Subcutaneous adipose tissue pattern in lean and obese women with polycystic ovary syndrome

The new optical device, Lipometer, permits the noninvasive, quick, safe, and precise measurement of the thickness of subcutaneous adipose tissue (SAT) layers at any given site of the human body. Fifteen anatomically well-defined body sites from neck to calf describe the SAT topography (SAT-Top) like an individual "fingerprint." SAT-Top was examined in 33 women with polycystic ovary syndrome (PCOS), in 87 age-matched healthy controls and in 20 Type-II diabetic women. SAT-Top differences of these three groups were described, and, based on a hierarchical cluster analysis, two distinctly different groups of PCOS women, a lean (PCOS(L)) and an obese (PCOS(O)) cluster, were found. For visual comparison of the different types of body fat distribution, the 15-dimensional body fat information was condensed to a two-dimensional factor plot by factor analysis. For comparison of the PCOS like body fat distribution with the "healthy" fat pattern, the (previously published) SAT-Top results of 590 healthy women and men (20-70 years old) and 162 healthy girls and boys (7-11 years old) were added to the factor plot. PCOS(O) women showed a SAT-Top pattern very similar to that of women with Type-II diabetes, even though the diabetic women were on average 30 years older. Compared with their healthy controls, SAT-Top of these PCOS(O) patients was strongly skewed into the android direction, providing significantly decreased leg SAT development and significantly higher upper body obesity. Compared with healthy women, PCOS(L) patients had significantly lower total SAT development (even though height, weight, and body mass index did not deviate significantly), showing a slightly lowered amount of body fat in the upper region and a highly significant leg SAT reduction. This type of fat pattern is the same as found in girls and boys before developing their sex specific body fat distribution. We conclude that women with PCOS develop an android SAT-Top, but compared in more detail, we found two typical types of body fat distribution: the "childlike" SAT pattern in lean PCOS patients, and the "diabetic" body fat distribution in obese PCOS women.     

Evaluation of risk profiles by subcutaneous adipose tissue topography in obese juveniles

Objective: To compare subcutaneous adipose tissue topography (SAT‐top) in obese juveniles with age‐matched normal‐weight controls. Research Methods and Procedures: The optical device LIPOMETER (European Patent EP 0516251) enables the non‐invasive, rapid, safe, and precise measurement of the thickness of subcutaneous adipose tissue. Fifteen defined body sites (1 = neck to 15 = calf) characterize the individual SAT‐top like an individual fingerprint. SAT‐top of 1351 juveniles (obese: 42 boys, 59 girls, normal weight: 680 boys, 570 girls) from 7 to 19 years of age were measured. For visual comparison, the 15‐dimensional SAT‐top information was condensed by factor analysis into a two‐dimensional factor plot. Results: Both female and male obese juveniles had markedly increased adipose tissue layers at 7 = upper abdomen, 8 = lower abdomen, 5 = front chest, and 6 = lateral chest. The pubertal changes of body shape and fat distribution of the normal‐weight boys and girls (boys show thinner adipose tissue layers on their legs, whereas girls had thicker adipose tissue layers at the extremities) were not seen in the obese group. Independently of age and sex, all of the obese juveniles showed a similar, more android body fat distribution with increased trunk fat. Discussion: SAT‐top of the obese juveniles is similar to that of patients with type 2 diabetes, polycystic ovary syndrome, and coronary heart disease. Patients with these metabolic disorders and obese juveniles are located in the factor plot in the same area. This body shape may indicate a risk profile for developing polycystic ovary syndrome (women), type 2 diabetes, and early atherosclerosis (both sexes).     

Android subcutaneous adipose tissue topography in lean and obese women suffering from PCOS: comparison with type 2 diabetic women

The new optical device, the lipometer, enables the noninvasive, quick, safe, and precise determination of the thickness of subcutaneous adipose tissue (SAT) layers at any given site of the human body. Fifteen anatomically well-defined body sites from neck to calf describe a SAT topography (SAT-Top) like an individual "fingerprint" of a subject. This SAT-Top was examined in 16 women with polycystic ovary syndrome (PCOS) and compared to the body fat distribution of 87 age-matched healthy controls and 20 type-2 diabetic women. SAT-Top differences of these three groups were described and, to render the possibility of visual comparison, the 15-dimensional body fat information was condensed to a two-dimensional factor plot by factor analysis. All PCOS patients had an android body fat distribution with significantly thinner SAT layers on the legs as compared to healthy controls. Moreover, a hierarchical cluster analysis resulted in two distinctly different groups of PCOS women, a lean (PCOSL) and an obese (PCOSO) cluster: compared to healthy women, lean PCOS patients had significantly lower total SAT development, even though height, weight, and body mass index did not deviate significantly. Especially on the legs, their SAT layers were significantly lowered, indicating a more "apple-like" fat distribution type. Obese PCOS women showed a SAT-Top pattern very similar to that of women with type-2 diabetes, although the mean age difference between these groups was more than 30 years. Compared to healthy controls, the SAT-Top of these obese PCOS patients was strongly shifted into the android direction, appearing as "super-apples" with a significantly increased upper trunk obesity to 237.8% and a significantly decreased leg SAT development to 79.8%.     

Differences of subcutaneous adipose tissue topography between type-2 diabetic men and healthy controls

Men with noninsulin-dependent diabetes mellitus (type 2 DM) provide a different subcutaneous body fat distribution and a concentration of fatness on the upper trunk compared with healthy subjects. However, subcutaneous fat distribution is always measured in an inaccurate and/or very simplified way (e.g., by caliper), and to date, there exists no study reporting on the exact and complete subcutaneous adipose tissue distribution of type 2 DM men. A new optical device, the LIPOMETER, enables the nonivasive, quick, and safe determination of the thickness of subcutaneous adipose tissue layers at any given site of the human body. The specification of 15 evenly distributed body sites allows the precise measurement of subcutaneous body fat distribution, so-called subcutaneous adipose tissue topography (SAT-Top). SAT-Tops of 21 men with clinically proven type 2 DM (mean age of 57.5 +/- 6.7 years) and 111 healthy controls of similar age (mean age 59.0 +/- 5.4 years) were measured. In this paper, we describe the precise SAT-Top differences of these two groups and we present the multidimensional SAT-Top information condensed in a two-dimensional factor value plot. In type 2 DM men, especially in the upper trunk, SAT-Top is significantly increased (up to +50.7% at the neck) compared with their healthy controls. One hundred eleven of the 132 individuals (84.1%) are correctly classified (healthy or type 2 DM) by their subcutaneous fat pattern by stepwise discriminant analysis.     

Differences of subcutaneous adipose tissue topography in type-2 diabetic (NIDDM) women and healthy controls

Women suffering from type-2 diabetes mellitus (non-insulin-dependent diabetes mellitus [NIDDM]) have more total body fat and upper body obesity compared with healthy controls. However, the standard measurement methods have disadvantages such as radiological burden, lack of precision, or high time consumption. A new optical device, the Lipometer, enables the noninvasive, quick, and save determination of the thickness of subcutaneous adipose tissue layers at any given site of the human body. The specification of 15 evenly distributed body sites allows the precise measurement of subcutaneous body fat distribution, so-called subcutaneous adipose tissue topography (SAT-Top). SAT-Tops of 20 women with clinically proven NIDDM and 122 healthy controls matched by age group were measured. In this paper, we describe the precise SAT-Top differences of these two groups and present the multidimensional SAT-Top information condensed in a two-dimensional factor plot and in a response plot of an artificial neural network. NIDDM women provide significantly lower leg SAT-Top and significantly higher upper trunk SAT-Top development ("apple"-type) compared with their healthy controls.     

Development of centrality indices of subcutaneous fat during growth

Changes of fat distribution were followed up in Czech and Slovak children from 1.5 to 15 years of age, using centrality indices, which relate the values of skinfolds on the trunk to the skinfolds on the extremities, head and neck. Up to 5 years of age, subcutaneous fat was deposited relatively more on the extremities, head and neck than on the trunk, which was expressed by lower values of the centrality indices. After the age of 5 years, the accumulation of subcutaneous fat was greater on the trunk, which was also expressed by higher values of the centrality indices. The comparison of the individual indices revealed in both genders a relatively higher amount of subcutaneous fat on the trunk in boys until 12 years of age. During puberty subcutaneous fat over triceps and on the forearm was reduced. In girls the deposition of the subcutaneous fat was relatively greater at different sites of the trunk than in boys, with the exception of the age of 14-15 years. The deposition of subcutaneous fat was greater on the trunk than on the head (cheek) and on the extremities in Czech compared to Slovak children, except for 12-year-old girls. During the period between the fifties and the seventies of the last century, in Czech children, especially in girls, the deposition of subcutaneous fat on the trunk was relatively smaller than on other parts of the body surface, which was expressed by the reduction of the centrality indices. Index 12 was therefore considered as the most valuable for the characterization of fat distribution on the body surface.     

Measurements of total and regional body composition in preschool children: A comparison of MRI,DXA, and anthropometric data

Objective:

There are clear sex differences in the distribution of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) in adults, with males having more VAT and less SAT than females. This study assessed whether these differences between the sexes were already present in preschool children. It also evaluated which measures of body composition were most appropriate for assessing abdominal obesity in this age group.

Design and Methods:

One‐hundred and five children (57 boys and 48 girls) participated in the study. Body composition was measured using dual‐energy X‐ray absorptiometry (DXA). Weight, height, and waist circumference (WC) were also recorded. Magnetic resonance imaging (MRI) of the entire abdomen using sixteen 10‐mm‐thick T₁‐weighted slices was performed in a subgroup of 48 children (30 boys and 18 girls); SAT and VAT volumes were measured using semiautomated segmentation.

Results:

Boys had significantly more VAT than girls (0.17 versus 0.10 l, P < 0.001). Results showed that VAT correlated significantly with all measurements of anthropometry (P < 0.01) after adjusting for SAT and for total fat mass measured with DXA. The mean limits of agreement between DXA and MRI regarding truncal FM were calculated to be ?11.4 (range ?17.8 to ?3.6), using a Bland–Altman plot.

Conclusion:

Sex differences in adipose tissue distribution are apparent at an early age. MRI is the best method with which to study abdominal fat distribution in young children.

     

Plasma visfatin concentration as a surrogate marker for visceral fat accumulation in obese children

Objective: This study was designed to elucidate whether the plasma visfatin level reflects visceral or subcutaneous fat accumulation and metabolic derangement in obese children. Methods and Procedures: Fifty‐six obese Japanese children, including 37 boys and 19 girls were enrolled in the study. The age of the subjects ranged from 5 to 15 (10.2 ± 0.3; mean ± s.e.m.) years. The age‐matched control group for measuring visfatin consisted of 20 non‐obese children. Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) areas were measured by computed tomography. The plasma concentrations for visfatin and leptin were assayed by enzyme‐linked immunosorbent assay kits. Results: The plasma visfatin level was higher in the obese (14.7 ± 0.9 ng/ml) than in the control children (8.6 ± 0.6 ng/ml). In a univariate analysis, the visfatin correlated significantly with age, height, body weight, waist circumference, VAT and SAT area, triglyceride (TG), insulin, and the homeostasis model assessment for insulin resistance (HOMA‐R). After being adjusted for age and sex, only the VAT area retained significant partial correlation with visfatin, and in contrast the body weight, BMI–s.d., and SAT area with leptin. The plasma visfatin concentration was not correlated with leptin. The plasma visfatin levels in the control, non‐metabolic syndrome (MS) (n = 49), and MS groups (n = 7) were significantly different from each other. Discussion: These results suggest that plasma visfatin level is a specific marker for visceral fat accumulation in obese children. As a good surrogate marker, plasma visfatin level can predict the VAT area in obese children.     

ROC analysis of subcutaneous adipose tissue topography (SAT-Top) in female coronary heart disease patients and healthy controls

The aim of this study was to investigate whether subcutaneous adipose tissue topography (SAT-Top) is different in female CHD patients (n=26) and healthy controls (n=36) matched to age, body size, weight, and BMI. The thicknesses of SAT layers were measured by LIPOMETER at 15 specified body sites. To calculate the power of the different body sites to discriminate between CHD women and healthy controls, receiver operating characteristic (ROC) curve analysis was performed. For each parameter, sensitivity and specificity were calculated at different cutoff points. CHD women showed a significant decrease to 78.36% (p=0.012) at body site 11-front thigh, 73.10% (p=0.012) at 12-lateral thigh, 72.20% (p=0.009) at 13-rear thigh, 66.43% (p<0.001) at 14-inner thigh, and 49.19% (p<0.001) at 15-calf. The best discriminators analysed by ROC curves between female CHD patients and healthy controls turned out to be calf and inner thigh (optimal cut off values: calf: 3.85 mm and inner thigh: 11.15 mm). Stepwise discriminant analysis identified the body sites calf, lateral chest, and inner thigh as significant. In conclusion, information was obtained on the extent to which SAT thickness at each measured body site is able to discriminate between the two subject groups. The good discrimination results obtained for the present dataset are encouraging enough to recommend applying LIPOMETER SAT-Top measurements in further studies to investigate individual risks for CHD.     

Effects of a hyperbaric environment on subcutaneous adipose tissue topography (SAT-top)

The physiological reactions of the body in scuba diving situation can be simulated in a pressure chamber by increasing the ambient pressure. In this study the influence of a hyperbaric environment of 6 bar on the changes of the subcutaneous adipose tissue (SAT) thicknesses on different body sites in 68 voluntary men with undersea diving experience was investigated. Measurements of SAT-topography (SAT-Top) were performed with the optical device Lipometer before and after hyperbaric exposure. We observed a significant increase of the SAT-layers of the upper body zones, upper abdomen (+24.5%), lower abdomen (+21%) and front chest (+19%) after hyperbaric exposure. This increase of volume can be assumed to the nitrogen accumulation in fat cells at increased ambient pressures. In conclusion we describe for the first time in detail the influence of a hyperbaric environment on quantitative and topographic changes of SAT.     

Changes in the human fat mass from the ages of 6 to 18

In 2,300 persons of both sex, 6, 8, 10, and 18 years of age, using the caliper of "Holtein"-type for measuring thickness of skin-fat folds, age dynamics in distribution of subcutaneous fat, as well as general, subcutaneous and internal fat have been estimated. Both in boys and girls at the age of 6-12 years the place of the greatest accumulation of the subcutaneous fat is the anterior surface of the femur; its least layer up to 10 years of age is localized on the brachium, and at the age of 12 and 18 years--on the forearm. The subcutaneous fat mass from 6 up to 12 years of age increases more than 3 times, while the body mass at the same time increases only by 91-98%. The most significant increment of the general fat mass is noted at 10-12 years of age. In 6-year-old children the part of the subcutaneous fat in the body mass is less than that of the internal fat. By 12 years of age the relative mass of the subcutaneous fat increases, and that of the internal fat remains practically the same. This, evidently, demonstrates that equilibrium between volumetric characteristics of tissues in the internal medium of the organism is preserved in the process of its age development. Up to 12 years of age sexual differences in the dynamics of all the parameters are insignificant. Comparing with the adolescents, in 18-year-old boys fat mass--body mass ratio decreases, and in the girls it continues to increase.(ABSTRACT TRUNCATED AT 250 WORDS)     

Measurement of subcutaneous adipose tissue using ultrasound images.

The objectives of this paper are to explore the potential of the ultrasound technique to quantify subcutaneous adipose tissue, and to explain the differences between skinfolds and ultrasound measurements across a large range of ages and levels of adiposity. The sample consisted of 115 men and 117 women aged 35 to 51 years, 132 girls and 145 boys aged 12 to 20 years. Subcutaneous fat thickness was measured at four sites using skinfolds calipers, and at seven sites using a real-time B-mode ultrasound scanner. Anthropometric measurements were obtained, and percent body fat was estimated using electric impedance. The agreement between skinfolds and ultrasound measurements was calculated for each age and sex group. The agreement between techniques, and the levels of correlation between body composition and fatness measurements were high in the sample of young men. However, the results were less consistent in the other groups. Site specific differences were also noted.     

Gender differences in fat patterning in children living in Ankara

Body composition is an excellent indicator for assessing obesity and nutritional status of both individuals and populations. Youth obesity has important health and social implications, because a large proportion of adult obesity has its origin in childhood. Numerous studies report that adverse levels of cardiovascular diseases risk factors are associated with adiposity in children. Concerning the Turkish population there is up to now only limited information with regard to adiposity in children. The aim of this study was therefore to determine the anthropometric and body composition characteristics and to investigate sex differences in fat patterning including fat distribution in a group of children living in Ankara. The present study evaluated the body composition of 332 boys and 269 girls aged between 8 and 11 years, attending public schools. It was carried out by a cross-sectional study and was focused on that anthropometric variables, which reflect body fat and fat-free mass. Anthropometric measurements including height, weight, triceps and subscapular skinfolds thickness were carried out on these children. The body mass index (BMI) was also calculated. The measurements were used to estimate the two-compartment model of body composition: fat-free mass (FFM) and body fat (BF) from skinfold equations. The mean fat percentage in boys is highest at 11 years (16.8%) and lowest at 10 years (15.6%). In girls these figures come to 18.2% and 17.1%, respectively. Girls of these age groups have a significantly larger percentage of body fat and skinfold thickness. At this young age there is therefore clear evidence of sexual dimorphism in fat patterning, as girls are showing a greater subcutaneous adiposity, which is mainly contributed by the triceps fat. The body fat (kg) increases in both sexes all over the investigated age groups. The Pearson correlation matrix showed a high significant relation between the anthropometric measurements (p < 0.01). The present study confirms the findings that sexual dimorphism of fat patterning in children is to be seen in the age of 8 - 11 years. It furthermore presents basic data of body composition, which could serve as reference data in other studies on the Turkish population.     

Development of fat distribution patterns in children and its association with the type of body shape assessed by the Metric-Index

The present cross-sectional anthropometric study evaluates new approaches in preventing overweight in children. Anthropometric data were obtained in 289 German children (146 boys, 143 girls) aged 6-11 years and 41 20-29 year old German female students for describing the type of body shape by Metric-Index (thoracic breadth, thoracic depth, height). The data were correlated with 15 fat layers measured with a lipometer with Principal Component Analyses and ANOVA. In females the android respectively gynoid type of body shape was significantly associated with the pyknomorphic respectively leptomorphic type. The study demonstrates that this pattern is established by an age of 8 years, when the earliest maturing children start to enter puberty. This pattern can be used to check the individual's risk of overweight and to recommend preventive healthcare interventions.     

Stress and abdominal fat: preliminary evidence of moderation by the cortisol awakening response in Hispanic peripubertal girls

Stress and the cortisol awakening response (CAR) have been independently linked to increases in abdominal fat depots. This cross-sectional study examined the CAR as a moderator of the association between stress, visceral adipose tissue (VAT), and subcutaneous abdominal adipose tissue (SAT) in a sample (N = 23) of female peripubertal Hispanic girls aged from 8 to 11. The study included: (i) monitored salivary cortisol collection, (ii) VAT and SAT obtained by multislice magnetic resonance imaging, and (iii) a stressful life events checklist with four domain-specific subscales: peer, family, personal, and school. Regression analysis indicated an interaction of school-related life events and CAR on VAT and SAT, with greater numbers of school-related events being related to greater VAT and SAT for girls with high CAR, but no association with VAT or SAT for girls with low CAR. Similar to job stress in adults, school-related stress in children may contribute to central adiposity, especially for girls with high CAR.     

Comparison of BMI and percentage of body fat of Indian and German children and adolescents

Today, serious health problems as overweight and obesity are not just constricted to the developed world, but also increase in the developing countries (Prentice 2006, Ramachandram et al. 2002). Focusing on this issue, BMI and percentage of body fat were compared in 2094 schoolchildren from two cross-sectional studies from India and Germany investigated in 2008 and 2009. The German children are in all age groups significantly taller, whereas the Indian children show higher values in BMI (e.g. 12 years: Indian: around 22 kg/m2; German: around 19 kg/m2) and in the percentage of body fat (e.g. 12 years: Indian: around 27%; German: around 18-20%) in most of the investigated age groups. The Indian children have significantly higher BMI between 10 and 13 (boys) respectively 14 years (girls). Indian children showed significant higher percentage of body fat between 10 and 15 years (boys) and between 8 and 16 years (girls). The difference in overweight between Indian and German children was strongest at 11 (boys) and 12 (girls) years: 70% of the Indian but 20% of the German children were classified as overweight. In countries such as India that undergo nutritional transition, a rapid increase in obesity and overweight is observed. In contrast to the industrialized countries, the risk of overweight in developing countries is associated with high socioeconomic status. Other reasons of the rapid increase of overweight in the developing countries caused by different environmental or genetic factors are discussed.     

A factor analysis of cranial base and vault dimensions in children

Lengths within the cranial base and vault were measured in cephalometric radiographs of 220 boys and 177 girls ranging in age from 0 to 15 years; all these children are participants in The Fels Longitudinal Growth Study. The present study is based on mixed longitudinal data derived from 1640 radiographs for boys and 1260 radiographs for girls. Factor analysis was applied separately for boys and girls for each age group; i.e., 0–3, 4–6, 7–9, 10–12, and 13–15 years. For the 0–3 year age group, two factors were extracted in each sex, whereas four factors were extracted in the rest of the age groups. The factor structures are similar in the three older age groups of boys (7–9, 10–12, and 13–15 years). The first four factors for these groups are labelled, respectively: cranial vault size, posterior cranial base length, presphenoid length, and basisphenoid length. The order of the third and fourth factors is reversed in the 7–9 year olds. For girls, the factors extracted were also the same in both the 7–9 and 10–12 year age groups, even though the order of factors was different between age groups; i.e., anterior cranial base length, cranial vault size, basisphenoid length, and basioccipital length. Differential growth rates among cranial base dimensions probably cause changes in factor patterns. Obliteration of the spheno-occipital synchondrosis is suggested as the mechanism responsible for the change of factor pattern in the girls. Closure of this synchondrosis would have occurred too late to affect the patterns in boys.     

Comparisons of fatness indicators in Budapest children

The aim of this study was to estimate the fatness level of Budapest children and youth in different ways and to compare these estimations using a large representative sample. Eighteen body measurements were taken on 2606 healthy boys and 2471 healthy girls aged between 3 and 18 years. About 20% of this sample was measured by the Futrex 5000A near infrared (NIR) spectrophotometer to assess the body fat percent (data of 419 boys and 462 girls aged between 5 and 18 years were analysed). Triceps skinfold thickness (TSF), sum of triceps, medial calf, subscapular and suprailiac skinfold thicknesses (SFS), body fat percent estimated according to Slaughter et al. (%BF), BMI (calculated from height and weight) and body fat percent assessed by NIR-method (NIR%BF) were compared. chi 2 tests of independence show significant connections among the distributions ranged by the five fatness indicators. However, correlation coefficients and standard errors indicate that strong relationships are only among the assessments based on skinfold thicknesses (r = 0.92-0.97, SEE = 1.8-2.6%). BMI and NIR%BF assess body fatness differently compared to skinfold thicknesses: r-values are moderate and SEE-values are relatively large (r = 0.59-0.87, SEE = 1.9-4.7%). These findings can be seen in both the boys and the girls. NIR%BF comparing to %BF significantly overpredicts body fat percent in the boys and significantly underpredicts it in the girls. BMI, height and weight are not in significant correlation with NIR%BF in the boys but there are moderate correlations in the girls. Our suggestion is that more research is needed with the use of NIR-method in children and adolescents, and it is necessary to refine prediction equations taking into consideration very carefully sex sand age differences.