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Objective: One of the main features of polycystic ovary syndrome (PCOS) is increased adipose tissue, which can result in hormonal disturbances. In the present study, we aimed to investigate which indicator of obesity could better associate with hormonal disturbances in PCOS women. Methods: In this cross-sectional analysis, women with PCOS were included according to the Rotterdam criteria. Fasting blood samples were analyzed for biochemical, metabolic, and hormonal parameters. Anthropometric measures comprised body composition indices (assessed by bioelectric impedance analysis [BIA]), waist circumference, body mass index (BMI), and waist-to-height ratio (WHtR). Linear regression modeling was used to assess the association between anthropometric indices and hormonal imbalance, adjusted for age, mensuration status, and the homeostasis model assessment-estimated insulin resistance (HOMA-IR). Receiver operating characteristics (ROC) curves were utilized to ascertain the sensitivity, specificity, and optimal cut-off points of various anthropometric indices in identifying hyperandrogenism. Results: A total of 129 PCOS women with a median (interquartile range [IQR]) age of 32.0 (23.0–32.0) years and a median BMI of 26.3 (23.00-29.70) kg/m2 were enrolled. In the adjusted linear regression model, BMI (β = 0.053, P < 0.001), waist circumference (β = 0.021, P = 0.001), WHtR (β = 3.325, P = 0.002), total fat mass (β = 0.021, P = 0.002), trunk fat mass (β = 0.038, P = 0.006), and leg fat mass (β = 0.045, P = 0.004) were positively associated with free androgen index (FAI). In addition, BMI (β=−0.017, P = 0.003), waist circumference (β=−0.008, P = 0.002), WHtR (β=−1.167, P = 0.004), total fat mass (β=−0.008, P=0.003), trunk fat mass (β=−0.017, P=0.001), and leg fat mass (β=−0.018, P=0.004) were negatively associated with the serum level of sex hormone binding globulin (SHBG). WHtR showed the greatest area under the curve (AUC) value (AUC = 0.676, P = 0.001) for identifying hyperandrogenism (FAI ≥ 4.97 or total testosterone ≥ 0.7 ng/mL) in PCOS women with corresponding sensitivity of 87.30% and specificity of 39.70%. Conclusions: WHtR is related to hyperandrogenism in PCOS better than other anthropometric measures. [ABSTRACT FROM AUTHOR]

Abstract Objective One of the main features of polycystic ovary syndrome (PCOS) is increased adipose tissue, which can result in hormonal disturbances. In the present study, we aimed to investigate which indicator of obesity could better associate with hormonal disturbances in PCOS women. Methods In this cross-sectional analysis, women with PCOS were included according to the Rotterdam criteria. Fasting blood samples were analyzed for biochemical, metabolic, and hormonal parameters. Anthropometric measures comprised body composition indices (assessed by bioelectric impedance analysis [BIA]), waist circumference, body mass index (BMI), and waist-to-height ratio (WHtR). Linear regression modeling was used to assess the association between anthropometric indices and hormonal imbalance, adjusted for age, mensuration status, and the homeostasis model assessment-estimated insulin resistance (HOMA-IR). Receiver operating characteristics (ROC) curves were utilized to ascertain the sensitivity, specificity, and optimal cut-off points of various anthropometric indices in identifying hyperandrogenism. Results A total of 129 PCOS women with a median (interquartile range [IQR]) age of 32.0 (23.0–32.0) years and a median BMI of 26.3 (23.00-29.70) kg/m2 were enrolled. In the adjusted linear regression model, BMI (β = 0.053, P

Abstract Background Visceral fat accumulation and obesity-induced chronic inflammation have been proposed as early markers for multiple disease states, especially in women. Nevertheless, the potential impact of fat distribution on α1-acid glycoprotein(AGP), a marker of inflammation, remains unclear. This research was conducted to investigate the relationships among obesity, fat distribution, and AGP levels. Methods A cross-sectional observational study was performed using blood samples from adult females recruited through the National Health and Nutrition Examination Survey from 2015 to 2018. Serum levels of AGP were measured using the Tina-quant α-1-Acid Glycoprotein Gen.2 assay. Based on the fat distribution data obtained from dual-energy X-ray absorptiometry assessments, body mass index (BMI), total percent fat (TPF), android percent fat (APF), gynoid percent fat (GPF), android fat/gynoid fat ratio (AGR), visceral percent fat (VPF), subcutaneous percent fat (SPF), visceral fat/subcutaneous fat ratio (VSR) were used as dependent variables. To investigate the link between fat distribution and AGP, multivariate linear regression analysis was utilized. Furthermore, a sensitivity analysis was also performed. Results The present study included 2,295 participants. After adjusting for covariates, BMI, TPF, APF, GPF, VPF, and SPF were found to be positively correlated with AGP levels (BMI: β = 23.65 95%CI:20.90–26.40; TPF: β = 25.91 95%CI:23.02–28.80; APF: β = 25.21 95%CI:22.49–27.93; GPF: β = 19.65 95%CI:16.96–22.34; VPF: β = 12.49 95%CI:9.08–15.90; SPF: β = 5.69, 95%CI:2.89–8.49; AGR: β = 21.14 95%CI:18.16–24.12; VSR: β = 9.35 95%CI:6.11–12.59, all P

Abstract Background Trimethylamine-N-oxide (TMAO) is linked with obesity, while limited evidence on its relationship with body fat distribution. Herein, we investigated the associations between serum TMAO and longitudinal change of fat distribution in this prospective cohort study. Methods Data of 1964 participants (40–75y old) from Guangzhou Nutrition and Health Study (GNHS) during 2008–2014 was analyzed. Serum TMAO concentration was quantified by HPLC–MS/MS at baseline. The body composition was assessed by dual-energy X-ray absorptiometry at each 3-y follow-up. Fat distribution parameters were fat-to-lean mass ratio (FLR) and trunk-to-leg fat ratio (TLR). Fat distribution changes were derived from the coefficient of linear regression between their parameters and follow-up duration. Results After an average of 6.2-y follow-up, analysis of covariance (ANCOVA) and linear regression displayed women with higher serum TMAO level had greater increments in trunk FLR (mean ± SD: 1.47 ± 4.39, P -trend = 0.006) and TLR (mean ± SD: 0.06 ± 0.24, P -trend = 0.011). Meanwhile, for women in the highest TMAO tertile, linear mixed-effects model (LMEM) analysis demonstrated the annual estimated increments (95% CI) were 0.03 (95% CI: 0.003 – 0.06, P = 0.032) in trunk FLR and 1.28 (95% CI: -0.17 – 2.73, P = 0.083) in TLR, respectively. In men, there were no similar significant observations. Sensitivity analysis yielded consistent results. Conclusion Serum TMAO displayed a more profound correlation with increment of FLR and TLR in middle-aged and older community-dwelling women in current study. More and further studies are still warranted in the future. Trial registration NCT 03179657.

Introduction. Body mass index (BMI), which is measured as the ratio of body weight to height squared, is one of the widely used criteria for classifying overweight and obesity. Despite its popularity, BMI is often criticized for not taking into account individual differences in body composition and fat distribution, which can lead to inaccuracies in the classification of the degree of obesity. Aim. To develop and test a somatotype diagnostic algorithm based on the integration and comprehensive analysis of fat content, skeletal muscle mass, and fat distribution. Materials and methods. The study was conducted on a group of 82 men with different indicators of BMI. A developed algorithm was used to diagnose somatotype, which included body fat index (IBF), limb muscle mass index (IASM), and waist circumference to height ratio (WHtR). The results were analyzed and classified according to the defined criteria. Results. The proposed algorithm was tested on a sample of 82 examined men, who were divided into 2 groups depending on BMI. Thanks to our algorithm, it was possible to identify prognostically unfavorable somatotypes characterized by sarcopenia with a central type of fat distribution. These are F1S1C1 and F2S1C1 somatotypes, the total number of which was 9 examined (10.96% of the sample). Approbation of the algorithm was carried out on a group of examined men, confirmed its effectiveness and ability to detect different somatotypes, taking into account complex parameters of the body. Conclusions. Our research algorithm turned out to be a useful tool for somatotype diagnosis, especially in cases where BMI may not accurately reflect the real state of health. Taking into account individual differences in body components such as fat content, skeletal muscle mass and fat distribution, we provide a more accurate classification of somatotype and the possibility of a more individualized approach to treatment and prevention.

Background: Visceral fat accumulation and obesity-induced chronic inflammation have been proposed as early markers for multiple disease states, especially in women. Nevertheless, the potential impact of fat distribution on α1-acid glycoprotein(AGP), a marker of inflammation, remains unclear. This research was conducted to investigate the relationships among obesity, fat distribution, and AGP levels. Methods: A cross-sectional observational study was performed using blood samples from adult females recruited through the National Health and Nutrition Examination Survey from 2015 to 2018. Serum levels of AGP were measured using the Tina-quant α-1-Acid Glycoprotein Gen.2 assay. Based on the fat distribution data obtained from dual-energy X-ray absorptiometry assessments, body mass index (BMI), total percent fat (TPF), android percent fat (APF), gynoid percent fat (GPF), android fat/gynoid fat ratio (AGR), visceral percent fat (VPF), subcutaneous percent fat (SPF), visceral fat/subcutaneous fat ratio (VSR) were used as dependent variables. To investigate the link between fat distribution and AGP, multivariate linear regression analysis was utilized. Furthermore, a sensitivity analysis was also performed. Results: The present study included 2,295 participants. After adjusting for covariates, BMI, TPF, APF, GPF, VPF, and SPF were found to be positively correlated with AGP levels (BMI: β = 23.65 95%CI:20.90–26.40; TPF: β = 25.91 95%CI:23.02–28.80; APF: β = 25.21 95%CI:22.49–27.93; GPF: β = 19.65 95%CI:16.96–22.34; VPF: β = 12.49 95%CI:9.08–15.90; SPF: β = 5.69, 95%CI:2.89–8.49; AGR: β = 21.14 95%CI:18.16–24.12; VSR: β = 9.35 95%CI:6.11–12.59, all P < 0.0001). All the above indicators exhibited a positive dose–response relationship with AGP. In terms of fat distribution, both AGR and VSR showed positive associations with AGP (P for trend < 0.0001). In particular, when compared to individuals in tertile 1 of AGR, participants in tertiles 2 and 3 had 13.42 mg/dL (95% CI 10.66–16.18) and 21.14 mg/dL (95% CI 18.16–24.12) higher AGP levels, respectively. Participants in the highest tertile of VSR were more likely to exhibit a 9.35 mg/dL increase in AGP compared to those in the lowest tertile (95% CI 6.11–12.59). Conclusions: Overall, this study revealed a positive dose-dependent relationship between fat proportion/distribution and AGP levels in women. These findings suggest that physicians can associate abnormal serum AGP and obesity with allow timely interventions. [ABSTRACT FROM AUTHOR]

Background: Trimethylamine-N-oxide (TMAO) is linked with obesity, while limited evidence on its relationship with body fat distribution. Herein, we investigated the associations between serum TMAO and longitudinal change of fat distribution in this prospective cohort study. Methods: Data of 1964 participants (40–75y old) from Guangzhou Nutrition and Health Study (GNHS) during 2008–2014 was analyzed. Serum TMAO concentration was quantified by HPLC–MS/MS at baseline. The body composition was assessed by dual-energy X-ray absorptiometry at each 3-y follow-up. Fat distribution parameters were fat-to-lean mass ratio (FLR) and trunk-to-leg fat ratio (TLR). Fat distribution changes were derived from the coefficient of linear regression between their parameters and follow-up duration. Results: After an average of 6.2-y follow-up, analysis of covariance (ANCOVA) and linear regression displayed women with higher serum TMAO level had greater increments in trunk FLR (mean ± SD: 1.47 ± 4.39, P-trend = 0.006) and TLR (mean ± SD: 0.06 ± 0.24, P-trend = 0.011). Meanwhile, for women in the highest TMAO tertile, linear mixed-effects model (LMEM) analysis demonstrated the annual estimated increments (95% CI) were 0.03 (95% CI: 0.003 – 0.06, P = 0.032) in trunk FLR and 1.28 (95% CI: -0.17 – 2.73, P = 0.083) in TLR, respectively. In men, there were no similar significant observations. Sensitivity analysis yielded consistent results. Conclusion: Serum TMAO displayed a more profound correlation with increment of FLR and TLR in middle-aged and older community-dwelling women in current study. More and further studies are still warranted in the future. Trial registration: NCT 03179657. [ABSTRACT FROM AUTHOR]

This study investigates the relationship between obesity and cardiovascular disease (CVD) risk by comparing the use of body mass index (BMI) versus other biomarkers in predicting CVD risk among obese individuals. It conducts a systematic literature review following the PRISMA guidelines, searching databases for relevant articles published from 2017-2022. The review analyzes 12 eligible articles and finds that factors beyond just BMI, such as genetics, physical activity, metabolic disorders, previous heart disease history, nutrition, fat distribution, and changes in BMI, can significantly impact the prognosis of heart disease in obese individuals. Importantly, the study shows that measures of fat distribution like waist-to-height ratio, waist circumference, logtransformed body shape index (LBSIZ), and the ratio of visceral adipose tissue (VAT) to subcutaneous adipose tissue (SAT) are superior to BMI in predicting CVD risk among those with obesity. The key takeaway is that while obesity is strongly linked to CVD risk, BMI alone often fails to predict that risk accurately. Fat distribution measures may be a more effective tool for identifying obesity status and predicting associated CVD risk compared to relying solely on BMI. The findings imply that future research should further explore these alternative biomarkers, and clinical practice may benefit from incorporating them into risk assessment protocols. Explicitly stating the significance or impact of these findings strengthens the abstract and highlights the potential implications for future research and clinical practice. INSET: c. [ABSTRACT FROM AUTHOR]

Objective: To investigate the impacts of fat distribution on assisted reproductive outcomes in infertile women. Methods: The study randomly recruited 576 infertile women who underwent assisted reproductive technology treatment at the Reproductive Medicine Center of the First Affiliated Hospital of Anhui Medical University between July and October 2022. Questionnaires and body composition measurements were administered to assess baseline information and fat distribution. The numbers of oocytes, zygotes presenting with two pronuclei (2PN), and available embryos were tracked at the end of the cycle. Multifactorial logistic regression models and restricted cubic spline (RCS) curve models were used to explore the relationships between fat distribution and reproductive outcomes while controlling for confounding factors. Results: The study found that the participants had a mean age of 30.82 years. The analysis showed that there was a significant difference between the amount of leg body fat mass (LBFM) and the distribution of reproductive outcomes. However, there was no significant correlation between the level of visceral fat and reproductive outcomes. After taking confounding factors into account, the multifactorial regression analysis showed that the total body fat mass and the number of oocytes (odds ratio (OR) 0.92, 95% confidence interval (CI) 0.84–0.99), 2PN (OR 0.92, 95% CI 0.84–0.99), and embryos available for transfer (OR 0.90, 95% CI 0.82–0.99) were negatively correlated. RCS modeling revealed a linear dose–response relationship between LBFM and assisted reproductive outcomes. Conclusion: Fat distribution varies among infertile women, and higher amounts of fat are associated with poorer assisted reproductive outcomes. Synopsis: Infertile women with varying fat distribution experience reduced reproductive outcomes when undergoing assisted reproductive technology. [ABSTRACT FROM AUTHOR]

Introduction. Physical activity and good diet are the primary determinants of body weight. The aim of the study was to compare physical activity and eating behaviours of overweight and obese females (taking into consideration their body fat distribution) with individuals with normal levels of body fat. Material and methods. The study included females aged 20-35. The study group consisted of 449 subjects, who were categorised into groups based on their body fat percentage: underweight, normal body fat, overweight and obese. The WHR index was computed in individuals who were overweight or obese. The assessment of physical activity levels was conducted using data obtained from the IPAQ, while eating behaviours were examined using the Dietary Habits And Nutrition Beliefs Questionnaire developed by the Polish Academy of Sciences. Results. Females who were overweight or obese exhibited greater values of the examined physical characteristics in comparison to individuals with normal levels of body fat. Subjects with fat tissue in the abdomen area had higher values of somatic characteristics. There were no statistically significant differences in physical activity levels between individuals with normal body fat and overweight or obese females. However, when the second group was divided into those with abdominal fatness and those with peripheral fatness, it was observed that individuals with abdominal fatness had lower levels of physical activity, including both total activity as well as vigorous and moderate activity. There were no significant differences in eating behaviours found between the groups. Conclusions. The amount and placement of fat tissue in young females is more closely linked to their levels of physical activity rather than their eating habits and knowledge about food and nutrition. [ABSTRACT FROM AUTHOR]

Individual patterns of fat accumulation (visceral, subcutaneous, and/or liver fat) can determine cardiometabolic risk profile. To investigate risk stratification using personalized fat z-scores in persons with a body mass index (BMI) of 30–40 kg/m2 from the UK Biobank imaging study. Population-based study. Whole-body magnetic resonance (MR) images of 40,174 participants from the UK Biobank imaging study were analyzed for visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (aSAT), and liver fat (LF) and used to calculate sex- and body size-invariant fat z-scores (VATz, aSATz, LFz). Associations between z-scores and later incident cardiovascular disease (CVD) and type 2 diabetes (T2D) were investigated using Cox proportional hazards modeling and Kaplan-Meier curves in participants with BMI 30–40 kg/m2. A total of 6716 participants had BMI 30–40 kg/m2 and within this group, CVD was positively associated with VATz (crude hazard ratio (cHR) [95% CI]: 1.30 [1.20–1.40], P <.001) and negatively associated with aSATz and LFz (cHR: 0.91 [0.85–0.99], P =.028, and 0.88 [0.82–0.95], P =.002). All z-scores remained significant after adjustment for sex, BMI, and age, but only VATz was significant when previous CVD was added. T2D was positively associated with VATz and LFz (cHR: 1.53 [1.40–1.67], P <.001, and 1.35 [1.23–148], P <.001) and negatively associated with aSATz (cHR: 0.90 [0.81–0.99], P =.026). All z-scores remained significant after adjustment for sex, BMI, and age. Personalized MR-derived fat z-scores can identify phenotypes of obesity with specific cardiometabolic risk profiles regardless of BMI. Current guidelines for bariatric surgery based on BMI exclude some of these high-risk patients. • Visceral, subcutaneous and liver fat z-scores identify different obesity phenotypes • Fat distribution phenotypes can determine cardiometabolic risk profile • Persons with high cardiometabolic risk may qualify for intensive obesity treatment [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease originates in early life. We aimed to investigate the association between breastfeeding in infancy and cardiovascular disease in adult life. Methods: We followed 364,240 participants from UK Biobank aged 40–73 years from 2006 – 2010 to 2021. Information on breastfeeding in infancy was self-reported by questionnaire. Cox proportional hazard regression models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI) for the association between breastfeeding and cardiovascular disease in middle-aged and older adulthood. The multivariable Cox models were used by adjusting for the age (used as the time scale), sex, ethnicity, assessment centre, birth weight, multiple birth status, maternal smoking during pregnancy, Townsend deprivation index, smoking status, alcohol drinker status, physical activity, and menopausal status for women. Binary and multinomial multivariable logistic regression models were used to explore the associations of breastfeeding in infancy with cardiovascular disease risk factors including obesity, body composition, metabolic and inflammatory disorders. Results: During a median of 12.6 years of follow-up, we documented 29,796 new cases of cardiovascular disease, including 24,797 coronary heart disease and 6229 stroke. The multivariable adjusted HRs for breastfed versus non-breastfed were 0.94 (95% CI: 0.91, 0.96) for cardiovascular disease, 0.94 (95% CI: 0.91, 0.96) for coronary heart disease, and 0.95 (95% CI: 0.89, 1.01) for stroke. Furthermore, the strength of observed association between breastfeeding and cardiovascular disease seems to decrease with age (P for interaction

BackgroundHeterogenous deposition and homeostasis roles of physiologic and ectopic adipose tissues underscore the impact of fat compartmentalization on cardiometabolic risk. We aimed to characterize the distribution of abdominal visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), epicardial adipose tissue (EAT), and liver fat on magnetic resonance imaging (MRI), and evaluate their associations with anthropometric indices and adverse cardiac remodeling.MethodsIn this cross-sectional observational study, 149 Asian adults (57.0 ± 12.8 years; 65% males) with at least one cardiometabolic risk factor underwent multiparametric fat and cardiovascular MRI. Anthropometric indices included body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), and bioimpedance body fat mass (BFM). Associations between fat depots and anthropometric measures as well as cardiac remodeling features were examined as a single cohort and stratified by type 2 diabetes mellitus (T2DM) status.ResultsVAT and SAT had opposing associations with liver fat and EAT. Therefore the VAT/SAT ratio was explored as an integrated marker of visceral adiposity. VAT/SAT was positively associated with EAT (β=0.35, P

Abstract Background Using Zonulin and Copeptin as potential obesity markers in children, hasn’t yet been focused. Aim To evaluate the association between serum levels of both Zonulin and Copeptin with the obesity markers, and to assess their role as metabolic disturbance predictors in obese children. Methods A case-control study comprised 111 Egyptian children (45 males and 66 females); aged 6–10 years to avoid the effect of puberty (prepubertal). They were classified according to their body mass index (BMI) percentiles into: 72 obese (BMI ≥ 95th ), and 39 control ones (BMI > 15th -

Abstract Background Obesity has been related to depression and adhering healthy lifestyle was beneficial to lower the risk of depression; however, little is known about the relationship between body composition and fat distribution with depression risk and the influence of body composition and fat distribution on the association of lifestyle and depression. Therefore, we aimed to investigate whether body composition and fat distribution were associated with the adverse events of depression and the relationship between lifestyle and depression. Methods We included 330,131 participants without depression at baseline in the UK Biobank (mean age, 56.9 years; 53.83% females). The assessment of depression was sourced from health outcomes across self-report, primary care, hospital inpatient data, and death data. Body composition was determined by bioelectrical impedance. Seven lifestyles (no current smoking, moderate alcohol consumption, regular physical activity, healthy diet, less sedentary behavior, healthy sleep pattern, and appropriate social connection) were used to generate a lifestyle score. Results During a median of 11.7 years of follow-up, 7576 incident depression occurred. All the body composition measures were positively associated with depression risk, with the Hazard ratios (HR) for the uppermost tertile (T3) versus the lowest tertile (T1) ranging from 1.26 (95% CI: 1.15–1.39) for trunk fat-free mass (TFFM) to 1.78 (1.62–1.97) for leg fat percentage (LFP). In addition, we found significant interactions between fat mass-related indices, especially leg fat mass (LFM) (p = 1.65 × 10−9), and lifestyle score on the risk of depression, for which the beneficial associations of a healthy lifestyle with the risk of depression were more evident among participants with low body fat measurement. Conclusions High levels of body composition measures were associated with an increased depression risk. Adverse body composition measures may weaken the link between a healthy lifestyle and a reduced risk of depression.

Little is known about whether body composition changes differently between children with and without obesity following 1 year of nonintervention. Therefore, we investigated body composition in early pubescent children (8–12 yr) with and without obesity before and after a period of 1 year of nonintervention. Early pubescent children (8–12 yr; Tanner stage ≤ 3) with (body mass index, BMI ≥ 95th percentile) and without obesity (15th < BMI < 85th percentile) were recruited. At baseline, 88 children (n = 25 without obesity) completed dual-energy X-ray absorptiometry imaging (DXA) for body composition measurements [%body fat, fat mass, fat-free mass (FFM)]. One year later, 47 participants (n = 15 without obesity) returned for repeat testing. The children without obesity were older (11.0 ± 1.0 vs. 10.0 ± 1.2 yr; means ± SD) (P = 0.013). There was no group difference in height, and both groups increased in height similarly after 1 year (147.7 ± 8.9 to 154.5 ± 9.2 cm without vs. 145.6 ± 5.8 to 152.5 ± 5.9 cm with obesity) (P < 0.001). Weight was greater (P < 0.001) in children with obesity at baseline as was the increase in weight after 1 yr (9.25 vs. 5.82 kg) (interaction, P = 0.005). Fat mass increased by 4.4 kg in children with obesity and by 1.1 kg in children without obesity (interaction, P < 0.001). However, there was no difference in fat-free mass between those with and without obesity at baseline (29.9 ± 5.9 vs. 31.6 ± 4.8 kg) (P = 0.206) with both groups increasing similarly over 1 year (gain of 4.87 vs. 4.85 kg with and without obesity, respectively). Without intervention, the increase in fat mass is four times greater in children with obesity after 1 year as compared with children without obesity. NEW & NOTEWORTHY: Little is known about changes in body composition in children with and without obesity following 1 year of nonintervention. We report that without intervention, fat mass gain is significantly greater in children with obesity after 1 year compared with those without obesity. Body mass index (BMI) and %body fat measurements after 1 year yielded no significant increase suggesting that BMI and %fat alone are not suitable measures for tracking changes in adiposity among children. [ABSTRACT FROM AUTHOR]

The novel sex-specific anthropometric equation relative fat mass (RFM) is a new estimator of whole-body fat %. The study aimed to investigate the predictive role of RFM in cardiometabolic abnormalities, cardiovascular disease (CVD), all-cause and cardiovascular mortality, and explored potential sex differences. The study analyzed data from 26,754 adults in NHANES 1999–2010, with a median follow-up of 13.8 years. The correlation between RFM and body composition as well as fat distribution assessed by dual-energy X-ray absorptiometry was investigated. Weighted multivariable generalized linear models, Cox proportional hazards models and restricted cubic spline were applied to investigate the predictive role of RFM in metabolic markers, cardiovascular risk factors, CVD, all-cause and cardiovascular mortality. RFM exhibited a robust correlation with both whole-body fat % and trunk fat %. Higher RFM exhibited a stronger association with impaired glucose homeostasis, serum lipids, the incidence of hypertension, and coronary heart disease in males, while a stronger association with C-reactive protein in females. A U-shaped association between RFM and all-cause mortality was observed only in males. The hazard ratio (HR) of all-cause and cardiovascular mortality in males increased rapidly when RFM exceeded 30. However, in females, the HR of all-cause and cardiovascular mortality fluctuated until RFM exceeded 45, after which it increased rapidly. RFM was a sex-specific estimator for both general and central obesity, sex-specific differences in predicting cardiometabolic abnormalities and adverse events using RFM might be partially attributed to differences in body composition and fat distribution between sexes. • RFM is a robust sex-specific indicator for assessing both overall and central adiposity. • With the same RFM, there are sex differences in fat distribution. • Sex differences in RFM for predicting cardiometabolic abnormalities and adverse events. • RFM is a promising indicator for assessing obesity and determining preventive and therapeutic strategies. [ABSTRACT FROM AUTHOR]

Background: Visceral adiposity has been associated with an increased risk of critical illness in COVID-19 patients. However, if it also associates to a poor survival is still not well established. The aim of the study was to assess the relationship between abdominal fat distribution and COVID-19 mortality. Methods: In this six-month longitudinal cohort study, abdominal visceral (VAT) and subcutaneous adipose tissues (SAT) were measured by computed tomography in a cohort of 174 patients admitted to the emergency department with a diagnosis of COVID-19, during the first wave of pandemic. The primary exposure and outcome measures were VAT and SAT at hospital admission, and death at 30 and 180 days, respectively. Results: Overall survival was not different according to VAT (p = 0.94), SAT (p = 0.32) and VAT/SAT ratio (p = 0.64). However, patients in the lowest SAT quartile (thickness ≤ 11.25 mm) had a significantly reduced survival compared to those with thicker SAT (77 vs. 94% at day 30; 74 vs. 91% at day 180, p = 0.01). Similarly, a thinner SAT was associated with lower survival in Intensive Care Unit (ICU) admitted patients, independently of sex or age (p = 0.02). The VAT/SAT ratio showed a non-linear increased risk of ICU admission, which plateaued out and tended for inversion at values greater than 1.9 (p = 0.001), although was not associated with increased mortality rate. Conclusions: In our cohort, visceral adiposity did not increase mortality in patients with COVID-19, but low SAT may be associated with poor survival. [ABSTRACT FROM AUTHOR]

In this paper, we discuss horizontal immersions of discs in certain corank- 2 fat distributions on 6 -dimensional manifolds. The underlying real distribution of a holomorphic contact distribution on a complex 3 manifold belongs to this class. The main result presented here says that the associated nonlinear PDE is locally invertible. Using this we prove the existence of germs of embedded horizontal discs. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to compare the difference in abdominal fat distribution between different metabolic groups and find the ectopic fat with the most risk significance. Methods: A total of 98 subjects were enrolled; there were 53 cases in the normal glucose metabolism group and 45 cases in the abnormal glucose metabolism group. Chemical shift-encoded magnetic resonance imaging was applied for quantification of pancreatic fat fraction (PFF) and hepatic fat fraction (HFF), subcutaneous adipose tissue (SAT), and visceral adipose tissue (VAT). The correlation and the difference of fat distribution between different metabolism groups were analyzed. The receiver operating characteristic (ROC) curve was used to analyze the suggestive effect of different body fat fraction. Results: Correlation analysis showed that body mass index (BMI) had the strongest correlation with fasting insulin (r = 0.473, p < 0.001), HOMA-IR (r = 0.363, p < 0.001), and C-reactive protein (r = 0.245, p < 0.05). Pancreatic fat has a good correlation with fasting blood glucose (r = 0.247, p < 0.05) and HbA1c (r = 0.363, p < 0.001). With the increase of BMI, PFF, VAT, and SAT showed a clear upward trend, but liver fat was distributed relatively more randomly. The pancreatic fat content in the abnormal glucose metabolism group is significantly higher than that in the normal group, and pancreatic fat is also a reliable indicator of abnormal glucose metabolism, especially in the normal and overweight groups (the area under the curve was 0.859 and 0.864, respectively). Conclusion: MR-based fat quantification techniques can provide additional information on fat distribution. There are differences in fat distribution among people with different metabolic status. People with more severe pancreatic fat deposition have a higher risk of glucose metabolism disorders. [ABSTRACT FROM AUTHOR]

Background: Using Zonulin and Copeptin as potential obesity markers in children, hasn't yet been focused. Aim: To evaluate the association between serum levels of both Zonulin and Copeptin with the obesity markers, and to assess their role as metabolic disturbance predictors in obese children. Methods: A case-control study comprised 111 Egyptian children (45 males and 66 females); aged 6–10 years to avoid the effect of puberty (prepubertal). They were classified according to their body mass index (BMI) percentiles into: 72 obese (BMI ≥ 95th), and 39 control ones (BMI > 15th - <85th), based on the Egyptian Growth Charts for children and adolescents. Anthropometric parameters and blood pressure were measured, and body composition analysis, lipid profile, Zonulin, and Copeptin levels were assessed. Results: The obese group showed a significantly higher value of Copeptin and a lower value of Zonulin than the control one Also, the obese group showed significant negative correlations between Zonulin and both anthropometric obesity markers and body composition, whereas Copeptin showed significant positive ones. Moreover, significant positive correlations were found between Copeptin and both body weight and fat distribution. Insignificant correlations were observed between both serum Zonulin and Copeptin levels and blood pressure and lipid profile. Conclusion: Zonulin and Copeptin cannot be used as metabolic disturbance predictors, among Egyptian children, as they were insignificantly correlated with lipid profile or blood pressure. [ABSTRACT FROM AUTHOR]

Background: Obesity has been related to depression and adhering healthy lifestyle was beneficial to lower the risk of depression; however, little is known about the relationship between body composition and fat distribution with depression risk and the influence of body composition and fat distribution on the association of lifestyle and depression. Therefore, we aimed to investigate whether body composition and fat distribution were associated with the adverse events of depression and the relationship between lifestyle and depression. Methods: We included 330,131 participants without depression at baseline in the UK Biobank (mean age, 56.9 years; 53.83% females). The assessment of depression was sourced from health outcomes across self-report, primary care, hospital inpatient data, and death data. Body composition was determined by bioelectrical impedance. Seven lifestyles (no current smoking, moderate alcohol consumption, regular physical activity, healthy diet, less sedentary behavior, healthy sleep pattern, and appropriate social connection) were used to generate a lifestyle score. Results: During a median of 11.7 years of follow-up, 7576 incident depression occurred. All the body composition measures were positively associated with depression risk, with the Hazard ratios (HR) for the uppermost tertile (T3) versus the lowest tertile (T1) ranging from 1.26 (95% CI: 1.15–1.39) for trunk fat-free mass (TFFM) to 1.78 (1.62–1.97) for leg fat percentage (LFP). In addition, we found significant interactions between fat mass-related indices, especially leg fat mass (LFM) (p = 1.65 × 10−9), and lifestyle score on the risk of depression, for which the beneficial associations of a healthy lifestyle with the risk of depression were more evident among participants with low body fat measurement. Conclusions: High levels of body composition measures were associated with an increased depression risk. Adverse body composition measures may weaken the link between a healthy lifestyle and a reduced risk of depression. [ABSTRACT FROM AUTHOR]

Objective: Previous studies have reported sex differences in non-alcoholic fatty liver disease (NAFLD) among adults; however, little is known about its occurrence in children and adolescents. This study aims to examine the prevalence of NAFLD among them and investigate the relationship between sex hormones and NAFLD. Method: This study included 2999 obese Chinese children aged 2–18 years. We examined the prevalence of NAFLD by sex, age, and Tanner stage. The regression model and principal component analysis were used to analyze the relationship between sex hormones and NAFLD. Results: The prevalence of NAFLD increased with age in both sexes, and the gender difference appeared before puberty. The prevalence in boys tended to stabilize at the age of 11 years, whereas girls reached their peak temporarily. NAFLD prevalence was positively associated with estradiol in boys (p = 0.011), but the opposite trend was observed in girls (p = 0.031). Testosterone levels decreased with the increase of NAFLD prevalence in boys (p < 0.001). Luteinizing hormone and prolactin were inversely associated with NAFLD prevalence in boys and girls, respectively. Results from the principal component analysis showed that sex hormone levels and fat distribution were important risk factors for the prevalence of NAFLD in obese children (p < 0.001). Conclusion: The significant difference in NAFLD prevalence between genders in obese children begins in early childhood. This distinction emerges long before puberty onset and tends to stabilize during late adolescence. Sex hormones are associated with NAFLD prevalence and are influenced by the Tanner stages and fat distribution. [ABSTRACT FROM AUTHOR]

Abstract Background Fat distribution is closely related to vascular stiffness. This study aimed to investigate age and sex differences in fat distribution and brachial-ankle pulse wave velocity (baPWV), and the association between fat parameters and baPWV. Methods A total of 10,811 participants aged 20–59 years were recruited. Measures included waist and hip circumference, waist-to-hip ratio (WHR), body mass index (BMI), percentage body fat (PBF), subcutaneous fat area (SFA), visceral fat area (VFA), and baPWV. Results The results confirm that fat accumulates with age and that men tend to carry more abdominal fat than women in the same age group. The findings also indicate that baPWV increases with age and is significantly higher in men than in women in the same age group. In addition, WHR, VFA, and baPWV were more strongly correlated than baPWV and BMI, SFA, and PBF. Finally, the effects of age, PBF, WHR, and VFA on baPWV were greater for the higher quantiles. Conclusions There are age and sex differences in fat distribution and baPWV. Abdominal obesity is more closely linked to arterial stiffness than overall obesity, and people with higher baPWV are more affected by obesity parameters.

Yansu Wang,1,&ast; Yiting Xu,1,&ast; Tingting Hu,1 Yunfeng Xiao,2 Yufei Wang,1 Xiaojing Ma,1 Haoyong Yu,1 Yuqian Bao1 1Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, People’s Republic of China; 2Department of Radiology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yuqian Bao, Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, People’s Republic of China, Tel +86-21-64369181, Fax +86-21-64368031, Email yqbao@sjtu.edu.cnBackground: It has been reported recently that the ratio of uric acid to high-density lipoprotein cholesterol (UHR) is correlated with several metabolic disorders. The present study aimed to investigate the associations of UHR with body fat content and distribution.Methods: This study enrolled 300 participants (58 men and 242 women) aged 18 to 65 years. The levels of serum uric acid and high-density lipoprotein cholesterol were measured by standard enzymatic methods. The overall fat content and segmental fat distribution were assessed with an automatic bioelectrical impedance analyzer. In the population with obesity, the visceral fat area (VFA) and subcutaneous fat area (SFA) were measured using magnetic resonance imaging.Results: Among the study population, 219 individuals (73.0%) were with obesity. The median level of UHR in individuals with obesity was 33.7% (26.2% - 45.9%), which was significantly higher than that in those without obesity [22.6% (17.0% - 34.4%), P < 0.01]. UHR was positively associated with overall fat content and segmental fat distribution parameters (all P < 0.01). In multivariate linear regression analysis, compared with body mass index, waist circumference was more closely associated with UHR (standardized β = 0.427, P < 0.001) after adjusting for confounding factors. Additionally, total fat mass (standardized β = 0.225, P = 0.002) and trunk fat mass (standardized β = 0.296, P = 0.036) were more closely linked to UHR than total fat-free mass and leg fat mass, respectively. In the population with obesity, VFA was independently correlated with UHR (P < 0.01), while SFA was not associated with UHR.Conclusion: UHR was significantly associated with overall fat content and trunk fat accumulation. In the population with obesity, UHR was positively associated with VFA. Attention should be paid to the role of excessive trunk fat mass in the relationship between UHR and metabolic disorders.Keywords: fat distribution, the UHR index, trunk fat mass, visceral fat area

Introduction: The purpose of this study was to compare the difference in abdominal fat distribution between different metabolic groups and find the ectopic fat with the most risk significance. Methods: A total of 98 subjects were enrolled; there were 53 cases in the normal glucose metabolism group and 45 cases in the abnormal glucose metabolism group. Chemical shift-encoded magnetic resonance imaging was applied for quantification of pancreatic fat fraction (PFF) and hepatic fat fraction (HFF), subcutaneous adipose tissue (SAT), and visceral adipose tissue (VAT). The correlation and the difference of fat distribution between different metabolism groups were analyzed. The receiver operating characteristic (ROC) curve was used to analyze the suggestive effect of different body fat fraction. Results: Correlation analysis showed that body mass index (BMI) had the strongest correlation with fasting insulin (r = 0.473, p < 0.001), HOMA-IR (r = 0.363, p < 0.001), and C-reactive protein (r = 0.245, p < 0.05). Pancreatic fat has a good correlation with fasting blood glucose (r = 0.247, p < 0.05) and HbA1c (r = 0.363, p < 0.001). With the increase of BMI, PFF, VAT, and SAT showed a clear upward trend, but liver fat was distributed relatively more randomly. The pancreatic fat content in the abnormal glucose metabolism group is significantly higher than that in the normal group, and pancreatic fat is also a reliable indicator of abnormal glucose metabolism, especially in the normal and overweight groups (the area under the curve was 0.859 and 0.864, respectively). Conclusion: MR-based fat quantification techniques can provide additional information on fat distribution. There are differences in fat distribution among people with different metabolic status. People with more severe pancreatic fat deposition have a higher risk of glucose metabolism disorders.

Abstract Background The relationship between lean body mass (LBM) and blood pressure (BP) is controversial and limited. This study investigated the associations between LBM indexes and BP in adults of different ages and with varying body fat distribution. Methods The data for the present analysis was obtained from a cross-sectional survey of 1,465 adults (50.7% males) aged 18–70 years conducted in Beijing, China. Regional LBM and fat distribution, including fat mass (FM) and android to gynoid fat ratio (AOI), were assessed using a dual-energy X-ray bone densitometer. Generalized Liner Model (GLM) was employed. Confounders, including age, sex, height, weight, smoking, and alcohol use, were evaluated through questionnaires and physical examinations. Results Males had higher rates of hypertension (11.19% vs. 4.92%) and prehypertension (21.57% vs. 14.59%) than females. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 122.04 mmHg and 76.68 mmHg. There were no significant associations between LBM and DBP (p > 0.05). However, arms LBM (β = 1.86, 95% CI: 0.77, 2.94) and trunk LBM (β = 0.37, 95% CI: 0.01, 0.73) were significantly associated with SBP. The association of LBM on DBP was stronger with increasing ages, and stronger in females than in males (p

Background: Fat distribution is closely related to vascular stiffness. This study aimed to investigate age and sex differences in fat distribution and brachial-ankle pulse wave velocity (baPWV), and the association between fat parameters and baPWV. Methods: A total of 10,811 participants aged 20–59 years were recruited. Measures included waist and hip circumference, waist-to-hip ratio (WHR), body mass index (BMI), percentage body fat (PBF), subcutaneous fat area (SFA), visceral fat area (VFA), and baPWV. Results: The results confirm that fat accumulates with age and that men tend to carry more abdominal fat than women in the same age group. The findings also indicate that baPWV increases with age and is significantly higher in men than in women in the same age group. In addition, WHR, VFA, and baPWV were more strongly correlated than baPWV and BMI, SFA, and PBF. Finally, the effects of age, PBF, WHR, and VFA on baPWV were greater for the higher quantiles. Conclusions: There are age and sex differences in fat distribution and baPWV. Abdominal obesity is more closely linked to arterial stiffness than overall obesity, and people with higher baPWV are more affected by obesity parameters. [ABSTRACT FROM AUTHOR]

Aim: To investigate the sex‐specific causality of body compositions in type 2 diabetes and related glycaemic traits using Mendelian randomization (MR). Materials and Methods: We leveraged sex‐specific summary‐level statistics from genome‐wide association studies for three adipose deposits adjusted for body mass index and height, including abdominal subcutaneous adipose tissue, visceral adipose tissue (VATadj) and gluteofemoral adipose tissue (GFATadj), measured by MRI (20 038 women; 19 038 men), and fat mass‐adjusted appendicular lean mass (ALMadj) (244 730 women; 205 513 men) in the UK Biobank. Sex‐specific statistics of type 2 diabetes were from the Diabetes Genetics Replication and Meta‐analysis Consortium and those for fasting glucose and insulin were from the Meta‐analyses of Glucose and Insulin‐related Traits Consortium. Univariable and multivariable MR (MVMR) were performed. We also performed MR analyses of anthropometric traits and genetic association analyses using individual‐level data of body composition as validation. Results: Univariable MR analysis showed that, in women, higher GFATadj and ALMadj exerted a causally protective effect on type 2 diabetes (GFATadj: odds ratio [OR] 0.59, 95% confidence interval [CI; 0.50, 0.69]; ALMadj: OR 0.84, 95% CI [0.77, 0.91]) and VATadj to be riskier in glycaemic traits. MVMR showed that GFATadj retained a robust effect on type 2 diabetes (OR 0.57, 95% CI [0.42, 0.77]; P = 2.6 × 10−4) in women, while it was nominally significant in men (OR 0.58, 95% CI [0.35, 0.96]; P = 3.3 × 10−2), after adjustment for ASATadj and VATadj. MR analyses of anthropometric measures and genetic association analyses of glycaemic traits confirmed the results. Conclusions: Body composition has a sex‐specific effect on type 2 diabetes, and higher GFATadj has an independent protective effect on type 2 diabetes in both sexes. [ABSTRACT FROM AUTHOR]

Determining the mechanism driving body fat distribution will provide insights into obesity-related health risks. We used functional genomics tools to profile the epigenomic landscape to help infer the differential transcriptional potential of apple- and pear-shaped women's subcutaneous adipose-derived stem cells (ADSCs). We found that CCCTC-binding factor (CTCF) expression and its chromatin binding were increased in ADSCs from pear donors compared to those from apple donors. Interestingly, the pear enriched CTCF binding sites were located predominantly at the active transcription start sites (TSSs) of genes with active histone marks and YY1 motifs and were also associated with pear enriched RNAPII binding. In contrast, apple enriched CTCF binding sites were mainly found at intergenic regions and when identified at TSS, they were enriched with the bivalent chromatin signatures. Altogether, we provide evidence that CTCF plays an important role in differential regulation of subcutaneous ADSCs gene expression and may influence the development of apple vs. pear body shape. [ABSTRACT FROM AUTHOR]

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Background: The relationship between lean body mass (LBM) and blood pressure (BP) is controversial and limited. This study investigated the associations between LBM indexes and BP in adults of different ages and with varying body fat distribution. Methods: The data for the present analysis was obtained from a cross-sectional survey of 1,465 adults (50.7% males) aged 18–70 years conducted in Beijing, China. Regional LBM and fat distribution, including fat mass (FM) and android to gynoid fat ratio (AOI), were assessed using a dual-energy X-ray bone densitometer. Generalized Liner Model (GLM) was employed. Confounders, including age, sex, height, weight, smoking, and alcohol use, were evaluated through questionnaires and physical examinations. Results: Males had higher rates of hypertension (11.19% vs. 4.92%) and prehypertension (21.57% vs. 14.59%) than females. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 122.04 mmHg and 76.68 mmHg. There were no significant associations between LBM and DBP (p > 0.05). However, arms LBM (β = 1.86, 95% CI: 0.77, 2.94) and trunk LBM (β = 0.37, 95% CI: 0.01, 0.73) were significantly associated with SBP. The association of LBM on DBP was stronger with increasing ages, and stronger in females than in males (p < 0.001). The association between adults' arms LBM and SBP was stronger in the high level FM group (β = 2.74 vs. β = 1.30) and high level AOI group (β = 1.80 vs. β = 2.08). Conclusion: The influence of LBM on SBP increases with age, particularly after the age twenty years in females. For adults with high FM or high AOI, LBM in the arms, showed a stronger positive predictive association with SBP. This suggests that, in addition to controlling fat content, future efforts to improve cardiovascular health in adults should include the management of LBM (especially in the upper body). [ABSTRACT FROM AUTHOR]

In previous genome-wide association studies (GWAS), genetic loci associated with obesity and impaired fat distribution (FD) have been identified. In the present study, we elucidated the role of the PEMT gene, including the waist–hip-ratio-associated single nucleotide polymorphism rs4646404, and its influence on obesity-related metabolic traits. DNA from 2926 metabolically well-characterized subjects was used for genotyping. PEMT expression was analyzed in paired visceral (vis) and subcutaneous (sc) adipose tissue (AT) from a subset of 574 individuals. Additionally, PEMT expression was examined in vis, sc AT and liver tissue in a separate cohort of 64 patients with morbid obesity and liver disease. An in vitro Pemt knockdown was conducted in murine epididymal and inguinal adipocytes. Our findings highlight tissue-specific variations in PEMT mRNA expression across the three studied tissues. Specifically, vis PEMT mRNA levels correlated significantly with T2D and were implicated in the progression of non-alcoholic steatohepatitis (NASH), in contrast to liver tissue, where no significant associations were found. Moreover, sc PEMT expression showed significant correlations with several anthropometric- and metabolic-related parameters. The rs4646404 was associated with vis AT PEMT expression and also with diabetes-related traits. Our in vitro experiments supported the influence of PEMT on adipogenesis, emphasizing its role in AT biology. In summary, our data suggest that PEMT plays a role in regulating FD and has implications in metabolic diseases. [ABSTRACT FROM AUTHOR]

Metabolic diseases are a host of complex conditions, including obesity, diabetes mellitus, and metabolic syndrome. Endocrine control systems (eg, adrenals, thyroid, gonads) are causally linked to metabolic health outcomes. N/NIH Heterogeneous Stock (HS) rats are a genetically heterogeneous outbred population developed for genetic studies of complex traits. Genetic mapping studies in adult HS rats identified loci associated with cardiometabolic risks, such as glucose intolerance, insulin resistance, and increased body mass index. This study determined underappreciated metabolic health traits and the associated endocrine glands within available substrains of the HS rat founders. We hypothesize that the genetic diversity of the HS rat founder strains causes a range of endocrine health conditions contributing to the diversity of cardiometabolic disease risks. ACI/EurMcwi, BN/NHsdMcwi, BUF/MnaMcwi, F344/StmMcwi, M520/NRrrcMcwi, and WKY/NCrl rats of both sexes were studied from birth until 13 weeks of age. Birth weight was recorded, body weight was measured weekly, metabolic characteristics were assessed, and blood and tissues were collected. Our data show wide variation in endocrine traits and metabolic health states in ACI, BN, BUF, F344, M520, and WKY rat strains. This is the first report to compare birth weight, resting metabolic rate, endocrine gland weight, hypothalamic–pituitary–thyroid axis hormones, and brown adipose tissue weight in these rat strains. Importantly, this work unveils new potential for the HS rat population to model early life adversity and adrenal and thyroid pathophysiology. The HS population likely inherited risk alleles for these strain-specific traits, making the HS rat a powerful model to investigate interventions on endocrine and metabolic health. [ABSTRACT FROM AUTHOR]

Abstract Background and objective Dysmobility Syndrome (DS) is characterized as an accumulation of clinical risk factors for functional disability, such as osteoporosis, sarcopenia, and obesity. Neurological disorders that affect the motor and sensory systems can also contribute to the condition, resulting in gait and muscle strength disturbances, as well as a history of falls and fractures. The study aimed to determine the association between fat distribution in different body areas and the odds of older adults developing DS, as there is still uncertainty about the accumulation of fat in which area is most closely linked to the condition. Methods This cross-sectional study was conducted according to the data from the second phase of the Bushehr Elderly Health Cohort (BEH). Dysmobility Syndrome was defined based on the co-occurrence of at least three outcomes of its criteria. Body composition was measured using dual-energy X-ray absorptiometry (DXA) and anthropometric studies. For evaluating the relationship, multivariate logistic regression and adjusted univariate linear regression were used. Results Of 2,359 who were recruited in the study, 1,277 participants (54.13%) had DS. According to the final logistic regression model in the limb region, FM and FM to FFM ratios were significantly associated with DS [OR (95%CI) = 1.04 (1.02 to 1.05), and 3.42 (1.95 to 5.99), respectively]. Also, In the trunk region, the FM and FM to FFM ratio were significantly related to the odds of DS, although this relationship was weaker than in the limbs region [OR (95%CI) = 1.02 (1.00 to 1.03), and 2.45 (1.36 to 4.39), respectively]. Conclusion Our findings indicate that a higher regional and whole-body amount of fat mass rather than fat-free mass is closely linked to an increased risk of DS, particularly in the elderly population. Notably, higher fat mass in the limbs (especially in the legs) is associated with greater odds of DS, while a higher android-to-gynoid fat mass ratio is associated with lower DS risk. Screening fat mass distribution in older individuals can be a valuable strategy for promptly diagnosing DS, implementing interventions to prevent disabilities, and improving their quality of life.

Background and objective: Dysmobility Syndrome (DS) is characterized as an accumulation of clinical risk factors for functional disability, such as osteoporosis, sarcopenia, and obesity. Neurological disorders that affect the motor and sensory systems can also contribute to the condition, resulting in gait and muscle strength disturbances, as well as a history of falls and fractures. The study aimed to determine the association between fat distribution in different body areas and the odds of older adults developing DS, as there is still uncertainty about the accumulation of fat in which area is most closely linked to the condition. Methods: This cross-sectional study was conducted according to the data from the second phase of the Bushehr Elderly Health Cohort (BEH). Dysmobility Syndrome was defined based on the co-occurrence of at least three outcomes of its criteria. Body composition was measured using dual-energy X-ray absorptiometry (DXA) and anthropometric studies. For evaluating the relationship, multivariate logistic regression and adjusted univariate linear regression were used. Results: Of 2,359 who were recruited in the study, 1,277 participants (54.13%) had DS. According to the final logistic regression model in the limb region, FM and FM to FFM ratios were significantly associated with DS [OR (95%CI) = 1.04 (1.02 to 1.05), and 3.42 (1.95 to 5.99), respectively]. Also, In the trunk region, the FM and FM to FFM ratio were significantly related to the odds of DS, although this relationship was weaker than in the limbs region [OR (95%CI) = 1.02 (1.00 to 1.03), and 2.45 (1.36 to 4.39), respectively]. Conclusion: Our findings indicate that a higher regional and whole-body amount of fat mass rather than fat-free mass is closely linked to an increased risk of DS, particularly in the elderly population. Notably, higher fat mass in the limbs (especially in the legs) is associated with greater odds of DS, while a higher android-to-gynoid fat mass ratio is associated with lower DS risk. Screening fat mass distribution in older individuals can be a valuable strategy for promptly diagnosing DS, implementing interventions to prevent disabilities, and improving their quality of life. [ABSTRACT FROM AUTHOR]

Metabolically healthy or unhealthy obesity is closely related to metabolic syndrome (MetS). To validate a more accurate diagnostic method for obesity that reflects the risk of metabolic disorders in a pre‐clinical mouse model, C57BL/6J mice were fed high‐sucrose–high‐fat and chow diets for 12 weeks to induce obesity. MRI was performed and analysed by chemical shift‐encoded fat–water separation based on the transition region extraction method. Abdominal fat was divided into upper and lower abdominal regions at the horizontal lower border of the liver. Blood samples were collected, and the glucose level, lipid profile, liver function, HbA1c and insulin were tested. k‐means clustering and stepwise logistic regression were applied to validate the diagnosis of hyperglycaemia, dyslipidaemia and MetS, and to ascertain the predictive effect of MRI‐derived parameters to the metabolic disorders. Pearson or Spearman correlation was used to assess the relationship between MRI‐derived parameters and metabolic traits. The receiver‐operating characteristic curve was used to evaluate the diagnostic effect of each logistic regression model. A two‐sided p value less than 0.05 was considered to indicate statistical significance for all tests. We made the precise diagnosis of obesity, dyslipidaemia, hyperglycaemia and MetS in mice. In all, 14 mice could be diagnosed as having MetS, and the levels of body weight, HbA1c, triglyceride, total cholesterol and low‐density lipoprotein cholesterol were significantly higher than in the normal group. Upper abdominal fat better predicted dyslipidaemia (odds ratio, OR = 2.673; area under the receiver‐operating characteristic curve, AUCROC = 0.9153) and hyperglycaemia (OR = 2.456; AUCROC = 0.9454), and the abdominal visceral adipose tissue (VAT) was better for predicting MetS risk (OR = 1.187; AUCROC = 0.9619). We identified the predictive effect of fat volume and distribution in dyslipidaemia, hyperglycaemia and MetS. The upper abdominal fat played a better predictive role for the risk of dyslipidaemia and hyperglycaemia, and the abdominal VAT played a better predictive role for the risk of MetS. [ABSTRACT FROM AUTHOR]

Evolutionary perspectives on obesity have aimed to understand how the genetic constitution of individuals has been shaped by selective pressures such as famine, predation or infectious disease. The dual intervention model assumes strong selection on lower and upper limits of adiposity, but negligible fitness implications for intermediate adiposity. These frameworks are agnostic to age, sex and condition. I argue that selection has favoured a 'crafty genotype'—a genetic basis for accommodating variability in the 'fitness value' of fat through phenotypic plasticity, depending on the endogenous and exogenous characteristics of each individual. Hominin evolution occurred in volatile environments. I argue that the polygenetic basis of adiposity stabilizes phenotype in such environments, while also coordinating phenotypic variance across traits. This stability underpins reaction norms through which adiposity can respond sensitively to ecological factors. I consider how the fitness value of fat changes with age, sex and developmental experience. Fat is also differentially distributed between peripheral and abdominal depots, reflecting variable prioritization of survival versus reproduction. Where longevity has been compromised by undernutrition, abdominal fat may promote immediate survival and fitness, while long-term cardiometabolic risks may never materialize. This approach helps understand the sensitivity of adiposity to diverse environmental factors, and why the health impacts of obesity are variable. This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part I)'. [ABSTRACT FROM AUTHOR]

Background: The body fat in polycystic ovary syndrome (PCOS) women is mostly centrally distributed and is associated with insulin resistance, diabetes mellitus, and hyperandrogenemia. This study compared the fat distributions of Thai PCOS and non-PCOS women, and it investigated the association between body fat distribution in PCOS women with glucose tolerance and serum androgens. Methods: The PCOS and non-PCOS groups each had 60 women. The body mass indexes (BMI) of the groups were matched. Blood tests and fat distributions were compared between group. Results: The mean age of the non-PCOS group was significantly higher than that of the PCOS group (30.85 ± 6.41 vs. 25.95 ± 5.16 years; p-value < 0.001). The glucose level after a 2-hour, 75-gram, oral glucose tolerance test (75-g OGTT) of the PCOS group, and its insulin resistance, triglyceride, low-density lipoprotein, total testosterone, free testosterone, and dehydroepiandrosterone sulphate levels, were significantly higher than the corresponding values of the non-PCOS group. The fat distribution patterns of the 2 groups were generally not significantly different. The level of fat distributed in the arms was significantly elevated among PCOS women with abnormal 75-g OGTT values. The fat distributions of PCOS women, regardless of hyperandrogenemia status, did not significantly differ. Conclusions: No significant differences in fat distribution were observed between the PCOS and non-PCOS groups. PCOS participants with abnormal 75-g OGTT levels had a higher proportion of arm-fat compared to those with normal results. There were no discernible differences in fat distribution patterns between PCOS women with hyperandrogenemia and those with normal androgen levels.

Knee osteoarthritis (KOA) is one of the most common joint diseases, especially in individuals with obesity. Another condition within this population, and which presents frequently, is sarcopenic obesity (SO), defined as an increase in body fat and a decrease in muscle mass and strength. The current paper aims to describe recent nutritional strategies which can generally improve KOA clinical severity and, at the same time, ameliorate SO indices. Searches were carried out in the PubMed and Science Direct databases and data were summarized using a narrative approach. Certain key findings have been revealed. Firstly, the screening and identification of SO in patients with KOA is important, and to this end, simple physical performance tests and anthropometric measures are available in the literature. Secondly, adherence to a Mediterranean diet and the achievement of significant body weight loss by means of low-calorie diets (LCDs) remain the cornerstone nutritional treatment in this population. Thirdly, supplementation with certain micronutrients such as vitamin D, essential and non-essential amino acids, as well as whey protein, also appear to be beneficial. In conclusion, in the current review, we presented a detailed flowchart of three different nutritional tracks that can be adopted to improve both KOA and SO based on joint disease clinical severity. [ABSTRACT FROM AUTHOR]

The study aimed to examine leukocyte telomere length (LTL) and serum neuregulin-4 levels and their relationship with disease activity, co-morbidities and body fat distribution in female acromegaly patients. Forty female patients with acromegaly and thirty-nine age and body mass index (BMI) similar healthy female volunteers were included in the study. Patients were classified into two groups: active acromegaly (AA) and controlled acromegaly (CA). The quantitative polymerase chain reaction (PCR) method was used to study LTL, and T/S ratio < 1 was accepted as shortened telomere length. Neuregulin-4 was studied by ELISA. There was no difference in median LTL between acromegaly and the control group (p = 0.530). The percentage of T/S < 1 in patients with acromegaly (60.0%) was similar to that of the control group (43.6%) (p = 0.144). However, serum neuregulin-4 was significantly higher in patients with acromegaly than those in the control group (p = 0.037). There were no significant differences concerning LTL, percentage of T/S < 1 and neuregulin-4 levels between active and controlled acromegaly groups (p > 0.05). Neuregulin-4 correlated positively with fasting glucose, triglyceride (TG), triglyceride/glucose (TyG) index, and lean body mass in the acromegaly group. A negative correlation was observed between LTL and neuregulin-4 in the control group (p = 0.039). When the factors affecting neuregulin-4 were evaluated by multivariate linear regression analysis with an enter method, TG (β: 0.316, p = 0.025) was independently and positively associated with neuregulin-4. Our findings indicate that acromegaly is associated with unchanged LTL and high neuregulin-4 levels in female patients. However, the relationship between acromegaly, the aging process, and neuregulin-4 involves complex mechanisms, and further studies are needed. [ABSTRACT FROM AUTHOR]

Habitual declines in sleep duration and increased rates of obesity are public health concerns worldwide. Accumulating evidence suggests a prominent link between reduced sleep duration and weight gain. Our cross-sectional study investigated the relationship between sleep duration and body fat distribution in US adults. We extracted data for 5151 participants (2575 men and 2576 women) aged 18–59 years from the US National Health and Nutrition Examination Survey 2011–2012 and 2013–2014. Weekday or workday night-time sleep duration was estimated using an in-home interview questionnaire. Dual-energy x-ray absorptiometry scans were used to determine regional body fat mass (arms, legs, trunk [android and gynoid], and abdominal [subcutaneous and visceral]). Multiple linear regression and restricted cubic spline analyses were performed after adjusting for several demographic, anthropometric, and nutritional covariates. There was a significant negative association between sleep duration and visceral fat mass overall (β : −12.139, P < 0.001) and by sex (men: β : −10.096, P < 0.001; women: β : −11.545, P = 0.038), after adjusting for age, ethnicity, body mass index, total body fat mass, daily energy and alcohol intake, sleep quality and sleep disorder status. Sleep duration and visceral fat appeared to plateau at ≥ 8 h of daily sleep. Sleep duration is negatively associated with visceral fat mass accumulation during adulthood with possibly no benefits beyond 8 h of sleep per day. Mechanistic and prospective studies are required to confirm the effect of sleep duration on visceral adiposity and determine its causes. • Obesity has raised in parallel with a habitual decline in hours of sleep in Western societies. • We investigated the association between sleep duration and body fat distribution in US adults. • Sleep duration was negatively associated with visceral fat mass, reaching a plateau effect at ≥ 8 h of sleep per day. • Chronic sleep restriction constitutes a contributor of increased visceral fat mass adiposity. [ABSTRACT FROM AUTHOR]

Purpose: Body composition is considered to be associated with obstructive sleep apnea (OSA) severity. This cross-sectional study aimed to examine associations of overnight body composition changes with positional OSA. Methods: The body composition of patients diagnosed with non-positional and positional OSA was measured before and after overnight polysomnography. Odds ratios (ORs) of outcome variables between the case (positional OSA) and reference (non-positional OSA) groups were examined for associations with sleep-related parameters and with changes in body composition by a logistic regression analysis. Results: Among 1584 patients with OSA, we used 1056 patients with non-positional OSA as the reference group. We found that a 1-unit increase in overnight changes of total fat percentage and total fat mass were associated with 1.076-fold increased OR (95% confidence interval (CI): 1.014, 1.142) and 1.096-fold increased OR (95% CI: 1.010, 1.189) of positional OSA, respectively (all p < 0.05). Additionally, a 1-unit increase in overnight changes of lower limb fat percentage and upper limb fat mass were associated with 1.043-fold increased OR (95% CI: 1.004, 1.084) and 2.638-fold increased OR (95% CI: 1.313, 5.302) of positional OSA, respectively (all p < 0.05). We observed that a 1-unit increase in overnight changes of trunk fat percentage and trunk fat mass were associated with 1.056-fold increased OR (95% CI: 1.008, 1.106) and 1.150-fold increased OR (95% CI: 1.016, 1.301) of positional OSA, respectively (all p < 0.05). Conclusion: Our findings indicated that nocturnal changes in the body's composition, especially total fat mass, total fat percentage, lower limb fat percentage, upper limb fat mass, trunk fat percentage, and trunk fat mass, may be associated with increased odds ratio of positional OSA compared with non-positional OSA. [ABSTRACT FROM AUTHOR]

Human voice is an extremely important biological signal which contains information about sex, age, emotional state, health and physical features of a speaker. Estimating a physical appearance from a vocal cue can be an important asset for sciences including forensics and dietetics. Although there have been several studies focused on the relationships between vocal parameters and ratings of height, weight, age and musculature of a speaker, to our knowledge, there has not been a study examining the assessment of one’s BMI based on voice alone. The purpose of the current study was to determine the ability of female “Judges” to evaluate speakers’ (men and women) obesity and body fat distribution from their vocal cues. It has also been checked which voice parameters are key vocal cues in this assessment. The study material consisted of 12 adult speakers’ (6 women) voice recordings assessed by 87 “Judges” based on a 5-point graphic scale presenting body fat level and distribution (separately for men and women). For each speaker body height, weight, BMI, Visceral Fat Level (VFL, InBody 270) and acoustic parameters were measured. In addition, the accuracy of BMI category was verified. This study also aimed to determine which vocal parameters were cues for the assessment for men and women. To achieve it, two independent experiments were conducted: I: “Judges” had to choose one (obese) speaker from 3 voices (in 4 series); II: they were asked to rate body fat level of the same 12 speakers based on 5-point graphic scale. Obese speakers (i.e., BMI above 30) were selected correctly with the accuracy greater than predicted by chance (experiment I). By using a graphic scale, our study found that speakers exhibiting higher BMI were rated as fatter (experiment II). For male speakers the most important vocal predictors of the BMI were harmonics-to-noise ratio (HNR) and formant dispersion (Df); for women: formant spacing (Pf) and intensity (loudness). Human voice contains information about one’s increased BMI level which are hidden in some vocal cues.

Abstract Background Eating speed has been reported to be associated with energy intake, body weight, waist circumference (WC), and total body fat. However, no study has explored the association between eating speed and body fat distribution, especially its difference among different age or body mass index (BMI) groups. Methods 4770 participants aged 18–80 years were recruited from the baseline survey of the Lanxi Cohort Study. They were categorized into three groups according to meal duration. Linear regression analyses were performed among all participants and separately by age group and obesity status to evaluate the associations of WC and total and regional fat mass percentages (FM%) with eating speed. Results After adjusting for confounding factors, eating slowly was significantly related to lower WC, lower total, trunk, and android FM%, lower android-to-gynoid fat mass ratio, and higher leg and gynoid FM%. After stratification by age or obesity status, the associations were especially prominent among participants aged 18–44 years or those with BMI

Abstract Purpose Previous studies have shown that at a similar body mass index, Middle Eastern immigrants are more insulin resistant and at higher risk for type 2 diabetes (T2D) than native Europeans. Insulin resistance is strongly associated with disturbed fat metabolism and cardiovascular disease (CVD). However, fat metabolism is poorly investigated comparing Middle Eastern and European ethnicities. Methods This observational study included 26 Iraqi and 16 Swedish-born men without T2D or clinical risk factors for CVD. An oral fat tolerance test (OFTT) was performed, where plasma triglycerides (p-TG) were measured for 6 h. mRNA expression and adipocyte size were measured in subcutaneous adipose tissue biopsies collected prior to OFTT, and magnetic resonance imaging was conducted to assess body fat distribution. Results The median p-TG accumulation was higher and the clearance slower among Iraqis than Swedes. None of the groups reached their fasting p-TG (Iraqis 1.55 mmol/l; Swedes 0.95 mmol/l) after 6 h (Iraqis p-TG 3.10 mmol/l; Swedes p-TG 1.50 mmol/l). Adipocyte size, mRNA expression, and fat accumulation in the liver, muscle and abdomen were similar in both groups. Conclusion Postprandial p-TG levels rather than fat distribution may reflect early signs of disturbed fat metabolism in Iraqi immigrants without CVD risk factors.

Background Abdominal obesities are better markers for predicting cardiovascular abnormalities than risk stratification based only on body mass index (BMI). We aimed to estimate the prevalence of abdominal adiposities using predictive equations for Asian Indian adults and to determine the prevalence of metabolically healthy subjects among those overweight/obese and with normal BMI. Methods A community-based survey was conducted among those aged 18–69 years in the district of Puducherry between February 2019 and February 2020. We surveyed 2,560 individuals selected through multi-stage cluster random sampling from urban and rural areas (50 wards and 50 villages, respectively) of the district. Anthropometric measurements, such as height, weight, waist circumference, and blood pressure were recorded from each participant. Fasting blood sample was collected from each alternate participant to estimate metabolic risk factors. Results Over four-fifths (85.6%; 95% CI: 84.2–86.9) and two-thirds (69.7%; 95% CI: 67.9–71.6) of the population in the district had high levels of intra-abdominal adipose tissue (IAAT) and total abdominal fat (TAF), respectively. Both the risk factors were significantly higher among women and urban population. About 43% (95% CI: 41–44.9) of the population had high abdominal subcutaneous adipose tissue (SCAT) with a significantly higher prevalence among the urban population. Among those overweight/obese (n  = 773), almost all 99.4% (95% CI: 98.7–99.9) were metabolically unhealthy. Among subjects with normal BMI (n  = 314), only about 2.9% (95% CI: 1.3–4.8) were metabolically healthy. Conclusion We highlight the substantially high prevalence of IAAT, TAF, and SCAT in the district of Puducherry. Almost all the study population was metabolically unhealthy irrespective of their BMI levels. [ABSTRACT FROM AUTHOR]

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