A study was conducted on a group of 50 obese females with a mean body mass index of 39 +/- 16, aged 19 years, in order to determine if sonography could be adopted as a direct means for measuring intra-abdominal fat deposits. Adipose tissue evaluation was performed by computed tomography (CT) and ultrasonography (using 3.5-MHz and 5-MHz probes) at the L4 level. CT intra-abdominal fat area (VAT) and ultrasonography visceral thickness from abdominal muscle to aorta were the values mainly considered. Ultrasonographic intra-abdominal thickness correlated well with VAT (r = 0.669, p less than 0.001), supporting the hypothesis that ultrasonography could be useful in the direct evaluation of intra-abdominal fat deposits.

OBJECTIVE: To ascertain in obesity the role of body fat distribution (the strongest predictor of morbility and mortality in obese subjects) in determining the degree of endothelial dysfunction, an early marker of atherosclerotic disease. SUBJECTS: 18 premenopausal women with uncomplicated obesity excluding other cardiovascular risk factors and 12 age-matched slim healthy women. MEASUREMENTS: Endothelium-dependent vasodilation, studied as diameter variation in response to an increase in shear-stress, was evaluated in the right common femoral artery of obese and slim subjects by a non invasive approach and compared to glyceril-trinitrate vasodilation. To characterize better the vascular functional andaor structural properties, we studied the arterial wall distensibility by an echo-tracking system. Adipose tissue regional distribution was determined by computerised axial tomography. RESULTS: The endothelium-dependent vasodilation was signi®cantly impaired in obese subjects (P`0.005 versus non-obese subjects) while glyceril-trinitrate vasodilation and arterial distensibility were similar in the two groups. In our obese subjects endothelial-dependent vasodilation was inversely correlated to body fat distribution (visceralasubcutaneous adipose tissue ratio: r À0.624, P 0.0058). In contrast, metabolic parameters (except C-peptide response during oral glucose tolerance test (OGTT): r À0.587, P 0.01), blood pressure values and body weight did not correlate with the endothelial function. CONCLUSION: Uncomplicated obesity per se is characterised by an alteration of the endothelial function; the degree of this vascular damage is predicted by body fat distribution independently of body weight and metabolic and other haemodynamic parameters, and correlates with an index of insulin secretion.

OBJECTIVE: To evaluate the relationships between the supine sagittal abdominal diameter (SAD) and visceral fat, as well as to evaluate intra-and inter-observer reliability of sagittal diameter measurement. PATIENTS: Twenty-eight women ranging in age from 27±78 y with a body mass index (BMI) ranging from 16.9±48.1 kg/m 2 and 23 men ranging in age from 32±75 y with BMI ranging from 20±41.6 kg/m 2 . MEASUREMENT: Body fat distribution was measured by waist circumference, waist to hip ratio (WHR), SAD, anthropometrically assessed and a single slice of computed tomography (CT) at the L4-L5 level. RESULTS: In both genders, a signi®cant association was found between visceral adipose tissue (AT) and SAD, as evaluated by CT (women r 0.80; men r 0.83, P`0.001), and SAD by anthropometry (women r 0.76; men r 0.82, P`0.001), as well as between visceral AT and waist circumference (women r 0.76, men r 0.86, P`0.001) and WHR (women r 0.57, P`0.01, men r 0.80, P`0.001). A signi®cant association was also found between subcutaneous AT and SAD by anthropometry (women r 0.79, men r 0.74, P`0.001). After adjusting for BMI, the association between subcutaneous AT and SAD was no longer signi®cant in men and only moderately signi®cant in women (r 0.42, P`0.05), while the association between visceral AT and SAD by anthropometry remained signi®cant in both genders (women r 0.63, P`0.001; men r 0.66, P`0.001). When the subjects were divided into two groups according to BMI (lean to moderately overweight women with BMI`28 and men with BMI`30 and obese women with BMI b 28 and men with BMI b 30) we found that the relationships between SAD by anthropometry, as well as SAD by CT and visceral AT, were higher in lean to moderately overweight subjects than in those who were obese. High inter-observer correlation was found concerning SAD measurement (r 0.99, P`0.001). Intra-and interobserver precision as evaluated by coef®cient of variation and intraclass correlation coef®cient for SAD measurement was very high. CONCLUSION: Our study shows the usefulness of SAD by anthropometry to predict visceral fat and its very high inter-and intra-observer precision.

We conducted a cross-sectional study of body fat distribution and metabolic variables and the interrelations among these factors in 134 women aged 18-71.9 y. Body fat distribution was measured with use of computerized tomography. A significant positive correlation was observed between age and visceral adipose tissue (VAT) and between VAT and body weight. When subjects were divided into five age groups, VAT values were significantly higher in older groups. Values for triacylglycerols, cholesterol, fasting glucose, 2-h glucose, and the sum of glucose values during an oral-glucose-tolerance test were significantly higher in older subjects. After adjustment for visceral fat, no significant differences in any metabolic variable studied, except cholesterol, were found across the five age groups. In conclusion, we found that regional body fat distribution in older women was different from that in younger subjects: older women had larger amounts o visceral fat. Values for metabolic variables were also higher in older subjects. Our data suggest that redistribution of body fat in older subjects is associated with changes in metabolic variables.

This study evaluates effects of weight loss on regional fat distribution and compares waist-to-hip ratio (WHR) and computed tomography (CT) as methods of assessing body fat distribution in 16 premenopausal obese women (body weight 104.3 +/- 18.1 kg, WHR 0.84 +/- 0.08). Mean weight loss was 6.6 kg after 2 wk on a very-low-energy diet (VLED) and 16 kg after 14 additional weeks on a low-energy diet (LED). Visceral abdominal fat and sagittal diameter significantly decreased after both the VLED and LED. Subcutaneous abdominal fat decreased significantly only after the LED. WHR showed no significant reduction over the entire study period. The decrease in visceral fat after both the VLED and LED was greater than the decrease in subcutaneous fat. Changes in body weight over the entire study period correlated with initial body weight and with total and subcutaneous abdominal fat, but not with visceral abdominal fat. They also correlated with changes in subcutaneous abdominal fat, visceral abdominal fat, sagittal diameter, and WHR. In conclusion, weight loss is associated with changes in regional fat distribution. In premenopausal subjects weight loss correlates more closely with the amount of subcutaneous than visceral fat.