Fat Distribution and Cardiovascular Risk Factors in Obese Adolescent Girls: Importance of Intra-Abdominal Fat Depot. † 498

Caprio, Sonia; Hyman, Lauren D; McCarthy, S.; Lange, Robert; Bronson, Mary L.; Tamborlane, W. V.

doi:10.1203/00006450-199604001-00518

Cited by 13 publications

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“…In our study group, we did not ®nd any correlation of testosterone or of SHBG with waist/hip ratio or waist/ thigh ratio. These results support the low usefulness of these indices in this age group (32).…”

Section: Discussionsupporting

confidence: 80%

Sex hormone-binding globulin as a marker for hyperinsulinemia and/or insulin resistance in obese children

Gascón

Valle

Martos

et al. 2000

European Journal of Endocrinology

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Objective: A relationship between hyperinsulinemia and decreased serum sex hormone-binding globulin (SHBG) has been described in adults. We evaluated the usefulness of SHBG as an index of hyperinsulinemia and/or insulin resistance in obese children (aged 6±9 years) of both sexes and its possible in¯uence on the androgenic status. Design: We carried out a cross-sectional study of cases and controls. We studied 61 obese children (22 males, 39 females) with body mass index (BMI) superior to the 90 th percentile and a control group of age-and sex-matched non-obese children. We measured serum glucose, insulin, TSH, free thyroxine, 17b-estradiol, testosterone and SHBG. Also, we correlated these parameters with anthropometric measures. Results: The obese group presented signi®cantly elevated levels of insulin (P 0:001) and insulin/ glucose ratio (P 0:0012) compared with the control group. SHBG (P 0:0001) and testosterone (P 0:0169) levels were signi®cantly lower than those in the non-obese group. We did not ®nd any difference in the free androgen index (FAI). Fasting insulin (r À0.4512; P < 0:001), BMI (r À0.3185; P < 0:05) and testosterone (r À0.3705; P < 0:01) were inversely correlated with SHBG concentration. According to multivariate analyses, insulin was the only independent predictor factor for serum SHBG concentration in the obese group (r partial=0.1280; P 0:0171). Conclusions: In summary, at this age there is a strong relationship between insulin and SHBG. The changes in SHBG levels of the obese group did not affect FAI and, therefore, they did not cause changes in the androgenic status. Our data support the role of insulin in the regulation of serum SHBG levels.

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Section: Discussionsupporting

confidence: 80%

Sex hormone-binding globulin as a marker for hyperinsulinemia and/or insulin resistance in obese children

Gascón

Valle

Martos

et al. 2000

European Journal of Endocrinology

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“…This finding is in agreement with a previous study in prepubertal obese children. 35 The dramatic reduction in abdominal fat content, which is an early marker of increased cardiovascular risk in nonobese [37][38][39] and obese 40,41 children, could contribute to the benefits linked to BW loss. 3 We confirm that unlike WHR, WC is well correlated to total FM and trunk FM content in both sexes.…”

Section: Discussionmentioning

confidence: 99%

Effects of a multidisciplinary weight loss intervention on body composition in obese adolescents

et al. 2004

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OBJECTIVE:To investigate if a multidisciplinary weight loss program in adolescents suffering severe obesity allows adequate growth and development and avoid lean mass loss. DESIGN: A total of 55 adolescents (33 girls and 22 boys) suffering severe obesity were enrolled in an interdisciplinary weight reduction program lasting 6-12 months. Progressive submaximal physical activity was performed and national dietary allowances for adolescents with low levels of physical activity energy were provided. MEASUREMENTS: Total and segmental body composition was assessed by means of dual-energy X-ray absorptiometry. RESULTS: The mean height significantly increased (Po0.001). The mean body mass index (BMI) dropped in boys from 34.573.2 to 25.572.3 kg/m 2 and in girls from 38.474.1 to 28.474.1 kg/m 2 . Height increased according to the expected pattern (Po0.001). Total lean mass (LM) did not vary and was positively correlated to pubertal development in both sexes before and after weight loss. Steepest drop in fat mass (FM) was observed in the trunk (À63.2710.1% in boys and -51.5711.4% in girls). Decrease in BMI and FM was tightly correlated in both sexes. However, slopes significantly differed (Po0.0005) so that a decrease of 1 kg/m 2 in BMI corresponded to a decrease of 3.92 kg in FM in girls and of 5.44 kg in boys. In each sex, FM at baseline and duration of the treatment were the main determinants of the decrease in FM. CONCLUSION: During adolescence, despite a major weight loss, adequate growth and preservation of LM can be achieved. Weight loss kinetics markedly differs between boys and girls. Low-calorie diets are unnecessary to achieve a marked reduction of severe obesity during puberty. International Journal of Obesity (2004) 28, 290-299. doi:10.1038/sj.ijo.0802542Keywords: adolescents; diet; exercise; body composition IntroductionThe steep increase of obesity in children and adolescents is partly due to major changes in lifestyle in all industrialized countries. In France, the prevalence of obesity has doubled every 15 y since 1970 and reached 16% in 2000. 1 It has been extensively demonstrated that low physical activity levels are a cause and a consequence of overweight. 2 Obese children tend to remain obese in adulthood. 3 Many severe complications of adult obesity are embedded in childhood and adolescence. 4 So strategies are needed to prevent and to treat childhood obesity. 2,5 The treatment of obese children and adolescent should aim at decreasing fat mass (FM), avoiding loss of lean body mass, ensuring adequate growth and development and preventing cyclic weight regain. 2,6 Improving well-being is a second major aspect since psychological disturbances and social distress tend to be early features of obesity in the young. As such a multidisciplinary approach proves to be difficult to reach in the usual environment, in-patient units have been designed to help adolescents suffering the most severe forms of obesity. 7,8 Managing weight loss in obese adolescents actually requires paying special attention to potential...

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“…Changes in lipid and lipoprotein concentrations may result from insulin resistance and the accompanying hyperinsulinemia in children and adolescents. 14,15 Fat measurements , and weight for-stature indexes, skinfold measures, electrical bioimpedance analysis, dual energy X-ray absorptiometry (DXA) and imaging techniques (magnetic resonance imaging (MRI); and computed tomography (CT)). 22 We review in detail DXA and MRI, while emphasizing the importance of assessment of fat distribution in children and adolescents.…”

Section: Fat Distributionmentioning

confidence: 99%

Adipose tissue and metabolic effects: new insight into measurements

2005

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BACKGROUND: Epidemiologic evidence supports the theory that the relation between obesity and disease risk begins early in life, and those risk factors for disease track, or remain at a similar level, with advancing age, growth, and development. The fat tissue, once considered as a depot for energy substrate, is a metabolically active tissue. The fat cells produce agents that regulate a host of physiological processes directly related to carbohydrate and fat metabolism and the development of cardiovascular disease and type 2 diabetes. AIM: To discuss fat tissue, and fat distribution in relation to body composition measurements, with particular emphasis on imaging techniques (ie, dual energy X-ray absorptiometry (DXA), computed tomography (CT), and magnetic resonance imaging (MRI)) and its relationship with metabolic and cardiovascular heath variables mediated by the metabolic characteristics of the adipose tissue. DISCUSSION: In sum, the medical and physiological health complications of childhood obesity are well documented. Imaging methods are considered the most accurate means available for in vivo quantification at the tissue-organ level and the methods of choice for calibration of field methods designed to measure adipose tissue.

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Fat Distribution and Cardiovascular Risk Factors in Obese Adolescent Girls: Importance of Intra-Abdominal Fat Depot. † 498

Cited by 13 publications

References 0 publications

Sex hormone-binding globulin as a marker for hyperinsulinemia and/or insulin resistance in obese children

Sex hormone-binding globulin as a marker for hyperinsulinemia and/or insulin resistance in obese children

Effects of a multidisciplinary weight loss intervention on body composition in obese adolescents

Adipose tissue and metabolic effects: new insight into measurements

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