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Song XH, Zhu ML, Zhang C, Wang JY, Jia YD, Wang DN. Association of fat distribution differences in infertile women with assisted reproductive outcomes: A prospective cohort study. Int J Gynaecol Obstet 2024; 166:250-257. [PMID: 38268339 DOI: 10.1002/ijgo.15371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/30/2023] [Accepted: 01/02/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVE To investigate the impacts of fat distribution on assisted reproductive outcomes in infertile women. METHODS The study randomly recruited 576 infertile women who underwent assisted reproductive technology treatment at the Reproductive Medicine Center of the First Affiliated Hospital of Anhui Medical University between July and October 2022. Questionnaires and body composition measurements were administered to assess baseline information and fat distribution. The numbers of oocytes, zygotes presenting with two pronuclei (2PN), and available embryos were tracked at the end of the cycle. Multifactorial logistic regression models and restricted cubic spline (RCS) curve models were used to explore the relationships between fat distribution and reproductive outcomes while controlling for confounding factors. RESULTS The study found that the participants had a mean age of 30.82 years. The analysis showed that there was a significant difference between the amount of leg body fat mass (LBFM) and the distribution of reproductive outcomes. However, there was no significant correlation between the level of visceral fat and reproductive outcomes. After taking confounding factors into account, the multifactorial regression analysis showed that the total body fat mass and the number of oocytes (odds ratio (OR) 0.92, 95% confidence interval (CI) 0.84-0.99), 2PN (OR 0.92, 95% CI 0.84-0.99), and embryos available for transfer (OR 0.90, 95% CI 0.82-0.99) were negatively correlated. RCS modeling revealed a linear dose-response relationship between LBFM and assisted reproductive outcomes. CONCLUSION Fat distribution varies among infertile women, and higher amounts of fat are associated with poorer assisted reproductive outcomes.
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Affiliation(s)
- Xiao-Huan Song
- Department of Health Promotion and Behavioral Sciences, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Meng-Li Zhu
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, China
| | - Chao Zhang
- Department of Health Promotion and Behavioral Sciences, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui, China
| | - Jie-Yu Wang
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yue-di Jia
- Department of Health Promotion and Behavioral Sciences, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Dan-Ni Wang
- Department of Health Promotion and Behavioral Sciences, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, Anhui, China
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Schulze MB, Stefan N. Metabolically healthy obesity: from epidemiology and mechanisms to clinical implications. Nat Rev Endocrinol 2024:10.1038/s41574-024-01008-5. [PMID: 38937638 DOI: 10.1038/s41574-024-01008-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/31/2024] [Indexed: 06/29/2024]
Abstract
The concept of metabolic health, particularly in obesity, has attracted a lot of attention in the scientific community, and is being increasingly used to determine the risk of cardiovascular diseases and diabetes mellitus-related complications. This Review assesses the current understanding of metabolically healthy obesity (MHO). First, we present the historical evolution of the concept. Second, we discuss the evidence for and against its existence, the usage of different definitions of MHO over the years and the efforts made to provide novel definitions of MHO. Third, we highlight epidemiological data with regard to cardiovascular risk in MHO, which is estimated to be moderately elevated using widely used definitions of MHO when compared with individuals with metabolically healthy normal weight, but potentially not elevated using a novel definition of MHO. Fourth, we discuss novel findings about the physiological mechanisms involved in MHO and how such knowledge helps to identify and characterize both people with MHO and those with metabolically unhealthy normal weight. Finally, we address how the concept of MHO can be used for risk stratification and treatment in clinical practice.
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Affiliation(s)
- Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
- German Center for Diabetes Research, Neuherberg, Germany.
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany.
| | - Norbert Stefan
- German Center for Diabetes Research, Neuherberg, Germany
- Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany
- Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Centre Munich, Tübingen, Germany
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Mavroeidi I, Manta A, Asimakopoulou A, Syrigos A, Paschou SA, Vlachaki E, Nastos C, Kalantaridou S, Peppa M. The Role of the Glycemic Index and Glycemic Load in the Dietary Approach of Gestational Diabetes Mellitus. Nutrients 2024; 16:399. [PMID: 38337683 PMCID: PMC10857473 DOI: 10.3390/nu16030399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/19/2024] [Accepted: 01/20/2024] [Indexed: 02/12/2024] Open
Abstract
Gestational diabetes mellitus (GDM) is a common metabolic disorder that often develops during pregnancy, characterized by glucose intolerance and insulin resistance (IR). To ensure the well-being of both the mother and the fetus, the body undergoes multiple metabolic and immunological changes that result in peripheral IR and, under certain hereditary or acquired abnormalities, GDM in predisposed women. The adverse short- and long-term effects of GDM impact both the mother and the fetus. Nutrition seems to play an important role to prevent GDM or improve its evolution. An emphasis has been given to the proportion of carbohydrates (CHO) relative to protein and lipids, as well as dietary patterns, in GDM. The effects of CHO on postprandial glucose concentrations are reflected in the glycemic index (GI) and glycemic load (GL). Diets rich in GI and GL may induce or exacerbate IR, whereas diets low in GI and GL appear to enhance insulin sensitivity and improve glycemic control. These positive outcomes may be attributed to direct interactions with insulin and glucose homeostasis or indirect effects through improved body composition and weight management. This comprehensive narrative review aims to explore the significance of nutrition, with a focus on the critical evaluation of GI and GL in the dietary management of women with GDM.
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Affiliation(s)
- Ioanna Mavroeidi
- Endocrine Unit, 2nd Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12461 Athens, Greece
| | - Aspasia Manta
- Endocrine Unit, 2nd Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12461 Athens, Greece
| | - Athina Asimakopoulou
- 3rd Department of Internal Medicine, Sotiria General Hospital, 11527 Athens, Greece
| | - Alexandros Syrigos
- 3rd Department of Internal Medicine, Sotiria General Hospital, 11527 Athens, Greece
| | - Stavroula A Paschou
- Endocrine Unit and Diabetes Center, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Efthimia Vlachaki
- Hematological Laboratory, 2nd Department of Internal Medicine, Hippokrateion Hospital, Aristotle University, 54640 Thessaloniki, Greece
| | - Constantinos Nastos
- 3rd Department of Surgery, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12461 Athens, Greece
| | - Sophia Kalantaridou
- Department of Obstetrics and Gynecology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12461 Athens, Greece
| | - Melpomeni Peppa
- Endocrine Unit, 2nd Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12461 Athens, Greece
- 3rd Department of Internal Medicine, Sotiria General Hospital, 11527 Athens, Greece
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Wang M, Ou Y, Yuan XL, Zhu XF, Niu B, Kang Z, Zhang B, Ahmed A, Xing GQ, Su H. Heterogeneously elevated branched-chain/aromatic amino acids among new-onset type-2 diabetes mellitus patients are potentially skewed diabetes predictors. World J Diabetes 2024; 15:53-71. [PMID: 38313852 PMCID: PMC10835491 DOI: 10.4239/wjd.v15.i1.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/03/2023] [Accepted: 12/13/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND The lack of specific predictors for type-2 diabetes mellitus (T2DM) severely impacts early intervention/prevention efforts. Elevated branched-chain amino acids (BCAAs: Isoleucine, leucine, valine) and aromatic amino acids (AAAs: Tyrosine, tryptophan, phenylalanine)) show high sensitivity and specificity in predicting diabetes in animals and predict T2DM 10-19 years before T2DM onset in clinical studies. However, improvement is needed to support its clinical utility. AIM To evaluate the effects of body mass index (BMI) and sex on BCAAs/AAAs in new-onset T2DM individuals with varying body weight. METHODS Ninety-seven new-onset T2DM patients (< 12 mo) differing in BMI [normal weight (NW), n = 33, BMI = 22.23 ± 1.60; overweight, n = 42, BMI = 25.9 ± 1.07; obesity (OB), n = 22, BMI = 31.23 ± 2.31] from the First People's Hospital of Yunnan Province, Kunming, China, were studied. One-way and 2-way ANOVAs were conducted to determine the effects of BMI and sex on BCAAs/AAAs. RESULTS Fasting serum AAAs, BCAAs, glutamate, and alanine were greater and high-density lipoprotein (HDL) was lower (P < 0.05, each) in OB-T2DM patients than in NW-T2DM patients, especially in male OB-T2DM patients. Arginine, histidine, leucine, methionine, and lysine were greater in male patients than in female patients. Moreover, histidine, alanine, glutamate, lysine, valine, methionine, leucine, isoleucine, tyrosine, phenylalanine, and tryptophan were significantly correlated with abdominal adiposity, body weight and BMI, whereas isoleucine, leucine and phenylalanine were negatively correlated with HDL. CONCLUSION Heterogeneously elevated amino acids, especially BCAAs/AAAs, across new-onset T2DM patients in differing BMI categories revealed a potentially skewed prediction of T2DM development. The higher BCAA/AAA levels in obese T2DM patients would support T2DM prediction in obese individuals, whereas the lower levels of BCAAs/AAAs in NW-T2DM individuals may underestimate T2DM risk in NW individuals. This potentially skewed T2DM prediction should be considered when BCAAs/AAAs are to be used as the T2DM predictor.
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Affiliation(s)
- Min Wang
- School of Chemical Science and Technology, Yunnan University, Kunming 650091, Yunnan Province, China
| | - Yang Ou
- Department of Endocrinology, The First People’s Hospital of Yunnan Province, Kunming 650032, Yunnan Province, China
| | - Xiang-Lian Yuan
- Department of Endocrinology, The First People’s Hospital of Yunnan Province, Kunming 650032, Yunnan Province, China
| | - Xiu-Fang Zhu
- School of Chemical Science and Technology, Yunnan University, Kunming 650091, Yunnan Province, China
| | - Ben Niu
- Department of Endocrinology, The First People’s Hospital of Yunnan Province, Kunming 650032, Yunnan Province, China
| | - Zhuang Kang
- Department of Endocrinology, The First People’s Hospital of Yunnan Province, Kunming 650032, Yunnan Province, China
| | - Bing Zhang
- Clinical Laboratory, Nanchong Central Hospital & The Second Clinical Medical College of North Sichuan Medical University, Nanchong 637000, Sichuan Province, China
| | - Anwar Ahmed
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, United States
| | - Guo-Qiang Xing
- The Affiliated Hospital and Second Clinical Medical College, North Sichuan Medical University, Nanchong 637000, Sichuan Province, China
- Department of Research and Development, Lotus Biotech.com LLC, Gaithersburg, MD 20878, United States
| | - Heng Su
- Department of Endocrinology, The First People’s Hospital of Yunnan Province, Kunming 650032, Yunnan Province, China
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Magalhaes ACLD, Carvalho VF, Cruz SPD, Ramalho A. Characteristics of the metabolically unhealthy phenotype in menopausal resistance training practitioners. NUTR HOSP 2023; 40:975-983. [PMID: 37534449 DOI: 10.20960/nh.04342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023] Open
Abstract
Introduction Objective: to evaluate clinical, metabolic and body characteristics related to the metabolically unhealthy phenotype (MUH) in menopausal women who practice resistance training (RT). Methods: cross-sectional study with a sample of 31 women. Clinical and metabolic variables were measured. Body adiposity was assessed by body mass index, waist circumference, visceral adiposity index (VAI) and lipid accumulation product (LAP). Body composition analysis was performed by DEXA. Results: the prevalence of the MH phenotype was 74.2 %. Metabolically healthy (MH) women were younger, had more years of RT practice, higher HDL-c levels and lower VAI and android/gynoid ratio (A/G) than the MUH women. Women with inadequacy of HDL-c, TG, A/G and VAI had 12.50 (95 % CI: 3.30-47.23), 4.83 (95 % CI: 2.37-9.85), 5.20 (95 % CI: 1.90-14.16) and 3.12 (95 % CI: 1.07-9.04) times greater prevalence of the MUH phenotype, respectively, than those with adequacy of these parameters. Binary logistic regression analysis demonstrated that age is a predictor of the MUH phenotype (OR = 1.254; 95 % CI: 1.00-1.56) and this variable showed correlation with TG, VAI and A/G. There was no association between thyrotropin and MUH phenotype in the present sample. Conclusion: age and visceral adiposity are predictors for the MUH phenotype in RT practitioners in menopause, which may initially be characterized by alterations in serum lipid profile.
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Affiliation(s)
| | | | - Sabrina Pereira da Cruz
- Center for Research on Micronutrients. Instituto de Nutrição Josué de Castro. Universidade Federal do Rio de Janeiro
| | - Andréa Ramalho
- Center for Research on Micronutrients. Instituto de Nutrição Josué de Castro. Universidade Federal do Rio de Janeiro
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de Magalhães ACL, Carvalho VF, da Cruz SP, Ramalho A. Dose-Response Relationship of Resistance Training on Metabolic Phenotypes, Body Composition and Lipid Profile in Menopausal Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10369. [PMID: 36012004 PMCID: PMC9408617 DOI: 10.3390/ijerph191610369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 08/06/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
The relationship between volume training of resistance training (RT), body composition and cardiometabolic profile in menopausal women is poorly understand. This study aimed to evaluate the dose−response relationship of RT on lipid profile, body composition and metabolic phenotypes in menopausal women. A total of 31 women were categorized according to different volume of RT. Body composition was evaluated by DEXA and the cardiometabolic risk by metabolic phenotypes and lipid profile. There was a higher frequency of metabolically unhealthy phenotype in women who practiced RT for less than two years and had a weekly frequency lower than three days a week (p > 0.05). Women with more than two years and a higher weekly frequency of RT had lower trunk fat mass than their counterparties (15.33 ± 7.56 versus 10.57 ± 4.87, p = 0.04; 16.31 ± 7.46 versus 10.98 ± 5.49, p = 0.03, respectively). There was an association between HDL-c and time of RT in years. A moderate correlation was identified between variables of body adiposity, time in years and weekly frequency of RT. The present study concludes that more time in years and weekly frequency of RT practice are associated with lower body adiposity in menopausal women, the first also being associated with HDL-c.
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Affiliation(s)
- Ana Carla Leocadio de Magalhães
- Center of Micronutrients Researche, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro 20000, Brazil
| | - Vilma Fernandes Carvalho
- Center of Micronutrients Researche, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro 20000, Brazil
- Kinanthropometry Laboratory, Belo Horizonte Campus, Salgado de Oliveira University, Belo Horizonte 30170, Brazil
| | - Sabrina Pereira da Cruz
- Center of Micronutrients Researche, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro 20000, Brazil
| | - Andrea Ramalho
- Center of Micronutrients Researche, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro 20000, Brazil
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Juppi H, Sipilä S, Fachada V, Hyvärinen M, Cronin N, Aukee P, Karppinen JE, Selänne H, Kujala UM, Kovanen V, Karvinen S, Laakkonen EK. Total and regional body adiposity increases during menopause-evidence from a follow-up study. Aging Cell 2022; 21:e13621. [PMID: 35509177 PMCID: PMC9197413 DOI: 10.1111/acel.13621] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 02/14/2022] [Accepted: 04/12/2022] [Indexed: 12/19/2022] Open
Abstract
For women, menopausal transition is a time of significant hormonal changes, which may contribute to altered body composition and regional adipose tissue accumulation. Excess adiposity, and especially adipose tissue accumulation in the central body region, increases women's risk of cardiovascular and metabolic conditions and affects physical functioning. We investigated the associations between menopausal progression and total and regional body adiposity measured with dual-energy X-ray absorptiometry and computed tomography in two longitudinal cohort studies of women aged 47-55 (n = 230 and 148, mean follow-up times 1.3 ± 0.7 and 3.9 ± 0.2 years, mean baseline BMI 25.5 kg/m2 ). We also examined associations between menopausal progression and skeletal muscle fiber characteristics, as well as adipose tissue-derived adipokines. Relative increases of 2%-14% were observed in regional and total body adiposity measures, with a pronounced fat mass increase in the android area (4% and 14% during short- and long-term follow-ups). Muscle fiber oxidative and glycolytic capacities and intracellular adiposity were not affected by menopause, but were differentially correlated with total and regional body adiposity at different menopausal stages. Menopausal progression and regional adipose tissue masses were positively associated with serum adiponectin and leptin, and negatively associated with resistin levels. Higher diet quality and physical activity level were also inversely associated with several body adiposity measures. Therefore, healthy lifestyle habits before and during menopause might delay the onset of severe metabolic conditions in women.
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Affiliation(s)
- Hanna‐Kaarina Juppi
- Gerontology Research Center and Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
| | - Sarianna Sipilä
- Gerontology Research Center and Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
| | - Vasco Fachada
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
| | - Matti Hyvärinen
- Gerontology Research Center and Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
| | - Neil Cronin
- Neuromuscular Research Center, Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
- School of Sport and Exercise University of Gloucestershire Cheltenham UK
| | - Pauliina Aukee
- Department of Obstetrics and Gynecology Central Finland Health Care District Jyväskylä Finland
| | - Jari E. Karppinen
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
| | - Harri Selänne
- Department of Psychology University of Jyväskylä Jyväskylä Finland
| | - Urho M. Kujala
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
| | - Vuokko Kovanen
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
| | - Sira Karvinen
- Gerontology Research Center and Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
| | - Eija K. Laakkonen
- Gerontology Research Center and Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
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Fang D, Tang W, Zhao X, Sun H, Gu T, Bi Y. Gender differences in the association of body composition and biopsy-proved nonalcoholic steatohepatitis. Hepatol Int 2022; 16:337-347. [PMID: 35201574 DOI: 10.1007/s12072-021-10265-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 10/20/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND AND AIM Body composition was associated with nonalcoholic steatohepatitis (NASH), but results were controversial probably due to gender differences. Hence, we aim to explore the association of body composition and NASH in males and females. METHODS We conducted a cross-sectional analysis of obese subjects undergone liver biopsy. According to NASH Clinical Research Network system, subjects were categorized as Normal Control (NC), non-NASH or NASH. Body composition was accessed by dual-energy X-ray absorptiometry. RESULTS This study enrolled 336 subjects (mean age 32.0 years, mean BMI 39.15 kg/m2, female, 64.0%). Males have lower relative muscle mass (RMM 55.21 ± 4.07%) and females have higher android to gynoid ratio (AGR, 0.82 ± 0.21) in NASH when compared with non-NASH (RMM 57.49 ± 4.75%; AGR 0.7 ± 0.15) and NC (RMM 58.69 ± 4.09%; AGR 0.66 ± 0.19, p < 0.05 for each). After adjusting for confounding factors, low RMM was the independent risk factor for NASH in males (odds ratio [OR] 0.550; 95% confidence interval [CI] 0.312-0.970), high AGR was the independent risk factor for NASH in females (OR 1.694; 95% CI 1.073-2.674). Further, RMM in males and AGR in females, respectively, was associated with liver steatosis and activity, but not with fibrosis. ROC curve revealed that the optimal cutoff value of RMM was 58.09% in males and AGR was 0.92 in females for predicting NASH. CONCLUSIONS We firstly revealed that low RMM and high AGR were the independent risk factors for NASH in males and females, respectively, indicating that sex-specific interventions for improving body composition may reduce the risk of NASH in obese subjects.
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Affiliation(s)
- Da Fang
- Department of Endocrinology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Wenjuan Tang
- Department of Endocrinology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Xiaoyu Zhao
- Department of Endocrinology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Haixiang Sun
- Department of Endocrinology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Tianwei Gu
- Department of Endocrinology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
| | - Yan Bi
- Department of Endocrinology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China. .,Department of Endocrinology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
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Kim HK, Kim CH. Quality Matters as Much as Quantity of Skeletal Muscle: Clinical Implications of Myosteatosis in Cardiometabolic Health. Endocrinol Metab (Seoul) 2021; 36:1161-1174. [PMID: 34986299 PMCID: PMC8743592 DOI: 10.3803/enm.2021.1348] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 12/13/2021] [Indexed: 12/12/2022] Open
Abstract
Although age-related changes in skeletal muscles are closely associated with decreases in muscle strength and functional decline, their associations with cardiometabolic diseases in the literature are inconsistent. Such inconsistency could be explained by the fact that muscle quality-which is closely associated with fatty infiltration of the muscle (i.e., myosteatosis)-is as important as muscle quantity in cardiometabolic health. However, muscle quality has been less explored compared with muscle mass. Moreover, the standard definition of myosteatosis and its assessment methods have not been established yet. Recently, some techniques using single axial computed tomography (CT) images have been introduced and utilized in many studies, as the mass and quality of abdominal muscles could be measured opportunistically on abdominal CT scans obtained during routine clinical care. Yet, the mechanisms by which myosteatosis affect metabolic and cardiovascular health remain largely unknown. In this review, we explore the recent advances in the assessment of myosteatosis and its changes associated with aging. We also review the recent literature on the clinical implication of myosteatosis by focusing on metabolic and cardiovascular diseases. Finally, we discuss the challenges and unanswered questions that need addressing to set myosteatosis as a therapeutic target for the prevention or treatment of cardiometabolic diseases.
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Affiliation(s)
- Hong-Kyu Kim
- Subdivision of Endocrinology and Metabolism, Health Screening and Promotion Center, Asan Medical Center, Seoul, Korea
- Corresponding authors: Hong-Kyu Kim Subdivision of Endocrinology and Metabolism, Health Screening and Promotion Center, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-4802, Fax: +82-2-3010-4917, E-mail:
| | - Chul-Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
- Chul-Hee Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170 Jomaru-ro, Wonmi-gu, Bucheon 14584, Korea Tel: +82-32-621-5155, Fax: +82-32-621-5018, E-mail:
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Skeletal mass indices are inversely associated with metabolically unhealthy phenotype in overweight/obese and normal-weight men: a population-based cross-sectional study. Br J Nutr 2021; 126:501-509. [PMID: 33143771 DOI: 10.1017/s0007114520004262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Muscle mass may play an important role in the metabolic profile of individuals with or without excess weight. Metabolic phenotypes classify individuals as healthy or unhealthy based on certain metabolic conditions. We investigated the association between skeletal mass indices (SMI) and the metabolically unhealthy phenotype in normal-weight and overweight/obese adults. A total of 660 adults aged 20 to 59 years were assessed by a population-based cross-sectional study. Muscle mass of the limbs or appendicular lean mass (ALM) adjusted for weight (SMIweight) and BMI (SMIBMI) was used to evaluate SMI. Logistic regression was employed to estimate the association between SMIweight, SMIBMI and metabolic phenotypes of normal-weight and overweight/obese individuals. Metabolically unhealthy individuals were older in both sexes. Metabolically unhealthy men had lower SMI values and higher fat percentage than metabolically healthy men. SMIweight was inversely associated with the metabolically unhealthy phenotype, both in normal-weight men (OR 0·49, 95 % CI 0·24, 0·99, P = 0·04) and in overweight/obese men (OR 0·32, 95 % CI 0·16, 0·64, P = 0·001). SMIBMI was inversely associated with the metabolically unhealthy phenotype in overweight/obese men (OR 0·36, 95 % CI 0·18, 0·72, P = 0·004), but not in normal-weight men (OR 0·70, 95 % CI 0·34, 1·43, P = 0·33). Among women, SMI showed no significant association with the phenotypes. In conclusion, the SMI are inversely associated with the metabolically unhealthy phenotype in men, especially among overweight/obese men.
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Kim HK, Lee MJ, Kim EH, Bae SJ, Kim KW, Kim CH. Comparison of muscle mass and quality between metabolically healthy and unhealthy phenotypes. Obesity (Silver Spring) 2021; 29:1375-1386. [PMID: 34235892 DOI: 10.1002/oby.23190] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/31/2021] [Accepted: 03/31/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The aim of this study was to examine whether higher skeletal muscle mass is associated with a metabolically healthy phenotype and whether muscle quality affects metabolic health. METHODS This cross-sectional analysis included 20,659 participants (7,966 women) who underwent abdominal computed tomography scans during health checkups. The total abdominal muscle area (TAMA) on the third lumbar vertebral level was demarcated. Intermuscular adipose tissue and skeletal muscle area were measured. The skeletal muscle area was divided into normal attenuation muscle area (NAMA) and low attenuation muscle area (LAMA). The NAMA/TAMA index was calculated. The metabolically unhealthy phenotype was defined as having two or more components of metabolic syndrome or the presence of hypertension or diabetes. RESULTS TAMA and skeletal muscle area were not significantly different or even lower in metabolically healthy phenotypes compared with metabolically unhealthy phenotypes. However, metabolically healthy phenotypes had significantly higher NAMA (except in women with obesity) and NAMA/TAMA index than in the metabolically unhealthy phenotypes. In people without obesity, lower NAMA/TAMA index was independently associated with higher risk of the metabolically unhealthy phenotype in the fully adjusted model. CONCLUSIONS The metabolically healthy phenotypes had more good-quality muscles than did the metabolically unhealthy phenotypes. These results suggest that not only muscle mass but also muscle quality (i.e., degree of myosteatosis) are associated with metabolic health.
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Affiliation(s)
- Hong-Kyu Kim
- Subdivision of Endocrinology and Metabolism, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Min Jung Lee
- Subdivision of Endocrinology and Metabolism, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Eun Hee Kim
- Subdivision of Endocrinology and Metabolism, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sung-Jin Bae
- Subdivision of Endocrinology and Metabolism, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kyung Won Kim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Biomedical Research Center, Asan Institute for Life Sciences, Seoul, Republic of Korea
| | - Chul-Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
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Tranæs K, Ding C, Chooi YC, Chan Z, Choo J, Leow MKS, Magkos F. Dissociation Between Insulin Resistance and Abnormalities in Lipoprotein Particle Concentrations and Sizes in Normal-Weight Chinese Adults. Front Nutr 2021; 8:651199. [PMID: 33718425 PMCID: PMC7952320 DOI: 10.3389/fnut.2021.651199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 02/09/2021] [Indexed: 11/25/2022] Open
Abstract
Insulin resistance in obesity coincides with abnormalities in lipid profile and lipoprotein subclass distribution and size even before abnormalities in glucose homeostasis manifest. We aimed to assess this relationship in the absence of obesity. Insulin sensitivity (3-h intravenous glucose tolerance test and minimal modeling) and lipoprotein particle concentrations and sizes (proton nuclear magnetic resonance spectroscopy) were evaluated in 15 insulin-resistant and 15 insulin-sensitive lean Asians of Chinese descent with normal glucose tolerance, matched on age, sex, and body mass index. Despite a ~50% lower insulin sensitivity index (Si) in insulin-resistant than in insulin-sensitive subjects, which was accompanied by significantly greater acute insulin response to glucose (AIRg) and fasting insulin concentration but not different fasting glucose concentration, there were no significant differences between groups in the blood lipid profile (p ≥ 0.44) or the lipoprotein subclass concentrations (p ≥ 0.30) and particle sizes (p ≥ 0.43). We conclude that, contrary to observations in subjects with obesity, insulin resistance is not accompanied by unfavorable changes in the plasma lipid profile and lipoprotein particle concentrations and sizes in lean Asians with normal glucose tolerance. Therefore, insulin resistance at the level of glucose metabolism is mechanistically or temporally dissociated from lipid and lipoprotein metabolism. Trial Registration:clinicaltrials.gov, NCT03264001.
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Affiliation(s)
- Kaare Tranæs
- Section for Obesity Research, Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Cherlyn Ding
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR) and National University Health System, Singapore, Singapore
| | - Yu Chung Chooi
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR) and National University Health System, Singapore, Singapore
| | - Zhiling Chan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR) and National University Health System, Singapore, Singapore
| | - John Choo
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR) and National University Health System, Singapore, Singapore
| | - Melvin K-S Leow
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR) and National University Health System, Singapore, Singapore.,Department of Endocrinology, Tan Tock Seng Hospital, Singapore, Singapore.,Cardiovascular and Metabolic Disorders Program, Duke-NUS Medical School, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Faidon Magkos
- Section for Obesity Research, Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR) and National University Health System, Singapore, Singapore
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13
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Yam P, Albright J, VerHague M, Gertz ER, Pardo-Manuel de Villena F, Bennett BJ. Genetic Background Shapes Phenotypic Response to Diet for Adiposity in the Collaborative Cross. Front Genet 2021; 11:615012. [PMID: 33643372 PMCID: PMC7905354 DOI: 10.3389/fgene.2020.615012] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/15/2020] [Indexed: 12/13/2022] Open
Abstract
Defined as chronic excessive accumulation of adiposity, obesity results from long-term imbalance between energy intake and expenditure. The mechanisms behind how caloric imbalance occurs are complex and influenced by numerous biological and environmental factors, especially genetics, and diet. Population-based diet recommendations have had limited success partly due to the wide variation in physiological responses across individuals when they consume the same diet. Thus, it is necessary to broaden our understanding of how individual genetics and diet interact relative to the development of obesity for improving weight loss treatment. To determine how consumption of diets with different macronutrient composition alter adiposity and other obesity-related traits in a genetically diverse population, we analyzed body composition, metabolic rate, clinical blood chemistries, and circulating metabolites in 22 strains of mice from the Collaborative Cross (CC), a highly diverse recombinant inbred mouse population, before and after 8 weeks of feeding either a high protein or high fat high sucrose diet. At both baseline and post-diet, adiposity and other obesity-related traits exhibited a broad range of phenotypic variation based on CC strain; diet-induced changes in adiposity and other traits also depended largely on CC strain. In addition to estimating heritability at baseline, we also quantified the effect size of diet for each trait, which varied by trait and experimental diet. Our findings identified CC strains prone to developing obesity, demonstrate the genotypic and phenotypic diversity of the CC for studying complex traits, and highlight the importance of accounting for genetic differences when making dietary recommendations.
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Affiliation(s)
- Phoebe Yam
- Integrative Genetics and Genomics Graduate Group, University of California, Davis, Davis, CA, United States
- Western Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Davis, CA, United States
| | - Jody Albright
- Nutrition Research Institute, University of North Carolina, Chapel Hill, NC, United States
| | - Melissa VerHague
- Nutrition Research Institute, University of North Carolina, Chapel Hill, NC, United States
| | - Erik R. Gertz
- Western Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Davis, CA, United States
| | | | - Brian J. Bennett
- Integrative Genetics and Genomics Graduate Group, University of California, Davis, Davis, CA, United States
- Western Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Davis, CA, United States
- Department of Nutrition, University of California, Davis, Davis, CA, United States
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14
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Sociodemographic and metabolic risk characteristics associated with metabolic weight categories in the Women's Health Initiative. Cardiovasc Endocrinol Metab 2020; 9:42-48. [PMID: 32537564 DOI: 10.1097/xce.0000000000000194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 01/22/2020] [Indexed: 11/26/2022]
Abstract
To identify sociodemographic and metabolic correlates of weight categories in postmenopausal women. Methods The Women's Health Initiative enrolled 161 808 postmenopausal women ages 50-79. We included those free of cardiovascular disease (CVD) and with CVD risk factors and biomarkers (n = 19 412). Normal weight was defined as a BMI ≥18.5 and <25 kg/m2 and waist circumference <88 cm and overweight/obesity as a BMI ≥25 kg/m2 or waist circumference ≥88 cm. Metabolically healthy was based on <2 and metabolically unhealthy ≥2 traits: triglycerides ≥150 mg/dl, systolic blood pressure (BP) ≥130 mmHg or diastolic BP ≥85 mmHg or antihypertensives or diuretics, fasting glucose ≥100 mg/dl or diabetes medication, and high-density lipoprotein cholesterol <50 mg/dl. Polytomous multinomial logistic regression with generalized link logit function provided the odds of metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUHNW), metabolically healthy overweight/obese (MHO), and metabolically unhealthy overweight/obese (MUHO) according to demographic and risk factor measures. Results Among the 19 412 postmenopausal women, 2369 (12.2%) participants had prevalent diabetes. Advanced age was associated with an increased odds of MUHNW as compared with the MHNW after adjusting for covariates [odds ratio (OR) 1.04, P < 0.0001]. Black/African American ethnicity was associated with a decreased odds of MUHNW (OR 0.64, P < 0.0001) and MUHO (OR 0.77, P = 0.0004), while an increased odds for MHO (OR 1.50, P < 0.0001) as compared with White MHNW. Conclusions Advanced age and ethnicity are important indicators of metabolic weight categories among postmenopausal women.
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15
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Cordola Hsu AR, Ames SL, Xie B, Peterson DV, Garcia L, Going SB, Phillips LS, Manson JE, Anton-Culver H, Wong ND. Incidence of diabetes according to metabolically healthy or unhealthy normal weight or overweight/obesity in postmenopausal women: the Women's Health Initiative. Menopause 2020; 27:640-647. [PMID: 32108731 PMCID: PMC11324332 DOI: 10.1097/gme.0000000000001512] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the relationship of metabolic weight categories with incident diabetes mellitus (DM) in postmenopausal women. METHODS The Women's Health Initiative (WHI) enrolled 161,808 postmenopausal women aged 50 to 79 years. We included those with cardiovascular disease (CVD) biomarkers and free of CVD and prevalent DM (n = 17,043) at baseline. Normal weight was defined as a body mass index (BMI) ≥18.5 and <25 kg/m, and waist circumference (WC) <88 cm and overweight/obesity as a BMI ≥25 kg/m or WC ≥88 cm. Metabolically healthy was based on <2 and metabolically unhealthy ≥2 traits of the following: triglycerides ≥150 mg/dL, systolic blood pressure (BP) ≥130 mm Hg or diastolic BP ≥85 mm Hg, or antihypertensives or diuretics, fasting glucose ≥100 mg/dL or DM medication, and high-density lipoprotein cholesterol <50 mg/dL. Cox regression was performed to determine the risk of incident DM among metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUHNW), metabolically healthy overweight/obese (MHO), and metabolically unhealthy overweight/obese (MUHO). RESULTS Among our sample, 2,253 (13.3%) participants developed DM over a mean ± standard deviation follow-up time of 15.6 ± 3.4 years. Compared with MHNW (n = 162 incident DM cases), an increased risk of incident DM was observed in MUHNW (n = 102 cases) (hazard ratio [HR] 2.24, 95% confidence interval [CI] 1.74-2.88, P < 0.0001), MHO (n = 624 cases) (HR 1.68, 95% CI 1.40-2.00, P < 0.0001), and MUHO (n = 1,365 cases) (HR 4.51, 95% CI 3.82-5.35, P < 0.0001). CONCLUSIONS Among postmenopausal women, MUHNW and MHO confer an approximate doubling in the risk and MUHO more than a four-fold increased risk for developing DM.
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Affiliation(s)
- Amber R. Cordola Hsu
- School of Community and Global Health, Claremont Graduate
University, The Claremont Colleges, Claremont, CA
- Heart Disease Prevention Program, Division of Cardiology,
Department of Medicine, UC Irvine School of Medicine, University of California,
Irvine, Irvine, CA
| | - Susan L. Ames
- School of Community and Global Health, Claremont Graduate
University, The Claremont Colleges, Claremont, CA
| | - Bin Xie
- School of Community and Global Health, Claremont Graduate
University, The Claremont Colleges, Claremont, CA
| | - Darleen V. Peterson
- School of Community and Global Health, Claremont Graduate
University, The Claremont Colleges, Claremont, CA
| | - Lorena Garcia
- Department of Public Health Sciences, Division of
Epidemiology, UC Davis School of Medicine, Davis, CA
| | - Scott B. Going
- Department of Nutritional Sciences, College of Agriculture
and Life Sciences, University of Arizona, Tucson, AZ
| | - Lawrence S. Phillips
- Atlanta VA Medical Center and Division of Endocrinology,
Department of Medicine, Emory University, Atlanta, GA
| | - JoAnn E. Manson
- Department of Medicine, Brigham and Women’s
Hospital, Harvard Medical School, Boston, MA
| | - Hoda Anton-Culver
- Department of Medicine, UC Irvine School of Medicine,
University of California, Irvine, Irvine, CA
| | - Nathan D. Wong
- Heart Disease Prevention Program, Division of Cardiology,
Department of Medicine, UC Irvine School of Medicine, University of California,
Irvine, Irvine, CA
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Ali AT, Guidozzi F. Midlife women's health consequences associated with polycystic ovary syndrome. Climacteric 2019; 23:116-122. [PMID: 31657237 DOI: 10.1080/13697137.2019.1679111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Polycystic ovary syndrome (PCOS) is one of the most common female endocrinopathies. Its symptoms may appear as early as adolescence and may include irregular menstrual periods, amenorrhea, hirsutism and obesity. Regardless of their phenotypic appearance, women with PCOS are metabolically obese. PCOS is associated with metabolic syndrome, type 2 diabetes, depression, cardiovascular disease and gynecological cancers. The metabolic disorders in obese women with PCOS are invariably due to insulin resistance, while inflammation, oxidative stress and possible interaction with environmental factors are among the features linking women with PCOS alone to metabolic disorders. The current review aims to highlight the relationship between PCOS and midlife women's health complications.
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Affiliation(s)
- A T Ali
- Department of Chemical Pathology, NHLS, Tygerberg Hospital and Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - F Guidozzi
- Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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17
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Kang EY, Yim JE. Differences in dietary intakes, body compositions, and biochemical indices between metabolically healthy and metabolically abnormal obese Korean women. Nutr Res Pract 2019; 13:488-497. [PMID: 31814924 PMCID: PMC6883231 DOI: 10.4162/nrp.2019.13.6.488] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/22/2018] [Accepted: 06/17/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND/OBJECTIVES There are various factors that affect metabolic abnormalities related to obesity. The purpose of this study is to analyze the differences in dietary intakes and body compositions of obese women according to metabolic risks and to classify them as metabolically healthy obese (MHO) or metabolically abnormal obese (MAO). SUBJECTS/METHODS This study was conducted on 59 obese Korean women aged 19 to 60 years. NCEP-ATPIII criteria were applied and the women classified as MHO (n = 45) or MAO (n = 14). Body composition of each subject was measured by using dual-energy x-ray absorptiometry (DEXA). Three-day food records were used to analyze dietary intake. Eating habits and health-related behaviors were determined through questionnaires. Indirect calorimetry was used to measure resting metabolic rate and respiratory rate. RESULTS The average age of the subjects was 43.7 years. The analysis of body composition according to phenotype revealed significantly higher body fat mass (P < 0.05), arm fat mass (P < 0.05), and android fat mass (P < 0.05), as measured by DEXA, in the MAO group than in the MHO group. There was no significant difference in the dietary intake of the two groups. However, eating behaviors differed. Compared to the MHO group, the MAO women had a shorter meal time (less than 10 minutes), a preference of oily foods, and a tendency to eat until full. Therefore, the eating habits of MHO women were more positive than those of MAO women. CONCLUSIONS The results suggest that fat distribution in each body region affects various metabolic abnormalities. A high level of arm fat mass in obese Korean women may increase metabolic risk. In addition, eating habits of obese Korean women are considered to be environmental factors affecting the metabolic phenotype of obese Korean women.
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Affiliation(s)
- Eun Yeong Kang
- Department of Food and Nutrition, Changwon National University, 20 Changwondaehak-ro Uichang-gu, Changwon 51140, Korea
| | - Jung-Eun Yim
- Department of Food and Nutrition, Changwon National University, 20 Changwondaehak-ro Uichang-gu, Changwon 51140, Korea
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Effects of Protein Intake Beyond Habitual Intakes Associated With Resistance Training on Metabolic Syndrome-Related Parameters, Isokinetic Strength, and Body Composition in Older Women. J Aging Phys Act 2019; 27:545–552. [PMID: 30676196 DOI: 10.1123/japa.2018-0370] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The objective of this study was to investigate the effects of protein intake beyond habitual intakes associated with resistance training on metabolic syndrome (MetS)-related parameters, isokinetic strength, and body composition in health older women. A total of 30 older women (68.8 ± 4.3 years) participated in this investigation and were assigned to receive 35 g of whey protein or placebo combined with resistance training, over 12-weeks, three times per week. Blood samples, blood pressure, dietary intake, strength, and body composition were assessed before and after the intervention period. Two-way analysis of variance for repeated measures was applied for comparisons. Both groups improved the skeletal muscle mass, muscular strength, waist circumference, triglycerides, high-density lipoprotein, glucose, resistance, reactance, and MetS Z-score risk. However, the improvements in skeletal muscle mass, waist circumference, and MetS Z-score risk were significantly greater in protein group when compared with control group. Moreover, protein group significantly decreased %body fat when compared with control group. Higher protein intake combined with resistance training promoted greater improvements in skeletal muscle mass, %body fat, waist circumference, and MetS Z-score risk in older women.
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Maev IV, Yurenev GL, Mironova EM, Yureneva-Thorzhevskaya TV. Phenotype of obesity and gastroesophageal reflux disease in the context of comorbidity in patients with cardiovascular diseases. TERAPEVT ARKH 2019; 91:126-133. [PMID: 31094183 DOI: 10.26442/00403660.2019.02.000099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The relevance of studying such problems as gastroesophageal reflux disease (GERD) and obesity is caused by their high prevalence in the developed countries of the world. Epidemiological data indicate that obesity is a significant risk factor for developing GERD due to increased intra-abdominal pressure and gastroesophageal gradient, slowing of gastric evacuation and formation of hiatal hernia. Abdominal obesity increases the likelihood of complications of GERD: erosive esophagitis, Barrett's esophagus and adenocarcinoma. This fact is connected with humoral influences: increased production of pro-inflammatory cytokines and leptin, and decreased secretion of adiponectin. Treatment of comorbid patients requires higher dosages and longer courses of antisecretory medicines, and an additional prescription of ursodeoxycholic acid.
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Affiliation(s)
- I V Maev
- A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - G L Yurenev
- A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - E M Mironova
- A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - T V Yureneva-Thorzhevskaya
- A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation, Moscow, Russia
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Lee S, Arslanian S. Body Composition and Cardiorespiratory Fitness Between Metabolically Healthy Versus Metabolically Unhealthy Obese Black and White Adolescents. J Adolesc Health 2019; 64:327-332. [PMID: 30389203 DOI: 10.1016/j.jadohealth.2018.08.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 07/25/2018] [Accepted: 08/22/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE We compared body composition and cardiorespiratory fitness (CRF) between metabolically healthy overweight/obese (MHO) versus metabolically unhealthy overweight/obese (MUO) adolescents in 189 black and white adolescents (BMI ≥ 85th percentile, 12-18 years of age). METHODS Participants were defined as MHO or MUO if their insulin-stimulated glucose disposal, measured by a 3-hour hyperinsulinemic-euglycemic clamp, was in the upper quartile or in the lower three quartiles. Total fat was measured by dual-energy X-ray absorptiometry, and visceral adiposity and liver fat were measured by magnetic resonance imaging and proton magnetic resonance spectroscopy, respectively. CRF was measured by a graded maximal treadmill test. RESULTS Black MHO adolescents had lower (p < .05) 2-hour oral glucose tolerance test glucose, triglycerides, very-low-density lipoprotein cholesterol, and higher high-density lipoprotein cholesterol, with a lower prevalence of impaired fasting glucose and impaired glucose tolerance compared with black MUO adolescents. White MHO adolescents had lower (p < .05) triglycerides and very-low-density lipoprotein cholesterol, with a lower prevalence of impaired fasting glucose compared with white MUO adolescents. Independent of race, CRF was higher in MHO versus MUO adolescents. After accounting for gender, Tanner stage, and BMI, there were no differences in total fat (kg, %) between MHO versus MUO in both races. MHO adolescents had significantly lower trunk fat, waist circumference, and visceral fat compared with MUO adolescents in both races. In whites, MHO adolescents had lower (p = .055) liver fat compared with MUO adolescents. CONCLUSIONS Independent of race, the MHO phenotype is characterized by high CRF, lower waist circumference and visceral fat, and lower rates of dysglycemia in youth.
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Affiliation(s)
- SoJung Lee
- Division of Sports Medicine, Graduate School of Physical Education, Kyung Hee University, Yongin, Republic of Korea.
| | - Silva Arslanian
- Center for Pediatric Research in Obesity and Metabolism, Children's Hospital of Pittsburgh of UPMC, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Children's Hospital of Pittsburgh of UPMC, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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Estrella ML, Pirzada A, Durazo-Arvizu RA, Cai J, Giachello AL, Espinoza Gacinto R, Siega-Riz AM, Daviglus ML. Correlates of and Body Composition Measures Associated with Metabolically Healthy Obesity Phenotype in Hispanic/Latino Women and Men: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). J Obes 2019; 2019:1251456. [PMID: 30775036 PMCID: PMC6350597 DOI: 10.1155/2019/1251456] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/27/2018] [Accepted: 12/18/2018] [Indexed: 12/31/2022] Open
Abstract
Background Individuals with "metabolically healthy obesity" (MHO) phenotype (i.e., obesity and absence of cardiometabolic abnormalities: favorable levels of blood pressure, lipids, and glucose) experience lower risk of cardiovascular disease compared with those with "metabolically at-risk obesity" (MAO) phenotype (i.e., obesity with concurrent cardiometabolic abnormalities). Among Hispanic/Latino women and men with obesity, limited data exist on the correlates of and body composition measures associated with obesity phenotypes. Methods Data from the Hispanic Community Health Study/Study of Latinos (2008-2011) were used to estimate the age-adjusted distribution of obesity phenotypes among 5,426 women and men (aged 20-74 years) with obesity (BMI ≥ 30 kg/m2) and to compare characteristics between individuals with MHO and MAO phenotypes. Weighted Poisson regression models were used to examine cross-sectional associations between 1-standard deviation (SD) increase in body composition measures (i.e., body fat percentage, waist circumference, and body lean mass) and MHO phenotype prevalence. Results The age-adjusted proportion of the MHO phenotype was low (i.e., 12.5% in women and 6.5% in men). In bivariate analyses, women and men with the MHO phenotype were more likely to be younger, have higher education and acculturation levels, report lower lifetime cigarette use, and have fasting insulin and waist circumference levels than MAO. Adjusting for sociodemographic and lifestyle factors, among women, each 1-SD increase in body fat percentage, waist circumference, and lean body mass was, respectively, associated with a 21%, 33%, and 31% lower prevalence of the MHO phenotype. Among men, each 1-SD increase in waist circumference and lean body mass was, respectively, associated with a 20% and 15% lower prevalence of the MHO phenotype. Conclusions We demonstrated that higher waist circumference and higher lean body mass were independently associated with a lower proportion of the MHO phenotype in Hispanic/Latino women and men. Findings support the need for weight reduction interventions to manage cardiometabolic health among Hispanics/Latinos.
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Affiliation(s)
- Mayra L. Estrella
- Institute for Minority Health Research, University of Illinois at Chicago, 1819 West Polk Street, Chicago, IL 60612, USA
| | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois at Chicago, 1819 West Polk Street, Chicago, IL 60612, USA
| | - Ramon A. Durazo-Arvizu
- Division of Biostatistics, Public Health Sciences, Loyola University Chicago, 2160 South First Avenue, Maywood, IL 60153, USA
| | - Jianwen Cai
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, 123 W. Franklin Street, Chapel Hill, NC 27516, USA
| | - Aida L. Giachello
- Department of Preventive Medicine, Northwestern University, 680 N Lake Shore Dr Suite, Chicago, IL 60611, USA
| | - Rebeca Espinoza Gacinto
- Graduate School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA
| | - Anna Maria Siega-Riz
- School of Nursing and Departments of Public Health Sciences and Obstetrics and Gynecology, School of Medicine, University of Virginia, P.O. Box 800717, Charlottesville, VA 22908, USA
| | - Martha L. Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, 1819 West Polk Street, Chicago, IL 60612, USA
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22
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Abdurahman AA, Azadbakhat L, Rasouli M, Chamari M, Qorbani M, Dorosty AR. Association of dietary inflammatory index with metabolic profile in metabolically healthy and unhealthy obese people. Nutr Diet 2018; 76:192-198. [PMID: 30402959 DOI: 10.1111/1747-0080.12482] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 08/29/2018] [Accepted: 09/10/2018] [Indexed: 11/27/2022]
Abstract
AIM Obesity is an emerging public health problem, with its incidence on the rise. An abnormal metabolic profile is a risk factor for developing obesity. Dietary factors play a central role in the regulation of inflammation and obesity. The aim of the present study was to determine the prevalence of metabolically healthy obese and metabolically unhealthy obese (MUO) phenotypes, and their association with dietary inflammatory index (DII) among obese Iranian people. METHODS A cross-sectional study was conducted from July to October 2017 among 300 obese participants in southern Tehran. DII scores were computed based on the overall inflammatory properties of 32 dietary components using dietary intake assessed by food frequency questionnaire. MUO phenotype was defined as having three or more of these metabolic abnormalities: high blood glucose, high triglycerides, low high-density lipoprotein cholesterol, elevated blood pressure or abdominal obesity. The association was determined using logistic regression analysis. RESULTS The MUO phenotype (n = 176) was found in 63.5% of obese participants. Compared with participants in the first quartile, those in the fourth quartile of DII score (more pro-inflammatory diet) had higher odds of MUO phenotype (odds ratio, OR: 2.58 (95% CI: 1.19-5.59), P = 0.04), and there was a significant association between the continuous form of DII score and the odds of MUO phenotype (OR: 1.18 (95% CI: 1.01-1.37)) after adjusting for potential confounders. CONCLUSIONS Higher DII scores were positively associated with the MUO phenotype. A more pro-inflammatory diet is a potential risk factor for MUO phenotype.
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Affiliation(s)
- Ahmed A Abdurahman
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences International Campus (TUMS-IC), Tehran, Iran
| | - Leila Azadbakhat
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.,Diabetic Research Centre, Endocrine and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mahkameh Rasouli
- Department of anesthesiology, Medicine Faculty, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Maryam Chamari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Centre, Alborz University of Medical Sciences, Tehran, Iran.,Chronic Diseases Research Centre, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmed R Dorosty
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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23
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Konieczna J, Abete I, Galmés AM, Babio N, Colom A, Zulet MA, Estruch R, Vidal J, Toledo E, Díaz-López A, Fiol M, Casas R, Vera J, Buil-Cosiales P, Martín V, Goday A, Salas-Salvadó J, Martínez JA, Romaguera D. Body adiposity indicators and cardiometabolic risk: Cross-sectional analysis in participants from the PREDIMED-Plus trial. Clin Nutr 2018; 38:1883-1891. [PMID: 30031660 DOI: 10.1016/j.clnu.2018.07.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 06/18/2018] [Accepted: 07/03/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND & AIMS Excess adiposity is associated with poor cardiometabolic (CM) health. To date, several techniques and indicators have been developed to determine adiposity. We aimed to compare the ability of traditional anthropometric, as well as standard and novel DXA-derived parameters related to overall and regional adiposity, to evaluate CM risk. METHODS Using the cross-sectional design in the context of the PREDIMED-Plus trial, 1207 Caucasian senior men and women with overweight/obesity and metabolic syndrome (MetS) were assessed. At baseline, anthropometry- and DXA-measured parameters of central, visceral, peripheral and central-to-peripheral adiposity together with comprehensive set of CM risk factors were obtained. Partial correlations and areas under the ROC curve (AUC) were estimated to compare each adiposity measure with CM risk parameters, separately for men and women, and in the overall sample. RESULTS DXA-derived indicators, other than percentage of total body fat, showed stronger correlations (rho -0.172 to 0.206, p < 0.001) with CM risk than anthropometric indicators, after controlling for age, diabetes and medication use. In both sexes, DXA-derived visceral adipose tissue measures (VAT, VAT/Total fat, visceral-to-subcutaneous fat) together with lipodystrophy indicators (Trunk/Legs fat and Android/Gynoid fat) were strongly and positively correlated (p < 0.001) with glycated hemoglobin (HbA1c), the triglyceride and glucose index (TyG), triglycerides (TG), the ratio TG/HDL-cholesterol (TG/HDL-C), and were inversely related to HDL-C levels (p < 0.001). Furthermore, in AUC analyses for both sexes, VAT/Total fat showed the highest predictive ability for abnormal HbA1c levels (AUC = 0.629), VAT for TyG (AUC = 0.626), both lipodystrophy indicators for TG (AUCs = 0.556), and Trunk/Legs fat for HDL-C (AUC = 0.556) and TG/HDL-C (AUC = 0.581). CONCLUSIONS DXA regional adiposity measures offer advantages beyond traditional anthropometric and DXA overall adiposity indicators for CM risk assessment in senior overweight/obese subjects with MetS. In particular, in both sexes, visceral adiposity better stratifies individuals at risk for glucose abnormalities, and indicators of lipodystrophy better predict markers of dyslipidemia.
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Affiliation(s)
- Jadwiga Konieczna
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), University Hospital Son Espases, Palma de Mallorca, Spain
| | - Itziar Abete
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Nutrition, Food Sciences and Physiology, Center for Nutrition Research, University of Navarra (UNAV), Pamplona, Spain
| | - Aina M Galmés
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), University Hospital Son Espases, Palma de Mallorca, Spain
| | - Nancy Babio
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Pere Virgili Institute for Health Research, Rovira i Virgili University, Reus, Spain
| | - Antoni Colom
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), University Hospital Son Espases, Palma de Mallorca, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Angeles Zulet
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Nutrition, Food Sciences and Physiology, Center for Nutrition Research, University of Navarra (UNAV), Pamplona, Spain
| | - Ramón Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Internal Medicine, Hospital Clinic, IDIBAPS August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain
| | - Josep Vidal
- Department of Endocrinology, Hospital Clinic, University of Barcelona, Barcelona, Spain; CIBER Diabetes y enfermedades metabólicas (CIBERdem), Instituto de Salud Carlos III (ISCIII), Spain
| | - Estefanía Toledo
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, University of Navarra-Navarra Institute for Health Research, Pamplona, Spain
| | - Andrés Díaz-López
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Pere Virgili Institute for Health Research, Rovira i Virgili University, Reus, Spain
| | - Miguel Fiol
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), University Hospital Son Espases, Palma de Mallorca, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Rosa Casas
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Internal Medicine, Hospital Clinic, IDIBAPS August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain
| | - Josep Vera
- IDIBAPS August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain
| | - Pilar Buil-Cosiales
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, University of Navarra-Navarra Institute for Health Research, Pamplona, Spain; Atención Primaria, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
| | - Vicente Martín
- Instituto de Biomedicina (IBIOMED), University of León, León, Spain; CIBER Epidemiología y Salud Pública (CIBEResp), Instituto de Salud Carlos III (ISCIII), Spain
| | - Albert Goday
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Pere Virgili Institute for Health Research, Rovira i Virgili University, Reus, Spain
| | - J Alfredo Martínez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Nutrition, Food Sciences and Physiology, Center for Nutrition Research, University of Navarra (UNAV), Pamplona, Spain; Madrid Institute for Advanced Studies (IMDEA) Food Institute, Madrid, Spain
| | - Dora Romaguera
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), University Hospital Son Espases, Palma de Mallorca, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
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Ding WQ, Liu JT, Shang YX, Gao B, Zhao XY, Zhao HP, Wu WJ. DXA-measured visceral fat mass and lean body mass reflect abnormal metabolic phenotypes among some obese and nonobese Chinese children and adolescents. Nutr Metab Cardiovasc Dis 2018; 28:618-628. [PMID: 29699814 DOI: 10.1016/j.numecd.2018.03.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 02/26/2018] [Accepted: 03/02/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND AIM The exact constellation of body composition characteristics among metabolically unhealthy obese (MUO) and nonobese (MUNO) children and adolescents remains unclear. The purpose of this study was to identify the major body composition determinants of metabolically unhealthy phenotypes among Chinese children and adolescents. METHODS AND RESULTS We used data from a cross-sectional survey in 2015 that included 1983 children and adolescents aged 6-18 years. Subjects were classified into two phenotypes based on a combination of body mass index (BMI) and metabolic syndrome components. Body composition was measured by dual-energy X-ray absorptiometry (DXA). Among all boys and among adolescent boys, those with MUNO phenotypes displayed significantly higher indices of body composition except for fat mass (FM) percentage and trunk-to-legs FM ratio compared with the metabolically healthy nonobese phenotype (all P < 0.05). MUO individuals had higher arm FM, lean body mass (LBM), and trunk lean mass compared to metabolically healthy obese individuals (all P < 0.05). Visceral fat mass (VFM) and BMI were the major independent determinants of MUNO (VFM, 6- to 9-year-old boys, OR = 1.02, 95% CI = 1.00-1.03, P = 0.021; BMI, 6- to 9-year-old girls, OR = 1.90, 95% CI = 1.31-2.84, P = 0.001; and adolescent boys, OR = 1.34, 95% CI = 1.23-1.44, P < 0.001). LBM was the major independent predictor of MUO among adolescent boys (OR = 1.90, 95% CI = 1.03-1.17, P = 0.003). CONCLUSIONS Among children and adolescents, the metabolically unhealthy phenotype was associated with excess of body composition, but with significant differences observed based on age and sex. VFM and LBM derived by DXA can predict the metabolically unhealthy phenotype effectively in specific sex and age groups.
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Affiliation(s)
- W Q Ding
- Department of Children and Adolescents Health Care, School of Public Health, Ningxia Medical University, Ningxia, China.
| | - J T Liu
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Y X Shang
- Department of Children and Adolescents Health Care, School of Public Health, Ningxia Medical University, Ningxia, China
| | - B Gao
- Department of Cardiology, Zhongwei Municipal Hospital, Ningxia, China
| | - X Y Zhao
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - H P Zhao
- Department of Children and Adolescents Health Care, School of Public Health, Ningxia Medical University, Ningxia, China
| | - W J Wu
- Department of AIDS/STD/TB Control and Prevention, Yinchuan Center for Diseases Prevention and Control, Ningxia, China
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Waist Circumference Is an Anthropometric Parameter That Identifies Women with Metabolically Unhealthy Phenotypes. Nutrients 2018; 10:nu10040447. [PMID: 29617320 PMCID: PMC5946232 DOI: 10.3390/nu10040447] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 03/27/2018] [Accepted: 04/02/2018] [Indexed: 12/20/2022] Open
Abstract
Metabolically healthy (MH) and metabolically unhealthy (MUH) phenotypes can be present in any subject independently of their body mass index (BMI). However, factors related to the presence of these phenotypes are poorly understood. Therefore, the aim of this cross-sectional study is to describe the prevalence and characteristics associated with the MH and MUH phenotypes in Mexican subjects with different BMI categories. Anthropometric and biochemical parameters were evaluated after 12 h of fasting. HMW (High Molecular Weight) adiponectin and insulin levels were measured by ELISA (enzyme-linked immunosorbent assay). A total of 345 subjects were included, of which, 73.9% were women. The prevalence of the MH phenotype was 69.9%, 46.7%, and 19% in normal weight, overweight, and obesity, respectively. ROC (receiver operating characteristic) curve analysis showed that the waist circumference demonstrated a statistical significance (p < 0.01) in detecting the MUH phenotype in each BMI group only in women. Furthermore, subjects with lower HMW adiponectin levels showed a 2.1 increased risk of presenting the MUH phenotype. In conclusion, in this Mexican population, waist circumference was an anthropometric parameter that identified women with the MUH phenotype in all BMI categories and hypoadiponectinemia was a risk factor for the presence of this phenotype.
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26
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Sebastian RS, Wilkinson Enns C, Goldman JD, Moshfegh AJ. Dietary Flavonoid Intake Is Inversely Associated with Cardiovascular Disease Risk as Assessed by Body Mass Index and Waist Circumference among Adults in the United States. Nutrients 2017; 9:E827. [PMID: 28767062 PMCID: PMC5579620 DOI: 10.3390/nu9080827] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 07/25/2017] [Accepted: 07/27/2017] [Indexed: 11/17/2022] Open
Abstract
Although flavonoids may confer anti-inflammatory and anti-oxidant benefits, no research has examined if flavonoid intake is related to cardiovascular disease (CVD) risk defined by anthropometric measures in the USA population. This study sought to determine whether flavonoid intake is associated with combined body mass index (BMI) and waist circumference (WC) measures indicative of high, very high, or extremely high ("high+") risk for CVD, using one day of 24-h recall data from adult (≥20 years) participants in What We Eat in America, National Health and Nutrition Examination Survey 2007-2010. Individuals were divided into categories of intake of total flavonoids and each flavonoid class, and adjusted estimates of the percentages at high+ CVD risk (based on BMI and WC, as per National Heart, Lung, and Blood Institute guidelines) were calculated. Inverse linear trends were found in percentages of adults at high+ CVD risk by intake of total flavonoids, anthocyanidins, flavan-3-ols, and flavanones (p < 0.01). For individuals in the highest (versus the lowest) intake category of anthocyanidins, flavan-3-ols, and flavanones, relative risk and confidence intervals (RR and CI, respectively) were 0.86 (99% CI: 0.79, 0.93), 0.88 (99% CI: 0.79, 0.98), and 0.89 (99% CI: 0.80, 0.98), respectively. Research is needed to determine whether the inverse relationships found in this study are applicable to CVD endpoints at the population level.
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Affiliation(s)
- Rhonda S Sebastian
- USDA, Agricultural Research Service, Food Surveys Research Group, 10300 Baltimore Avenue, BARC-West, Bldg 005, Rm 102, Beltsville, MD 20705-2350, USA.
| | - Cecilia Wilkinson Enns
- USDA, Agricultural Research Service, Food Surveys Research Group, 10300 Baltimore Avenue, BARC-West, Bldg 005, Rm 102, Beltsville, MD 20705-2350, USA.
| | - Joseph D Goldman
- USDA, Agricultural Research Service, Food Surveys Research Group, 10300 Baltimore Avenue, BARC-West, Bldg 005, Rm 102, Beltsville, MD 20705-2350, USA.
| | - Alanna J Moshfegh
- USDA, Agricultural Research Service, Food Surveys Research Group, 10300 Baltimore Avenue, BARC-West, Bldg 005, Rm 102, Beltsville, MD 20705-2350, USA.
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Abstract
OBJECTIVE Some individuals with metabolically healthy obesity (MHO) convert to metabolically unhealthy obesity (MUO) phenotype, and visceral adiposity is one of proposed mechanisms underlying such conversion. Visceral adipose index (VAI) is a novel mathematical model which estimates visceral adiposity based on anthropometric and lipid profiles. We aimed to determine the association of VAI-estimated visceral adiposity with the MHO-to-MUO conversion and the predictive value of VAI in estimating such unfavorable outcomes. METHODS A total of 2,204 Korean subjects with the MHO phenotype were enrolled and stratified by body mass index and metabolic health state according to Wildman criteria at baseline and last follow-up examinations. VAI was calculated at baseline. RESULTS Over a median follow-up period of 41.1 months, 46.0% of subjects converted to MUO phenotype. Higher VAI quartiles were associated with a greater proportion of subjects who underwent MHO-to-MUO conversion, and also with increased odds ratios for such conversion even after multivariate analyses. The optimal VAI cut off value was around 1.00, and VAI had a greater power in the prediction of MHO-to MUO conversion than waist circumference in both genders. CONCLUSION MHO phenotypes with high VAI values are associated with poor future metabolic outcomes. VAI-estimated visceral adiposity is well correlated with the prognosis of MHO subjects, and VAI has a good predictive value in determining the MHO-to-MUO conversion.
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Eftekharzadeh A, Asghari G, Serahati S, Hosseinpanah F, Azizi A, Barzin M, Mirmiran P, Azizi F. Predictors of incident obesity phenotype in nonobese healthy adults. Eur J Clin Invest 2017; 47:357-365. [PMID: 28294315 DOI: 10.1111/eci.12743] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 03/06/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Despite their different cardiovascular consequences, little is known about predictors of metabolically healthy (MHO) and metabolically unhealthy obesity (MUHO). This cohort study was designed to address this question in participants of the Tehran Lipid and Glucose Study. MATERIALS AND METHODS Employing the Joint Interim Statement (JIS) metabolic syndrome criteria to define MHO/MUHO phenotypes, nonobese, otherwise healthy individuals, aged > 20 years (n = 3489) were recruited and followed up for a median of 13·4 years. RESULTS At the follow-up, MHO incidence rate in obese individuals was 36·6%. Comparing MHO vs. MUHO, female gender [odds ratio (OR) = 3·28, 95% confidence interval (CI) 1·27, 8·46)], increased body mass index (BMI; OR = 1·32, 95% CI: 1·12, 1·60) and elevated high-density lipoprotein cholesterol (HDL-C) levels (OR = 1·04, 95% CI: 1·02, 1·07) were related to higher odds of incident MHO, while older age (OR = 0·95, 95% CI: 0·92, 0·98), increased waist circumference (WC; OR = 0·86, 95% CI: 0·81, 0·91), higher WC gain (OR = 0·91, 95% CI: 0·87, 0·95) and increased diastolic blood pressure (DBP; OR = 0·94, 95% CI: 0·91, 0·98) prevented progression towards MHO. CONCLUSIONS While baseline BMI and WC were detrimental for developing MHO vs. MUHO, gender was the strongest predictor of incident obesity phenotype in healthy nonobese individuals.
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Affiliation(s)
- Anita Eftekharzadeh
- Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Golaleh Asghari
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Serahati
- Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Azizi
- Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Barzin
- Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Lee SC, Hairi NN, Moy FM. Metabolic syndrome among non-obese adults in the teaching profession in Melaka, Malaysia. J Epidemiol 2016; 27:130-134. [PMID: 28142038 PMCID: PMC5350617 DOI: 10.1016/j.je.2016.10.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 04/09/2016] [Indexed: 12/28/2022] Open
Abstract
Background Non-obese individuals could have metabolic disorders that are typically associated with elevated body mass index (BMI), placing them at elevated risk for chronic diseases. This study aimed to describe the prevalence and distribution of metabolically obese, non-obese (MONO) individuals in Malaysia. Methods We conducted a cross-sectional study involving teachers recruited via multi-stage sampling from the state of Melaka, Malaysia. MONO was defined as individuals with BMI 18.5–29.9 kg/m2 and metabolic syndrome. Metabolic syndrome was diagnosed based on the Harmonization criteria. Participants completed self-reported questionnaires that assessed alcohol intake, sleep duration, smoking, physical activity, and fruit and vegetable consumption. Results A total of 1168 teachers were included in the analysis. The prevalence of MONO was 17.7% (95% confidence interval [CI], 15.3–20.4). Prevalence of metabolic syndrome among the normal weight and overweight participants was 8.3% (95% CI, 5.8–11.8) and 29.9% (95% CI, 26.3–33.7), respectively. MONO prevalence was higher among males, Indians, and older participants and inversely associated with sleep duration. Metabolic syndrome was also more prevalent among those with central obesity, regardless of whether they were normal or overweight. The odds of metabolic syndrome increased exponentially from 1.9 (for those with BMI 23.0–24.9 kg/m2) to 11.5 (for those with BMI 27.5–29.9 kg/m2) compared to those with BMI 18.5–22.9 kg/m2 after adjustment for confounders. Conclusions The prevalence of MONO was high, and participants with BMI ≥23.0 kg/m2 had significantly higher odds of metabolic syndrome. Healthcare professionals and physicians should start to screen non-obese individuals for metabolic risk factors to facilitate early targeted intervention. The prevalence of metabolic syndrome among the non-obese teachers was 17.7%. The odds of metabolic syndrome increased exponentially from a BMI of 23.0 kg/m2. Metabolic syndrome was more prevalent among males, Indians, and older teachers.
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Affiliation(s)
- Soo Cheng Lee
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Noran Naqiah Hairi
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Foong Ming Moy
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Figueroa A, Alvarez-Alvarado S, Jaime SJ, Johnson SA, Campbell JC, Feresin RG, Elam ML, Navaei N, Pourafshar S, Arjmandi BH. Influence of low and normal appendicular lean mass on central blood pressure and wave reflection responses to muscle metaboreflex activation in postmenopausal women. Clin Exp Pharmacol Physiol 2016; 43:1243-1246. [DOI: 10.1111/1440-1681.12655] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 08/09/2016] [Accepted: 08/12/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Arturo Figueroa
- Department of Nutrition, Food and Exercise Sciences; Florida State University; Tallahassee FL USA
| | - Stacey Alvarez-Alvarado
- Department of Nutrition, Food and Exercise Sciences; Florida State University; Tallahassee FL USA
| | - Salvador J Jaime
- Department of Nutrition, Food and Exercise Sciences; Florida State University; Tallahassee FL USA
| | - Sarah A Johnson
- Department of Food Science and Human Nutrition; Colorado State University; Fort Collins CO USA
| | - Jeremiah C Campbell
- Department of Nutrition, Food and Exercise Sciences; Florida State University; Tallahassee FL USA
| | - Rafaela G Feresin
- Department of Dietetics and Nutrition; University of Arkansas for Medical Sciences; Little Rock AR USA
| | - Marcus L Elam
- Department of Human Nutrition and Food Science; Cal Poly Pomona; Pomona CA USA
| | - Negin Navaei
- Department of Nutrition, Food and Exercise Sciences; Florida State University; Tallahassee FL USA
| | - Shirin Pourafshar
- Department of Nutrition, Food and Exercise Sciences; Florida State University; Tallahassee FL USA
| | - Bahram H Arjmandi
- Department of Nutrition, Food and Exercise Sciences; Florida State University; Tallahassee FL USA
- Center for Advancing Exercise and Nutrition Research on Aging (CAENRA); Florida State University; Tallahassee FL USA
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Mongraw-Chaffin M, Foster MC, Kalyani RR, Vaidya D, Burke GL, Woodward M, Anderson CAM. Obesity Severity and Duration Are Associated With Incident Metabolic Syndrome: Evidence Against Metabolically Healthy Obesity From the Multi-Ethnic Study of Atherosclerosis. J Clin Endocrinol Metab 2016; 101:4117-4124. [PMID: 27552544 PMCID: PMC5095229 DOI: 10.1210/jc.2016-2460] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
CONTEXT Although the health risks of obesity compared to normal weight have been well studied, the cumulative risk associated with chronic obesity remains unknown. Specifically, debate continues about the importance of recommending weight loss for those with metabolically healthy obesity. OBJECTIVE We hypothesized that relatively greater severity and longer duration of obesity are associated with greater incident metabolic syndrome. Design, Setting, Participants, and Measures: Using repeated measures logistic regression with random effects, we investigated the association of time-varying obesity severity and duration with incident metabolic syndrome in 2,748 Multi-Ethnic Study of Atherosclerosis participants with obesity (body mass index ≥30 kg/m2) at any visit. Obesity duration was defined as the cumulative number of visits with measured obesity and obesity severity by the World Health Organization levels I-III based on body mass index. Metabolic syndrome was defined using Adult Treatment Panel III criteria modified to exclude waist circumference. RESULTS Higher obesity severity (level II odds ratio [OR], 1.32 [95% confidence interval, 1.09-1.60]; level III OR, 1.63 [1.25-2.14] vs level I) and duration (by number of visits: two visits OR, 4.43 [3.54-5.53]; three visits OR, 5.29 [4.21-6.63]; four visits OR, 5.73 [4.52-7.27]; five visits OR, 6.15 [4.19-9.03] vs one visit duration of obesity) were both associated with a higher odds of incident metabolic syndrome. CONCLUSION Both duration and severity of obesity are positively associated with incident metabolic syndrome, suggesting that metabolically healthy obesity is a transient state in the pathway to cardiometabolic disease. Weight loss should be recommended to all individuals with obesity, including those who are currently defined as metabolically healthy.
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Affiliation(s)
- Morgana Mongraw-Chaffin
- Department of Medicine (M.M.-C.), University of California, San Diego, La Jolla, California; William B. Schwartz Division of Nephrology (M.C.F.), Tufts Medical Center, Boston, Massachusetts; Department of Medicine (R.R.K.), Johns Hopkins University, Baltimore, Maryland; Department of Epidemiology (D.V., M.W., C.A.M.A.), Johns Hopkins University, Baltimore, Maryland; Division of Public Health Sciences (G.L.B.), Wake Forest School of Medicine, Winston-Salem, North Carolina; The George Institute for Global Health (M.W.), University of Oxford, Oxford, United Kingdom; The George Institute for Global Health (M.W.), University of Sydney, Sydney, Australia; Department of Family Medicine and Public Health (C.A.M.A.), University of California, San Diego, La Jolla, California
| | - Meredith C Foster
- Department of Medicine (M.M.-C.), University of California, San Diego, La Jolla, California; William B. Schwartz Division of Nephrology (M.C.F.), Tufts Medical Center, Boston, Massachusetts; Department of Medicine (R.R.K.), Johns Hopkins University, Baltimore, Maryland; Department of Epidemiology (D.V., M.W., C.A.M.A.), Johns Hopkins University, Baltimore, Maryland; Division of Public Health Sciences (G.L.B.), Wake Forest School of Medicine, Winston-Salem, North Carolina; The George Institute for Global Health (M.W.), University of Oxford, Oxford, United Kingdom; The George Institute for Global Health (M.W.), University of Sydney, Sydney, Australia; Department of Family Medicine and Public Health (C.A.M.A.), University of California, San Diego, La Jolla, California
| | - Rita R Kalyani
- Department of Medicine (M.M.-C.), University of California, San Diego, La Jolla, California; William B. Schwartz Division of Nephrology (M.C.F.), Tufts Medical Center, Boston, Massachusetts; Department of Medicine (R.R.K.), Johns Hopkins University, Baltimore, Maryland; Department of Epidemiology (D.V., M.W., C.A.M.A.), Johns Hopkins University, Baltimore, Maryland; Division of Public Health Sciences (G.L.B.), Wake Forest School of Medicine, Winston-Salem, North Carolina; The George Institute for Global Health (M.W.), University of Oxford, Oxford, United Kingdom; The George Institute for Global Health (M.W.), University of Sydney, Sydney, Australia; Department of Family Medicine and Public Health (C.A.M.A.), University of California, San Diego, La Jolla, California
| | - Dhananjay Vaidya
- Department of Medicine (M.M.-C.), University of California, San Diego, La Jolla, California; William B. Schwartz Division of Nephrology (M.C.F.), Tufts Medical Center, Boston, Massachusetts; Department of Medicine (R.R.K.), Johns Hopkins University, Baltimore, Maryland; Department of Epidemiology (D.V., M.W., C.A.M.A.), Johns Hopkins University, Baltimore, Maryland; Division of Public Health Sciences (G.L.B.), Wake Forest School of Medicine, Winston-Salem, North Carolina; The George Institute for Global Health (M.W.), University of Oxford, Oxford, United Kingdom; The George Institute for Global Health (M.W.), University of Sydney, Sydney, Australia; Department of Family Medicine and Public Health (C.A.M.A.), University of California, San Diego, La Jolla, California
| | - Gregory L Burke
- Department of Medicine (M.M.-C.), University of California, San Diego, La Jolla, California; William B. Schwartz Division of Nephrology (M.C.F.), Tufts Medical Center, Boston, Massachusetts; Department of Medicine (R.R.K.), Johns Hopkins University, Baltimore, Maryland; Department of Epidemiology (D.V., M.W., C.A.M.A.), Johns Hopkins University, Baltimore, Maryland; Division of Public Health Sciences (G.L.B.), Wake Forest School of Medicine, Winston-Salem, North Carolina; The George Institute for Global Health (M.W.), University of Oxford, Oxford, United Kingdom; The George Institute for Global Health (M.W.), University of Sydney, Sydney, Australia; Department of Family Medicine and Public Health (C.A.M.A.), University of California, San Diego, La Jolla, California
| | - Mark Woodward
- Department of Medicine (M.M.-C.), University of California, San Diego, La Jolla, California; William B. Schwartz Division of Nephrology (M.C.F.), Tufts Medical Center, Boston, Massachusetts; Department of Medicine (R.R.K.), Johns Hopkins University, Baltimore, Maryland; Department of Epidemiology (D.V., M.W., C.A.M.A.), Johns Hopkins University, Baltimore, Maryland; Division of Public Health Sciences (G.L.B.), Wake Forest School of Medicine, Winston-Salem, North Carolina; The George Institute for Global Health (M.W.), University of Oxford, Oxford, United Kingdom; The George Institute for Global Health (M.W.), University of Sydney, Sydney, Australia; Department of Family Medicine and Public Health (C.A.M.A.), University of California, San Diego, La Jolla, California
| | - Cheryl A M Anderson
- Department of Medicine (M.M.-C.), University of California, San Diego, La Jolla, California; William B. Schwartz Division of Nephrology (M.C.F.), Tufts Medical Center, Boston, Massachusetts; Department of Medicine (R.R.K.), Johns Hopkins University, Baltimore, Maryland; Department of Epidemiology (D.V., M.W., C.A.M.A.), Johns Hopkins University, Baltimore, Maryland; Division of Public Health Sciences (G.L.B.), Wake Forest School of Medicine, Winston-Salem, North Carolina; The George Institute for Global Health (M.W.), University of Oxford, Oxford, United Kingdom; The George Institute for Global Health (M.W.), University of Sydney, Sydney, Australia; Department of Family Medicine and Public Health (C.A.M.A.), University of California, San Diego, La Jolla, California
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Lipid accumulation product (LAP) as a criterion for the identification of the healthy obesity phenotype in postmenopausal women. Exp Gerontol 2016; 82:81-7. [DOI: 10.1016/j.exger.2016.06.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 06/16/2016] [Accepted: 06/17/2016] [Indexed: 01/11/2023]
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Body composition in clinical practice. Eur J Radiol 2016; 85:1461-8. [DOI: 10.1016/j.ejrad.2016.02.005] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 12/01/2015] [Accepted: 02/03/2016] [Indexed: 01/26/2023]
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Hepatic fat content is a determinant of metabolic phenotypes and increased carotid intima-media thickness in obese adults. Sci Rep 2016; 6:21894. [PMID: 26902311 PMCID: PMC4763213 DOI: 10.1038/srep21894] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 02/03/2016] [Indexed: 01/22/2023] Open
Abstract
Individuals with metabolically healthy obesity (MHO) are at relatively low risk for the development of metabolic abnormalities and subclinical atherosclerosis. This study aims to examine whether hepatic fat accumulation determines metabolic phenotype of obesity and associated with subclinical atherosclerosis. A total of 485 obese adults (aged 40–65 years) who received magnetic resonance spectroscopy were divided into metabolically abnormally obesity (MAO) and MHO groups according to metabolic status. MHO individuals had lower levels of intrahepatic triglyceride (IHTG) content and carotid intima-media thickness (CIMT) than MAO individuals. In multivariable linear regression analyses, IHTG content was independently associated with metabolic syndrome components and CIMT. Based on receiver operating characteristic curve analysis, the IHTG content displayed a higher area under the curve (AUC) for detecting the MAO phenotype (AUC = 0.70, 95%CI = 0.65–0.75) and increased CIMT (AUC = 0.60, 95%CI = 0.54–0.66) than BMI, waist circumference, and body fat percent. MHO individuals were 1.9 times (p < 0.001) more likely to have metabolic syndrome per 1 SD change in IHTG content in multivariable-adjusted models. Likewise, the risk for high CIMT increased 29% per 1 SD change in IHTG content [OR (95% CI):1.29(1.01–1.64)]. These findings suggest that hepatic fat is a potential predictor of metabolically unhealthy obesity phenotype and subclinical atherosclerosis.
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Wainright KS, Fleming NJ, Rowles JL, Welly RJ, Zidon TM, Park YM, Gaines TL, Scroggins RJ, Anderson-Baucum EK, Hasty AH, Vieira-Potter VJ, Padilla J. Retention of sedentary obese visceral white adipose tissue phenotype with intermittent physical activity despite reduced adiposity. Am J Physiol Regul Integr Comp Physiol 2015; 309:R594-602. [PMID: 26180183 DOI: 10.1152/ajpregu.00042.2015] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 07/06/2015] [Indexed: 12/31/2022]
Abstract
Regular physical activity is effective in reducing visceral white adipose tissue (AT) inflammation and oxidative stress, and these changes are commonly associated with reduced adiposity. However, the impact of multiple periods of physical activity, intercalated by periods of inactivity, i.e., intermittent physical activity, on markers of AT inflammation and oxidative stress is unknown. In the present study, 5-wk-old male C57BL/6 mice were randomized into three groups (n = 10/group): sedentary, regular physical activity, and intermittent physical activity, for 24 wk. All animals were singly housed and fed a diet containing 45% kcal from fat. Regularly active mice had access to voluntary running wheels throughout the study period, whereas intermittently active mice had access to running wheels for 3-wk intervals (i.e., 3 wk on/3 wk off) throughout the study. At death, regular and intermittent physical activity was associated with similar reductions in visceral AT mass (approximately -24%, P < 0.05) relative to sedentary. However, regularly, but not intermittently, active mice exhibited decreased expression of visceral AT genes related to inflammation (e.g., monocyte chemoattractant protein 1), immune cell infiltration (e.g., CD68, CD11c, F4/80, CD11b/CD18), oxidative stress (e.g., p47 phagocyte oxidase), and endoplasmic reticulum stress (e.g., CCAAT enhancer-binding protein homologous protein; all P < 0.05). Furthermore, regular, but not intermittent, physical activity was associated with a trend toward improvement in glucose tolerance (P = 0.059). Collectively, these findings suggest that intermittent physical activity over a prolonged period of time may lead to a reduction in adiposity but with retention of a sedentary obese white AT and metabolic phenotype.
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Affiliation(s)
- Katherine S Wainright
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - Nicholas J Fleming
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - Joe L Rowles
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - Rebecca J Welly
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - Terese M Zidon
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - Young-Min Park
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - T'Keaya L Gaines
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - Rebecca J Scroggins
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | | | - Alyssa H Hasty
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee
| | | | - Jaume Padilla
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; and Department of Child Health, University of Missouri, Columbia, Missouri
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Castro AVB, Kolka CM, Kim SP, Bergman RN. Obesity, insulin resistance and comorbidities? Mechanisms of association. ACTA ACUST UNITED AC 2015; 58:600-9. [PMID: 25211442 DOI: 10.1590/0004-2730000003223] [Citation(s) in RCA: 134] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 03/30/2014] [Indexed: 12/25/2022]
Abstract
Overall excess of fat, usually defined by the body mass index, is associated with metabolic (e.g. glucose intolerance, type 2 diabetes mellitus (T2DM), dyslipidemia) and non-metabolic disorders (e.g. neoplasias, polycystic ovary syndrome, non-alcoholic fat liver disease, glomerulopathy, bone fragility etc.). However, more than its total amount, the distribution of adipose tissue throughout the body is a better predictor of the risk to the development of those disorders. Fat accumulation in the abdominal area and in non-adipose tissue (ectopic fat), for example, is associated with increased risk to develop metabolic and non-metabolic derangements. On the other hand, observations suggest that individuals who present peripheral adiposity, characterized by large hip and thigh circumferences, have better glucose tolerance, reduced incidence of T2DM and of metabolic syndrome. Insulin resistance (IR) is one of the main culprits in the association between obesity, particularly visceral, and metabolic as well as non-metabolic diseases. In this review we will highlight the current pathophysiological and molecular mechanisms possibly involved in the link between increased VAT, ectopic fat, IR and comorbidities. We will also provide some insights in the identification of these abnormalities.
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Affiliation(s)
- Ana Valeria B Castro
- Divisão de Endocrinologia e Metabolismo, Departamento de Clínica Médica, FMRP-USP, Ribeirão Preto, SP, Brazil
| | - Cathryn M Kolka
- Diabetes and Obesity Research Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Stella P Kim
- Diabetes and Obesity Research Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Richard N Bergman
- Diabetes and Obesity Research Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
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Gómez-Ambrosi J, Catalán V, Rodríguez A, Andrada P, Ramírez B, Ibáñez P, Vila N, Romero S, Margall MA, Gil MJ, Moncada R, Valentí V, Silva C, Salvador J, Frühbeck G. Increased cardiometabolic risk factors and inflammation in adipose tissue in obese subjects classified as metabolically healthy. Diabetes Care 2014; 37:2813-21. [PMID: 25011950 DOI: 10.2337/dc14-0937] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE It has been suggested that individuals with the condition known as metabolically healthy obesity (MHO) may not have the same increased risk for the development of metabolic abnormalities as their non-metabolically healthy counterparts. However, the validity of this concept has recently been challenged, since it may not translate into lower morbidity and mortality. The aim of the current study was to compare the cardiometabolic/inflammatory profile and the prevalence of impaired glucose tolerance (IGT) and type 2 diabetes (T2D) in patients categorized as having MHO or metabolically abnormal obesity (MAO). RESEARCH DESIGN AND METHODS We performed a cross-sectional analysis to compare the cardiometabolic/inflammatory profile of 222 MHO and 222 MAO patients (62% women) matched by age, including 255 lean subjects as reference (cohort 1). In a second cohort, we analyzed the adipokine profile and the expression of genes involved in inflammation and extracellular matrix remodeling in visceral adipose tissue (VAT; n = 82) and liver (n = 55). RESULTS The cardiometabolic and inflammatory profiles (CRP, fibrinogen, uric acid, leukocyte count, and hepatic enzymes) were similarly increased in MHO and MAO in both cohorts. Moreover, above 30%of patients classified as MHO according to fasting plasma glucose exhibited IGT or T2D [corrected]. The profile of classic (leptin, adiponectin, resistin) as well as novel (serum amyloid A and matrix metallopeptidase 9) adipokines was almost identical in MHO and MAO groups in cohort 2. Expression of genes involved in inflammation and tissue remodeling in VAT and liver showed a similar alteration pattern in MHO and MAO individuals. CONCLUSIONS The current study provides evidence for the existence of a comparable adverse cardiometabolic profile in MHO and MAO patients; thus the MHO concept should be applied with caution. A better identification of the obesity phenotypes and a more precise diagnosis are needed for improving the management of obese individuals.
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Affiliation(s)
- Javier Gómez-Ambrosi
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, Spain
| | - Victoria Catalán
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, Spain
| | - Amaia Rodríguez
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, Spain
| | - Patricia Andrada
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Beatriz Ramírez
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, Spain
| | - Patricia Ibáñez
- Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, Spain Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Neus Vila
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Sonia Romero
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - María A Margall
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - María J Gil
- Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, Spain Department of Biochemistry, Clínica Universidad de Navarra, Pamplona, Spain
| | - Rafael Moncada
- Department of Anesthesiology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Víctor Valentí
- Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, Spain Department of Surgery, Clínica Universidad de Navarra, Pamplona, Spain
| | - Camilo Silva
- Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, Spain Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Javier Salvador
- Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, Spain Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Gema Frühbeck
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, Spain Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
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