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Gradidge PJL, Jaff NG, Norris SA, Toman M, Crowther NJ. The negative association of lower body fat mass with cardiometabolic disease risk factors is partially mediated by adiponectin. Endocr Connect 2022; 11:e220156. [PMID: 36169024 PMCID: PMC9641776 DOI: 10.1530/ec-22-0156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 09/28/2022] [Indexed: 11/08/2022]
Abstract
Gluteofemoral fat correlates negatively with a number of cardiometabolic disease risk factors, but the mechanisms involved in these relationships are unknown. The aim of this study was to test the hypothesis that gluteofemoral fat attenuates the risk of cardiometabolic disease by increasing blood adiponectin levels. This was a cross-sectional study in which arm, leg, gluteofemoral, abdominal s.c. and visceral fat levels were measured by dual-energy X-ray absorptiometry in 648 African females. Fasting serum adiponectin, lipid, insulin and plasma glucose levels and blood pressure were measured. Relationships between variables were analysed using multivariable linear regression and structural equation modelling. Adiponectin correlated positively (β = 0.45, P < 0.0001) with gluteofemoral fat in a multivariable regression model that included age, height, and arm, s.c. and visceral fat levels. In further regression models, there was a negative correlation of gluteofemoral fat with fasting glucose (β = -0.28; P < 0.0001) and triglyceride levels (β = -0.29; P < 0.0001) and insulin resistance (HOMA; β = -0.26; P < 0.0001). Structural equation modelling demonstrated that adiponectin mediated 20.7% (P < 0.01) of the association of gluteofemoral fat with insulin resistance and 16.1% (P < 0.01) of the association with triglyceride levels but only 6.67% (P = 0.31) of the association with glucose levels. These results demonstrate that gluteofemoral and leg fat are positively associated with adiponectin levels and that the negative association of lower body fat with insulin resistance and triglyceride levels may partially be mediated by this adipokine. Further studies are required to determine other factors that mediate the effect of lower body fat on cardiometabolic disease risk factors.
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Affiliation(s)
- Philippe Jean-Luc Gradidge
- Centre for Exercise Science and Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicole G Jaff
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Global Health Research Institute, School of Human Development and Health, University of Southampton, Southampton, UK
| | - Marketa Toman
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nigel J Crowther
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Tay J, Goss AM, Garvey WT, Lockhart ME, Bush NC, Quon MJ, Fisher G, Gower BA. Race affects the association of obesity measures with insulin sensitivity. Am J Clin Nutr 2020; 111:515-525. [PMID: 31879755 PMCID: PMC7049529 DOI: 10.1093/ajcn/nqz309] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 11/22/2019] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Race differences in body composition and fat distribution may in part explain the differences in insulin sensitivity and the disproportionate burden of type 2 diabetes in African Americans. OBJECTIVE To determine if differences in body composition and fat distribution explain race differences in insulin sensitivity and identify obesity measures that were independently associated with insulin sensitivity. METHODS Participants were 113 lean, overweight, and obese African-American and Caucasian-American adults without diabetes. Skeletal muscle insulin sensitivity was determined using a hyperinsulinemic-euglycemic clamp (SIClamp, insulin rate:120 mU/m2/min). Subcutaneous abdominal adipose tissue (SAAT), intra-abdominal adipose tissue (IAAT), and liver fat were measured by MRI; leg fat, total fat, and lean mass were measured by DXA. RESULTS Race-by-adiposity interactions were significant in cross-sectional analyses utilizing multiple linear regression models for SIClamp (P < 0.05); higher BMI, fat mass, SAAT, leg fat, and liver fat were associated with lower SIClamp in Caucasian Americans but not African Americans. Race-by-IAAT interaction was not significant (P = 0.65). A central fat distribution (SAAT adjusted for leg fat) was associated with lower SIClamp in African Americans (β = -0.45, SE = 0.11, P < 0.001) but not Caucasian Americans (β = -0.42, SE = 0.30, P = 0.17). A peripheral fat distribution (leg fat adjusted for IAAT/SAAT) was associated with a higher SIClamp in African Americans (β = 0.11, SE = 0.05, P = 0.02) but lower SIClamp in Caucasian Americans (β = -0.28, SE = 0.14, P = 0.049). Lean mass was inversely associated with SIClamp in African Americans (β = -0.05, SE = 0.03, P = 0.04) but not Caucasian Americans (β = 0.08, SE = 0.05, P = 0.10) in the model for leg fat. CONCLUSIONS Measures of overall adiposity were more strongly associated with SIClamp in Caucasian Americans, whereas body fat distribution and lean mass showed stronger correlations with SIClamp in African Americans. Insulin sensitivity may have a genetic basis in African Americans that is reflected in the pattern of body fat distribution. These findings suggest a race-specific pathophysiology of insulin resistance, which has implications for the prevention of diabetes and related cardiometabolic diseases.
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Affiliation(s)
- Jeannie Tay
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
- Singapore Institute of Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
- Address correspondence to JT (e-mail: )
| | - Amy M Goss
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - W Timothy Garvey
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mark E Lockhart
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nikki C Bush
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Michael J Quon
- Division of Endocrinology, Department of Medicine, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Gordon Fisher
- Department of Human Studies, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Barbara A Gower
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
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Cioffi CE, Welsh JA, Alvarez JA, Hartman TJ, Narayan KMV, Vos MB. Associations of Added Sugar from All Sources and Sugar-Sweetened Beverages with Regional Fat Deposition in US Adolescents: NHANES 1999-2006. Curr Dev Nutr 2019; 3:nzz130. [PMID: 32154500 PMCID: PMC7053569 DOI: 10.1093/cdn/nzz130] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/24/2019] [Accepted: 11/07/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The relative distribution of upper- versus lower-body fat may be an important determinant of cardiometabolic disease risk in youths. Dietary components associated with adolescent regional body fat distribution require further investigation. OBJECTIVE To evaluate associations of added sugar intake overall and from sugar-sweetened beverages (SSBs) with relative upper-body fat deposition in US adolescents. METHODS This was a cross-sectional analysis of data from 6585 adolescents (aged 12-19 y) in the NHANES cycles 1999-2006. Trunk, leg, and total fat mass were assessed by DXA. Participants were grouped into categories of total and SSB added sugar intake as a percentage of total energy intake (TEI) in 5% increments. Stepwise multivariable linear regression was used to examine associations of added sugar intake with truncal-to-leg fat ratio (TLR) and truncal-to-total fat ratio (TTR). RESULTS There were no associations of total added sugar intake with TLR or TTR. For SSB added sugar, compared with the lowest category of intake (<2% TEI), the highest category (>22% TEI) was associated with higher log-TLR [β (95% CI): >22% TEI versus <2% TEI: 0.05 (0.01, 0.09)] and TTR [1.30 (0.53, 2.07)] in the partially adjusted model with sex, age, race/ethnicity, income, physical activity, and smoking status as covariates (P-trend = 0.0001 for both). When BMI z-score and TEI were added as covariates, the magnitude of the associations were attenuated, but remained significant [log-TLR β (95% CI): 0.03 (0.005, 0.06), P-trend = 0.0018; TTR β (95% CI): 0.75 (0.27, 1.23), P-trend = 0.0004]. CONCLUSIONS These findings support that added sugar from beverages is associated with higher upper-body adiposity, though the magnitude and clinical significance of the associations may be small, especially when adjusted for BMI and TEI. Additional studies are needed to elucidate the underlying biological mechanisms to explain these findings.
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Affiliation(s)
- Catherine E Cioffi
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA
| | - Jean A Welsh
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Department of Gastroenterology, Hepatology, and Nutrition, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Jessica A Alvarez
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Terryl J Hartman
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - K M Venkat Narayan
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Miriam B Vos
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Department of Gastroenterology, Hepatology, and Nutrition, Children's Healthcare of Atlanta, Atlanta, GA, USA
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Nie X, Xu Y, Ma X, Shen Y, Wang Y, Bao Y. Trunk fat and leg fat in relation to free triiodothyronine in euthyroid postmenopausal women. Endocr Connect 2019; 8:1425-1432. [PMID: 31581130 PMCID: PMC6826169 DOI: 10.1530/ec-19-0394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 09/26/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND A high level of free triiodothyronine (FT3) within the reference range may be a potential metabolic risk marker. However, the relationship between different fat depots and FT3 has remained unclear. OBJECTIVE We aimed to explore the relationships between segmental fat distribution and FT3 in euthyroid middle-aged and elderly men and postmenopausal women. METHODS A total of 891 subjects (394 men and 497 women) were enrolled. A bioelectrical impedance analyzer was used to measure total, trunk, arm and leg fat mass (FM) and fat percentage (fat%). The leg fat mass to trunk fat mass ratio (LTR) was calculated to evaluate the relative distribution of leg fat compared with that of trunk fat. Thyroid hormones were measured by electrochemical luminescence immunoassay. RESULTS FT3 in men did not change significantly with increases in LTR quartiles, while FT3 in women decreased significantly (P for trend = 0.004). In multivariate linear regression analysis, multiple metabolic and cardiovascular risk factors were adjusted. The LTR was negatively related to FT3 in women (P < 0.05). After further mutual adjustment for trunk fat and leg fat parameters, trunk FM and fat% were positively related to FT3, while leg FM and fat% were negatively related to FT3 in women (all P < 0.05). CONCLUSIONS In euthyroid postmenopausal women, trunk fat was positively correlated with FT3, whereas leg fat was negatively correlated with FT3. Our findings supported that a high level of FT3 within the reference range was related to adverse fat distribution.
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Affiliation(s)
- Xiaomin Nie
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Yiting Xu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Xiaojing Ma
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
- Correspondence should be addressed to X Ma or Y Bao: or
| | - Yun Shen
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Yufei Wang
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
- Correspondence should be addressed to X Ma or Y Bao: or
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Cioffi CE, Alvarez JA, Welsh JA, Vos MB. Truncal-to- leg fat ratio and cardiometabolic disease risk factors in US adolescents: NHANES 2003-2006. Pediatr Obes 2019; 14:e12509. [PMID: 30682733 PMCID: PMC6546534 DOI: 10.1111/ijpo.12509] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/04/2018] [Accepted: 12/08/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND This study aims to describe patterns of truncal versus peripheral fat deposition measured by truncal-to-leg fat ratio (TLR) in adolescents and examine associations of TLR with cardiometabolic (CMD) risk factors. METHODS Data were from 3810 adolescents (12-19 years old) in the National Health and Examination Survey (NHANES) 2003-2006. Body fat was assessed by dual-energy X-ray absorptiometry, and CMD risk factors were determined by blood samples and physical examination. Linear and logistic regressions adjusted for BMI z-score and other covariates were used to examine associations of TLR with CMD risk factors as continuous and dichotomized outcomes, respectively. RESULTS Adolescents who were Mexican American, who have lower income, and with obesity had the highest mean TLR (all p < 0.05). In linear regression, increasing TLR was associated positively with homeostasis model assessment of insulin resistance (HOMA-IR), triglycerides, total cholesterol, systolic blood pressure (BP), c-reactive protein, and alanine aminotransferase (ALT), and negatively with high-density lipoprotein (HDL) cholesterol in both sexes (p < 0.05). TLR was also associated with diastolic BP in boys and low-density lipoprotein cholesterol in girls (p < 0.05). A similar pattern of findings resulted from logistic regression. When further stratified by race/ethnicity, TLR was positively associated with high triglycerides, total cholesterol, and ALT for White and/or Mexican American (p < 0.05), but not Black adolescents, while associations with HOMA-IR and HDL were significant for all race/ethnicities. CONCLUSIONS In this cohort of adolescents, TLR was associated with several risk factors independent of BMI z-score, although some findings were sex or race/ethnicity specific. Body fat distribution may be an important determinant of future CMD.
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Affiliation(s)
- Catherine E. Cioffi
- Department of Nutrition and Health Sciences; Laney Graduate
School; Emory University; Atlanta, GA, 30322,CORRESPONDING AUTHOR: Catherine Cioffi, RD; 1760
Haygood Drive NE; Health Sciences Research Building; Suite W-440B; Emory
University; Atlanta, GA, 30322.
| | - Jessica A. Alvarez
- Department of Medicine; Division of Endocrinology, Diabetes
and Lipids; Emory University School of Medicine; Atlanta, GA, 30322
| | - Jean A. Welsh
- Department of Pediatrics; Emory University School of
Medicine; Atlanta, GA, 30322,Children’s Healthcare of Atlanta; Atlanta, GA,
30322
| | - Miriam B. Vos
- Department of Pediatrics; Emory University School of
Medicine; Atlanta, GA, 30322,Children’s Healthcare of Atlanta; Atlanta, GA,
30322
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Samouda H, De Beaufort C, Stranges S, Hirsch M, Van Nieuwenhuyse JP, Dooms G, Gilson G, Keunen O, Leite S, Vaillant M, Lair ML, Dadoun F. Cardiometabolic risk: leg fat is protective during childhood. Pediatr Diabetes 2016; 17:300-8. [PMID: 26083149 DOI: 10.1111/pedi.12292] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 04/25/2015] [Accepted: 05/26/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Childhood obesity is associated with early cardiometabolic risk (CMR), increased risk of adulthood obesity, and worse health outcomes. Leg fat mass (LFM) is protective beyond total fat mass (TFM) in adults. However, the limited evidence in children remains controversial. OBJECTIVE We investigated the relationship between LFM and CMR factors in youth. SUBJECTS A total of 203 overweight/obese children, 7-17-yr-old, followed in the Pediatric Clinic, Luxembourg. METHODS TFM and LFM by dual energy x-ray absorptiometry and a detailed set of CMR markers were analyzed. RESULTS After TFM, age, sex, body mass index (BMI) Z-score, sexual maturity status, and physical activity adjustments, negative significant partial correlations were shown between LFM and homeostasis model assessment of insulin resistance (HOMA) (variance explained: 6.05% by LFM*; 7.18% by TFM**), fasting insulin (variance explained: 5.71% by LFM*; 6.97% by TFM**), triglycerides (variance explained: 3.96% by LFM*; 2.76% by TFM*), systolic blood pressure (variance explained: 2.68% by LFM*; 4.33% by TFM*), C-reactive protein (variance explained: 2.31% by LFM*; 4.28% by TFM*), and resistin (variance explained: 2.16% by LFM*; 3.57% by TFM*). Significant positive partial correlations were observed between LFM and high-density lipoprotein (HDL) cholesterol (variance explained: 4.16% by LFM*) and adiponectin (variance explained: 3.09% by LFM*) (*p-value < 0.05 and **p-value < 0.001). In order to adjust for multiple testing, Benjamini-Hochberg method was applied and the adjusted significance level was determined for each analysis. LFM remained significant in the aforementioned models predicting HOMA, fasting insulin, triglycerides, and HDL cholesterol (Benjamini and Hochberg corrected p-value < 0.01). CONCLUSIONS LFM is protective against CMR in children, at least in terms of insulin resistance and adverse blood lipid profiles.
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Affiliation(s)
- Hanen Samouda
- Population Health Department, Center for Health Studies, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Carine De Beaufort
- Diabetes & Endocrinology Care Clinique Pédiatrique (DECCP), Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Saverio Stranges
- Population Health Department, Center for Health Studies, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Marco Hirsch
- Rheumatology Department, ZithaKlinik, Luxembourg, Luxembourg
| | | | - Georges Dooms
- Radiology Department, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Georges Gilson
- Department of Clinical Biology, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Olivier Keunen
- Norlux Neuro-Oncology Laboratory, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Sonia Leite
- Centre of Competence for Methodology and Statistics (CCMS), Luxembourg Institute of Health, Strassen, Luxembourg
| | | | - Marie-Lise Lair
- Population Health Department, Center for Health Studies, Luxembourg Institute of Health, Strassen, Luxembourg.,Santé et Prospectives, Sanem, Luxembourg
| | - Frédéric Dadoun
- Population Health Department, Center for Health Studies, Luxembourg Institute of Health, Strassen, Luxembourg.,Endocrinology and Diabetology Department, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
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Marwaha RK, Garg MK, Tandon N, Mehan N, Sastry A, Bhadra K. Relationship of body fat and its distribution with bone mineral density in Indian population. J Clin Densitom 2013; 16:353-359. [PMID: 23910719 DOI: 10.1016/j.jocd.2012.08.074] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Revised: 07/30/2012] [Accepted: 08/02/2012] [Indexed: 11/26/2022]
Abstract
Obesity has been associated with increased bone mineral density (BMD). There is evidence of differential effect of regional fat on BMD. Hence, we undertook this study to evaluate the correlation between total body fat and its distribution with BMD in nonobese (mean body mass index: 25.0 ± 4.7 kg/m²) Indian adult volunteers. A total of 2347 participants (men: 39.4% and women: 60.6%) included in this cross-sectional study were divided according to sex and age. Fasting blood samples were drawn for biochemical parameters. Percent total body, truncal, and leg fat and BMD at lumbar spine, femur, and forearm were measured by dual-energy X-ray absorptiometry. The BMD at all sites (radius, femur, and spine) increased from lowest to highest quartiles of percent body fat. Percent truncal fat was positively correlated with BMD at all sites in both sexes, except for femoral neck in men, where it had negative correlation. Percent leg fat was positively related with BMD at all sites in premenopausal women, and spine and radius BMD in postmenopausal women. However, in men, it had negative correlation with femoral neck BMD. On multiple regression analysis, regional fat had positive association with BMD at all sites after adjusting for age, sex, lean mass index, 25-hydroxyvitamin D, and intact parathyroid hormone levels. Leg-to-total body fat ratio was negatively associated with BMD at all sites in men and pre- and postmenopausal women. Percent total body and regional fat have positive association with BMD at all sites in men and women.
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Affiliation(s)
- Raman Kumar Marwaha
- Department of Endocrinology and Thyroid Research Centre, Institute of Nuclear Medicine & Allied Sciences, Timarpur, New Delhi 110054, India.
| | - Mahendra K Garg
- Department of Endocrinology and Metabolism, Army Hospital (Research & Referral), Delhi Cantonment, New Delhi, India
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Neena Mehan
- Department of Medicine, B. R. Sur Institute of Homeopathy, New Delhi, India
| | - Aparna Sastry
- Department of Endocrinology and Thyroid Research Centre, Institute of Nuclear Medicine & Allied Sciences, Timarpur, New Delhi 110054, India
| | - Kuntal Bhadra
- Department of Endocrinology and Thyroid Research Centre, Institute of Nuclear Medicine & Allied Sciences, Timarpur, New Delhi 110054, India
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