Age‐ and sex‐specific changes in visceral fat mass throughout the life‐span

Falkentoft, Rikke; Jensen, Mads Radmer; Hansen, Ole Møller; Haddock, Bryan; Prescott, Eva; Hovind, Peter; Simonsen, Lene; Bülow, Jens; Suetta, Charlotte

doi:10.1002/oby.23779

Cited by 4 publications

(2 citation statements)

References 29 publications

(61 reference statements)

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“…Obesity-related nephropathy is thought to result from changes in kidney hemodynamics, specifically, overactivation of the renin-angiotensin system; kidney adaptation endocrine activity of fat tissue, including secreted adipokines; and adverse accumulation of lipids in the kidney due to dysregulated lipid metabolism . The contribution of each mechanism is still under debate, and sex differences, as observed in our study, are possibly due to the nephroprotective effects of estrogen and to differences in fat distribution . In this respect, our analysis suggests that even in the absence of incident diabetes or hypertension, the risk is increased by 1.5- to 2.7-fold for persons with overweight and obesity in adolescence.…”

Section: Discussionmentioning

confidence: 51%

Adolescent Body Mass Index and Early Chronic Kidney Disease in Young Adulthood

Tsur,

Akavian,

Landau

et al. 2024

JAMA Pediatr

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ImportanceDespite increasing obesity rates in adolescents, data regarding early kidney sequelae are lacking.ObjectiveTo assess the association between adolescent body mass index (BMI) and early chronic kidney disease (CKD) in young adulthood (&lt;45 years of age).Design, Setting, and ParticipantsThis cohort study linked screening data of mandatory medical assessments of Israeli adolescents to data from a CKD registry of a national health care system. Adolescents who were aged 16 to 20 years; born since January 1, 1975; medically evaluated for mandatory military service through December 31, 2019; and insured by Maccabi Healthcare Services were assessed. Individuals with kidney pathology, albuminuria, hypertension, dysglycemia, or missing blood pressure or BMI data were excluded. Body mass index was calculated as weight in kilograms divided by height in meters squared and categorized by age- and sex-matched percentiles according to the US Centers for Disease Control and Prevention. Follow-up started at the time of medical evaluation or January 1, 2000 (whichever came last), and ended at early CKD onset, death, the last day insured, or August 23, 2020 (whichever came first). Data analysis was performed from December 19, 2021, to September 11, 2023.Main Outcomes and MeasuresEarly CKD, defined as stage 1 to 2 CKD by moderately or severely increased albuminuria, with an estimated glomerular filtration rate of 60 mL/min/1.73 m2 or higher.ResultsOf 629 168 adolescents evaluated, 593 660 (mean [SD] age at study entry, 17.2 [0.5] years; 323 293 [54.5%] male, 270 367 [45.5%] female) were included in the analysis. During a mean (SD) follow-up of 13.4 (5.5) years for males and 13.4 (5.6) years for females, 1963 adolescents (0.3%) developed early CKD. Among males, the adjusted hazard ratios were 1.8 (95% CI, 1.5-2.2) for adolescents with high-normal BMI, 4.0 (95% CI, 3.3-5.0) for those with overweight, 6.7 (95% CI, 5.4-8.4) for those with mild obesity, and 9.4 (95% CI, 6.6-13.5) for those with severe obesity. Among females, the hazard ratios were 1.4 (95% CI, 1.2-1.6) for those with high-normal BMI, 2.3 (95% CI, 1.9-2.8) for those with overweight, 2.7 (95% CI, 2.1-3.6) for those with mild obesity, and 4.3 (95% CI, 2.8-6.5) for those with severe obesity. The results were similar when the cohort was limited to individuals who were seemingly healthy as adolescents, individuals surveyed up to 30 years of age, or those free of diabetes and hypertension at the end of the follow-up.Conclusions and RelevanceIn this cohort study, high BMI in late adolescence was associated with early CKD in young adulthood. The risk was also present in seemingly healthy individuals with high-normal BMI and before 30 years of age, and a greater risk was seen among those with severe obesity. These findings underscore the importance of mitigating adolescent obesity rates and managing risk factors for kidney disease in adolescents with high BMI.

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Section: Discussionmentioning

confidence: 51%

Adolescent Body Mass Index and Early Chronic Kidney Disease in Young Adulthood

Tsur,

Akavian,

Landau

et al. 2024

JAMA Pediatr

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“…Android fat accumulation (around the abdomen and midsection) is recognized as a greater risk factor than gynoid fat (around the hips and thighs) ( Xu et al , 2023 ). The type and distribution of adipose tissue are being increasingly recognized as key risk factors for cardiometabolic disease, even more so than traditional metrics such as BMI and waist circumference ( Baarts et al , 2023 ).…”

Section: Introductionmentioning

confidence: 99%

The association between reproductive history and abdominal adipose tissue among postmenopausal women: results from the Women’s Health Initiative

Banack,

Cook,

Grandi

et al. 2024

Human Reproduction

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STUDY QUESTION What is the association between reproductive health history (e.g. age at menarche, menopause, reproductive lifespan) with abdominal adiposity in postmenopausal women? SUMMARY ANSWER Higher visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) tissue levels were observed among women with earlier menarche, earlier menopause, and greater parity. WHAT IS KNOWN ALREADY Postmenopausal women are predisposed to accumulation of VAT and SAT. Reproductive health variables are known predictors of overall obesity status in women, defined by BMI. STUDY DESIGN, SIZE, DURATION This study is a secondary analysis of data collected from the baseline visit of the Women’s Health Initiative (WHI). The WHI is a large prospective study of postmenopausal women, including both a randomized trial and observational study. There were 10 184 women included in this analysis. PARTICIPANTS/MATERIALS, SETTING, METHODS Data were collected from a reproductive health history questionnaire, dual-energy x-ray absorptiometry scans, and anthropometric measures at WHI baseline. Reproductive history was measured via self-report, and included age at menarche, variables related to pregnancy, and age at menopause. Reproductive lifespan was calculated as age at menopause minus age at menarche. Statistical analyses included descriptive analyses and multivariable linear regression models to examine the association between reproductive history with VAT, SAT, total body fat, and BMI. MAIN RESULTS AND THE ROLE OF CHANCE Women who reported early menarche (<10 years) or early menopause (<40 years) had the highest levels of VAT. Adjusted multivariable linear regression results demonstrate women who experienced menarche >15 years had 23 cm2 less VAT (95% CI: −31.4, −14.4) and 47 cm2 less SAT (95% CI: −61.8, −33.4) than women who experienced menarche at age 10 years or earlier. A similar pattern was observed for age at menopause: compared to women who experienced menopause <40 years, menopause at 50–55 years was associated with 19.3 cm2 (95% CI: −25.4, −13.3) less VAT and 27.4 cm2 (−29.6, 10.3) less SAT. High parity (>3 pregnancies) was also associated with VAT and SAT. For example, adjusted beta coefficients for VAT were 8.36 (4.33, 12.4) and 17.9 (12.6, 23.2) comparing three to four pregnancies with the referent, one to two pregnancies. LIMITATIONS, REASONS FOR CAUTION The WHI reproductive health history questionnaire may be subject to poor recall owing to a long look-back window. Residual confounding may be present given lack of data on early life characteristics, such as maternal and pre-menarche characteristics. WIDER IMPLICATIONS OF THE FINDINGS This study contributes to our understanding of reproductive lifespan, including menarche and menopause, as an important predictor of late-life adiposity in women. Reproductive health has also been recognized as a sentinel marker for chronic disease in late life. Given established links between adiposity and cardiometabolic outcomes, this research has implications for future research, clinical practice, and public health policy that makes use of reproductive health history as an opportunity for chronic disease prevention. STUDY FUNDING/COMPETING INTEREST(S) HRB and AOO are supported by the National Institute of Health National Institute of Aging (R01AG055018-04). JWB reports royalties from ‘ACSM’S Body Composition Assessment Book’ and consulting fees from the WHI. The remaining authors have no competing interests to declare. TRIAL REGISTRATION NUMBER N/A.

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