Association of total body and visceral fat mass with iron deficiency in preadolescents: the Healthy Growth Study

The aim of the present study was to examine the associations of obesity, percentage body fat and visceral fat mass with body Fe status in a representative sample of 1493 schoolchildren aged 9-13 years. Anthropometric, body composition, biochemical, clinical (Tanner stage, age of menarche) and dietary intake data were collected. Fe deficiency (ID) was defined as transferrin saturation (TS) < 16 %; and Fe-deficiency anaemia (IDA) as ID with Hb < 120 g/l. Obese boys and girls and those in the highest quartiles of percentage body fat mass had significantly higher levels of serum ferritin (P ≤ 0.05) compared to their normal-weight peers and those in the corresponding lowest quartiles. Similarly, obese boys and girls and those in the highest quartiles of percentage body fat and visceral fat mass had significantly lower levels of TS (P ≤ 0.05) compared to normal-weight children and those in the corresponding lowest quartiles. The prevalence of ID and IDA was significantly higher in boys and girls in the highest quartiles of percentage body fat than in peers in the lowest quartile. Higher quartiles of percentage body fat and visceral fat mass were the main significant predictors of ID in boys, after controlling for other important confounders, with OR of 2.48 (95 % CI, 1.26, 4.88) and 2.12 (95 % CI, 1.07, 4.19), respectively. Similar significant associations were observed for girls. In conclusion, percentage body fat and visceral fat mass were positively associated with ID in both sexes of preadolescents. These associations might be attributed to the chronic inflammation induced by excess adiposity.     

Body mass index and waist circumference independently contribute to the prediction of nonabdominal, abdominal subcutaneous, and visceral fat

BACKGROUND: It is unknown whether the ability of waist circumference (WC) to predict health risk beyond that predicted by body mass index (BMI) alone is explained in part by the ability of WC to identify those with elevated concentrations of total or abdominal fat. OBJECTIVE: We sought to determine whether BMI and WC independently contribute to the prediction of non-abdominal (total fat - abdominal fat), abdominal subcutaneous, and visceral fat. DESIGN: Fat distribution was measured by magnetic resonance imaging in 341 white men and women. Multiple regression analysis was performed to measure whether the combination of BMI and WC explained a greater variance in non-abdominal, abdominal subcutaneous, and visceral fat than did BMI or WC alone. These fat depots were also compared after a subdivision of the cohort into 3 BMI (normal, overweight, and class I obese) and 3 WC (low, intermediate, and high) categories according to the classification system used to identify associations between BMI, WC, and health risk. RESULTS: Independent of age and sex, the combination of BMI and WC explained a greater variance in non-abdominal, abdominal subcutaneous, and visceral fat than did either BMI or WC alone (P < 0.05). For non-abdominal and abdominal subcutaneous fat, BMI was the strongest correlate; thus, by adding BMI to WC, the variance accrued was greater than when WC was added to BMI. However, when WC was added to BMI, the added variance explained for visceral fat was greater than when BMI was added to WC. Furthermore, within each of the 3 BMI categories studied, an increase in the WC category was associated with an increase in visceral fat (P < 0.05). CONCLUSIONS: BMI and WC independently contribute to the prediction of non-abdominal, abdominal subcutaneous, and visceral fat in white men and women. These observations reinforce the importance of using both BMI and WC in clinical practice.     

Predicting total body fat from anthropometry in Latino children

OBJECTIVE: To develop prediction equations for total body fat specific to Latino children, using demographic and anthropometric measures. RESEARCH METHODS AND PROCEDURES: Ninety-six Latino children (7 to 13 years old) were studied. Two-thirds of the sample was randomized into the equation development group; the remainder served as the cross-validation group. Total body fat was measured by DXA. Measures included weight, height, waist and hip circumferences, and skinfolds (suprailiac, triceps, abdomen, subscapula, thigh, and calf). RESULTS: The previously published equation from Dezenberg et al. did not accurately predict total body fat in Latino children. However, newly developed equations with either body weight alone (intercept +/- SE = 1.78 +/- 1.53 kg, p > 0.05; slope +/- SE = 0.90 +/- 0.07, p > 0.05 against slope = 1.0; R(2) = 0.86), weight plus age and gender (intercept +/- SE = 2.28 +/- 1.20 kg, p > 0.05; slope +/- SE = 0.91 +/- 0.05, p > 0.05; against slope = 1.0; R(2) = 0.92), or weight plus height, gender, Tanner stage, and abdominal skinfold (intercept +/- SE = 1.47 +/- 1.01 kg, p > 0.05; slope +/- SE = 0.93 +/- 0.04, p > 0.05; against slope = 1.0, R(2) = 0.97) predicted total body fat without bias. DISCUSSION: Unique prediction equations of total body fat may be needed for Latino children. Weight, as the single most significant predictor, can be used easily to estimate total body fat in the absence of any additional measures. Including age and gender with weight produces an equally stable prediction equation with increasing precision. Using a combination of demographic and anthropometric measures, we were able to capture 97% of the variance in measured total body fat.     

内脏脂肪区域、体脂肪率及血脂异常与糖尿病前期的关系

目的 了解内脏脂肪区域(visceral fat area,VFA)、体脂肪率(body fat percentage,BFP)、血脂异常与糖尿病前期(impaired glucose regulation,IGR)的关系并探讨IGR的危险因素。 方法 采用病例-对照法,选择克拉玛依市中心医院健康管理中心确诊糖尿病前期组238人,血糖正常组292人进行体格测量、生化指标及人体成分检测,采用logistic回归分析糖尿病前期的危险因素。 结果 IGR组的体重指数(body mass index,BMI)、甘油三酯(triglyceride,TG)、高密度脂蛋白(high density lipoprotein,HDL)、VFA均高于血糖正常组(P<0.05),BFP与血糖正常组比较差异无统计学意义(P>0.05);IGR组中高TG血症、高TC血症及高LDL血症的检出率分别为26.50%、10.90%、8.80%,均高于血糖正常组(P<0.05);二分类logistic回归分析显示,肥胖(OR=2.035,95%CI:1.183~3.501),VFA≥111.74 cm²(OR=1.910,95%CI:1.183~3.501),高TG血症者(OR=2.779,95%CI:1.685~4.582)为糖尿病前期的危险因素。 结论 糖尿病前期与肥胖、内脏脂肪区域及高TG血症有关,未发现体脂率水平与糖尿病前期有关系。     

Increased fat accumulation in liver may link insulin resistance with subcutaneous abdominal adipocyte enlargement, visceral adiposity, and hypoadiponectinemia in obese individuals

BACKGROUND: Enlargement of adipocytes from subcutaneous abdominal adipose tissue (SAT), increased intrahepatic lipid content (IHL), intramyocellular lipid content (IMCL), and low circulating adiponectin concentrations are associated with insulin resistance. OBJECTIVE: Because adiponectin increases fat oxidation in skeletal muscle and liver, and the expression of the adiponectin gene in SAT is inversely associated with adipocyte size, we hypothesized that hypoadiponectinemia links hypertrophic obesity with insulin resistance via increased IMCL and IHL. DESIGN: Fifty-three obese Pima Indians with a mean (+/-SD) age of 27 +/- 8 y, body fat of 35 +/- 5%, and normal glucose regulation (normal fasting and 2-h glucose concentration per WHO 1999 criteria) underwent euglycemic-hyperinsulinemic clamp, biopsies of SAT and vastus lateralis muscle, and magnetic resonance imaging of the abdomen. RESULTS: Adipocyte diameter (AD) correlated positively with body fat (P < 0.0001) and IHL (estimated from magnetic resonance imaging intensity of liver; P = 0.047). No association was found between AD and plasma adiponectin or IMCL. Plasma adiponectin negatively correlated with type II IMCL (IIA, P = 0.004; IIX, P = 0.009) or IHL (P = 0.02). In a multivariate analysis, plasma adiponectin, AD, and visceral adipose tissue (VAT) independently predicted IHL. Low insulin-mediated glucose disposal was associated with low plasma adiponectin (P = 0.02) and high IHL (P = 0.0003), SAT (P = 0.02), and VAT (P = 0.04). High IHL was the only predictor of reduced insulin-mediated suppression of hepatic glucose production (P = 0.02) and the only independent predictor of insulin-mediated glucose disposal in a multivariate analysis. CONCLUSIONS: Increased lipid content in the liver may independently link hypoadiponectinemia, hypertrophic obesity, and increased visceral adiposity with peripheral and hepatic insulin resistance.     

Evidence of pleiotropic loci for fasting insulin, total fat mass, and abdominal visceral fat in a sedentary population: the HERITAGE family study

OBJECTIVE: To examine whether there is a major gene effect on fasting insulin and pleiotropic loci for fasting insulin, total fat mass (FM), and abdominal visceral fat (AVF). RESEARCH METHODS AND PROCEDURES: A major gene hypothesis for fasting plasma insulin levels was assessed using segregation analyses of data on 495 members in 98 normolipidemic sedentary families of white descent who participated in the HERITAGE Family Study. RESULTS: Segregation analyses were performed on insulin adjusted for age, on insulin adjusted for age and FM, and on insulin adjusted for age and AVF. Before adjustment for AVF and FM, a major gene effect on fasting insulin levels was indicated. The putative locus accounted for 54% of the variance under a recessive inheritance pattern, affecting 11% of the sample (i.e., allele frequency = 0.33). However, after adjusting for the effects of AVF or FM, neither a major effect alone nor a multifactorial component alone could be rejected, and support for a major gene was equivocal, i.e., neither the hypothesis of Mendelian tau values or that of the equal tau(s) were rejected and the equal tau model fit the data better than the Mendelian tau model. This pattern (i.e., major gene evidence for insulin before but not after adjustment for AVF or FM) suggests that there is a putative locus with pleiotropic effects on both insulin and FM and another pleiotropic locus for both insulin and AVF. DISCUSSION: Although these data do not directly support an additional major gene for insulin independent of AVF and FM, such support cannot be ruled out because there is still a significant major effect on FM- or AVF-adjusted insulin (albeit the Mendelian nature of this effect is ambiguous).     

Birth weight,adult body composition,and subcutaneous fat distribution

OBJECTIVES: To investigate if birth weight is related to both body mass index (BMI) and distribution of subcutaneous fat at adult age. RESEARCH METHODS AND PROCEDURES: A 9-year longitudinal study was performed in 229 subjects (192 women) with ages ranging from 27 to 36 years. Birth weight was retrieved by a questionnaire, and adult weight, height, skinfold thicknesses, and waist-to-hip ratio (WHR) were repeatedly measured at mean ages 27, 29, 31, and 36 years. BMI, sum of four skinfolds (S4S), the ratio between two truncal skinfolds and S4S (SS/S4S), and the ratio between WHR and the cross-sectional area of the left thigh were calculated with the available data. RESULTS: The adjusted model showed that in women, birth weight was significantly negatively related to adult S4S [beta = -5.211; (-9.768 to -0.654)], waist circumference [beta = -1.449; (-2.829 to -0.069)], and SS/S4S ratio [beta = -3.579; (-5.296 to -1.862)]. In men, a significant negative association was observed between birth weight and adult WHR [beta = -1.096; (-2.092 to -0.100)] only. Other relationships showed, although not significantly, the same negative trend, namely that lower birth weight is related to higher adult body fat mass (S4S) and a more truncal subcutaneous fat distribution (SS/S4S). No associations were found between birth weight and either adult BMI or the cross-sectional area of the thigh. DISCUSSION: Lower birth weight is, in both adult men and women, related to a higher adult subcutaneous fat mass and a more truncal distribution of subcutaneous fat, indicating a higher risk for obesity.     

老年人体质量指数、体脂总量及分布与血脂异常的相关性

目的 观察老年人体质量指数、总体脂肪及分布与血脂异常的相关性.方法 连续定点抽取2013年10月至2014年3月在北京协和医院接受年度体检的395名健康老年人进行调查.采用多频生物电阻抗测定体质量、总体脂肪(TBF)、腹部脂肪(AF)、内脏脂肪(VF)、内脏脂肪面积(VFA)和腰臀围比值(WHR),并测定血清三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C).分析体质量指数(BMI)、TBF及分布与血脂异常的相关性.结果 老年男性肥胖(17.8％比9.6％,P=0.036)、超重(49.6％比30.4％,P=0.000)和血脂异常(67.0％比44.8％,P=0.000)发生率均显著高于女性.女性表现为TBF％显著增高(60.0％比41.1％,P=0.001).TC分别与TBF (P =0.020)、AF (P =0.018)、VF (P=0.015)和VFA (P =0.017)呈正相关;TG分别与BMI(P=0.000)、TBF(P=0.000)、WHR(P=0.000)、AF(P=0.000)、VF (P =0.000)和VFA (P=0.000)呈正相关;LDL-C分别与BMI (P =0.049)、TBF (P =0.005)、AF(P=0.004)、VF (P=0.003)和VFA (P=0.004)呈正相关,而HDL-C分别与BMI(P=0.000)、TBF(P=0.020)、WHR(P=0.000)、AF (P=0.021)、VF (P=0.024)和VFA (P=0.022)呈负相关.BMI、TBF、WHR、AF、VF和VFA预测血脂异常风险的受试者工作特征曲线均在参考线上方.超重和肥胖组TBF(P=0.000)、WHR(P=0.000)、AF (P=0.000)、VF (P=0.000)、VFA (P=0.000)、TG (P =0.000)和LDL-C(女性:P=0.021)均显著高于体质量正常组.结论 肥胖/超重和体脂总量超标及腰围增大,可增加老年人血脂异常的发生风险.     

腹部脂肪增厚产妇皮下引流不缝合脂肪层效果观察

目的目前针对剖宫产术后切口的缝合主要有皮下缝合联合美容缝合,但切口相关并发症发生率较高。本研究探讨皮下引流不缝合脂肪层在腹部脂肪增厚产妇中的临床应用价值。方法选择2018-02-01-2019-06-30本院收治的剖宫产产妇80例为研究对象,按组间基本特征均衡可比的原则分为观察组和对照组,各40例。对照组使用2/0可吸收缝线间断缝合皮下筋膜,连带部分脂肪组织,观察组实施皮下引流管不缝合脂肪层形式进行切口处理,比较两组切口相关并发症、手术操作相关指标、术后恢复情况。结果观察组切口并发症发生率为10.0%,低于对照组的82.5%,差异有统计学意义,χ~2=39.422,P<0.001。观察组操作时间为(3.1±0.3)min,短于对照组的(15.3±2.1)min,t=57.511,P<0.001;操作过程出血量为(0.2±0.1)min,少于对照组的(1.2±0.2)min,差异有统计学意义,t=44.721,P<0.001。观察组术后下床时间为(1.4±0.2)d,短于对照组的(2.4±0.2)d,t=29.069,P<0.001;切口愈合时间为(6.2±0.3)min,短于对照组的(9.3±0.5)d,t=53.165,P<0.001;术后住院时间为(2.3±0.2)d,短于对照组的(2.6±0.2)d,t=10.607,P<0.001。结论针对皮下脂肪增厚剖宫产者,实施皮下引流处理切口,能有效减少切口相关并发症,促进切口早期愈合,降低出血量。     

The use of anthropometric and dual-energy X-ray absorptiometry (DXA) measures to estimate total abdominal and abdominal visceral fat in men and women.

OBJECTIVE: A single-slice computed tomography (CT) scan provides a criterion measure of total abdominal fat (TAF) and abdominal visceral fat (AVF), but this procedure is often prohibitive due to radiation exposure, cost, and accessibility. In the present study, the utility of anthropometric measures and estimates of trunk and abdominal fat mass by dual-energy X-ray absorptiometry (DXA) to predict CT measures of TAF and AVF (cross-sectional area, cm2) was assessed. RESEARCH METHODS AND PROCEDURES: CT measures of abdominal fat (at the level of the L4-L5 inter-vertebral space), DXA scans, and anthropometric measures were obtained in 76 Caucasian adults ages 20-80 years. RESULTS: Results demonstrated that abdominal sagittal diameter measured by anthropometry is an excellent predictor of sagittal diameter measured from a CT image (r=0.88 and 0.94; Total Error [TE]=4.1 and 3.1 cm, for men and women, respectively). In both men and women, waist circumference and abdominal sagittal diameter were the anthropometric measures most strongly associated with TAF (r=0.87 to 0.93; Standard Error of Estimate (SEE)=60.7 to 75.4 cm2) and AVF (r=0.84 to 0.93; SEE=0.7 to 30.0 cm2). The least predictive anthropometric measure of TAF or AVF was the commonly used waist-to-hip ratio (WHR). DXA estimates of trunk and abdominal fat mass were strongly associated with TAF (r=.94 to 0.97; SEE=36.9 to 50.9 cm2) and AVF (r=0.86 to 0.90; SEE=4.9 to 27.7 cm2). DISCUSSION: The present results suggest that waist circumference and/or abdominal sagittal diameter are better predictors of TAF and AVF than the more commonly used WHR. DXA trunk fat and abdominal fat appear to be slightly better predictors of TAF but not AVF compared to these anthropometric measures. Thus DXA does not offer a significant advantage over anthropometry for estimation of AVF.     

Influence of total vs. visceral fat on insulin action and secretion in African American and white children

OBJECTIVE: To examine whether total body fat (FAT) in general or visceral fat (VFAT) in particular is associated with greater metabolic risk in white and African American children. RESEARCH METHODS AND PROCEDURES: A total of 68 white and 51 African American children had measures of insulin sensitivity (Si) and acute insulin response (AIR) by a frequently sampled intravenous glucose tolerance test, total body fat by DXA and abdominal fat distribution (visceral vs. subcutaneous) by computed tomography. The influence of FAT and VFAT on insulin parameters were examined by comparing subgroups of children with high or low FAT vs. high or low VFAT and by multiple regression analysis. RESULTS: In whites, fasting insulin, Si, and AIR were significantly influenced by FAT, but not VFAT (e.g., for Si, 9.8 +/- 0.8 in low FAT vs. 4.6 +/- 0.7 x 10(-4)/min/[microIU/mL[ in high FAT, p < 0.05; 6.8 +/- 0.7 in low VFAT vs. 7.5 +/- 0.8 x 10(-4)/min/[microIU/mL] in high VFAT, p > 0.1). In African Americans, fasting insulin and Si were also primarily influenced by FAT (e.g., for Si, 4.9 +/- 0.4 in low FAT vs. 2.8 +/- 0.5 x 10(-4)/min/[microIU/mL] in high FAT, p < 0.05) but not by VFAT, and there were no significant effects of either fat compartment on AIR. In multiple regression analysis, Si was significantly influenced by FAT (negative effect), ethnicity (lower in African Americans), and gender (lower in females), whereas fasting insulin was significantly influenced by VFAT (positive effect), ethnicity (higher in African Americans), and fat free mass (positive effect). DISCUSSION: Body fat in general is the predominant factor influencing Si, but VFAT may have additional effects on fasting insulin. The lack of major effects of VFAT on Si in children may be explained by lower levels of VFAT or because VFAT affects aspects of whole body insulin action that are not measured by the minimal model.     

超重肥胖小学生BMI、腰围与体脂百分比及腹部脂肪率的关系

目的 研究超重肥胖小学生BMI、腰围与体脂百分比及腹部脂肪率的相关性.方法 于2010年5月,采用方便抽样方法在北京市东城区抽取2所小学,以两所学校医务处4月份体检记录中符合超重肥胖标准的162名2～5年级学生为研究对象,对其进行体检,测量其体脂百分比、腹部脂肪率和内脏脂肪等级,并计算BMI.采用t检验和秩和检验分析各指标性别间的差异;采用相关分析探索各脂肪分布指标(体脂百分比、腹部脂肪率和内脏脂肪等级)与BMI及腰围的相关性;运用单因素回归分析探索各变量对各脂肪分布指标的贡献率.结果 超重肥胖小学生体脂百分比为(43.62±2.98)％,腹部脂肪率为(28.06±6.02)％,内脏脂肪等级为7.51±3.43,BMI为(23.41±2.83) kg/m2.男生腰围、体脂百分比和腹部脂肪率分别为(78.57-±7.76)cm、(42.36±2.56)％和(26.47±5.39)％,女生分别为(73.34 ±7.22)cm、(45.88±2.26)％和(30.92±6.07)％,差异均有统计学意义(t值分别为-4.22、8.75和4.81,P值均＜0.01);男、女生内脏脂肪等级分别为8.86±3.42和5.09±1.70,差异有统计学意义(Z=-7.08,P＜0.01).BMI与体脂百分比的相关性及对其方差贡献率(r =0.563,R2 =31.7％)高于腰围(r=0.402,R2=16.1％)(P值均＜0.01),腰围与内脏脂肪等级的相关性及对其方差贡献率(r=0.723,R2=57.3％)高于BMI(r=0.621,R2=41.7％)(P值均＜0.01).结论 BMI对体脂百分比的相关性及预测能力优于腰围,腰围则对内脏脂肪的相关性和预测性较BMI强.     

Aerobic fitness, blood lipids, and body fat in children.

This study examined the association between aerobic fitness and serum cholesterol and the effects of controlling for gender, body composition, abdominal fat, and dietary saturated fat in 262 children. The 1-mile run was used to estimate fitness. Skinfolds were used in assessing body fat. Fit children had lower total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels and higher high-density lipoprotein cholesterol levels than unfit children, except after adjustment for body fat and/or abdominal fat. Unfit children appear to be at an increased risk of unhealthy levels of serum cholesterol due primarily to increased levels of body fat.     

学龄儿童内脏脂肪面积与尿酸的相关性研究

目的 探讨学龄儿童内脏脂肪面积与尿酸水平的关联,为预防儿童高尿酸血症(HUA)提供依据。 方法 研究对象来自“儿童青少年心血管与骨健康促进项目”于2019年11月—2020年1月进行的随访调查,最终纳入8～18岁儿童青少年10 609人进行分析。内脏脂肪面积(VFA)与各心血管代谢指标间的关联采用Spearman相关性分析。根据BMI和VFA诊断的肥胖与否将体型划分为4组,多因素Logistic回归分析不同肥胖类型与HUA的关联,并调整年龄、血压、血糖、血脂等潜在混杂因素。 结果 VFA在生长发育进程中逐渐增加,并存在性别差异。男女童VFA与尿酸水平均呈正相关关系(r=0.399、0.375,P＜0.001),BMI评价的非超重、超重、肥胖组HUA患病率依次升高(男童依次为28.9%、43.5%和52.1%,女童依次为6.0%、15.9%和32.4%),VFA评价的肥胖组HUA患病率显著高于非肥胖组(男童:57.5% vs. 33.7%;女童:31.6% vs. 7.7%;P<0.001)。在调整了年龄、血压、血糖、血脂等混杂因素后,男童单纯腹型肥胖组HUA风险较非肥胖组增加1.70倍(OR=2.70, 95%CI: 1.36~5.35),女童混合型肥胖组的HUA风险较非肥胖组增加3.74倍(OR=4.74, 95%CI: 3.77~5.95)。 结论 儿童VFA与血尿酸水平密切相关,在健康体检中加入体成分分析可以早期发现儿童肥胖,对防控儿童HUA也具有重要意义。