Relationship of obesity and visceral adiposity with serum concentrations of CRP, TNF-α and IL-6

Numerous techniques are available to estimate body composition and fat distribution, and the method to use will depend on the aim of the study, economic resources, availability, time, and sample size. 6–8 Multi-compartment models, such as underwater weighing, dilution techniques and dual-energy X-ray absorptiometry (DXA) are all reliable methods to obtain accurate measures of total body fat. However, because of their costs in terms of time andmoney, thesemethods are not practical in large epidemiological studies and for routine clinical use. In these situations, body mass index (BMI) is often used and assumed to represent the degree of body fat. BMI, however, does not distinguish between fat mass and lean (non-fat) mass. For example, well-trained body builders have a very low percentage of body fat, but their BMI may be in the overweight range because of their large lean (muscle) mass. In addition, in the elderly and non-Caucasian populations, the relationship between BMI and body fatness may be different as compared with younger Caucasian populations. 9–14 Another potential limitation of the BMI is that the distribution of fat over the body is not captured. Many studies have shown that an abdominal fat distribution, independent of overall obesity, is associated with metabolic disturbances and increased disease risk. 15–23 An increased abdominal fat accumulation is largely caused by the accumulation of visceral (or intraabdominal) fat (for distinction of these fat depots, see Figure 1). Owing tometabolic differences between different fat depots, they differ in their role of predicting metabolic disturbances and diseases. Table 1 summarizes the capability of the most commonly used methods to assess total adiposity and fat distribution. Abdominal obesity is usually assessed by the easily measured waist circumference, the waist-to-hip circumference ratio (WHR), or the less-commonly used sagittal abdominal diameter (SAD). By the use of sophisticated imaging techniques, such as magnetic resonance imaging (MRI) and computed tomography (CT), different fat depots can be distinguished at the waist level, and it has been shown that in particular the visceral fat depot is associated with metabolic disease risk. 24–30 Because the SAD or waist circumference alone are more strongly correlated with visceral fat than the WHR, 31–35 guidelines tend to focus onwaist circumference to estimate disease risk as suggested by Lean et al. 36 These widely used cut-points (i.e. 102 cm formen and 88 cm for women) were originally based on a replacement of the classification of BMI, 36 but other cut-points have also been suggested on the basis of relationships with visceral fat area. 37

/pdf/what-aspects-of-body-fat-are-particularly-hazardous-and-how-qiphgw55re.pdf

What aspects of body fat are particularly hazardous and how do we measure them

Over the past two decades our view of adipose tissue has undergone a dramatic change from an inert energy storage tissue to an active endocrine organ. Adipose tissue communicates with other central and peripheral organs by synthesis and secretion of a host of molecules that we generally refer to as adipokines. The levels of some adipokines correlate with specific metabolic states and have the potential to impact directly upon the metabolic homeostasis of the system. A dysregulation of adipokines has been implicated in obesity, type 2 diabetes, hypertension, cardiovascular disease, and an ever-growing larger list of pathological changes in a number of organs. Here, we review the recent progress regarding the synthesis, secretion, and physiological function of adipokines with perspectives on future directions and potential therapeutic goals.

https://nyaspubs.onlinelibrary.wiley.com/doi/pdf/10.1111/j.1749-6632.2010.05875.x

Adipokines as novel biomarkers and regulators of the metabolic syndrome

Background— Body fat distribution has been cross-sectionally associated with atherosclerotic disease risk factors, but the prospective relation with coronary heart disease remains uncertain. Methods and Results— We examined the prospective relation between fat distribution indices and coronary heart disease among 24 508 men and women 45 to 79 years of age using proportional hazards regression. During a mean 9.1 years of follow-up, 1708 men and 892 women developed coronary heart disease. The risk for developing subsequent coronary heart disease increased continuously across the range of waist-hip ratio. Hazard ratios (95% CI) of the top versus bottom fifth of waist-hip ratio were 1.55 (1.28 to 1.73) in men and 1.91 (1.44 to 2.54) in women after adjustment for body mass index and other coronary heart disease risk factors. Hazard ratios increased with waist circumference, but risk estimates for waist circumference without hip circumference adjustment were lower by 10% to 18%. After adjustment for waist circu...

Body Fat Distribution and Risk of Coronary Heart Disease in Men and Women in the European Prospective Investigation Into Cancer and Nutrition in Norfolk Cohort A Population-Based Prospective Study

We investigated whether low subcutaneous thigh fat is an independent risk factor for unfavourable glucose and lipid levels, and whether these associations differ between sexes, and between white and black adults. Our secondary aim was to investigate which body composition characteristics (lean tissue, fat tissue) are reflected by anthropometric measures (waist and thigh circumference). Anthropometric measurements and computed tomography of the abdomen and of the thigh were performed for all participants of the Health, Aging and Body Composition Study, who were aged 70–79 years. Fasting glucose, triglycerides and HDL-cholesterol, and 2-h postload glucose were determined. After excluding those already diagnosed with diabetes or dyslipidaemia, we analysed data from 2,106 participants. After adjustment for abdominal subcutaneous and visceral fat, and intermuscular thigh fat, larger thigh subcutaneous fat area was statistically significantly associated with lower ln-transformed triglycerides [standardised beta (95% CI) −0.12 (−0.20 to −0.04) in men and −0.13 (−0.21 to −0.05) in women] and higher ln-HDL-cholesterol [0.10 (0.02 to 0.19) and 0.09 (0.01 to 0.18), respectively]. The associations with lower glucose levels were strong in men [−0.11 (−0.20 to −0.02) for fasting and −0.14 (−0.23 to −0.05) for postload glucose], but not statistically significant in women [−0.02 (−0.10 to 0.07) and −0.04 (−0.13 to 0.05), respectively]. There were no differences in the associations between white and black persons. Waist circumference was more strongly associated with abdominal subcutaneous fat, and this association became stronger with increasing BMI, whereas the association with visceral fat became weaker. Thigh circumference was equally dependent on thigh fat and thigh muscle in men, whereas in women the fat component was the main contributor. Larger subcutaneous thigh fat is independently associated with more favourable glucose (in men) and lipid levels (in both sexes) after accounting for abdominal fat depots, which are associated with unfavourable glucose and lipid levels. Anthropometric measures reflect different fat depots at different levels of BMI at the abdomen, and reflect both fat and lean tissue at the thigh. These results emphasise the importance of accurate measures of regional body composition when investigating potential health risks.

/pdf/low-subcutaneous-thigh-fat-is-a-risk-factor-for-unfavourable-5b5q4znt6s.pdf

Low subcutaneous thigh fat is a risk factor for unfavourable glucose and lipid levels, independently of high abdominal fat. The Health ABC Study

High plasma plasminogen activator inhibitor-1 (PAI-1) activity is a frequent finding in obesity and adipose tissue has recently been sug-gested to be a source of circulating PAI-1 in humans. In the present study, differences in adipose tissue gene expression and protein secretion rate of PAI-1 between subcutaneous and visceral adipose tissue was ana-lysed in specimens obtained from 22 obese individuals. The secretion rate of PAI-1 was two-fold higher in subcutaneous adipose tissue than in visceral adipose tissue (292 ± 50 vs 138 ± 24 ng PAI-1/107 cells, P

Regional variation in plasminogen activator inhibitor-1 expression in adipose tissue from obese individuals.

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Regional variation in plasminogen activator inhibitor-1 expression in adipose tissue from obese individuals.