2型糖尿病患者不同部位骨密度和骨折相关性研究

目的研究2型糖尿病患者不同部位骨密度和骨折相关性。方法随机选取2016年8月—2018年8月该院2型糖尿病患者60例,将这些患者作为2型糖尿病组,另选取同期我院健康体检人员60名为对照组,统计分析两组人员的身高、体重、体质量指数、WC、血糖、血脂水平、不同部位BMD、OP发生情况。结果 2型糖尿病组患者的体重、体质量指数、WC均显著高于健康对照组(P0.05),FBG、HbA1c水平均显著高于健康对照组(P0.05)。2型糖尿病组男性患者L2 BMD显著低于女性(P0.05),股骨颈、Wards三角BMD均显著高于女性(P0.05),L2 BMD显著低于健康对照组男性人员(P0.05),女性患者股骨颈、Ward三角BMD均显著低于健康对照组女性人员(P0.05)。2型糖尿病组女性患者L1 OP发生率显著高于健康对照组女性人员(P0.05),男性患者L2、L1-4 OP发生率均显著高于健康对照组男性人员(P0.05);女性患者股骨颈、Wards三角、全股骨OP发生率均显著高于健康对照组女性人员(P0.05)。结论 2型糖尿病患者不同部位骨密度和骨折显著相关。     

双能X线吸收法对体脂测量的应用

目的:探索双能X线吸收(Dual Energy X-Ray Absorptiometry,DEXA)法测量体脂分布的应用价值.方法:对85名受试者应用体重测量仪测定法逐一测量简易体脂参数:身高、体重、腰围、臀围,以体重指数≥25 kg/m2为标准,区分为肥胖者52名,非肥胖者33名;参照2005年代谢综合征全球统一定义中国人中心性肥胖的切点,腹型肥胖的诊断标准:腰围≥90 cm(男性),腰围≥80 cm(女性),区分为腹型肥胖者47名,非腹型肥胖者38名.同时利用DEXA法记录体重、各部位脂肪含量,计算全身脂肪比例、腰臀部脂肪比;比较DEXA法和体重测量仪测定法测得的人体体重差异,分别比较体重指数与全身脂肪比例对肥胖检出的一致性,腰围与腰臀部脂肪比对腹型肥胖检出的一致性,并将男、女两者的腰臀部脂肪比与简易体脂参数进行相关性分析.结果:应用两种方法分别对85名受试者进行体重测量,DEXA法测得的结果为(69.07±13.05)kg,体重测量仪测得的结果为(70.24±13.22)kg,对两组测量结果进行配对t检验,P>0.05,差异无统计学意义.全身脂肪比例用于男、女性肥胖诊断的敏感性分别为73.33%、86.36%,特异性分别为100%、81.82%;腰臀部脂肪比用于男、女性腹型肥胖诊断的敏感性分别为73.08%、85.72%,特异性分别为73.33%、78.26%;男性的腰臀比、女性的腰围与腰臀部脂肪比相关系数最高.结论:DEXA技术可用于测定体脂含量及分布,全身脂肪比例判断肥胖症的切点男性为27.97%,女性为34.27%,腰臀部脂肪比判断腹型肥胖的切点男性为0.64,女性为0.49;男性测量腰臀比、女性测量腰围均能更好的预测腰臀部脂肪比.     

非酒精性脂肪性肝病患者人体脂肪成分指标的变化

目的 调查非酒精性脂肪性肝病（NAFLD）患者人体成分及其变化情况,为NAFLD的早期预防和治疗提供科学依据。 方法 使用百利达MC180人体成分分析仪对148例NAFLD患者进行人体成分分析,获得体质量、身高、体质指数（BMI）、肌肉量、脂肪量、骨量、脂肪率及其分布、内脏脂肪等级等指标。 结果 本组NAFLD患者高体脂肪含量发生率为51.4%,其中,18~39岁患者高体脂肪含量发生率（86.3%）显著高于中老年患者（分别为39.3%和24.4%）;男性患者肌肉量、骨量、内脏脂肪等级均高于女性,女性脂肪量和体脂肪率高于男性（P<0.01）;男女性患者随年龄增加体脂肪率和躯体脂肪率降低（P<0.01）,男性患者上肢脂肪率和女性患者上、下肢脂肪率均随年龄增加而降低（P<0.01）;本组NAFLD患者骨量低于标准发生率,为49.3%,NASH发生率为20.3%。 结论 NAFLD患者人体成分的变化主要表现在体脂肪率增加和骨量降低,并且年轻患者高体脂肪含量发生率更高。     

定量CT分析成人椎后肌群脂肪含量与腰椎骨密度的相关性

目的 探讨成人椎后肌群脂肪含量与腰椎骨密度的相关性。方法 根据纳入标准收集2019年1月至6月在贵州医科大学附属医院健康体检者1 847名,其中男性1 057名,女性790名,平均年龄分别为(50.92±9.79)岁和(51.67±9.87)岁,行胸部CT扫描时获取腰椎定量CT(quantitative computed tomography, QCT)数据,测量椎后肌群脂肪含量和腰1-2椎体骨密度(bone mineral density, BMD)。将受检者按年龄进行分组后,对男女组间体质量指数(body mass index, BMI)、腰围、BMD、患骨质疏松的人数和比例、椎后肌群平均脂肪含量进行比较。受检者按BMI分组后采用方差分析比较各组椎后肌群平均脂肪含量,两两比较采用Games-Howell检验。将资料按照男女进行分组后,应用一般线性回归分析椎后肌群脂肪含量与腰椎BMD之间的相关性。结果 随年龄的增加,椎后肌群脂肪含量增加,且女性(9.66%±3.92%)椎后肌群脂肪含量高于男性(7.06%±2.91%);随着BMI增加,椎后肌群脂肪含量逐渐增加(F=35.051,P&...     

不同性别健康体检者血生化指标、腹部脂肪分布与骨密度的关系

目的探讨不同性别健康体检人群的血生化指标、腹部脂肪分布和骨密度的关系。方法纳入本院1 738名健康体检人群,用定量计算机断层扫描(QCT)测量腰1、腰2椎体骨密度和腹部脂肪分布。按每10岁一个年龄段对受检者进行分组,比较不同性别骨密度随年龄变化的关系;同时比较不同性别骨密度正常和异常组之间血生化指标、腹部脂肪分布的差异性及腹部脂肪组织和血脂之间的关系。利用多因素Logistic回归分析评估性别影响骨密度的风险因素。结果骨量异常者男性为37%,女性为41%;年轻男性随着年龄增加骨密度变化较年轻女性明显,但50岁以后骨密度降低在女性中更明显。腹部脂肪和血脂之间存在不同程度的相关性。多因素Logistic回归分析显示,年龄(OR=1.108,P 0.01)、总胆固醇(OR=1.374,P=0.001)和高密度脂蛋白(OR=1.863,P 0.05)是男性人群骨量异常的危险因素。年龄(OR=1.239,P 0.01)、腹内脂肪面积(OR=1.004,P0.05)是女性人群骨量异常的危险因素。结论多种因素对骨密度均有不同程度的影响。年龄、总胆固醇和高密度脂蛋白是男性骨量异常的危险因素,年龄、腹内脂肪面积是女性骨量异常的危险因素。腹部脂肪和血脂之间存在相关性。     

绝经后2型糖尿病患者体成分与骨密度关系初步探讨

目的探讨绝经后2型糖尿病患者骨密度与体成分的关系。方法选择绝经后2型糖尿病患者(DM组)68例,绝经后血糖正常女性(NC组)73例。详细记录全部受试者年龄、身高、体重、体重指数、绝经年限,双能X线吸收测定仪检测正位腰椎(L_(2-4))、股骨(股骨颈、大转子、粗隆间)骨密度(BMD)与全身各部位的脂肪和肌肉含量,并进行临床指标测定,分析骨密度与对应的肌肉和脂肪含量的相关关系。结果 2组受试者的年龄、BMI、绝经年限差异无统计学意义(P0.05);DM组空腹血糖(FBG)、餐后2 h血糖(PBG)、糖化血红蛋白(HbAlc)均明显高于NC组,差异有统计学意义(P0.05);DM组L_(2-4)、股骨颈、大转子BMD较NC组显著下降,差异有统计学意义(P0.05);DM组躯干、腿部、总肌肉含量均较NC组显著下降,差异有统计学意义(P0.05);DM组躯干、总脂肪含量较NC组明显增加,(P0.05)。根据骨密度测定结果将糖尿病组进一步分为糖尿病骨质疏松组(DM-OP组)和糖尿病非骨质疏松组(DM-NP组):2组受试者年龄、BMI、绝经年限的差异无统计学意义(P0.05);DM-OP组DM病程、FBG、PBG、HbAlc明显高于DM-NP组(P0.05),DM-OP组躯干、腿部、总肌肉含量均明显低于DM-NP组(P0.05);总脂肪含量DM-OP组明显高于DM-NP组(P0.05),其他部位脂肪含量2组间的差异无统计学意义(P0.05)。多元线性回归分析显示,糖尿病患者L_(2-4)、股骨均值BMD与年龄、绝经年限、糖尿病病程、BMI、TLM、TKLM关系最为密切。结论绝经后2型糖尿病患者较血糖正常女性容易发生骨质疏松,绝经后2型糖尿病患者肌肉含量、脂肪含量均与骨密度密切相关,肌肉含量较脂肪含量对骨密度影响更为显著。     

2型糖尿病患者肌肉量减少的多因素分析

目的探究2型糖尿病患者肌肉量减少的相关影响因素, 为2型糖尿病患者预防肌少症提供依据。方法采用横断面调查方法, 选取2019年1月至2019年8月青岛大学附属医院内分泌科收治的2型糖尿病患者为研究对象, 所有研究对象均进行双能X线骨密度仪检查。根据亚洲肌少症工作组(AWGS)的诊断标准将研究对象分为肌量减少组与非肌量减少组, 收集年龄、性别、体重指数、病程、血液指标、尿微量白蛋白/肌酐比值(UACR)、四肢骨骼肌指数(ASMI)、内脏脂肪/皮下脂肪(VAT/SAT)、腹部脂肪百分比/臀部脂肪百分比(A/G)、握力及步速等相关临床资料, 对2型糖尿病患者发生肌量减少的相关影响因素进行分析。结果共调查2型糖尿病患者369例, 其中合并肌少症患者42例(患病率为11.38%), 合并肌量减少患者155例(患病率为42.01%)。肌量减少组的年龄、收缩压、高密度脂蛋白胆固醇、UACR、VAT/SAT及A/G均高于非肌量减少组(P<0.05)。肌量减少组的体重指数、稳态模型评估的胰岛素抵抗指数、估算的肾小球滤过率(eGFR)、ASMI及握力均低于非肌量减少组(P<0.05)。多因素l...     

男性2型糖尿病患者体脂分布与心血管危险因素的关系

目的探讨男性2型糖尿病患者体脂分布特点及其与心血管危险因素的关系。方法横断面研究,用CT测量91例男性T2DM患者腹壁皮下脂肪面积（SA）及腹腔脏器脂肪面积（VA）,计算VA／SA（VSR）以及腹部总体脂量（TAF）,同时检测代谢参数,计算BMI;对体脂参数与代谢危险因素行peanson相关分析、偏相关分析及多元逐步回归分析。结果（1）相关分析结果显示,体脂分布与年龄无相关关系;无论BMI高低,其VSR均明显高于欧美肥胖人群和我国肥胖人群;内脏型肥胖的HbA1 c、TG、FFA水平高于皮下型肥胖组,FIns、FPG水平低于皮下型肥胖组,差异有统计学意义（P〈0．05）;（2）在校正年龄、糖尿病病程和BMI后,VA、SA和TAF均与FFA呈正相关,VSR与HbA1c呈正相关;（3）BMI为影响DBP、UA、Fins的独立危险因素,影响SBP、TG、HDL-C的重要因素;TAF是影响2hFFA的独立危险因素;VA为影响FFA的独立危险因素;SA是影响FPG的独立危险因素;VSR是影响HbA1 c的独立危险因素。结论男性T2DM患者体脂分布以中心性肥胖、尤其是腹部内脏脂肪增加为特点;其心血管危险因素不仅与总体脂有关,更与体脂分布（腹型肥胖）有关。     

糖尿病前期患者内脏脂肪面积与脂肪因子的相关性研究

目的探讨糖尿病前期患者内脏脂肪面积(VATA)与血清脂肪因子的相关性。方法选择在该院门诊确诊的糖尿病前期患者57例,其中超重组22例,肥胖组14例(P-NGT),正常体重组21例。检测其血清胰岛素(FINS)、脂联素(APN)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平,按稳态模型计算胰岛素抵抗指数(HOMA-IR),采用双能X线骨密度仪检测观察对象全身脂肪比例及VATA。结果 (1)超重及肥胖组血清FINS、HOMA-IR及TNF-α水平明显高于正常体重组(P0.01);APN水平明显低于正常体重组(P0.01)。IL-6在三组之间差异无统计学意义。(2)肥胖组的全身脂肪比例明显高于超重组及正常体重组(P0.01);肥胖组及超重组VATA均显著高于正常体重组(均P0.01);(3)APN与腰臀比(WHR)、HOMA-IR、全身体脂比例、VATA、甘油三酯(TG)呈负相关;TNF-α与WHR、HOMA-IR、全身体脂比例、VATA、TG呈正相关。结论糖尿病前期超重及肥胖患者VATA明显增加,与APN分泌减少密切相关,可能是糖代谢紊乱的重要影响因素。     

代谢综合征患者腹部内脏脂肪厚度测量的价值

目的 探讨代谢综合征(MS)患者内脏脂肪厚度(VFT)测量的价值.方法 选择2007年9月到2009年1月在我院住院的166例代谢综合征患者为研究对象,代谢综合征采用2005年国际糖尿病联盟MS全球共识定义中国标准,其中男性85例,平均年龄(58±11)岁,女性81例,平均年龄(60±13)岁.记录所有患者的身高、体重、腰围、血压等,检测受试者的血脂、空腹血糖(FPG)、尿酸、肾功能等指标,同时应用超声测量腹部内脏脂肪厚度(VFT)和颈动脉内膜中层厚度(IMT).结果 男性组IMT与年龄、甘油三酯、尿酸、高血压病、糖尿病、腹部内脏脂肪呈正相关.女性组IMT值与年龄、低密度脂蛋白胆固醇、2型糖尿病及腹部内脏脂肪呈正相关,与高密度脂蛋白胆固醇呈负相关.校正腰围后,VFT仍然是IMT的独立危险因素.在代谢综合征患者中,无论男女,随着VFT的增加,IMT逐渐增加,高血压病、糖尿病、冠心病的发病率明显增高,差异有统计学意义.结论 代谢综合征患者VFT与颈动脉粥样硬化及心血管疾病发病率明显相关,VFT测量可以作为代谢综合征患者心血管疾病危险评估的有用指标.     

老年男性糖代谢异常合并代谢综合征患者体脂分布特点分析

目的了解老年男性糖代谢异常合并代谢综合征(MS)患者体脂含量及分布特点。方法选择糖代谢异常的老年男性患者146例,以10岁为界,分为60～69岁组54例,70～79岁组48例,≥80岁组44例;另根据是否合并MS分为MS组107例和非MS组39例。用双能X线骨密度仪测量软组织脂肪(STF)、腰腹部Android区域脂肪(Android F)、髋部Gynoid区域脂肪(Gynoid F)、全身脂肪(TBF)百分含量、Android F与Gynoid F比值,并进行分析。结果与60～69岁组比较,70～79岁组和≥80岁组腰围、TG、Android F、Gynoid F、TBF、STF明显升高(P<0.05,P<0.01)。MS组和非MS组腰围、体重指数、HDL-C、TG、Android F、Gynoid F、TBF、STF差异均有统计学意义(P<0.05,P<0.01)。MS与TBF、体重指数呈正相关(P<0.01),与Gynoid F、HDL-C呈负相关(P<0.05)。结论老年男性MS患病率高;随年龄增加,TBF增多,MS患者TBF、STF和Android F明显增加。     

DXA estimates of fat in abdominal,trunk and hip regions varies by ethnicity in men

Objective:

The aim of this study was to determine whether the quantity of fat is different across the central (that is, android, trunk) and peripheral (that is, arm, leg and gynoid) regions among young African-American (AA), Asian (AS), Hispanic (HI) and non-Hispanic White (NHW) men.

Subjects and Methods:

A cohort of 852 men (18–30 years; mean total body fat percent (TBF%)=18.8±7.9, range=3.7–45.4) were assessed for body composition in five body regions via dual-emission X-ray absorptiometry (DXA).

Results:

HI men (21.8±8.3) had higher TBF% than AA (17.0±10.0), NHW (17.9±7.2) and AS (18.9±8.0) groups (P-values <0.0001). AS had a lower BMI (23.9±3.4) than all other groups, and NHW (24.7±3.2) had a lower BMI than HI (25.7±3.9) and AA (26.5±4.7; P-values<0.0001). A linear mixed model (LMM) revealed a significant ethnicity by region fat% interaction (P<0.0001). HI men had a greater fat% than NHW for every region (adjusted means (%); android: 29.6 vs 23.3; arm: 13.3 vs 10.6; gynoid: 27.2 vs 23.8; leg: 21.2 vs 18.3; trunk: 25.5 vs 20.6) and a greater fat% than AA for every region except the arm. In addition, in the android and trunk regions, HI had a greater fat% than AS, and AS had a higher fat% than AA. Finally, the android fat% for AS was higher than that of NHW. When comparing the region fat% within ethnicities, the android region was greater than the gynoid region for AS and HI, but did not differ for AA and NHW, and the arm region had the least fat% in all ethnicities.

Conclusions:

Fat deposition and body fat patterning varies by ethnicity.     

Central obesity and incident atherosclerotic cardiovascular disease events in hemodialysis patients

Background and aimsWaist circumference and waist-hip ratio have been shown to predict atherosclerotic cardiovascular disease (ASCVD) in the general population, but the association is less clear in patients with CKD. Both anthropometric measures of central obesity are surrogates for underlying fat and are prone to measurement error. The aim of this study was to investigate the association between central obesity determined by dual-energy X-ray -absorptiometry (DXA) and ASCVD among patients undergoing maintenance hemodialysis.Methods and resultsWe prospectively analyzed a cohort of 166 prevalent hemodialysis patients (60 ± 12 years of age). Total adiposity (total fat mass) and central adiposity (android and gynoid fat mass) were assessed by using DXA. Central obesity was defined as a sex-specific android to gynoid fat mass ratio (A/G ratio) above the median. The main outcome measure was incident ASCVD events. Patients with central obesity had significantly higher BMI, total fat mass, high-sensitivity C-reactive protein, and triglycerides but significantly lower high-density lipoprotein cholesterol than patients without central obesity. During a median follow-up of 4.3 years, 40 patients had an incident ASCVD event. Patients with central obesity did not display a significantly higher risk of ASCVD in multivariate Cox regression analysis (hazard ratio 1.03, 95% confidence interval 0.54–1.97). A/G ratio, when examined as a continuous variable, was not an independent predictor of ASCVD in either sex.ConclusionsHemodialysis patients with central obesity, as measured by the A/G ratio, had less favorable plasma lipid profiles and higher levels of inflammation but not an increased risk of ASCVD.     

Relationship Between Body Composition Parameters and Metabolic Syndrome in Young Thai Adults

Objective: The aim of this study was to evaluate the relationship between body composition parameters, i.e. waist circumference, android fat mass (AFM), gynoid fat mass (GFM), android to gynoid fat mass ratio (AG ratio) and metabolic syndrome (MS) risk components in young Thai adults.Methods: This was a cross-sectional study conducted among 391 adolescents (174 male, 217 female). The body mass index (BMI), waist circumference, blood pressure, triglyceride, high-density lipoprotein (HDL) cholesterol and glucose levels were determined. AFM, GFM and AG ratio were assessed by dual-energy X-ray absorptiometry (DXA). Linear regression analysis was done to assess the relationship of waist circumference, AFM, GFM and AG ratio with MS risk components’ score, separately.Results: Among 391 young adults aged 18.5-21.8 years, MS was found in 5.9%. Participants with MS (n=23) had a significantly higher weight, height and BMI than those without MS. There was no statistically significant difference in bone mineral density between the two groups. At univariable linear regression analysis, waist circumferences, AFM, GFM and AG ratio showed significant relationship with MS risk components’ score. However, after adjusting for gender, birth weight and BMI, AG ratio demonstrated greater relationship with MS risk components’ score (β 1.89, 95%CI 1.096-2.978) than waist circumference (β 0.046, 95%CI 0.033-0.058) and AFM (β 0.979, 95%CI 0.667-1.290). No significant association was observed between GFM and MS risk components’ score (β 0.077, 95%CI -0.089-0.243).Conclusion: The results from this study indicated that AG ratio is a stronger predictor of MS than waist circumference and AFM in young Thai adults. The role of AG ratio for the diagnosis of MS needs to be further investigated.     

Impact of fat distribution on metabolic,cardiovascular and symptomatic aspects in postmenopausal women

The aim of this study was to investigate the anthropometric, metabolic, cardiovascular and symptomatic profile in gynoid and android postmenopausal women. Forty five postmenopausal women aged 50 to 60 years were divided into two groups according to fat distribution [waist-to-hip ratio (WHR)]: gynoid group (WHR between 0.68 and 0.8; N?=?13) and android group (WHR?>?0.8; N?=?32). Body composition, skinfold thickness, serum/plasma estradiol, creatinine, urea, lipid profile, glucose and insulin, maximal exercise testing and menopause rating scale (MRS) were evaluated. The android group when compared to the gynoid group showed (P?<?0.05): (i) higher values of body mass, BMI, waist circumference, body fat, lean mass and skinfold thickness; (ii) higher values of estradiol, triglycerides, very low-density lipoprotein (VLDL) and insulin levels with lower insulin sensitivity (%S) and greater insulin resistance (%IR) index; (iii) higher blood pressure (BP) during rest and lower maximal heart rate (HRmax) during maximal exercise testing and; (iv) higher scores of the somatic and urogenital-sexual symptoms. This study suggests that android postmenopausal women develop features that can lead to metabolic syndrome (MetS) and future cardiovascular disease (CVD), and these women may present higher scores of somatic and urogenital-sexual symptoms.     

Does lipid oxidation differ in gynoid and android obese women?

This study was performed to investigate whether body fat distribution influences resting metabolic rate and lipid oxidation in obese individuals. Eighty-nine obese women were divided in two groups (android obese, n = 36, BMI = 31.1 +/- 4.5 kg/m2 (mean +/- s.d.); gynoid obese, n = 53, BMI = 29.9 +/- 4.5 kg/m2 on the basis of their waist/hip ratio (0.86 +/- 0.05 vs 0.75 +/- 0.04 respectively). Body weight, per cent body fat and fat-free mass were similar in the two groups. Moreover, resting metabolic rate and respiratory quotient were also identical in android and gynoid obese women, indicating that there was no intergroup difference in the absolute level of lipid oxidation. If, like most other android obese women, they had higher rates of lipolysis and plasma FFA concentrations, the failure of android obese individuals to exhibit a higher lipid oxidation than gynoid obese women may partly explain their increased risk to develop metabolic complications.     

Commingling effect of gynoid and android fat patterns on cardiometabolic dysregulation in normal weight American adults

Aim:

To determine the independent and commingling effect of android and gynoid percent fat (measured using Dual Energy X-Ray Absorptiometry) on cardiometabolic dysregulation in normal weight American adults.

Methods:

The 2005–2006 data (n=1802) from the United States National Health and Nutritional Examination Surveys (NHANES) were used in this study. Associations of android percent fat, gynoid percent fat and their joint occurrence with risks of cardiometabolic risk factors were estimated using prevalence odds ratios from logistic regression analyses.

Results:

Android-gynoid percent fat ratio was more highly correlated with cardiometabolic dysregulation than android percent fat, gynoid percent fat or body mass index. Commingling of android and gynoid adiposities was associated with much greater odds of cardiometabolic risk factors than either android or gynoid adiposities. Commingling of android and gynoid adiposities was associated with 1.75 (95% confidence interval (CI)=1.42–2.93), 1.48 (95% CI=1.32–1.91), 1.61 (95% CI=1.50–1.89), 3.56 (95% CI=2.91–4.11) and 1.86 (95% CI=1.49–1.96) increased odds of elevated glucose, elevated blood pressure, elevated low-density lipoprotein-cholesterol, elevated triglyceride and low high-density lipoprotein-cholesterol, respectively.

Conclusions:

Normal weight subjects who present with both android and gynoid adiposities should be advised of the associated health risks. Both android and gynoid fat accumulations should be considered in developing public health strategies for reducing cardiometabolic disease risk in normal weight subjects.     

Sex and race differences in fat distribution among Asian, African-American, and Caucasian prepubertal children

Sexual dimorphism in fat distribution is thought to emerge during puberty. Truncal or android body fat distribution is characteristic of adult males but is also recognized as a human cardiovascular risk factor. Race differences in truncal fat are clearly evident in adults and have been described in prepubertal children but not between Asians and other race groups. The aim of this study in African-American, Asian, and Caucasian prepubertal children was to evaluate sex differences and race differences in body fat distribution. Analysis of covariance was used to explore fat distribution in 358 prepubertal children (176 girls and 182 boys; 143 Asians, 95 African-Americans, and 120 Caucasians), measured by skinfold thickness and dual-energy x-ray absorptiometry (DXA) in a cross-sectional study. Extremity and gynoid fat masses were evaluated after adjustment for trunk or android fat, respectively, and for covariates including age, weight, height, and interactions. In Asian children, sex differences were present in models for gynoid fat by DXA only (P < 0.001), with girls having greater gynoid fat than boys. In African-American and Caucasian children, sex differences were present in models for extremity and gynoid fat masses, measured by both methods. Among girls, Asians had generally lower adjusted extremity and gynoid fat than Caucasians and African-Americans. Among boys, Asians had lower adjusted extremity fat by DXA than Caucasians (P < 0.01) but greater gynoid fat by skinfolds than African-Americans (P < 0.01). This study of prepubertal children demonstrates that: 1) sex differences in body fat distribution are present in prepubertal children but that the specific characteristics for Asians differ from African-Americans and Caucasians, and 2) differences in body fat distribution in Asian children, compared with African-Americans and Caucasians, are present but vary by sex. This comparison of African-American, Asian, and Caucasian prepubertal children suggests phenotypic differences. Additional studies are needed to explore the metabolic and health risk implications of these findings.     

Body fat in nonobese women with prolactinoma treated with dopamine agonists

Objectives To evaluate body fat in nonobese women with prolactinoma treated with dopamine agonists, using whole body dual energy X‐ray absorptiometry (DXA) and to correlate DXA results with biochemical data and clinical aspects of the prolactinoma. Design, patients and measurements A cross‐sectional study was performed in two University referral centres. Thirty‐one nonobese premenopausal women with prolactinoma were subjected to DXA and blood analysis at clinical evaluation. They were compared with 21 control women of similar age and body mass index (BMI). Results Women with prolactinoma treated with dopamine agonists and controls had similar body fat percentages in all sites evaluated with DXA (arms, legs, trunk, android, gynoid and total body). Patients with normal PRL levels at study entry had lower body fat percentages in all sites. In the patient group, arm, leg, truncal, android, gynoid and total body fat were positively associated with PRL levels. Conclusion Body fat percentage is similar in nonobese women with prolactinoma and in controls. The lower body fat content in patients with normal PRL levels is likely to be due to the metabolic effects of adequate dopamine receptor type 2 (DR2) activation as a result of regular dopamine agonist treatment. This finding reinforces the importance of the appropriate treatment with dopamine agonists in women with prolactinoma, which, besides normalizing PRL levels, reduces body fat content and the consequent risk of developing Metabolic Syndrome and its complications.     

Body-fat distribution and responsiveness of the pituitary-adrenal axis to corticotropin-releasing-hormone stimulation in sedentary and exercising women.

Excess upper-body (android) fat is considered an health hazard. Exercise training is known to have the potential to modify body composition and to induce a preferential loss of abdominal fat. We studied and compared the composition of whole body and major body regions using dual-energy X-ray absorptiometry (DEXA) in 21 exercising (3-4 hours of intense physical activity/day) and 21 sedentary eumenorrhoic women of similar ages, body mass index (BMI), waist-to-hip ratio (WHR) and age of menarche. In a small number of women in each group (6 out of 21), the ACTH and cortisol response to CRH test and the 24-h urinary cortisol excretion was evaluated. Exercising women had 10% higher total and leg lean mass (p<0.05), and 38% lower total fat mass (p<0.01) than sedentary women. Furthermore, the proportion of android fat was 22% lower in exercising than sedentary women (p<0.01), while the proportion of lower-body (gynoid fat) was unchanged. BMI and WHR were not different between the two groups, while the android/gynoid fat ratios were 16% lower in exercising than in sedentary women (p<0.01). In the exercising women, ACTH and cortisol plasma levels, as well as the 24-h urinary cortisol excretion, were significantly (p<0.01) higher than in the sedentary women studied. In these subjects, a direct relationship between the peak delta percentage increases of ACTH and cortisol after the CRH test and the proportion of android fat was found (r=0.60, p<0.05 and r=0.69, p<0.02, respectively). These results demonstrate that in women who practise intense exercise there are significant differences in body fat distribution in comparison to sedentary women, with a marked less amount of android fat, and suggest that this difference may be related to a reduced response of the pituitary-adrenal axis to CRH.