Subcutaneous and visceral fat distribution according to sex, age, and overweight, evaluated by computed tomography

Enzi, Giuliano; Gasparo, Marc de; Biondetti, Pietro; Fiore, D.; Semisa, M; Zurlo, F.

doi:10.1093/ajcn/44.6.739

Cited by 502 publications

(320 citation statements)

References 16 publications

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“…Yet a possible explanation for our findings is the fact that our patients had an elevated BMI and that the higher levels of visceral fat were a consequence of this. Against this are the findings of Enzi et al 53 who have found that healthy volunteers with BMIs 26 have less intra-abdominal fat (3700 mm 2 in females and 5600 mm 2 in males) than our patients with schizophrenia (13 232 mm 2 ). Therefore, it would appear that the increase in visceral fat is not merely a 'mass effect' of a raised BMI.…”

Section: Discussionsupporting

confidence: 76%

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

et al. 2002

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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...

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Section: Discussionsupporting

confidence: 76%

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

et al. 2002

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“…A decrease in appendicular BF accompanied by a significant increase in central BF, would have been expected with aging, in accordance with previous findings in adults (34,35). This outcome endorses the beneficial effect of our CET program intervention as compared with standard care.…”

Section: Discussionsupporting

confidence: 91%

Body Fat Responses to a 1-Year Combined Exercise Training Program in Male Coronary Artery Disease Patients

Pimenta¹,

Santa-Clara²,

Sardinha³

et al. 2012

Obesity

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Objective: To analyze the body fat (BF) content and distribution modifications in coronary artery disease (CAD) patients in response to a 1-year combined aerobic and resistance exercise training (CET) program. Design and Methods: We followed two groups of CAD male patients for 12 months. One group consisted of 17 subjects (57 6 12 years) who engaged in a CET program (CET group) and the other was a age-matched control group of 10 subjects (58 6 11 years). BF content and distribution were measured through dual energy X-ray absorptiometry (DXA) at baseline and follow-up. Results: We found no differences on body mass and BMI between baseline and end of follow-up in both groups but, in CET group, we found significant reductions in all analyzed BF depots, including total BF (21.60 6 6.00 vs. 20.32 6 5.89 kg, P < 0.01), % total BF (27.8 6 5.5 vs. 26.4 6 5.4%, P < 0.05), trunk fat (12.54 6 3.99 vs. 11.77 6 4.01 kg, P < 0.05), % trunk fat (31.1 6 6.9 and 29.2 6 7.1%, P < 0.05), appendicular fat (8.22 6 2.08 vs. 7.72 6 2.037 kg, P < 0.01), % appendicular fat (25.7 6 4.9 and 24.5 6 4.9%, P < 0.05), and abdominal fat (2.95 6 1.06 vs. 2.75 6 1.10 kg, P < 0.05). Control group showed significant increase in appendicular fat (7.63 6 1.92 vs. 8.10 6 2.12 kg, P < 0.05). Conclusions: These results confirm the positive effect of CET on body composition of CAD patients, despite no changes in body mass or BMI. In this study, we observed no alterations on BF distribution meaning similar rate of fat loss in all analyzed BF depots. These results also alert for the limitations of BMI for tracking body composition changes.

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“…In humans, MTS exposure increases visceral adiposity in males earlier than in females (32,33). Animal studies also demonstrate sex specificity in metabolic outcomes from adverse intrauterine environments.…”

Section: Mts Increased Vat In Male Ratsmentioning

confidence: 92%

Maternal tobacco smoke increased visceral adiposity and serum corticosterone levels in adult male rat offspring

Zinkhan

Lang

et al. 2014

Pediatr Res

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Background: Maternal tobacco smoke (MTS) predisposes human and rat offspring to visceral obesity in early adulthood. Glucocorticoid excess also causes visceral obesity. We hypothesized that in utero MTS would increase visceral adiposity and alter the glucocorticoid pathway in young adult rats. Methods:We developed a novel model of in utero MTS exposure in pregnant rats by exposing them to cigarette smoke from E11.5 to term. Neonatal rats were cross-fostered to control dams and weaned to standard rat chow through young adulthood (postnatal day 60). results: We demonstrated increased visceral adiposity (193%)*, increased visceral adipose 11-β hydroxysteroid dehydrogenase 1 mRNA (204%)*, increased serum corticosterone (147%)*, and no change in glucocorticoid receptor protein in adult male MTS rat offspring. Female rats exposed to MTS in utero demonstrated no change in visceral or subcutaneous adiposity, decreased serum corticosterone (60%)*, and decreased adipose glucocorticoid receptor protein (66%)*. *P < 0.05. conclusion: We conclude that in utero MTS exposure increased visceral adiposity and altered in the glucocorticoid pathway in a sex-specific manner. We speculate that in utero MTS exposure programs adipose dysfunction in adult male rat offspring via alteration in the glucocorticoid pathway.M aternal tobacco smoke (MTS) impacts more than 13% of pregnancies despite aggressive antismoking campaigns (1). In adult human studies, MTS exposure in utero predisposes to the development of metabolic syndrome, including increased visceral adiposity (2). The increased adiposity seen after gestating in an adverse intrauterine environment, such as maternal tobacco or nicotine exposure, is often adipose depot specific, with the visceral adipose tissue (VAT) increasing in excess to the subcutaneous adipose tissue (SAT) (3,4).VAT seems to have a detrimental role in the development of metabolic syndrome (5,6). Even when considering dietary and lifestyle choices, MTS exposure in utero independently increases the risk of developing visceral obesity (7,8). Children whose mothers smoked during pregnancy had decreased birth weights yet an increased obesity and BMI index as early as 9-10 y of age, independent of dietary intake and activity levels (8). Furthermore, the effect of MTS on body weight was stronger when mothers smoked during pregnancy compared with that of isolated smoke exposure in childhood (7). Taken together, these findings suggest that MTS exposure during this developmentally sensitive time period both causes intrauterine growth restriction (IUGR) and adversely programs obesity later in life.Little insight exists on how MTS programs increased visceral adiposity. Rodent studies examining the effect of in utero MTS exposure on the offspring have not examined the etiology of increased visceral adiposity. Rodent studies of tobacco smoke exposure only during lactation demonstrate increased adiposity (9). Furthermore, rodent studies of maternal nicotine, one of the many compounds found in tobacco smoke, demonstrate increa...

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Subcutaneous and visceral fat distribution according to sex, age, and overweight, evaluated by computed tomography

Cited by 502 publications

References 16 publications

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

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

Body Fat Responses to a 1-Year Combined Exercise Training Program in Male Coronary Artery Disease Patients

Maternal tobacco smoke increased visceral adiposity and serum corticosterone levels in adult male rat offspring

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