Body fat distribution measured with CT: correlations in healthy subjects, patients with anorexia nervosa, and patients with Cushing syndrome.

Mayo-Smith, William W.; Hayes, Carrie; Biller, Beverly M. K.; Klibanski, Anne; Rosenthal, H; Rosenthal, D.I.

doi:10.1148/radiology.170.2.2911678

Cited by 154 publications

(100 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…128 Abdominal fat accumulation in CS has been attributed to the redistribution of peripheral fat to the visceral fat depot. 129,130 However, it is interesting to note that visceral fat accumulation in CS does not correlate with lipid and glucose profiles. 131 It is well established that glucocorticoid excess, as observed in CS, is associated with an adverse glucose and lipid profile that increases metabolic and cardiovascular risk.…”

Section: Glucocorticoid Excessmentioning

confidence: 99%

Gluteofemoral body fat as a determinant of metabolic health

2010

View full text Add to dashboard Cite

Body fat distribution is an important metabolic and cardiovascular risk factor, because the proportion of abdominal to gluteofemoral body fat correlates with obesity-associated diseases and mortality. Here, we review the evidence and possible mechanisms that support a specific protective role of gluteofemoral body fat. Population studies show that an increased gluteofemoral fat mass is independently associated with a protective lipid and glucose profile, as well as a decrease in cardiovascular and metabolic risk. Studies of adipose tissue physiology in vitro and in vivo confirm distinct properties of the gluteofemoral fat depot with regards to lipolysis and fatty acid uptake: in day-to-day metabolism it appears to be more passive than the abdominal depot and it exerts its protective properties by long-term fatty acid storage. Further, a beneficial adipokine profile is associated with gluteofemoral fat. Leptin and adiponectin levels are positively associated with gluteofemoral fat while the level of inflammatory cytokines is negatively associated. Finally, loss of gluteofemoral fat, as observed in Cushing's syndrome and lipodystrophy is associated with an increased metabolic and cardiovascular risk. This underlines gluteofemoral fat's role as a determinant of health by the long-term entrapment of excess fatty acids, thus protecting from the adverse effects associated with ectopic fat deposition.

show abstract

Section: Glucocorticoid Excessmentioning

confidence: 99%

Gluteofemoral body fat as a determinant of metabolic health

2010

View full text Add to dashboard Cite

show abstract

“…Seeking to tackle serious methodological limitations of the early research, Thakore et al (2002) applied a wellvalidated technique of computed tomography (Mayo-Smith et al, 1989) to directly measure abdominal adiposity in a sample of drug-naive/free schizophrenic patients and ageand sex-matched healthy controls. They found that schizophrenic patients had higher body mass index (BMI) and over three times more abdominal fat , accumulation of which poses even greater cardiovascular/ diabetes risks than overall obesity .…”

Section: Weight Status Of Drug Naive/free Schizophrenic Patientsmentioning

confidence: 99%

“…Moreover, high rates of obesity and type II diabetes mellitus, observed in drug-naive/free patients (Mukherjee et al, 1996;Allison et al, 1999a;Thakore et al, 2002;Ryan et al, 2003Ryan et al, , 2004 before Kohen, 2004) and after the advent of antipsychotics and in nonschizophrenic blood relatives (Dynes, 1969;Mukherjee et al, 1989;Cheta et al, 1990;Martins et al, 2001;Lamberti et al, 2004), were potentially attributed to genetic factors (Stone et al, 2004), illness neurobiology (Thakore, 2005) and to unhealthy lifestyle (Brown et al, 1999). The interpretability of the preneuroleptic era data (reviewed in Kohen, 2004) is, however, limited by flaws in epidemiological methodology including lack of evaluation of and adjustments for adiposity, lifestyle, and anthropometric measures together with inconsistent diagnostic criteria for schizophrenia and glucose/insulin abnormalities Newcomer, 2005).Seeking to tackle serious methodological limitations of the early research, Thakore et al (2002) applied a wellvalidated technique of computed tomography (Mayo-Smith et al, 1989) to directly measure abdominal adiposity in a sample of drug-naive/free schizophrenic patients and ageand sex-matched healthy controls. They found that schizophrenic patients had higher body mass index (BMI) and over three times more abdominal fat , accumulation of which poses even greater cardiovascular/ diabetes risks than overall obesity .…”

mentioning

confidence: 99%

Food Intake and Reward Mechanisms in Patients with Schizophrenia: Implications for Metabolic Disturbances and Treatment with Second-Generation Antipsychotic Agents

Elman

Borsook

Lukas

2006

Neuropsychopharmacol

138

142

View full text Add to dashboard Cite

Obesity is highly prevalent among patients with schizophrenia and is associated with detrimental health consequences. Although excessive consumption of fast food and pharmacotherapy with such second-generation antipsychotic agents (SGAs) as clozapine and olanzapine has been implicated in the schizophrenia/obesity comorbidity, the pathophysiology of this link remains unclear. Here, we propose a mechanism based on brain reward function, a relevant etiologic factor in both schizophrenia and overeating. A comprehensive literature search on neurobiology of schizophrenia and of eating behavior was performed. The collected articles were critically reviewed and relevant data were extracted and summarized within four key areas: (1) energy homeostasis, (2) food reward and hedonics, (3) reward function in schizophrenia, and (4) metabolic effects of the SGAs. A mesolimbic hyperdopaminergic state may render motivational/incentive reward system insensitive to low salience/palatability food. This, together with poor cognitive control from hypofunctional prefrontal cortex and enhanced hedonic impact of food, owing to exaggerated opioidergic drive (clinically manifested as pain insensitivity), may underlie unhealthy eating habits in patients with schizophrenia. Treatment with SGAs purportedly improves dopamine-mediated reward aspects, but at the cost of increased appetite and worsened or at least not improved opiodergic capacity. These effects can further deteriorate eating patterns. Pathophysiological and therapeutic implications of these insights need further validation via prospective clinical trials and neuroimaging studies. INTRODUCTIONObesity has reached pandemic proportions and it is rapidly surpassing smoking as a number one killer in the industrialized world (Sturm, 2002;Skidmore and Yarnell, 2004). Its annual cost to the American society is staggering, and is estimated to be around $117 billion owing to related illnesses and loss of productivity (National Institute of Diabetes and Digestive and Kidney Diseases, 2005).In schizophrenia, obesity is twice as prevalent as in the general public, afflicting over half this patient population (Allison et al, 1999a;Dixon et al, 2000; American Diabetes Association, 2004;Marder et al, 2004;Wirshing, 2004). Besides negative psychosocial impacts (distorted selfesteem and societal stigmatization) and medications noncompliance, schizophrenics appear to be particularly susceptible to the detrimental medical sequelae of obesity such as the 'Metabolic Syndrome', which is a cluster of cardiovascular risk factors, including abdominal adiposity, insulin resistance, impaired, glucose tolerance, dyslipidemia, and hypertension (McKee et al, 1986;Mukherjee et al, 1996;Brown et al, 2000;Haupt and Newcomer, 2002;Ryan and Thakore, 2002;Ryan et al, 2003;Holt et al, 2004;Kohen, 2004;Marder et al, 2004;Lieberman et al, 2005).Excessive body weight gain (BWG) could be attributed to a constellation of endocrine, molecular, genetic, demographic, and lifestyle-related factors. Provided that a common tra...

show abstract

“…15 However, a single 3 mm CT scan slice through the level of the fourth lumbar vertebra still remains the best validated direct measure of visceral fat deposition as is reflected by a number of published studies which have used this technique to determine central obesity in patients suffering from certain general medical conditions 18,19 and psychiatric disorders. 22,23 To date, there has been no published study in the literature directly examining regional abdominal adiposity in patients with schizophrenia. Therefore, it was our intention in this study to measure abdominal fat distribution using CT scanning in patients with schizophrenia and compare them to normal controls.…”

Section: Introductionmentioning

confidence: 99%

Increased visceral fat distribution in drug-naive and drug-free patients with schizophrenia

et al. 2002

View full text Add to dashboard Cite

OBJECTIVE:To investigate visceral fat distribution in patients with schizophrenia. DESIGN: Cross sectional study using CT scanning in patients with drug-naive and drug-free schizophrenia. SUBJECTS: Fifteen (13 men and two women) subjects with schizophrenia (mean age 33.7 y; mean body mass index (BMI) ¼ 26.7 kg=m 2 ), and 15 age-and sex-matched controls (mean age 30.5 y; mean BMI ¼ 22.8 kg= 2 ). MEASUREMENTS: Various fatness and fat distribution parameters (by CT scanning and anthropometry) and 16:00 h plasma cortisol. RESULTS: In comparison to controls, patients with schizophrenia had central obesity and had significantly higher levels of plasma cortisol. Furthermore, previous neuroleptic exposure did not appear to influence these findings as both drug-naive and drug-free patients had equally high levels of visceral fat deposition. CONCLUSION: Central obesity is a well recognized risk factor in developing certain general medical conditions. This study shows that patients with schizophrenia have increased intra-abdominal fat which may provide one explanation for why they die prematurely. International Journal of Obesity (2002 Keywords: schizophrenia; cortisol; imaging IntroductionReduced life expectancy is a well recognized feature of psychiatric illness. 1 -3 With respect to schizophrenia, the precise reasons underlying this excessive mortality are as yet unknown. 4,5 However, it is clear that suicide cannot fully account for these findings. 6,7 A meta-analysis of the relevant literature by Harris and Barraclough found that 'unnatural' causes of death such as suicide and accidents were far more likely to occur than expected in patients with schizophrena. 8 However, the standardized mortality ratios for 'natural causes', such as cardiovascular illness, was also significantly increased, a finding which was supported by Allbeck 9 and Ruschena et al. 3 A number of reasons may explain the excessive death rate due to 'natural causes' observed in schizophrenia; these include psychosocial deprivation, an unhealthy lifestyle and psychotropic medication. 10 -12 Yet, the general medical illnesses which tend to occur in those suffering from schizophrenia form a cluster which is termed the metabolic syndrome. 13 Hypertension, type 2 diabetes mellitus and dyslipidaemias are the primary constituents of this syndrome and are associated with increased intra-abdominal fat deposition. 14,15 Abdominal fat distribution consists of two discrete depots, subcutaneous and visceral (intra-abdominal) and numerous variables can account for the pattern of body fat deposition observed in the general population. 16,17 Of note is the fact that cortisol has a marked effect on regional fat distribution, in that patients with Cushing's syndrome who have marked hypercortisolaemia, have increased visceral fat distribution as measured by computerized axial tomography (CT) scanning. 18,19 Indeed, reduction of plasma cortisol in this subgroup of patients leads to a decrease in intra-abdominal fat stores 20 and also a normalization of certain features...

show abstract

Body fat distribution measured with CT: correlations in healthy subjects, patients with anorexia nervosa, and patients with Cushing syndrome.

Cited by 154 publications

References 0 publications

Gluteofemoral body fat as a determinant of metabolic health

Gluteofemoral body fat as a determinant of metabolic health

Food Intake and Reward Mechanisms in Patients with Schizophrenia: Implications for Metabolic Disturbances and Treatment with Second-Generation Antipsychotic Agents

Increased visceral fat distribution in drug-naive and drug-free patients with schizophrenia

Contact Info

Product

Resources

About