title: Body fat distribution and inflammation among obese older adults with and without metabolic syndrome.
abstract: 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.
authors.affiliation: Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland, USA. kostera@mail.nih.gov
authors.forename: Annemarie
authors.initials: A
authors.lastname: Koster
authors.forename: Sari
authors.initials: S
authors.lastname: Stenholm
authors.forename: Dawn E
authors.initials: DE
authors.lastname: Alley
authors.forename: Lauren J
authors.initials: LJ
authors.lastname: Kim
authors.forename: Eleanor M
authors.initials: EM
authors.lastname: Simonsick
authors.forename: Alka M
authors.initials: AM
authors.lastname: Kanaya
authors.forename: Marjolein
authors.initials: M
authors.lastname: Visser
authors.forename: Denise K
authors.initials: DK
authors.lastname: Houston
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Nicklas
authors.forename: Frances A
authors.initials: FA
authors.lastname: Tylavsky
authors.forename: Suzanne
authors.initials: S
authors.lastname: Satterfield
authors.forename: Bret H
authors.initials: BH
authors.lastname: Goodpaster
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
mesh_terms: 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
chemical_list: D054392:Adipokines; D018836:Inflammation Mediators
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