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Greater beneficial effects of visceral fat reduction compared with subcutaneous fat reduction on parameters of the metabolic syndrome: a study of weight reduction programmes in subjects with visceral and subcutaneous obesity.

AIMS: To evaluate the effect of weight reduction on parameters of the metabolic syndrome in obese patients according to their pattern of abdominal fat distribution. METHODS: A longitudinal intervention study, consisting of a 12-week weight reduction programme, including lifestyle modification and adjuvant appetite suppressant, in 38 subjects with visceral obesity and 47 subjects with subcutaneous obesity. Visceral, subcutaneous and total adipose tissue areas were determined by CT scan at the level of L4-L5. Parameters for components of the metabolic syndrome were measured before and after weight reduction. RESULTS: Reductions in body weight, BMI and subcutaneous adipose tissue area were greater in the subcutaneous than in the visceral obesity group. In contrast, changes in fasting plasma glucose, insulin, and HOMA score were higher in the visceral than in the subcutaneous obesity group. Changes in visceral adipose tissue area were significantly related to changes in fasting plasma glucose, triglycerides and HOMA score. CONCLUSIONS: Visceral fat reduction induced greater beneficial effects on parameters of the metabolic syndrome than subcutaneous fat reduction. Evaluation of changes in abdominal fat distribution is necessary when obese subjects enter a weight reduction programme.

Abdomen↗

Styrene and related hydrocarbons in subcutaneous fat from polymerization workers.

Subcutaneous fat samples from 25 workers in a styrene polymerization plant have been analyzed for styrene, ethyl benzene, toluene, benzene, and benzaldehyde by gas chromatography. Styrene was found in samples from 13 of 17 workers who had been heavily exposed within the previous 3 days, 5 of 13 having been exposed 2-3 days earlier. Six workers 4-90 days removed from exposure and two 2-3 days removed from low (less than 5 ppm) exposures had no detectable styrene in fat tissue samples. Toluene and ethyl benzene were found in varying amounts in many samples, and benzene was observed in three samples. Benzaldehyde was observed at levels of 5-53 microng/g in all samples. Although urinary metabolites and breath levels of styrene are reported to be detectable for less than 24 hr following exposure, styrene was found in subcutaneous fat from the subjects of this study for as long as 3 days after the most recent occupational exposure. The combination exposures in such a setting are reflected in the variety of hydrocarbons found in fat samples of workers.

Adipose Tissue↗

Body size, subcutaneous fatness and total body fat in older adults.

In a sample of healthy adults (24 men, 21 women; 54 to 85 years of age) anthropometry was collected and body density measured by underwater weighing. Estimates of body fat were computed from body density. The men were significantly larger than the women in body size and have significantly less percent body fat and less subcutaneous fat on their arms and legs. There were no sex differences in measures of subcutaneous fat on the trunk or in estimates of total body fat. Chest and abdominal circumferences were the measurements most highly correlated with total and percent body fat in the men. In the women, abdominal circumference and subscapular skinfolds were highly correlated with percent body fat, as were subscapular and midaxillary skinfold with total body fat.

Adipose Tissue↗

Subcutaneous fat distribution in males and females from 1 to 39 years of age.

Subcutaneous fat thicknesses measured in two longitudinal studies, the Denver Growth Study and the Melbourne Growth Study, were examined to determine 1) if one site of subcutaneous fat measurement is more representative than another of the body's subcutaneous fat layer, 2) if some measurements of subcutaneous fat from specific body areas are more representative of the subcutaneous fat layer than others, and 3) if there are sex and age differences in intersite relationships. Data from the Denver Study include skinfold thicknesses from 10 sites measured serially at annual ages from 4 to 39 yr and radiographic fat thickness measured at five sites at annual ages from 1 to 18 yr. In the Melbourne Study, five skinfold thicknesses were measured serially in children from 2 to 15 yr of age. Relatively low intersite communalities during the prepubertal years suggest a tendency in each sex for considerable site-to-site variation during this period. However, immediately before puberty and throughout adolescence, high communalities indicate that the thickness of subcutaneous fat at any site is highly related to thickness at all other sites. After puberty and into the mid-20's, there is a reoccurrence of greater site-to-site variability. This higher degree of variation continues into early middle age only in women, implying that more changes occur in their subcutaneous fat, that differentially affect various parts of the body, than in men.

Adipose Tissue↗

Calcium redistribution into subcutaneous fat at parturition in the dairy cow.

Blood samples and subcutaneous fat biopsies from six dairy cows at -14, 0, 14, and 28 days of parturition were analyzed to test the hypothesis that movement of calcium into subcutaneous fat contributes to hypocalcemia of parturient paresis. Plasma and subcutaneous fat calcium decreased while plasma free fatty acids increased at parturition. No trends were significant in magnesium or total lipid content of subcutaneous fat. Calcium content of subcutaneous fat was related positively to calcium concentration in plasma.

Adipose Tissue↗

Utility of subcutaneous fat aspiration for diagnosing amyloidosis in patients with isolated peripheral neuropathy.

OBJECTIVE: To determine the value of subcutaneous fat aspiration in patients with sensorimotor peripheral neuropathy. PATIENTS AND METHODS: We retrospectively reviewed the medical records of all patients undergoing subcutaneous fat aspiration for suspected amyloidosis from January 1, 1994, through December 31,1999. We classified patients undergoing subcutaneous fat aspiration due to peripheral neuropathy into 2 groups: (A) those with isolated peripheral neuropathy and (B) those with any family history and laboratory or clinical findings typically associated with systemic amyloidosis. RESULTS: The study population consisted of 450 patients with peripheral neuropathy in whom fat aspiration was performed for suspected amyloidosis. This constituted 56% of all fat aspirations performed during the study period. Group A had 143 patients, and group B had 307 patients. None of the patients in group A had a positive subcutaneous fat aspirate, whereas 17 patients (6%) in group B had a positive subcutaneous fat aspirate (P=.002, Fisher exact test). The subcutaneous fat aspirate was most commonly positive in patients with a monoclonal protein or other clinical findings associated with amyloidosis. CONCLUSIONS: The yield of a subcutaneous fat aspirate in patients with isolated peripheral neuropathy and no other associated family history, signs, or symptoms of amyloidosis is low. Subcutaneous fat aspiration should be reserved for evaluating patients with peripheral neuropathy who also have findings associated with systemic amyloidosis.

Adipose Tissue↗

Influences of age and sex on abdominal muscle and subcutaneous fat thickness.

This study aimed to investigate the influences of age and sex on the thickness of the rectus abdominis muscle and subcutaneous fat at the abdomen. The two tissue thickness values were determined using ultrasonography in a total of 194 young (20-29 years) and elderly (70-79 years) persons of both genders. In both sexes, the elderly groups showed significantly thinner muscle and thicker fat than the younger groups. The percentage of the mean value of subcutaneous fat thickness in the elderly group compared to that in the younger group was higher in the women (176%) than in the men (128%), but the corresponding value of muscle thickness was similar between men (68%) and women (65%). In both generations, the women had significantly thinner muscle and thicker fat than the men. The percentage of the mean value of subcutaneous fat thickness in the women compared to that in the men was higher in the elderly group (169%) than in the younger group (123%), but the corresponding value of muscle thickness was similar between the younger (80%) and elderly (77%) groups. In every group, subcutaneous fat thickness significantly correlated with waist circumference, but muscle thickness did not. The findings here indicated that: (1). aging was associated with a decrease of muscle thickness and an increase of subcutaneous fat at the abdomen in men and women, with a similar relative loss of muscle thickness in both genders and a greater increase of subcutaneous fat thickness in women than in men, and (2). subcutaneous fat rather than muscle thickness reflected waist circumference, regardless of age and gender.

Abdominal Muscles↗

Ultrasound measurement in defining the regional distribution of subcutaneous fat tissue.

The aim of this research is to determine the significance of ultrasound diagnostics in measuring the thickness of subcutaneous fat tissue as well as to point out sex and age differences in regional distribution of subcutaneous fat tissue. The research included 37 men and 33 women with different body mass indexes. Ultrasound measuring of subcutaneous fat tissue was conducted on 16 measuring points. The thickness of subcutaneous fat tissue measured by ultrasound and estimated proportion of fat tissue obtained by comparative methods coincided mostly on the back side of the upper arm, lower abdominal region in interspinal line and the front side of the forearm. Analysis of the subcutaneous fat tissue distribution indicates that there is more equal accumulation of fat tissue in women than in men. BMI limit value for obesity is not the same for men and women because the point at which abdominal region becomes the main storage of subcutaneous fat in body depends on sex. That BMI value represents the physiological beginning of obesity since it marks the change in distribution pattern of subcutaneous fat tissue in different body regions.

Adipose Tissue↗

Subcutaneous fat distribution of the abdomen and buttocks in Japanese women aged 20 to 58 years.

Subcutaneous fat is an essential element in shaping the body of human beings. In this research, skinfold thickness was measured specifically in 33 regions of the human body, including the abdomen and buttocks. Based on our measurements, the subcutaneous fat distribution was assessed for several age groups. The subjects were healthy Japanese women aged 20 to 58 years. Skinfold thickness was measured using the B-mode ultrasound methods, together with anthropometric measurement. A comparison was made between the following five age groups: early 20's, late 20's, 30's, 40's and 50's. The measured values for the early 20's group were used as the standard and the relationship between increase ratio of subcutaneous fat and age was studied. Through our research, we obtained data on the subcutaneous fat distribution in each age group. The largest change was observed between the ages of the early 20's and late 20's. The skinfold thickness measurements of the abdomen and buttocks was consistently around 10 mm for the early 20's, and increased up to 23.8 mm on the rear side section for the late 20's. This result indicates that the increase ratio varied depending on the part of body. Furthermore, the changes in skinfold thickness were different in specific parts of the abdomen and buttocks among different age groups. The difference in skinfold thickness between upper and lower sections of the abdomen also becomes more pronounced with age. Skinfold thickness increased significantly between the early 20's and late 20's. Among the body regions, measurements at the rear side showed the largest change with age; averaging 11.3 mm for the early 20's compared to 33.6 mm for the 50's. The subcutaneous fat distribution on the buttock also showed the differences with age, indicating changes in body shape. Using careful measurements of the abdomen and buttocks, subcutaneous fat distribution among each age group was determined as well as the variation in changes with the aging process.

Abdomen↗

CT density of mesenteric, retroperitoneal, and subcutaneous fat in cirrhotic patients: comparison with control subjects.

We determined the density in Hounsfield units of the mesenteric, retroperitoneal, and subcutaneous fat on CT scans made in 41 patients with biopsy-proved cirrhosis and compared the results with the density of the fat in these locations in 34 control subjects, in an attempt to quantify changes in fat density in patients with cirrhosis. The mean densities of mesenteric, retroperitoneal, and subcutaneous fat in patients with cirrhosis were -56, -107, and -111 H, respectively. The corresponding mean densities in control subjects were -107, -118, and -124 H. The mean density of mesenteric fat in patients with cirrhosis was 50% greater than that of their subcutaneous fat (p less than .0001), 48% greater than that of their retroperitoneal fat (p less than .0001), and 48% greater than that of the mesenteric fat in control subjects (p less than .0001). The mean density of subcutaneous fat in the anterior abdominal wall in patients with cirrhosis was -96 H compared with -119 H for that in their posterior abdominal wall. The corresponding mean densities in control subjects were -109 and -131 H. Density of subcutaneous fat in the anterior abdominal wall for all subjects (patients and controls) was 18% greater than that of subcutaneous fat in the posterior abdominal wall (p less than .05). In all locations, the statistical trend was for patients with cirrhosis to have higher density fat than did control subjects. These changes in density are thought to represent diffuse fat edema, most prominently in the mesentery because of portal hypertension.

Adipose Tissue↗

Association of islet cell carcinoma of the pancreas with subcutaneous fat necrosis.

A 57-year-old man with generalized, subcutaneous fat necrosis was found at autopsy to have islet cell carcinoma of the pancreas. The histologic diagnosis of islet cell carcinoma was confirmed by the finding by electron microscopy of characteristic intracytoplasmic granules within pancreatic neoplastic cells. Lipase levels were elevated in serum as well as in tissues in areas of subcutaneous fat necrosis. Enzyme histochemical stains for alkaline and acid phosphatase, leucine, aminopeptidase, succinic dehydrogenase, and indoxyl and nonspecific esterase were positive in the areas of subcutaneous fat necrosis. This is the first report of the association of islet cell carcinoma of the pancreas with generalized subcutaneous fat necrosis.

Acid Phosphatase↗

[Subcutaneous fat distribution in Japanese women. Part 1. Fat thickness of the trunk].

The thickness of subcutaneous fat were measured at 215 different points on the trunk in Japanese young women with using B-mode ultrasonic device. Subjects were 10 healthy Japanese females aged from 20 to 24 years. Average subcutaneous fat thickness over the trunk of 10 subjects was 9.8 mm, and it's standard deviation was 1.5 mm. Subcutaneous fat thickness showed the higher value at the buttock, the breasts and the abdomen and the lower value at the back. The difference of fat distribution between obese subjects and lean subjects was exhibited mainly on the abdominal parts but not on the chest and back parts of the trunk.

Adipose Tissue↗

Subcutaneous fat necrosis: report of two cases.

Subcutaneous fat necrosis of the newborn is an uncommon, benign process in full-term infants or postmature neonates who experienced a perinatal distress. It is a transient condition of unknown origin; however, hypercalcemia may be a potentially life-threatening complication of this otherwise self-healing process. We report two cases of subcutaneous fat necrosis and discuss the clinical features, etiology, and complications of the disease.

Fat Necrosis↗

Oral clodronate therapy for hypercalcemia related to extensive subcutaneous fat necrosis in a newborn.

Hypercalcemia is occasionally found in newborns with subcutaneous fat necrosis and carries potential life-threatening risk. Bisphosphonates have been recently introduced in the treatment of subcutaneous fat necrosis in newborns. We report a case of extensive subcutaneous fat necrosis in a female infant complicated with intractable hypercalcemia. Standard treatment for hypercalcemia was given, including saline hydration, a low calcium diet, furosemide, and glucocorticoid, but without response. Serum 1,25-dihydroxyvitamin D level was elevated at 126 pg/mL, 25-hydroxyvitamin D level was normal, and intact parathyroid hormone was suppressed at < 1 pg/mL. Oral clodronate disodium, a second-generation bisphosphonate, was administered, and resulted in the normalization of serum calcium, urine N-telopeptide, urine calcium/creatinine ratio, and serum intact parathyroid hormone level. This case suggests that oral clodronate may be an effective treatment for subcutaneous fat necrosis with hypercalcemia in newborns.

Administration, Oral↗

Subcutaneous fat necrosis with hypercalcemia.

Subcutaneous fat necrosis of the newborn (SCFN) is an uncommon condition and may be complicated by hypercalcemia. A 28-day-old neonate, presenting with SCFN, hypercalcemia and nephrocalcinosis was managed with intravenous saline followed by furosemide, oral prednisolone, potassium citrate and etidronate.

Administration, Oral↗

Subcutaneous fat necrosis in pancreatitis.

A case of subcutaneous fat necrosis as the initial manifestation of an attack of acute pancreatitis is presented. The accompanying features of respiratory distress syndrome, leukemoid reaction, shock, pleural effusions, and arthritis due to necrosis of periarticular fat are described. Autopsy findings are pancreatic pseudocyst, serofibrinous peritonitis, pleuritis, and pericarditis and fat necrosis not only in the subcutaneous fat but also in the pericardial, pleural, mediastinal, mesenteric, retroperitoneal, and pericalyceal fat.

Acute Disease↗

Obesity and relative subcutaneous fat distribution among Canadians of First Nation and European ancestry.

OBJECTIVE: To compare Canadians of Aboriginal (First Nation, FN) and European ancestry (EA), with respect to obesity, subcutaneous fatness and relative subcutaneous fat distribution. DESIGN: Cross-sectional comparison. SUBJECTS: 118 First Nation and 472 European ancestry Canadians from Northern Ontario, youth (5-19 y) and adults (20-75 y). MEASUREMENTS: Stature, mass and skinfold thicknesses at the triceps, biceps, medial calf, subscapular, suprailiac and abdominal sites. ANALYSIS: Prevalence of obesity was determined using the 85th percentile of body mass index (BMI) from NHANES II as the cut-off. Principal components (PC) analyses were performed on the six skinfolds. The first component (PC1) represented a trunk-extremity skinfold contrast. Differences in mean component scores between FN and EA were assessed using independent samples t-tests. RESULTS: Prevalence of obesity among FN was high, ranging from 29% in youth to 60% in adult females. FN demonstrated greater subcutaneous adiposity and greater values for PC1, with the exception of adult males, where the difference is in the expected direction, but is not significant. The direction of the differences indicates that the FN have a greater centralization of subcutaneous fat. CONCLUSIONS: FN Canadians generally have a greater prevalence of obesity, greater subcutaneous fatness and a more centralized distribution of body fat than those of European ancestry.

Adipose Tissue↗