title: Negative association between trunk fat, insulin resistance and skeleton in obese women.
abstract: OBJECTIVE
  To evaluate the potential interference of trunk fat (TF) mass on metabolic and skeletal metabolism.
  
  
  METHODS
  In this cross-sectional study, 340 obese women (mean age: 44.8 ± 14 years; body mass index: 36.0 ± 5.9 kg/m(2)) were included. Patients were evaluated for serum vitamin D, osteocalcin (OSCA), inflammatory markers, lipids, glucose and insulin (homeostasis model assessment of insulin resistance, HOMA-IR) levels, and hormones profile. Moreover, all patients underwent measurements of bone mineral density (BMD; at lumbar and hip site) and body composition (lean mass, total and trunk fat mass) by dual-energy X-ray absorptiometry.
  
  
  RESULTS
  Data showed that: (1) high TF mass was inversely correlated with low BMD both at lumbar (P < 0.001) and hip (P < 0.01) sites and with serum vitamin D (P < 0.0005), OSCA (P < 0.0001) and insulin-like growth factor-1 (IGF-1; P < 0.0001) levels; (2) a positive correlation was found between TF and HOMA-IR (P < 0.01), fibrinogen (P < 0.0001) and erythrocyte sedimentation rate (P < 0.0001); (3) vitamin D levels were directly correlated with IGF-1 (P < 0.0005), lumbar (P < 0.006) and hip (P < 0.01) BMD; and (4) inversely with HOMA-IR (P < 0.001) and fibrinogen (P < 0.0005).Multivariate analysis demonstrated that only vitamin D was independent of TF variable.
  
  
  CONCLUSIONS
  In obese women, TF negatively correlates with BMD independently from vitamin D levels. Reduced IGF-1 and increased inflammatory markers might be some important determinants that account for this relationship.
authors.affiliation: Emanuela A Greco, Davide Francomano, Rachele Fornari, Chiara Marocco, Carla Lubrano, Lorenzo M Donini, Andrea Lenzi, Antonio Avers, Silvia Migliaccio, Department of Experimental Medicine, Section of Medical Pathophysiology, Endocrinology and Nutrition, University "Sapienza" of Rome, 00195 Rome, Italy.
authors.forename: Emanuela A
authors.initials: EA
authors.lastname: Greco
authors.forename: Davide
authors.initials: D
authors.lastname: Francomano
authors.forename: Rachele
authors.initials: R
authors.lastname: Fornari
authors.forename: Chiara
authors.initials: C
authors.lastname: Marocco
authors.forename: Carla
authors.initials: C
authors.lastname: Lubrano
authors.forename: Vincenza
authors.initials: V
authors.lastname: Papa
authors.forename: Francesca
authors.initials: F
authors.lastname: Wannenes
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Luigi
authors.forename: Lorenzo M
authors.initials: LM
authors.lastname: Donini
authors.forename: Andrea
authors.initials: A
authors.lastname: Lenzi
authors.forename: Antonio
authors.initials: A
authors.lastname: Aversa
authors.forename: Silvia
authors.initials: S
authors.lastname: Migliaccio
keywords: Inflammation; Insulin resistance; Obesity; Osteocalcin; Skeleton; Trunk fat; Vitamin D