Gender differences in the association of visceral and subcutaneous adiposity with adiponectin in African Americans: the Jackson Heart Study
TL;DR: The statistically significant inverse association of VAT and adiponectin persisted after additionally adjusting for SAT, body mass index (BMI) and waist circumference (WC), suggesting that VAT provides significant information above and beyond BMI and WC.
Abstract: Adiponectin, paradoxically reduced in obesity and with lower levels in African Americans (AA), modulates several cardiometabolic risk factors. Because abdominal visceral adipose tissue (VAT), known to be reduced in AA, and subcutaneous adipose tissue (SAT) compartments may confer differential metabolic risk profiles, we investigated the associations of VAT and SAT with serum adiponectin, separately by gender, with the hypothesis that VAT is more strongly inversely associated with adiponectin than SAT. Participants from the Jackson Heart Study, an ongoing cohort of AA (n = 2,799; 64% women; mean age, 55 ± 11 years) underwent computer tomography assessment of SAT and VAT volumes, and had stored serum specimens analyzed for adiponectin levels. These levels were examined by gender in relation to increments of VAT and SAT. Compared to women, men had significantly lower mean levels of adiponectin (3.9 ± 3.0 μg/mL vs. 6.0 ± 4.4 μg/mL; p < 0.01) and mean volume of SAT (1,721 ± 803 cm3 vs. 2,668 ± 968 cm3; p < 0.01) but significantly higher mean volume of VAT (884 ± 416 cm3 vs. 801 ± 363 cm3; p < 0.01). Among women, a one standard deviation increment in VAT was inversely associated with adiponectin (β = − 0.13; p < 0.0001) after controlling for age, systolic blood pressure, fasting plasma glucose, high-density lipoprotein cholesterol, triglycerides, education, pack-years of smoking and daily intake of alcohol. The statistically significant inverse association of VAT and adiponectin persisted after additionally adjusting for SAT, body mass index (BMI) and waist circumference (WC), suggesting that VAT provides significant information above and beyond BMI and WC. Among men, after the same multivariable adjustment, there was a direct association of SAT and adiponectin (β = 0.18; p = 0.002) that persisted when controlling for BMI and WC, supporting a beneficial effect of SAT. Insulin resistance mediated the association of SAT with adiponectin in women. In African Americans, abdominal visceral adipose tissue had an inverse association with serum adiponectin concentrations only among women. Abdominal subcutaneous adipose tissue appeared as a protective fat depot in men.
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TL;DR: Abdominal fat distribution was different between males and females and their correlations with some lipid profiles were found to be sex dependent, revealing that MRI can be used as an alternative tool for obesity assessment.
7 citations
Cites background from "Gender differences in the associati..."
...Many studies reported that adiponectin was negatively correlated with BMI and body fat mass.(42,61,62) A crosssectional analysis of Azuma et al(63) showed that serum resistin was significantly higher in obese than in lean volunteers (24....
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Journal Article•
TL;DR: It is confirmed that it is likely for AA men to have significantly lower adiponectin concentrations in comparison to AA women, and men had a significantly higher risk of developing CVD than women, which has been shown previously.
Abstract: African Americans have higher risk of developing type 2 diabetes and cardiovascular disease (CVD) compared to other racial groups. Modifiable and non-modifiable factors play a role in the development of both diseases. This study assessed diabetes indicators in relation to other CVD risk factors taking into account confounders, among African American adults. This was a cross-sectional study in mid-life and older African Americans (≥45 years) who were recruited from the local churches. Fasting blood was collected and serum analyzed for diabetes indicators, apolipoproteins, adipokines, and lipid profile. CVD risk scores were determined using the American Heart Association and Framingham Risk Score assessments. Homeostasis Model Assessments (HOMAs) were calculated using glucose and insulin concentrations. Confounding variables were assessed by questionnaires. Data were analyzed using SPSS software, version 21, and p<0.05 was deemed significant. Descriptive statistics was used to analyze continuous variables. Frequencies and percentages were used to examine categorical variables. T-tests compared different groups while Pearson correlations provided preliminary relationships and determined variables for multiple regression analyses. A total of n=79 participants were evaluated (69% women), 59.3±9.2 years, BMI=34.7±8.3 (mean ± SD). As expected, AA men had higher fasting blood glucose than women (123.6±54.9 mg/dL versus 99.0±21.8 mg/dL), and AA women had higher insulin (11.8±13.1 mg/dL versus 7.6±6.0 mg/dL). Our study confirmed that it is likely for AA men to have significantly lower adiponectin concentrations in comparison to AA women. Based on the CVD risk assessments, men had a significantly higher risk of developing CVD than women, which has been shown previously. Apolipoproteins, adipokines, and lipid profile also negatively influenced the cardiovascular health outcomes in men. Dietary intake, probably by influencing participants’ weight/adiposity, contributed to the differences in cardiovascular outcomes between men and women. In conclusion, the findings of this study revealed that diabetes and serum glucose appeared to be the leading factors for high CVD risk, on the contrary to some other indicators reported in some studies, e.g. hypertension or dyslipidemia.
7 citations
Cites result from "Gender differences in the associati..."
...Men in our study had higher serum triglycerides concentrations compared to women, which was also corroborated in other studies [5, 22]....
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...Another study showed similar gender differences among African Americans only [22]....
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01 Jan 2014
TL;DR: Combining biological and radiological parameters in an adipo-inflammation score could help to define the importance of abdominal obesity in morbidly obese subjects.
Abstract: With the escalating incidence of massive obesity and evidence for visceral fat being implicated in cardiometabolic risk, better phenotyping of patients is necessary to develop personalized medicine. Massive obesity is difficult to explore and little is known about the importance of visceral fat in the massively obese population and their cardiometabolic risk. Numerous techniques have been developed to assess visceral fat but very few have been validated in morbidly obese population. Neck circumference is an interesting clinical parameter in such patients. Computed tomography and magnetic resonance imaging are the best physical methods to assess abdominal obesity and to distinguish between subcutaneous and visceral abdominal tissues, but these methods have technical limits when applied for assessing massive obesity. Combining biological and radiological parameters in an adipo-inflammation score could help to define the importance of abdominal obesity in morbidly obese subjects. New indicators of visceral fat (histological and cardiovascular markers) have recently emerged.
6 citations
TL;DR: It was shown that patients undergoing “heat acclimatization combined with exercise training” were less susceptible to ischemic injury, therefore expressing less diastolic dysfunction after cardiopulmonary bypass compared to non-acclimatized patients, which promoted a clinical study on patients with coronary artery disease scheduled for elective coronary artery bypass operations.
Abstract: During the period of 1986-1997 the first 4 publications on the mechanical and metabolic properties of heat acclimated rat's heart were published. The outcome of these studies implied that heat acclimation, sedentary as well as combined with exercise training, confers long lasting protection against ischemic/reperfusion insult. These results promoted a clinical study on patients with coronary artery disease scheduled for elective coronary artery bypass operations aiming to elucidate whether exploitation of environmental stress can be translated into human benefits by improving physiological recovery. During the 1998 study, immediate-post operative chamber stiffness was assessed in patients acclimatized to heat and low intensity training in the desert (spring in the Dead Sea, 17-33°C) vs. patients in colder weather (spring in non-desert areas, 6-19°C) via echocardiogram acquisition simultaneous with left atrial pressure measurement during fast intravascular fluid bolus administration. We showed that patients undergoing "heat acclimatization combined with exercise training" were less susceptible to ischemic injury, therefore expressing less diastolic dysfunction after cardiopulmonary bypass compared to non-acclimatized patients. This was the first clinical translational study on cardiac patients, while exploiting environmental harsh conditions for human benefits. The original experimental data are described and discussed in view of the past as well as the present knowledge of the protective mechanisms induced by Heat Acclimation Mediated Cross-tolerance.
6 citations
References
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TL;DR: The correlation of the model's estimates with patient data accords with the hypothesis that basal glucose and insulin interactions are largely determined by a simple feed back loop.
Abstract: The steady-state basal plasma glucose and insulin concentrations are determined by their interaction in a feedback loop. A computer-solved model has been used to predict the homeostatic concentrations which arise from varying degrees beta-cell deficiency and insulin resistance. Comparison of a patient's fasting values with the model's predictions allows a quantitative assessment of the contributions of insulin resistance and deficient beta-cell function to the fasting hyperglycaemia (homeostasis model assessment, HOMA). The accuracy and precision of the estimate have been determined by comparison with independent measures of insulin resistance and beta-cell function using hyperglycaemic and euglycaemic clamps and an intravenous glucose tolerance test. The estimate of insulin resistance obtained by homeostasis model assessment correlated with estimates obtained by use of the euglycaemic clamp (Rs = 0.88, p less than 0.0001), the fasting insulin concentration (Rs = 0.81, p less than 0.0001), and the hyperglycaemic clamp, (Rs = 0.69, p less than 0.01). There was no correlation with any aspect of insulin-receptor binding. The estimate of deficient beta-cell function obtained by homeostasis model assessment correlated with that derived using the hyperglycaemic clamp (Rs = 0.61, p less than 0.01) and with the estimate from the intravenous glucose tolerance test (Rs = 0.64, p less than 0.05). The low precision of the estimates from the model (coefficients of variation: 31% for insulin resistance and 32% for beta-cell deficit) limits its use, but the correlation of the model's estimates with patient data accords with the hypothesis that basal glucose and insulin interactions are largely determined by a simple feed back loop.
29,217 citations
TL;DR: The ob gene product may function as part of a signalling pathway from adipose tissue that acts to regulate the size of the body fat depot.
Abstract: The mechanisms that balance food intake and energy expenditure determine who will be obese and who will be lean. One of the molecules that regulates energy balance in the mouse is the obese (ob) gene. Mutation of ob results in profound obesity and type II diabetes as part of a syndrome that resembles morbid obesity in humans. The ob gene product may function as part of a signalling pathway from adipose tissue that acts to regulate the size of the body fat depot.
12,394 citations
"Gender differences in the associati..." refers background in this paper
..., leptin [42], adiponectin [43], tumor necrosis factor-α (TNF-α) [44], plasminogenactivator inhibitor type-1 (PAI-1) [45] and resistin [46]....
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TL;DR: A role for TNF-alpha in obesity and particularly in the insulin resistance and diabetes that often accompany obesity is indicated.
Abstract: Tumor necrosis factor-alpha (TNF-alpha) has been shown to have certain catabolic effects on fat cells and whole animals. An induction of TNF-alpha messenger RNA expression was observed in adipose tissue from four different rodent models of obesity and diabetes. TNF-alpha protein was also elevated locally and systemically. Neutralization of TNF-alpha in obese fa/fa rats caused a significant increase in the peripheral uptake of glucose in response to insulin. These results indicate a role for TNF-alpha in obesity and particularly in the insulin resistance and diabetes that often accompany obesity.
7,347 citations
Additional excerpts
...Several studies have demonstrated that adipose tissue actively produces a variety of locally and systemically functioning bioactive molecules that interact in various obesity-related diseases, e.g., leptin [42], adiponectin [43], tumor necrosis factor-α (TNF-α) [44], plasminogenactivator inhibitor type-1 (PAI-1) [45] and resistin [46]....
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..., leptin [42], adiponectin [43], tumor necrosis factor-α (TNF-α) [44], plasminogen-activator inhibitor type-1 (PAI-1) [45] and resistin [46]....
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TL;DR: Plasma concentrations of adiponectin in obese subjects were significantly lower than those in non-obese subjects, although adip onectin is secreted only from adipose tissue.
4,882 citations
TL;DR: It is shown that adipocytes secrete a unique signalling molecule, which is named resistin (for resistance to insulin), which circulating resistin levels are decreased by the anti-diabetic drug rosiglitazone, and increased in diet-induced and genetic forms of obesity.
Abstract: Diabetes mellitus is a chronic disease that leads to complications including heart disease, stroke, kidney failure, blindness and nerve damage. Type 2 diabetes, characterized by target-tissue resistance to insulin, is epidemic in industrialized societies and is strongly associated with obesity; however, the mechanism by which increased adiposity causes insulin resistance is unclear. Here we show that adipocytes secrete a unique signalling molecule, which we have named resistin (for resistance to insulin). Circulating resistin levels are decreased by the anti-diabetic drug rosiglitazone, and increased in diet-induced and genetic forms of obesity. Administration of anti-resistin antibody improves blood sugar and insulin action in mice with diet-induced obesity. Moreover, treatment of normal mice with recombinant resistin impairs glucose tolerance and insulin action. Insulin-stimulated glucose uptake by adipocytes is enhanced by neutralization of resistin and is reduced by resistin treatment. Resistin is thus a hormone that potentially links obesity to diabetes.
4,557 citations
Additional excerpts
..., leptin [42], adiponectin [43], tumor necrosis factor-α (TNF-α) [44], plasminogen-activator inhibitor type-1 (PAI-1) [45] and resistin [46]....
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