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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fat distribution (waist/hip ratio) was assessed in a population of 11,825 women, aged 40-73 years, presenting for routine breast cancer screening (the DOM project in Utrecht) in the period 1984 to 1986. Waist/hip ratio increased with increasing Quetelet's index and age. Postmenopausal women did not have higher waist/hip ratios compared to premenopausal women after adjustment for Quetelet's index and age. In pre- and postmenopausal women, waist/hip ratio increased with increasing number of cigarettes smoked per day (while Quetelet's index decreased) and a positive linear relationship was found between parity and waist/hip ratio (also after adjustment for Quetelet's index and age). Age at menarche was strongly inversely related to Quetelet's index but was not related to waist/hip ratio. In postmenopausal women, waist/hip ratio was lower in women who reported to use oestrogens for menopausal complaints in comparison with similar women who did not, but this difference disappeared after adjustment for age and degree of obesity. This study emphasizes the role of some variables that are associated with fat distribution and are potential confounders of risk estimates of abdominal obesity.
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PMID:Fat distribution in relation to age, degree of obesity, smoking habits, parity and estrogen use: a cross-sectional study in 11,825 Dutch women participating in the DOM-project. 222 8

It has been proposed that central obesity, by virtue of the enhanced lipolytic activity of abdominal adipose tissue, leads to higher plasma FFA concentrations, which, in turn, decrease both hepatic removal of insulin and insulin-stimulated glucose uptake by peripheral tissues. In short, the predicted consequences of abdominal obesity are elevations in circulating FFA and insulin levels as well as insulin resistance. The goal of this study was to evaluate the relationships predicted by the overall hypothesis; this study was carried out in 31 obese females, defined as having normal glucose tolerance (n = 12), impaired glucose tolerance (n = 8), or noninsulin-dependent diabetes mellitus (n = 11). Abdominal obesity was estimated by determining the ratio of waist to hip girth, fasting and postprandial plasma FFA and insulin concentrations were measured at hourly intervals from 0800-1600 h, and insulin-stimulated glucose disposal was quantified by the euglycemic hyperinsulinemic clamp technique. The first step in the postulated sequence of events to be tested was that the greater the WHR, the higher the total integrated plasma FFA response. The correlation coefficient between these two variables was 0.29, indicating that the results did not support the prediction. Furthermore, we could not demonstrate any relationship between the magnitude of the plasma FFA and insulin responses (r = 0.20; P = NS). However, there was a modest inverse relationship between height of circulating plasma insulin concentration and a decrease in insulin-stimulated glucose uptake (r = -0.43; P less than 0.03) in the group as a whole. On the other hand, when the three groups were analyzed individually, a significant inverse relationship was only seen in the control group (r = -0.67), and a direct relationship was actually seen in patients with impaired glucose tolerance (r = 0.88). Furthermore, when the mean responses for the variables in each of the three groups were compared, it was apparent that the postulated relationships between abdominal obesity, plasma FFA concentration, and insulin secretion and action were not present. Thus, the data presented do not support the hypothesis that differences in the degree of central obesity play an important role in regulation of plasma concentrations of either FFA or insulin or in modulation of insulin-stimulated glucose uptake in the patients we studied.
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PMID:Effect of central obesity on regulation of carbohydrate metabolism in obese patients with varying degrees of glucose tolerance. 222 87

Abdominal obesity is associated with high plasma triglyceride (TG) and with low plasma high density lipoprotein (HDL)-cholesterol (CHOL) levels. As plasma TG and HDL-CHOL are negatively correlated, the associations between obesity, the regional distribution of body fat, plasma TG levels, and plasma lipoprotein concentration and composition were studied in a sample of 76 premenopausal women (52 obese and 24 non-obese). Obese women had significantly higher plasma levels of VLDL-TG, low density lipoprotein (LDL)-CHOL, LDL-TG, LDL-apolipoprotein (apo) B and reduced HDL-CHOL levels compared to non-obese controls (p less than 0.01). However, plasma concentrations of HDL-apo A-I and HDL-TG were not different between obese and non-obese women. Partial correlation analyses revealed that both fat mass and abdominal fat accumulation significantly contributed to VLDL-TG and HDL-CHOL variances. After control for body fat mass, the waist-to-hip circumference ratio (WHR) remained significantly correlated with plasma LDL-apo B levels and with the LDL-apo B/LDL-CHOL ratio (0.01 greater than p less than 0.05). Body fat mass was, however, associated with TG enrichment of LDL (p less than 0.01). After control for WHR, body fat mass showed no significant association with plasma HDL-TG levels, whereas the WHR was positively correlated with HDL-TG levels (p less than 0.05). Partial correlation analyses indicated that adjustment for fat mass or for the WHR failed to eliminate the associations between plasma VLDL-TG levels and lipoprotein lipid composition. This study emphasizes the importance of plasma VLDL-TG level as a correlate of plasma LDL and HDL lipid composition in abdominal obesity.
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PMID:Relation of high plasma triglyceride levels associated with obesity and regional adipose tissue distribution to plasma lipoprotein-lipid composition in premenopausal women. 261 90

Whereas up to the end of the last century overweight reflected the privilege of the high society and her relative good health, the recent epidemiological studies have assessed the relations between body weight and general or cause specific morbidity and mortality. The major diseases associated with obesity are hypertension, atherosclerosis and diabetes, as well as certain types of cancer. Less well known complications include hepatic steatosis, gallbladder diseases, pulmonary function impairment, endocrine abnormalities, obstetric complications, trauma to the weight bearing joints, gout, cutaneous diseases, proteinuria, increased hemoglobin concentration and possibly immunologic impairments. From these wide epidemiological studies arise the definition of obesity: with an excess of 20% beyond the desirable weight, the complications bound to the overweight become statistically more frequent. Over there a U or J shaped curve illustrates the relation between the overweight and the degree of these various complications. An excess of 45 kg or more represents the critical level which defined "morbid obesity" with its own complications, the most important are sudden unexplained death, ventilatory disorders, circulatory congestion and functional limitations in activities of daily living and of course psychological consequences. When for certain complications, such as diabetes, the relationship with the overweight is evident, discrepancies between certain studies, especially for the cardiovascular diseases, had focused the attention on the regional patterns of fat distribution. Cross-sectional studies have shown abdominal obesity to be strongly associated with risk factors for cardiovascular disease, stroke and death independent of the total degree of obesity.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The contribution of epidemiology to the definition of obesity and its risk factors]. 266 68

Since there is evidence that fat distribution is a better predictor of cardiovascular disease than the degree of obesity, some risk factors for atherosclerosis have been evaluated in middle age Type II male diabetics and in obese subjects with and without glucose intolerance. In non-insulin-dependent diabetics (NIDD), abdominal obesity reflected by the waist/hip-circumference ratio (WHR) is related to parameters of metabolic control, lipid parameters, insulin status and response, hypertension, and vascular complications. High WHR is associated with: (a) significantly (p less than 0.01) higher HbA1 values than in the group without abdominal fat distribution; (b) a highly significant (p less than 0.001) negative correlation with high-density-lipoprotein cholesterol (HDL-C) and a positive correlation with the total/HDL-C ratio, which remains after correction for the body mass index; (c) higher apolipoprotein B concentrations; and (d) an elevated atherogenic index. Both fasting and postprandial insulin and C-peptide values may be a link between abdominal fat deposits and metabolic disturbances. Obese patients with upper body fat accumulation have significantly lower HDL-C levels, and a higher prevalence of glucose intolerance and diabetes than do patients with lower body fat obesity. Fasting glycemia, insulin, and the insulin area under the curve during an oral glucose load are significantly (p less than 0.005) increased in those with the greatest WHR, which is similar to that in NIDD and central obesity. An excess of abdominally located fat, even without manifest obesity, is associated with metabolic disturbances that indicate increased risk of atherogenesis and of higher morbidity and mortality, which may be due to characteristics of abdominally located adipocytes.
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PMID:Upper body adiposity and the risk for atherosclerosis. 269 50

Several expert panels have recommended the use of a body mass index (BMI = weight/height2) to assess obesity. Excessive risks of chronic diseases and mortality are clear when BMI exceeds 30 kg/m2. Probably more important in assessing the health risks of excessive fat stores is the distribution of fat over the body. Accumulation of fat in the abdominal cavity (mesenteric and omental fat) predisposes to important metabolic aberrations and leads to an increased incidence of diabetes mellitus, cardiovascular disease, and stroke. Importantly, the increased risks associated with abdominal obesity are seen in obese as well as in non-obese individuals.
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PMID:Overweight: fat distribution and health risks. Epidemiological observations. A review. 269 28

In order to assess the relationship between obesity and serum lipids, a homogenous group of adult men and premenopausal women is assessed for body mass index, body fat distribution reflected by the waist/hip ratio (WHR), serum lipid parameters and apolipoproteins. Body fat distribution is distinguished in an abdominal and gluteal-femoral type using a cut-off point of 1.00 for the ratio of waist-to-hips girth for men. In women the cut-off value is considered as 0.80 but was also evaluated when considered as 0.85. In the next step tertiles for WHR are created to show a graded relationship between WHR and lipoprotein fraction. The results indicate that WHR is an important determinant for most atherosclerosis-related lipids and apoproteins: in both men (P less than 0.05) and women (P less than 0.005) WHR is significantly correlated with apolipoprotein B. Using multiple regression analysis, in women WHR seems to be the most important dependent variable, where body mass index is not significantly contributing to the explained variance. In men, however, besides WHR age is the most significant variable, although age distribution is similar in men and women. Using tertiles of WHR, we show a clear graded relationship with most lipids and lipoproteins; this gives additionally an argument to confirm that in women WHR = 0.80 is the most accurate cut-off value for abdominal obesity. This study demonstrates that both obese men and women with an abdominal fat mass distribution show a lipid and apoprotein profile that is less favorable than that seen in gluteal-femoral obese subjects insofar as the risk of coronary artery disease is concerned.
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PMID:Apolipoprotein concentrations in obese subjects with upper and lower body fat mass distribution. 276 78

Due to the recent knowledge that the distribution of fat deposits would be a better predictor of cardiovascular disease than the degree of obesity, some risk factors for atherosclerosis were evaluated in middle age type II male diabetics and in obese subjects with and without glucose intolerance. In non-insulin dependent diabetes, abdominal adiposity reflected by the waist/hip-circumference (WHR) was related to parameters of metabolic control, lipid parameters, blood rheology, insulin status, hypertension and known vascular complications in three different groups. In the groups with abdominal obesity, the mean annual HbA1 is significantly (p less than 0.01) higher than the group without an abdominal fat mass distribution. Atherogenic index is significantly increased in the group with the highest WHR. HDL-cholesterol levels are significantly decreased in both groups with upper body fat distribution. A highly significant (p less than 0.001) correlation was present between WHR and HDL-cholesterol and WHR and total/HDL-cholesterol ratio; this significant correlation remains after correction for body mass index. Whole blood and plasma viscosity and fibrinogen levels are significantly (p less than 0.05) increased in diabetics with upper body fat accumulation and could be compared to patients with proven coronary ischemic heart disease. The frequency of peripheral vascular disease, coronary ischemic heart disease and hypertension is most prominent in diabetics with an abdominal fat mass distribution. Systolic blood pressure even seems to be increased in non-obese diabetics with the highest WHR. A correlation could be found between WHR and both systolic and diastolic blood pressure. When corrected for body mass index the same significant correlation between WHR and blood pressure remained. Both fasting and postprandial insulin and C-peptide values may be the link between abdominal fat deposits and all metabolic disturbances. These results confirm the negative effect of an excess of abdominally located fat cells, even without manifest obesity, on diabetes metabolic control, lipid fractions, hypertension, insulin behaviour, blood rheology and cardiovascular complications. In obese patients with upper body fat accumulation a higher prevalence of glucose intolerance and diabetes is present, in contrast to their counterparts with lower body fat deposit. Both fasting glycemia, insulin and insulin area are significantly (p less than 0.005) increased in the group with the greatest WHR.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Body fat mass distribution. Influence on metabolic and atherosclerotic parameters in non-insulin dependent diabetics and obese subjects with and without impaired glucose tolerance. Influence of weight reduction. 280 Jun 85

Recent research has shown that statistical correlation of disease is usually stronger to abdominal distribution of adipose tissue than to obesity. Abdominal distribution of adipose tissue in women is associated to other male characteristics of muscle tissue mass and morphology, as well as signs of androgenicity in circulating hormones. Abdominal adipose tissue is sensitive to lipolytic stimuli. It might be considered that the endocrine aberrations in combination with elevated concentrations of circulating free fatty acids might cause the complications associated with abdominal obesity.
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PMID:Are regional metabolic differences of adipose tissue responsible for different risks of obesity? 306 91

Femoral and abdominal adipose tissue cellularity and metabolism as well as muscle morphology and metabolism were examined in women with Cushing's syndrome and compared with those in nonobese women and obese women with the android and gynoid types of fat distribution. Cushing's syndrome was characterized by abdominal obesity and enlarged abdominal fat cells, with adipose tissue lipoprotein lipase activity elevated 2-3 times that in normal women and low lipolytic capacity. Muscle tissue in women with Cushing's syndrome had a relatively low proportion of type I (30%) and a high proportion of type IIB (32%) muscle fibers, similar to those in android obesity (45% and 25%, respectively) and in contrast to fiber composition in gynoid obesity (55% and 12%, respectively). Glycogen synthase activity in the lateral vastus muscle was very low. We suggest that the enlargement of abdominal fat depots in women with Cushing's syndrome is at least partially due to elevated adipocyte lipoprotein lipase activity and low lipolytic activity. Furthermore, the abnormal muscle fiber composition might be caused by the corticosteroid excess. Such muscle is known to be relatively insulin insensitive and might thus contribute to the marked insulin resistance that occurs during chronic corticosteroid excess.
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PMID:Muscle and adipose tissue morphology and metabolism in Cushing's syndrome. 314 10


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