Search

Variations in genes involved in energy expenditure affect aerobic exercise efficiency, but it remains unclear whether the effect of aerobic exercise on adipocytokines is modified by the obesity-associated genotypes in the uncoupling protein 2 gene (UCP2). The purpose of this study was to assess whether genetic variation in UCP2 may affect exercise-mediated changes in adipocytokines and markers of metabolic syndrome in postmenopausal obese women. Forty-two sedentary postmenopausal obese women (age 52.74 ± 6.39 years) participated in this study. Participants were encouraged to train for 3 days a week, for 6 months, for 60 min per session of treadmill walking/running at 60 % $$ \mathop V\limits^{ \cdot } {\text{O}}_{ 2} {\text{R}} $$ . Subjects were genotyped for the 45-bp insertion/deletion (I/D) polymorphism in the 3′-untranslated region (UTR) of UCP2. Among the subjects, 23 (57.1 %) and 19 (42.9 %), were deletion homozygotes (DD) and ID heterozygotes, respectively. For DD homozygotes, body weight, body mass index (BMI), % body fat, and waist circumference, and body weight, BMI, and waist circumference of ID heterozygotes, were significantly decreased after the exercise program. There were no significant changes in metabolic markers in individuals with the ID genotype, whereas insulin and HOMA-IR in individuals with the DD genotype were significantly decreased after the exercise program. In DD homozygotes, but not in ID heterozygotes, adiponectin was significantly increased, and leptin, TNF-α, and IL-6 were significantly decreased after exercise training. Exercise-mediated changes in insulin resistance and adiponectin levels may be affected by genotypes in the 3′UTR I/D polymorphism in UCP2 in postmenopausal obese women.

SummaryObjective It has been suggested that insulin resistance, low-grade inflammation and vitamin D deficiency are associated with obesity and sarcopenia. However, their relationships with sarcopenic obesity (SO) are unclear. We evaluated the impact of homoeostasis model assessment of insulin resistance (HOMA-IR), high-sensitivity C-reactive protein (hsCRP) and 25-hydroxyvitamin D (25[OH]D) levels on SO in Korean adults. Study subject/measurements This study included 493 apparently healthy adults (180 men and 313 women) enrolled in the Korean Sarcopenic Obesity Study. Sarcopenia was defined as a skeletal muscle mass index (SMI) of 1 SD below the sex-specific mean value for a young reference group. Obesity was defined as a visceral fat area (VFA) ≥100 cm2. We classified the participants into four sarcopenia/obesity groups based on both SMI and VFA. Results The prevalence of SO was 17·8% in men and 24·9% in women. In women, the SO group had higher HOMA-IR and hsCRP levels compared with the non-SO group. In men, the 25[OH]D levels were significantly lower in the SO group than the non-SO group. Both hsCRP and HOMA-IR levels were negatively correlated with SMI and positively correlated with VFA in both men and women, whereas 25[OH]D levels were positively correlated with SMI in both men and women. Multiple binary logistic regression analysis showed that HOMA-IR and 25[OH]D levels were independently associated with SO in men, while HOMA-IR and hsCRP were significant factors predicting SO in women. Conclusion Insulin resistance, inflammation and vitamin D deficiency were associated with SO in a Korean adult population.

Background/aims: Abdominal obesity is associated with metabolic syndrome and non-alcoholic fatty liver disease (NAFLD). Although there have been many studies to determine the optimal cutoff points of waist circumference or visceral fat area in screening for metabolic syndrome, there have been no reports to establish adequate cutoff points of abdominal obesity indices in screening for NAFLD. Therefore, we examined the appropriate cutoff points of abdominal obesity indices associated with NAFLD in Korean men and women using receiver operating characteristic (ROC) curve analysis. Furthermore, we compared the usefulness of various abdominal obesity indices measured using computed tomography (CT), dual-energy X-ray absorptiometry (DXA) and anthropometric parameters for detecting NAFLD. Methods: We analysed the baseline data of an ongoing prospective, observational cohort study, including a total of 456 healthy subjects 20–88 years of age. NAFLD was diagnosed by unenhanced CT using the liver attenuation index. Results: All ROC curves of waist circumference, waist-to-height ratio, DXA-measured trunk fat mass and CT-measured visceral fat area were significantly above the diagonal line. There were no significant differences in the area under the curve values among these abdominal obesity indices in each gender. The appropriate cutoff point of waist circumference in screening for NAFLD was 89 cm for men and 84 cm for women and the optimal cutoff point of waist-to-height ratio was 0.52 for men and 0.53 for women with very high negative predictive values. Conclusions: The simple anthropometric parameters, such as waist circumference and waist-to-height ratio, are as useful as DXA and CT for predicting NAFLD in Korean adults.

To examine the prevalence of sarcopenia and sarcopenic obesity (SO) as defined by different indices, including appendicular skeletal muscle mass (ASM)/height(2), skeletal muscle mass index (SMI) and residuals for Korean adults, and to explore the association between SO and metabolic syndrome.Our study sample included 526 participants (328 women, 198 men) for whom complete data on body composition were collected using available dual X-ray absorptiometry. Modified National Cholesterol Education Program Adult Treatment Panel III criteria were used to identify the individuals with metabolic syndrome.The prevalence of sarcopenia and SO is higher in older adults. Using two s.d. of ASM/height(2) below reference values from young, healthy adults as a definition of sarcopenia, the prevalence of sarcopenia and SO was 6.3% and 1.3% in older (or =60 years) men and 4.1% and 0.8% in older women, respectively. The prevalence of sarcopenia using the residuals method was 15.4% in older men and 22.3% in older women. In addition, using two s.d. of SMI, the prevalence of sarcopenia and SO was 5.1% and 5.1%, respectively, in older men and 14.2% and 12.5%, respectively, in older women. Among women, SO subjects defined by the SMI had three times the risk of metabolic syndrome (odds ratios (OR)=3.24, 95% confidence interval (CI)=1.21-8.66) and non-sarcopenic obese subjects had approximately twice the risk of metabolic syndrome (OR=2.17, 95% CI=1.22-3.88) compared with normal subjects. Similar trends were observed in men.The prevalence and cutoff values of sarcopenia and SO in the Korean population were evaluated using different methods. Among the different indices of sarcopenia and SO, SO only defined using the SMI was associated with the risk of metabolic syndrome. As the Korean population gets older and more obese, the problematics of SO need to be elucidated.

[Purpose] The present study was to examine whether or not the appropriate exercise intensity of water-walking could be accurately prescribed by land-based walking speed. [Methods] Using a crossover design, nine healthy male college students completed bouts of walking for thirty minutes at 100m/min, 50m/min, respectively, on land and water treadmills. Heart rate (HR), ratings of perceived exertion (RPE), energy expenditure, blood lactic acid and catecholamine concentration were measured. Two-way repeated measured ANOVA was used with the SPSS program for data analysis. [Results] HR (P < 0.001), RPE (P < 0.001), energy expenditure (P < 0.001), blood lactic acid (P < 0.001) and epinephrine concentration (P < 0.05) were significantly increased during walking both in water and on land. The change of HR was significantly lower at 50min/m in water than 100min/m on land (P < 0.01). There were no significant interaction effects for RPE, energy expenditure, blood lactic acid and catecholamine concentration, but these variables were slightly lower in water than on land. These results indicated that the use of land walking speed-based prescriptive norms would underestimate the physiological cost in water walking at the moderate intensity. [Conclusion] Therefore, approximately two-half of the speed would be needed to walk in water in order to obtain the same level of physiological load as during treadmill walking at the moderate intensity.

Aims Sarcopenia measured as appendicular skeletal muscle mass (ASM), and central obesity measured as visceral fat area (VFA) may act synergistically to influence metabolic syndrome and atherosclerosis. However, several previous studies reported that metabolic risk is higher in non-sarcopenic obesity groups than in sarcopenic obesity groups because of the close relationship between muscle mass and body fat. We investigated the association of the ASM to VFA ratio, which we have termed the muscle-to-fat ratio (MFR), with metabolic syndrome and arterial stiffness. Methods This study was performed in 526 apparently healthy adults enrolled in the Korean Sarcopenic Obesity Study, an ongoing prospective observational cohort study. ASM was evaluated with dual energy X-ray absorptiometry and VFA with computed tomography. Arterial stiffness was measured using brachial-ankle pulse wave velocity (baPWV). Results MFR was significantly associated with waist circumference, blood pressure, lipid profiles, glucose and baPWV. By multiple logistic regression analysis, the odds ratio for metabolic syndrome was 5.43 (lowest versus highest tertile of MFR, 95% confidence interval, 2.56–13.34). Multiple stepwise regression analysis showed that MFR was an independent determinant of baPWV ( R 2 = 0.57). Conclusions MFR, a new index of sarcopenic obesity, showed an independent negative association with metabolic syndrome and arterial stiffness.

Osteoporosis and obesity are important public health problems in an aging society. We investigated the differential impacts of fat on bone mineral density (BMD) according to gender and menopausal status. We analyzed the baseline data of an ongoing observational cohort study, including a total of 502 healthy subjects 20–88 years of age (144 men, 159 premenopausal women, 199 postmenopausal women). Body composition and fat mass were measured using computed tomography and dual energy X-ray absorptiometry (DXA). BMD was measured at lumbar spines using DXA. In men and postmenopausal women, there was no significant correlation between fat and bone parameters after adjusting for age and body weight. However, in premenopausal women, BMD had significant negative correlations with waist circumference, total fat area, subcutaneous fat area, appendicular fat mass and percentage fat mass after adjusting for age and body weight. Furthermore, only in premenopausal women, the subjects with the highest quartile of percentage fat mass had the lowest BMD even after adjusting for confounding factors including age, body weight, physical activity, alcohol use and smoking history. Multiple linear regression analysis showed that percentage fat mass was a significant negative decisive factor for BMD in premenopausal women. Our study showed the differential relationship between fat mass and BMD according to gender and menopausal status. Only in premenopausal women did fat mass have a significant negative effect on bone mass. This result suggests the importance of reducing fat mass in order to achieve peak bone mass in young adult women.

Abdominal obesity is associated with metabolic syndrome and non-alcoholic fatty liver disease (NAFLD). Although there have been many studies to determine the optimal cutoff points of waist circumference or visceral fat area in screening for metabolic syndrome, there have been no reports to establish adequate cutoff points of abdominal obesity indices in screening for NAFLD. Therefore, we examined the appropriate cutoff points of abdominal obesity indices associated with NAFLD in Korean men and women using receiver operating characteristic (ROC) curve analysis. Furthermore, we compared the usefulness of various abdominal obesity indices measured using computed tomography (CT), dual-energy X-ray absorptiometry (DXA) and anthropometric parameters for detecting NAFLD.We analysed the baseline data of an ongoing prospective, observational cohort study, including a total of 456 healthy subjects 20-88 years of age. NAFLD was diagnosed by unenhanced CT using the liver attenuation index.All ROC curves of waist circumference, waist-to-height ratio, DXA-measured trunk fat mass and CT-measured visceral fat area were significantly above the diagonal line. There were no significant differences in the area under the curve values among these abdominal obesity indices in each gender. The appropriate cutoff point of waist circumference in screening for NAFLD was 89 cm for men and 84 cm for women and the optimal cutoff point of waist-to-height ratio was 0.52 for men and 0.53 for women with very high negative predictive values.The simple anthropometric parameters, such as waist circumference and waist-to-height ratio, are as useful as DXA and CT for predicting NAFLD in Korean adults.

*Context:* Sarcopenic obesity (SO), a combination of excess weight and reduced muscle mass and/or strength, is suggested to be associated with an increased risk of adverse health outcomes. *Objectives:* To examine the prevalence and characteristics of Sarcopenic and SO defined by using different indices such as Appendicular Skeletal muscle Mass (ASM)/height^2^ and Skeletal Muscle Index (SMI (%): skeletal muscle mass (kg)/weight (kg) × 100) for Korean adults. *Methods:* 591 participants were recruited from the Korean Sarcopenic Obesity Study (KSOS) which is an ongoing prospective observational cohort study. Analysis was conducted in 526 participants (328 women, 198 men) who had complete data on body composition using Dual X-ray absorptiometry and computed tomography. *Results:* The prevalence of sarcopenia and SO increases with aging. Using two or more standard deviations (SD) of ASM/height^2^ below reference values from young, healthy adults as a definition of sarcopenia, the prevalence of sarcopenia and SO was 6.3% and 1.3% in men and 4.1% and 1.7% in women over 60 years of age. However, using two or more SD of SMI, the prevalence of sarcopenia and SO was 5.1% and 5.1% respectively in men and 14.2% and 12.5% respectively in women. As defined by SMI, subjects with SO had 3 times the risk of metabolic syndrome (OR = 3.03, 95% confidence interval (CI) = 1.26-7.26) and subjects with non-sarcopenic obesity had approximately 2 times the risk of metabolic syndrome (OR = 1.89, 95% CI = 1.18-3.02) compared with normal subjects. *Conclusion:* Obese subjects with relative sarcopenia were associated with a greater likelihood for metabolic syndrome. As Koreans were more obese and aging, the prevalence of SO and its impact on health outcomes are estimated to be rapidly grow. Further research is requested to establish the definition, cause and consequences of SO.