Exogenous androgens influence body composition and regional body fat distribution in obese postmenopausal women--a clinical research center study

Abdominal fat distribution is influenced by androgen levels in both men and women. The purpose of this study was to assess the effects on fat distribution of administering nandrolone decanoate (ND; an anabolic steroid with weak androgenic activity) or spironolactone (SP; an antiandrogen) in obese postmenopausal women. The design was a randomized, placebo-controlled, 9-month trial with simultaneous calorie restriction for weight loss. Women in all three groups lost comparable amounts of weight, but the ND-treated women gained lean mass relative to the other two groups (P < 0.0005) and lost more body fat than women in the SP group (P < 0.01). The resting metabolic rate also increased slightly in the ND group. ND treatment produced a gain in visceral fat, as determined by computed tomography scan, and a relatively greater loss of sc abdominal fat. SP-treated women lost significantly less sc fat than the other two groups. Serum cholesterol decreased in the placebo group, but increased slightly in the other two groups (significant for SP vs. placebo, P < 0.05). High density lipoprotein cholesterol decreased significantly in the ND-treated women. There were no significant changes in fasting glucose or insulin sensitivity. We conclude that administration of exogenous androgens modulates body composition in obese postmenopausal women and independently affects visceral and sc abdominal fat.     

Reversibility of lumbar epidural lipomatosis in obese patients after weight-reduction diet

We present three obese patients with symptomatic lumbar epidural lipomatosis. All three were treated with a calorie-controlled diet and considerable weight reduction was achieved. MRI demonstrated a reduction in the epidural fat and relief of thecal sac compression in all three; two also improved clinically.     

Comparison of body composition by dual energy X-ray absorptiometry to other estimates of body composition during weight loss in obese patients with rheumatoid arthritis

Body composition was determined by dual energy X-ray absorptiometry (DXA) scanning and classical reference methods (40K, 3H2O, and a combination of these in a four-compartment model) in 19 overweight patients with rheumatoid arthritis who underwent a 12-week weight-reducing regimen. The aim of the study was to investigate whether DXA provides a valid estimate of body composition. The results showed that weight as determined by DXA was highly significantly correlated to weight determined by scales. Furthermore, significant correlations were found in the body components (fat-free mass, fat mass) determined by DXA, 40K, 3H2O and the four-compartment model. Mean values differed slightly but significantly. With respect to changes in body composition, no significant correlations were found between any of the methods, except for the weight loss recorded by DXA and scales, and loss of fat mass (and fat free mass) estimated by 3H2O and the four-compartment model. The sparseness of correlations reflected the small changes in fat-free mass and fat mass (2.6 and 1.7 kg respectively), and the fact that changes were comparable to measurement errors of the various methods. We suggest that DXA scanning is a valid supplement for determination of body composition. Validation of DXA scanning requires new experimental in vitro investigations, which, incidentally, also applies to the classical reference methods.     

Effect of exercise and tepary bean type diet on body composition and fat accretion in obese Zucker rats

OBJECTIVE: The effectiveness of a tepary bean high fat type diet, compared to a purified type high fat diet and exercise, on body composition in fatty Zucker rats was determined. SUBJECTS AND DESIGN: Approximately 6-week-old female fa/fa Zucker rats were divided into four groups of 10 rats each: TE, fed the tepary bean type diet and exercised; TN, fed the tepary bean type diet and not exercised; CE, fed the purified type control diet and exercised; CN, fed the purified type control diet and not exercised. The exercise modality was treadmill running and the experiment lasted 13 weeks. MEASUREMENTS: Body weight, cumulative food intake, body composition, weights of adipose tissues and liver, heart and gastrocnemius muscle. RESULTS: At the end of the 13 week experiment, TE rats weighed 511 +/- 22 g and were significantly lighter than TN, 588 +/- 15 g; CE, 606 +/- 22 g; and CN, 660 +/- 27 g. All are means +/- s.e.m. The carcass of CN rats had 58, 20 and 13% more fat than TE, TN and CE rats, respectively; P < 0.01. Lean body mass was the same for all the groups of rats and ranged from means of 216-228 g. However, TE rats had significantly more fat free dry mass (FFDM) than CN rats; 68 +/- 4 vs 58 +/- 2 (means +/- s.e.m.) and tended to have more FFDM than TN and CE rats. Inguinal fat depots weighed 20-30% less in T than in C rats (diet comparisons) and also 20-30% less in E than in N rats (exercise comparisons). Perirenal/retroperitoneal fat depots weighed 25% less in TN than in CN rats and 38% less in TE than in CE rats. Exercise did not reduce perirenal/retroperitoneal fat depot weights. Parametrial fat depot weights were not influenced by diet or exercise. CONCLUSIONS: In diets which provided 37% of the energy from fat, the incorporation of tepary beans attenuated weight gain, and subcutaneous and visceral fat gain compared to a purified type diet. Exercised rats gained less weight and subcutaneous, but not visceral fat, than non-exercised rats.     

Foreign body in the frontal sinus

The authors describe the case of the foreign body in frontal sinus left there after prior surgery. The case was treated surgically with good results.     

Body composition during weight loss in obese patients estimated by dual energy X-ray absorptiometry and by total body potassium

OBJECTIVE: To validate the ability of DXA to measure total body composition before and after weight loss and the composition of the lost body mass. DESIGN: Cross sectional and follow-up study of body composition before and after a weight loss of 10.6 +/- 6.8 kg. SUBJECTS: 31 obese subjects with a mean body weight of 105.2 +/- 15.2 kg at baseline, and a mean body weight of 94.6 +/- 16.5 kg at follow-up. MEASUREMENTS: Body composition was measured by dual X-ray absorptiometry, total body potassium counting, and high precision scales before and after a weight loss. RESULTS: DXA and the scales showed a strong linear relation (r = 1). At baseline, however, DXA underestimated the body weight by a maximum of 3.2 kg because the subjects were too large for the scan table. After weight loss body weight measurements were accurate. Before and after weight loss the linear relations between DXA and TBK for FFM were strong (r = 0.92 and 0.93). Bland and Altman plots showed limits of agreement of +/-9 kg before and after weight loss; DXA underestimated FFM in women and overestimated FFM in men. DXA accounted for 80% of the lost body weight. The composition of the lost body mass did not differ from that estimated by TBK (7.6% FFM and 92.4% FM by TBK; 11% FFM and 89% FM by DXA). CONCLUSION: DXA estimates accurately the body composition and the composition of weight loss in groups of obese subjects. However, the scan table may be too small for patients weighing more than 95 kg.     

Renal function and urinary urokinase in hypertensive and diabetic pregnancies

In Vanuatu malaria is a major killer, especially of young children. As most deaths occur outside the hospital it is very important to have simple, clear guidelines on the management of patients with suspected malaria for the primary health care workers who treat the majority of cases. Despite the encouragement of early treatment, malaria was the major cause of death in children after the neonatal period in 1988. During 1989 and 1990 the treatment of malaria in Vanuatu was reviewed with the aim of trying to reduce the morbidity and mortality from the disease. New guidelines were included in the Vanuatu Health Workers' Manual, issued to all nurses, nurse practitioners and doctors in 1991. The major changes were the introduction of immediate slide microscopy, the use of a combination of chloroquine and sulphadoxine-pyrimethamine for Plasmodium falciparum malaria and for children under 5 years and pregnant women, the discontinuation of single-dose primaquine (previously given as a gametocytocidal agent), and the use of a loading dose of quinine. The constraints of the previous guidelines, the rationale for the changes and the expected improvements resulting from using the new treatments are discussed.     

Reduced cardiac contractile responsiveness to isoproterenol in obese rabbits

Although obesity is characterized by increased sympathetic nervous system activity, there is often a paradoxical reduction in cardiovascular end-organ response to sympathetic stimulation. Mechanisms involved in reduced sympathetic responsiveness in obesity have not been well characterized. Therefore, we determined cardiac contractile responsiveness to beta-stimulation in the obese rabbit model using both isolated heart (IH) and isolated papillary muscle (IPM) preparations. Female New Zealand White rabbits were fed control (IH: n=9; IPM: n=6) or 10% fat diets (IH: n=9; IPM: n=7) for 12 weeks. Contractile responsiveness in the IH was determined using a modified Langendorff preparation to evaluate the dose-response relationship between isoproterenol and 1) peak developed pressure/g of left ventricular wet weight and 2) maximal rate of pressure development (+dP/dt/P). Contractile responsiveness in the IPM was determined using right ventricular papillary muscles to evaluate the dose-response relationship between isoproterenol and (1) peak developed tension (T)/mm2 cross-sectional area (CSA) and (2) maximal rate of tension development (dT/dt/CSA). In the IH, baseline and maximum developed pressure/g were reduced in obese rabbits by 37% and 31%, respectively (P< or =.05). In the IPM, baseline and maximum T/CSA responses were reduced in obese rabbits by 59% and 33%, respectively (P< or =.05). Potency of isoproterenol as reflected by the EC50 did not differ between lean and obese animals in either preparation. These results demonstrate that left ventricular contractility in obesity is reduced at baseline and in response to stimulation with isoproterenol and suggest that decreased responsiveness to beta-stimulation may be a factor in the obesity-related systolic dysfunction.     

Lipolytic sensitivity and response to fasting in normotensive and hypertensive obese humans

Obese persons with hypertension are at greater risk for diabetes and hyperlipidemia than normotensive obese persons. It has been postulated that increased lipolytic rates contribute to these metabolic diseases. Therefore, we evaluated the glycerol rate of appearance (Ra) in plasma, an index of whole-body lipolytic activity, during basal conditions and during 60 minutes of epinephrine infusion after 12 and 84 hours of fasting in six normotensive (body mass index [BMI], 39.9 +/- 1.8 kg/m2) and six hypertensive (BMI, 38.7 +/- 1.6 kg/m2) obese persons. Basal glycerol Ra was lower in hypertensive than in normotensive subjects at both 12 hours (1.58 +/- 0.21 v 2.27 +/- 0.28 mumol/kg/min, respectively; P < .01) and 84 hours (2.04 +/- 0.06 v 2.50 +/- 0.13 mumol/kg/min, respectively; P < .01) of fasting. Peak glycerol Ra during epinephrine infusion after 84 hours of fasting (5.69 +/- 0.72 and 11.40 +/- 0.78 mumol/kg/min for hypertensive and normotensive subjects, respectively) was significantly greater than at 12 hours (3.09 +/- 0.29 and 5.06 +/- 0.69 mumol/kg/min) in both hypertensive and normotensive subjects. However, peak glycerol Ra was lower in hypertensive than in normotensive subjects after 12 and 84 hours of fasting (P < .01 for 84 hours). We conclude that hypertension in obese persons is associated with a decrease in both basal lipolytic rates and lipolytic sensitivity to epinephrine infusion.     

Blood insulin values after the oral glucose tolerance test (OGTT) and the body composition in 30 obese children

The body composition and plasma insulin after OGTT were evaluated in 30 obese children, aged 6 to 14 years. The obese children higher serum insulin after OGTT. There was a relationship between plasma insulin and Body Mass Index (MBI) and between plasma insulin and Weight For Height (WFH) (p < 0.001). There is the accumulating evidence that chronic day-long hyperinsulinemia is associated with an insulin-resistance syndrome characterized by the development of hypertension, hyperlipidemia, atherosclerosis and non insulin depend diabetes.     

Renal hemodynamic responses to dynamic exercise in rabbits

Cardiovascular hemodynamics, including renal blood flow, were measured in rabbits with one intact and one denervated kidney during various intensities of treadmill exercise. Within the first 10 s of exercise, there was rapid vasoconstriction in the innervated kidney associated with decreases in renal blood flow (range -10 to -17%). The vasoconstriction in the innervated kidney was evident at all workloads and was intensity dependent. There was no significant vasoconstriction or change in renal blood flow (range 0.5 to -3.1%) in the denervated kidney at the onset of exercise. However, a slowly developing vasoconstriction occurred in the denervated kidney as exercise progressed to 2 min at all workloads. Examination of responses to exercise performed under alpha-adrenergic blockade with phentolamine (5 mg/kg iv) revealed that the vasoconstriction in the innervated kidney at the onset of exercise and the delayed vasoconstriction in the denervated kidney were due primarily to activation of alpha-adrenergic receptors. In addition, a residual vasoconstriction was also present in the innervated kidney after alpha-adrenergic blockade, suggesting that, during exercise, activation of other renal vasoconstrictor mechanisms occurs which is dependent on the presence of renal nerves.     

Dietary fat and body composition

Vascular endothelial growth factor (VEGF) is a cytokine that induces angiogenesis. Angiogenesis is a prominent histologic component of the luteinization process. Luteinization is also characterized by granulosa cell progesterone secretion in response to the luteinizing hormone (LH) surge. Local VEGF production in human pre-ovulatory follicles, induced by LH, was postulated to be a luteinization mediator in women. To investigate this hypothesis, serum and fluid from the dominant follicle of 31 healthy regularly cycling multiparous women undergoing laparoscopic sterilization were obtained. VEGF was measured by enzyme-linked immunosorbent assay, and LH and progesterone were measured by radioimmunoassay. Follicle aspiration was performed at a median of 13 days from the last menstrual period (range 11-17 days). The median pre-ovulatory follicle diameter was 16 mm (range 11-23 mm). Follicle fluid VEGF concentrations (mean 6900 pg/ml, range 1200-17 100 pg/ml) were correlated positively with follicle fluid progesterone concentrations (mean 10 176 nmol/l, range 636-66780 nmol/l, r=0.62, P=0.002). This correlation was even tighter (r=0.87, P < 0.0001) when only samples from the 22 women in the earliest stages of follicle luteinization were considered. In these women serum LH concentrations were also correlated with follicle fluid VEGF concentrations (r=0.51, P=0.02). Our findings demonstrate the close dynamic relationship between VEGF production and early luteinization in human follicles during normal non-stimulated cycles.     

Body composition and glucose metabolism in hypertensive middle-aged males

The growth curves of 2 different strains of P. brasiliensis were determined. Cultures were made in a dialyzed trypticase soy broth and the growth assesed at selected intervals by means of viable cell counts. In the yeast form, both strains exhibited un uniform pattern of growth; the mycelial forms were also similar although one of the strains survived for a longer period of time. When the 2 yeast curves were compared with the mycelial ones, large differences were noticed. Thus, the mean survival time for the yeasts was 13.5 days while it was 50.25 days for the mycelia. During the exponential phase, the mean rate of growth was accelerated for the yeasts (0.110) in comparison with the one exhibited by the mycelia (0.0265). Irrespective of the form of growth and for both strains, death occurred abruptly, a few hours after a period when colony counts were high, indicating that the fugus was viable at the preceeding interval.     

Renal 11beta-hydroxysteroid dehydrogenase in genetically salt-sensitive hypertensive rats

-Renal 11beta-hydroxysteroid dehydrogenase II (11beta-HSDII) converts glucocorticoids into inactive metabolites and plays an important role in controlling blood pressure and sodium retention. To examine whether this enzyme may be involved in the pathophysiology of salt-sensitive hypertension, we determined 11beta-HSDII activity and mRNA levels in the blood vessel and kidney of Dahl Iwai salt-sensitive (DS) rats and Dahl Iwai salt-resistant (DR) rats. Urinary free corticosterone:free 11-dehydrocorticosterone ratio was measured to estimate renal 11beta-HSD activity. Vascular 11beta-HSDII activity was expressed as percent conversion of [3H]corticosterone to [3H]11-dehydrocorticosterone in homogenized mesenteric arteries. 11beta-HSDII mRNA was estimated with the use of competitive polymerase chain reaction (PCR). Renal 11beta-HSDII activity and mRNA levels were significantly decreased in 8- and 12-week-old high salt DS rats compared with DR, Sprague-Dawley (SD), or low salt DS rats of the same age. Decreased 11beta-HSDII activity and mRNA levels in mesenteric arteries were observed in 8- and 12-week-old high salt DS rats. Urinary excretion of 11beta-HSDII inhibitory factors was measured by inhibition of enzyme activity in microsomes from human kidney. The urinary inhibitors were significantly increased in 8- and 12-week-old high salt DS rats compared with DR, SD, or low salt DS rats of the same age. There were no significant differences in 11beta-HSDII activity and mRNA levels in mesenteric arteries and kidney or in urinary inhibitors between 4-week-old DS, DR, and SD rats. These results indicate that 11beta-HSDII may play a role in salt sensitivity and development of hypertension in the DS rat.     

Practical body composition assessment for children, adults, and older adults

This paper provides an overview of practical methods for assessing body composition of children, adults, and older adults. Three methods commonly used in field and clinical settings are skinfolds, bioelectrical impedance analysis, and anthropometry. For each method, standardized testing procedures, sources of measurement error, recommendations for technicians, and selected prediction equations for each age category are presented. The skinfold method is appropriate for estimating body fat of children (6-17 years) and body density of adults (18-60 years) from diverse ethnic groups. Likewise, bioimpedance is well suited for estimating the fat-free mass of children (10-19 years) as well as American Indian, black, Hispanic, and white adults. Anthropometric prediction equations that use a combination of circumferences and bony diameters are recommended for older adults (up to 79 years of age), as well as obese men and women.     

Assessment of body image dissatisfaction in obese women: Specificity, severity, and clinical significance.

This study assessed the specificity, severity, and clinical significance of body image dissatisfaction in 79 obese women using the Body Dysmorphic Disorder Examination—Self-Report (J. C. Rosen & J. Reiter, 1996). The vast majority of obese women demonstrated body image dissatisfaction related to their obesity, with almost half reporting the greatest dissatisfaction with their waist or abdomen. On average, they reported significantly more body image dissatisfaction than did 43 nonobese controls. The 2 groups did not differ on self-reported symptoms of depression or self-esteem. Body image dissatisfaction correlated significantly with reports of depressive symptoms and lower self-esteem but was not correlated with body mass index. Results are discussed in terms of the role of body image dissatisfaction in understanding and treating obese individuals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex hormones, body fat distribution, resting metabolic rate and glucose-induced thermogenesis in premenopausal obese women

The topographic specificity of upper body obesity is known to be at the origin of a series of metabolic complications. In contrast to this negative effect, women with abdominal obesity usually can lose more body weight than women with gluteal-femoral obesity. In order to find some contributive explanations for this effect, we studied resting metabolic rate (RMR) and glucose-induced thermogenesis (GIT) in both types of obesity. Since upper body obesity is characterized by androgen excess, a relationship between body fat distribution, sex hormones, RMR and indices of thermogenesis was studied. Of 39 obese women who were recruited (mean age: 32.4 +/- 9.3 years), 30 were compared for analysis. Upper body obesity (waist-to-hip ratio (WHR): 0.84 +/- 0.02; body mass index (BMI) 36.2: 36.2 +/- 6.0) is not characterized by differences in RMR, whereas glucose-induced thermogenesis is significantly higher in this subgroup (P < 0.008), expressed as percentage increase above RMR (18.3 +/- 8.5 vs. 11.9 +/- 3.6%) or as percentage of metabolisable energy intake (8.2 +/- 3.3 vs. 5.8 +/- 2.3%). Correlation coefficient data show that GIT determinants are closely related to WHR (r = 0.43; P < 0.01) and not to BMI. Resting metabolic rate, both in absolute terms and corrected for fat-free mass (FFM), is not related to indices of androgenicity, but is negatively related to serum oestradiol levels; this negative relationship with oestradiol disappears when RMR is corrected for both fat mass (FM) and FFM. GIT parameters are not related to free testosterone or oestradiol, regardless of the phase of the menstrual cycle.(ABSTRACT TRUNCATED AT 250 WORDS)