOVASCULAR RISK FACTORS IN POSTMENOPAUSAL WOMEN 500

The waist-to-hip circumference ratio (WHR) is a widely accepted method for assessing regional fat distribution (RFD) and an increased WHR is a risk factor for cardiovascular disease (CVD). Dual energy x-ray absorptiometry(DXA) analysis is now being explored as an alternative method for assessing RFD. In this study we examined the feasibility of using, as a risk factor, the ratio of waist fat to hip fat obtained from a total body DXA scan (Hologic QDR-2000). Total cholesterol (TC), high density lipoproteins (HDL), non-high density lipoproteins (TC-HDL = Non-HDL), triglycerides (TG), and apolipoprotein B (apo B) were measured in 43 postmenopausal women (49-74yrs) presently not on hormone replacement therapy and having cholesterol above 200 mg/dL. Regional fat mass (RFM) was estimated in the waist from the 2nd lumbar vertebra to the anterior superior iliac spine and in the hip from the anterior superior iliac crest to the ischial tuberosities regions by DXA (RFM-DXA) soft tissue analysis. Given below are the correlations with p values in parentheses. The correlation analysis revealed that the RFM-DXA was significantly correlated with all serum lipids, lipoproteins, and apo B; the WHR was not significantly correlated with TC and apo B; and a stronger correlation was noted between the lipid/lipoprotein profile with RFM-DXA technique than with the WHR method. Based on the sample population of postmenopausal women used in this study, these results indicate that the RFM-DXA analysis is more reflective of CVD risk as indicated by circulating lipids/lipoproteins and apo B than is the WHR. Thus, the RFM-DXA technique may be an alternative method to the conventional WHR in assessing CVD risk factors. Table