Obesity, Regional Body Fat Distribution, and the Metabolic Syndrome in Older Men and Women

Published on Apr 11, 2005in JAMA Internal Medicine 19.99
· DOI :10.1001/archinte.165.7.777
Bret H. Goodpaster79
Estimated H-index: 79
(University of Pittsburgh),
Shanthi Krishnaswami6
Estimated H-index: 6
(University of Pittsburgh)
+ 6 AuthorsA. B. Newman138
Estimated H-index: 138
(University of Pittsburgh)
Abstract
Background:Themetabolicsyndromeisadisorderthat includes dyslipidemia, insulin resistance, and hypertension and is associated with an increased risk of diabetes andcardiovasculardisease.Wedeterminedwhetherpatterns of regional fat deposition are associated with metabolic syndrome in older adults. Methods: A cross-sectional study was performed that included a random, population-based, volunteer sample of Medicare-eligible adults within the general communities of Pittsburgh, Pa, and Memphis, Tenn. The subjects consisted of 3035 men and women aged 70 to 79 years, of whom 41.7% were black. Metabolic syndrome was defined by Adult Treatment Panel III criteria, including serum triglyceride level, high-density lipoprotein cholesterol level, glucose level, blood pressure, and waist circumference. Visceral, subcutaneous abdominal, intermuscular, and subcutaneous thigh adipose tissue was measured by computed tomography. Results:Visceral adipose tissue was associated with the metabolic syndrome in men who were of normal weight (odds ratio, 95% confidence interval: 2.1, 1.6-2.9), overweight (1.8, 1.5-2.1), and obese (1.2, 1.0-1.5), and in women who were of normal weight (3.3, 2.4-4.6), overweight (2.4, 2.0-3.0), and obese (1.7, 1.4-2.1), adjustingforrace.Subcutaneousabdominaladiposetissuewas associated with the metabolic syndrome only in normalweight men (1.3, 1.1-1.7). Intermuscular adipose tissue was associated with the metabolic syndrome in normalweight (2.3, 1.6-3.5) and overweight (1.2, 1.1-1.4) men. In contrast, subcutaneous thigh adipose tissue was inversely associated with the metabolic syndrome in obese men (0.9, 0.8-1.0) and women (0.9, 0.9-1.0). Conclusion: In addition to general obesity, the distribution of body fat is independently associated with the metabolic syndrome in older men and women, particularly among those of normal body weight. Arch Intern Med. 2005;165:777-783
  • References (36)
  • Citations (440)
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References36
Published on Jan 1, 1993in Nutrition 3.73
Després Jp1
Estimated H-index: 1
374 Citations
Published on Apr 1, 2004in Journal of the American Geriatrics Society 4.16
Jennifer S. Brach43
Estimated H-index: 43
(University of California, San Francisco),
Eleanor Marie Simonsick88
Estimated H-index: 88
(University of California, San Francisco)
+ 2 AuthorsA. B. Newman138
Estimated H-index: 138
(University of California, San Francisco)
OBJECTIVES: To determine whether older adults who exercise demonstrate higher levels of physical function than those who do not exercise but are physically active throughout the day. DESIGN: Cross-sectional examination of baseline data from the Health, Aging and Body Composition (Health ABC) study. SETTING: Health ABC field centers in Pittsburgh, Pennsylvania, and Memphis, Tennessee. PARTICIPANTS: Three thousand seventy-five well-functioning black and white men and women aged 70 to 79. MEASUREME...
309 Citations Source Cite
Published on Jan 1, 2001in Journal of Investigative Medicine 2.03
Richard N. Bergman100
Estimated H-index: 100
(University of Southern California),
Gregg W. Van Citters8
Estimated H-index: 8
(University of Southern California)
+ 4 AuthorsMartin Ellmerer25
Estimated H-index: 25
(University of Southern California)
Abstract Insulin resistance is associated with a plethora of chronic illnesses, including Type 2 diabetes, dyslipidemia, clotting dysfunction, and colon cancer. The relationship between obesity and insulin resistance is well established, and an increase in obesity in Western countries is implicated in increased incidence of diabetes and other diseases. Central, or visceral, adiposity has been particularly associated with insulin resistance; however, the mechanisms responsible for this associatio...
174 Citations Source Cite
Published on Apr 1, 2001in Diabetes Care 13.40
Bo Isomaa47
Estimated H-index: 47
,
Peter Almgren64
Estimated H-index: 64
+ 5 AuthorsLeif Groop125
Estimated H-index: 125
OBJECTIVE —To estimate the prevalence of and the cardiovascular risk associated with the metabolic syndrome using the new definition proposed by the World Health Organization (WHO). RESEARCH DESIGN AND METHODS —A total of 4,483 subjects aged 35–70 years participating in a large family study of type 2 diabetes in Finland and Sweden (the Botnia study) were included in the analysis of cardiovascular risk associated with the metabolic syndrome. In subjects who had type 2 diabetes ( n = 1,697), impai...
3,789 Citations Source Cite
Published on Apr 1, 2004in Nature Medicine 32.62
Apoorva Mandavilli7
Estimated H-index: 7
,
David Cyranoski31
Estimated H-index: 31
All the world loves to mock obese Americans, but weightier issues lurk in Asia, where diabetes and heart disease run rampant. The first hurdle may be a Western measure that is blind to the expanding fat in Asians' deceptively thin bodies.
38 Citations Source Cite
R. E. Van Pelt5
Estimated H-index: 5
(Anschutz Medical Campus),
Ellen M. Evans33
Estimated H-index: 33
+ 2 AuthorsWendy M. Kohrt56
Estimated H-index: 56
(Anschutz Medical Campus)
The aim of this study was to determine whether trunk fat mass, measured by dual-energy X-ray absorptiometry (DEXA), is predictive of insulin resistance and dyslipidemia, independently of arm and leg fat mass, in postmenopausal women. Total and regional body composition was measured by DEXA in 166 healthy, postmenopausal women (66 ± 4 yr). Four primary markers of insulin resistance and dyslipidemia were assessed: 1) area under the curve for the insulin (INSAUC) response to an oral glucose toleran...
201 Citations Source Cite
Published on Aug 1, 2003in Medicine and Science in Sports and Exercise 4.29
Timo A. Lakka75
Estimated H-index: 75
,
David E. Laaksonen53
Estimated H-index: 53
+ 4 AuthorsJukka T. Salonen15
Estimated H-index: 15
ABSTRACTLAKKA, T. A., D. E. LAAKSONEN, H.-M. LAKKA, N. MANNIKKO, L. K. NISKANEN, R. RAURAMAA, and J. T. SALONEN. Sedentary Lifestyle, Poor Cardiorespiratory Fitness, and the Metabolic Syndrome. Med. Sci. Sports Exerc., Vol. 35, No. 8, pp. 1279–1286, 2003.PurposeThe cross-sectional associations of le
343 Citations Source Cite
Published on Mar 1, 1989in Diabetes 7.27
Jean-Pierre Després110
Estimated H-index: 110
,
André Nadeau52
Estimated H-index: 52
+ 6 AuthorsClaude Bouchard129
Estimated H-index: 129
Computed tomography (CT) was used to study the association between adipose tissue localization and glucose tolerance in a sample of 52 premenopausal obese women aged 35.7 ± 5.5 yr (mean ± SD) and with a body fat of 45.9 ± 5.5%. Body-fat mass and the body mass index (BMI) were significantly correlated with plasma glucose, insulin, and connecting peptide (C-peptide) areas after glucose (75 g) ingestion (.40 ≥ r ≤ .51, P r = .76, P r = .59, P r = .29, P r = .44 and .49, respectively; P r = .57, P
384 Citations Source Cite
Published on Feb 1, 1993in Diabetes 7.27
Wendy M. Kohrt56
Estimated H-index: 56
(Washington University in St. Louis),
John P. Kirwan53
Estimated H-index: 53
(Washington University in St. Louis)
+ 3 AuthorsJohn O. Holloszy96
Estimated H-index: 96
(Washington University in St. Louis)
Studies have shown that insulin resistance increases with age, independent of changes in total adiposity. However, there is growing evidence that the development of insulin resistance may be more closely related to abdominal adiposity. To evaluate the independent effects of aging and regional and total adiposity on insulin resistance, we performed hyperinsulinemic euglycemic clamps on 17 young (21–33 yr) and 67 older (60–72 yr) men and women. We assessed FFM and total and regional adiposity by h...
246 Citations Source Cite
Susan K. Fried47
Estimated H-index: 47
,
Dove A. Bunkin1
Estimated H-index: 1
,
Andrew S. Greenberg67
Estimated H-index: 67
The purpose of this study was to determine whether human adipocytes from different depots of obese subjects produce interleukin-6 (IL-6) and whether IL-6 release is regulated by glucocorticoids. Fragments of omental and abdominal sc adipose tissue released immunodetectable IL-6 into the medium during acute incubations. Omental adipose tissue released 2–3 times more IL-6 than did sc adipose tissue. Isolated adipocytes prepared from these tissues also released IL-6 (omental> sc), but this accounte...
1,355 Citations Source Cite
  • References (36)
  • Citations (440)
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Cited By440
Fernando Flexa Ribeiro Filho8
Estimated H-index: 8
,
Lydia Sebba Souza Mariosa2
Estimated H-index: 2
+ 1 AuthorsMaria Teresa Zanella20
Estimated H-index: 20
ABSTRACT Visceral Fat and Metabolic Syndrome: More Than a Simple Association.Metabolic syndrome (MS) is seen nowadays as a worldwide epidemicevent associated with high cardiovascular morbi-mortality and highsocioeconomic cost. The ponderal gain is an independent predictor forthe development of MS, although not all obese individuals present it. Onthe other hand, some populations with low obesity prevalence presenthigh prevalence of MS and cardiovascular mortality. The distribution ofcorporal fat ...
Published on Dec 1, 2015in Obesity Surgery 3.89
Mujjahid Abbas1
Estimated H-index: 1
(Albert Einstein College of Medicine),
Lindsay Cumella4
Estimated H-index: 4
(Albert Einstein College of Medicine)
+ 4 AuthorsDiego R. Camacho7
Estimated H-index: 7
(Albert Einstein College of Medicine)
Background The proportion of population older than 60 years is rapidly increasing. The majority of this older population suffers from multiple comorbid conditions including obesity. Non-surgical means of weight loss do not offer a predictable solution. Surgical interventions seem to be the most promising solution for the obesity problem, but there is a relative lack of data in literature regarding bariatric procedures in older populations.
23 Citations Source Cite
Published on Sep 1, 2015in Current obesity reports
Lydia E. Gill5
Estimated H-index: 5
(Dartmouth College),
Stephen J. Bartels41
Estimated H-index: 41
,
John A. Batsis25
Estimated H-index: 25
As the number of older adults increases rapidly, the national epidemic of obesity is also affecting our aging population. This is particularly concerning given the numerous health risks and increased costs associated with this condition. Weight management is extremely important for older adults given the risks associated with abdominal adiposity, which is a typical fat redistribution during aging, and the prevalence of comorbid conditions in this age group. However, approaches to weight loss mus...
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Published on Oct 1, 2015in Acta Diabetologica 3.13
Antonella Marucci11
Estimated H-index: 11
(Casa Sollievo della Sofferenza),
Claudia Menzaghi19
Estimated H-index: 19
(Casa Sollievo della Sofferenza)
+ 7 AuthorsVincenzo Trischitta49
Estimated H-index: 49
(Casa Sollievo della Sofferenza)
Aims Our aims were to investigate in several large samples, with a wide range of adiposity, whether: (1) the effect of BMI on insulin sensitivity is different between sexes; (2) also waist circumference plays a sex-specific role on insulin sensitivity; and (3) serum adiponectin and resistin are mediators of such sex-dimorphic effect.
3 Citations Source Cite
Published on Jun 30, 2015in Korean Journal of Ophthalmology
Dong-Il Kim2
Estimated H-index: 2
(Yonsei University)
Background: It is well known that obesity increases the risk of metabolic syndrome (MS); however, the associations between walking and MS risk factors among Korean adults still need to be elucidated. The purpose of this study was to examine the relationships of body mass index (BMI) and walking with MS risk factors among Korean adults from the fifth Korea national health and nutrition examination survey. Methods: A total of 17,019 (7,334 males, 9,685 females) Korean adults participated in the cr...
3 Citations Source Cite
Published on May 1, 2016in Irish Journal of Medical Science 1.04
Clodagh Toomey9
Estimated H-index: 9
(University of Limerick),
S. Leahy1
Estimated H-index: 1
(Trinity College, Dublin)
+ 2 AuthorsPhilip M. Jakeman21
Estimated H-index: 21
(University of Limerick)
Background Regional distribution of adiposity and lean tissue mass are predictors of health risk that cannot be defined by body mass index but can be attained by dual-energy X-ray absorptiometry (DXA). Age and sex-related adult ranges of whole-body and regional adiposity and lean tissue are not available for Irish men and women.
5 Citations Source Cite
Published on Jan 1, 2008in Eastern Mediterranean Health Journal 0.72
M.A. Abolfotouh1
Estimated H-index: 1
,
L.A. Soliman1
Estimated H-index: 1
+ 2 AuthorsA.A. El-Dawaiaty1
Estimated H-index: 1
1Department of Family Health, High Institute of Public Health, University of Alexandria, Alexandria, Egypt (Correspondence to M.A. Abolfotouh: mabolfotouh@yahoo.com). 2Department of Primary Health Care; 3Department of Integrated Health Care, Ministry of Health and Population, Cairo, Egypt. 4Department of Community Medicine, Al-Azhar University, Cairo, Egypt. Received: 19/06/05; accepted: 19/09/05 ABSTRACT Through a home-based survey, all people aged 18 years and over (n = 1800) in the catchment ...
33 Citations
Published on Sep 1, 2010in Arquivos Brasileiros De Cardiologia 1.32
Hudsara Aparecida de Almeida Paula3
Estimated H-index: 3
(Universidade Federal de Viçosa),
Rita de Cássia Lanes Ribeiro12
Estimated H-index: 12
(Universidade Federal de Viçosa)
+ 2 AuthorsSylvia do Carmo Castro Franceschini25
Estimated H-index: 25
(Universidade Federal de Viçosa)
Correspondencia: Hudsara Aparecida de Almeida Paula • Departamento de Nutricao e Saude da Universidade Federal de Vicosa (UFV) Edificio Centro de Ciencias Biologicas II. Avenida PH Rolfs s/n 36570-000 Vicosa, MG Brasil E-mail: hud_sara@hotmail.com Articulo recibido el 04/10/09; revisado recibido el 26/12/09; aceptado el 04/03/10. Resumen Fundamento: Los criterios para mejor definicion del sindrome metabolico/(SM), especialmente para la poblacion de adultos mayores, son todavia poco conocidos, y ...
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Published on Mar 1, 2015in Obesity 4.04
Henry J. Pownall50
Estimated H-index: 50
(Baylor College of Medicine),
George A. Bray108
Estimated H-index: 108
(Pennington Biomedical Research Center)
+ 8 AuthorsAnne V. Schwartz2
Estimated H-index: 2
(University of California, San Francisco)
Objective To determine the effects of an intensive lifestyle intervention vs. a comparison group on body composition in obese or overweight persons with type 2 diabetes at baseline and at 1, 4, and 8 years.
16 Citations Source Cite
Published on May 1, 2015in Obesity 4.04
Yi Zhu13
Estimated H-index: 13
(Mayo Clinic),
Tamara Tchkonia39
Estimated H-index: 39
(Mayo Clinic)
+ 8 AuthorsH. Robert Bergen23
Estimated H-index: 23
(Mayo Clinic)
Objective Visceral white adipose tissue (WAT) expansion and macrophage accumulation are associated with metabolic dysfunction. Visceral WAT typically shows greater macrophage infiltration. Preadipocytes show varying proinflammatory expression profiles among WAT depots. The objective was to examine the secretomes and chemoattractive properties of preadipocytes from visceral and subcutaneous WAT. Methods A label-free quantitative proteomics approach was applied to study secretomes of subcutaneous ...
17 Citations Source Cite
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