Lower-Body Adiposity and Metabolic Protection in Postmenopausal Women

University of Colorado, Denver, Colorado, United States
Journal of Clinical Endocrinology &amp Metabolism (Impact Factor: 6.21). 09/2005; 90(8):4573-8. DOI: 10.1210/jc.2004-1764
Source: PubMed


It has been suggested that the propensity to store fat in the gluteal-femoral region may be cardioprotective.
The primary aim of this study was to test whether the favorable associations of leg fat with risk factors for cardiovascular disease persist after controlling for the highly unfavorable effects of abdominal (visceral or sc) adiposity in postmenopausal women.
The study included 95 postmenopausal women [age, 60 +/- 8 yr (mean +/- SD)].
Whole-body and regional fat distribution was measured using dual-energy x-ray absorptiometry and abdominal computed tomography. Markers of insulin resistance and dyslipidemia were determined from oral glucose tolerance tests and fasted lipid and lipoprotein measurements, respectively. Primary outcomes were: fasting insulin (INS0), area under the insulin curve (INS(AUC)), product of the oral glucose tolerance test insulin and glucose AUC (INS(AUC) - GLU(AUC)), serum triglycerides (TG), and high-density lipoprotein (HDL) cholesterol.
Controlling for trunk fat revealed a favorable effect of leg fat on INS0, INS(AUC), INS(AUC) x GLU(AUC), TG, and HDL. However, after controlling for either visceral or sc abdominal adiposity, TG was the only risk factor for which the favorable effect of leg fat persisted.
The lack of an association between leg fat and most of the risk factors, after adjusting for abdominal visceral or sc fat, suggests an overriding deleterious influence of abdominal adiposity on cardiovascular risk. Nevertheless, our finding that regional adipose tissue depots have apparent independent and opposing effects on serum TG supports the need for further research into the physiological mechanisms governing these effects.

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    • "Interestingly, even not harboring increased truncal fat, these patients are severely metabolically compromised, suggesting that the lack of adipose tissue in the lower body is the main feature for metabolic abnormalities. Indeed, studies have suggested such a role for the peripheral fat in non-lipodystrophic subjects [14-16]. Van Pelt et al. [14] concluded that leg fat mass is associated with reduced CVD risk, independently of increased risk attributable to trunk fat mass. "
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    ABSTRACT: Background Familial partial lipodystrophies (FPLD) are clinically heterogeneous disorders characterized by selective loss of adipose tissue, insulin resistance and metabolic complications. Until genetic studies become available for clinical practice, clinical suspicion and pattern of fat loss are the only parameters leading clinicians to consider the diagnosis. The objective of this study was to compare body composition by dual energy X-ray absorptiometry (DXA) in patients with FPLD and control subjects, aiming to find objective variables for evaluation of FPLD. Methods Eighteen female patients with partial lipodystrophy phenotype and 16 healthy controls, matched for body mass index, sex and age were studied. All participants had body fat distribution evaluated by DXA measures. Fasting blood samples were obtained for evaluation of plasma leptin, lipid profile and inflammatory markers. Genetic studies were carried out on the 18 patients selected that were included for statistical analysis. Thirteen women confirmed diagnosis of Dunnigan-type FPLD (FPLD2). Results DXA revealed a marked decrease in truncal fat and 3 folds decrease in limbs fat percentage in FPLD2 patients (p <0.001). Comparative analysis showed that ratio between trunk and lower limbs fat mass, characterized as Fat Mass Ratio (FMR), had a greater value in FLPD2 group (1.86 ± 0.43 vs controls 0.93 ± 0.10; p <0.001) and a improved accuracy for evaluating FPLD2 with a cut-off point of 1.2. Furthermore, affected women showed hypoleptinemia (FLPD2 4.9 ± 2.0 vs controls 18.2 ± 6.8; p <0.001), insulin resistance and a more aggressive lipid profile. Conclusion In this study, assessment of body fat distribution by DXA permitted an objective characterization of FLPD2. A consistent pattern with marked fat reduction of lower body was observed in affected patients. To our knowledge this is the first time that cut-off values of objective variables were proposed for evaluation of FPLD2.
    Diabetology and Metabolic Syndrome 08/2012; 4(1):40. DOI:10.1186/1758-5996-4-40 · 2.17 Impact Factor
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    • "Several studies have assessed the associations of leg and trunk adiposity with cardiometabolic risk factors (6–12). Some, but not all, of these studies have found an inverse association of leg adiposity with blood pressure (11,12), glucose (7–12), dyslipidemia (6–8,11), and the metabolic syndrome (12). Moreover, these studies were carried out in white (6–10), Japanese (11), and Chinese (12) populations, and no studies included African Americans. "
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    ABSTRACT: To determine contributions of trunk and extremity adiposity to cardiometabolic risk factors (blood pressure, fasting blood glucose, HDL cholesterol, and triglycerides) among white and African American adults. The sample consisted of 1,129 white women, 779 African American women, 1,012 white men, and 300 African American men. Higher trunk adiposity was significantly associated with an increased risk of having two or more cardiometabolic risk factors among African American and white men and women. After adjustment for trunk and arm adiposity, higher leg adiposity was significantly associated with a decreased risk of having two or more cardiometabolic risk factors among white men and women and African American women. In contrast with adverse risk with high trunk adiposity, high leg adiposity is associated with a decreased risk of having two or more cardiometabolic risk factors in both African American and white adults.
    Diabetes care 06/2011; 34(6):1415-8. DOI:10.2337/dc10-2019 · 8.42 Impact Factor
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    ABSTRACT: The role of adipose tissue is energy storage, but there is increasing evidence that adipocytes and adipokines are involved in metabolic and inflammatory processes. This paper reviews the pathophysiology of different adipose tissue depots. Interrelationships between sex hormones, adipose tissue and risk factors are also discussed. Present study focuses on the effects of adipokines on immune system and on the mechanisms relating adiposity to cancer risk.
    Endokrynologia Polska 01/2007; 58(4):330-42. · 0.99 Impact Factor
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