[Sensitivity and specificity of abdominal adiposity with metabolic syndrome in the elderly]

OBJECTIVES

It is recognised that abdominal adiposity is associated with cardiovascular risk factors, such as intolerance to glucose, hypertension and dyslipidaemia. The objective of the present study was to assess the relationship of trunk fat and visceral fat index, obtained by anthropometric and bioelectrical impedance, with metabolic syndrome (SM) in an elderly population.

METHODS

The study included 208 subjects (78 men and 130 women) with a mean age of 82.5 years. Abdominal obesity was assessed by anthropometry and bioelectrical impedance. ROC curves were calculated in order to assess the ability of these variables to diagnose metabolic syndrome.

RESULTS

There are differences between men and women in body mass index, waist to height ratio, waist circumference, and bioelectrical impedance measurements as trunk fat and visceral fat (p<.05). Also, found differences in anthropometric indices and variables and abdominal bioelectrical impedance between subjects with and without SM (p<.05) and only exist differences in blood glucose, triglycerides and HDL cholesterol (p<.05). There are significant correlations between anthropometric variables and abdominal bioelectrical impedance (p<.05). Areas under the curve (AUC) of waist to height index, waist circumference, sagittal abdominal diameter, and trunk fat were greater than 0.8 (all p<.01), and in women did not exceed values of 0.65. The cut-off points obtained for BMI were 26.81 and 23.53kg/m², 102 and 91cm for waist circumference, 22.1 and 20.7cm for sagittal abdominal diameter, 34% and 43.7% for trunk fat, and 17 and 11.5 for visceral fat ratio in men and women, respectively.

CONCLUSIONS

There are different levels of predictive ability for metabolic syndrome according to gender. Trunk fat and visceral fat index and anthropometric measures have higher predictive ability for metabolic syndrome in men than in women.

Negative association between trunk fat, insulin resistance and skeleton in obese women

AIM

To evaluate the potential interference of trunk fat (TF) mass on metabolic and skeletal metabolism.

METHODS

In this cross-sectional study, 340 obese women (mean age: 44.8 ± 14 years; body mass index: 36.0 ± 5.9 kg/m(2)) were included. Patients were evaluated for serum vitamin D, osteocalcin (OSCA), inflammatory markers, lipids, glucose and insulin (homeostasis model assessment of insulin resistance, HOMA-IR) levels, and hormones profile. Moreover, all patients underwent measurements of bone mineral density (BMD; at lumbar and hip site) and body composition (lean mass, total and trunk fat mass) by dual-energy X-ray absorptiometry.

RESULTS

Data showed that: (1) high TF mass was inversely correlated with low BMD both at lumbar (P < 0.001) and hip (P < 0.01) sites and with serum vitamin D (P < 0.0005), OSCA (P < 0.0001) and insulin-like growth factor-1 (IGF-1; P < 0.0001) levels; (2) a positive correlation was found between TF and HOMA-IR (P < 0.01), fibrinogen (P < 0.0001) and erythrocyte sedimentation rate (P < 0.0001); (3) vitamin D levels were directly correlated with IGF-1 (P < 0.0005), lumbar (P < 0.006) and hip (P < 0.01) BMD; and (4) inversely with HOMA-IR (P < 0.001) and fibrinogen (P < 0.0005).Multivariate analysis demonstrated that only vitamin D was independent of TF variable.

CONCLUSION

In obese women, TF negatively correlates with BMD independently from vitamin D levels. Reduced IGF-1 and increased inflammatory markers might be some important determinants that account for this relationship.

Body fat distribution and its association with cardiovascular risk factors in adolescent Iranian girls

OBJECTIVE

The relationships between body fat distribution, lipid profile and blood pressure, have not been studied extensively in young population. This study was designed to evaluate the association between measures of adiposity and established cardiovascular risk factors in adolescent girls.

METHODS

A total of 477 adolescent girls aged 15 to 18 years were recruited from Mashhad high schools. Socio-demographic characteristics were assessed using a self-administered questionnaire. Anthropometric assessments, blood pressure measurement and biochemical assessment were performed. Total and regional fat mass were determined by bio-impedance analysis. Cardiovascular disease risk factors were assessed in relation to body fat measures with adjustment for confounder factors including age and family socioeconomic status.

FINDINGS

The prevalence of overweight and obesity was 14.6% and 3.4% respectively; 16% of study population had greater fat mass compared to its ideal distribution. The majority of cardiovascular risk factors, especially systolic and diastolic blood pressure, triglyceride concentration, CRP and fasting blood sugar were significantly higher in group with a high body fat when compared to those with normal and low values. All anthropometric indices showed significant correlation with fat mass, fat free mass, total and regional body fat percent (P<0.001). After adjustment for age and family socioeconomic status, a high fat mass especially, truncal fat, was positively associated with triglyceride and blood pressure.

CONCLUSION

Adiposity, especially truncal adiposity, which can be assessed by simple measures such as Body Mass Index (BMI) and Waist Circumference (WC) may predispose adolescent girls for demonstration of metabolic abnormalities and consequently cardiovascular diseases.