DXA measurements confirm that parental perceptions of elevated adiposity in young children are poor

Objective: To compare parental assessments of child body weight status with BMI measurements and determine whether children who are incorrectly classified differ in body composition from those whose parents correctly rate child weight. Also to ascertain whether children of obese parents differ from those of non‐obese parents in actual or perceived body weight. Research Methods and Procedures: Weights, heights, BMI, and waist girths of New Zealand children ages 3 to 8 years were determined. Fat mass, fat percentage, and lean mass were measured by DXA (n = 96). Parents classified child weight status as underweight, normal‐weight, slightly overweight, or overweight. Centers for Disease Control and Prevention 2000 percentiles of BMI were used. Results: Parents underestimated child weight status. Despite having 83% more fat mass than children with BMI values below the 85th percentile, only 7 of 31 children with BMI values at or above the 85th percentile were rated as slightly overweight or overweight. In the whole sample, participants whose weight status was underestimated by parents (40 of the 96 children) had l9% less fat mass but similar lean mass as children whose weight status was correctly classified. However, children of obese and non‐obese parents did not differ in body composition or anthropometry, and obese parents did not underestimate child weight more than non‐obese parents. Discussion: Because parents underestimate child weight, but BMI values at or above the 85th percentile identify high body fat well, advising parents of the BMI status of their children should improve strategies to prevent excessive fat gain in young children.     

Increased Serum Cholesteryl Ester Transfer Protein in Obese Children

Objective: To determine whether serum cholesteryl ester transfer protein (CETP), which is one of the physiologically active gene products secreted from adipose tissue, is increased and associated with atherogenic lipoprotein profile in obese children. Research Methods and Procedures: Subjects were 42 consecutive outpatient Japanese obese children, 29 boys and 13 girls, ranging in age from 5 to 14 years, and 25 age‐matched non‐obese children, 13 boys and 12 girls, as the control group for measuring CETP mass. Blood was drawn after an overnight fast and, at the same time, and anthropometric measurements including height, body weight, waist girth, hip girth, and triceps and subscapular skinfold thicknesses were taken. Paired samples were obtained from 15 obese children who underwent psychoeducational therapy. Serum CETP mass was assayed by an enzyme‐linked immunosorbent assay. Results: The serum levels of triglyceride, total cholesterol (TC), low‐density lipoprotein cholesterol, TC/high‐density lipoprotein cholesterol (HDLC), apolipoproteins (apo) B, apo B/apo A₁, and insulin in obese children were significantly higher than the respective reference values. Serum CETP level was ～2‐fold higher (98.7 ± 3.6 vs. 50.9 ± 4.0 nM, means ± SEM, p < 0.001) in the obese children than in the controls. In 15 obese children, whose percentage of overweight declined during therapy, CETP levels decreased significantly. CETP level was correlated with HDLC, TC/HDLC, and insulin, and with percentage of overweight when the data of the obese and non‐obese children were combined. Discussion: CETP is increased and associated with the atherogenic lipoprotein profile in obese children.     

Obesity history as a predictor of walking limitation at old age

Objective: To study whether walking limitation at old age is determined by obesity history. Research Methods and Procedures: In a retrospective longitudinal study based on a representative sample of the Finnish population of 55 years and older (2055 women and 1337 men), maximal walking speed, body mass, and body height were measured in a health examination. Walking limitation was defined as walking speed <1.2 m/s or difficulty in walking 0.5 km. Recalled height at 20 years of age and recalled weight at 20, 30, 40, and 50 years of age were recorded. Results: Subjects who had been obese at the age of 30, 40, or 50 years had almost a 4‐fold higher risk of walking limitation compared to non‐obese. Obesity duration increased the age‐ and gender‐adjusted risk of walking limitation among those who had been obese since the age of 50 (odds ratio, 4.33; 95% confidence interval, 2.59 to 7.23, n = 114), among the obese since the age of 40 [6.01 (2.55 to 14.14), n = 39], and among the obese since the age of 30 [8.97 (3.06 to 26.29), n = 14]. The risk remained elevated even among those who had previously been obese but lost weight during their midlife or late adulthood [3.15 (1.63 to 6.11), n = 71]. Discussion: Early onset of obesity and obesity duration increased the risk of walking limitation, and the effect was only partially mediated through current BMI and higher risk of obesity‐related diseases. Preventing excess weight gain throughout one's life course is an important goal in order to promote good health and functioning in older age.     

Calcium and Dairy Intake and Measures of Obesity in Hyper‐ and Normocholesterolemic Children

Objective: Calcium intake has been inversely associated with body weight and body fatness in adults and, to a lesser extent, in children. Dairy intake has been inversely associated with metabolic syndrome in overweight but not normal‐weight adults. We assessed whether intakes of calcium and dairy foods were associated with measures of obesity in hypercholesterolemic (HC) and normocholesterolemic (non‐HC) children at baseline and over 1 year. Research Methods and Procedures: Non‐obese 4‐ to 10‐year‐old HC and non‐HC children (342) completed three 24‐hour dietary recalls and provided measures of relative weight (BMI and BMI z scores) and adiposity (sum of skinfolds, trunk skinfolds) at baseline, 3, 6, and 12 months. Cross‐sectional and longitudinal regression analyses, stratified by cholesterol risk status (HC vs. non‐HC) and age (4 to 6 years and 7 to 10 years) and adjusted for potential confounders, were conducted. Results: After adjusting for age, sex, energy intake, and percentage energy from fat, calcium intake was inversely associated with BMI, sum of skinfolds, and trunk skinfolds at baseline and over 1 year in the 7‐ to 10‐year‐old non‐HC children. Results from the regression models also indicated an inverse relation between intake of dairy foods and measures of obesity at baseline in these children. Calcium or dairy intake was not associated with measures of obesity in HC children or in the 4‐ to 6‐year‐old non‐HC children. Discussion: These results suggest a complex relation among intake of calcium and dairy foods, measures of obesity, age, and serum cholesterol in children. Older children without risk of metabolic syndrome may benefit most from increased calcium intake.     

Usefulness of Anthropometry and DXA in Predicting Intra‐abdominal Fat in Obese Men and Women

Objective: To investigate the usefulness of anthropometry and DXA in predicting intra‐abdominal fat (IAF) in obese men and women. Research Methods and Procedures: Observational, cross sectional study of 22 women and 18 men with a body mass index of 30 or above. IAF from 20 cm above and 10 cm below the L4 to L5 intervertebral disc was measured by magnetic resonance imaging (MRI) as a reference method. Central abdominal fat was measured from the upper border of L2 to the lower border of L4 by DXA. Waist and hip circumferences were also measured. Results: In obese women DXA, waist circumference and waist‐hip ratio were equally well correlated with IAF (r = 0.74, 0.75, and 0.70, respectively). In obese men DXA was moderately correlated with IAF measured by MRI (r = 0.46), whereas waist circumference and waist‐hip ratio were not significantly correlated with IAF. Discussion: The prediction of IAF in obese subjects was highly dependent on sex more than in non‐obese persons. Anthropometry and DXA were equally useful in obese women, whereas anthropometry had no predictive power and DXA was the only acceptable predictor of IAF in obese men.     

Increasing Fruit and Vegetable Intake and Decreasing Fat and Sugar Intake in Families at Risk for Childhood Obesity

Objective: The goal of this study was to evaluate the effect of a parent‐focused behavioral intervention on parent and child eating changes and on percentage of overweight changes in families that contain at least one obese parent and a non‐obese child. Research Methods and Procedures: Families with obese parents and non‐obese children were randomized to groups in which parents were provided a comprehensive behavioral weight‐control program and were encouraged to increase fruit and vegetable intake or decrease intake of high‐fat/high‐sugar foods. Child materials targeted the same dietary changes as their parents without caloric restriction. Results: Changes over 1 year showed that treatment influenced targeted parent and child fruit and vegetable intake and high‐fat/high‐sugar intake, with the Increase Fruit and Vegetable group also decreasing their consumption of high‐fat/high‐sugar foods. Parents in the increased fruit and vegetable group showed significantly greater decreases in percentage of overweight than parents in the decreased high‐fat/high‐sugar group. Discussion: These results suggest that focusing on increasing intake of healthy foods may be a useful approach for nutritional change in obese parents and their children.     

The Feet of Overweight and Obese Young Children: Are They Flat or Fat?

Objective: The purpose of this study was to determine whether the flat feet displayed by young obese and overweight children are attributable to the presence of a thicker midfoot plantar fat pad or a lowering of the longitudinal arch relative to that in non‐overweight children. Research Methods and Procedures: Foot anthropometry, an arch index derived from plantar footprints, and midfoot plantar fat pad thickness measured by ultrasound were obtained for 19 overweight/obese preschool children (mean age, 4.3 ± 0.9 years; mean height, 1.07 ± 0.1 m; mean BMI, 18.6 ± 1.2 kg/m²) and 19 non‐overweight children matched for age, height, and sex (mean age, 4.3 ± 0.7 years; mean height, 1.05 ± 0.1 m; mean BMI, 15.7 ± 0.7 kg/m²). Results: Independent t tests revealed no significant between‐subject group differences (p = 0.39) in the thickness of the midfoot plantar fat pad. However, the overweight/obese children had a significantly lower plantar arch height (0.9 ± 0.3 cm) than their non‐overweight counterparts (1.1 ± 0.2 cm; p = 0.04). Discussion: The lower plantar arch height found in the overweight/obese children suggests that the flatter feet characteristic of overweight/obese preschool children may be caused by structural changes in their foot anatomy. It is postulated that these structural changes, which may adversely affect the functional capacity of the medial longitudinal arch, might be exacerbated if excess weight bearing continues throughout childhood and into adulthood.     

Overweight and Obesity: Two Predictors for Worse Early Outcome in Total Hip Replacement?

Objective: Doctors and patients assume that overweight and obesity are negative predictors for good and excellent early outcome after total hip replacement. It was the purpose of this prospective investigation to assess whether overweight or obese patients have worse early postoperative outcome in comparison with normal‐weight patients. Research Methods and Procedures: Sixty‐seven consecutive patients receiving a total hip replacement were enrolled in the study. Patients were grouped into three samples according to BMI: normal‐weight (BMI < 25 kg/m², n = 11), overweight (BMI 25 to 29.9 kg/m², n = 36), and obese (BMI ≥30 kg/m², n = 20). At 10 days and at 3 months after surgery, the patient‐centered outcome was analyzed with a self‐administered assessment chart, the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index. Statistical analysis was performed with a multiple regression model that took into consideration further confounding parameters (age, sex, affected side, anchorage of the implant, duration of surgery, hospital length of stay, and prior pain, stiffness, and function). Results: No significant influence of individual BMI on subjective outcome according to the WOMAC questionnaire was observed at either 10 days or 3 months after surgery. Hospital length of stay was comparable, and WOMAC scores did not differ significantly preoperatively, at 10 days, or at 3 months postoperatively among patients with different BMI. Discussion: These data showed that the BMI of the patients in our study sample had no significant impact on early outcome or hospital length of stay after total hip replacement. Our data suggest, therefore, that body weight should not be a justification for withholding surgery from overweight or obese patients.     

Obesity does not increase external mechanical work per kilogram body mass during walking

Walking is the most common type of physical activity prescribed for the treatment of obesity. The net metabolic rate during level walking (W/kg) is ~10% greater in obese vs. normal weight adults. External mechanical work (W_ext) is one of the primary determinants of the metabolic cost of walking, but the effects of obesity on W_ext have not been clearly established. The purpose of this study was to compare W_ext between obese and normal weight adults across a range of walking speeds. We hypothesized that W_ext (J/step) would be greater in obese adults but W_ext normalized to body mass would be similar in obese and normal weight adults. We collected right leg three-dimensional ground reaction forces (GRF) while twenty adults (10 obese, BMI=35.6 kg/m² and 10 normal weight, BMI=22.1 kg/m²) walked on a level, dual-belt force measuring treadmill at six speeds (0.50–1.75 m/s). We used the individual limb method (ILM) to calculate external work done on the center of mass. Absolute W_ext (J/step) was greater in obese vs. normal weight adults at each walking speed, but relative W_ext (J/step/kg) was similar between the groups. Step frequencies were not different. These results suggest that W_ext is not responsible for the greater metabolic cost of walking (W/kg) in moderately obese adults.     

Vitamin D status and response to Vitamin D(3) in obese vs. non-obese African American children

Background: Serum 25‐hydroxyvitamin D (25(OH)D) is low in obese adults. Objective: To examine serum 25(OH)D in obese (BMI >95th percentile for age) vs. non‐obese (BMI = 5th–75th percentile for age) 6–10‐year‐old African American children and compare their differences in therapeutic response to vitamin D supplementation. Methods and Procedures: In an open label non‐randomized pre‐post comparison 21 obese (OB) and 20 non‐obese (non‐OB) subjects matched for age, sex, skin color, and pubertal maturation were treated with 400 IU of vitamin D₃ daily for 1 month. Serum 25(OH)D, 1,25‐dihydroxyvitamin D (1,25(OH)₂D), parathyroid hormone (PTH), leptin, and markers of bone turnover (serum bone‐specific alkaline phosphatase (BSAP), osteocalcin (OC), and urine n ‐telopeptide cross‐links of type 1 collagen (urine NTX)) were measured. Vitamin D deficiency was defined as serum 25(OH)D ≤20 ng/ml and insufficiency as 21–29 ng/ml respectively. Results: Vitamin D deficiency occurred in 12/21 (57%) OB vs. 8/20 (40%) non‐OB at baseline (P = 0.35) and persisted in 5/21 (24%) OB vs. 2/18 (11%) non‐OB (P = 0.42) after treatment. When the cohort was stratified by the baseline levels of 25(OH)D, there were differences in the response to treatment in the obese and non‐obese cohorts. Discussion: Vitamin D deficiency was common among OB and non‐OB preadolescent African American children, and 400 IU of vitamin D₃ (2× the recommended adequate intake) daily for 1 month was inadequate to raise their blood levels of 25(OH)D to ≥30 ng/ml.     

The effects of Goami No. 2 rice, a natural fiber-rich rice, on body weight and lipid metabolism

Objective : Increased intake of dietary fiber reduces the risk of obesity and type 2 diabetes. We assessed the effects of a fiber‐rich diet on body weight, adipokine concentrations, and the metabolism of glucose and lipids in non‐obese and obese subjects in Korea, where rice is the main source of dietary carbohydrates. Research Methods and Procedures : Eleven healthy, non‐obese and 10 obese subjects completed two 4‐week phases of individual isoenergetic food intake. During the control diet phase, subjects consumed standard rice; during the modified diet phase, subjects consumed equal proportions of fiber‐rich Goami No. 2 rice and standard rice. We used a randomized, controlled, crossover study design with a washout period of 6 weeks between the two phases. Results : After the modified diet phase, body weight was significantly lower in both the non‐obese and obese subjects (non‐obese, 57.0 ± 2.9 vs. 56.1 ± 2.8 kg, p = 0.001; obese, 67.7 ± 2.1 vs. 65.7 ± 2.0 kg, p < 0.001 for before vs. after). The BMI was significantly lower in obese subjects (26.9 ± 0.5 vs. 26.0 ± 0.6 kg/m², p < 0.001). The modified diet was associated with lower serum triacylglycerol (p < 0.01), total cholesterol (p < 0.01), low‐density lipoprotein cholesterol (p < 0.05), and C‐peptide (p < 0.05) concentrations in the obese subjects. Discussion : These results indicate that fiber‐rich Goami No. 2 rice has beneficial effects and may be therapeutically useful for obese subjects.     

Effect of weight loss on free insulin-like growth factor-I in obese women with hyposomatotropism

Objective: It has been hypothesized that increased free insulin‐like growth factor (IGF)‐I levels generated from an increase in IGF‐binding protein (IGFBP) protease activity could be the inhibitory mechanism for the decreased growth hormone (GH) secretion observed in obese subjects. Research Methods and Procedures: In this study, we determined basal and 24‐hour levels of free IGF‐I and ‐II, total IGF‐I and ‐II, IGFBP‐1, as well as basal IGFBP‐2, ?3, and ?4, acid‐labile subunit (ALS), IGFBP‐1, ?2, and ?3 protease activity, and 24‐hour GH release in obese women before and after a diet‐induced weight loss. Sixteen obese women (age, 29.5 ± 1.4 years) participated in a weight loss program and 16 age‐matched non‐obese women served as controls. Results: Circulating free IGF‐I and 24‐hour GH release were significantly decreased in obese women at before weight loss compared with non‐obese women (1.29 ± 0.12 vs. 0.60 ± 0.09 μg/L; p < 0.001 and 862 ± 90 vs. 404 ± 77 mU/24 hours; p < 0.001, respectively). Free IGF‐I and 24‐hour GH release were not inversely correlated to each other. IGFBP‐1 and ?2 levels were decreased, whereas ALS, IGFBP‐3 and ?4, and IGFBP‐1, ?2, and ?3 protease activity were similar in obese and non‐obese women. Eight of the 16 obese women achieved an average weight loss of 30 ± 5 kg during 26 to 60 weeks of dieting. After the considerable weight loss, significant differences in free IGF‐I, GH release, and IGFBP‐1 and ?2 levels were no longer present between previously obese and non‐obese women. Discussion: We showed that circulating free IGF‐I is markedly decreased in severely obese women and does not per se mediate the concomitant hyposomatotropism. The decreased levels of free IGF‐I seem to be transient and restored to normal levels after weight loss.     

Obesity and inpatient rehabilitation outcomes following knee arthroplasty: a multicenter study

Objective: This multicenter study examined whether inpatient rehabilitation outcomes following total knee arthroplasty (TKA) were influenced by BMI. Methods and Procedures: This was a retrospective, comparative study conducted using a computerized medical database and medical records derived from TKA patients, at 15 independent rehabilitation hospitals (N = 5,428). Patients were separated into four groups based on BMI: non‐obese (BMI < 25 kg/m²), overweight (25–29.9 kg/m²), moderately obese (30–40 kg/m²), severely obese (BMI ≥ 40 kg/m²). All patients completed an interdisciplinary inpatient rehabilitation program post‐TKA. Total and individual functional independence measure (FIM) scores, length of stay (LOS), FIM efficiency scores, itemized hospital charges, and discharge disposition location, were collected. Results: The percentage of total FIM change was 7.5% greater by the time of discharge in the non‐obese than in the very severely obese (P < 0.05). FIM efficiency was lowest in the severely obese as compared to the remaining groups (3.7 points (pts)/day vs. 4.0–4.3 pts/day; P = 0.044). The change in the motor FIM score from admission to discharge was 6.7–15.6% greater in the non‐obese than in the remaining groups (P < 0.05). The changes in cognition FIM, toilet transfer and walking without assistance scores were higher in the non‐obese as compared to the severely obese group (P < 0.05). The severely obese group had higher total, physical and occupational therapy and pharmacy charges than the remaining groups (P < 0.05). Discussion: An excessive BMI does not prevent gains during inpatient rehabilitation; however, these gains are made less efficiently and at a higher cost than those made when the BMI is low.     

Characteristic gait patterns in older adults with obesity—Results from the Baltimore Longitudinal Study of Aging

Obesity in older adults is a growing public health problem. Excess weight causes biomechanical burden to lower extremity joints and contribute to joint pathology. The aim of this study was to identify specific characteristics of gait associated with body mass index (BMI). Preferred and maximum speed walking and related gait characteristics were examined in 164 (50–84 years) participants from Baltimore Longitudinal Study of Aging (BLSA) able to walk unassisted. Participants were divided into three groups based on their BMI: normal weight (19≤BMI<25 kg/m²), overweight (25≤BMI<30 kg/m²) and obese (BMI 30≤BMI<40 kg/m²). Total ankle generative mechanical work expenditure (MWE) in the anterior–posterior (AP) plane was progressively and significantly lower with increase in BMI for both preferred (p=0.026) and maximum speed walking (p<0.001). In the medial–lateral (ML) plane, total knee generative MWE was higher in obese participants in the preferred speed task (p=0.002), and total hip absorptive MWE was higher in obese in both preferred speed (p<0.001) and maximum speed (p=0.002) walking task compared to the normal weight participants. Older adults with obesity show spatiotemporal gait patterns that may help in reducing contact impacts. In addition, in obese persons mechanical energy usages tend to be lower in the AP plane and higher in the ML plane. Since forward progression forces are mainly implicated in normal walking, this pattern found in obese participants is suggestive of lower energetic efficiency.     

Changes in obesity-related attitudes in women seeking weight reduction

Objective: To examine changes in obesity‐related attitudes in a sample of obese women who participated in either dieting or non‐dieting interventions. Research Methods and Procedures: A total of 123 obese women were randomly assigned to one of three weight control programs: meal replacement diet, balanced deficit diet, or a non‐dieting program. (The first two groups were combined as a single dieting condition.) Participants completed questionnaires (at baseline, Week 20, and Week 40) to assess beliefs and attitudes about obesity, along with measures of self‐esteem, depression, and body image. Results: At Weeks 20 and 40, participants in the non‐dieting condition reported significantly less negativity about obesity than those in the dieting group. Women in the dieting condition did not report an increase in negative attitudes toward obesity, despite losing significantly more weight than non‐dieting participants. Both groups experienced improvements in self‐esteem, body image, and depressive symptoms. Improvement in self‐esteem was associated with a reduction in negativity about obesity and with improvements in body image. Discussion: The non‐dieting program produced greater reductions in negative attitudes toward obesity than the dieting intervention. Dieting (with successful weight loss), however, did not result in greater negativity toward obesity. Non‐dieting programs seem to be useful in obese women for improving self‐esteem, body image, and internalized negative attitudes about obesity.     

The growth of children in relation to the timing of obesity development

Objective: To examine whether there is an association between the timing of the development of obesity and children's growth. Research Methods and Procedures: This study investigated 141 prepubertal obese children (76 girls) and 72 healthy non‐obese children (39 girls). The target height standard deviation score (SDS), the percentage weight for height, and the height SDS (H‐SDS) at presentation and at the age of 2 years were calculated. Patients were classified, according to whether obesity developed before or after the age of 3 years, as presenting with early‐onset or late‐onset obesity, respectively. Results: Mean age (±SD) at presentation was 9.4 (2.1) years. At the age of 2 years, the H‐SDS of the children with early‐onset obesity was 1.3 (1.0) vs. 0.9 (1.3) for the late‐onset obese (p > 0.5) and 0.4 (1.0) for controls (p < 0.001), and the children with late‐onset obesity were also significantly taller than controls (p < 0.005). At presentation, children with early‐onset obesity were significantly taller than children with late‐onset obesity [1.1 (0.8) vs. 0.6 (1.0); p < 0.001] and controls [0.2 (0.8); p < 0.001]. There was no increase in H‐SDS after the age of 2 years in the late‐onset obese children (p > 0.05). H‐SDS values were below average in 21% of the children with late‐onset obesity and in only 4% of the children with early‐onset obesity. Discussion: These findings indicate that late development of obesity is not associated with increased stature in prepubertal children; however, it may be preceded by growth acceleration in the early years of life. Growth acceleration in early life may be a predictor for future obesity.     

Ground reaction forces and lower-limb joint kinetics of turning gait in typically developing children

Turning is a common locomotor task essential to daily activity; however, very little is known about the forces and moments responsible for the kinematic adaptations occurring relative to straight-line gait in typically developing children. Thus, the aims of this study were to analyse ground reaction forces (GRFs), ground reaction free vertical torque (T_Z), and the lower-limb joint kinetics of 90° outside (step) and inside (spin) limb turns. Step, spin, and straight walking trials from fifty-four typically developing children were analysed. All children were fit with the Plug-in Gait and Oxford Foot Model marker sets while walking over force plates embedded in the walkway. Net internal joint moments and power were computed via a standard inverse dynamics approach. All dependent variables were statistically analysed over the entire curves using the mean difference 95% bootstrap confidence band approach. GRFs were directed medially for step turns and laterally for spin turns during the turning phase. Directions were reversed and magnitudes decreased during the approach phase. Step turns showed reduced ankle power generation, while spin turns showed large T_Z. Both strategies required large knee and hip coronal and transverse plane moments during swing. These kinetic differences highlight adaptations required to maintain stability and reorient the body towards the new walking direction during turning. From a clinical perspective, turning gait may better reveal weaknesses and motor control deficits than straight walking in pathological populations, such as children with cerebral palsy, and could potentially be implemented in standard gait analysis sessions.     

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.     

Visceral adiposity is associated with serum retinol binding protein-4 levels in healthy women

Objective: Retinol binding protein‐4 (RBP4) has been reported to impair insulin sensitivity throughout the body. We investigated the relationship between serum RBP4 levels and adiposity indices as well as metabolic risk variables. Research Methods and Procedure: We recruited a total of 102 healthy women 21 to 67 years old. We assessed body composition by computed tomography and divided the study population into four groups based on body weight and visceral fat area (non‐obese without visceral adiposity, non‐obese with visceral adiposity, obese without visceral adiposity, and obese with visceral adiposity). Serum RBP4 levels were measured by radioimmunoassay. Results: Despite similar levels of total body fat, non‐obese women had lower systolic blood pressure, total cholesterol, triglyceride (TG), low‐density lipoprotein (LDL)‐cholesterol levels, insulin resistance indices, and RBP4 levels than non‐obese women with visceral adiposity and had higher high‐density lipoprotein‐cholesterol levels. Similarly, obese women without visceral adiposity had lower blood pressure, total cholesterol, TG levels, insulin resistance indices, and RBP4 levels than obese women with visceral adiposity. In addition, despite having increased body fat, obese women without visceral adiposity had lower TGs, insulin resistance indices, and serum RBP4 levels than non‐obese women with visceral adiposity. By step‐wise multiple regression analysis, visceral fat areas and LDL‐cholesterol levels independently affected RBP4 levels. Discussion: We determined that serum RBP4 levels are independently associated with visceral fat and LDL‐cholesterol levels. These results suggest that, irrespective of body weight, visceral obesity is an independent predictor of serum RBP4 levels, and RBP4 may represent a link between visceral obesity and cardiovascular disease.