Effect of Android to Gynoid Fat Ratio on Insulin Resistance in Obese Youth

Abstract

Background:Upper body fat distribution is associated with the early development of insulin resistance in obese children and adolescents.Objective:: To determine if an android to gynoid fat ratio is associated with the severity of insulin resistance in obese children and adolescents, whereas peripheral subcutaneous fat may have a protective effect against insulin resistance. Setting:Participants: Data from 66 obese children and adolescents coming to the hospital for medical consultation were used in this study.Main Outcome Measures: Subjects were stratified into tertiles of android to gynoid fat ratio determined by dual-energy x-ray absorptiometry. Insulin resistance was assessed by the homeostasis model of insulin resistance (HOMA-IR) index.Results: There were no differences in weight, body mass index, and body fat percentage between tertiles. Values of HOMA-IR were significantly increased in the 2 higher tertiles (mean [SD], tertile 2, 2.73 [1.41]; tertile 3, 2.89 [1.28]) compared with the lower tertile (tertile 1, 1.67 [1.24]) of android to gynoid fat ratio (P Ͻ .001). The HOMA-IR value was significantly associated with android to gynoid fat ratio (r=0.35; P Ͻ.01). Conclusions:Android fat distribution is associated with an increased insulin resistance in obese children and adolescents. An android to gynoid fat ratio based on dualenergy x-ray absorptiometry measurements is a useful and simple technique to assess distribution of body fat associated with an increased risk of insulin resistance.

Left Ventricular Function Impairment in Patients With Normal-Weight Obesity

“…This might be of paramount relevance for the development of cardiac impairment in view of different biological roles of abdominal and gynoid fat, with the former secreting various compounds affecting the myocardium and contributing to metabolic alterations and the latter protecting against cardiovascular diseases (through the mechanisms linked to the larger lipoprotein lipase activity and more efficacious storage of free fatty acids, as well as enhanced release of adiponectin exerting favorable cardiometabolic effects). [32][33][34] Consistent with these considerations, we showed higher CRP (a marker of inflammation), PICP (a marker of collagen I synthesis), insulin, and HOMA IR in individuals with NWO that might attest to the inflammatory and fibrotic upregulation, and metabolic disturbances associated with excess body fat.…”

“…27,29 -31 As most of the aforementioned mechanisms are attributable to the excessive accumulation of adipose tissue rather than to an increased total body weight per se, it is tempting to suppose that the risk of cardiac complications in patients with excess body fat and a normal BMI might parallel that evidenced in obesity diagnosed on the basis of the BMI criteria. In the currently investigated population with NWO, as well as in other studies exploring obesity profiles, 21,32,33 increased body fat content was associated with larger amounts of adipose tissue in abdominal and gynoid depots; however, the proportion of these two components was altered with the predominance of the abdominal distribution. This might be of paramount relevance for the development of cardiac impairment in view of different biological roles of abdominal and gynoid fat, with the former secreting various compounds affecting the myocardium and contributing to metabolic alterations and the latter protecting against cardiovascular diseases (through the mechanisms linked to the larger lipoprotein lipase activity and more efficacious storage of free fatty acids, as well as enhanced release of adiponectin exerting favorable cardiometabolic effects).…”

Distinct Developmental Profile of Lower-Body Adipose Tissue Defines Resistance Against Obesity-Associated Metabolic Complications

“…Using DEXA-quantified fat mass, we provide further support for the protective nature of lower-body fat in a large healthy population-based cohort-the OBB. Earlier DEXA studies have generally been limited by small sample size (40) or have not been performed in relevant populations (children, elderly) (41,42). Our findings highlight the importance of correcting for overall adiposity when examining the relationship between lower-body fat and metabolic health; due to colinearity, gynoid fat mass per se was positively related to metabolic risk factors, but this was reversed by adjusting for TFM and may thus provide an explanation for conflicting results in the literature (42).…”

Impacts of obesity on the health of women of childbearing age: A call for action

“…[16] Android fat distribution is associated with an increased insulin resistance in obese adolescents. [17] Women suffering from this type of obesity develop a more masculine feature like the growth of more hairs throughout the body called hirsutism and usually have more fat than men suffering from the same type of obesity. [16] 2.…”