Intra-abdominal obesity and metabolic risk factors: a study of young adults

OBJECTIVE

To assess the relative importance of the extent and regional distribution of fat for metabolic risk factors in young adults.

DESIGN

Cross-sectional study of findings from a hospital-based case-control study.

SUBJECTS

A total of 46 adult Danish Caucasian patients (40 men and six women, aged 34-54 y). Of these, 22 had had non fatal acute myocardial infarction before 41 y of age and 24 were age- and gender-matched controls without coronary heart disease.

MEASUREMENTS

Four measurements of fat: body mass index (BMI, kg/m(2)), body fat percentage measured using a dual energy X-ray absorptiometry (DEXA) scanner, waist/hip circumference ratio (WHR), and intra-abdominal adipose tissue area measured using computed tomography (CT) scanning, and eight metabolic risk factors: systolic and diastolic blood pressure, HbA(1c) percentage, fasting concentrations of capillary whole blood glucose, high-density lipoprotein (HDL) cholesterol, serum triglyceride, plasma plasminogen activator inhibitor 1 (PAI-1), and urinary albumin:creatinine excretion ratio.

RESULTS

Of 46 participants, 10 were obese (BMI >30 kg/m(2)), 12 were abdominally obese (WHR >0.90 for men and >0.85 for women), and 20 were intra-abdominally obese (intra-abdominal adipose tissue area >135 cm(2)). Men had a higher intra-abdominal adipose tissue area than women (P=0.0053, Mann-Whitney U-test). In multiple regression analyses of the four fat variables, only intra-abdominal adipose tissue area significantly predicted the levels of six metabolic risk factors: systolic blood pressure, diastolic blood pressure, fasting concentrations of capillary whole blood glucose, serum HDL cholesterol, serum triglyceride, and PAI-1. The intra-abdominal adipose tissue area had a linear relation with the six metabolic risk factors.

CONCLUSIONS

For young individuals, intra-abdominal fat is the important component of the body fat for six of the eight metabolic risk factors. Intra-abdominal fat might contribute to that most patients with acute myocardial infarction at a young age are men.

[Traumatic pseudoaneurysm of the peroneal artery]

Traumatic arterial pseudo-aneurysm is a rare phenomenon. We describe a case of pseudoaneurysm of the peroneal artery as a late complication to an open crural fracture. Persistent or occurrence of swelling, pain, paraesthesias or sensory deficit at the fracture site should be considered symptoms of a developing arterial pseudo-aneurysm. The presence of a distal pulse and negative results of ultrasound examination in the Doppler modality does not rule out arterial pseudo-aneurysm, therefore arteriography is often indicated. Treatment of traumatic arterial pseudo-aneurysms is surgical, as they often tend to progress.

[Negative bone scintigraphy in a child with acute osteomyelitis]

Diagnosis of acute osteomyelitis in childhood is conventionally established by a combination of clinical symptoms and results of inflammation parameters in blood and blood culture, plain radiography, bone scintigraphy and ultrasound. High sensitivity of bone scintigraphy enables it to be positive in the majority of cases, especially when clinical symptoms and blood tests are inconclusive. We present a case of a nine month old girl with an established diagnosis of vertebral osteomyelitis. Her two bone scintigraphies were negative despite obvious destruction of vertebra L5 and S1, documented by plain radiography and magnetic resonance imaging (MRI). MRI should be used when conventional examinations are inconclusive.