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Effect of visceral fat accumulation on uric acid metabolism in male obese subjects: visceral fat obesity is linked more closely to overproduction of uric acid than subcutaneous fat obesity.

We investigated the relationship between uric acid (UA) metabolism and fat distribution in 36 obese men with a mean +/- SD age of 38 +/- 16 years and mean body-mass index (BMI) of 34 +/- 4 kg/m2. Subjects were divided into two groups: subcutaneous fat obesity (SFO) and visceral fat obesity (VFO), according to their abdominal fat distribution based on the results of computed tomography (CT). SFO was defined as having a ratio of visceral fat area (VFA) to subcutaneous fat area (V/S) of less than 0.4, and VFO was defined as having a V/S ratio > or = 0.4. The levels of serum total cholesterol (T-Chol), triglyceride (TG), and fasting plasma glucose (FPG), and the diastolic blood pressure (dBP) were significantly higher in the VFO group than in the SFO group. Serum UA levels were much higher in both the SFO and VFO groups than in the non-obese control group (492 +/- 107 and 474 +/- 90 v 309 +/- 48 micromol/L, respectively). The 24-hour urinary urate excretion (u-UA24h) and the UA clearance (Cua) to creatinine clearance (Ccr) ratio were significantly higher in the VFO group than in the SFO group (3.75 +/- 1.43 v 2.69 +/- 1.12 mmol/d, P < .05; and 5.9% +/- 2.0% v 3.6% +/- 1.7%, P < .001, respectively). The frequency of hyperuricemia was markedly higher in both the SFO and VFO groups compared with the control group (71% and 73% v 0%, respectively). Although the high serum UA level seemed to be related to low u-UA24h in 80% of SFO subjects with hyperuricemia, this was the case in only 10% of VFO subjects. While 44% of VFO subjects with hyperuricemia were designated as an overproduction type. These results suggest that the mechanism of hyperuricemia in obesity may be affected by the difference in body fat distribution and that the assessment of body fat distribution and types of hyperuricemia is crucial for the treatment of obese patients with hyperuricemia.

Adipose Tissue↗

[Submandibular fold. An alternative for the assessment of subcutaneous fat].

BACKGROUND: Folds are a useful method of measuring subcutaneous fat. This study reports the feasibility of the use of the submandibular fold to evaluate the subcutaneous fat. METHODS: A transversal descriptive study was designed by a poly-staged stratified randomized sample (n = 572). A series of anthropometric measurements (weight, height, different folds and surrounding areas) were performed in addition to the measurement of the submandibular fold. In addition blood pressure was determined as well as oral glucose tolerance test. RESULTS: After correction of the effect of age, the submandibular fold was found to be related with both the Quetelet's index (BMI) (males r = 0.50; females r = 0.61, both p < 0.0001) and the Benn's index (males r = 0.53; females r = 0.60, both p < 0.0001). Their correlations with those of other folds and with the measurements of centralization place the submandibular fold in a median position with respect to central and peripheral fat deposits. Furthermore, the percentage of fat which the increase in BMI carries is practically constant. Likewise, it was associated with the presence of high blood pressure in both sexes (males F = 9.7, p < 0.025; females F = 6.1, p < 0.025), diabetes mellitus (F = 6.1, p < 0.005) and inguinal hernias (F = 10.8, p < 0.0025) in males and in females, as well as to the presence of abdominal striae in females (F = 12.2, p < 0.001). CONCLUSIONS: The submandibular fold may be used by investigators who wish to evaluate subcutaneous fat through one sole fold, which is accessible and easy to measure. This measure is intermediate between the central and peripheral zones. In addition, it may reflect the fat deposit which is produced with both an increase in the body mass index and age.

Adult↗

[Subcutaneous fat necrosis of the newborn].

Subcutaneous fat necrosis presents as red-to-bluish, indolent, well-circumscribed, subcutaneous nodules and plaques, unusually in healthy infants. Histologically, a lobular panniculitis with a mixed inflammatory infiltrate is seen. Characteristic crystalloid structures can be found within some of the lipocytes and, most prominently, within macrophages. This rarely diagnosed skin disease is harmless and self-limited, yet the associated hypercalcaemia has a high complication rate.

Fat Necrosis↗

Use of ultrasound in the measurement of subcutaneous fat and prediction of total body fat in dogs.

An ultrasonographic unit (A-scan mode) has been evaluated as a noninvasive method for estimating body fat in 25 dogs. Six anatomical sites were defined and subcutaneous fat thickness was measured by means of ultrasound and histology. Total body fat was subsequently calculated in 12 dogs. There was a high correlation between histology and ultrasound for the measurement of subcutaneous fat (r = 0.81; P less than 0.001). Total body fat was successfully predicted using measurements taken with ultrasound at the lumbar area (r = 0.87; P less than 0.001). Measurements of subcutaneous fat thickness from other anatomical sites did not estimate body fat with the same accuracy. These results suggest that ultrasound can reliably measure subcutaneous fat in dogs and that these measurements, when taken from the mid lumbar area, can be used to predict total body fat.

Adipose Tissue↗

The importance of local subcutaneous fat thickness in pilonidal disease.

PURPOSE: This study was designed to investigate the local subcutaneous fat thickness in sacrococcygeal pilonidal disease. METHODS: Subcutaneous fat thickness was measured by ultrasonography in 125 patients with sacrococcygeal pilonidal disease and 125 age-matched, body mass index-matched and gender-matched controls. RESULTS: The sacrococcygeal subcutaneous fat thickness was 14.4 +/- 2.9 mm, 18.3 +/- 3.1 mm, and 22 +/- 2.2 mm, respectively, in normal, overweight, and obese patients with sacrococcygeal pilonidal disease and 9.1 +/- 3.1 mm, 11.3 +/- 2.6 mm, and 20 +/- 1.8 mm, respectively, in normal, overweight, and obese controls. Sacrococcygeal fat was significantly thicker in normal and overweight patients with pilonidal disease compared with controls with same body mass index (P< 0.01). There were no significant differences in fat thickness between obese patients and obese controls (P > 0.05). CONCLUSIONS: Sacrococcygeal fat thickness, as a local factor, is closely associated with pilonidal disease.

Adult↗

Birth weight, adult body composition, and subcutaneous fat distribution.

OBJECTIVES: To investigate if birth weight is related to both body mass index (BMI) and distribution of subcutaneous fat at adult age. RESEARCH METHODS AND PROCEDURES: A 9-year longitudinal study was performed in 229 subjects (192 women) with ages ranging from 27 to 36 years. Birth weight was retrieved by a questionnaire, and adult weight, height, skinfold thicknesses, and waist-to-hip ratio (WHR) were repeatedly measured at mean ages 27, 29, 31, and 36 years. BMI, sum of four skinfolds (S4S), the ratio between two truncal skinfolds and S4S (SS/S4S), and the ratio between WHR and the cross-sectional area of the left thigh were calculated with the available data. RESULTS: The adjusted model showed that in women, birth weight was significantly negatively related to adult S4S [beta = -5.211; (-9.768 to -0.654)], waist circumference [beta = -1.449; (-2.829 to -0.069)], and SS/S4S ratio [beta = -3.579; (-5.296 to -1.862)]. In men, a significant negative association was observed between birth weight and adult WHR [beta = -1.096; (-2.092 to -0.100)] only. Other relationships showed, although not significantly, the same negative trend, namely that lower birth weight is related to higher adult body fat mass (S4S) and a more truncal subcutaneous fat distribution (SS/S4S). No associations were found between birth weight and either adult BMI or the cross-sectional area of the thigh. DISCUSSION: Lower birth weight is, in both adult men and women, related to a higher adult subcutaneous fat mass and a more truncal distribution of subcutaneous fat, indicating a higher risk for obesity.

Adipose Tissue↗

Computed tomographic observations on subcutaneous fat: implications for liposuction.

The anatomy of the abdominal subcutaneous tissues is discussed in the light of data obtained in 20 female patients examined on a modern computed tomographic system. We have shown that the superficial fascia, which separates the superficial and deep layers of subcutaneous fat, forms a continuous circumferential fascial plane. This superficial fascia, contrary to previous reports, does not appear to merge with the deep fascial plane around the external oblique muscle. The fat in the deep subcutaneous layer, bounded by the superficial fascia, is the target for liposuction techniques. The CT data have shown that about 50 percent of subcutaneous fat resides within this deep layer.

Adipose Tissue↗

Physique, subcutaneous fat, adipose tissue distribution, and risk factors in the Québec Family Study.

OBJECTIVE: To investigate the relationships among subcutaneous fatness, subcutaneous adipose tissue (SAT) distribution, somatotype and risk factors for coronary heart disease (CHD). SUBJECTS: The sample included 1410 (715 male and 695 female) youths and adults from the Quebec Family Study. MEASUREMENTS: Six skinfolds and the dimensions necessary for the derivation of the Heath-Carter anthropometric somatotype (endomorphy, mesomorphy, ectomorphy) were measured. The six skinfolds were summed to provide an index of subcutaneous adiposity (SUM). In addition, the trunk-to-extremity skinfold ratio, adjusted for SUM using regression procedures (TER), and the first principal component (PC1) of skinfold residuals (also adjusted for SUM) were used to indicate SAT distribution, independent of the overall level of fatness. Risk factors for CHD included systolic and diastolic blood pressures, and fasting glycaemia, triglycerides (TGs), plasma cholesterol, high and low density lipoprotein (HDL-C and LDL-C) cholesterol, and the HDL-C/total cholesterol (CHOL) ratio. RESULTS: In general, SUM was positively correlated with endomorphy and mesomorphy, and negatively correlated with ectomorphy. On the other hand, SAT distribution was not associated with somatotype, except in females where TER and PC1 were negatively correlated with mesomorphy. Results of forward stepwise regression analyses to predict CHD risk factors, indicated that a significant proportion of the variance in the risk factors could be accounted for by SUM, SAT distribution and somatotype (up to 16%). SUM is the best predictor, entering the regressions first (most important) in six of 15 significant regressions in males and 14 of 16 significant regressions in females. Somatotype components enter as predictors 10 times in males, and six times in females. Similarly, TER and PC1 enter as predictors nine times in males and five times in females. CONCLUSIONS: Somatotype is related to SUM, while somatotype and SAT distribution are largely independent of one another. Furthermore, SUM, somatotype and SAT distribution are significant predictors of biological risk factors for CHD.

Adipose Tissue↗

Subcutaneous fat necrosis of the newborn with hypercalcemia.

A newborn infant with subcutaneous fat necrosis and hypercalcemia is presented. Literature on the association between subcutaneous fat necrosis of the newborn and hypercalcemia is reviewed. Affected infants generally experience severe perinatal difficulties. Both vaginal deliveries and cesarean sections can be associated with subcutaneous fat necrosis.

Adipose Tissue↗

[Ultrasonic observation on distribution of subcutaneous fat in Japanese young adults with reference to sexual difference].

Utilizing an ultrasonic device (B-mode, 7.5MHz), the thickness of subcutaneous fat was measured at 54 different points in the bodies of 59 males (aged 20-25) and 66 females (aged 20-23). The results were as follows: 1. The females had significantly thicker subcutaneous fat than those of the males at every point measured. 2. The thick subcutaneous fats were observed at the abdomen, buttocks, and the anterior and medial parts of the thigh in the males, and at the breast, buttocks, abdomen, the posterior, medial, and anterior parts of the thigh, and the anterior, medial, and posterior parts of the upperarm in the females, respectively. 3. The subcutaneous fat of both sexes was more likely to be thicker in body parts closer to the trunk than the extremities. 4. The correlation coefficient between the percent body fat and the mean thickness of subcutaneous fat obtained from data was 0.91 for the males and 0.83 for the females.

Adipose Tissue↗

Increased depth of subcutaneous fat is protective against abdominal injuries in motor vehicle collisions.

The objective of this study was to determine the effect of differences in subcutaneous fat depth on adult injury patterns in motor vehicle collisions. Sixty-seven consecutive adult crash subjects aged 19-65 who received computed tomography of their chest, abdomen and pelvis as part of their medical evaluation and who consented to inclusion in the Crash Injury Research Engineering Network (CIREN) study were included. Subcutaneous fat was measured just lateral to the rectus abdominus muscle in a transverse section taken through the subject at the level of L4. Women had significantly greater subcutaneous fat depth than men. Increased subcutaneous fat depth was associated with significantly decreased injury severity to the abdominal region of females. A similar trend was noted in males although it did not reach statistical significance. Our findings suggest that increased subcutaneous fat may be protective against injuries by cushioning the abdominal region against injurious forces in motor vehicle collisions.

Abbreviated Injury Scale↗

Measurement of dielectric properties of subcutaneous fat with open-ended coaxial sensors.

A three-layer model of stratum corneum, epidermis/dermis and subcutaneous fat has been developed for the capacitance of an open-ended coaxial line in contact with human skin. Applying the model, the electrical properties of subcutaneous fat can be calculated from skin dielectric measurements with three probes of different sizes. The three-layer model is based on a variational formula for the capacitance of the coaxial probe. An accurate approximation for the dielectric constant of the multilayer cutaneous structure is presented for the inverse problem of solving the dielectric constants of various layers. The method was tested at 300 MHz with breast cancer patients who often have radiotherapy-induced late alterations in the structure of subcutaneous fat due to the development of subcutaneous fibrosis. Measurements from 206 sites yielded a good agreement between the dielectric constant of subcutaneous fat and the clinical score for subcutaneous fibrosis.

Adipose Tissue↗

Detection of early micrometastases in subcutaneous fat of primary malignant melanoma patients by identification of tyrosinase-mRNA.

To improve survival following melanoma excision, wide margin resection including subcutaneous fat, is indicated. Subcutaneous fat, resected with primary melanomas, was investigated using the tyrosinase PCR method originally described for detection of melanoma cells in peripheral blood. Identification of tyrosinase transcripts was possible in 4 melanoma patients (3 Clark level IV, 1 level III), while negative results were obtained from 6 other patients (2 level IV, 3 level III and 1 level I). In control experiments, after infiltration of the reference cell line SkMel into normal fat tissue, the PCR was positive in 33% (3/9) with 10(2) infiltrated cells, 69% (9/13) with 10(4) cells and in 100% (7/7) with 10(6) cells. We conclude that detection of melanoma cells in subcutaneous fat tissue is possible by tyrosinase PCR. Follow-up studies should show whether such positive tyrosinase PCR can define patients at very high risk of tumour relapse.

Adipose Tissue↗

Familial aggregation of amount and distribution of subcutaneous fat and their responses to exercise training in the HERITAGE family study.

OBJECTIVE: Investigate the familial aggregation of amount and distribution of subcutaneous fat and their changes in response to endurance training. RESEARCH METHODS AND PROCEDURES: A total of 483 sedentary subjects from 99 nuclear families were recruited, trained for 20 weeks of exercising on cycle ergometers, and measured before and after training for the following indicators of subcutaneous fat and fat distribution: trunk fat (TRUNK = sum of abdominal, subscapular, suprailiac, and midaxillary skinfolds), extremity fat (EXTREM = sum of biceps, triceps, thigh, and calf skinfolds), subcutaneous fat (SF8 = sum of the eight skinfolds), the trunk to extremity skinfolds ratio adjusted for SF8 (TER) and waist girth adjusted for body mass index (WAIST). The familial aggregation of the age- and sex-adjusted baseline phenotypes and their responses to training (delta) after adjustment for the baseline values was investigated using a familial correlation model. RESULTS: Significant familial aggregation was observed for all the phenotypes measured at baseline and for deltaTRUNK and deltaWAIST. Transmissibility estimates reached about 30% to 35% for TRUNK, EXTREM, and SF8 and 50% for TER and WAIST. The transmissibilities of the response phenotypes were lower, ranging from 0% for deltaWAIST to 21% for deltaTRUNK and the pattern of familial correlations suggested a greater within- than between-generation resemblance in the response. DISCUSSION: This study suggests that the amount and distribution of subcutaneous fat strongly aggregates in families, whereas the response to exercise training is characterized by a moderate and more complex pattern of familial resemblance. We conclude that familial/genetic factors are more important in determining the amount and distribution of subcutaneous fat than their responses to exercise training.

Adipose Tissue↗

Three protocols for measuring subcutaneous fat thickness on the upper extremities.

Three protocols for measuring subcutaneous fat thickness were compared and their level of association determined in young adults. Subjects included 21 men and 21 women, 18-24 years of age. Skinfold calipers, A- and B-mode ultrasound were used to measure the thickness of the subcutaneous fat layer overlying the anterior and posterior aspects of the upper arm. Each protocol was independently administered within a 30-min block of time in a randomly rotated sequence. Significant differences (p less than 0.05) between protocols were observed depending upon site of measurement and gender of the subject. At both the anterior and posterior sites for men, B-mode and halved skinfold were similar but significantly less than A-mode measurements. At the anterior site for women, A-mode and skinfold were similar but significantly greater than B-mode measurements. At the posterior site for women, all three measurements were similar. Correlations between the protocols were positive with men's levels ranging from 0.59 to 0.74, while women's levels were from 0.39 to 0.89. It was concluded that although skinfold calipers, A-mode ultrasound, and B-mode ultrasound may be used to obtain moderately associated measurements of upper-arm subcutaneous fat thickness in young adults, the three protocols yield inconsistently similar data.

Adolescent↗

Subcutaneous fat necrosis presenting as a large mass.

Subcutaneous fat necrosis, though a rare phenomenon, can occur in patients of all ages. In newborns, it is an uncommon, self-limited panniculitis of traumatic origin, while in adults it is most commonly encountered among women presenting to breast clinics following a trivial or unnoticed injury sustained long ago. An acute presentation of fat necrosis as a large mass, however, is quite unusual and that may confuse the observer. History of trauma gives a clue to the diagnosis. We report an interesting case of traumatic subcutaneous fat necrosis because of massage therapy in a 66-year-old lady.

Aged↗

Regional differences in ultrasonic assessment of subcutaneous fat thickness in the abdomen: effects on the TRAM flap.

The authors describe the results of fat thickness patterning of the abdominal sites in 50 patients, all of whom required breast reconstruction with a transverse rectus abdominis musculocutaneous flap. The thickness of the abdominal fat was measured at 12 anatomic locations with an ultrasonic instrument. The highest value of the subcutaneous fat thickness was 29.0+/-10.0 mm at a site 2 cm below the umbilicus at the center of the rectus abdominis muscle. The lowest value of the subcutaneous fat thickness was 17.8+/-7.6 mm at a site 2 cm above the umbilicus on the anterior superior iliac spine. Average subcutaneous fat thickness over the abdomen of 50 patients was 24.0+/-9.4 mm. There were 13 patients (group 1) who had an abdominal fat thickness of more than 30 mm, 19 patients (group 2) with an abdominal fat thickness less than 30 mm and more than 20 mm, and 18 patients (group 3) with an abdominal fat thickness less than 20 mm. Complications occurred in 12 of 50 flaps (24%). Among groups 1, 2, and 3 there was no significant difference (p<0.01) in the overall flap complications (15.4: 36.8: 16.7). In summary, subcutaneous fat thickness showed the higher value at the center of the abdomen and the lower value at the lateral site. Abdominal fat thickness is not a risk factor for necrosis of pedicled transverse rectus abdominis musculocutaneous flaps in patients who are thin, average, or mildly obese. Preoperative examination of the abdominal subcutaneous fat thickness should provide useful information for detailed simulation of a reconstructive operation.

Abdominal Muscles↗

Short-term longitudinal changes in subcutaneous fat distribution and body size among Japanese women in the third decade of life.

This research clarified the changes in body shape among Japanese women aged in their 20's, by measuring the subcutaneous fat distribution over the whole body and its circumference at certain points. The subjects, 13 healthy women, were measured twice, once in their early 20's and 5 years later in their late 20's. Subcutaneous fat thickness was measured at 14 points on the body using the B-mode ultrasound method and the body size was measured directly at 8 points on the body using a steel measure. Subcutaneous fat thickness tends to increase with age, except at the cheek, neck, bust and leg. Significant increases were detected especially at lower parts of the trunk such as the waist and infragluteal region. Meanwhile, despite the significant change in subcutaneous fat thickness, the circumferences measured did not change, and also weight tended to decrease with age. Based on this finding, except for fat, body mass, such as muscle and bone, decreases with age due to decreased exercise and changes in calorie intake. Cluster analysis of the accumulation patterns of subcutaneous fat indicated that there were the following 3 patterns of subcutaneous fat accumulation from the early 20's to the late 20's. I. Accumulation on the whole trunk (bust, abdomen, waist and back) and upper arm--trunk/upper arm accumulation pattern. II. Significant accumulation around waist--waist accumulation pattern. III. Even accumulation at abdomen, side abdomen, hip and lower hip--abdomen/hip accumulation pattern.

Adipose Tissue↗