Validation of BIA in Obese Children and Adolescents and Re‐evaluation in a Longitudinal Study

Decrease in fat mass (FM) is a one of the aims of pediatric obesity treatment; however, measurement techniques suitable for routine clinical assessment are lacking. The objective of this study was to validate whole‐body bioelectrical impedance analysis (BIA; TANITA BC‐418MA) against the three‐component (3C) model of body composition in obese children and adolescents, and to test the accuracy of our new equations in an independent sample studied longitudinally. A total of 77 white obese subjects (30 males) aged 5–22 years, BMI‐standard deviation score (SDS) 1.6–3.9, had measurements of weight, height (HT), body volume, total body water (TBW), and impedance (Z). FM and fat‐free mass (FFM) were calculated using the 3C model or predicted from TANITA. FFM was predicted from HT²/Z. This equation was then evaluated in 17 other obese children (5 males) aged 9–13 years. Compared to the 3C model, TANITA manufacturer's equations overestimated FFM by 2.7 kg (P < 0.001). We derived a new equation: FFM = ?2.211 + 1.115 (HT²/Z), with r² of 0.96, standard error of the estimate 2.3 kg. Use of this equation in the independent sample showed no significant bias in FM or FFM (mean bias 0.5 ± 2.4 kg; P = 0.4), and no significant bias in change in FM or FFM (mean bias 0.2 ± 1.8 kg; P = 0.7), accounting for 58% (P < 0.001) and 55% (P = 0.001) of the change in FM and FFM, respectively. Our derived BIA equation, shown to be reliable for longitudinal assessment in white obese children, will aid routine clinical monitoring of body composition in this population.     

Rapid Postnatal Weight Gain and Visceral Adiposity in Adulthood: The Fels Longitudinal Study

Rapid infant weight gain is associated with increased abdominal adiposity, but there is no published report of the relationship of early infant growth to differences in specific adipose tissue depots in the abdomen, including visceral adipose tissue (VAT). In this study, we tested the associations of birth weight, infant weight gain, and other early life traits with VAT, abdominal subcutaneous adipose tissue (ASAT), and other body composition measures using magnetic resonance imaging (MRI) and dual‐energy X‐ray absorptiometry in middle adulthood (mean age = 46.5 years). The sample included 233 appropriate for gestational age singleton white children (114 males) enrolled in the Fels Longitudinal Study. Multivariate‐adjusted general linear models were used to test the association of infant weight gain (from 0 to 2 years), maternal BMI, gestational age, parity, maternal age, and other covariates with adulthood body composition. Compared to infants with slow weight gain, rapid weight gain was associated with elevated risk of obesity (adjusted odds ratio = 4.1, 95% confidence interval = 1.4, 11.1), higher total body fat (+7 kg, P = 0.0002), percent body fat (+5%, P = 0.0006), logVAT mass (+0.43 kg, P = 0.02), logASAT mass (+0.47 kg, P = 0.001), and percent abdominal fat (+5%, P = 0.03). There was no evidence that the increased abdominal adipose tissue was due to a preferential deposition of VAT. In conclusion, rapid infant weight gain is associated with increases in both VAT and ASAT, as well as total adiposity and the risk of obesity in middle adulthood.     

Maternal corticotropin-releasing hormone levels during pregnancy and offspring adiposity

Objective: Animal models suggest that fetal exposure to glucocorticoids can program adiposity, especially central adiposity, later in life. We examined associations of maternal corticotropin‐releasing hormone (CRH) levels in the late 2nd trimester of pregnancy, a marker of fetal glucocorticoid exposure, with child adiposity at age 3 years. Research Methods and Procedures: We analyzed data from 199 participants in Project Viva, a prospective cohort study of pregnant women and their children, At age 3 years, the main outcomes were age‐sex‐specific BMI z score and the sum of subscapular (SS) and triceps (TR) skinfold thicknesses to represent overall adiposity, and ratio of SS to TR (SS:TR) to represent central adiposity. Results: Mean (standard deviation) maternal 2nd trimester log CRH was 4.94 (0.56) pg/mL. At age 3, mean (standard deviation) for BMI z score was 0.52 (1.02); for SS + TR, 16.51 (3.94) mm; and for SS:TR, 0.67 (0.17). Log CRH was mildly inversely correlated with birth weight (r = ?0.08), chiefly because of its association with length of gestation (r = ?0.21) rather than fetal growth (r = ?0.004). After adjustment for sociodemographic factors, maternal smoking, BMI, and gestational weight gain, fetal growth, length of gestation, breastfeeding duration, and (for SS:TR only) child's 3‐year BMI, each increment of 1 unit of log CRH was associated with a reduction in BMI z score [?0.43; 95% confidence interval (CI), ?0.73, ?0.14; p = 0.004] and possible reduction in SS + TR (?1.10; 95% CI, ?2.33, 0.14; p = 0.08). In contrast, log CRH was associated with higher SS:TR (0.07; 95% CI, 0.02, 0.13; p = 0.007). Discussion: Fetal exposure to glucocorticoids, although associated with an overall decrease in body size, may cause an increase in central adiposity.     

Testosterone,physical activity,and somatic outcomes among Filipino males

Testosterone (T) facilitates male investment in reproduction in part through its anabolic effects on skeletal muscle. Traits like muscle and strength are energetically costly but are believed to enhance competitive ability in humans and other mammals. However, there are limited data on relationships between T and somatic outcomes in lean, non‐western populations. We evaluate relationships between waking and pre‐bed salivary T and adiposity, fat‐free mass (FFM), arm muscle area (AMA), and grip strength (GS) in a large, population‐based birth cohort of young adult Filipino males (20.8–22.6 years, n = 872). Data were collected as part of the Cebu Longitudinal Health and Nutrition Survey. Neither waking nor evening T predicted FFM, AMA, or GS. However, there were borderline or significant interactions between T and basketball playing (the most common team sport) and weight lifting as predictors of outcomes: higher waking T predicted higher FFM (activity × T interaction P < 0.01), AMA (interaction P < 0.1), and GS (interaction P < 0.02) among frequent basketball players, and GS (interaction P < 0.09) among the smaller sample of weight lifters. In contrast to clinical studies, but consistent with findings in several subsistence‐level populations, T was positively related to adiposity in these lean young males, suggesting that energy status might regulate circulating T. Our findings support a role of the prewaking rise in T as a determinant of energetic allocation to lean mass and strength in the context of repeated muscular use and support the hypothesized role of T as a mediator of investment in costly somatic traits in human males. Am J Phys Anthropol 142:590–599, 2010. © 2010 Wiley‐Liss, Inc.     

The association between birth weight and visceral fat in middle-age adults

Objective: Low birth weight, a proxy for fetal underdevelopment, is associated with increased risk of developing type 2 diabetes during adulthood. Low birth weight is also associated with central obesity, but little is known about the association between birth weight and visceral adiposity. The purpose of this study is to test the hypothesis that lower birth weight is associated with increased amounts of visceral fat in middle‐age adults. Research Methods and Procedures: This is an observational study of 91 adults (58 men and 33 women) 40 ± 6 years of age (mean ± standard deviation). Ethnicity was either Japanese American (79%) or non‐Hispanic white (21%). Birth weight was obtained from State Departments of Health. Measurements included smoking status, BMI, and visceral (intra‐abdominal) fat measured by computed tomography. Results: Visceral fat was not associated with birth weight after adjustment for age, sex, ethnicity, BMI, or smoking status (p = 0.76). There was no evidence that the association between birth weight and visceral fat varied by age, sex, or ethnicity. Discussion: We found no evidence that low birth weight is associated with increased visceral fat in middle‐age adults     

Effects of Adiposity and 30 Days of Caloric Restriction Upon Protein Metabolism in Moderately vs. Severely Obese Women

Protein metabolism adapts during caloric restriction (CR) to minimize protein loss, and it is unclear whether greater fat stores favorably affect this response. We sought to determine whether protein metabolism is related to degree of obesity and whether the response to CR is impacted by pre‐CR adiposity level. Whole body protein metabolism was studied in 12 obese women over a wide range of BMI (30–53 kg/m²) as inpatients using [1‐¹³C]leucine as a tracer following 5 days of a weight‐maintaining diet and then after 30 days of CR (1,400 kcal deficit with maintained protein intake). When expressed as total rates, per body weight (BW) or per fat‐free mass (FFM), leucine rate of appearance (Ra), and nonoxidative leucine disposal (NOLD) were significantly higher in the individuals with a greater degree of obesity (P < 0.05). Leucine oxidation (Rox) was also higher in more highly obese women when expressed as a total rate (P < 0.05) but not if expressed per BW or FFM. CR reduced BW, FFM, and fat mass (P < 0.001), and declines were relatively similar between individuals. CR reduced Ra (P < 0.001), NOLD (P < 0.01), and Rox (P < 0.05), and the relative decline was not affected by differences in fat mass. CR‐induced declines were significant even when Ra and NOLD were normalized to BW or FFM. We conclude that fat mass, like FFM, is a key determinant of protein turnover. However, during CR, higher fat mass does not favorably alter the response of protein metabolism and does not mitigate the loss of FFM.     

Gestational and early life influences on infant body composition at 1 year

Excess weight gain during both pre‐ and postnatal life increases risk for obesity in later life. Although a number of gestational and early life contributors to this effect have been identified, there is a dearth of research to examine whether gestational factors and weight gain velocity in infancy exert independent effects on subsequent body composition and fat distribution.

Objective:

To test the hypothesis that birth weight, as a proxy of prenatal weight gain, and rate of weight gain before 6 months would be associated with total and truncal adiposity at 12 months of age.

Design and Methods:

Healthy, term infants (N = 47) were enrolled in the study and rate of weight gain (g/day) was assessed at 0‐3 months, 3‐6 months, and 6‐12 months.

Results:

Total and regional body composition were measured by dual‐energy X‐ray absorptiometry (DXA) at 12 months. Stepwise linear regression modeling indicated that lean mass at 12 months, after adjusting for child length, was predicted by rate of weight gain during each discrete period of infancy (P < 0.05), and by maternal pre‐pregnancy BMI (P < 0.05). Total fat mass at 12 months was predicted by rate of weight gain during each discrete period (P < 0.01), and by older maternal age at delivery (P < 0.05). Trunk fat mass at 12 months, after adjusting for leg fat mass, was predicted by rate of weight gain from 0‐3 months and 3‐6 months (P < 0.05).

Conclusion:

Results suggest that growth during early infancy may be a critical predictor of subsequent body composition and truncal fat distribution.     

Increased Adiposity in Female Rhesus Monkeys Exposed to Androgen Excess During Early Gestation

Objective: The aim of this study was to investigate the effects of early‐gestational androgen excess on adult body fat distribution in female rhesus monkeys. Research Methods and Procedures: Six midreproductive‐aged, adult female rhesus monkeys that were exposed to androgen excess started during the first one‐third of gestation were pair‐matched to control females by age, body weight, and body mass index. Body composition was determined using somatometrics, DXA, and computed tomography. Results: Total abdominal and intra‐abdominal fat depots are increased in adult female rhesus monkeys exposed to prenatal androgen excess. Discussion: Early gestational androgen excess in female rhesus monkeys causes a preferential accumulation of total abdominal and intra‐abdominal fat during adulthood. Fat accumulation in these regions is independent of total body adiposity, occurring throughout the spectrum of body mass index in these animals. This study establishes alterations in abdominal adiposity as another consequence of prenatal androgen excess in female rhesus monkeys that may contribute to the impaired insulin secretion observed in these animals during adulthood.     

Prenatal Exposure to Maternal Cigarette Smoking and Accumulation of Intra‐abdominal Fat During Adolescence

In industrialized countries, prenatal exposure to maternal cigarette smoking (PEMCS) is the most common environmental insult to the fetus. Here, we tested the hypothesis that PEMCS amplifies accumulation of abdominal fat during the accelerated weight gain occurring in late puberty. This hypothesis was tested in 508 adolescents (12–18 years, 237 exposed prenatally to maternal cigarette smoking) in whom subcutaneous and intra‐abdominal fat were quantified with magnetic resonance imaging (MRI). We found that, in early puberty, exposed and nonexposed adolescents did not differ in MRI‐based measures of adiposity. In late puberty, on the other hand, exposed compared with nonexposed adolescents demonstrated markedly higher quantities of both subcutaneous fat (by 26%, P = 0.004) and intra‐abdominal fat (by 33%, P = 0.001). These group differences remained virtually unchanged after adjusting for sex and potential confounders, including birth weight and breastfeeding. As such, our results suggest that PEMCS may represent a major risk factor for the development of abdominal obesity at the later stages of puberty.     

Physical,Behavioral, and Body Image Characteristics in a Tri‐Racial Group of Adolescent Girls

Objectives: The purpose of this study was to evaluate physical characteristics, nutrient intake, physical activity level, and body image in white (CC), African‐American (AA), and Hispanic‐American (HA) female adolescents. Research Methods and Procedures: High school volunteers were solicited for this study. Self‐reported information was used to determine subject characteristics, family income, physical activity, body image, and nutrient intake. Physical evaluations were used to determine body mass index, percent body fat, fat distribution, resting heart rate, and blood pressure (BP). Results: Results showed that AA girls displayed significantly higher diastolic BP than HA girls (p = 0.029). CC adolescents showed greater physical activity (p = 0.010) and lower adiposity than HA adolescents (p = 0.048), as well as lower subscapular skinfold than AA adolescents (p = 0.018). AA adolescents selected a higher ideal body size than CC girls (p = 0.038). There was also a significant difference in percentage carbohydrates (p < 0.034) and cholesterol consumed (p < 0.016) among groups, with CC girls showing the highest values for carbohydrates and lowest values for cholesterol intake among groups. Discussion: Given our findings of higher adiposity and lower physical activity levels in HA adolescents and greater diastolic BP levels and subscapular skinfold in AA adolescents, more interventions should be targeted toward improving health‐related variables among minority populations.     

Association of FTO Gene Variants With Adiposity in African‐American Adolescents

The prevalence of obesity continues to increase significantly, with the largest rise in the African‐American adolescents. Genetic contributions to obesity are being identified with the advent of genome‐wide association studies (GWAS). Specifically, variants of the fat mass and obesity associated (FTO) gene have been associated with obesity in populations of European descent. The studies in African Americans have been inconclusive. To further evaluate the association of the FTO gene and adiposity in African Americans, we genotyped 47 single‐nucleotide polymorphisms (SNPs), including seven SNPs previously reported to be significant in the literature in a cohort consisting of 561 non‐Hispanic white and 497 African‐American individuals. Analysis of our data showed 17 SNPs to be associated with BMI Z‐score (BMI‐Z) in our study population. The strongest association was found in the African Americans. The most significant SNP was rs8057044, which was associated with BMI‐Z in the African Americans (P = 0.00054). SNP rs9939609 was found to be significant in the non‐Hispanic white population (P = 0.028). Our data confirm the association between FTO and adiposity suggesting that FTO is a childhood obesity susceptibility gene. Our data also identify a novel SNP of the FTO gene (rs8057044) that is associated with measures of adiposity in the African‐American population.     

Ethnic Differences in Subcutaneous Adiposity and Waist Girth in Children and Adolescents

The purpose of this study was to examine ethnic differences in adiposity as measured by sum of skinfolds (SKF) and waist circumference (WC) in children and adolescents, after statistical adjustment for the BMI and age. A cross sectional sample of 3,218 (55% white, 49% male) children and adolescents aged 5–18 years who participated in the Bogalusa Heart Study (1992–1994) were included in these analyses. Sex‐specific ANOVAs, adjusted for BMI and age, for each 2‐year age group compared measures of adiposity (SKF and WC) between ethnic groups. No significant differences in the proportions of children and adolescents who were overweight and obese by ethnicity or sex were found. Mean SKF in normal weight (P < 0.0001) and overweight (P < 0.0001) categories was higher for white than black children of both sexes. Across most age categories, white boys and girls had significantly higher SKF than black boys and girls, respectively (P ≤ 0.05). Across most age categories, white boys had significantly higher WC than black boys (P ≤ 0.05) with no difference in the girls, when adjusted for BMI and age. Measures of adiposity in childhood and adolescence were significantly higher in white children compared to black children, when adjusted for BMI and age. Throughout childhood and adolescence, white boys and girls had higher SKF and white boys had higher WC. Differences in adiposity between ethnic groups should be considered in disease risk assessment and stratification as they are observed even for a given BMI level.     

Prediction of Fatness by Standing 8‐Electrode Bioimpedance: A Multiethnic Adolescent Population

The objective of this study was to validate an 8‐electrode bioimpedance analysis (BIA₈) device (BC‐418; Tanita, Tokyo, Japan) for use in populations of European, Maori, Pacific Island, and Asian adolescents. Healthy adolescents (215 M, 216 F; 129 Pacific Island, 120 Asian, 91 Maori, and 91 European; age range 12–19 years) were recruited by purposive sampling of high schools in Auckland, New Zealand. Weight, height, sitting height, leg length, waist circumference, and whole‐body impedance were measured. Fat mass (FM) and fat‐free mass (FFM) derived from the BIA₈ manufacturer's equations were compared with measurements by dual‐energy X‐ray absorptiometry (DXA). DXA‐measured FFM was used as the reference to develop prediction equations based on impedance. A double cross‐validation technique was applied. BIA₈ underestimated FM by 2.06 kg (P < 0.0001) and percent body fat (%BF) by 2.84% (P < 0.0001), on average. However, BIA₈ tended to overestimate FM and %BF in lean and underestimate FM and %BF in fat individuals. Sex‐specific equations developed showed acceptable accuracy on cross‐validation. In the total sample, the best prediction equations were, for boys: FFM (kg) = 0.607 height (cm)²/impedance (Ω) + 1.542 age (y) + 0.220 height (cm) + 0.096 weight (kg) + 1.836 ethnicity (0 = European or Asian, 1 = Maori or Pacific) ? 47.547, R² = 0.93, standard error of estimate (SEE) = 3.09 kg; and, for girls: FFM (kg) = 0.531 height (cm)²/impedance (Ω) + 0.182 height (cm) + 0.096 weight (kg) + 1.562 ethnicity (0 = non‐Pacific, 1 = Pacific) ? 15.782, R² = 0.91, SEE = 2.19 kg. In conclusion, equations for fatness estimation using BIA₈ developed for our sample perform better than reliance on the manufacturer's estimates. The relationship between BIA and body composition in adolescents is ethnicity dependent.     

Height and Adiposity among Children

Objectives : Although BMI (kilograms per meter squared) is widely used as a surrogate measure of adiposity, it is moderately associated (r ～ 0.3) with height among children. We examined whether the resulting preferential classification of taller children as overweight, based on a BMI ≥95th percentile, is appropriate. Research Methods and Procedures : We assessed the cross‐sectional relation of height among 5‐ to 18‐year‐old subjects (n = 1180) to levels of BMI, the sum of 10 skinfold thicknesses, and percentage body fat as determined by DXA. Results : The prevalence of a BMI level ≥95th percentile was substantially higher among 5‐ to 11‐year‐old subjects who were relatively tall for their age than among shorter children. Among 5‐ to 8‐year‐old boys, for example, each SD increase in height‐for‐age was associated with a 4.6‐fold increase in the prevalence of overweight (p < 0.001). Height not only was associated with BMI but also showed similar correlations with the skinfold sum and with percentage body fat; furthermore, the magnitudes of these associations decreased with age. We also found that the association between percentage body fat and BMI (r = 0.85 to 0.90) was close to the maximum correlation that can be achieved by any weight‐height index. Discussion : The use of BMI, which preferentially classifies taller young children as overweight, is appropriate because height and adiposity are correlated before the age of 12 years.     

The Development of Obesity Begins at an Early Age in Captive Common Marmosets (Callithrix jacchus)

Animal models to study the causes and consequences of obesity during infancy in humans would be valuable. In this study, we examine the patterns of fat mass gain from birth to 12 months in common marmosets (Callithrix jacchus). Lean and fat mass was measured by quantitative magnetic resonance at 1, 2, 6, and 12 months for 31 marmosets, 15 considered Normal and 16 considered Fat (>14% body fat) at 12 months. Animals were fed either the regular colony diet mix or a high‐fat variation. Subjects classified as Fat at 12 months already had greater lean mass (198.4 ± 6.2 g vs. 174.0 ± 6.8 g, P = 0.013) and fat mass (45.5 ± 5.0 g vs. 24.9 ± 3.4 g, P = .002) by 6 months. Body mass did not differ between groups prior to 6 months, however, by 1 month, Fat infants had greater percent body fat. Percent body fat decreased between 1 and 12 months in Normal subjects; in Fat subjects, it increased. The high‐fat diet was associated with body fat >14% at 6 months (P = 0.049), but not at 12 months. This shift was due to three subjects on the normal diet changing from Normal to Fat between 6 and 12 months. Although maternal prepregnancy adiposity did not differ, overall, between Normal and Fat subjects, the subjects Normal at 6 and Fat at 12 months all had Fat mothers. Therefore, diet and maternal obesity appear to have potentially independent effects that may also vary with developmental age. Although birth weight did not differ between groups, it was associated with fat mass gain from 1 to 6 months in animals with >14% body fat at 6 months of age (r = 0.612, P = 0.026); but not in 6‐month‐old animals with <14% body fat (r = –0.012, P = 0.964). Excess adiposity in captive marmosets develops by 1 month. Birth weight is associated with adiposity in animals vulnerable to obesity.     

Childbearing may increase visceral adipose tissue independent of overall increase in body fat

Objective: To examine whether childbearing is associated with increased visceral adiposity and whether the increase is proportionally larger than other depots. Methods and Procedures: This prospective study examined changes in adiposity assessed via computed tomography (CT) and dual‐energy X‐ray absorptiometry among 122 premenopausal women (50 black, 72 white) examined in 1995–1996 and again in 2000–2001. During the 5‐year interval, 14 women had one interim birth and 108 had no interim births. Multiple linear regression models estimated mean (95% confidence interval (CI)) 5‐year changes in anthropometric and adiposity measures by interim births adjusted for age, race, and changes in total and subcutaneous adiposity. Results: We found no significant differences between one interim birth and no interim births for 5‐year changes in weight, BMI, total body fat, subcutaneous adipose tissue, or total abdominal adipose tissue. Visceral adipose tissue increased by 40 and 14% above initial levels for 1 birth and 0 birth groups, respectively. Having 1 birth vs. 0 births was associated with a greater increase in visceral adipose tissue of 18.0 cm² (4.8, 31.2), P < 0.01; gain of 27.1 cm² (14.5, 39.7) vs. 9.2 cm² (4.8, 13.6), and a borderline greater increase in waist girth of 2.3 cm (0, 4.5), P = 0.05; gain of 6.3 cm (4.1, 8.5) vs. 4.0 cm (3.2, 4.8), controlling for gain in total body fat and covariates. Discussion: Pregnancy may be associated with preferential accumulation of adipose tissue in the visceral compartment for similar gains in total body fat. Further investigation is needed to confirm these findings and determine whether excess visceral fat deposition with pregnancy adversely affects metabolic risk profiles among women.     

Stability of Adiposity Phenotypes from Childhood and Adolescence into Young Adulthood with Contribution of Parental Measures

Objective: The stability of several indicators of body composition and adipose tissue distribution over 12 years was quantified. Research Methods and Procedures: The participants were 77 boys and 76 girls who were evaluated along with their parents at baseline as children and adolescents (8 to 18 years of age) and remeasured as young adults 12 years later. Indicators of body composition included the body mass index, fat mass, fat free mass, percentage of body fat, sum of six skinfolds (SF6), and the first principal component of six age‐adjusted skinfold residuals. Relative adipose tissue distribution was represented by the second principal component of skinfold residuals and a trunk‐to‐extremity skinfold ratio, adjusted for SF6. Results: Partial interage correlations, controlling for initial age and length of follow‐up, were 0.65 and 0.59 for the body mass index, 0.59 and 0.64 for fat mass, 0.65 and 0.57 for fat free mass, 0.50 and 0.57 for percentage of body fat, 0.66 and 0.44 for SF6, 0.64 and 0.42 for the first principal component of six age‐adjusted skinfold residuals, 0.19 and 0.31 for the second principal component of skinfold residuals, and 0.41 and 0.47 for trunk‐to‐extremity skinfold ratio, adjusted for SF6, in men and women, respectively. Multiple regression analyses indicated that the significant partial R² values of parental measurements on the prediction of their offspring in young adulthood ranged from 2% to 9%. Discussion: The results indicate moderately high stability of indicators of body composition and somewhat lower stability of measures of adipose tissue distribution. Overall, parental measures offer less predictive value than do measures of childhood and adolescent body composition and adipose tissue distribution.     

Placental weight mediates the effects of prenatal factors on fetal growth: the extent differs by preterm status

Objective:

Elevated pre‐pregnancy BMI, excessive gestational weight gain (GWG), and gestational diabetes mellitus (GDM) are known determinants of fetal growth. The role of placental weight is unclear. We aimed to examine the extent to which placental weight mediates the associations of pre‐pregnancy BMI, GWG, and GDM with birth weight‐for‐gestational age, and whether the relationships differ by preterm status.

Design and Methods:

We examined 1,035 mother‐infant pairs at birth from the Boston Birth Cohort. Data were collected by questionnaire and clinical measures. Placentas were weighed without membranes or umbilical cords. We performed sequential models excluding and including placental weight, stratified by preterm status.

Results:

We found that 21% of mothers were obese, 42% had excessive GWG, and 5% had GDM. Forty‐one percent were preterm. Among term births, after adjustment for sex, gestational age, maternal age, race, parity, education, smoking, and stress during pregnancy, birth weight‐for‐gestational age z‐score was 0.55 (0.30, 0.80) units higher for pre‐pregnancy obesity vs. normal weight. It was 0.34 (0.13, 0.55) higher for excessive vs. adequate GWG, 0.67 (0.24, 1.10) for GDM vs. no DM, with additional adjustment for pre‐pregnancy BMI. Adding placental weight to the models attenuated the estimates for pre‐pregnancy obesity by 20%, excessive GWG by 32%, and GDM by 21%. Among preterm infants, GDM was associated with 0.67 (0.34, 1.00) higher birth weight‐for‐gestational age z‐score, but pre‐pregnancy obesity and excessive GWG were not. Attenuation by placental weight was 36% for GDM.

Conclusions:

These results suggest that placental weight partially mediates the effects of pre‐pregnancy obesity, GDM, and excessive GWG on fetal growth among term infants.     

Single‐nucleotide Polymorphism of CD36 Locus and Obesity in European Adolescents

CD36 is a membrane receptor with a wide variety of functions, including the regulation of energy metabolism, fat storage, and adipocyte differentiation. To assess the relationship between CD36 gene single‐nucleotide polymorphisms (SNPs) and obesity in adolescents, we evaluated the relationship between CD36 SNPs and the risk of obesity in a case–control study composed of 307 obese (age = 15.0 ± 1.1 years) and 339 normal‐weight adolescents (age = 14.6 ± 1.1 years). To validate the results, we assessed the relation between the same SNPs and percentage of body fat (BF%) and BMI in 1,151 European adolescents (age = 14.8 ± 1.4 years). SNPs with a minor allele frequency >0.10 were selected to tag CD36. Genotyping was performed on an Illumina system. Four SNPs (rs3211867, rs3211883, rs3211908, and rs1527483) were associated with increased risk of obesity in the case–control study (odds ratio (OR) (95% confidence interval)): 1.96 (1.26–3.04], P = 0.003; 1.73 (1.16–2.59), P = 0.007; 2.42 (1.47–4.01), P = 0.0005 and 1.95 (1.25–3.05), P = 0.003, respectively). The same four SNPs were associated with higher BMI (P < 0.05) and BF% (P < 0.04) in the validation study. Further analyses identified a haplotype (frequency: 0.05) carrying the minor allele of these SNPs as being associated with obesity (OR: 2.28; P = 0.0008) in the case–control study and with excess adiposity (i.e., higher BF% (P = 0.03) and BMI (P = 0.04)) in the validation study. Our data suggest that genetic variability at the CD36 gene locus could be associated with body weight variability in European adolescents but these findings require replication.     

Atherogenecity of LDL and unfavorable adipokine profile in metabolically obese, normal-weight woman

Objective: The relationship of visceral adiposity with adipocytokines and low‐density lipoprotein (LDL) particle distribution and oxidation in Asian metabolically obese, normal‐weight (MONW) individuals has not been evaluated. We aimed to investigate the association between visceral adiposity and adipocytokines and cardiovascular disease (CVD) risk factors in MONW Korean women with normal glucose tolerance. Methods and Procedures: We examined the metabolic characteristics of 135 non‐obese (BMI <25 kg/m²) women aged 25–64 years. Twenty‐five women (BMI <25 kg/m² and visceral fat adiposity (VFA) ≥100 cm²) were classified as MONW and 25 women (BMI <25 kg/m² and VFA <100 cm²), pair‐matched for age, weight, height, and menopausal status, as control group. Plasma lipid profiles and adipocytokines were evaluated in these two groups. Results: MONW subjects had higher systolic (P < 0.05) and diastolic blood pressure (P < 0.005) and higher concentrations of triacylglycerol (TG) (P < 0.005), insulin (P < 0.01), and free fatty acid (FFA) (P < 0.05) than control subjects. There was no significant difference between two groups in LDL‐cholesterol (LDL‐C) concentrations; however, MONW subjects had smaller LDL particles (P < 0.01) and higher concentrations of oxidized LDL (ox‐LDL) (P < 0.05) compared with controls. Moreover, MONW subjects had higher concentrations of tumor necrosis factor‐α (TNF‐α) (P < 0.05), interleukin‐6 (IL‐6) (P < 0.05) and leptin (P < 0.05), and lower plasma adiponectin concentrations (P < 0.05). Higher intake of saturated fat with lower ratio of polyunsaturated fatty acids (PUFAs) to saturated fatty acids (SFA) and lower fiber intake than normal subjects were found in MONW women. Discussion: We found an unfavorable inflammatory profile and a more atherogenic LDL profile in MONW female subjects even in the absence of a known CVD risk factors. Moreover, MONW consumed more saturated fat and less fiber than the control group.