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Feng Q, Bešević J, Conroy M, Omiyale W, Woodward M, Lacey B, Allen N. Waist-to-height ratio and body fat percentage as risk factors for ischemic cardiovascular disease: a prospective cohort study from UK Biobank. Am J Clin Nutr 2024; 119:1386-1396. [PMID: 38839194 DOI: 10.1016/j.ajcnut.2024.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/06/2024] [Accepted: 03/22/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND The independent effect of waist-to-height ratio (WHtR) and body fat percentage (BF%) on ischemic cardiovascular disease (CVD) remains uncertain. OBJECTIVES This study aimed to investigate the independent associations of WHtR and BF% with ischemic CVD. METHODS This prospective cohort study used data from the UK Biobank. BF% was calculated as fat mass divided by body weight, measured by bioimpedance. Cox models estimated hazard ratios (HRs) with 95% confidence intervals (CIs) for overall and sex-specific associations of BF% and WHtR with risks of ischemic CVD and its main subtypes [myocardial infarction (MI) and ischemic stroke (IS)], adjusted for a range of potential confounders, including mutual adjustment for BF% and WHtR. RESULTS In total, 468,333 participants without existing CVD were included in the analysis. During 12 y of follow-up, 20,151 ischemic CVD events, 13,604 MIs, and 6681 ISs were recorded. WHtR was linearly associated with ischemic CVD, MI, and IS, with an HR per 5% increase of 1.23 (95% CI: 1.20, 1.25), 1.24 (95% CI: 1.21, 1.27), and 1.22 (95% CI: 1.18, 1.26), respectively, independent of BF%. A stronger association between WHtR and MI was seen in females than in males. The association of BF% with these outcomes was substantially attenuated in both sexes after adjustment for WHtR. For example, in females, the HR (highest compared with lowest fifth) was reduced from 1.94 (95% CI: 1.76, 2.15) to 1.04 (95% CI: 0.90, 1.01) for ischemic CVD, from 2.04 (95% CI: 1.79, 2.32) to 0.97 (95% CI: 0.81, 1.16) for MI, and from 1.81 (95% CI: 1.54, 2.13) to 1.07 (95% CI: 0.85, 1.33) for IS. CONCLUSIONS WHtR, when used as a proxy measure for central obesity, is linearly associated with ischemic CVD in both sexes, which is independent of BF%. In contrast, the relationship of BF% with these health outcomes is predominantly driven by its correlation with WHtR.
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Affiliation(s)
- Qi Feng
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong.
| | - Jelena Bešević
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; UK Biobank, Stockport, United Kingdom
| | - Megan Conroy
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; UK Biobank, Stockport, United Kingdom
| | - Wemimo Omiyale
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; UK Biobank, Stockport, United Kingdom
| | - Mark Woodward
- The George Institute for Global Health, University of New South Wales, Newtown, NSW, Australia; The George Institute for Global Health, Imperial College London, London, United Kingdom
| | - Ben Lacey
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; UK Biobank, Stockport, United Kingdom.
| | - Naomi Allen
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; UK Biobank, Stockport, United Kingdom
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Li F, Wang Z, Li S, Liu W, Li Y, Jiang C, Tian Y, Cui W, Zhang X, Zhang J, Xu Y. Association of body fat distribution with all-cause and cardiovascular mortality in US adults: a secondary analysis using NHANES. BMJ Open 2023; 13:e072752. [PMID: 37989359 PMCID: PMC10668279 DOI: 10.1136/bmjopen-2023-072752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 09/11/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVE To investigate the association of fat and lean mass in specific regions with all-cause and cardiovascular-related mortality. DESIGN Population based cohort study. SETTING US National Health and Nutrition Examination Survey (2003-2006 and 2011-2018). PARTICIPANTS 22 652 US adults aged 20 years or older. EXPOSURES Fat and lean mass in specific regions obtained from the whole-body dual-energy X-ray absorptiometry. MAIN OUTCOME MEASURES All-cause and cardiovascular-related mortality. RESULTS During a median of 83 months of follow-up, 1432 deaths were identified. Associations between body composition metrics and mortality risks were evident above specific thresholds. For all-cause mortality, Android fat mass showed elevated HRs above 2.46 kg (HR: 1.17, 95% CI 1.02 to 1.34), while Android lean mass (ALM) had similar trends above 2.75 kg (HR: 1.17, 95% CI 1.03 to 1.33), and Android total mass above 5.75 kg (HR: 1.08, 95% CI 1.01 to 1.16). Conversely, lower HRs were observed below certain thresholds: Gynoid fat mass (GFM) below 3.71 kg (HR: 0.72, 95% CI 0.56 to 0.93), Gynoid lean mass below 6.44 kg (HR: 0.77, 95% CI 0.64 to 0.92), and Gynoid total mass below 11.78 kg (HR: 0.76, 95% CI 0.70 to 0.84). Notably, below 0.722 kg, the HR of visceral adipose tissue mass (VATM) was 1.25 (95% CI 1.04 to 1.48) for all-cause mortality, and above 3.18 kg, the HR of total abdominal fat mass was 2.41 (95% CI 1.15 to 5.05). Cardiovascular-related mortality exhibited associations as well, particularly for Android fat mass (AFM) above 1.78 kg (HR: 1.22, 95% CI 1.01 to 1.47) and below 7.16 kg (HR: 0.50, 95% CI 0.36 to 0.69). HRs varied for Gynoid total mass below and above 10.98 kg (HRs: 0.70, 95% CI 0.54 to 0.93, and 1.12, 95% CI 1.02 to 1.23). Android per cent fat, subcutaneous fat mass (SFM), AFM/GFM, and VATM/SFM were not statistically associated with all-cause mortality. Android per cent fat, Gynoid per cent fat, AFM/GFM, and VATM/SFM were not statistically associated with cardiovascular-related mortality. Conicity index showed that the ALM/GLM had the highest performance for all-cause and cardiovascular-related mortality with AUCs of 0.785, and 0.746, respectively. CONCLUSIONS The relationship between fat or lean mass and all-cause mortality varies by region. Fat mass was positively correlated with cardiovascular mortality, regardless of the region in which they located. ALM/GLM might be a better predictor of all-cause and cardiovascular-related mortality than other body components or body mass index.
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Affiliation(s)
- Fuhai Li
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Zhi Wang
- Department of Emergency Medicine, Qingdao Municipal Hospital (Group), Qingdao, Shandong, China
| | - Shaohua Li
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Wenheng Liu
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yan Li
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Chen Jiang
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yulong Tian
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Weining Cui
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Xuejuan Zhang
- Department of comprehensive internal medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shangdong, China
| | - Jidong Zhang
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yan Xu
- Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shangdong, China
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Cao X, He L, Sun R, Chen S. Gender-specific associations between abdominal adipose mass and bone mineral density in the middle-aged US population. BMC Musculoskelet Disord 2023; 24:715. [PMID: 37684622 PMCID: PMC10485967 DOI: 10.1186/s12891-023-06844-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
OBJECTIVES The relationship between abdominal adipose tissue and osteoporosis is poorly understood. The purpose of this study was to examine the associations of abdominal adipose tissue with bone mineral density (BMD) among a nationally representative sample of US middle-aged adults. MATERIAL AND METHODS This study included 1498 participants from the National Health and Nutrition Examination Survey 2013-2014 and 2017-2018. Dual-energy x-ray absorptiometry was used to measure BMD at the lumbar spine and femoral neck, as well as to assess abdominal adipose mass by categorizing total adipose tissue (TAT) into visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). Linear regression was used to assess the relationship between abdominal adipose tissue and BMD, and logistic regression and generalized additive model were used to assess the associations of abdominal adipose tissue with the development of low BMD. RESULTS In our study, men accounted for 51.3%, and the mean age and body mass index for men and women were 49.3 and 49.6 years, and 23.9 and 28.3 kg/m2, respectively. In the univariate model, we found that abdominal adipose mass was positively associated with BMD at femoral neck and spine in both genders. In the multivariate model, among men, a negative correlation was observed between TAT and SAT and BMD at the femoral neck. Additionally, higher masses of TAT, SAT, and VAT were found to significantly increase the risk of low BMD at both the femoral neck and lumbar spine. In contrast, there was no significant association between abdominal adipose mass and BMD in middle-aged women, regardless of menopausal status. CONCLUSIONS Our finding suggested that abdominal adipose tissue, regardless of its location (SAT or VAT), may have a negative impact on BMD in middle-aged men independently of body weight, but this relationship was not observed in women. Further research is needed to confirm these findings and investigate potential mechanisms underlying these associations.
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Affiliation(s)
- Xueqin Cao
- Department of Endocrinology, The Dushu Lake Hospital Affiliated to Soochow University, Chongwen Road No. 9, Suzhou, 215000, Jiangsu, China
| | - Leilei He
- Department of Obstetrics and Gynecology, The Dushu Lake Hospital Affiliated to Soochow University, Chongwen Road No. 9, Suzhou, 215000, Jiangsu, China
| | - Rong Sun
- Department of Endocrinology, The Dushu Lake Hospital Affiliated to Soochow University, Chongwen Road No. 9, Suzhou, 215000, Jiangsu, China
| | - Siyu Chen
- Department of Endocrinology, The Dushu Lake Hospital Affiliated to Soochow University, Chongwen Road No. 9, Suzhou, 215000, Jiangsu, China.
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Ma W, Zhu H, Yu X, Zhai X, Li S, Huang N, Liu K, Shirai K, Sheerah HA, Cao J. Association between android fat mass, gynoid fat mass and cardiovascular and all-cause mortality in adults: NHANES 2003-2007. Front Cardiovasc Med 2023; 10:1055223. [PMID: 37273879 PMCID: PMC10233278 DOI: 10.3389/fcvm.2023.1055223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 04/14/2023] [Indexed: 06/06/2023] Open
Abstract
Objectives Evidence of the relationship between android fat mass and gynoid fat mass with the mortality prediction is still limited. Current study analyzed the NHANES database to investigate the relationship between android fat mass, gynoid fat mass and CVD, with all-cause mortality. Method The study subjects were NHANES participants over 20 years old, two indicators of regional body composition, android fat and gynoid fat were measured by Dual Energy x-ray Absorptiometry (DEXA). The other various covariates data obtained from the NHANES questionnaire and laboratory measurements, including age, gender, education, race/ethnicity, uric acid, total serum cholesterol, albumin, Vitamin C, folate, alcohol drinking, smoking status, history of diabetes, and hypertension. Mortality status was ascertained from a linked mortality file prepared by the National Center for Health Statistics. The study population was divided quartiles based on the distribution of android fat mass and gynoid fat mass. The relationship between these two indicators with cardiovascular and all-cause mortality was investigated by using Cox regression. The covariates age, gender, smoking status, drinking status, history of diabetes, and history of hypertension were stratified. Results In the fully adjusted model, Q3 had the lowest HR in android fat mass and gynoid fat mass. When examining the relationship between android fat mass and CVD mortality, current smokers and drinkers had the lowest CVD risk in Q2 [smoking: 0.21 (0.08, 0.52), drinking: 0.14 (0.04, 0.50)]. In diabetic patients, compared with Q1, other groups with increased android fat mass can significantly reduce the risk of CVD [Q4: 0.17 (0.04, 0.75), Q3: 0.18 (0.03, 1.09), Q2: 0.27 (0.09, 0.83)]. In ≥60 years old and female, the greater the gynoid fat mass, the smaller the HR of all-cause mortality [Q4 for ≥60 years old: 0.57 (0.33, 0.96), Q4 for female: 0.37 (0.23, 0.58)]. People <60 years old had a lower risk of all-cause mortality with gynoid fat mass in Q3 than those ≥60 years old [<60 years: 0.50 (0.27, 0.91), ≥60 years: 0.65 (0.45, 0.95)]. Among subjects without hypertension, the group with the largest android fat mass had the lowest risk of CVD mortality, and the group with the largest gynoid fat mass had the lowest risk of all-cause mortality [Android fat mass: 0.36 (0.16, 0.81), gynoid fat mass: 0.57 (0.39, 0.85)]. Conclusion Moderate android fat mass and gynoid fat mass (Q3) had the most protective effect. Smokers and drinkers need to control their body fat. Being too thin is harmful to people with diabetes. Increased gynoid fat mass is a protective factor for all-cause mortality in older adults and females. Young people's gynoid fat mass is more protective in the moderate range than older people's. If no high blood pressure exists, people with more android and gynoid fat mass have a lower risk of CVD or all-cause mortality.
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Affiliation(s)
- Wenzhi Ma
- School of Public Health, Wuhan University, Wuhan, China
| | - Huiping Zhu
- School of Public Health, Capital Medical University, Beijing, China
| | - Xinyi Yu
- School of Public Health, Capital Medical University, Beijing, China
| | - Xiaobing Zhai
- Center for Artificial Intelligence Driven Drug Discovery, Faculty of Applied Sciences, Macao Polytechnic University, Macao, China
| | - Shiyang Li
- School of Public Health, Wuhan University, Wuhan, China
| | - Nian Huang
- School of Public Health, Wuhan University, Wuhan, China
| | - Keyang Liu
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Japan
| | - Kokoro Shirai
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Japan
| | - Haytham A. Sheerah
- Assistant Deputyship for International Collaborations, Ministry of Health, Riyadh, Saudi Arabia
| | - Jinhong Cao
- School of Management, Hubei University of Chinese Medicine, Wuhan, China
- Research Center for the Development of Chinese Medicine, Hubei Province Project of Key Research Institute of Humanities and Social Sciences at Universities, Wuhan, China
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de Ritter R, Sep SJS, van Greevenbroek MMJ, Kusters YHAM, Vos RC, Bots ML, Kooi ME, Dagnelie PC, Eussen SJPM, Schram MT, Koster A, Brouwers MCG, van der Sangen NMR, Peters SAE, van der Kallen CJH, Stehouwer CDA. Sex differences in body composition in people with prediabetes and type 2 diabetes as compared with people with normal glucose metabolism: the Maastricht Study. Diabetologia 2023; 66:861-872. [PMID: 36805778 PMCID: PMC10036428 DOI: 10.1007/s00125-023-05880-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 11/22/2022] [Indexed: 02/23/2023]
Abstract
AIMS/HYPOTHESIS Obesity is a major risk factor for type 2 diabetes. However, body composition differs between women and men. In this study we investigate the association between diabetes status and body composition and whether this association is moderated by sex. METHODS In a population-based cohort study (n=7639; age 40-75 years, 50% women, 25% type 2 diabetes), we estimated the sex-specific associations, and differences therein, of prediabetes (i.e. impaired fasting glucose and/or impaired glucose tolerance) and type 2 diabetes (reference: normal glucose metabolism [NGM]) with dual-energy x-ray absorptiometry (DEXA)- and MRI-derived measures of body composition and with hip circumference. Sex differences were analysed using adjusted regression models with interaction terms of sex-by-diabetes status. RESULTS Compared with their NGM counterparts, both women and men with prediabetes and type 2 diabetes had more fat and lean mass and a greater hip circumference. The differences in subcutaneous adipose tissue, hip circumference and total and peripheral lean mass between type 2 diabetes and NGM were greater in women than men (women minus men [W-M] mean difference [95% CI]: 15.0 cm2 [1.5, 28.5], 3.2 cm [2.2, 4.1], 690 g [8, 1372] and 443 g [142, 744], respectively). The difference in visceral adipose tissue between type 2 diabetes and NGM was greater in men than women (W-M mean difference [95% CI]: -14.8 cm2 [-26.4, -3.1]). There was no sex difference in the percentage of liver fat between type 2 diabetes and NGM. The differences in measures of body composition between prediabetes and NGM were generally in the same direction, but were not significantly different between women and men. CONCLUSIONS/INTERPRETATION This study indicates that there are sex differences in body composition associated with type 2 diabetes. The pathophysiological significance of these sex-associated differences requires further study.
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Affiliation(s)
- Rianneke de Ritter
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands.
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands.
| | - Simone J S Sep
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Adelante, Center of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands
| | - Marleen M J van Greevenbroek
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Yvo H A M Kusters
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Rimke C Vos
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Leiden University Medical Center, Department of Public Health and Primary Care/LUMC-Campus, The Hague, the Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - M Eline Kooi
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Pieter C Dagnelie
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Simone J P M Eussen
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Miranda T Schram
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, the Netherlands
- MHeNs School for Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Annemarie Koster
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
| | - Martijn C G Brouwers
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | | | - Sanne A E Peters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- The George Institute for Global Health, Imperial College London, London, UK
| | - Carla J H van der Kallen
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
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Spain DR, Andrews AM, Crews SA, Khan JM. Males With Traumatic Lower Limb Loss Differ in Body Fat Distribution Compared to Those Without Limb Loss. Mil Med 2023; 188:e140-e144. [PMID: 34143209 DOI: 10.1093/milmed/usab237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/08/2021] [Accepted: 06/04/2021] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES The primary objective was to examine body fat composition in males with traumatic lower limb loss and a comparison group without limb loss. A secondary objective was to determine if there are differences in body fat composition by traumatic limb loss level. RESEARCH METHODS AND PROCEDURES Cross-sectional analyses of baseline in-person intake data was completed at a large military medical center. Data were collected from 2011 to 2020, and analysis was conducted in 2020. Participants (n = 89) included males who sustained traumatic lower limb loss (n = 50) and an age-matched comparison group without limb loss (n = 39). Mean age of participants was 36.0 ± 13.2 years. Main outcomes measured included age, height, body mass index, weight, body fat mass and percent, android fat mass and percent, gynoid fat mass and percent, and android/gynoid percent fat ratio. Differences between groups were assessed using t-tests or Mann-Whitney U tests. Differences between limb loss levels were assessed using one-way ANOVA or Wilcoxon signed-rank test. RESULTS Body fat percent (P = .001), gynoid fat percent (P = .010), android fat mass (P = .01), and percent (P = .02) were higher in the group with limb loss. There were no differences in body fat composition between limb loss levels (P > .05). CONCLUSION Males with traumatic lower limb loss had a higher body fat percent compared to those without limb loss. Given higher body fat composition in individuals with limb loss and the relationship between body fat composition and cardiovascular disease risk, including body composition analysis with clinical screening could identify changes and allow for early intervention.
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Affiliation(s)
- David R Spain
- Nutrition Services Department, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA.,U.S. Military-Baylor, Graduate Program of Nutrition, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA.,Nutrition Care Division, Tripler Army Medical Center, Honolulu, HI 96859, USA
| | - Anne M Andrews
- Research Protections Office, National Institute of Standards and Technology, Gaithersburg, MD 20889, USA.,Department of Orthopaedics and Rehabilitation, and US Military-Baylor Graduate Program in Nutrition, Nutrition Services Department, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
| | - Sara A Crews
- U.S. Military-Baylor, Graduate Program of Nutrition, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA.,Nutrition Services Department, Darnall Army Medical Center, Fort Hood, TX 76544, USA
| | - Joetta M Khan
- Nutrition Services Department, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
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Ma M, Liu X, Jia G, Geng B, Xia Y. The association between body fat distribution and bone mineral density: evidence from the US population. BMC Endocr Disord 2022; 22:170. [PMID: 35787696 PMCID: PMC9254427 DOI: 10.1186/s12902-022-01087-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/27/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To investigate the association between different body fat distribution and different sites of BMD in male and female populations. METHODS Use the National Health and Nutrition Examination Survey (NHANES) datasets to select participants. The weighted linear regression model investigated the difference in body fat and Bone Mineral Density (BMD) in different gender. Multivariate adjusted smoothing curve-fitting and multiple linear regression models were used to explore whether an association existed between body fat distribution and BMD. Last, a subgroup analysis was performed according to age and gender group. RESULTS Overall, 2881 participants were included in this study. Compared to males, female participants had lower BMD (P < 0.05) and higher Gynoid fat mass (P < 0.00001), while there was no difference between Android fat mass (P = 0.91). Android fat mass was positively associated with Total femur BMD (Males, β = 0.044, 95% CI = 0.037, 0.051, P < 0.00001; Females, β = 0.044, 95% CI = 0.039, 0.049, P < 0.00001), Femoral neck BMD (Males, β = 0.034, 95% CI = 0.027, 0.041, P < 0.00001; Females, β = 0.032, 95% CI = 0.027, 0.037, P < 0.00001), and Total spine BMD (Males, β = 0.036, 95% CI = 0.029, 0.044, P < 0.00001; Females, β = 0.025, 95% CI = 0.019, 0.031, P < 0.00001). The Gynoid fat mass, subgroup analysis of age and ethnicity reached similar results. CONCLUSION Body fat in different regions was positively associated with BMD in different sites, and this association persisted in subgroup analyses across age and race in different gender.
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Affiliation(s)
- Ming Ma
- Department of Orthopaedics, Gansu Key Laboratory of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Second Clinical Medical School, Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Orthopaedic Clinical Medical Research Center, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
| | - Xiaolong Liu
- Department of Orthopaedics, Gansu Key Laboratory of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Second Clinical Medical School, Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Orthopaedic Clinical Medical Research Center, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
| | - Gengxin Jia
- Department of Orthopaedics, Gansu Key Laboratory of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Second Clinical Medical School, Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Orthopaedic Clinical Medical Research Center, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
| | - Bin Geng
- Department of Orthopaedics, Gansu Key Laboratory of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Second Clinical Medical School, Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Orthopaedic Clinical Medical Research Center, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Technology Center for Intelligent Orthopedic Industry, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
| | - Yayi Xia
- Department of Orthopaedics, Gansu Key Laboratory of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Second Clinical Medical School, Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Orthopaedic Clinical Medical Research Center, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Technology Center for Intelligent Orthopedic Industry, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
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Liu J, Li J, Yu J, Xia C, Pu H, He W, Li X, Zhou X, Tong N, Peng L. Regional Fat Distributions Are Associated With Subclinical Right Ventricular Dysfunction in Adults With Uncomplicated Obesity. Front Cardiovasc Med 2022; 9:814505. [PMID: 35548430 PMCID: PMC9081765 DOI: 10.3389/fcvm.2022.814505] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 03/22/2022] [Indexed: 01/05/2023] Open
Abstract
Objective Obesity is a prominent public health problem that has increased cardiovascular mortality risks. However, the specific effects of obesity, independent of comorbidities, on cardiac structure and function have not been well clarified, especially those effects on the right ventricle (RV). Cardiovascular magnetic resonance (CMR) tissue tracking can assess detailed RV mechanical features. This study aimed to evaluate RV strain using CMR in uncomplicated obese adults and assess its association with fat distributions. Methods A total of 49 obese patients and 30 healthy controls were included. The RV global systolic function and strain parameters based on CMR were assessed. Body fat distributions were measured with dual X-ray absorptiometry. RV function indices of obese patients were compared with those of healthy controls. Correlations among related body fat distribution parameters and RV function indices were conducted with multivariable linear regression. Results Compared with healthy controls, the obese group had impaired RV strain with lower global longitudinal peak strain (PS), longitudinal peak systolic strain rate (PSSR), circumferential and longitudinal peak diastolic strain rates (PDSR) (all P < 0.05), while LV and RV ejection fractions were not significantly different between the two groups (P > 0.05). Multivariable linear regression analysis demonstrated that android fat% was independently associated with longitudinal PS (β = −0.468, model R2 = 0.219), longitudinal PDSR (β = −0.487, model R2 = 0.237), and circumferential PSSR (β = −0.293, model R2 = 0.086). Trunk fat% was independently associated with longitudinal PSSR (β = −0.457, model R2 = 0.209). In addition, the strongest correlations of circumferential PDSR were BMI and gynoid fat% (β = −0.278, β = 0.369, model R2 = 0.324). Conclusions Extensive subclinical RV dysfunction is found in uncomplicated obese adults. BMI, as an index of overall obesity, is independently associated with subclinical RV dysfunction. In addition, central obesity (android fat and trunk fat distributions) has a negative effect on subclinical RV function, while peripheral obesity (gynoid fat distribution) may have a positive effect on it. Clinical Trials Registration Effect of lifestyle intervention on metabolism of obese patients based on smart phone software (ChiCTR1900026476).
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Affiliation(s)
- Jing Liu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Li
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Jianqun Yu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Chunchao Xia
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Huaxia Pu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Wenzhang He
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xue Li
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoyue Zhou
- MR Collaboration, Siemens Healthineers Ltd., Shanghai, China
| | - Nanwei Tong
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Nanwei Tong
| | - Liqing Peng
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Liqing Peng
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9
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Oliveira BBRD, Coelho CG, Barreto SM, Giatti L, Araújo LF. Body fat distribution and its risk for cardiovascular events in 10 years: Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). CAD SAUDE PUBLICA 2022; 38:e00346520. [DOI: 10.1590/0102-311x00346520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 04/26/2021] [Indexed: 12/23/2022] Open
Abstract
Body fat distribution seems to have different effects in cardiovascular diseases (CVD). We aimed to estimate the associations between lower limbs and trunk fat ratio and the 10-year CVD risk, and isolated risk factors in men and women. A total of 10,917 participants from ELSA-Brasil were eligible for this cross-sectional study. Associations between lower limb/trunk fat ratio with the percentage of 10-year CVD risk - according to the Framingham Risk Score - and its risk factors (systolic blood pressure, total cholesterol and HDL-cholesterol, diabetes, and use of antihypertensive medication) were performed using generalized linear models, linear and logistic regressions. All analyses were stratified by gender and adjustments were made by age, self-reported skin color, educational attainment, alcohol consumption, leisure physical activity, hypolipidemic drug use and, for women, menopausal status. In this study, 55.91% were women, with a mean age of 52.68 (SD = 6.57) years. A higher lower limb/trunk fat ratio was related to lower 10-year CVD risk, as well as a reduction in systolic blood pressure, total cholesterol, and antihypertensive drug use, also an increasing HDL-cholesterol in both genders, but this relationship was stronger in women. Besides, a protective relationship to diabetes was observed in women. Higher fat accumulation in the lower body, when compared to the trunk, seems to have a lower risk of CVD and associated risk factors - even in the presence of fat in the abdominal region - with women presenting lower risks than men.
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10
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Gowri S M, Antonisamy B, Geethanjali FS, Thomas N, Jebasingh F, Paul TV, Karpe F, Osmond C, Fall CHD, Vasan SK. Distinct opposing associations of upper and lower body fat depots with metabolic and cardiovascular disease risk markers. Int J Obes (Lond) 2021; 45:2490-2498. [PMID: 34331002 DOI: 10.1038/s41366-021-00923-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 07/03/2021] [Accepted: 07/21/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND To examine the associations of total and regional adiposity with metabolic and cardiovascular disease (CVD) risk markers. METHODS This cross-sectional study included 1080 (53.8% men, aged 39-44 years) individuals from South India. Anthropometry (height, weight, waist and hip circumference), body composition assessment using dual-energy X-ray absorptiometry (DXA), blood pressure (BP), and plasma glucose, insulin and lipids were measured. Regression analysis was used to examine associations of standardized fat measurements with type 2 diabetes (T2D), insulin resistance (IR), hypertension and hypertriglyceridemia and continuous measurements of BP, glucose, insulin, HOMA-IR and lipids. Contour plots were constructed to visualize the differential effect of upper and lower fat depots. RESULTS DXA-measured fat depots were positively associated with metabolic and CVD risk markers. After adjusting for fat mass index, upper body fat remained positively, while lower body fat was negatively associated with risk markers. A one standard deviation (SD) increase in android fat showed higher odds ratios (ORs) for T2D (6.59; 95% CI 3.17, 13.70), IR (4.68; 95% CI 2.31, 9.50), hypertension (2.57; 95% CI 1.56, 4.25) and hypertriglyceridemia (6.39; 95% CI 3.46, 11.90) in men. A 1 SD increase in leg fat showed a protective effect with ORs for T2D (0.42; 95% CI 0.24, 0.74), IR (0.31; 95% CI 0.17, 0.57) and hypertriglyceridemia (0.61; 95% CI 0.38, 0.98). The magnitude of the effect was greater with DXA-measured fat compared with anthropometry. CONCLUSION At any level of total body fat, upper and lower body fat depots demonstrate opposite risk associations with metabolic and CVD risk markers in Asian Indians.
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Affiliation(s)
| | | | | | - Nihal Thomas
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India
| | - Felix Jebasingh
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India
| | - Thomas V Paul
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India
| | - Fredrik Karpe
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK
- NIHR Oxford Biomedical Research Centre, OUH Foundation Trust, Oxford, UK
| | - Clive Osmond
- MRC Environmental Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Caroline H D Fall
- MRC Environmental Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Senthil K Vasan
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK.
- MRC Environmental Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK.
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11
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Chen GC, Arthur R, Iyengar NM, Kamensky V, Xue X, Wassertheil-Smoller S, Allison MA, Shadyab AH, Wild RA, Sun Y, Banack HR, Chai JC, Wactawski-Wende J, Manson JE, Stefanick ML, Dannenberg AJ, Rohan TE, Qi Q. Association between regional body fat and cardiovascular disease risk among postmenopausal women with normal body mass index. Eur Heart J 2020; 40:2849-2855. [PMID: 31256194 DOI: 10.1093/eurheartj/ehz391] [Citation(s) in RCA: 129] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 03/20/2019] [Accepted: 05/21/2019] [Indexed: 12/31/2022] Open
Abstract
AIMS Central adiposity is associated with increased cardiovascular disease (CVD) risk, even among people with normal body mass index (BMI). We tested the hypothesis that regional body fat deposits (trunk or leg fat) are associated with altered risk of CVD among postmenopausal women with normal BMI. METHODS AND RESULTS We included 2683 postmenopausal women with normal BMI (18.5 to <25 kg/m2) who participated in the Women's Health Initiative and had no known CVD at baseline. Body composition was determined by dual energy X-ray absorptiometry. Incident CVD events including coronary heart disease and stroke were ascertained through February 2017. During a median 17.9 years of follow-up, 291 incident CVD cases occurred. After adjustment for demographic, lifestyle, and clinical risk factors, neither whole-body fat mass nor fat percentage was associated with CVD risk. Higher percent trunk fat was associated with increased risk of CVD [highest vs. lowest quartile hazard ratio (HR) = 1.91, 95% confidence interval (CI) 1.33-2.74; P-trend <0.001], whereas higher percent leg fat was associated with decreased risk of CVD (highest vs. lowest quartile HR = 0.62, 95% CI 0.43-0.89; P-trend = 0.008). The association for trunk fat was attenuated yet remained significant after further adjustment for waist circumference or waist-to-hip ratio. Higher percent trunk fat combined with lower percent leg fat was associated with particularly high risk of CVD (HR comparing extreme groups = 3.33, 95% CI 1.46-7.62). CONCLUSION Among postmenopausal women with normal BMI, both elevated trunk fat and reduced leg fat are associated with increased risk of CVD.
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Affiliation(s)
- Guo-Chong Chen
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, USA
| | - Rhonda Arthur
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, USA
| | - Neil M Iyengar
- Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, USA.,Department of Medicine, Weill Cornell Medical College, 525 East 68th Street, New York, NY, USA
| | - Victor Kamensky
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, USA
| | - Xiaonan Xue
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, USA
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, USA
| | - Matthew A Allison
- Department of Family Medicine and Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, USA
| | - Aladdin H Shadyab
- Department of Family Medicine and Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, USA
| | - Robert A Wild
- Departments of Obstetrics and Gynecology, Biostatistics and Clinical Epidemiology, Oklahoma University Health Sciences Center, 2466 AAT 800 SLYoung Blvd, Oklahoma City, OK, USA
| | - Yangbo Sun
- Department of Epidemiology, College of Public Health, University of Iowa, 145 N Riverside Drive, Iowa, IA, USA
| | - Hailey R Banack
- Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, 401 Kimball Tower Buffalo, NY, USA
| | - Jin Choul Chai
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, 401 Kimball Tower Buffalo, NY, USA.,Department of Gynecology-Obstetrics, University at Buffalo, State University of New York at Buffalo, 955 Main Street, Buffalo, NY, USA
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - Marcia L Stefanick
- Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, 1265 Welch Road, Stanford, CA, USA
| | - Andrew J Dannenberg
- Department of Medicine, Weill Cornell Medical College, 525 East 68th Street, New York, NY, USA
| | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, USA
| | - Qibin Qi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, USA
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12
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Lin TY, Hung SC, Lim PS. Central obesity and incident atherosclerotic cardiovascular disease events in hemodialysis patients. Nutr Metab Cardiovasc Dis 2020; 30:500-507. [PMID: 31831366 DOI: 10.1016/j.numecd.2019.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 11/03/2019] [Accepted: 11/04/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Waist 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 RESULTS We 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. CONCLUSIONS Hemodialysis 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.
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Affiliation(s)
- Ting-Yun Lin
- Division of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Szu-Chun Hung
- Division of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and School of Medicine, Tzu Chi University, Hualien, Taiwan.
| | - Paik-Seong Lim
- Division of Renal Medicine, Department of Internal Medicine, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan; Department of Rehabilitation, Jenteh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan.
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13
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Piché ME, Vasan SK, Hodson L, Karpe F. Relevance of human fat distribution on lipid and lipoprotein metabolism and cardiovascular disease risk. Curr Opin Lipidol 2018; 29:285-292. [PMID: 29994839 DOI: 10.1097/mol.0000000000000522] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE OF REVIEW Upper body abdominal and lower body gluteofemoral fat depot masses display opposing associations with plasma lipid and lipoprotein and cardiovascular disease (CVD) risk profiles. We review developments on adipose tissue fatty acid metabolism in the context of body fat distribution and how that might be related to adverse lipid and lipoprotein profiles and CVD risk. RECENT FINDINGS Recent data have confirmed the paradoxical relationship of upper abdominal and lower body gluteofemoral adiposity and CVD risk. Mechanistically, this is likely to reflect the different ways fat depots handle lipid storage and release, which impacts directly and indirectly on lipid and lipoprotein metabolism. The upper body enhances immediate fat storage pathway with rapid uptake of dietary-derived fatty acids, whereas the lower body fat depot has a reduced lipid turnover accommodating a slower fat redistribution. Body fat distribution and the fat depots' ability to undergo appropriate expansion when fat storage is required, rather than overall body fatness, appear as the important determinant of metabolic health. SUMMARY A focus on fat distribution in overweight people, preferably using precise imaging methods, rather than quantifying total body fatness, is likely to provide the medical community with better tools to stratify and treat patients with obesity-related complications.
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Affiliation(s)
- Marie-Eve Piché
- Quebec Heart and Lung Institute, Laval University, Canada
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital
| | - Senthil K Vasan
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital
| | - Leanne Hodson
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital
| | - Fredrik Karpe
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital
- NIHR Oxford Biomedical Centre, Oxford University Hospital Trust and University of Oxford, Oxford, UK
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14
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Cao Q, Yu S, Xiong W, Li Y, Li H, Li J, Li F. Waist-hip ratio as a predictor of myocardial infarction risk: A systematic review and meta-analysis. Medicine (Baltimore) 2018; 97:e11639. [PMID: 30045310 PMCID: PMC6078643 DOI: 10.1097/md.0000000000011639] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND AND AIM Several studies have identified that obesity and being overweight can increase the risk of developing myocardial infarction (MI). However, the predictive value of the central obesity index, that is, the waist-hip ratio (WHR), regarding MI risk remains unclear. This study aimed to provide a systematic review and meta-analysis of WHR as a predictor of MI incidence. METHODS This study used relevant keywords and MeSH terms to identify studies of MI risk and WHR from PubMed, Web of Science, Embase, and Cochrane databases in November 2017. RESULTS We conducted a meta-analysis of 12 case-control studies in 14 eligible trials and further explored whether the predictive value of WHR on MI risk varies according to sex. The results showed that a high WHR increased MI risk (pooled odds ratio [OR] 2.62, 95% confidence interval [CI] 2.02-3.39, P < 0.00001) and that elevated WHR is more strongly predictive of MI in women than in men (pooled OR 4.63, 95% CI 3.28-6.53 in women; pooled OR 2.71, 95% CI 2.15-3.41 in men). CONCLUSIONS MI is significantly associated with increased WHR, with a stronger association among women.
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15
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Piché ME, Poirier P, Lemieux I, Després JP. Overview of Epidemiology and Contribution of Obesity and Body Fat Distribution to Cardiovascular Disease: An Update. Prog Cardiovasc Dis 2018; 61:103-113. [PMID: 29964067 DOI: 10.1016/j.pcad.2018.06.004] [Citation(s) in RCA: 278] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 06/21/2018] [Indexed: 01/14/2023]
Abstract
Obesity is recognized as a heterogeneous condition in which individuals with similar body mass index may have distinct metabolic and cardiovascular risk profiles. Susceptibility to obesity-related cardiometabolic complications is not solely mediated by overall body fat mass, but is largely dependent upon individual differences in regional body fat distribution and ability of subcutaneous adipose tissue to expand. The present review will discuss to what extent the individual variation in body fat distribution is one of the clinical key variables explaining the metabolic heterogeneity of obesity and its related cardiovascular risk. We will present the evidence for the complex nature of the relationship between obesity and cardiovascular disease, outline our current understanding of the mechanisms involved, and identify future direction of research pertinent to this interaction.
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Affiliation(s)
- Marie-Eve Piché
- Quebec Heart and Lung Institute, Québec, Canada; Faculty of Medicine, Université Laval, Québec, Canada.
| | - Paul Poirier
- Quebec Heart and Lung Institute, Québec, Canada; Faculty of Pharmacy, Université Laval, Québec, Canada
| | | | - Jean-Pierre Després
- Quebec Heart and Lung Institute, Québec, Canada; Faculty of Medicine, Université Laval, Québec, Canada
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16
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Rost S, Freuer D, Peters A, Thorand B, Holle R, Linseisen J, Meisinger C. New indexes of body fat distribution and sex-specific risk of total and cause-specific mortality: a prospective cohort study. BMC Public Health 2018; 18:427. [PMID: 29609587 PMCID: PMC5879745 DOI: 10.1186/s12889-018-5350-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 03/21/2018] [Indexed: 01/04/2023] Open
Abstract
Background A number of prior studies have examined the association between anthropometric measures and mortality, but studies investigating the sex-specific predictive value of novel anthropometric measures on mortality are scarce so far. Therefore, we investigated the sex-specific relevance of the new anthropometric measures body adiposity index (BAI) and waist to height ratio (WHtR) as well as the common measures body mass index (BMI), waist circumference (WC), and waist to hip ratio (WHR) for cause-specific mortality risk. Methods The analysis was based on data from the German population based KORA (Cooperative Health Research in the Region of Augsburg) Augsburg cohort study. A total of 6670 men and 6637 women aged 25 to 74 years at baseline examination were included. During a mean follow-up period of 15.4 years, 2409 persons died. Via Cox proportional hazard regression, the associations between the different anthropometric measures and all cause-, cardiovascular disease (CVD)- and cancer mortality were assessed. Results BMI, WC, and WHR were significantly associated with all-cause and CVD-mortality in both sexes. WC and WHR were particularly associated with higher all-cause and CVD-mortality risk in women, while in men especially WHtR and BAI were strongly related to these outcomes. Females with WC, WHtR, and WHR measures in the 4th quartile compared with women in the 2nd quartile had a higher risk of death from cancer. Contrary, men in the lowest quartile of WC and WHtR in comparison to men in the 2nd quartile had a significantly elevated cancer mortality risk. BAI was no risk predictor for all-cause and cause-specific mortality in women. Conclusions Central obesity reflects higher all-cause and CVD-mortality risk particularly in women. BAI and WHtR seem to be valid as risk predictors for all-cause and especially CVD mortality in men but not women. There are marked sex-differences regarding cancer mortality risk for the different anthropometric measures. Electronic supplementary material The online version of this article (10.1186/s12889-018-5350-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Susanne Rost
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany.,Institute for Medical Informatics, Biometry and Epidemiology; LMU Munich, Munich, Germany
| | - Dennis Freuer
- Chair of Epidemiology, Ludwig-Maximilians-Universität München, UNIKA-T Augsburg, Neusässer Str. 47, 86156, Augsburg, Germany
| | - Annette Peters
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany
| | - Barbara Thorand
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany
| | - Rolf Holle
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany
| | - Jakob Linseisen
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany.,Chair of Epidemiology, Ludwig-Maximilians-Universität München, UNIKA-T Augsburg, Neusässer Str. 47, 86156, Augsburg, Germany
| | - Christa Meisinger
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany. .,Chair of Epidemiology, Ludwig-Maximilians-Universität München, UNIKA-T Augsburg, Neusässer Str. 47, 86156, Augsburg, Germany.
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Vasan SK, Osmond C, Canoy D, Christodoulides C, Neville MJ, Di Gravio C, Fall CHD, Karpe F. Comparison of regional fat measurements by dual-energy X-ray absorptiometry and conventional anthropometry and their association with markers of diabetes and cardiovascular disease risk. Int J Obes (Lond) 2017; 42:850-857. [PMID: 29151596 PMCID: PMC5965665 DOI: 10.1038/ijo.2017.289] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 10/06/2017] [Accepted: 11/06/2017] [Indexed: 01/05/2023]
Abstract
Background/Objectives: Fat distribution is a strong and independent predictor of type 2 diabetes (T2D) and cardiovascular disease (CVD) and is usually determined using conventional anthropometry in epidemiological studies. Dual-energy X-ray absorptiometry (DXA) can measure total and regional adiposity more accurately. Nonetheless, whether DXA provides more precise estimates of cardiovascular risk in relation to total and regional adiposity is not known. We determined the strength of the associations between DXA- and conventional anthropometry determined fat distribution and T2D and CVD risk markers. Subjects/Methods: Waist (WC) and hip circumference (HC) and DXA was used to measure total and regional adiposity in 4950 (2119 men) participants aged 29–55 years from the Oxford Biobank without pre-existing T2D or CVD. Cross-sectional associations were compared between WC and HC vs. DXA-determined regional adiposity (all z-score normalised) with impaired fasting glucose, hypertriglyceridemia, hypertension and insulin resistance (IR). Results: Following adjustment for total adiposity, upper body adiposity measurements showed consistently increased risk of T2D and CVD risk markers except for abdominal subcutaneous fat in both sexes, and arm fat in men, which showed protective associations. Among upper adiposity depots, visceral fat mass showed stronger odds ratios (OR) ranging from 1.69 to 3.64 compared with WC 1.07–1.83. Among lower adiposity depots, HC showed modest protection for IR in both sexes (men: OR 0.80 (95% confidence interval 0.67, 0.96); women: 0.69 (0.56, 0.86)), whereas gynoid fat and in particular leg fat showed consistent and strong protective effects for all outcomes in both men and women. The differential effect of body fat distribution on CVD and T2D were more pronounced at higher levels of total adiposity. Conclusions: Compared with DXA, conventional anthropometry underestimates the associations of regional adiposity with T2D and CVD risk markers. After correcting for overall adiposity, greater subcutaneous fat mass in particular in the lower body is protective relative to greater android or visceral adipose tissue mass.
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Affiliation(s)
- S K Vasan
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK
| | - C Osmond
- MRC Life-course Epidemiology Unit, University of Southampton, Southampton, UK
| | - D Canoy
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - C Christodoulides
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK
| | - M J Neville
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK.,NIHR Oxford Biomedical Centre, Oxford University Hospital Trust and University of Oxford, Oxford, UK
| | - C Di Gravio
- MRC Life-course Epidemiology Unit, University of Southampton, Southampton, UK
| | - C H D Fall
- MRC Life-course Epidemiology Unit, University of Southampton, Southampton, UK
| | - F Karpe
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK.,NIHR Oxford Biomedical Centre, Oxford University Hospital Trust and University of Oxford, Oxford, UK
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18
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Gonzales JU, Hadri O. Role of heart rate in the relation between regional body fat and subendocardial viability ratio in women. Clin Exp Pharmacol Physiol 2016; 43:789-94. [PMID: 27220028 DOI: 10.1111/1440-1681.12597] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 05/17/2016] [Accepted: 05/19/2016] [Indexed: 01/04/2023]
Abstract
Subendocardial viability ratio (SEVR) is a measure of left ventricular function, specifically; it is an index of myocardial perfusion relative to left ventricular workload. Women have lower SEVR than men, partly due to a faster resting heart rate that reduces diastolic time (i.e., time for myocardial perfusion). It is unclear if body fat relates to SEVR, thus the purpose of this study was to examine the relation between body fat and SEVR in women. Twenty-eight middle-aged (31-45 years) and 31 older (60-80 years) women were examined. Radial artery applanation tonometry was used to calculate SEVR from a synthesized central aortic pressure wave. Dual-energy X-ray absorptiometry was used to assess body composition including fat in the trunk, legs, android and gynoid regions. Body fat was not related (P>.05) with SEVR in older women. In middle-aged women, all measures of regional fat were correlated with heart rate (range, r=.49-.59, P≤.01) and SEVR (range, r=.43-.53, P≤.01). Android-to-gynoid ratio was identified as the strongest predictor (r(2) =-.26, P<.01) of SEVR among measures of regional fat. Middle-aged women with lower android-to-gynoid fat ratio had higher SEVR (1.96±0.33 vs 1.66±0.20, P=.009) than women with higher fat ratio, even after adjusting for age, height, daily physical activity, and aortic mean pressure (P=.02). Adjusting for heart rate or diastolic time abolished the difference in SEVR between groups (1.80±0.09 vs 1.82±0.09, P=.56). These results suggest that middle-aged women with a greater distribution of fat in the abdomen have poorer left ventricular function that is dependent on the negative influence of heart rate on diastolic time.
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Affiliation(s)
- Joaquin U Gonzales
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Omar Hadri
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, USA
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19
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Min KB, Min JY. Android and gynoid fat percentages and serum lipid levels in United States adults. Clin Endocrinol (Oxf) 2015; 82:377-87. [PMID: 24974911 DOI: 10.1111/cen.12505] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 03/23/2014] [Accepted: 05/16/2014] [Indexed: 12/20/2022]
Abstract
CONTEXT Accumulating evidence suggests that fat distribution is a better predictor of cardiovascular disease than body mass index (BMI). OBJECTIVE The aim of this study was to investigate the association of android and gynoid fat percentages with lipid profiles to determine whether android and/or gynoid fat percentages are associated with serum lipid levels. DESIGN A population-based cross-sectional study. PATIENTS Five thousand six hundred and ninety-six adults (20 years and older) who participated in the National Health and Nutrition Examination Survey 2003-2006. MEASUREMENT The regional body composition in the android and gynoid regions was defined by dual energy X-ray absorptiometry (DXA). The estimation of lipid risk profiles included total cholesterol, high-density lipoprotein (HDL) -cholesterol, low-density lipoprotein (LDL) -cholesterol and triglycerides (TG). RESULTS Regardless of gender, android and gynoid body fat percentages were positively and significantly correlated with BMI and waist circumference. After adjustment for age, ethnicity, education, smoking, alcohol consumption, dyslipidaemia and BMI, increases in android fat percentage were significantly associated with total cholesterol, TG and HDL cholesterol in males, and total cholesterol, HDL cholesterol and LDL cholesterol in females. The gynoid fat percentages showed a positive correlation with total cholesterol in males, whereas gynoid fat accumulation in females showed a favourable association with TG and HDL cholesterol. The observed associations differed according to ethnic groups. CONCLUSION Our results suggest that regional fat distribution in the android and gynoid regions have different effects on lipid profiles, and that fat in the android region, rather than the gynoid region, may be an important factor in determining the risk of cardiovascular disease.
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Affiliation(s)
- Kyoung-Bok Min
- Department of Occupational and Environmental Medicine, Ajou University School of Medicine, Suwon, Korea
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20
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Kuper H, Taylor A, Krishna KVR, Ben-Shlomo Y, Gupta R, Kulkarni B, Prabhakaran D, Davey Smith G, Wells J, Ebrahim S, Kinra S. Is vulnerability to cardiometabolic disease in Indians mediated by abdominal adiposity or higher body adiposity. BMC Public Health 2014; 14:1239. [PMID: 25438835 PMCID: PMC4289237 DOI: 10.1186/1471-2458-14-1239] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 11/18/2014] [Indexed: 11/10/2022] Open
Abstract
Background Indians may be particularly vulnerable to cardiometabolic disease, potentially due to higher body fat for a given BMI, or a tendency towards depositing abdominal adiposity. The aim of the study is to assess whether different measures of the distribution of adiposity (abdominal versus whole body) or amount of adiposity (DXA versus traditional anthropometric) are better at predicting prevalent cardiometabolic risk markers in an Indian population. Methods Participants were recruited from the Indian Migration Study (IMS) and the Andhra Pradesh Children and Parent Study (APCAPS). Participants attended a clinic in Hyderabad, India, January 2009-December 2010. Adiposity was measured by conventional anthropometry (including weight, height, waist) and DXA scanning (whole body and abdominal). Blood samples were taken and assessed for fasting plasma glucose, insulin, cholesterol, and triglycerides and blood pressure was measured. Lifestyle data were collected by questionnaire. Results We invited 4 617 participants to the clinic (1 995 IMS; 2 622 APCAPS) and examined 918 from IMS (46%) and 1 451 from APCAPS (55%). There were strong and consistent relationships between adiposity and cardiometabolic risk factors. Cardiometabolic risk factors did not appear to be more strongly associated with DXA measures as opposed to BMI, or skinfold measures of body fat. There was some evidence that WHR was more closely related to diabetes than total body adiposity, but this was not apparent for the other measures of abdominal adiposity (DXA measures, waist circumference) or other cardiometablic risk factors. Conclusions No strong evidence supports that DXA measures or abdominal measures of adiposity are better at predicting the prevalence of cardiometabolic risk factors in comparison to BMI. Electronic supplementary material The online version of this article (doi:10.1186/1471-2458-14-1239) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hannah Kuper
- Clinical Research Department, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
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21
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Bann D, Cooper R, Wills AK, Adams J, Kuh D. Socioeconomic position across life and body composition in early old age: findings from a British birth cohort study. J Epidemiol Community Health 2014; 68:516-23. [PMID: 24567442 PMCID: PMC4033171 DOI: 10.1136/jech-2013-203373] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Previous studies have reported associations between lower lifetime socioeconomic position (SEP) and higher body mass index in adulthood, but few have examined associations with direct measures of fat and lean mass which are likely to have independent roles in health and physical functioning. METHODS We examined associations of SEP across life with dual-energy X-ray absorptiometry measures of fat and lean mass at 60-64 years using data from a total of 1558 men and women participating in the Medical Research Council (MRC) National Survey of Health and Development. We also examined whether associations of childhood SEP with fat and lean mass were explained by preadulthood weight gain (birth weight, 0-7 and 7-20 years) and adult SEP. RESULTS Lower SEP across life was associated with higher fat mass and higher android to gynoid fat mass ratio. For example, the mean difference in fat mass index comparing the lowest with the highest paternal occupational class at 4 years (slope index of inequality) was 1.04 kg/m(1.2) in men (95% CI 0.09 to 1.99) and 2.61 in women (1.34 to 3.89), equivalent to a 8.6% and 16.1% difference, respectively. After adjustment for fat mass, lower SEP across life was associated with lower lean mass in women, while only contemporaneous household income was associated in men. Associations between childhood SEP and outcomes were partly explained by preadulthood weight gain and adult SEP. CONCLUSIONS This study identified lifetime socioeconomic patterning of fat and lean mass in early old age. This is likely to have important implications and may partly explain socioeconomic inequalities in health and physical functioning.
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Affiliation(s)
- David Bann
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
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22
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Scafoglieri A, Tresignie J, Provyn S, Marfell-Jones M, George K, Clarys JP, Bautmans I. Accuracy and concordance of anthropometry for measuring regional fat distribution in adults aged 20-55 years. Am J Hum Biol 2012; 25:63-70. [DOI: 10.1002/ajhb.22342] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 10/07/2012] [Accepted: 10/10/2012] [Indexed: 11/06/2022] Open
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23
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Nordström A, Högström G, Eriksson A, Bonnerud P, Tegner Y, Malm C. Higher Muscle Mass but Lower Gynoid Fat Mass in Athletes Using Anabolic Androgenic Steroids. J Strength Cond Res 2012; 26:246-50. [DOI: 10.1519/jsc.0b013e318218daf0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Miller CN, Kauffman TG, Cooney PT, Ramseur KR, Brown LM. Comparison of DEXA and QMR for assessing fat and lean body mass in adult rats. Physiol Behav 2010; 103:117-21. [PMID: 21167190 DOI: 10.1016/j.physbeh.2010.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Revised: 11/05/2010] [Accepted: 12/05/2010] [Indexed: 11/26/2022]
Abstract
There are several techniques used to measure body composition in experimental models including dual energy X-ray absorptiometry (DEXA) and quantitative magnetic resonance (QMR). DEXA/QMR data have been compared in mice, but have not been compared previously in rats. The goal of this study was to compare DEXA and QMR data in rats. We used rats that varied by sex, diet, and age, in addition we compared dissected samples containing subcutaneous (pelt) or visceral fat (carcass). The data means were compared by focusing on the differences between DEXA/QMR data using a series of scatter plots without assuming that either method is more accurate as suggested by Bland and Altman. DEXA/QMR data did not agree sufficiently in carcass or pelt FM or in pelt LBM. The variation observed within these groups suggests that DEXA and QMR measurements are not comparable. Carcass LBM in young rats did yield comparable data once the data for middle-aged rats was removed. The variation in our data may be a result of different direct and indirect measures that DEXA and QMR technologies use to quantify FM and LBM. DEXA measures FM and estimates fat-free mass. In contrast, QMR uses separate equations of magnetic resonance to measure FM, LBM, total body water and free water. We found that QMR overestimated body mass in our middle-aged rats, and this increased the variation between methods. Our goal was to evaluate the precision of DEXA/QMR data in rats to determine if they agree sufficiently to allow direct comparison of data between methods. However DEXA and QMR did not yield the same estimates of FM or LBM for the majority of our samples.
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Affiliation(s)
- Colette N Miller
- Department of Nutrition, University of North Carolina at Greensboro, P.O. Box 26170, Greensboro, NC, 27402-6170, USA.
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