체지방 분포와 대사위험 인자들과의 연관성

오세진,강상중,송수근,임동현,김성만,최영식,박요한,차형수 고신대학교(의대) 고신대학교 의과대학 학술지 2000 고신대학교 의과대학 학술지 Vol.15 No.1

Background : Obesity is the prevalent disorder and is a serious public health concern because it is a significant forerunner of major chronic debilitating metabolic disease including diabetes, hypertension, lipid disorders and coronary artherosclerosis. Recently many studies shows that upper-body obesity, particulary increased visceral, abdominal fat, is most strongly associated with metabolic risk factors. The aims of this study were to establish the relationship of body fat and its distribution to metabolic risk factors and the clinical usefulness of waist circumference as a new indices of intra-abdominal fat distribution. Methods : Forty-one non-diabetic patients who visited to the health promotion center of Kosin Medical Center from March, 1998 to June, 1998 were divided into two groups according to the body mass index (BMI) : obese group (BMI≥25kg/m2) and non obese group (BMI<25kg/m2) also were divided into two group according to the waist circumference (W) : center obese group (W>94cm in men and W>80cm in women) and central non obese group (W≤94cm in men and W≤80cm in women). The amount of body fat was measured by bioelectrical impedence method. Insulin resistance was calculated by homeostasis model assessment. Results : The result were as follows. 1) In obese group W and waist/hip ratio (WHP), basal insulin level in men and Smin, C-peptide and atherogenic index in women of obese group were higher than those of non-obese group (p<0.05). Insulin resistance, fat weight and lean body mass in the obese group were higher than those of non-obese group in both sexes (p<0.05). 2) In central obese group BMI, basal insulin level, insulin resistance, fat weight and lean body mass in men and atherogenic index in women were higher than those of central non-obese group. WHR in the central obese type group was higher than of central non-obese group in both sexes (p<0.05). 3) BMI was positively correlated with systolic blood pressure (r=0.32, p<0.05), diastolic blood pressure (r=0.36, p<0.05), insulin resistance (r=0.39, p<0.05), waist circumference (r=0.61, p<0.01), percentage of body fat (r=0.32, p<0.05), fat weight (r=0.61, p<0.01) and lean body mass (r=0.54, p<0.01), but negatively correlated with HDL-cholesterol (r=-0.76, p<0.01). 4) Waist circumference was positively correlated with systolic blood pressure (r=0.46, p<0.01), diastolic blood pressure (r=0.37, p<0.05), fat weight (r=0.37, p<0.05), lean body mass (r=0.37, p<0.05), and WHR (r=0.82, p<0.01). 5) WHR was not significantly correlated with other metabolic risk factors except systolic blood pressure (r=0.39, p<0.05). 6) Fat weight was positively correlated with diastolic blood pressure (r=0.36, p<0.05), insulin resistance (r=0.53, p<0.01), basal insulin level (r=0.53, p<0.01), and percentage of body fat. Conclusion : Conclusively body fat, waist circumference and WHR were positively correlated with metabolic risk factors and waist circumference appeared more useful than WHR.

체지방 분포와 대사위험 인자들과의 연관성

오세진,강상중,송수근,임동현,김성만,최영식,박요한,차형수 고신대학교 의학부 2000 고신대학교 의학부 학술지 Vol.15 No.1

체지방 분포와 대사위험 인자들과의 연관성

오세진,강상중,송수근,임동현,김성만,최영식,박요한,차형수 고신대학교 의학부 2000 高神大學校 醫學部 論文集 Vol.15 No.1

Background Obesity is the prevalent disorder and is a serious public health concern because it is a significant forerunner of major chronic debilitating metabolic disease including diabetes, hypertension, lipid disorders and coronary artherosclerosis. Recently many studies shows that upper-body obesity, particulary increased visceral, abdominal fat, is most strongly associated with metaboloc risk factors. The aims of this study were to establish the relationship of body fat and its distribution to metaboloc risk factors and the clinical usefulness of waist circumference as a new indices of intraabdominal fat distribution. Methods Forty-one non-diabetic patients who visited to the health promotion center of Kosin Medical Center from March, 1998 to June, 1998 were divided into two groups according to the body mass index (BMI) : obese group (BMI≥25㎏/m^(2)) and non obese group (BMI<25㎏/m^(2)) also were divided into two group according to the waist circumference (W) : center obese group (W>94㎝ in men and W>80㎝ in women) and central non onese group (W≤94㎝ in men and W≤80㎝ in women). The amount of body fat was measured by bioelectrical impedence method. Insulin resistance was calculated by homeostasis model assessment. Results The result were as follows. 1) In obese group W and waist/hip ratio (WHP). basal insulin level in men and Smin, C-peptide and atherogenic index in women of obese group were higher than those of non-obese group (p<0.05). Insulin resistance, fat weight and lean body mass in the obese group were higher than those of non-obese group in both sexes (p<0.05). 2) In central obese group BMI, basal insulin level, insulin resistance, fat weight and lean body mass in men and atherogenic index in women were higher than those of central non-obese group. WHR in the central obese type group was higher than of central non-obese group in both sexes (p<0.05). 3) BMI was positively correlated with systolic blood pressure (r=0.32, p<0.05), diastolic blood pressure (r=0.36, p<0.05), insulin resistance (r=0.39, p<0.05), waist circumference (r=0.61, p<0.05), percentage of body fat (r=0.32, p<0.05), fat weight (r=0.61, p<0.01) and lean body mess (r=0.54, p<0.01), but negatively correlated with HDL-cholesterol (r=0.76, p<0.01). 4) Waist circumference was positively correlated with systolic blood pressure (r=0.46, p<0.01), diastolic blood pressure (r=0.37, p<0.05), fat weight (r=0.37, p<0.05), lean body mass (r=0.37, p<0.05), and WHR (r=0.82, p<0.01). 5) WHR was not significantly correlated with other metabolic risk factors except systolic blood pressure (r=0.39, p<0.05). 6) Fat weight was positively correlated with diastolic blood pressure (r=0.36, p<0.05), insulin resistance (r=0.53, p<0.01), basal insulin level (r=0.53, p<0.01),and percentage of body fat. Percentage of body fat was positively correlated with diastolic blood pressure (r=0.33, p<0.05), and insulin resistance (r=0.44, p<0.01). Conclusion Conclusively body fat, waist circumference and WHR were positively correlated with metabolic risk factors and waist circumference appeared more useful than WHR.

A prospective study on changes in body composition and fat percentage during the first year of cancer treatment in children

Hye Ran Yang,Hyoung Soo Choi 한국영양학회 2019 Nutrition Research and Practice Vol.13 No.3

BACKGROUNDS/OBJECTIVES: Cancer treatment may lead to significant body composition changes and affect growth and disease outcomes in pediatric cancer patients. This prospective study aimed to evaluate short- and long-term body compositions changes focused on body fat during the first year of cancer treatment in children. SUBJECTS/METHODS: A prospective study was conducted in 30 pediatric cancer patients (19 hematologic malignancies and 11 solid tumors) and 30 age- and sex-matched healthy controls. Anthropometric measurements and body composition analysis using whole body dual energy X-ray absorptiometry were performed at baseline and 1, 6, and 12 month(s) of cancer treatment. Kruskal-Wallis tests, Wilcoxon paired t tests, and generalized estimation equation (GEE) were applied for statistical analysis. RESULTS: At baseline, no differences in weight, height, body mass index, abdominal circumferences, body fat, and fat-free mass were observed between 30 controls and 30 pediatric cancer patients. Total fat mass (P < 0.001) and body fat percentage (P = 0.002) increased significantly during the first month, but no changes were observed from 1 to 12 months; however, no changes in the total mass were observed during the first year of cancer treatment. Meanwhile, the total fat-free mass decreased during the first month (P = 0.008) and recovered between 6 and 12 months of follow-up (P < 0.001). According to GEE analysis, there was a significant upward trend in body fat percentage during the first year, especially the first month, of cancer treatment in children with hematologic malignancies, but not in those with solid tumors. CONCLUSIONS: Our results indicate that cancer treatment is related to significant body composition changes and rapid body fat gain, particularly during the first month after initiating cancer treatment, in children with hematologic malignancies. Therefore, individualized dietary strategies to prevent excessive fat gain are needed in pediatric cancer patients for better outcomes.

A prospective study on changes in body composition and fat percentage during the first year of cancer treatment in children

Yang, Hye Ran,Choi, Hyoung Soo The Korean Nutrition Society 2019 Nutrition Research and Practice Vol.13 No.3

BACKGROUNDS/OBJECTIVES: Cancer treatment may lead to significant body composition changes and affect growth and disease outcomes in pediatric cancer patients. This prospective study aimed to evaluate short- and long-term body compositions changes focused on body fat during the first year of cancer treatment in children. SUBJECTS/METHODS: A prospective study was conducted in 30 pediatric cancer patients (19 hematologic malignancies and 11 solid tumors) and 30 age- and sex-matched healthy controls. Anthropometric measurements and body composition analysis using whole body dual energy X-ray absorptiometry were performed at baseline and 1, 6, and 12 month(s) of cancer treatment. Kruskal-Wallis tests, Wilcoxon paired t tests, and generalized estimation equation (GEE) were applied for statistical analysis. RESULTS: At baseline, no differences in weight, height, body mass index, abdominal circumferences, body fat, and fat-free mass were observed between 30 controls and 30 pediatric cancer patients. Total fat mass (P < 0.001) and body fat percentage (P = 0.002) increased significantly during the first month, but no changes were observed from 1 to 12 months; however, no changes in the total mass were observed during the first year of cancer treatment. Meanwhile, the total fat-free mass decreased during the first month (P = 0.008) and recovered between 6 and 12 months of follow-up (P < 0.001). According to GEE analysis, there was a significant upward trend in body fat percentage during the first year, especially the first month, of cancer treatment in children with hematologic malignancies, but not in those with solid tumors. CONCLUSIONS: Our results indicate that cancer treatment is related to significant body composition changes and rapid body fat gain, particularly during the first month after initiating cancer treatment, in children with hematologic malignancies. Therefore, individualized dietary strategies to prevent excessive fat gain are needed in pediatric cancer patients for better outcomes.

신체의 지방분포양상과 고혈압

이충원,윤능기,Lee, Choong-Won,Yoon, Nung-Ki 대한예방의학회 1991 Journal of Preventive Medicine and Public Health Vol.24 No.1

중심성 지방분포와 고혈압과의 관계와 비근 내측 피부두께가 기존의 말초성 지방분포를 나타내주는 삼두근 피부두께에 비해 더 우수한 지표가 되는지를 알아보기위해서 1990 년 해군수중 근무자 특수신체검사자 중에서 450 명을 연구자의 편의에 의해 추출되었다. 대상자의 평균 연령이 27.9 세였고 범위가 19-51세었다. 말초성 지방분포의 지표로 삼두근과 비골 내측 피부두께를, 중심성 지방분포는 견갑골하 피부두께와 이것과 삼두근으로 이루어진 비와 차이로 측정을 했다. 신체의 지방분포를 나타내는 피부두께와 이 들을 기준으로한 비와 차이의 지수를 4 분위수로 나누어 첫 1/4 분위수를 기준으로 하고 나머지 3 가지 수준을 기준에 비교를 했다. 연령과 전체적인 비만도를 다중지수분석으로 통제를 한 후 고혈압과의 관계에서 견갑골하 피부두께가 기준인 1/4 분위수와 비교해 보아 2/4, 3/4, 4/4 분위수로 증가함에 따라 각각 2.05(95 % 신뢰구간 1.18-3.59), 2.02(1.06-3.86), 4.00 (1.99-8.06) 의 유병비차비를 보였다. 견갑골하 피부두께와 비골 내측 피부두께의 차이 역시 4/4 분위수가 되었을 때만 2.45 (1.28-4.68)의 비차비를 보였다. 그 외의 삼근 피부두께와 비근내측 피부두께에서는 기준에 비교해 보아 1 을 포함하지 않은 비차비는 없었다. 연령과 전체적인 비만도를 조정한 비차비는 조정치 않은 조비차비에 비해 대체적으로 조금 감소했다. 비근 내측의 피부두께는 삼두근 피부두께에 비교해보아 더 우수한 말초성 지방분포를 대표해주는 피부두께로 보였다. 이러한 결과는 전체적인 비만도 수준과는 독립적으로 견갑골하 피부두께로 측정된 중심성 지방분포가 고협압과 관계가 있으며 우수한 중심성 지방분포를 나타내주는 지표가 됨을 시사해주는 소견이다. This study examined the cross-sectional association of central body fat distribution with hypertension as well as the superiority of medial calf skinfold measured as peripheral fat distribution over the conventional triceps skinfold using 450 Korean Navy divers selected by authors' convenience in 1990. Their mean age was 27.9 and range of it was 19-51. The centrally located body fat was approximated by subscapular skinfold and peripherally located fat by triceps and medial calf skinfolds. Four indices were constructed from these skinfold measures to reflect central versus peripheral fat distribution pattern : 2 ratios and 2 differences. After controlling age and overall obesity (body mass index), prevalance odds ratios of the 2/4, 3/4, 4/4 quartiles of subscapular skinfold comparing with lowest 1/4 quartile were 2.05(95% confidence interval, CI 1.18-3.59), 2.02(95% CI 1.06-3.86), 4.00 (95% CI 1.99-8.06) respectively. The difference of subscapular and medial calf skinfolds was associated with hypertension (odds ratio 2.45, 95% CI 1.28-4.68 comparing highest with lowest quartiles). Triceps and medial calf skinfolds alone did not show any odds ratio not including unity. The adjusted odds ratios were generally reduced in small magnitude compared with crude odds ratios not adjusted for age and overall obesity. The medial calf skinfold appeared to be more representative of peripheral body fat distribution than triceps skinfold. These findings suggest that central fat distribution rather than peripheral distribution is associated with hypertension independent of age and overall level of obesity and medial calf skinfold may replace conventional triceps skinfold in predicting peripheral distribution of body fat.

Relationship between Regional Body Fat Distribution and Diabetes Mellitus: 2008 to 2010 Korean National Health and Nutrition Examination Surveys

최수인,정다은,임정수,이미영,신장열,정춘희,허지혜 대한당뇨병학회 2017 Diabetes and Metabolism Journal Vol.41 No.1

Background The aim of this study was to investigate the association between regional body fat distribution, especially leg fat mass, and the prevalence of diabetes mellitus (DM) in adult populations. Methods A total of 3,181 men and 3,827 postmenopausal women aged 50 years or older were analyzed based on Korea National Health and Nutrition Examination Surveys (2008 to 2010). Body compositions including muscle mass and regional fat mass were measured using dual-energy X-ray absorptiometry. Results The odds ratios (ORs) for DM was higher with increasing truncal fat mass and arm fat mass, while it was lower with increasing leg fat mass. In a partial correlation analysis adjusted for age, leg fat mass was negatively associated with glycosylated hemoglobin in both sexes and fasting glucose in women. Leg fat mass was positively correlated with appendicular skeletal muscle mass and homeostasis model assessment of β cell. In addition, after adjusting for confounding factors, the OR for DM decreased gradually with increasing leg fat mass quartiles in both genders. When we subdivided the participants into four groups based on the median values of leg fat mass and leg muscle mass, higher leg fat mass significantly lowered the risk of DM even though they have smaller leg muscle mass in both genders (P<0.001). Conclusion The relationship between fat mass and the prevalence of DM is different according to regional body fat distribution. Higher leg fat mass was associated with a lower risk of DM in Korean populations. Maintaining leg fat mass may be important in preventing impaired glucose tolerance.

Peroxisome Proliferator-Activated Receptor-γ 2 (PPARγ2) Pro12Ala (P12A) 유전자 다형성이 한국여성의 체지방분포에 미치는 영향

김길수 ( Kil Soo Kim ),최선미 ( Sun Mi Choi ),신승우 ( Seung Uoo Shin ),양현성 ( Hyun Sung Yang ),윤유식 ( Yoo Sik Yoon ) 한방비만학회 2004 한방비만학회지 Vol.4 No.1

Objectives : The effects of peroxisome proliferator-activated receptor γ2 (PPARγ2) Pro12Ala (P12A) polymorphism on body mass index (BMI) and type 2 diabetes are well documented; however, until now, only a few studies have evaluated the effects of this polymorphism on body fat distribution. This study was conducted to elucidate the effects of this polymorphism on computed tomography (CT)-measured body fat distribution and other obesity-related parameters in Korean female subjects. Methods & Results : The frequencies of PPARγ2 genotypes were: PP type, 93.0%; PA type, 6.8%; and AA type, 0.2%. The frequency of the A allele was 0.035. Body weight (P .012), BMI (P .012), and waist-to-hip ratio (WHR) (P .001) were significantly higher in subjects with PA/AA compared with subjects with PP. When body composition was analyzed by bioimpedance analysis, lean body mass and body water content were similar between the 2 groups. However, body fat mass (P .003) and body fat percent (P .025) were significantly higher in subjects with PA/AA compared with subjects with PP. Among overweight subjects with BMI of greater than 25, PA/AA was associated with significantly higher abdominal subcutaneous fat (P .000), abdominal visceral fat (P .031), and subcutaneous upper and lower thigh adipose tissue (P .010 and .013). However, among lean subjects with BMI of less than 25, no significant differences associated with PPARγ2 genotype were found, suggesting that the fat-accumulating effects of the PA/AA genotype were evident only among overweight subjects, but not among lean subjects. When serum lipid profiles, glucose, and liver function indicators were compared among overweight subjects, no significant difference associated with PPARγ2 genotype was found. Changes in body weight, BMI, WHR, and body fat mass were measured among overweight subjects who finished a 1-month weight lose program of a hypocaloric diet and exercise; no significant differences associated with PPARγ2 genotype were found. Conclusions : The results of this study suggest that the PPARγ2 PA/AA genotype is associated with increased subcutaneous and visceral fat areas in overweight Korean female subjects, but does not significantly affect serum biochemical parameters and outcomes of weight loss programs.1)

Peroxisome Proliferator-Activated $Receptor-{\gamma}$ 2 $(PPAR{\gamma}2)$ Pro12Ala (P12A) 유전자 다형성이 한국여성의 체지방분포에 미치는 영향

김길수,최선미,양현성,윤유식,신승우,Kim, Kil-Soo,Choi, Sun-Mi,Yang, Hyun-Sung,Yoon, Yoo-Sik,Shin, Seun-Uoo 한방비만학회 2004 한방비만학회지 Vol.4 No.1

Objectives: The effects of peroxisome proliferator-activated receptor ${\gamma}2\;(PPAR{\gamma}2)$ Pro12Ala (P12A) polymorphism on body mass index (BMI) and type 2 diabetes are well documented; however, until now, only a few studies have evaluated the effects of this polymorphism on body fat distribution. This study was conducted to elucidate the effects of this polymorphism on computed tomography (CT)-measured body fat distribution and other obesity-related parameters in Korean female subjects. Methods & Results: The frequencies of $PPAR{\gamma}2$ genotypes were: PP type, 93.0%; PA type, 6.8%; and AA type, 0.2%. The frequency of the A allele was 0.035. Body weight (P .012), BMI (P .012), and waist-to-hip ratio (WHR) (P .001) were significantly higher in subjects with PA/AA compared with subjects with PP. When body composition was analyzed by bioimpedance analysis, lean body mass and body water content were similar between the 2 groups. However, body fat mass (P .003) and body fat percent (P .025) were significantly higher in subjects with PA/AA compared with subjects with PP. Among overweight subjects with BMI of greater than 25, PA/AA was associated with significantly higher abdominal subcutaneous fat (P .000), abdominal visceral fat (P .031), and subcutaneous upper and lower thigh adipose tissue (P .010 and .013). However, among lean subjects with BMI of less than 25, no significant differences associated with $PPAR{\gamma}2$ genotype were found, suggesting that the fat-accumulating effects of the PA/AA genotype were evident only among overweight subjects, but not among lean subjects. When serum lipid profiles, glucose, and liver function indicators were compared among overweight subjects, no significant difference associated with $PPAR{\gamma}2$ genotype was found. Changes in body weight, BMI, WHR, and body fat mass were measured among overweight subjects who finished a 1-month weight lose program of a hypocaloric diet and exercise; no significant differences associated with $PPAR{\gamma}2$ genotype were found. Conclusions: The results of this study suggest that the $PPAR{\gamma}2$ PA/AA genotype is associated with increased subcutaneous and visceral fat areas in overweight Korean female subjects, but does not significantly affect serum biochemical parameters and outcomes of weight loss programs.

The Effect of Foeniculum Vulgare (Fennel) on Body Composition in Postmenopausal Women with Excess Weight: A Double-blind Randomized Placebo-controlled Trial

( Nafiseh Saghafi ),( Masumeh Ghazanfarpour ),( Talat Khadivzadeh ),( Masoudeh Babakhanian ),( Maliheh Afiat ) 대한폐경학회 2017 대한폐경학회지 Vol.23 No.3

Objectives: The goal of this study was to evaluate the effect of fennel on body composition. Methods: This study is a secondary analysis of a double-blind, randomized, placebo-controlled trial. Fifty-four out of 60 patients were able to successfully complete the original study. Seven out of 54 patients were excluded because they were not overweight and obese. Thus, 47 women were included in this secondary analysis. Of these 47 women, 22 were in the fennel group and 25 were in placebo group. Body weight, body mass index (BMI) as well as fat distribution was measured at the baseline and after a three-month follow-up. Results: Comparison of fennel and placebo groups did not reveal any significant effect in terms of body weight, BMI, waist and hip circumferences and fat distribution. Also, the results of paired t-test did not variation of these parameters across groups before and after 12-week treatment. Conclusions: Menopausal women in fennel group experienced a slight increase in body weight and fat distribution, which was not significant. Further studies with larger sample sizes are recommended to validate the results of this study. (J Menopausal Med 2017;23:166-171)