Leptin and body composition in healthy postmenopausal women

BACKGROUND: Leptin has been proposed to be involved in central control of adiposity and fat distribution but the role of this peptide is controversial. The aim of our study was to test the relationship between serum leptin and body composition, fat distribution, and some biochemical markers such as fasting insulinemia and lipoproteins in a population of healthy Italian postmenopausal women. METHODS: One hundred and twenty-three postmenopausal women (62.1+/-8.7 years) were evaluated. Body composition (fat and lean mass) was assessed by dual-energy X-ray absorptiometry (DXA). Two regions of interest were determined for regional fat analysis. Serum leptin and insulinemia were measured by radioimmunoassay, lipoproteins with colorimetric methods and apolipoproteins nephelometrically. RESULTS: Plasma leptin levels are strongly related to total fat mass, in grams (r=0.73, p<0.001) or as a percentage of soft tissue (r=0.75, p<0.001), and to adiposity, calculated as ratio between lean and fat mass (r=0.76, p<0.001). A significant correlation was also found between serum leptin and central fat distribution (r=0.29, p<0.01). As concerns biochemical markers, serum leptin was significantly related to fasting insulin (r=0.38, p<0.001), total cholesterol (r=0.29, p<0.01), Apolipoprotein-B (r=0.35, p<0.001), and triglycerides (r=0.22, p<0.05). When corrected for total fat mass, the partial correlation coefficients remain significant for percentage of total body fat (r=0.27, p<0.01), adiposity (r=0.23, p<0.01), and fat proportion in android region (r=0.18, p<0.05). CONCLUSIONS: These data indicate that leptin levels are related to adiposity and fasting insulin levels; indeed fast insulin mantains significant correlation with leptin (r=0.23, p<0.01) after controlling for fat mass. Android distribution of fat mass in elderly women is associated with leptin concentration.     

Lipid profile and socioeconomic status in healthy middle aged women in Sweden.

STUDY OBJECTIVE: To examine the relationship between socioeconomic status (SES) and full lipid profile in middle aged healthy women. PARTICIPANTS: These comprised 300 healthy Swedish women between 30 and 65 years who constitute the control group of the Stockholm female coronary risk study, a population based, case-control study of women with coronary heart disease (CHD). The age matched control group, drawn from the census register of greater Stockholm, was representative of healthy Swedish women aged 30-65 years. Five measures of SES were used; educational level, occupation, decision latitude at work, annual income, and size of house or apartment. MAIN RESULTS: Swedish women with low decision latitude at work, low income, low educational level, blue collar jobs, and who were living in small houses or apartments had an unhealthy lipid profile, suggesting an increased risk of CHD. Part of this social gradient in lipids was explained by an unhealthy lifestyle, but the lipid gradients associated with decision latitude at work and annual income were independent of these factors. Decision latitude, educational level, and annual income had the strongest associations with lipid profile. These associations were independent of age, menopausal status, smoking, sedentary lifestyle, alcohol consumption, obesity, excess abdominal fat, and unhealthy dietary habits. Of the lipid variables, low high density lipoprotein cholesterol (HDL) levels were most consistently associated with low SES. CONCLUSIONS: Decision latitude at work was the strongest SES predictor of HDL levels in healthy middle aged Swedish women, after simultaneous adjustment for other SES measures, age, and all lifestyle factors in the multivariable regression model.     

Depression in black and white women : The role of marriage and socioeconomic status

The degree to which the relationship between race and depression in US black and white women is modified by socioecanomic and marital status was investigated. Data on 534 black and 836 white women, 25 to 64 years old, obtained from the 1986 Americans' Changing Lives national survey were utilized. Depression was measured by the Centers for Epidemiologic Studies Depression scale. Poverty status and education were used as indicators of socioeconomic status (SES). For both black and white women, the prevalence of depression was higher among those with lower as compared to higher SES, and among the unmarried as compared to the married. The unstratified, age-adjusted odds of depression for black women was twice that for white women (odds ratio (OR) = 2.2; 95% confidence interval (CI), 1.7 to 2.8); however, when stratified by poverty status, race effects were observed for nonpoor (OR = 2.2; 95% CI, 1.6 to 3.0) but not for poor women (OR = 1.3; 95% CI, 0.7 to 2.1). Race effects were also more pronounced among married (OR = 2.0; 95% CI, 1.4 to 2.9) than unmarried women (OR = 1.6; 95% CI, 1.1 to 2.4). Controlling for known confounders did not alter these results. Additional analyses revealed that the black excess risk for depression was concentrated among higher SES, married women, with marital difficulties appearing to pay a major role in their elevated depression scores.     

Attitudes of African American and low socioeconomic status white women toward medical research

Minority and low socioeconomic status women are under-represented in clinical research due to logistical, informational, attitudinal, and sociocultural barriers. The primary objective of this study was to explore factors associated with research participation among African American and low socioeconomic status White women using the Theory of Planned Behavior. A secondary goal was to assess differences in barriers to research participation by age and race. A combination of qualitative (focus groups) and quantitative (trust scale) methodologies was employed. Ten focus groups were held, organized by age and race. Content analysis revealed three predominant themes: fear, distrust, and hope. Older women had higher trust; there was no difference in trust by race. The results suggest that women have conflicting feelings about research that cross ethnic lines and should be addressed by researchers. Effective strategies for overcoming barriers and increasing representation are those that establish ongoing relationships with relevant communities.     

Total and regional body composition and energy expenditure in multiple symmetric lipomatosis

AIMS: The aim of the present study was to investigate possible alterations in body composition and resting energy expenditure (REE) in type 1 multiple symmetric lipomatosis (MSL). SUBJECTS AND METHODS: Thirteen men aged from 40 to 78 years affected by type I MSL were compared with 13 healthy control subjects. Fat mass (FM) and fat-free mass (FFM) were determined by DEXA using both standard analysis and specifically for the lipomatous region. REE was measured by indirect calorimetry. RESULTS: FM was higher in MSL subjects at proximal arm level, but significantly lower at distal leg level than in controls (left 1.63+/-0.55 vs. 2.26+/-0.49 kg, P<0.05; right 1.63+/-0.53 vs. 2.40+/-0.54 kg, P<0.01). Arm FFM was similar in the two groups, while distal leg FFM was significantly lower in MSL cases (left: 7.8+/-1.3 vs. 8.7+/-0.8 kg, P<0.05; right: 8.0+/-1.5 vs. 9.2+/-0.9 kg, P<0.05). FFM strongly correlated with REE (r:0.86;P<0.001). REE, expressed as an absolute value and adjusted for FFM (1830+/-215 vs. 1675+/-120 kcal, P<0.05) was higher in MSL patients. CONCLUSION: In conclusion, MSL patients had a marked FFM and FM atrophy in the lower segments of the legs and an altered energy expenditure (hypermetabolism).     

Relation between body composition and age in healthy Japanese subjects.

OBJECTIVE: To describe the relation between body composition and age measured by dual-energy X-ray absorptiometry (DXA) in healthy Japanese adults. DESIGN: Cross-sectional study. SUBJECTS AND MEASUREMENTS: The subjects were 2411 healthy Japanese adults (males 625, females 1786, age 20--79 y) who attended the Fukuoka Health Promotion Center, Fukuoka, Japan for health check-up. Body composition was determined by DXA (QDR-2000, Hologic) for the whole body and three anatomical regions of arms, legs and trunk. RESULTS: The mean values of body mass index (BMI) and percentage fat mass (%FM) were 23.2+/-3.1 (s.d.) kg/m(2) and 21.8+/-6.8% for males and 22.1+/-3.3 kg/m(2) and 32.0+/-7.5% for females, respectively. For males, curvilinear relations with the peaks in their forties or fifties were seen for the variables associated adiposity, ie BMI, waist and hip circumference, waist-hip ratio, total or regional fat mass (FM), %FM and ratio of trunk FM to leg FM. For females, most of these variables increased linearly in older subjects. Lean mass (LM), bone mineral content (BMC) and bone mineral density (BMD) of the whole body and appendicular LM were relatively constant until the forties and then decreased in both sexes. The rates of decrease in the total or appendicular LM were larger for males than for females, whereas those in BMC or BMD were larger for females than for males. CONCLUSIONS: This study presents the first detailed data on body composition in Japanese, which may be useful when comparing with populations of different racial and ethnic backgrounds and studying ill subjects.     

Magnesium, insulin resistance and body composition in healthy postmenopausal women

OBJECTIVE: This study was conducted to determine the association between magnesium (Mg), body composition and insulin resistance in 136 sedentary postmenopausal women, 50 to 77 years of age. METHODS: Diabetics, hypertensives and women on hormonal replacement therapy were excluded and the remaining 74 were divided according to BMI> or =25 (obese: OG) and BMI<25 kg/m(2) (non-obese: NOG). Nutritional data disclosed that intakes were high for protein and saturated fat, low for carbohydrates, polyunsaturated fat and Mg and normal for the other nutrients, according to recommended dietary allowances (RDA). Mg values in red blood cells (RBC-Mg) and plasma (P-Mg), were determined, as were fasting glucose, and insulin levels, Homeostasis Model Assessment (HOMA), body mass index (BMI), body fat percent (BF %), abdominal fat (AF) and free fat mass (FFM). RESULTS: RBC-Mg values were low in both groups when compared with normal values. There were significant differences in body composition parameters, HOMA and insulin levels, with higher basal insulin levels in OG. RBC-Mg was directly correlated with insulin, HOMA and FFM in both groups, according to Pearson correlations. HOMA in OG was also directly correlated with BMI, FFM and AF. In NOG, HOMA was only correlated with FFM. The low RBC-Mg levels observed were probably due to low Mg intake and to deregulation of factors that control Mg homeostasis during menopause. CONCLUSIONS: Both Mg deficit and obesity may independently lead to a higher risk for insulin resistance and cardiovascular disease.     

The interplay of socioeconomic status and ethnicity on Hispanic and white men's cardiovascular disease risk and health communication patterns

In this article, we seek to confirm past studies that document increased levels of cardiovascular disease (CVD) risk factors among White men with lower educational attainment. Second, we include a population of Hispanic men (89% Mexican American) to examine the separate and interactive effects of ethnicity and education (our measure of socioeconomic status) on CVD risk factors. Third, we examine how education and ethnicity are related to receiving health messages from print media and interpersonal channels, with the hypothesis that less educated, higher CVD risk Hispanic and White men receive fewer messages than more educated men. Finally, we examine other psychosocial variables (e.g. knowledge, self-efficacy and motivation) that may help explain observed differences in CVD risk and health communication. The study sample included 2029 men, 25-64 years of age, from three population-based, cross-sectional surveys conducted from 1979 to 1990 as part of the Stanford Five-City Project. Hispanic and White men with lower educational attainment had higher levels of CVD risk factors, and received less health information from print media and interpersonal channels than Hispanic and White men with higher educational attainment. Furthermore, less educated men from both ethnic groups reported less CVD knowledge, lower self-efficacy and lower motivation to reduce CVD risk factors than higher educated men. These results highlight the need for effective intervention programs that target low educated Hispanic and White men to decrease their disproportionate risk of CVD.     

The interrelationship between body topology and body composition varies with age among women

The purpose of this analysis was to evaluate the relationship between age and the size and distribution of the fat and lean tissue compartments in a population-based sample of women. The study population consisted of the 875 women aged 18-94 y in the Iowa Bone Health Study who reported never smoking. Fat mass and lean mass were measured using dual X-ray absorptiometry. Hip and waist circumference and height were measured using standardized protocols. Regression was used to model the associations among age, composition and topology measures. When fat mass was modeled as a function of hip and waist circumference as well as age, age(2) and height, the age x height and age x waist circumference interaction terms remained in the fitted model and collectively accounted for 91% of the variance. In contrast, the quadratic model of age alone accounted for 8% of the observed variance in fat mass. Lean mass was modeled in two segments, with age dichotomized at 58 y. Age alone did not predict lean mass in women <58 y but did predict lean mass in women >/=58 y, with the modeled relationship including interactions with waist circumference and height. These models accounted for 70% of observed variance in lean mass. Age is associated with body composition but explains <10% of variation. When measures of height and circumferences are available, amounts of lean and fat mass are highly predictable. This is particularly important for lean mass because no other surrogate measures exist for lean mass, whereas there are surrogates for fat mass, including body mass index.     

Pro-cyclical mortality across socioeconomic groups and health status

Using variation across geographic regions, a number of studies from the U.S. and other developed countries have found more deaths in economic upturns and less deaths in economic downturns. We use data from regions in Norway for 1977–2008 and find the same pro-cyclical patterns. Using individual-level register data for the identical population, we find that disadvantaged socioeconomic groups are not hit harder by pro-cyclical mortality than advantaged groups. We also find that other indicators of deteriorated health (than death), like becoming disabled, are pro-cyclical. Overall, our analysis suggests that pro-cyclical mortality is rather related to deaths of people already in deteriorated health than to people of low socioeconomic status.     

Resting metabolic rate and body composition of healthy Swedish women during pregnancy

Body weight, resting metabolic rate (RMR), total body potassium (TBK), and total body water were measured and total body fat (TBF) was calculated in a longitudinal study of 22 pregnant, healthy Swedish women. Measurements were made before pregnancy, at gestational weeks 16-18, 30, and 36, and 5-10 d and 6 mo postpartum. RMR increased more during pregnancy than previous estimates on well-nourished women showed and the increase was significantly correlated with the birth weight of the baby. TBK decreased during the first part of pregnancy; measurements at weeks 16-18 and 30 were significantly lower than the prepregnancy value and changes in TBK and RMR were significantly correlated. TBF gain during pregnancy was 5.8 +/- 4.0 kg and 60% was already gained by gestational weeks 16-18. Gain in fat was not correlated with birth weight.     

Neighborhood socioeconomic status and cognitive function in women

Objectives. We examined whether neighborhood socioeconomic status (NSES) is associated with cognitive functioning in older US women and whether this relationship is explained by associations between NSES and vascular, health behavior, and psychosocial factors.Methods. We assessed women aged 65 to 81 years (n = 7479) who were free of dementia and took part in the Women''s Health Initiative Memory Study. Linear mixed models examined the cross-sectional association between an NSES index and cognitive functioning scores. A base model adjusted for age, race/ethnicity, education, income, marital status, and hysterectomy. Three groups of potential confounders were examined in separate models: vascular, health behavior, and psychosocial factors.Results. Living in a neighborhood with a 1-unit higher NSES value was associated with a level of cognitive functioning that was 0.022 standard deviations higher (P = .02). The association was attenuated but still marginally significant (P < .1) after adjustment for confounders and, according to interaction tests, stronger among younger and non-White women.Conclusions. The socioeconomic status of a woman''s neighborhood may influence her cognitive functioning. This relationship is only partially explained by vascular, health behavior, or psychosocial factors. Future research is needed on the longitudinal relationships between NSES, cognitive impairment, and cognitive decline.A growing body of research suggests that the characteristics of neighborhoods in which individuals live may influence their risk of poor self-rated health, cardiovascular disease, and mortality above and beyond individual-level characteristics.^1–15 The proposed mechanisms by which lower quality neighborhoods may affect physical health include increased exposure to chronic stressors and pollutants in the environment; increased access to alcohol and cigarette outlets; barriers to physical activity; reduced social support, networks, and cohesion; and reduced access to high-quality health and social services. Three recent studies have linked lower neighborhood socioeconomic status (NSES) to lower cognitive function in UK adults older than 52 years,¹⁶ US adults older than 70 years living in urban areas,¹⁷ and Mexican Americans older than 65 years living in 5 southwestern states.¹⁸ However, the mechanisms underlying this relationship are not well understood.Extensive epidemiological research has linked NSES to vascular-related conditions,^4,19–22 poor health behaviors,^23–25 and greater psychosocial stress.^26–30 Incidentally, these factors also have well-established linkages with brain health such that individuals who have vascular-related conditions,^31,32 who engage in low levels of physical activity, whose tobacco and alcohol consumption is excessive,^33–35 and who have pronounced symptoms of depression or low social support^36–38 are at increased risk for poor cognitive function. No studies to date have addressed whether these conditions may explain the relationship between NSES and cognitive function.Previous studies indicate that neighborhood environments may influence poor cognitive function above and beyond individual-level demographic characteristics such as age, race/ethnicity, educational attainment, and income.^16,17,39,40 Certain demographic subgroups may be especially vulnerable to the effects of NSES on cognitive function. For example, poor neighborhood environments may have stronger effects on older adults than on younger adults because older adults spend more time in their neighborhoods⁴¹; may have less access to social, financial, or health services; and have accumulated more exposures to stressors or pollutants. Non-White older adults who live in lower socioeconomic status (SES) neighborhoods may face discrimination or other stressors that may confer greater vulnerability to NSES effects on cognitive function.Wight et al.¹⁷ examined individual- and neighborhood-level educational interactions among US adults. However, no US study to date has addressed whether other individual-level demographic factors may buffer or exacerbate the negative effects on cognitive function of living in a lower SES neighborhood using an index consisting of important measures of SES beyond education alone.We examined whether an NSES index was related to cognitive function in a large, geographically and demographically diverse cohort of older US women with rich data on a sensitive measure of global cognitive function and a comprehensive set of clinical, behavioral, and psychosocial confounders. In addition, we assessed whether the relationship between NSES and cognitive function was explained by risk and protective factors for poor cognitive function that have also been linked with NSES and whether certain subgroups were more vulnerable to lower NSES.     

Total body potassium differs by sex and race across the adult age span

BACKGROUND: Total body potassium (TBK) is an index of fat-free mass. Data describing changes in TBK in African American, Asian, or Hispanic populations have not been reported. OBJECTIVE: The aim was to investigate possible sex and racial differences in TBK in adults over an age range of 70 y. DESIGN: The study used longitudinal and cross-sectional data collected in a body-composition unit from 973 men and 1368 women of African American, Asian, white, and Hispanic race-ethnicity. Random coefficient models in which baseline weight and height were taken into account were applied to estimate sex-specific changes in TBK among the 4 racial-ethnic groups. RESULTS: The ages of 30 and 31 y were identified for women and men, respectively, as the cutoffs after which TBK began to decline. Both sexes had similar racial-ethnic patterns for expected mean TBK at the age cutoffs: African Americans had the highest value, followed by whites, Hispanics, and Asians. After the age cutoffs, the decline in TBK differed by race and sex. In women, African Americans showed the most rapid decline, whereas Asians had the lowest. In men, Hispanics had the most rapid decline in TBK, followed by African Americans, whites, and Asians. CONCLUSION: Significant sex and racial differences exist in the rate of change in TBK with age. Further studies are needed to explore the associations of declining TBK with health risks.     

Energy expenditure,body composition,and biochemical indicators in healthy community women

A cross-sectional study was conducted on the associations between energy expenditure (EE), body composition (lean mass, fat mass, body mass index), and biochemical indicators (leptin, glucagon, insulin, cortisol, and triglycerides) among 17 sedentary African-American and Caucasian women living in the community (age, 40.7±6.0 years; body mass index, 32.8±9.0 kg/m²). Measurements included total, resting, and sleeping EE (via whole-room indirect calorimetery), body composition (via air-displacement plethysmography), body mass index, and biochemical indicators (leptin, glucagon, cortisol, insulin, and triglycerides). Analysis of associations between EE and body composition showed that EE increased with increasing body size, with lean mass explaining 79%, 71%, and 73% of the variability in total, resting, and sleeping EE, respectively. Analysis of associations between body composition and the biochemical indicators showed that leptin, glucagon, and insulin were positively correlated with increasing body size, whereas cortisol was negatively correlated with increasing body size. Analysis of associations between EE and biochemical indicators prior to controlling for body size showed that leptin was positively correlated with EE, and that the correlation between leptin and sleeping EE was significantly greater than the correlation between leptin and resting EE. After controlling for body size, the correlations between leptin and EE were no longer significant, and the partial correlation between leptin and sleeping EE was no longer significantly different from the partial correlation between leptin and resting EE. Glucagon was positively correlated with EE, but not after controlling for body composition. Future research should incorporate the use of sleeping EE in addition to resting EE, since clearly, for some biochemicals such as leptin and glucagon, this distinction is important. Methodological improvements may provide better insight into the effects of obesity modulating hormones.     

Energy expenditure, body composition, and biochemical indicators in healthy community women

A cross-sectional study was conducted on the associations between energy expenditure (EE), body composition (lean mass, fat mass, body mass index), and biochemical indicators (leptin, glucagon, insulin, cortisol, and triglycerides) among 17 sedentary African-American and Caucasian women living in the community (age, 40.7+/-6.0 years; body mass index, 32.8+/-9.0 kg/m2). Measurements included total, resting, and sleeping EE (via whole-room indirect calorimetery), body composition (via air-displacement plethysmography), body mass index, and biochemical indicators (leptin, glucagon, cortisol, insulin, and triglycerides). Analysis of associations between EE and body composition showed that EE increased with increasing body size, with lean mass explaining 79%, 71%, and 73% of the variability in total, resting, and sleeping EE, respectively. Analysis of associations between body composition and the biochemical indicators showed that leptin, glucagon, and insulin were positively correlated with increasing body size, whereas cortisol was negatively correlated with increasing body size. Analysis of associations between EE and biochemical indicators prior to controlling for body size showed that leptin was positively correlated with EE, and that the correlation between leptin and sleeping EE was significantly greater than the correlation between leptin and resting EE. After controlling for body size, the correlations between leptin and EE were no longer significant, and the partial correlation between leptin and sleeping EE was no longer significantly different from the partial correlation between leptin and resting EE. Glucagon was positively correlated with EE, but not after controlling for body composition. Future research should incorporate the use of sleeping EE in addition to resting EE, since clearly, for some biochemicals such as leptin and glucagon, this distinction is important. Methodological improvements may provide better insight into the effects of obesity modulating hormones.     

Association between socioeconomic status and obesity in 59,556 women

A study of 59,556 weight-conscious women in the United States who participated and supported this study is reported. A leader-directed confidential questionnaire was administered to small groups of TOPS Club women in 1969 and 1970, and obtained height, education, weight, age, family income, and husband's education.An inverse relationship between socioeconomic status (income) and obesity was found. The most important finding in the study was that the degree of obesity of the women was inversely related to their husband's education level, but not correlated with their own education level. The strength of the inverse relationship between income (or husband's education) and obesity was much less than that of a study conducted 20 yr ago. This suggests “melting pot” factors in our society which have reduced social class differences with regard to eating behavior and body image goals.     

Association between socioeconomic status and obesity in 59,566 women

A study of 59,556 weight-conscious women in the United States who participated and supported this study is reported. A leader-directed confidential questionnaire was administered to small groups of TOPS Club women in 1969 and 1970, and obtained height, education, weight, age, family income, and husband's education.An inverse relationship between socioeconomic status (income) and obesity was found. The most important finding in the study was that the degree of obesity of the women was inversely related to their husband's education level, but not correlated with their own education level. The strength of the inverse relationship between income (or husband's education) and obesity was much less than that of a study conducted 20 yr ago. This suggests “melting pot” factors in our society which have reduced social class differences with regard to eating behavior and body image goals.     

Impact of Hispanic ethnic concentration and socioeconomic status on obesity prevalence in Texas counties

The purpose of this study is to determine whether Hispanic ethnic concentration is associated with a higher prevalence of obesity and, if this relationship exists, whether it is affected by the socioeconomic environment. The study uses the Texas Behavioral Risk Factor Surveillance System (BRFSS) linked to 2000 census data to access the relationship between prevalence of obesity, Hispanic ethnic concentration, poverty and level of education at a county-level. The findings suggest that the association of Hispanic ethnic concentration and obesity varies by socioeconomic environment. Although little influence was observed for % poverty, the relationship between Hispanic ethnic concentration and obesity differed by county-level educational attainment. High proportion of residents with a bachelor's degree is associated with a low prevalence of obesity; counties with both high % Hispanic and high % with Bachelor's degrees had the lowest prevalence of obesity. Our results suggest that promoting and improving education, perhaps including training on healthful living, may serve as an effective means of curbing current obesity trends and associated health problems in Hispanic and possibly other ethnic communities.