The association of physical activity with obesity,fat distribution and glucose intolerance in Pima Indians

Summary The relationships between physical activity, obesity, fat distribution and glucose tolerance were examined in the Pima Indians who have the highest documented incidence of non-insulin-dependent diabetes. Fasting and 2-h post-load plasma glucose concentrations, body mass index, and waist-to-thigh circumference ratios were determined in 1054 subjects aged 15–59 years. Current (during the most recent calendar year) and historical (over a lifetime) leisure and occupational physical activity were determined by questionnaire. Current physical activity was inversely correlated with fasting and 2-h plasma glucose concentrations, body mass index and waist-to-thigh ratios for most sex-age groups even when diabetic subjects were excluded. Controlled for age, obesity and fat distribution, activity remained significantly associated with 2-h plasma glucose concentrations in males. In subjects aged 37–59 years, individuals with diabetes compared to those without reported significantly less leisure physical activity during the teenage years (median hours per week of activity, 9.1 vs 13.2 for men; 1.0 vs 2.2 for women). Controlled for body mass index, sex, age and waist-to-thigh ratio, subjects who reported low levels of historical leisure physical activity had a higher rate of diabetes than those who were more active. In conclusion, current physical activity was inversely related to glucose intolerance, obesity and central distribution of fat, particularly in males. Subjects with diabetes were currently less active and reported less historical physical activity than non-diabetic subjects. These findings suggest that activity may protect against the development of non-insulin-dependent diabetes both directly and through an influence on obesity and fat distribution.     

Chronic pain and its association with obesity among older adults in China

ObjectivesThere is a paucity of epidemiological data on chronic pain and obesity among older adults. This study attempted to present the characterization of chronic pain and its association with obesity among the Chinese elderly.MethodsA cross-sectional survey was undertaken among 6524 elderly individuals aged ≥60 years in China. Chronic pain was identified by self-reports based on the definition from the International Association for the Study of Pain (IASP). Body Mass Index (BMI) was measured to assess obesity. Binary logistic regression analysis was performed to explore the association between obesity and chronic pain.ResultsThe prevalence of chronic pain was 49.8%. The legs/feet (25.5%), back (23.2%), and neck/shoulder (14.6%) were the most salient locations for chronic pain. Compared with normal weight, subjects with overweight (OR = 1.234, 95%CI = 1.100–1.384) and obesity (OR = 1.715, 95%CI = 1.418–2.073) were considerably more likely to have chronic pain after adjusting for covariates (p < .05). Age was not significantly associated with chronic pain (p > .05). Further analyses revealed that the associations between chronic pain and obesity were restricted to the legs/feet and back.ConclusionChronic pain is common among older adults in China. Understanding the role of obesity in chronic pain is important for preventing and treating chronic pain.     

男性体脂肪含量及其分布与血脂关系的研究

目的探讨男性体脂肪含量及脂肪分布与血脂代谢的关系。方法采用临床横断面研究,对194例青岛港男职工行体脂肪测定仪检查和血脂的测定,将所有入选对象分为血脂异常组和血脂正常组,两组之间比较。结果两组间脂肪量和肥胖度差异没有统计学意义(P>0.05);血脂异常组脂肪率、腹部总脂肪面积、腰围(WC)、腰臀比(WHR)和体重高于对照组(P<0.05);脂肪量和肥胖度与甘油三酯(TG)成正相关;腹部总脂肪面积、WC和WHR均与总胆固醇(TC)、低密度脂蛋白-胆固醇(LDL-C)和TG成正相关,与高密度脂蛋白-胆固醇(HDL-C)成负相关;脂肪率与TC、LDL-C成正相关,与HDL-C成负相关。结论男性脂肪量、尤其是脂肪分布与血脂代谢有关,腹部总脂肪面积是预测心血管危险因素的一个指标。     

Relationship between juvenile obesity, dietary energy and fat intake and physical activity

OBJECTIVE: To determine the relationship of juvenile obesity to dietary fat, particularly saturated fat, and with dietary energy (controlling for activity patterns). DESIGN: Cross-sectional, evaluation of diet and activity patterns of obese and non-obese children and adolescents. SUBJECTS: A total of 181 children, aged 4-16 y. Subjects were divided into two groups: obese (body mass index, BMI, > 95th percentile for age and sex), 40 males and 51 females; and non-obese (BMI < 75th percentile for age and sex), 35 males and 55 females. MEASUREMENTS: Dietary intake was analyzed with a dietary history interview; activity patterns were analyzed with an activity interview and body fat was measured with bioelectrical impedance analysis. RESULTS: The obese subjects consumed significantly more total calories, total fat in grams and saturated fatty acids (SFA) in grams than did the non-obese subjects. Based on step-wise multiple regression, the total energy consumed, not total fat or SFA, had the strongest relationship to the subject's percentage body fat, controlling for activity levels. CONCLUSION: We suggest that, although obese children and adolescents consume more dietary energy and fat than non-obese children and adolescents, there is a stronger relationship between total energy consumed and juvenile adiposity than with dietary fat or type of dietary fat consumed.     

Relationship between regional fat distribution and insulin resistance

Visceral fat is a strong predictor of insulin resistance in obese subjects, but not in normal weight individuals, suggesting that this association might occur only beyond a certain threshold of visceral fat amount. Unlike subcutaneous fat, increased visceral fat is associated with increased hepatic glucose production and reduced glucose disposal. This association is independent of the methodology used to assess insulin sensitivity in humans. This article reviews all relevant data coming from epidemiological, clinical and interventional (weight loss) studies and studies obtained in identical twins.     

单纯性肥胖儿童生长激素结合蛋白、胰岛素与体脂、生长的关系

肥胖者有胰岛素抵抗 (表现为高胰岛素血症 )并与体脂积聚有关〔1〕。同时 ,肥胖者又有促生长素轴 (ＳＴＡ)的紊乱。ＳＴＡ是重要的代谢调控系统 ,其对生长和营养代谢呈双重调控是生长中的个体的重要特征。促生长素 (ＧＨ )的“下游” :促生长素受体 (ＧＨＲ) ,生长激素结合蛋白 (ＧＨＢＰ)和胰岛素样生长因子Ⅰ (ＩＧＦ Ⅰ )轴可产生与营养调控有关的非ＧＨ依赖性改变 ,并可以与胰岛素 (Ｉｎｓ)分泌状态有密切关系〔2 ,3〕。肥胖儿ＳＴＡ紊乱的机制不明 ,体脂过多积聚是肥胖的主要病理改变 ,高胰岛素血症和高ＧＨＢＰ都与体脂有关。本研究目…     

Regional distribution of muscle and fat mass in men--new insight into the risk of abdominal obesity using computed tomography

We studied 24 healthy men (25-50 years old) covering a wide range of fatness (body mass index range: 21-34 kg/m2) and fat distribution (waist/hip range: 0.75-1.06). Computed tomography scans were taken at five levels (thigh, hip, waist, arm, and liver) from which fat, muscle and bone areas were calculated. Both waist/hip and BMI were correlated with fat areas in the thigh, arm and waist scans. BMI showed stronger correlations with peripheral fat areas, whereas waist/hip showed stronger correlations with fat areas in the waist scan (particularly with visceral fat area: r = 0.88, P less than 0.001). BMI was correlated with muscle and bone areas in the thigh scan. In multiple regression BMI was, independently of waist/hip and age, positively correlated with fat areas in the arm, thigh, and waist (not with visceral fat) and muscle and bone areas in the thigh. Waist/hip was independently of BMI and age correlated with fat areas in the arm and waist, including visceral fat area (but not with fat areas in the thigh). Moreover, waist/hip showed an independent negative correlation with muscle area in the thigh, muscle endurance and physical activity. Serum triglycerides, plasma insulin, glucose, uric acid and diastolic and systolic blood pressure were associated with visceral fat area but also to anthropometric indicators of abdominal fat distribution (especially waist/hip ratio). Liver attenuation, but not the liver/spleen attenuation ratio, was associated with some liver enzymes and BMI but not with waist/hip or metabolic parameters. We conclude that a higher BMI is associated with increased central and peripheral fat stores (but not visceral fat) and increased thigh muscle whereas waist/hip is primarily associated with increased central fat stores (noteably with visceral fat), decreased thigh muscle and reduced physical fitness. It is suggested that physical training might be an important element in the treatment of abdominal obesity in men.     

Lean body mass and body fat distribution in participants with chronic low back pain

BACKGROUND: Loss of muscle mass and central obesity progress with aging, but the effect of muscle loss on chronic low back pain has not been precisely evaluated. METHODS: Three hundred thirty Japanese persons aged 45 to 69 years, with a complaint of low back pain for longer than 3 months (n = 203) and age- and sex-matched healthy control subjects (n = 127), were enrolled in this study. Participants with chronic low back pain were classified into the following groups: (1) women with a positive straight leg raise test result, (2) women with a negative straight leg raise test result, (3) men with a positive straight leg raise test result, and (4) men with a negative straight leg raise test result. Controls were classified by sex into a female and a male group. Anthropometric data, consisting of body mass index, percentage body fat, waist-hip ratio, and lean body mass of the upper extremities, trunk, and lower extremities divided by body weight, were measured in participants with low back pain, and the results were compared with those of controls. RESULTS: The waist-hip ratio in women with a negative straight leg raise test result was significantly higher than those in the female control group (P<.001) and in the women with a positive straight leg raise test result (P =.04). The lean body mass of the trunk and lower extremities divided by body weight of women with a negative straight leg raise test result was significantly lower than that of female controls (P =.03 for the trunk and P<.001 for the lower extremities). However, no significant differences were detected between the female negative straight leg raise test result group and the female control group for lean body mass of the upper extremities divided by body weight or body mass index. There were no significant differences in anthropometric data between the male test and control groups or between the female positive straight leg raise test result group and the female control group. CONCLUSION: Trunk and lower extremity loss of muscle mass and central obesity may be risk factors for chronic low back pain without a positive straight leg raise test result in women aged 45 to 69 years. Arch Intern Med. 2000;160:3265-3269.     

高血压患者体重指数与脂肪肝相关性探讨

目的　探讨高血压患者体重指数与脂肪肝、血脂及血压之间的关系。方法　对 13 5例高血压患者按体重指数(BMI)分为 3组 :正常体重组 (BMI=2 0～ 2 3 ) ,超重组 (BMI=2 4～ 2 7) ,肥胖组 (BMI≥ 2 8) ,所有患者均测血脂、血压 ,并行腹部 B超检查。结果　肥胖组较正常组总胆固醇 (TC)、三酰甘油 (TG)、低密度脂蛋白 (L DL )有明显差异(P<0 .0 5 ) ;肥胖组与超重组比较 ,仅 TC有差异 (P<0 .0 5 )。 BMI与脂肪肝的发生率呈正相关 (rs=0 .911,P<0 .0 1) ,且肥胖组中中、重度脂肪肝的发生率较正常组明显增多 (P<0 .0 1)。收缩压 (SBP)及舒张压 (DBP)均随着BMI的增加而明显增高 :肥胖组高于超重组 ,超重组高于正常组 ,差异有显著性 (P<0 .0 0 1及 P<0 .0 5 )。结论　合并超重的高血压患者应积极减重 ,并控制在正常范围 ,对降低血压、预防冠心病及脂肪肝均有重要意义     

肥胖患者体脂分布与肾脏损害的关系

目的:探讨肥胖患者体脂分布特点与肥胖相关性肾病(ORG)的发生及其进展中的关系。方法:对照研究30例经肾穿刺活检明确诊断的ORG患者和19例无肾脏损伤的单纯性肥胖患者,借助CT测量两组患者腹部脂肪的面积;采用B超测量肾周脂肪厚度,检测、记录胰岛素抵抗水平和肾小球滤过率以及体重指数、血脂等相关指标。并根据CT测定的内脏脂肪面积,将ORG患者分为3组,分别比较各组临床、病理和代谢异常的指标。结果:ORG患者全部(100%)表现为腹型肥胖,单纯肥胖患者中腹型肥胖仅占78·9%;前者内脏脂肪的面积约为后者的1·3倍。腹型肥胖导致ORG发生的风险是外周型肥胖患者的8·0倍。ORG空腹血糖(P<0·05)、胰岛素水平(P<0·05)和胰岛素抵抗水平(P<0·01)明显高于单纯肥胖患者。ORG总胆固醇水平高于单纯肥胖患者(P<0·05),但三酰甘油及高/低密度脂蛋白水平彼此间无明显差异。随着内脏脂肪面积的增大,ORG三组患者尿蛋白排泄量[(0·89±0·41),(1·47±0·69)和(2·25±1·23)g/24h]、局灶节段性肾小球硬化(40%,50%和100%)的比例明显增加(P<0·05,ANOVA)。与之相对应的是,肾小球滤过率、胰岛素抵抗程度亦随着内脏脂肪面积的增大而增加(P<0·05,ANOVA),脂质代谢差异不显著。C反应蛋白水平随内脏脂肪面积的增加有升高的趋势(P>0·05,ANOVA);而肾周脂肪厚度间无明显差别。结论:腹部脂肪的堆积不仅与ORG的发生,还与该病的进展密切相关。其中血流动力学异常和胰岛素抵抗可能起主要的作用。     

The relationship between body fat distribution and renal damage in Chinese with obesity.

OBJECTIVE: It has been recognized that in addition to being overweight, abnormal fat distribution may be associated with the etiology of metabolic syndrome. Asian people are more prone to develop visceral obesity than people in western countries. The present study was initiated to evaluate the relationship between visceral obesity and renal damage in Chinese obese people. METHODS: As measured by computed tomography, the areas of visceral fat were compared between 30 patients with biopsy-proven obesity-related glomerulopathy (ORG) and 20 obese volunteer controls that were free of renal diseases. The two groups were matched for age and sex. RESULTS: It was found that the areas of visceral fat were markedly increased in patients with ORG, while body mass indexes were similar in the two groups. Patients with ORG also showed higher levels of total cholesterol and a higher degree of insulin resistance than the controls. Multiple logistic regression analysis revealed that visceral obesity was significantly associated with the prevalence of ORG (OR 1.136; 95%CI, 1.106-1.166; P=0.003). Interestingly, proteinuria level was related directly with waist circumference, visceral obesity and levels of total cholesterol, fasting glucose, insulin and HOMA-IR ( P<0.05). Moreover, only HOMA-IR was independently associated with proteinuria level in stepwise linear regression ( R=0.641; P=0.001). CONCLUSIONS: The present study illustrated the positive association between visceral obesity and ORG and between insulin resistance and proteinuria level in Chinese obese subjects.     

The relation between obesity, abdominal fat deposit and the angiotensin-converting enzyme gene I/D polymorphism and its association with coronary heart disease

OBJECTIVE: To analyse the relation between overweight, obesity and fat distribution with I/D polymorphism of the angiotensin-converting enzyme (ACE) gene and its association with coronary heart disease (CHD). DESIGN: Cross-sectional, case-control study. SUBJECTS: A total of 185 cases (141 males) who had suffered at least one episode of CHD and 182 controls (127 males). MEASUREMENTS: Body mass index, waist circumference, blood pressure, plasma total cholesterol, triglycerides, HDL cholesterol and fasting glucose were measured with standard methods, genotyping the I/D polymorphism of ACE gene. RESULTS: Obesity and abdominal fat deposit are associated with CHD in women, but not independently. We have found an association between obesity and abdominal fat deposit with the ACE gene I/D polymorphism in subjects with CHD. Subjects with CHD and DD or ID genotypes have significantly higher prevalence of obesity and abdominal fat deposit and higher values of weight and waist circumference. In addition, the DD and ID genotypes increased crude OR of obesity. The DD and ID genotypes of the ACE gene I/D polymorphism and BMI are independently associated with CHD. CONCLUSION: There is a relation between the type and grade of obesity with the genotypes of the ACE gene I/D polymorphism in subjects with CHD.     

Relationships among serum testosterone levels, body fat and muscle mass distribution in women with polycystic ovary syndrome

We investigated the relationships among serum testosterone levels, body fat and muscle mass distribution in women with polycystic ovary syndrome (PCOS). Subjects were 67 women with PCOS (mean age +/- standard deviation, 28.8 +/- 6.6 years). Baseline characteristics included age and height. Trunk-leg fat ratio and trunk-leg muscle ratio were assessed with dual-energy x-ray absorptiometry. Serum testosterone and dehydroepiandrosterone sulfate levels were measured with radioimmunoassays. Relationships among serum testosterone levels, body fat and muscle mass distribution were investigated using Pearson and partial correlation tests. Serum testosterone levels were positively correlated with trunk-leg fat ratio (r = 0.398, P < 0.01), but were inversely correlated with trunk-leg muscle ratio (r = -0.332, P < 0.05). Trunk-leg muscle ratio was inversely correlated with trunk-leg fat ratio (r = -0.360, P < 0.01). Serum testosterone levels were still correlated with trunk-leg fat ratio (r = 0.500, P < 0.001) and trunk-leg muscle ratio (r = -0.286, P < 0.05), after adjusting for age and height. Trunk-leg fat ratio was still correlated with trunk-leg muscle ratio, after adjusting for age, height, and serum testosterone levels. Based on these results, we concluded that higher serum testosterone levels may contribute to the upper body fat distribution and peripheral muscle mass distribution. In addition, peripheral muscle mass distribution may also contribute to the upper body fat distribution.     

Relationship between ambulation and obesity in older persons with and without low back pain

CONTEXT: For obese older persons, ambulation is both functionally important and a means of weight control. The relationship between weight and ambulation is not known in this population. Also, the extent to which pain interferes with ambulation is not studied. OBJECTIVE: To examine the relationship between obesity and ambulation, and to determine the effect of pain and body mass index (BMI) on ambulation in older persons. DESIGN, SETTING, AND PARTICIPANTS: Retrospective study of 82 older persons, ages 55-79 y, some with no back pain recruited from the community, others with back pain or spinal stenosis recruited from a magnetic resonance imaging (MRI) scanner as part of a larger university study of spinal stenosis. OUTCOME MEASURES: Age, Visual Analog Scales for pain, BMI, patient diagnosis (no pain, mechanical back pain, and spinal stenosis), walking velocity and stride length on a 15-min laboratory ambulation test, and 1-week community ambulation measured with a pedometer (steps, distance, and energy expenditure). RESULTS: BMI had a significant inverse relationship with ambulatory measurements in terms of the distance walked, steps taken, and walking velocity. Pain severity and pain category also had a significant inverse relationship with these measures. A negative correlation was observed between pain and obesity, although the relationship was statistically nonsignificant. DISCUSSION: Obese older people walked less than the nonobese older people. Pain was associated with decreased ambulation. Clinicians who intend to encourage increased ambulation in older obese persons should consider possible barriers posed by musculoskeletal pain.     

腹型肥胖患者腹内脂肪厚度与臂踝脉搏波传导速度的相关性

目的：探讨腹型肥胖患者腹内脂肪厚度（VFT）与臂踝脉搏波传导速度（baPWV）的相关性。方法：选择我院2010年10月～2011年1月体检中心腹型肥胖患者107例（腹型肥胖组）,入选患者均测定baPWV以及腰围,以超声测量VFT,同时选择年龄、性别相匹配的健康人98例作为健康对照组。比较两组baPWV以及分析腹型肥胖患者VFT和baPWV的相关性。结果：与健康对照组比较,腹型肥胖组腰围[（80.32±8.54）cm比（95.79±10.59）cm,P〈0.05]、VFT[（31.36±9.72）mm比（53.71±11.42）mm,P〈0.001]明显增加,baPWV明显增速[（1373.19±128.91）cm/s比（1539.17±158.79）cm/s,P〈0.001];控制甘油三酯、低密度脂蛋白、年龄等相关因素,腹型肥胖组VFT与baPWV呈正相关（偏相关系数r=0.47,P=0.027）。结论：腹内脂肪是腹型肥胖患者动脉弹性减退的独立危险因素,早期予以血管保护,可能会延缓血管重塑,对改善预后有重要意义。