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Data from the First Health and Nutrition Examination Survey (HANES), 1971-1974, were used to examine the relationship between blood pressure and the distribution of subcutaneous body fat in 5506 survey participants, ages 30-59. Triceps and subscapular skinfolds were used as approximations of peripheral and centrally located body fat. The effects of race, sex and age on the obesity-blood pressure relationship were analyzed. Subscapular skinfold was the better predictor of both systolic and diastolic blood pressure in each race-sex group, sharing all of the association of triceps with blood pressure and having significant predictive power unshared by triceps. The slopes of regression of subscapular skinfolds with systolic blood pressure for each race-sex group were not significantly different. A 1 mm increase in skinfold thickness increased the predicted mean systolic blood pressure by 0.63 +/- 0.03 mmHg (F = 519). Mean diastolic blood pressure rose 0.43 +/- 0.02 mmHg per unit increase of skinfold in whites (F = 549), and 0.14 +/- 0.04 mmHg less in blacks (F = 13), indicating a significant racial difference. Age and subscapular skinfold contributed independently to the variability in blood pressure in each race-sex group. These results demonstrate that the blood pressure of middle-aged Americans is more directly associated with centrally deposited body fat. This finding is true across race and sex groups, and is independent of age.

SUMMARYThe aetiology of chronic fatigue syndrome (CFS) is not known. However, it has been suggested that CFS may be associated with underlying immune activation resulting in a Th2-type response. We measured intracellular production of interferon (IFN)-g and interleukin (IL)-2; type 1 cytokines), IL-4 (type 2) and IL-10 (regulatory) by both polyclonally stimulated and non-stimulated CD4 and CD8 lymphocytes from patients with CFS and control subjects by flow cytometry. After polyclonal activation we found evidence of a significant bias towards Th2-and Tc2-type immune responses in CFS compared to controls. In contrast, levels of IFN-g , IL-2 and IL-10-producing cells were similar in both study groups. Non-stimulated cultures revealed significantly higher levels of T cells producing IFN-g or IL-4 in CFS patients. Concluding, we show evidence for an effector memory cell bias towards type 2 responsiveness in patients with CFS, as well as ongoing type 0 immune activation in unstimulated cultures of peripheral blood cells.