Central-to-peripheral fat ratio,but not peripheral body fat,is related to insulin resistance and androgen markers in polycystic ovary syndrome

Background.?Overweight, hyperandrogenism and insulin resistance are cardinal features of patients with polycystic ovary syndrome (PCOS). Women with PCOS have excess accumulation of trunkal fat and metabolic complications. Recent findings suggest that peripheral fat may have metabolic protective behaviour. The aim of this study was to investigate body fat distribution in patients with PCOS and associations of peripheral fat with metabolic and hormonal profile.

Methods.?The study included 24 patients with PCOS and a control group of 13 women. Anthropometrical evaluation and dual-energy X-ray absorptiometry to determine body composition was performed. Plasma metabolic and hormonal profiles were evaluated.

Results.?Patients with PCOS have increased proportion of central to peripheral fat ratio (CPFR) when compared to controls (p?=?0.008). There was a positive correlation among trunkal fat, insulin, HOMA-IR and triglycerides (all p?<?0.05). Regarding to peripheral fat there was no difference between groups, a trend to negative correlation to insulin appeared. Positive correlation between free androgens index and CPFR (p?=?0.058) and a negative correlation between SHBG and CPFR (p?=?0.016) were appeared.

Conclusions.?Patients with PCOS showed an android pattern fat distribution when compared to controls. Peripheral fat contribution and its relations to androgens in this context could not be established. Android pattern of fat distribution showed inverse correlation to SHBG levels, suggesting that SHBG may be related to fat distribution.     

Composition of gestational weight gain impacts maternal fat retention and infant birth weight

OBJECTIVE: The purpose of this study was to evaluate how changes in gestational weight and body composition affect infant birth weight and maternal fat retention after delivery in underweight, normal-weight and overweight women. STUDY DESIGN: We assessed the body composition of 63 women (low body mass index, 17 women; normal body mass index, 34 women; and high body mass index, 12 women) on the basis of measurements of total body nitrogen by prompt-gamma activation analysis, total body potassium by whole body counting, and a multicomponent model based on total body water by deuterium dilution, body volume by densitometry, and bone mineral content by dual energy x-ray absorptiometry (DXA) before pregnancy, at 9, 22, and 36 weeks of gestation, and at 2, 6, and 27 weeks after delivery. Infant weight and length were recorded at birth; infant anthropometry and body composition by DXA were assessed at 2 and 27 weeks of age. RESULTS: Gestational weight gain was correlated significantly with gains in total body water, total body potassium, protein, fat-free mass, and fat mass (P=.001-.003). Gains in total body water, total body potassium, protein and fat-free mass did not differ among body mass index groups; however, fat mass gain was higher in the high body mass index group (P=.03). Birth weight was correlated positively with gain in total body water, total body potassium, and fat-free mass (P<.01), but not fat mass. Postpartum weight and fat retention were correlated positively with gestational weight gain (P=.001) and fat mass gain (P=.001) but not with total body water, total body potassium, or fat-free mass gain. CONCLUSION: Appropriate, but not excessive, gestational weight gain is needed to optimize infant birth weight and minimize maternal postpartum fat retention.     

Body mass index,body fat mass and the occurrence of amenorrhea in ballet dancers

To evaluate the connection between menstrual disorders and body fat mass, we examined a group of 30 ballet dancers and a group of 30 non-athletic girls (controls). Body mass index (BMI) was calculated and percent body fat (FAT_%) was measured using the bioelectrical impedance method. A questionnaire was used to obtain age at menarche and duration of menstrual cycles. Ballet dancers had significantly lower values of BMI (18.56?±?1.53 vs. 19.96?±?2.12?kg/m²) and FAT_% (18.85?±?4.50 vs. 23.41?±?4.34%) compared with controls. According to BMI, 50.0% of ballet dancers and 23.3% of the control group were underweight. Of underweight ballet dancers, 66.7% had lower values of body fat, while most underweight girls from the control group had normal body fat. Normal-weight obesity was registered in 40.9% of the control group and in 6.7% of ballet dancers. Amenorrhea was found in 20.0% and oligomenorrhea in 10.0% of ballet dancers. Ballet dancers more frequently had later appearance of menarche and menstrual cycles of longer duration than did non-athletic girls. A significant negative correlation was found between menstrual cycle duration and FAT_% among ballet dancers (r?=–0.415). To prevent complications caused by changes of body fat mass, we conclude that body composition assessment in ballet dancers is very important.     

Increasing maternal percentage body fat in early second trimester: a risk factor for preeclampsia

Objective: To determine if maternal percentage body fat (PBF) or fat free mass (FFM) in the early second trimester of pregnancy influenced the development of preeclampsia.

Methods: A matched nested case-control study was conducted from a cohort study of 1668 women at Gansu provincial maternal and child care hospital from July 2007 to August 2011 in China. Maternal PBF and FFM were assessed by bioelectrical impedance analysis during 12th–16th gestational week. The demographic characteristics were all chart abstracted. After childbirth, 70 cases of preeclampsia were matched by race/age with 140 uncomplicated pregnancies women. Multivariate logistic regression analysis was performed to determine the associated risk factors.

Results: Pre-pregnancy body mass index were higher in women who subsequently developed preeclampsia compared with controls (p?<?0.001). During 12th–16th gestational week, there were nearly 7-fold increase in the odds of preeclampsia (adjusted OR: 6.84, 95% CI: 4.15–41.60) among women with PBF?≥?40% versus women with PBF?<?40%. But FFM were not at further increased risk of the development of preeclampsia (adjusted OR, 1.02; 95% CI, 0.6–3.6).

Conclusion: Maternal PBF but not FFM is a predictor of preeclampsia in the early second trimester. Excessive adipose tissue possibly played an important role in developing of preeclampsia.     

Body mass index is a major determinant of abdominal fat accumulation in pre-, peri- and post-menopausal women

Objective. To investigate the role of menopause, body mass index (BMI) and aging on body fat distribution in women.

Design. In this population-based cross-sectional study, 335 women (126 in pre-menopause, 75 in peri-menopause and 134 in post-menopause according to Stages of Reproductive Aging Workshop criteria) were evaluated for body mass composition and fat distribution by dual X-ray absorptiometry procedure. A sub-group of 79 women with similar age and BMI was extracted from the sample to examine the relative influence of BMI in body fat distribution.

Results. ANCOVA analysis of total sample showed an age-independent increase of total fat mass (p < 0.001) and percentage on total weight (p < 0.001), arms fat mass (p < 0.01), legs fat mass percentage on total fat (p < 0.05) and trunk fat mass (p < 0.001) and percentage (p < 0.05) in peri- and post- with respect to pre-menopausal women. In the sub-sample including age and BMI matched women the difference of regional fat parameters among menopausal status was no more statistically significant.

Conclusion. BMI, and not age, is the main determinant of the increase of body fat mass (total and abdominal) observed during the menopausal transition.     

Body fat distribution and leptin correlation in women with polycystic ovary syndrome: Endocrine and biochemical evaluation in south Indian population

Aims:   Obesity is associated with the increased prevalence of infertility and is also an independent risk factor in women with polycystic ovary syndrome (PCOS). The aim of this study was to examine the extent to which the ob gene product, leptin, alone or in combination with other metabolic and endocrinal parameters, may be correlated to infertility with the incidence of PCOS.
Methods:  Serum leptin levels were measured in both PCOS and non-PCOS subjects of the following categories, such as thin, overweight, obese and morbidly obese, and compared with normal weight women. Female infertility is associated with body mass index, percentage of body fat, body fat distribution, and other biochemical and endocrinal parameters parameters.
Results:  Women with PCOS and normally menstruating control women were analyzed by univariate analysis for body fat distribution. Serum leptin was positively correlated with body mass index, percentage of body fat, serum levels of dehydroepiandrosterone sulfate, testosterone, free testosterone, luteinizing hormone and prolactin. Serum leptin was inversely correlated with serum sex hormone-binding globulin concentration and androstenedione.
Conclusions:  We report, for the first time in the Indian population, that leptin levels are different in thin and morbidly obese PCOS patients than in regularly menstruating normal weight subjects, and leptin could be a novel, independent risk factor for PCOS. (Reprod Med Biol 2005; 4 : 71–78)     

Possible correlation of leptin with body fat distribution and adiposity: Evaluation of serum leptin in South Indian population

Background:  Leptin, an adipocyte-derived hormone, is known to play an important role in body fat. Gender, age, degree of obesity and sex steroids are expressed differentially in men and women.
Methods:  We measured serum leptin, testosterone and β-estradiol concentration by radioimmunoassay in 300 subjects (60 normal weight, 60 underweight, 60 overweight, 60 obese and 60 morbidly obese) by age group (18–40 years and 41–62 years), using full-length recombinant human leptin as a standard.
Results:  The present study found that morbidly obese and obese men and women older than 50 years had 50–70% higher body mass index (BMI)-adjusted leptin levels than younger subjects. In addition, obese and underweight subjects showed a tendency towards lower BMI-adjusted leptin levels in younger than older, in both men and women subjects. Multiple regression analysis showed that age was positively correlated with leptin in both genders, even if the slope of rise was twice as high in women than in men. Together, these results indicate that in both genders, most prominently in females, aging is associated with increased leptin production that is independent from the amount of fat and/or the role of sex hormones.
Conclusion:  In conclusion, our data show that serum leptin concentrations in men and women gradually increase during aging, being higher in women than in men, but they are independent from BMI and other hormones. The inclusion of several hormones in our regression model showed that only testosterone in men, and estradiol and androstenedione in women were independent contributions to serum leptin levels, possibly accounting for part of the leptin sexual dimorphism in a south Indian population.     

Body fat composition and weight changes during pregnancy and 6–8 months post-partum in primiparous and multiparous women

Objective:  To compare changes in maternal weight and body fat composition from early to late pregnancy and 6–8 months postnatally between primiparous and multiparous patients
Methods:  Maternal weight and body fat percentage were assessed in a cohort of low-risk uncomplicated women in a general antenatal clinic at 14–20 weeks gestation, after 36 weeks, and around six to eight months after delivery using a Tanita TBF 105 Fat Analyser. Maternal epidemiological and anthropometric data, as well as pregnancy characteristics and perinatal outcome, were derived from standard antenatal records after delivery. The cohort was stratified into primiparous and multiparous women for comparison.
Results:  In a cohort of 104 women, 55 (52.8%) were primiparous and 49 (47.1%) were multiparous. A relatively good overall correlation between body fat percentage gain and weight gain was observed (correlation coefficient 0.33) from early to late pregnancy. Primiparous women had higher weight gain (12 kg) and higher body fat gain (7.7%) during the pregnancy compared to multiparous women (10.8 kg and 6%, respectively), and they also retained more of the fat accumulated during pregnancy (1.92% vs – 0.44%, P  < 0.001) when assessed over six months after their delivery.
Conclusion:  The findings could represent more exaggerated physiological responses to the pregnant state in the primiparous woman as compared to multiparous women.     

Menopause-related differences in inflammation markers and their relationship to body fat distribution and insulin-stimulated glucose disposal.

OBJECTIVE: To determine whether postmenopausal status is associated with elevated plasma inflammation markers compared to premenopausal status, and how this explains differences in fat distribution and insulin-stimulated glucose disposal. DESIGN: Cross-sectional. SETTING: Clinical research center. PATIENT(S): Forty-five premenopausal women and 44 postmenopausal women. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) were measured by ELISA. Intraabdominal, subcutaneous abdominal, and total fat were measured by computed tomographic scan and dual-photon x-ray absorptiometry. Insulin-stimulated glucose disposal was measured by euglycemic clamp. RESULT(S): The TNF-alpha was higher in postmenopausal compared to premenopausal women (4.81 +/- 1.99 vs. 3.54 +/- 0.85 pg/mL). Interleukin-6 and CRP did not differ by menopausal status. In both premenopausal and postmenopausal women, CRP was related positively to total fat. The CRP was related to intraabdominal fat only in postmenopausal women and was negatively related to insulin-stimulated glucose disposal in both premenopausal and postmenopausal women. CONCLUSION(S): Postmenopausal status is characterized by higher TNF-alpha. The CRP may be associated with increased cardiovascular risk in postmenopausal women by its association with higher intraabdominal fat. Higher CRP is associated with lower insulin-stimulated glucose disposal in both premenopausal and postmenopausal women.     

Central abdominal fat and endogenous hormones during the menopausal transition

OBJECTIVE: To investigate the effect of endogenous hormone levels on central abdominal fat during the menopausal transition in a population-based cohort of Australian-born women. DESIGN: Prospective observational study. SETTING: Population-based sample. Body composition was assessed in the Royal Melbourne Hospital, and interviews were conducted at the patient's home. SUBJECT(S): One hundred two women from the Melbourne Women's Midlife Health Project. Data, physical measures, and blood were obtained by interview when the longitudinal study commenced (baseline) and at the time of the total body scan approximately 5 years later. Body composition was measured using dual-energy X-ray absorptiometry. INTERVENTION(S): None. MAIN OUTCOME MEASURES: Total body fat and central abdominal fat. RESULT(S): The 102 women were either premenopausal or in the early menopausal transition at baseline. At the time of their dual-energy X-ray absorptiometry scan, 31 were in the early menopausal transition, 22 were in the late menopausal transition, and 49 were postmenopausal. Multiple regression analysis found that total percentage of body fat was associated with weight measures, whereas central abdominal fat was also positively associated with baseline free T index (FTI) and with the increase in FTI since baseline. CONCLUSION(S): The major hormonal change associated with central adiposity during the menopausal transition is the increase in the FTI. This effect is significant even after allowing for baseline and final weight.     

Body composition characteristics and fat distribution patterns in young infertile women

OBJECTIVE: To document body composition and fat patterning characteristics in normal and underweight infertile women. DESIGN: Status quo method. SETTING: University clinics. PATIENT(S): Fifteen amenorrheic women with anorexia nervosa, 16 women with polycystic ovary syndrome (PCO2), 10 women with primary amenorrhea and 19 healthy controls. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Determination of body mass index, body composition parameters such as fat mass, lean body mass, bone mass using dual-energy x-ray absorptiometry (DEXA), fat distribution patterns, 17beta-estradiol, FSH, LH, prolactin, progesterone, testosterone, DHEA-S, and androstenedione levels. RESULT(S): A statistically significant difference was found comparing all proband groups with healthy controls for the majority of body fat and bone mineral content parameters but not for lean body mass. Infertile women of normal weight, with PCOS, and with primary amenorrhea exhibited an extraordinarily high amount of fat tissue and a tendency toward android fat patterning. In contrast, patients with anorexia nervosa and the healthy controls showed predominantly gynoid fat patterning. According to logistic regression analyses, anorexia nervosa was characterized by reduced fat tissue and PCOS was characterized by android fat patterning and an increased fat percentage. Patients with primary amenorrhea were characterized by reduced bone mass. CONCLUSION(S): Infertile young women showed characteristic differences in body composition and fat distribution patterns when compared with healthy, fertile, age-matched counterparts.     

非肥胖型多囊卵巢综合征患者体脂分布与胰岛素抵抗的研究

目的:研究非肥胖型多囊卵巢综合征(non-obese polycystic ovary syndrome,Nob-PCOS)患者体脂分布与胰岛素抵抗的关系。方法:非肥胖型多囊卵巢综合征(Nob-P-COS组)40例,以年龄、体重指数相匹配健康育龄妇女45例为对照组,采用双能X线吸收仪(DXA)测量全身和局部身体脂肪含量,化学发光法检测生殖内分泌,全自动生化分析仪检测糖、脂代谢指标。结果:Nob-PCOS组空腹胰岛素(INS)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、睾酮(T)分别为9.90±4.40μIU/ml、4.62±0.65mmol/L、2.98±1.02mmol/L、1.72±0.81nmol/L,均显著高于对照组的7.39±4.45μIU/ml、4.37±0.73mmol/L、2.63±0.65mmol/L、1.20±0.62nmol/L,差异均有统计学意义(P<0.05);Nob-PCOS组胰岛素敏感指数(ISI)为0.026±0.016,低于对照组的0.050±0.034,差异有统计学意义(P<0.01);Nob-PCOS组躯干脂肪量9081.38±2726.81g,高于对照组的7878.69±1187.41g,差异有统计学意义(P<0.01);Nob-PCOS组躯干/大腿脂肪比为1.51±0.31,高于对照组的1.33±0.24,差异有统计学意义(P<0.01)。躯干/大腿脂肪比与ISI呈负相关(r=-0.307,P<0.05)。结论:Nob-PCOS患者糖、脂代谢存在异常和胰岛素抵抗;Nob-PCOS组脂肪分布呈男性脂肪分布模式,向心性脂肪分布与胰岛素抵抗呈正相关。     

体脂分布与体外受精-胚胎移植的妊娠结局相关性分析

目的 比较体脂定量分析、腰臀比及身体质量指数对IVF结局的影响.方法 本研究分析了自2017年1月至2018年1月于北京大学第一医院生殖中心进行IVF-ET治疗并接受体脂分布测量的109例患者.经过纳排标准选择后,比较体脂率、腰臀比及身体质量指数与体外受精胚胎移植结局的相关性.结果 ①体脂定量分析、腰臀比及身体质量指数...     

Women and Tattoos: Fashion,Meaning, and Implications for Health

Tattooing is a type of body modification that is both ancient and modern. Tattooing is rapidly increasing in popularity and prevalence, especially among younger people. Therefore, health care providers require knowledge about this form of artistic expression, including potential health implications and psychosocial significance. Tattooing is richly laden with cultural and personal meaning, but despite the increasingly mainstream status of this art form, individuals with tattoos may experience stigma, stereotyping, and discrimination in their personal and professional lives. The legal and regulatory aspects of tattoos have lagged behind the rapid growth of this art form, causing confusion and variation in practice. Particularly concerning is the multitude of largely unregulated tattoo inks marketed for human use but untested on humans. Common and uncommon side effects and complications of this procedure include hypersensitivity, infection, and regret. More women than men are now tattooed, and tattooing is associated with important implications for women's health care, including pregnancy, childbirth, and breastfeeding. Because of the frequency of regret, many individuals wish to be rid of previously acquired body art. Therefore, health care providers also need to be conversant with tattoo removal: motivations, techniques, risks, and factors influencing success. Familiarity with the many dimensions of body art will facilitate safe, compassionate health care provision and will enhance the therapeutic relationship enjoyed by clinicians and the individuals they serve.     

Customized versus population-based growth curves: Prediction of low body fat percent at term corrected gestational age following preterm birth

Objective: Compare customized versus population-based growth curves for identification of small-for-gestational-age (SGA) and body fat percent (BF%) among preterm infants. Methods: Prospective cohort study of 204 preterm infants classified as SGA or appropriate-for-gestational-age (AGA) by population-based and customized growth curves. BF% was determined by air-displacement plethysmography. Differences between groups were compared using bivariable and multivariable linear and logistic regression analyses. Results: Customized curves reclassified 30% of the preterm infants as SGA. SGA infants identified by customized method only had significantly lower BF% (13.8 ± 6.0) than the AGA (16.2 ± 6.3, p = 0.02) infants and similar to the SGA infants classified by both methods (14.6 ± 6.7, p = 0.51). Customized growth curves were a significant predictor of BF% (p = 0.02), whereas population-based growth curves were not a significant independent predictor of BF% (p = 0.50) at term corrected gestational age. Conclusion: Customized growth potential improves the differentiation of SGA infants and low BF% compared with a standard population-based growth curve among a cohort of preterm infants.