Relationships between abdominal body fat distribution and cardiovascular risk factors: an explanation for women's healthier cardiovascular risk profile. The D.E.S.I.R. Study

Adolescent determinants of cardiovascular risk factors in adult men and women

Aims: To investigate how physical activity, physical performance and sociodemographic characteristics at the age of 16 are related to adult health habits (physical activity, dietary intake, smoking) and biological risk factors for cardiovascular diseases (being overweight, low aerobic fitness, unfavorable levels of serum lipids, high blood pressure). Methods: A randomly selected group of 220 male and 205 female students at 16 years of age was tested in 1974, and reinvestigated 18 years later. Results: The predictive health profiles for adult lifestyle and biological risk factors were different in men and women. Leisure sports activity along with high performance in the nine-minute run among the boys and in the two-hand lift test among the girls were significant predictors of adult physical activity. A positive attitude to aerobic exercise and high performance in the nine-minute run test among the boys and high marks in physical education among the girls decreased the risk of smoking. Leisure sports activities together with body mass index at young ages were the most powerful predictors of adult biological risk factors, but attitudes to sports and educational level were also significant determinants. Conclusion: These results contribute to the knowledge of which factors at young ages may promote adult healthy habits in particular physical activities.

Body fat accumulation in zebrafish is induced by a diet rich in fat and reduced by supplementation with green tea extract

Fat-rich diets not only induce obesity in humans but also make animals obese. Therefore, animals that accumulate body fat in response to a high-fat diet (especially rodents) are commonly used in obesity research. The effect of dietary fat on body fat accumulation is not fully understood in zebrafish, an excellent model of vertebrate lipid metabolism. Here, we explored the effects of dietary fat and green tea extract, which has anti-obesity properties, on body fat accumulation in zebrafish. Adult zebrafish were allocated to four diet groups and over 6 weeks were fed a high-fat diet containing basal diet plus two types of fat or a low-fat diet containing basal diet plus carbohydrate or protein. Another group of adult zebrafish was fed a high-fat diet with or without 5% green tea extract supplementation. Zebrafish fed the high-fat diets had nearly twice the body fat (visceral, subcutaneous, and total fat) volume and body fat volume ratio (body fat volume/body weight) of those fed low-fat diets. There were no differences in body fat accumulation between the two high-fat groups, nor were there any differences between the two low-fat groups. Adding green tea extract to the high-fat diet significantly suppressed body weight, body fat volume, and body fat volume ratio compared with the same diet lacking green tea extract. 3-Hydroxyacyl-coenzyme A dehydrogenase and citrate synthase activity in the liver and skeletal muscle were significantly higher in fish fed the diet supplemented with green tea extract than in those fed the unsupplemented diet. Our results suggest that a diet rich in fat, instead of protein or carbohydrate, induced body fat accumulation in zebrafish with mechanisms that might be similar to those in mammals. Consequently, zebrafish might serve as a good animal model for research into obesity induced by high-fat diets.

Dietary intake relative to cardiovascular disease risk factors in individuals with chronic spinal cord injury: a pilot study

BACKGROUND

The relationship between cardiovascular disease (CVD) risk factors and dietary intake is unknown among individuals with spinal cord injury (SCI).

OBJECTIVE

To investigate the relationship between consumption of selected food groups (dairy, whole grains, fruits, vegetables, and meat) and CVD risk factors in individuals with chronic SCI.

METHODS

A cross-sectional substudy of individuals with SCI to assess CVD risk factors and dietary intake in comparison with age-, gender-, and race-matched able-bodied individuals enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Dietary history, blood pressure, waist circumference (WC), fasting blood glucose, high-sensitivity C-reactive protein (hs-CRP), lipids, glucose, and insulin data were collected from 100 SCI participants who were 38 to 55 years old with SCI >1 year and compared to 100 matched control participants from the CARDIA study.

RESULTS

Statistically significant differences between SCI and CARDIA participants were identified in WC (39.2 vs 36.2 in.; P < .001) and high-density lipoprotein cholesterol (HDL-C; 39.2 vs 47.5 mg/dL; P < .001). Blood pressure, total cholesterol, triglycerides, glucose, insulin, and hs-CRP were similar between SCI and CARDIA participants. No significant relation between CVD risk factors and selected food groups was seen in the SCI participants.

CONCLUSION

SCI participants had adverse WC and HDL-C compared to controls. This study did not identify a relationship between consumption of selected food groups and CVD risk factors.

Abdominal superficial subcutaneous fat: a putative distinct protective fat subdepot in type 2 diabetes

OBJECTIVE

Unlike visceral adipose tissue (VAT), the association between subcutaneous adipose tissue (SAT) and obesity-related morbidity is controversial. In patients with type 2 diabetes, we assessed whether this variability can be explained by a putative favorable, distinct association between abdominal superficial SAT (SSAT) (absolute amount or its proportion) and cardiometabolic parameters.

RESEARCH DESIGN AND METHODS

We performed abdominal magnetic resonance imaging (MRI) in 73 patients with diabetes (mean age 58 years, 83% were men) and cross-sectionally analyzed fat distribution at S1-L5, L5-L4, and L3-L2 levels. Patients completed food frequency questionnaires, and subgroups had 24-h ambulatory blood pressure monitoring and 24-h ambulatory electrocardiography.

RESULTS

Women had higher %SSAT (37 vs. 23% in men; P < 0.001) despite a similar mean waist circumference. Fasting plasma glucose (P = 0.046) and HbA(1c) (P = 0.006) were both lower with increased tertile of absolute SSAT. In regression models adjusted for age, waist circumference, and classes of medical treatments used in this patient population, increased %SSAT was significantly associated with decreased HbA(1c) (β = -0.317; P = 0.013), decreased daytime ambulatory blood pressure (β = -0.426; P = 0.008), and increased HDL cholesterol (β = 0.257; P = 0.042). In contrast, increased percent of deep SAT (DSAT) was associated with increased HbA(1c) (β = 0.266; P = 0.040) and poorer heart rate variability parameters (P = 0.030). Although total fat and energy intake were not correlated with fat tissue distribution, increased intake of trans fat tended to be associated with total SAT (r = 0.228; P = 0.05) and DSAT (r = 0.20; P = 0.093), but not with SSAT.

CONCLUSIONS

Abdominal SAT is composed of two subdepots that associate differently with cardiometabolic parameters. Higher absolute and relative distribution of fat in abdominal SSAT may signify beneficial cardiometabolic effects in patients with type 2 diabetes.

Associations of cholesterol and glucose with cardiovascular dysfunction in black Africans: the SABPA study

The aim was to determine whether blood glucose or cholesterol is the more prominent contributor to cardiovascular dysfunction in 101 African men and 99 African women. We measured ambulatory daytime blood pressure (BP), carotid intima-media thickness (CIMT), and determined blood glucose and lipids in serum. High-density lipoprotein cholesterol (HDL) (p = 0.002) and HDL: total cholesterol (HDL:TC) (p ≤ 0.001) were significantly lower, while serum glucose (p ≤ 0.001) was significantly higher in men. In single, partial, and multiple regression analysis, BP correlated positively with blood glucose in men. Furthermore, CIMT (B = -0.50; p = 0.009) correlated negatively with HDL:TC in men. While in women CIMT (B = 0.346; p = 0.015) correlated positively with glucose. In conclusion, subclinical atherosclerosis is significantly related to an unfavorable HDL profile in men, whereas in women, this link is stronger with fasting glucose.

Racial and ethnic patterns of allostatic load among adult women in the United States: findings from the National Health and Nutrition Examination Survey 1999-2004

OBJECTIVE

This study provides a descriptive sociodemographic profile of allostatic load (AL) among adult women of all age groups, focusing on how age patterns of AL vary across racial/ethnic groups. Allostatic load, an index of cumulative physiological dysregulation, captures how the cumulative impact of physiological stress responses from person-environment interactions causes wear and tear on the body's regulatory systems, which in turn can lead to disease outcomes and health disparities.

METHODS

Using data from the National Health and Nutrition Examination Survey (NHANES) 1999-2004, this study examines AL in a nationally representative sample of women ≥18 years of age (n=5765). Measures of AL using 10 biomarkers representing cardiovascular, inflammatory, and metabolic system functioning were created. Multivariate negative binomial regression models were used, and predicted AL scores were computed.

RESULTS

Black women had the highest predicted AL scores relative to other racial/ethnic groups, and a marked black/white gap in AL persisted across all age groups. Age by race/ethnicity interaction terms revealed significant racial/ethnic differences in AL patterns across age groups. Black women 40-49 years old had AL scores 1.14 times higher than white women 50-59 years old, suggesting earlier health deterioration. Mexican women not born in the United States had lower predicted AL scores than those born in the United States.

CONCLUSIONS

This study provides one of the first descriptive profiles of AL among a nationally representative sample of adult women in the United States and presents racial/ethnic trends in AL across age groups that are useful for identifying demographically and clinically important subgroups at risk of having high cumulative physiological dysregulation.

Risk factors for incident type 2 diabetes in individuals with a BMI of <27 kg/m2: the role of gamma-glutamyltransferase. Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR)

AIMS/HYPOTHESIS

Risk factors for incident type 2 diabetes, in particular, hepatic markers, have rarely been studied in leaner individuals. We aimed to identify the metabolic and hepatic markers associated with incident diabetes in men and women with a BMI of <27 kg/m(2) and to compare them with those in individuals with a BMI of >or=27 kg/m(2).

METHODS

Risk factors for 9 year incident diabetes were compared in the French Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR) cohort. Comparisons were made between the 2,947 participants with a BMI of <27 kg/m(2) and the 879 with a BMI of >or=27 kg/m(2).

RESULTS

There were 92 incident cases of diabetes in individuals with a BMI of <27 kg/m(2) and 111 in those with a BMI of >or=27 kg/m(2). Among those who were not markedly overweight, classical biological markers were associated with 9 year incident diabetes, glycaemia being the strongest predictor. gamma-Glutamyltransferase (GGT), either considered as a continuous variable or at levels >or=20 U/l, was associated with incident diabetes, with a stronger effect in the BMI <27 kg/m(2) group: OR 1.59 (95% CI 1.29-1.97, p < 0.001) in comparison with OR 1.07 (95% CI 0.82-1.38, p = 0.63) for those with a BMI of >or=27 kg/m(2) (results after adjustment for alcohol intake, alanine aminotransferase, waist circumference and the HOMA insulin resistance index).

CONCLUSIONS/INTERPRETATION

In individuals with a BMI of <27 kg/m(2), GGT was the strongest predictor of diabetes after fasting hyperglycaemia. This association with incident diabetes remained after adjustment for conventional markers of insulin resistance, suggesting potential interactions between GGT, enhanced hepatic neoglucogenesis and/or early alterations of insulin secretion.

Cardiovascular risk factor levels and their relationships with overweight and fat distribution in children: the Fleurbaix Laventie Ville Santé II study

This study aimed to document for the first time in a general population of French children the prevalence and levels of cardiovascular risk factors and to assess separately in boys and girls whether these risk factors were associated with fat mass distribution independently of subcutaneous overall adiposity. A cross-sectional analysis of baseline data from 452 children (235 boys and 217 girls) aged 8 to 17 years included in a 1999 population-based epidemiologic study (the Fleurbaix Laventie Ville Santé II study) was made. Overweight was defined according to the International Obesity Task Force references and the 90th percentiles of the French body mass index curves. The thresholds of parameters defining cardiovascular and metabolic risks were the 95th percentile of the Task Force Report on High Blood Pressure in Children and Adolescents for blood pressure and those of the American Academy of Pediatrics for lipids. Anthropometric and biological parameters were described by sex and according to overweight status. Partial correlations between cardiovascular risk factors and anthropometric measures of adiposity (body mass index, sum of 4 skinfold thicknesses, waist circumference, waist-to-height ratio) were calculated. Then, these correlations were additionally adjusted for the sum of 4 skinfold thicknesses. High plasma triglycerides, high insulin concentration, and low plasma high-density lipoprotein cholesterol (HDL-C) concentration were associated with all measures of adiposity (|r| > or = 0.20, P < .002). When obese children were excluded, overweight children already had high triglycerides and low HDL-C levels, respectively, 2 and 20 times more frequently than normal-weight children did. Among overweight children, 7.7% had at least 2 risk factors among high blood pressure, high plasma triglycerides or glucose, and low HDL-C concentration vs 0.25% among normal-weight children (P = .002). After adjusting for the sum of skinfolds, an independent association between the risk factors and waist circumference was found in girls. In conclusion, (a) modest excess weight is associated with increased levels of cardiovascular risk factors. (b) In girls, abdominal fat distribution is associated with cardiovascular risk factors, independently of overall adiposity. (c) International definition of abdominal obesity in children is required to standardize studies and to progress in the evaluation of childhood obesity and its consequences.

ABCA1 single nucleotide polymorphisms on high-density lipoprotein-cholesterol and overweight: the D.E.S.I.R. study

The adenosine triphosphate-binding cassette A1 (ABCA1) gene plays a key role in reverse cholesterol transport. Some ABCA1 gene polymorphisms have been associated with high-density lipoprotein-cholesterol (HDL-C) concentrations. The aim of this study was to assess the effect of three polymorphisms, C69T, G378C, and G1051A (R219K), on HDL-C levels and their interaction with BMI in more than 5000 French whites from the D.E.S.I.R. (Data from an Epidemiological Study on the Insulin Resistance syndrome) cohort study. The T allele of the C69T single nucleotide polymorphism (SNP) was associated with higher HDL-C levels in normal-weight men (BMI <25 kg/m(2)). The C allele of the G378C SNP was associated with lower HDL-C in overweight subjects (BMI > or =25 kg/m(2)). For the G1051A SNP, in the normal-weight group, the minor A allele was significantly associated with higher HDL-C levels. In contrast, in overweight people, the minor allele was associated with lower HDL-C levels. After accounting for multiple testing, empiric p values remained significant for the associations between G378C SNP and HDL-C in the overweight group and between G1051A SNP and HDL-C in the normal-weight group. This study suggests that ABCA1 gene polymorphisms modulate HDL-C concentrations, in interaction with BMI, and, thus, they might influence cardiovascular risk in the general population.

Waist circumference and the metabolic syndrome predict the development of elevated albuminuria in non-diabetic subjects: the DESIR Study

OBJECTIVE

Metabolic determinants of microalbuminuria remain poorly understood in non-diabetic individuals and particularly in women. We investigated in both sexes whether an elevated waist circumference (WC) or the presence of the metabolic syndrome (MetS) predict the development of elevated albuminuria at 6 years.

DESIGN AND PATIENTS

We studied 2738 subjects from the DESIR cohort without microalbuminuria or diabetes at baseline and who were followed up for 6 years.

RESULTS

At 6 years, 254 individuals [9.3%; 95% confidence interval (CI) 8.2-10.4%] had developed elevated albuminuria (> or = 20 mg/l), which was significantly and positively associated with WC and blood pressure, but not with fasting glucose, lipids or body mass index in either sex. In both sexes, subjects with a high WC or with MetS at baseline were more likely to develop elevated albuminuria at 6 years compared with those with a normal WC or absence of MetS. In multivariate logistic analysis, WC as a continuous variable or a WC of 94 cm or greater for men and a WC greater than 88 cm for women were predictive of the development of elevated albuminuria, after adjusting for age, hypertension, the use of angiotensin-converting enzyme inhibitors, fibrinogen and glycaemia. MetS was a risk factor for elevated albuminuria in men (odds ratio 1.87; 95% CI 1.25-2.81), with differences according to the MetS definition.

CONCLUSION

Abdominal adiposity is related to the development of elevated albuminuria in both sexes, suggesting that the measurement of WC may improve the identification of non-diabetic individuals at risk of developing microalbuminuria and emphasizing the interest of screening for albuminuria among those with MetS.

Prescreening tools for diabetes and obesity-associated dyslipidaemia: comparing BMI, waist and waist hip ratio. The D.E.S.I.R. Study

OBJECTIVE

To compare the sensitivities of BMI, waist circumference and waist hip ratio (WHR) in identifying subjects who should be screened for diabetes and/or for obesity-associated dyslipidaemia.

DESIGN

Cross-sectional study.

SETTING

Central-western France.

PARTICIPANTS

More than 3000 men and women, aged 40-64 years, from the French study: data from an epidemiological study on the insulin resistance syndrome (D.E.S.I.R.).

MAIN OUTCOME MEASURES

Sensitivity and specificity for screened diabetes (fasting plasma glucose>or=7.0 mmol/l) and screened dyslipidaemia (triglycerides>or=2.3 mmol/l and/or HDL-cholesterol <0.9/1.1 mmol/l (men/women)) according to BMI, waist circumference and WHR.

RESULTS

Sensitivities increased as more corpulent subjects were screened, but they increased slowly after screening the top 30%: body mass index (BMI)>or=27/26 kg/m(2) (men/women) or waist >or=96/83 cm or WHR>or=0.96/0.83. These values were chosen as thresholds. In men, BMI had a nonsignificantly higher sensitivity than waist or WHR for both diabetes and dyslipidaemia (77 vs 74 and 66% P<0.3, 0.09; 56 vs 54 and 49% P<0.5, 0.16). For women, waist had a slightly higher sensitivity than BMI or WHR (82 vs 77 and 77% P<0.8, 0.7) for diabetes; for dyslipidaemia, waist and WHR had similar sensitivities, higher than for BMI (65 and 67 vs 54% P<0.16, 0.13).

CONCLUSIONS

We propose that for screening in a French population 40-64 years of age, the more obese 30% of the population, identified either by BMI, waist or WHR be screened for diabetes and obesity-associated dyslipidaemia.

Growth curves of anthropometric indices in a general population of French children and comparison with reference data

BACKGROUND

The description of growth patterns of the different anthropometric measurements mainly used in epidemiological studies is useful to better understand the development of obesity in children and its consequences.

OBJECTIVE

Our aim was to establish growth curves of anthropometric indices in a general population of French children born during the 1980s and to compare them with the French reference curves based on children born in the 1950s.

DESIGN

As part of the Fleurbaix Laventie Ville Santé Studies I and II (FLVS), 441 girls and 467 boys were examined at least twice between 1993 and 2001. Height, weight and four skinfold thicknesses were measured. Body mass index (BMI), sum of peripheral and truncal skinfolds and truncal-to-peripheral ratio were calculated. Mean growth curves from ages 5 to 17 years were assessed for these indices, calculating means and 95% confidence interval per 1 year age group and by gender.

RESULTS

Trajectories with age differed importantly according to the index considered; BMI was the one with the smallest difference between genders and the most linear shape with age. From the age of 5 years and after, the FLVS children were on average taller and had a higher subcutaneous adiposity than children born 30 years earlier. Truncal-to-peripheral ratio was higher in our population; this difference became more marked with puberty in girls.

DISCUSSION

This study suggests the existence of a secular trend towards a precocious accelerated growth, and a more truncal adiposity distribution, especially in girls. It is a disquieting trend considering its expected consequences on adult health.

The preferred magnetic resonance imaging planes in quantifying visceral adipose tissue and evaluating cardiovascular risk

BACKGROUND

Magnetic Resonance Imaging (MRI) is a well-accepted non-invasive method in the quantification of visceral adipose tissue. However, a standard method of measurement has not yet been universally agreed.

OBJECTIVES

The objectives of the present study were 2-fold, firstly, to identify the imaging plane in the Chinese population which gives the best correlation with total visceral adipose tissue volume and cardiovascular risk factors; and secondly to compare the correlations between single-slice and multiple-slice approach with cardiovascular risk factors.

METHODS

Thirty-seven Chinese subjects with no known medical history underwent MRI examination for quantifying total visceral adipose tissue volume. The visceral adipose tissue area at five axial imaging levels within abdomen and pelvis were determined. All subjects had blood pressure measured and fasting blood taken for analysis of cardiovascular risk factors. Framingham risk score for each subject was calculated.

RESULTS

The imaging plane at the level of 'lower costal margin' (LCM) in both men and women had the highest correlation with total visceral adipose tissue volume (r = 0.97 and 0.99 respectively). The visceral adipose tissue area at specific imaging levels showed higher correlations with various cardiovascular risk factors and Framingham risk score than total visceral adipose tissue volume. The visceral adipose tissue area at 'umbilicus' (UMB) level in men (r = 0.88) and LCM level in women (r = 0.70) showed the best correlation with Framingham risk score.

CONCLUSIONS

The imaging plane at the level of LCM is preferred for reflecting total visceral adipose tissue volume in Chinese subjects. For investigating the association of cardiovascular risk with visceral adipose tissue in MRI-obesity research, the single-slice approach is superior to the multiple-slice approach, with the level of UMB in men and LCM in women as the preferred imaging planes.

Effects of raloxifene on body fat distribution and lipid profile in healthy post-menopausal women

The aim of our prospective, randomised, controlled and open-label clinical study was to evaluate in healthy post-menopausal women the effects of raloxifene (RLX) on body fat distribution and lipids, and the correlations between these parameters. The fat distribution, by dual energy X-ray absorptiometry, and lipids were evaluated at baseline and after 1 yr in 50 post-menopausal women: 25 were treated with RLX 60 mg/die, while 25 served as control group (CG). After 1 yr, we observed in RLX-users a slight reduction of fat mass in trunk and central region and an increase in legs and, in relation to CG, significantly lower values of adiposity in trunk and abdominal region (p < 0.05). At the same time, HDL-cholesterol (HDL-C) and apolipoprotein A1 (ApoA1) were significantly increased in relation to baseline values and CG (p < 0.05) and apolipoprotein B (ApoB), total cholesterol/HDL-C, LDL cholesterol/ HDL-C, and ApoB/ApoA1 ratios significantly decreased compared to baseline values and CG (p < 0.05). No correlation was underlined among lipids and regional fat distribution. These results highlight the positive effect of RLX on lipids and suggest, for the first time, that RLX promotes the shift from android to gynoid fat distribution, and prevents the uptrend of abdominal adiposity and body weight compared with untreated women.

Abdominal fat and hip fracture risk in the elderly: the Dubbo Osteoporosis Epidemiology Study

Background

Fat mass, which is a major component of body weight, is directly related to bone mineral density and reduced fracture risk. It is not known whether abdominal fat is associated with hip fracture. The present study was designed to examine the association between abdominal fat and hip fracture in women and men aged 60+ years.

Methods

This was a nested case-control study with one fracture case being matched with two controls of the same age. In women 63 cases were matched with 126 controls, and in men 26 cases were matched with 52 controls. Hip fracture was confirmed by X-ray and personal interview. Other measurements included weight, height, body mass index (BMI), abdominal fat, and femoral neck bone density (FNBMD). Conditional logistic regression model was used to analyse data.

Results

The odds ratio of hip fracture risk associated with each 10% lower abdominal fat was 1.5 (95% CI, 1.1 to 2.1) in women and 1.2 (95% CI, 0.7 to 2.0) in men. However after adjusting for FNBMD or body weight, the abdominal fat-fracture association was no longer statistically significant. Similarly, body weight and BMI was each significantly associated with hip fracture risk (in women), but after taking with account the effect of FNBMD, the association become statistically non-significant.

Conclusion

Lower abdominal fat was associated with an increased risk of hip fracture in elderly women, but the association was not independent of FNBMD or weight. The contribution of abdominal fat to hip fracture risk is likely to be modest.

Sex differentials in biological risk factors for chronic disease: estimates from population-based surveys

BACKGROUND

In light of substantial sex differences in health outcomes, researchers need to focus on disentangling the underlying biological and social determinants. The objective of this study is to determine whether two populations that differ in many cultural and social dimensions--Taiwan and the United States--also vary with regard to sex differentials in biological markers of chronic disease.

METHODS

The analysis is based on three population-based surveys that include interviews, urine and blood specimens, and physical examinations: the Social Environment and Biomarkers of Aging Study (SEBAS) in Taiwan, the Wisconsin Longitudinal Survey (WLS), and the MacArthur studies of successful aging. The outcomes comprise six indicators of cardiovascular risk (total/high-density lipoprotein [HDL] cholesterol, HDL cholesterol, systolic and diastolic blood pressure, glycosylated hemoglobin, and waist/hip ratio) and four markers of sympathetic nervous system (SNS) and hypothalamic-pituitary-adrenal (HPA) axis functioning (epinephrine, norepinephrine, cortisol, and dehydroepiandrosterone sulfate [DHEA-S]).

RESULTS

U.S. males have significantly higher risk than females for all indicators of cardiovascular risk except glycosylated hemoglobin (p < 0.05). Sex differences are less consistent and smaller in Taiwan. Indicators of SNS and HPA axis functioning reveal a significant female disadvantage in both countries.

CONCLUSIONS

The analysis identifies important sex differences between Taiwan and the United States in biomarkers of cardiovascular risk that are consistent with cause of death data and may emanate from cultural and social differences between the two societies. The similarity of sex differences in SNS and HPA axis functioning across studies may reflect either stable sex differences in biological aging of these axes or commonalities in the social construction of gender-based responses to life experiences.

Body fat distribution of overweight females with a history of weight cycling

Weight cycling may cause a redistribution of body fat to the upper body fat compartments. We investigated the distribution of subcutaneous adipose tissue (SAT) in 30 overweight women with a history of weight-cycling and age-matched controls (167 normal weight and 97 overweight subjects). Measurements of SAT were performed using an optical device, the Lipometer. The SAT topography describes the thicknesses of SAT layers at 15 anatomically well-defined body sites from neck to calf. The overweight women with a history of weight cycling had significantly thicker SAT layers on the upper body compared to the overweight controls, but even thinner SAT layers on their legs than the normal weight women. An android fat pattern was attributed to overweight females and, even more pronounced, to the weight cyclers. The majority of normal weight women showed a gynoid fat pattern. Using stepwise discriminant analysis, 89.0% of all weight cyclers and overweight controls could be classified correctly into the two groups. These findings show the importance of normal weight maintenance as a health-promoting factor.

Adiponectin gene polymorphisms and adiponectin levels are independently associated with the development of hyperglycemia during a 3-year period: the epidemiologic data on the insulin resistance syndrome prospective study

The plasma concentration of the adipocyte-derived peptide adiponectin is decreased in patients with obesity and type 2 diabetes. The adiponectin gene is located on chromosome 3q27, where a diabetes susceptibility locus has been mapped. Adiponectin gene polymorphisms (single nucleotide polymorphisms [SNPs]) have been associated with BMI, insulin sensitivity, and type 2 diabetes in some cross-sectional studies. Our aim was to assess the contribution of these SNPs in the development of features of the insulin resistance syndrome in a 3-year prospective study in approximately 4,500 French Caucasian subjects from the Epidemiologic Data on the Insulin Resistance Syndrome (DESIR) cohort. For subjects who were normoglycemic at baseline, the 3-year risk of becoming hyperglycemic (diabetes or impaired fasting glucose) was affected by two SNPs: G-11391A and T45G. For G-11391A, the risk was increased in GA carriers (odds ratio [OR] adjusted for sex [versus GG] = 1.60 [95% CI 1.16-2.20]; P = 0.004). For T45G, it was increased in GG carriers (OR [versus TT] = 2.71 [1.31-5.60]; P = 0.007). After 3 years, GG subjects had a greater increase in BMI (P = 0.009) and waist-to-hip ratio (P = 0.007). Adiponectin levels at baseline were associated with the development of hyperglycemia (P = 0.005), but the predictive effects on the risk for hyperglycemia were independent of adiponectin genotypes. In conclusion, in the DESIR study, variations at the adiponectin locus affect body weight gain, body fat distribution, and onset of hyperglycemia, as well as adiponectin levels. Adiponectin gene SNPs may have several phenotypic effects that co-occur with the development of the metabolic syndrome.

Sonographic measurement of mesenteric fat thickness is a good correlate with cardiovascular risk factors: comparison with subcutaneous and preperitoneal fat thickness, magnetic resonance imaging and anthropometric indexes

OBJECTIVE

Visceral fat, notably mesenteric fat, which is drained by the portal circulation, plays a critical role in the pathogenesis of metabolic syndrome through increased production of free fatty acids, cytokines and vasoactive peptides. We hypothesize that mesenteric fat thickness as measured by ultrasound scan could explain most of the obesity-related health risk. We explored the relationships between cardiovascular risk factors and abdominal fat as determined by sonographic measurements of thickness of mesenteric, preperitoneal and subcutaneous fat deposits, total abdominal and visceral fat measurement by magnetic resonance imaging (MRI) and anthropometric indexes.

DESIGN

A cross-sectional study.

SUBJECTS

Subjects included 18 healthy men and 19 women (age: 27-61 y, BMI: 19-33.4 kg/m(2)).

MEASUREMENTS

The maximum thickness of mesenteric, preperitoneal and subcutaneous fat was measured by abdominal ultrasound examination. MRI examinations of whole abdomen and pelvis were performed and the amount of total abdominal and visceral fat was quantified. The body mass index, waist circumference and waist-hip ratio were recorded. Cardiovascular risk factors were assessed by physical examination and blood taking.

RESULTS

Men had more adverse cardiovascular risk profile, higher visceral fat volume and thicker mesenteric fat deposits than women. Among all the investigated obesity indexes, the mesenteric fat thickness showed the highest correlations with total cholesterol, LDL-C, triglycerides, fasting plasma glucose, HbA(1c) and systolic blood pressure in men, and with triglycerides and HbA(1c) in women. On stepwise multiple regression analysis with different obesity indexes as independent variables, 30-65% of the variances of triglycerides, total cholesterol, LDL-C and HbA(1c) in men, and triglycerides in women were explained by the mesenteric fat thickness.

CONCLUSION

Compared with sonographic measurement of subcutaneous and preperitoneal fat thickness, MRI measurement of total abdominal and visceral fat and anthropometric indexes, sonographic measurement of mesenteric fat thickness showed better associations with some of the cardiovascular risk factors. It may potentially be a useful tool to evaluate regional distribution of obesity in the assessment of cardiovascular risk.

The incidence and persistence of the NCEP (National Cholesterol Education Program) metabolic syndrome. The French D.E.S.I.R. study

CONTEXT

In 2001 the "National Cholesterol and Education Program Expert Panel" gave a clinical definition of the metabolic syndrome. The frequency of this syndrome at baseline and its incidence and persistence at three years is studied in a French population.

SUBJECTS

2109 men and 2184 women from the D.E.S.I.R. longitudinal cohort study (Data from an Epidemiological Study on the Insulin Resistance syndrome) in central-western France, aged 30 to 64 years, were examined at inclusion and three years later.

METHODS

Evaluation of the frequencies, incidences and persistence of the metabolic syndrome and its abnormalities. This syndrome is defined by the presence of three or more of five abnormalities: waist circumference > 102/88 cm (men/women); triglycerides > o r=1.69 mmol/l, HDL-cholesterol<1.04/1.29 mmol/l (men/women); systolic/diastolic blood pressure > or =130 and/or 85 mmHg; fasting plasma glucose > or =6.1 mmol/l.

RESULTS

At baseline, 10% of men and 7% of women had the metabolic syndrome. If the syndrome was defined to include a treatment in the abnormalities (for diabetes, hypertension, dyslipidemia), the syndrome frequencies increased to 16% and 11%. However only 12% and 8% respectively, had this syndrome both at inclusion and at three years. High blood pressure was the most frequent abnormality: 70% and 47% in men and women respectively, at inclusion. The most stable abnormality was high waist circumference (80% persisted), hyperglycaemia the least stable (60% persisted). Hyperinsulinaemia did not cluster closely with this syndrome.

CONCLUSIONS

The age-specific frequency of the syndrome is more than 2.5 times higher in the US than in this French cohort and this ratio increased with age. The higher frequencies of abdominal obesity and low HDL-cholesterol in women than in men suggest that these gender-specific thresholds may need to be refined.

Birth weight, adult body composition, and subcutaneous fat distribution

OBJECTIVES

To investigate if birth weight is related to both body mass index (BMI) and distribution of subcutaneous fat at adult age.

RESEARCH METHODS AND PROCEDURES

A 9-year longitudinal study was performed in 229 subjects (192 women) with ages ranging from 27 to 36 years. Birth weight was retrieved by a questionnaire, and adult weight, height, skinfold thicknesses, and waist-to-hip ratio (WHR) were repeatedly measured at mean ages 27, 29, 31, and 36 years. BMI, sum of four skinfolds (S4S), the ratio between two truncal skinfolds and S4S (SS/S4S), and the ratio between WHR and the cross-sectional area of the left thigh were calculated with the available data.

RESULTS

The adjusted model showed that in women, birth weight was significantly negatively related to adult S4S [beta = -5.211; (-9.768 to -0.654)], waist circumference [beta = -1.449; (-2.829 to -0.069)], and SS/S4S ratio [beta = -3.579; (-5.296 to -1.862)]. In men, a significant negative association was observed between birth weight and adult WHR [beta = -1.096; (-2.092 to -0.100)] only. Other relationships showed, although not significantly, the same negative trend, namely that lower birth weight is related to higher adult body fat mass (S4S) and a more truncal subcutaneous fat distribution (SS/S4S). No associations were found between birth weight and either adult BMI or the cross-sectional area of the thigh.

DISCUSSION

Lower birth weight is, in both adult men and women, related to a higher adult subcutaneous fat mass and a more truncal distribution of subcutaneous fat, indicating a higher risk for obesity.

Bone, muscle, and fat: sex-related differences in prepubertal children

PURPOSE

To determine whether there are sex-related differences in vertebral cross-sectional dimensions, in paraspinous muscle area, and in the amount of fat in the subcutaneous and visceral compartments of prepubertal boys and girls.

MATERIALS AND METHODS

Subcutaneous fat, visceral fat, paraspinous musculature, and vertebral cross-sectional dimensions were studied in 31 pairs of prepubertal healthy white girls and boys 5-10 years of age, rigorously matched for age, height, and weight. Data were analyzed with the Student t test and multiple regression analysis.

RESULTS

Sex had a differential effect on fat accumulation and musculoskeletal development. Compared with boys, girls had, on average, 28% greater total fat and 30% higher subcutaneous fat (P <.001 for both), but 10% less paraspinous musculature (P =.002) and 15% smaller vertebral cross-sectional dimensions (P <.001). In contrast, the sexes were monomorphic for visceral fat (P =.24). Stepwise regression analysis indicated that only 22% of the difference in vertebral cross-sectional area could be explained by sex-related differences in paraspinous musculature.

CONCLUSION

Together, these data indicate that sex is an important determinant of the morphology in humans well before the beginning of puberty.

Prevalence of CVD risk factors and impact of a two-year education program for premenopausal women

Indicators of cardiovascular disease risk in premenopausal women before, during, and after a 2-year educational intervention measured prevalence of risk and program effectiveness. Women (n = 277) were assigned to either treatment/education (n = 174) or control (n = 103) group. Many had at least one cardiovascular disease risk factor: high BMI (n = 123); high-fat diet (n = 160); and/or high body fat percent (n = 136). The treatment group was significant for change in calories from fat (P <.01). This study shows that premenopausal women have cardiovascular disease risks that should be addressed, and that nutrition education can successfully change dietary behavior.