Body fat distribution and inflammation among obese older adults with and without metabolic syndrome.
The protective mechanisms by which some obese individuals escape the detrimental metabolic consequences of obesity are not understood. This study examined differences in body fat distribution and adipocytokines in obese older persons with and without metabolic syndrome. Additionally, we examined whether adipocytokines mediate the association between body fat distribution and metabolic syndrome. Data were from 729 obese men and women (BMI ≥ 30 kg/m(2)), aged 70-79 participating in the Health, Aging and Body Composition (Health ABC) study. Thirty-one percent of these obese men and women did not have metabolic syndrome. Obese persons with metabolic syndrome had significantly more abdominal visceral fat (men: P = 0.04; women: P < 0.01) and less thigh subcutaneous fat (men: P = 0.09; women: P < 0.01) than those without metabolic syndrome. Additionally, those with metabolic syndrome had significantly higher levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and plasminogen activator inhibitor-1 (PAI-1) than individuals without metabolic syndrome. Per standard deviation higher in visceral fat, the likelihood of metabolic syndrome significantly increased in women (odds ratio (OR): 2.16, 95% confidence interval (CI): 1.59-2.94). In contrast, the likelihood of metabolic syndrome decreased in both men (OR: 0.56, 95% CI: 0.39-0.80) and women (OR: 0.49, 95% CI: 0.34-0.69) with each standard deviation higher in thigh subcutaneous fat. These associations were partly mediated by adipocytokines; the association between thigh subcutaneous fat and metabolic syndrome was no longer significant in men. In summary, metabolically healthy obese older persons had a more favorable fat distribution, characterized by lower visceral fat and greater thigh subcutaneous fat and a more favorable inflammatory profile compared to their metabolically unhealthy obese counterparts.
Koster
Annemarie
A
Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland, USA. kostera@mail.nih.gov
Stenholm
Sari
S
Alley
Dawn E
DE
Kim
Lauren J
LJ
Simonsick
Eleanor M
EM
Kanaya
Alka M
AM
Visser
Marjolein
M
Houston
Denise K
DK
Nicklas
Barbara J
BJ
Tylavsky
Frances A
FA
Satterfield
Suzanne
S
Goodpaster
Bret H
BH
Ferrucci
Luigi
L
Harris
Tamara B
TB
D050153:Abdominal Fat; D054392:Adipokines / Q000097:blood; D000368:Aged; D050218:Body Fat Distribution; D005260:Female; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000097:blood / Q000378:metabolism*; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000378:metabolism*; D009765:Obesity / Q000097:blood / Q000150:complications / Q000378:metabolism*; D016017:Odds Ratio; D012307:Risk Factors; D012737:Sex Factors; D050151:Subcutaneous Fat
D054392:Adipokines; D018836:Inflammation Mediators
Obesity (Silver Spring). 2009 May;17(5):1062-9
19165157
J Clin Endocrinol Metab. 2001 Mar;86(3):1020-5
11238480
Circulation. 2007 Sep 11;116(11):1234-41
17709633
Obesity (Silver Spring). 2007 Nov;15(11):2855-65
18070778
J Clin Endocrinol Metab. 2004 Jun;89(6):2569-75
15181025
Am J Clin Nutr. 2005 Nov;82(5):923-34
16280421
J Gerontol A Biol Sci Med Sci. 2009 Jan;64(1):96-102
19164274
Int J Obes (Lond). 2008 May;32(5):772-9
18253163
Diabetes Care. 2000 Apr;23(4):465-71
10857936
Endocr Rev. 2000 Dec;21(6):697-738
11133069
J Gerontol A Biol Sci Med Sci. 2008 Apr;63(4):414-9
18426966
Endocrinology. 2004 May;145(5):2273-82
14726444
Clin Endocrinol (Oxf). 2010 Jul;73(1):55-65
19878507
Arterioscler Thromb Vasc Biol. 2001 Jun;21(6):961-7
11397704
Obesity (Silver Spring). 2008 Sep;16(9):2003-9
18551127
Arterioscler Thromb Vasc Biol. 2008 Jan;28(1):27-38
17690317
J Clin Endocrinol Metab. 2007 Sep;92(9):3490-7
17595248
Med Sci Sports Exerc. 2000 Sep;32(9 Suppl):S498-504
10993420
J Am Geriatr Soc. 2004 Apr;52(4):502-9
15066063
Arch Intern Med. 2008 Aug 11;168(15):1609-16
18695074
Endocr Rev. 2008 Dec;29(7):939-60
18723451
Ageing Res Rev. 2009 Oct;8(4):339-48
19576300
J Clin Endocrinol Metab. 2005 Mar;90(3):1434-9
15598678
Arch Intern Med. 2008 Aug 11;168(15):1617-24
18695075
J Clin Endocrinol Metab. 2005 Jul;90(7):4145-50
15855252
Diabetes Care. 2004 Feb;27(2):372-7
14747216
Natl Health Stat Report. 2009 May 5;(13):1-7
19634296
Am J Clin Nutr. 2003 May;77(5):1192-7
12716671
Diabetologia. 2005 Feb;48(2):301-8
15660262
J Am Geriatr Soc. 2006 Mar;54(3):413-20
16551307
Am J Clin Nutr. 2004 Mar;79(3):379-84
14985210
J Clin Endocrinol Metab. 2009 Nov;94(11):4492-8
19820014
Am J Clin Nutr. 2002 Oct;76(4):743-9
12324286
Int J Obes Relat Metab Disord. 1994 Apr;18(4):207-2
8044194
JAMA. 2008 Jul 9;300(2):182-8
18612115
Circulation. 2007 Jul 3;116(1):39-48
17576866
J Clin Endocrinol Metab. 2004 Nov;89(11):5517-22
15489217
Circulation. 2005 Oct 25;112(17):2735-52
16157765
Diabetes Care. 2003 Feb;26(2):372-9
12547865
Clin Chem. 2006 Oct;52(10):1934-42
16916991
Diabetologia. 2006 Apr;49(4):755-65
16463046
Diabetes. 2006 Jan;55(1):249-59
16380500
Diabetes. 2007 Apr;56(4):1010-3
17287468
J Clin Endocrinol Metab. 2004 Jun;89(6):2548-56
15181022