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Use of a reference four-component model to define the effects of insulin treatment on body composition in type 2 diabetes: the 'Darwin study'.

AIMS: To define the effects of insulin treatment on body composition and fat distribution, and investigate the potential role of body weight (BWt) gain predictors in patients with poorly controlled type 2 diabetes. METHODS: Assessments of body composition, using a four-component model, and biochemical indices were obtained in 19 patients [mean (SD): age, 60 (8.3) years; BMI, 25.3 (3.3) kg/m(2)] with poorly controlled type 2 diabetes, despite maximal oral hypoglycaemic agents, receiving insulin [40 (12.2) units/day] at baseline and after 1, 3 and 6 months. RESULTS: Insulin therapy significantly reduced plasma glucose [-6.0 (4.3) mmol/l], improved [HbA(1)c [-1.9 (1.8)%], and reversed the BWt lost [3.3 (1.8) kg] before treatment. The 6-month BWt gain [+5.2 (2.7) kg] consisted of body fat [+2.9 (2.7) kg] and fat-free mass [FFM; +2.3 (1.8) kg], with the FFM increase due solely to total body water [TBW; +2.4 (1.5) l], as there were no detectable changes in total body protein or bone mineral, thereby increasing FFM hydration by 1.3%. More body fat was deposited centrally in patients receiving insulin alone than those receiving insulin with an oral hypoglycaemic agent (metformin). Daily insulin dose, HbA(1)c and hip circumference were independent predictors of BWt gain. CONCLUSIONS: Insulin treatment increased fat and FFM similarly in poorly controlled type 2 diabetes patients, with the FFM gain due entirely to TBW. The possible role of metformin in reducing central fat accumulation following insulin treatment warrants further investigation into its mechanism and potential long-term benefits.

Adipose Tissue↗

Body composition in children with spastic quadriplegic cerebral palsy.

OBJECTIVE: To determine the pattern of body composition and nutritional status in a group of prepubertal children with spastic quadriplegic cerebral palsy (SQCP) compared with healthy control children. STUDY DESIGN: Subjects were enrolled for this cross-sectional study from two tertiary care settings. One hundred thirty-six subjects with SQCP, 2 to 12 years of age, were evaluated by anthropometric measures, or by anthropometric and total body water (TBW) measures (n = 28), with 39 control subjects. RESULTS: Body composition and nutritional status indicators were significantly reduced in children with SQCP. Accretion of fat-free mass with age was smaller for children with SQCP. Calculation of body fat from two skin folds correlated best with measures of fat mass from TBW. CONCLUSION: Malnutrition is common in children with SQCP. Clinically available, serial anthropometric measures enable the clinician to identify malnourished children with SQCP.

Age Factors↗

Body composition assessed by neutron activation analysis in dialysis patients.

Malnutrition is prevalent in end-stage renal disease (ESRD) patients treated with hemodialysis (HD) and peritoneal dialysis (PD). In addition, there is increased incidence of morbidity in this group. Evaluation of nutritional status is important. Application of body composition in the ESRD population to evaluate body compartments and to assess nutritional health has become more common in clinical practice. Neutron activation analysis (NAA) may provide data on metabolically active tissue by quantification of total body potassium (TBK) for body cell mass and assessment of protein by total body nitrogen (TBN). This method may be able to detect changes in body composition before clinical signs of malnutrition are apparent. Ten HD (5 male and 5 female) and 10 PD patients (7 male and 3 female) were evaluated by NAA, TBK, and isotope dilution. Female PD patients had an increased total body water (TBW) and increased intracellular water compared to HD females. Albumin was lower in PD women. There was no significant difference between PD men and laboratory controls in TBW, extracellular water, and TBN. The clinical application of body composition methods for evaluation of dialysis patients by serial assessment and for development of a bedside tool needs further study.

Adult↗

[Stability of body composition in boys and girls 12 through 15 years of age].

Although underwater weighing has been regarded as a representative of the criterion reference methods for determining body composition, this technique is cumbersome for screening. The purpose of the present study was to examine the stability of body composition assessed not only by underwater weighting but also by existing bioelectrical impedance equations and skinfold thickness equations during a 4-week period. Ten male and 10 female junior high school pupils, aged 12 to 15 years, volunteered to serve as subjects. Body density (Db) was estimated by underwater weighing (UW), skinfold thickness (ST) method, and bioelectrical impedance (BI) method. The UW was considered criterion reference method. The underwater weight was the heaviest value that was reproduced twice at least among 5 to 10 measurements. Residual lung volume was estimated "in water," with the subject in the sitting position, by a closed-circuit helium-dilution method. The ST equations used for determination of Db were those developed by Nagamine et al., while in the BI method equations proposed by Nakadomo et al. were applied. The Db for boys by UW did not differ significantly during the 4-week period; however, in girls it was significantly lower in the 2nd test (1.0479 +/- 0.018 g/ml) than in the 1st test (1.0500 +/- 0.019 g/ml). Likewise, the Db estimated by ST and BI methods remained unchanged in boys, while in girls it was significantly lower in the 2nd test (BI: 1.0445 +/- 0.010 vs. 1.0389 +/- 0.013 g/ml). Test-retest reliability of all the three methods for measurements conducted 4 weeks apart were statistically significant (e.g. UW: r = 0.99, ST: r = 0.94, BI: r = 0.89 in girls). In conclusion, the validity of Db estimated by these two methods was found to be insufficient when absolute values are required. However, body composition estimates assessed by ST and BI methods for boys and girls may be stable on a relative basis.

Adolescent↗

Body composition changes in cachectic patients receiving home parenteral nutrition.

BACKGROUND: The purpose of this study was to evaluate the initial body compositional changes experienced by malnourished patients requiring home parenteral nutrition (HPN) for repletion. METHODS: Eight patients were prospectively studied for 3 months. Body composition was determined by dual-energy X-ray absorptiometry (DXA), and a comprehensive nutrition assessment was performed including body weight, visceral proteins, triceps skinfold (TSF), midupper arm circumference (MUAC), midupper arm muscle circumference (MUAMC), body mass index (BMI), delayed hypersensitivity skin tests (DHST), and diet history. RESULTS: Body composition measured by DXA showed an increase in (mean +/- SD) total fat from 5770 +/- 2805 to 10581 +/- 1980 g (p < .001) and bone mineral content from 2155 +/- 429 to 2190 +/- 443 g (p = .047). Lean soft tissue remained unchanged. Body weight and BMI increased from 47.7 +/- 6.6 to 53.6 +/- 8.2 kg (p = .006) and from 16.6 +/- 1.5 to 18.6 +/- 1.5 kg/m2 (p = .005), respectively. TSF increased from 6.3 +/- 3.1 to 10.4 +/- 4.0 mm (p < .001), and MUAMC remained stable. There was a significant improvement in transferrin from 191 +/- 82 to 326 +/- 128 mg/dL (p = .043), and a trend toward improvement in albumin and DHST. Body weight was highly correlated with DXA weight at baseline (r = .997; 95% confidence interval [CI], 0.98 to 1.00; p < .001) and at 3 months (r = .988; 95% CI, 0.93 to 1.00; p <.001). TSF correlated with total fat as measured by DXA at baseline (r = .839; 95% CI, 0.33 to 0.97; p = .009) but not at 3 months (r = .693; 95% CI, -0.02 to 0.94; p = .057). MUAMC correlated with lean soft tissue measured by DXA both at baseline (r = .739; 95% CI 0.07 to 0.95; p = .036) and at 3 months (r = .870; 95% CI, 0.43 to 0.98; p = .005). Physical activity, on a subjective scale of 1 (low activity) to 3 (high activity), improved over the 3-month period from 1.3 +/- 0.5 to 2.2 +/- 0.8 (p = .031). CONCLUSIONS: Initial weight gain experienced by malnourished HPN patients is primarily fat. Bone mineral content increases, but lean soft tissue does not change. Overall nutritional status is improved as exhibited by significant improvements in body weight and serum transferrin and a trend toward improvement in albumin and delayed hypersensitivity skin tests.

Absorptiometry, Photon↗

Body composition of children in south-western Nigeria: validation of bio-electrical impedance analysis.

Bio-electrical impedance analysis (BIA) is a non-invasive method of estimating body composition and has the potential to be useful in clinics and for nutrition and health-related research in Africa. We sought to validate BIA for use among a Yoruba population in south-western Nigeria and to use BIA to assess the body composition of a healthy cohort of children. Total body water (TBW) was measured in 92 individuals (53 adults and 39 children) using deuterium dilution; height, weight and resistance were measured by BIA. Multiple regression analysis was used to develop prediction equations for TBW among children only or among all participants. Independent covariates tested in the regression models included the impedance index (height(2)/resistance), weight, age and gender with TBW as the dependent variable. Depending on the model used, between 97% (root MSE=0.7 kg ) and 99% (root MSE=0.7 kg) of the variance observed in TBW could be explained by the impedance index, weight and/or gender; age, however, was not significant in any model. In a separate cohort of 69 children, 5-8 years old, anthropometrics were measured and TBW was estimated using the developed equations. Body composition data are presented by gender and age group. BIA was validated for use among Nigerian children and adults and provides a potentially important tool for research.

Adolescent↗

Effect of bromocriptine withdrawal in acromegaly on body composition as assessed by bioelectrical impedance analysis.

To evaluate the effect of bromocriptine withdrawal after dopaminergic long-term treatment (15.0 +/- 6.8 mg/day, mean +/- SD) in 12 acromegalic patients on body composition, bioelectrical impedance was measured before and at the end of two weeks of drug withdrawal. During withdrawal basal hGH and IGF-I increased from 2.5 +/- 1.9 micrograms/l and 2.1 +/- 0.8 kU/l to 9.1 +/- 11.7 micrograms/l and 4.9 +/- 2.2 kU/l, respectively, and the hGH secretion deteriorated significantly both after oral glucose load and in the TRH test, indicating recurrence of active acromegaly. Reactance and resistance decreased by 5 +/- 4 and 23 +/- 19 omega, respectively (p less than 0.01), whereas body weight remained constant (+0.4 +/- 2.1 kg). Bioelectrical impedance analysis indicated evident shifts in body composition, i.e. a significant reduction of body fat (-2.0 +/- 1.7 kg) and a simultaneous increase in both lean body mass (+2.4 +/- 2.2 kg) and total body water (+1.8 +/- 1.6 l). The changes in body composition were related to a combined effect of unsuppressed hypersomatotropism and the lack of bromocriptine actions other than inhibition of hGH secretion (for example stimulation of the renin-angiotensin-aldosterone system by both the recurred hypersomatotropism and the absence of dopaminergic bromocriptine effects). We conclude that bioelectrical impedance analysis is a good additional tool to assess the pathophysiological effects of bromocriptine withdrawal in long-term treated acromegalic patients.

Acromegaly↗

Indirect calorimetry, body composition and small bowel function in asymptomatic HIV-seropositive women.

Extrapolation of data from energy balance studies in HIV-seropositive men to HIV-seropositive women may be inaccurate due to gender differences in body composition, hormones and metabolism. If women have a different metabolic response to the human immunodeficiency virus (HIV), nutritional advice may differ from HIV-seropositive men. Ten asymptomatic HIV-seropositive women were matched with 10 heterosexual female controls from low-risk groups. Subjects and controls had assessment of energy and protein intake, resting energy expenditure (REE) and substrate oxidation, small bowel absorption and permeability and body composition. There were no significant differences in REE, substrate oxidation and body composition. Energy and protein intake and small bowel permeability were increased and sugar absorption decreased in HIV-seropositive women (all P < 0.05). Unlike asymptomatic HIV-seropositive men, asymptomatic HIV-seropositive women do not have significant alterations in metabolism or body composition. Therefore, nutritional advice may need to vary according to the gender of the asymptomatic HIV-seropositive subject.

Adult↗

Critical appraisal of the estimation of body composition via two-, three-, and four-compartment models.

This review explores the robustness of the assumptions underpinning the two- (fat mass [FM], fat-free mass [FFM]), three- (FM; total body water [TBW], fat free dry solid), and four- (FM; TBW; bone mineral [BM], residual) compartment models of body composition. The measurement of body density (BD) via underwater weighing (UWW) and TBW via isotopic dilution are the two most frequently used two-compartment techniques. The former assumes that the FM and FFM have densities of 0.9007 g/cm(3) and 1.1000 g/cm(3), respectively, while the latter uses a FFM hydration constant. Although both techniques can estimate body composition precisely (technical error of measurement [TEM]: UWW = 0.4 %BF; TBW = 0.6 %BF), the validity of these estimates is adversely affected by biological variability in the assumed percentages for the FFM components (TBW = 73.72%; protein = 19.41%; BM = 5.63%; non-BM = 1.24%). The three-compartment model, which incorporates measures of BD and TBW, greatly increases validity by removing errors relating to variability in TBW, which comprises the largest percentage of the FFM and is furthermore acutely variable. The four-compartment model marginally improves on the three-compartment model by additionally controlling for BM, which displays less variability than the TBW component of the FFM. The three- and four-compartment models therefore provide more valid estimates of body composition than the two-compartment model, and this increased accuracy is not offset by propagation of errors (TEM = 0.7 %BF for both models) from the combinations of multiple measurements (BD, TBW, BM). Am. J. Hum. Biol. 11:175-185, 1999. Copyright 1999 Wiley-Liss, Inc.

Journal Article↗

Mathematical models and their application in body composition research.

Mathematical models are a means of formalizing the knowledge on living systems obtained in clinical physiology and theoretical biophysics. They allow the actual processes in living systems to be described and the mechanisms of these systems to be evaluated. The study of body composition strives to quantitatively evaluate intrinsic body compartments and to obtain important information on the nutritional and energy requirements of healthy persons and those with various pathologies. Although there has been great progress in the development of sophisticated instruments for body composition research, it is not always possible to directly measure certain body compartments (e. g. intracellular water and fat mass) because of either technical difficulties or for ethical reasons. Therefore, mathematical models, which can potentially estimate these compartments indirectly, may be a viable alternative. In this paper, we describe the various advances in the use of mathematical models for body composition research.

Body Composition↗

Body composition studies in patients with the acquired immunodeficiency syndrome.

Body composition studies were performed in 33 patients suffering from the acquired immunodeficiency syndrome (AIDS). Studies included measurements of total body potassium, fat, and total body and extracellular water volumes plus serum retinol binding protein concentration, iron binding capacity, and albumin concentration. AIDS patients were underweight (p less than 0.001) and were depleted of potassium (p less than 0.001) with the lowest values occurring in patients close to death at the time of study. Body fat contents also were reduced. Intracellular water volumes were decreased in the AIDS patients (p less than 0.001) with a relative increase in extracellular water volume (p less than 0.001). Serum protein concentrations were decreased in the AIDS patients. Longitudinal studies did not demonstrate tissue repletion in patients with AIDS, despite apparent clinical stability. These studies demonstrate that severe, progressive malnutrition occurs in patients with AIDS. If malnutrition can be shown to have a deleterious effect upon the disease course, therapy of malnutrition may play an important role in the treatment of this disorder.

Acquired Immunodeficiency Syndrome↗

Body composition: overview of methods and future directions of research.

A short overview is given on the most important analytical body composition methods. Principles of the methods and advantages and limitations of the methods are discussed also in relation to other fields of research such as energy metabolism. Attention is given to some new developments in body composition research such as chemical multiple-compartment models, computerized tomography or nuclear magnetic resonance imaging (tissue level), and multifrequency bioelectrical impedance. Possible future directions of body composition research in the light of these new developments are discussed.

Body Composition↗

Field methods for body composition assessment are valid in healthy chinese adults.

There is little information on the accuracy of simple body composition methods in non-Western populations. We determined the percentage of body fat (%BF) by isotope dilution [oxygen-18 (H(2)(18)O) and deuterium oxide ((2)H(2)O)] and anthropometry in 71 healthy, urban Chinese adults aged 35-49 y [body mass index (BMI) 18-35 kg/m(2)]. The accuracy of several prediction equations for assessment of %BF from skinfold measurements was evaluated against %BF determined by H(2)(18)O dilution. We also assessed the relationship between BMI and %BF, and the fat-free mass (FFM) hydration coefficient for our population. All skinfold equations yielded means within approximately 2%BF of H(2)(18)O-derived %BF. However, on the basis of residual plot analysis and the 95% confidence interval (CI) for the mean difference between methods, the equations of Durnin and Womersley (for assessment of body density from skinfolds) coupled with that of Brozek et al. (for assessment of %BF from body density) provided the most valid assessment for individuals. In addition, the FFM hydration coefficient averaged 0.734 +/- 0.002 (SEM), indicating that the usually assumed value of 0.732 is appropriate for this population. Finally, although BMI had high specificity (90%) for classifying individuals as having body fat within the normal range (<24%BF for men, and <35%BF for women), it had poor sensitivity (66%) for identifying individuals as having high body fat. We conclude that compared with H(2)(18)O dilution, skinfold thickness can provide an accurate and reliable assessment of body composition in healthy Chinese adults. Furthermore, using the equation of Brozek et al. may be preferable to using Siri's equation to predict %BF from body density in populations in which individuals have >30%BF.

Adipose Tissue↗

Relationship between temperament, nonresting energy expenditure, body composition, and physical activity in girls.

OBJECTIVES: To assess the extent that predilection for movement, as measured by a temperament questionnaire (activity temperament), contributes to nonresting energy expenditure and body composition in girls. DESIGN, SETTING, AND PARTICIPANTS: Baseline data for 196 premenarcheal non-obese girls aged 8-12 y were obtained from a longitudinal study of growth and development. The association of activity temperament with nonresting energy expenditure in girls with low and high levels of physical activity was evaluated, as was the association of activity temperament with body composition. MEASURES: Maternal reports of child activity temperament were obtained by questionnaire. Nonresting energy expenditure was calculated as total energy expenditure (measured by doubly labeled water) minus resting energy expenditure (obtained by indirect calorimetry). Body composition was estimated by total body water. Questionnaires and activity diaries were used to assess physical activity and sedentary behavior. RESULTS: Higher activity temperament was associated with higher nonresting energy expenditure after multivariate control for weight, vigorous activity, walking and light activity, and television viewing, although activity temperament did not account for a large percentage of the variability in nonresting energy expenditure (partial squared correlation coefficient=0.03). In girls with physical activity levels below the median, high activity temperament was associated with a mean+/-s.d., nonresting energy expenditure of 310+/-138 kJ (74+/-33 kcal) above that of girls with a low activity temperament. Girls with a high activity temperament had less body fat than did girls with a low activity temperament (21.6 vs 24.5%, a difference of 2.9 percentage points; 95% confidence interval, 1.3-4.4 percentage points). CONCLUSION: Predilection for movement, as measured by a temperament questionnaire, contributes to nonresting energy expenditure and may be useful in capturing an aspect of energy expenditure in population studies. The cross-sectional observation that girls with a high activity temperament were leaner than girls with a low activity temperament suggests that a constitutional predilection for movement may play a role in the development of obesity.

Anthropometry↗

No effect of the Trp64Arg beta(3)-adrenoceptor gene variant on weight loss, body composition, or energy expenditure in obese, caucasian postmenopausal women.

The Trp64Arg polymorphism in the beta(3)-adrenoceptor gene has been associated with increased prevalence of obesity, type 2 diabetes, and low rates of energy expenditure, although these findings are not unanimous. It is currently unknown if the presence of the Trp64Arg gene variant impedes the loss of body weight in obese, postmenopausal women via a reducing effect on energy expenditure. The objective of this study was to compare body composition and energy expenditure in carriers and noncarriers of the Trp64Arg variant in the beta(3)-adrenoceptor before and after weight loss. We measured body composition, total daily energy expenditure (TEE), resting metabolic rate (RMR), physical activity energy expenditure (PAEE), thermic effect of feeding (TEF), and respiratory quotient (RQ) in 34 obese, postmenopausal women (19 carriers and 15 noncarriers for the Trp64Arg variant) before and after a weight loss intervention. There were no differences in body composition or daily energy expenditure and its components between the 2 groups at baseline. There were significant reductions in body mass, body mass index (BMI), percent body fat, fat-free mass, and fat mass (main effect, all P <.0001) when analyzed with the 2 genotypes combined, but no significant differences between carriers and noncarriers with respect to change in these variables (group x time interaction term, all P >.05). Total energy expenditure tended to be reduced (490 kJ x d(-1), P =.13) in both groups following weight loss, but there was no significant group x time interaction term (P =.78), indicating no difference in the response of the 2 genotypes. There was a 9% reduction in RMR (611 kJ x d(-1), P <.001) when both groups were considered together, but no significant group x time interaction term (P =.84), suggesting that both groups responded in a similar manner to the weight loss intervention. PAEE and the TEF were not different following weight loss (both P >.60). There was a trend for RQ to be reduced after weight loss (P =.07), but there was no difference between carriers or noncarriers of the Trp64Arg variant (P =.58). In summary, we found that obese postmenopausal women who carry the Trp64Arg variant in the beta(3)-adrenoceptor had similar changes in body composition and energy expenditure to noncarriers of the variant in response to prolonged caloric restriction. These results suggest that the presence of the Trp64Arg variant in the beta(3)-adrenoceptor should not be a hindrance to weight reduction.

Amino Acid Substitution↗

Longitudinal assessment of body composition in CAPD patients using bioelectric impedance analysis. A comparison with hemodialysis patients.

The utility of bioelectric impedance analysis was assessed for longitudinal evaluation of body composition in two groups of uremic patients, one on CAPD and one on hemodialysis treatment, with no clinical marks of hyperhydration or infection. Nineteen CAPD patients (11 men 8 women) and 21 HD patients (12 men 9 women) were studied with bioelectric impedance analysis for a period of 12 months; total body water, fat free mass, and fat mass were calculated from bioelectric impedance analysis data of resistance and reactance at time 0 and 12 months later. No significant differences in body composition were found in the two groups at time 0 and 12 months later, with a similar trend for total body water, fat free mass, and fat mass. In CAPD, a significant increase in body weight was observed due mainly to a rise in fat mass, particularly evident in women with uremia. Bioelectric impedance analysis appears to be an instrument easily repeatable and reliable in CAPD and HD patients, reflecting at the same time body composition, the dialytic adequacy of a technique, and the patient's well being.

Adipose Tissue↗

Influence of family history to type 2 diabetes on the body composition and homeostasis model assessment: a comparison between young active and sedentary men.

AIM: Family history (FH) to type 2 diabetes mellitus (DM) is a risk factor to the development of illness, inducing early anthropometric and metabolic modifications in sedentary subjects. The aim of this paper was to study the FH to DM influence on body composition and glucose metabolism in young sedentary and active men. METHODS: In a cross-section analysis, we recorded anthropometric data, body composition (by BIA), plasmatic insulin and glucose in 60 young healthy Sicilian men (31 athletes and 29 sedentary subjects); FH was defined FH+ if subjects referred to have at least one family member of first degree with documented DM; men without FH to DM were defined FH-. RESULTS: In sedentary subjects, FH+ was associated with the highest values of body mass index (P<0.05) and an increase in the waist-hip ratio (P<0.0585). Sedentary FH+ had a worse body composition, because of an increase in fat mass (P<0.05 for absolute and percent values). Compared to FH- sedentary men, FH+, with lower basal plasmatic insulin, had lower levels of homeostasis model assessment (HOMA) (P<0.05). Between FH+ and FH- athletes no differences were found. CONCLUSIONS: In young men subjects, study confirms influence of FH to DM on physical data, body composition and glucose metabolism and the protective role of a regular physical activity. In subjects FH+ the promotion of health education can prevent the arising of obesity and diabetes; other studies on subjects of both sexes are necessary to assess relation between FH degree to type 2 DM and early physical and metabolic modifications.

Adult↗

Effect of menopausal status on body composition and abdominal fat distribution.

OBJECTIVE: Preliminary studies suggest that the menopause transition is associated with deleterious changes in body composition and abdominal fat distribution. Limitations of the methodology used in these studies, however, render their conclusions controversial. Thus, the present study used radiologic imaging techniques to examine the effect of menopausal status on body composition and abdominal fat distribution. DESIGN: Cross-sectional. SUBJECTS: Fifty-three healthy, middle-aged, premenopausal women (mean+/-SD; 47+/-3 y) and 28 early-postmenopausal women (51+/-4 y). MEASUREMENTS: Total and regional body composition by dual energy X-ray absorptiometry and abdominal fat distribution by computed tomography. RESULTS: No differences in total body fat-free mass or appendicular skeletal muscle mass were noted between groups. In contrast, total body fat mass was 28% higher (23+/-7 vs 18+/-7 kg) and percentage fat 17% higher (35+/-6 vs 30+/-9%; both P<0.01) in postmenopausal women compared with premenopausal women. Postmenopausal women had a 49% greater intra-abdominal (88+/-32 vs 59+/-32 cm2; P<0.01) and a 22% greater abdominal subcutaneous fat area (277+/-93 vs 227+/-108 cm2; P<0.05) compared to premenopausal women. The menopause-related difference in intra-abdominal fat persisted (P<0.05) after statistical adjustment for age and total body fat mass, whereas no difference in abdominal subcutaneous fat was noted. A similar pattern of differences in total and abdominal adiposity was noted in sub-samples of pre- and postmenopausal women matched for age or fat mass. CONCLUSION: Our data suggest that early-postmenopausal status is associated with a preferential increase in intra-abdominal fat that is independent of age and total body fat mass. International Journal of Obesity (2000) 24, 226-231

Abdomen↗