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Biomedical subjects

J C Seidell

Publications and source records attributed to J C Seidell.

At least 181 records · Page 10Linked to original sources
PubMed1990

The relationship between fat distribution and some chronic diseases in 11,825 women participating in the DOM-project.

The prevalence of reported chronic diseases was studied in quintiles of waist/hip ratio and Quetelet index in 11,825 women aged 40-73 presenting for mammographic screening in the DOM-project. After adjustment for age and Quetelet index, increased waist/hip ratio was found to be associated with an increased prevalence of diabetes mellitus, hypertension, cholecystectomy and a lower prevalence of varicose veins. No associations were observed between waist/hip ratio and the prevalence of angina pectoris, gout and rheumatism. The odds ratios, adjusted for age and Quetelet index, of the highest versus the lowest quintile of waist/hip ratio were 3.4 (95% CI 1.4-8.3) for diabetes mellitus; 2.2 (95% CI 1.7-2.8) for hypertension; 2.0 (95% CI 1.2-3.4) for cholecystectomy, and 0.81 (95% CI 0.68-0.95) for varicose veins. After adjustment for waist/hip ratio and age, Quetelet index was found to be associated with an increased prevalence of hypertension, cholecystectomy and varicose veins. Quetelet index, however, was not found to be related to diabetes, gout or rheumatism. We conclude that in a representative sample of Dutch women older than 40 years, fat distribution in addition to overweight is related to important chronic diseases.

Adipose Tissue↗
PubMed1990

Glucose tolerance and hyperinsulinaemia in obese women: role of adipose tissue distribution, muscle fibre characteristics and androgens.

The separate independent statistical contribution of abdominal distribution of fat, hyperandrogenicity and muscle morphology to glucose intolerance and hyperinsulinaemia was analysed in 88 obese women. In univariate analyses the waist/hip circumference ratio (WHR), body fat and lean body mass were all positively associated, and SHBG levels were negatively associated with insulin and glucose values. Muscle fibre areas were positively correlated with insulin but not with glucose concentrations. Adjustment for other variables did not remove the positive association between WHR and fasting insulin and glucose concentrations. SHBG, free testosterone and type IIb fibre areas were, however, significant confounding factors in the relationship between WHR and summed insulin and glucose concentrations. We conclude that fat distribution in obese women is associated with fasting hyperglycaemia and hyperinsulinaemia, independently of androgens and muscle fibre morphology, but that reduced SHBG concentrations and increased type IIb fibre areas may partly explain increased glucose and insulin responses to an oral glucose load in abdominally obese women.

Abdomen↗
PubMed1990

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.

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.

Adipose Tissue↗
PubMed1989

Fat distribution, androgens, and metabolism in nonobese women.

Eighty-five randomly selected women, all born in 1948, were studied. All were nonobese (body mass index [BMI], 23.3 +/- 0.3 (means +/- SD]). The relationships between three indicators of fat distribution (waist-hip, waist-thigh, and subscapular-triceps ratios) and hormonal and metabolic variables were studied. Increased androgenic activity (ratio of free testosterone [T] to total testosterone [free-total T ratio]) and degree of obesity (BMI) were independently related to increased waist-hip ratio. Waist-hip and waist-thigh ratios showed higher correlations with all metabolic variables than did the triceps-subscapular skinfold thickness ratio except for diastolic blood pressure. After adjustment for BMI and free-total T ratio, the waist-hip ratio was still significantly positively related to total cholesterol and C peptide and negatively to the HDL-total cholesterol ratio. In such multiple regression, BMI was independently related to insulin, C peptide, and diastolic blood pressure. The free-total T ratio was independently related to triglycerides. BMI and waist-hip ratio gave important complementary information about risk factors for diseases such as cardiovascular disease and diabetes mellitus.

Adipose Tissue↗
PubMed1989

Indicators of fat distribution, serum lipids, and blood pressure in European women born in 1948--the European Fat Distribution Study.

In the spring of 1986, the authors studied the relation between body mass index and anthropometric indicators of fat distribution to cardiovascular risk factors (serum lipids and blood pressure) in approximately 450 women aged 38 years randomly selected from population registers in five European centers. Waist circumference was, in univariate analysis, more strongly related to triglycerides (positive association) and high density lipoprotein (HDL) cholesterol (negative association) than to body mass index or any other anthropometric measurement. Among the centers, we observed considerable variation in the strength of the associations between anthropometric measurements and risk factors. After adjustment for body mass index, most associations between skinfolds and circumferences and risk factors were reduced to statistically nonsignificant levels, but in some centers there were independent contributions of circumferences or circumference ratios to serum lipids, but not to blood pressures. Adjustment for differences in body mass index and fat distribution between the centers did not reduce the differences in cardiovascular risk factors between the different centers but instead revealed that serum cholesterol levels were lowest in the centers of southern Europe (Italy) and that HDL cholesterol levels were higher. Blood pressure was highest in the Swedish women. We conclude that in some female populations, but not in others, indicators of fat distribution are related to serum lipids but not to blood pressure, independent of body mass index.

Adipose Tissue↗
PubMed1989

Overweight: fat distribution and health risks. Epidemiological observations. A review.

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.

Abdomen↗
PubMed1989

Fat distribution and gamma-glutamyl transferase in relation to serum lipids and blood pressure in 38-year old Dutch males.

In this study we describe the associations between indicators of fatness, fat distribution, and alcohol consumption (gamma-glutamyl transferase) with serum lipids and blood pressure in a random selected group (n = 69) of 38-year old men. Waist circumference, subscapular skinfold and body mass index all had similar positive associations with total cholesterol, triglycerides and diastolic blood pressure. Gamma-glutamyl transferase levels were associated with indicators of fatness and fat distribution (waist circumference, waist/hip ratio, body mass index, and subscapular skinfold) and serum lipids (total cholesterol, LDL-cholesterol, triglycerides). Gamma-glutamyl transferase and body mass index both made independent contributions to the explanation of the waist/hip ratio. In multiple regression analysis, gamma-glutamyl transferase levels were (after adjustment for waist/hip ratio and body mass index) associated with serum lipids (total cholesterol, LDL-cholesterol, and triglycerides), but not with HDL-cholesterol and blood pressure. Body mass index only showed an independent relation to triglyceride levels, whereas the waist/hip ratio was only associated with diastolic blood pressure in multiple regression. It is concluded that gamma-glutamyl transferase levels are a potentially important indicator of abdominal fat distribution and unfavourable lipoprotein profiles.

Adipose Tissue↗
PubMed1989

Factors influencing waist/hip ratio in randomly selected pre- and post-menopausal women in the dom-project (preliminary results).

In 452 pre- and post-menopausal women aged 41-75, participating in a breast cancer screening programme, we studied the associations between several factors and waist/hip ratio. Differences in waist/hip ratio between pre- and post-menopausal women could be accounted for by age and degree of obesity. In post-menopausal women, waist/hip ratio was positively related to age, independently of the degree of obesity. Post-menopausal women who reported to use oestrogens for menopausal complaints were found to have lower waist/hip values compared to non-users (0.74 vs 0.78 P less than 0.05). Waist/hip ratio was not related to age at menopause, age at menarche or parity. We confirmed that the Quetelet's index is positively related to waist/hip ratio and that, at least before menopause, smokers have higher waist/hip values compared to non-smokers although the mechanisms for such an association remain obscure. Hypertension was associated with abdominal fat distribution in premenopausal but not in post-menopausal women. Diabetes mellitus was associated with abdominal fat distribution in post-menopausal women. These observations in this cross-sectional study suggest that environmental factors (smoking and oestrogen use after menopause) relate to the distribution of fat over the body. The other observations illustrate the importance of stratifying for menopausal status in studies on fat distribution in women.

Adipose Tissue↗
PubMed1989

Regional distribution of muscle and fat mass in men--new insight into the risk of abdominal obesity using computed tomography.

We studied 24 healthy men (25-50 years old) covering a wide range of fatness (body mass index range: 21-34 kg/m2) and fat distribution (waist/hip range: 0.75-1.06). Computed tomography scans were taken at five levels (thigh, hip, waist, arm, and liver) from which fat, muscle and bone areas were calculated. Both waist/hip and BMI were correlated with fat areas in the thigh, arm and waist scans. BMI showed stronger correlations with peripheral fat areas, whereas waist/hip showed stronger correlations with fat areas in the waist scan (particularly with visceral fat area: r = 0.88, P less than 0.001). BMI was correlated with muscle and bone areas in the thigh scan. In multiple regression BMI was, independently of waist/hip and age, positively correlated with fat areas in the arm, thigh, and waist (not with visceral fat) and muscle and bone areas in the thigh. Waist/hip was independently of BMI and age correlated with fat areas in the arm and waist, including visceral fat area (but not with fat areas in the thigh). Moreover, waist/hip showed an independent negative correlation with muscle area in the thigh, muscle endurance and physical activity. Serum triglycerides, plasma insulin, glucose, uric acid and diastolic and systolic blood pressure were associated with visceral fat area but also to anthropometric indicators of abdominal fat distribution (especially waist/hip ratio). Liver attenuation, but not the liver/spleen attenuation ratio, was associated with some liver enzymes and BMI but not with waist/hip or metabolic parameters. We conclude that a higher BMI is associated with increased central and peripheral fat stores (but not visceral fat) and increased thigh muscle whereas waist/hip is primarily associated with increased central fat stores (noteably with visceral fat), decreased thigh muscle and reduced physical fitness. It is suggested that physical training might be an important element in the treatment of abdominal obesity in men.

Abdomen↗
PubMed1988

Regional obesity and serum lipids in European women born in 1948. A multicenter study.

In five different cities in four European countries, women born in 1948 were randomly selected. Anthropometric measurements (i.e. circumferences and skinfolds) were taken. Serum lipids were determined in one laboratory. Different levels of waist circumferences gave different averages and distribution of waist/hip ratio, which confirms the need of precise standardization of these measurements. Women in southern parts of Europe were more overweight than in Northern Europe (partly due to selection bias in Naples) and, when adjusted for that, southern women had a more central distribution of fat (higher waist/thigh, lower triceps/subscapula). When data were pooled, circumference ratios were positively correlated with triglycerides and total cholesterol and negatively with HDL cholesterol. Occupation of husband and body mass index were associated with fat distribution and triglycerides and HDL cholesterol. In multiple regression fat distribution was still correlated with serum lipids but differences in serum lipids between countries did not diminish.

Adult↗
PubMed1988

Measures of fat distribution as determinants of serum lipids in healthy volunteers consuming a uniform standardized diet.

The relation was investigated between body fat topology and serum lipoproteins in healthy, nonobese men and women. Twenty-four men and 24 women consumed a standardized affluent diet for 17 days. Serum was obtained after 14 and 17 days. Regression coefficients of lipids and lipoproteins with age, body mass index, measures of fat distribution, and estimates of fat areas at a cross-section of the body at the level of the umbilicus, were calculated. Waist-to-thigh circumference ratio proved to be the strongest correlate of serum lipids compared with other measures of fat distribution. Upon multiple regression analysis, the waist-to-thigh ratio proved to be a stronger predictor of total cholesterol, LDL-cholesterol and triglyceride levels in men than either age or body mass index. In women this was only true for HDL3-cholesterol. In addition, no significant relations were observed any more of age and body mass index with these serum lipids, with the exception of age for IDL-cholesterol in men. Estimates of intra-abdominal fat area showed in general a stronger correlation with serum lipids than estimates of subcutaneous fat area. It is concluded that, in non-obese subjects, fat distribution is a stronger determinant of serum lipids than either body mass index or age.

Adipose Tissue↗
PubMed1988

Abdominal fat depots measured with computed tomography: effects of degree of obesity, sex, and age.

Computed tomography scans at the level of L4/L5 were analysed in 66 men and 34 women who presented for routine tomography, stratified into different age categories. Areas of intra-abdominal fat and subcutaneous abdominal fat were calculated from the scans. In men and in women the proportion of the body surface as intra-abdominal fat increased with age (in men from 12.4 per cent in the age group less than 40 years to 18.0 per cent in the age group greater than 65 years; in women from 10.5 per cent to 14.7 per cent in the respective age categories). Only in men this increase with age was independent of the degree of obesity. In women younger than 40 years the proportion of intra-abdominal fat did not increase with increasing BMI while it did in older women and men. The proportion of intra-abdominal fat in 7 adolescents appeared to be 5.4 per cent, considerably lower compared to adult men and women. Subcutaneous fat areas increased with the degree of obesity but not with age. From simple anthropometric measurements, the intra-abdominal fat area was best correlated with the waist circumference in all ages (except for women younger than 40 years) while it showed weaker associations with abdominal skinfolds and circumference ratios. Age and BMI explained 68 and 74 per cent of the variance in intra-abdominal fat area in men and women respectively. Waist added 8 per cent to the explained variance in men but nothing in women. BMI and waist circumference showed similar correlations to total, intra-abdominal and subcutaneous fat areas in all age categories whereas correlations of skinfolds with intra-abdominal fat areas decreased with age.

Abdomen↗
PubMed1987

Assessment of intra-abdominal and subcutaneous abdominal fat: relation between anthropometry and computed tomography.

The ability to distinguish between intra-abdominal and subcutaneous abdominal fat may be important in epidemiologic and clinical research. In this study anthropometric measurements were taken from 71 men and 34 women presenting for routine computed tomography (CT). Areas of abdominal fat were calculated from CT scans made at the level of the L4 vertebra. The amounts of intra-abdominal and subcutaneous abdominal fat could be accurately predicted from several circumferences, skinfold measurements, body mass index, and age (R2 ranged from 0.79 to 0.84). In addition, it was found that the area of intra-abdominal fat on the CT scan was related to the waist:hip circumference ratio (r = 0.75 in men, r = 0.55 in women) and to the waist:thigh circumference ratio (r = 0.55 in men, r = 0.70 in women). The correlations of the circumference ratios with the areas of subcutaneous fat were invariably lower.

Abdomen↗
PubMed1987

Development of hypertension in obese subjects seen in general practice.

A group of 317 overweight men and 565 overweight women was compared with an age-matched normal control group of 444 men and 627 women in order to establish whether hypertension was more often recorded in the obese group. This was done by analysing the continuous morbidity registration of four general practices with a follow-up of up to 17 years. The risk of hypertension was found to be three to four times higher in overweight persons than in those of normal weight, and in women a linear relationship was found between the degree of overweight and the incidence of hypertension. The fat distribution was studied in 292 overweight persons, and fat deposited predominantly in the abdominal region was found to be related to the prevalence of hypertension, particularly in subjects under 50 years of age. Along with the degree of overweight, therefore, the fat distribution might be a useful aid in the early detection of hypertension. Since it is difficult to achieve long-term success in the treatment of overweight, its prevention merits special attention in general practice.

Adipose Tissue↗
PubMed1986

Overweight and chronic illness--a retrospective cohort study, with a follow-up of 6-17 years, in men and women of initially 20-50 years of age.

A retrospective cohort-study with a follow-up of 6-17 years was carried out in four general practices in the Netherlands in the period 1967-1983. In total 317 overweight men and 565 overweight women were followed in a continuous morbidity registration, starting in the year they were diagnosed as overweight (at age 20-50 years). Incidence of illnesses in this group was compared to that in a control group (444 men and 627 women not registered overweight), matched on sex, age and calendar-year at start of follow-up. The incidence of registered morbidity in the overweight group was higher for diabetes, gout, arteriosclerotic disease, arthrosis for men and women, and also for varicose veins for women. Increasing BMI at start of follow-up was associated with increased risk for most illnesses under study. For gout and arteriosclerotic disease in men, overweight appeared to be a risk factor at lower levels of BMI than in women.

Adult↗
PubMed1986

The relation between overweight and subjective health according to age, social class, slimming behavior and smoking habits in Dutch adults.

Subjective health status was assessed in relation to overweight by administering a list of 51 health complaints to adult men and women who were either chronically overweight as defined by Body Mass Index (BMI) or not overweight, in a continuous morbidity registration in four general practices during the period 1967-83. Responses were received from 455 men (182 overweight) and 790 women (386 overweight), ages 26-66 years. Response rate (71 per cent) and age distribution (mean age 48) were similar in overweight and non-overweight groups of both sexes. BMI was correlated with the total number of complaints in women (r = 0.15) but not in men (r = 0.07). Multiple regression analysis revealed, however, that age was an effect modifier in this relation, there being a negative association between BMI and subjective health in younger men and a positive association in older men, whereas in women the association between BMI and subjective health was much more pronounced at younger ages than at older ages. In addition, current smoking habits and social class (in men and women) and reported slimming behavior (in women) had an independent relation to the total number of health complaints. BMI was also related to specific complaints and groups of complaints, particularly in women.

Adult↗