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Obesity, Regional Body Fat Distribution, and the Metabolic Syndrome in Older Men and Women
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)
  • Cited By (432)
Jennifer S. Brach43
Estimated H-index: 43
(University of California, San Francisco),
Eleanor M. Simonsick87
Estimated H-index: 87
(University of California, San Francisco),
Stephen B. Kritchevsky94
Estimated H-index: 94
(University of California, San Francisco)
... more
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...
Ref 14Cited 302
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Richard N. Bergman104
Estimated H-index: 104
(University of Southern California),
Gregg W. Van Citters8
Estimated H-index: 8
(University of Southern California),
Steven D. Mittelman28
Estimated H-index: 28
(University of Southern California)
... more
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...
Ref 29Cited 173
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2001 in Diabetes Care [IF: 11.86]
Bo Isomaa45
Estimated H-index: 45
,
Peter Almgren62
Estimated H-index: 62
,
Tiinamaija Tuomi60
Estimated H-index: 60
... more
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...
Ref 34Cited 3763
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2004 in Nature Medicine [IF: 29.89]
Apoorva Mandavilli7
Estimated H-index: 7
,
David Cyranoski10
Estimated H-index: 10
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.
Cited 38
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R. E. Van Pelt5
Estimated H-index: 5
(Anschutz Medical Campus),
Ellen M. Evans33
Estimated H-index: 33
,
Kenneth B. Schechtman70
Estimated H-index: 70
(Washington University in St. Louis)
... more
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...
Ref 38Cited 201
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Timo A. Lakka72
Estimated H-index: 72
,
David E. Laaksonen52
Estimated H-index: 52
,
Hanna-Maaria Lakka22
Estimated H-index: 22
... more
ABSTRACT LAKKA, 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. The cross-sectional associations of leisure-time physical activity (LTPA) and cardiorespiratory fitness with the metabolic syndrome (MS) were investigated in a population-based sample of 1069 middle-aged men without diabetes, cardiovascular di...
Ref 31Cited 340
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1989 in Diabetes [IF: 8.68]
Jean-Pierre Després109
Estimated H-index: 109
,
André Nadeau51
Estimated H-index: 51
,
Angelo Tremblay93
Estimated H-index: 93
... more
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
Cited 380
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1993 in Diabetes [IF: 8.68]
Wendy M. Kohrt30
Estimated H-index: 30
(Washington University in St. Louis),
J. P. Kirwan5
Estimated H-index: 5
(Washington University in St. Louis),
M. A. Staten4
Estimated H-index: 4
(Washington University in St. Louis)
... more
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...
Cited 242
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Susan K. Fried47
Estimated H-index: 47
,
Dove A. Bunkin1
Estimated H-index: 1
,
Andrew S. Greenberg66
Estimated H-index: 66
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...
Ref 34Cited 1344
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  • References (36)
  • Cited By (432)
Yoon-Myung Kim1
Estimated H-index: 1
BACKGROUD: Abdominal obesity is a strong risk factor for cardiovascular disease (CVD) and insulin resistance. Currently, the role of regular exercise alone in the treatment of abdominal obesity is unknown in adolescent boys.OBJECTIVE: The aim of this study was to examine the effect of a 3-month regular exercise alone without calorie restriction on total and abdominal adiposity in overweight adolescent boys. More specifically, the effects of different types of exercise training (aerobic vs. resis...
Ref 174Cited 2
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Carlos K. B. Ferrari1
Estimated H-index: 1
Obesity and physical inactivity comprise an important worldwide epidemic that has been linked to the meta-bolic syndrome. This syndrome is characterized by increased risk of hypertension, diabetes, inflammation,renal, and many other metabolic disorders. Presenting the prevalence of metabolic syndrome in selectedworld populations, this paper strongly discusses the pivotal role of physical activity and exercise in prevent-ing central obesity, metabolic syndrome and their complications such as dysl...
Ref 96Cited 15
Fernando Flexa Ribeiro Filho8
Estimated H-index: 8
,
Lydia Sebba Souza Mariosa2
Estimated H-index: 2
,
Sandra Roberta Gouvea Ferreira28
Estimated H-index: 28
... more
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 ...
Ref 73 Download PDF
Insulin resistance (IR) is well documented in type 1 diabetes (T1D) and is theorized to relate to diabetes complications, including renal and coronary artery disease (CAD). The hyperinsulinemic-euglycemic clamp technique provides accurate assessment of IR, yet the laborious, costly, and invasive nature of this technique is often inappropriate for large investigations. Increasing use of the Estimated Glucose Disposal (eGDR) equation in T1D makes further examination of this equation desirable as i...
Ref 352
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Guido Lastra22
Estimated H-index: 22
(University of Missouri),
Camila Manrique23
Estimated H-index: 23
(University of Missouri),
James R. Sowers78
Estimated H-index: 78
(University of Missouri)
Obesity, Type 2 Diabetes Mellitus (T2DM) and Cardiovascular Disease (CVD) are worldwide leading causes of morbidity and mortality. Once considered as separate metabolic and hemodynamic/cardiovascular entities respectively, it has become nowadays clear that the relationship between these conditions is not coincidental, and has common pathophysiological features that allows considering both obesity and T2DM as part of the cardiovascular diseases spectrum. Furthermore, from a clinical standpoint it...
Ref 90Cited 1
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Dennis T. Villareal42
Estimated H-index: 42
(Baylor College of Medicine),
Krupa Shah16
Estimated H-index: 16
(University of Rochester)
Obesity is defined as an unhealthy excess of body fat, which increases the risk of morbidity and premature mortality. Obesity is a growing concern among adults. It has not only increased in prevalence, but it has also been associated with significant morbidity and mortality. Some of its medical risks include hypertension, diabetes, hyperlipidemia, coronary artery disease, and osteoarthritis. More so in older adults, obesity exacerbates the age-related decline in physical function, impairs qualit...
Ref 87
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Michael B. Stout12
Estimated H-index: 12
,
Tamara Tchkonia37
Estimated H-index: 37
,
James L. Kirkland6
Estimated H-index: 6
White adipose tissue (WAT) is an immensely plastic organ that plays a vital role in regulating metabolic homeostasis and systemic inflammation. Advancing age mitigates the dynamic nature of WAT which promotes the manifestation of several lipodystrophic-associated comorbidities. Inflammation and the accumulation of senescence cells likely play a key role in this process by inhibiting adipogenesis. The reduction of WAT functional capacity with aging and the role that inflammation and cellular sene...
Ref 125Cited 3
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University of Minnesota P.D. dissertation. May 2014. Major: Nutrition. Advisor: Mindy S. Kurzer. 1 computer file (PDF); vi, 107 pages, appendices A-E.
Ref 221 Source
Obesity is one of the major risk factors of atherosclerosis and arterial stiffness. Recent evidence suggests detrimental effect of fat mass rather than overall body mass. Abdominal fat has been indicated to have more negative impact than other fat depots. We evaluated the impact of regional fat distribution on atherosclerosis and compared the variances explained by 11-different adiposity measures on atherosclerosis and arterial stiffness among bi-racial women in menopausal transition. All analys...
Ref 238
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