Fat redistribution and accumulation of visceral adipose tissue predicts type 2 diabetes risk in middle-aged black South African women: a 13-year longitudinal study

Abstract Background A number of studies have shown central adiposity, in particular visceral adipose tissue (VAT) accumulation to be a hallmark of metabolic syndrome (MetS). In clinical practice, waist circumference (WC) is used as a proxy for VAT. Aim To compare the ability of dual energy x-ray absorptiometry (DXA)-derived VAT area and anthropometric measures of adiposity for diagnosing MetS in a sample of high risk South African women. Methods MetS was quantified using the Joint Interim Statement (JIS) criteria. Fasting glucose, insulin and lipid profile were measured in 204 post-menopausal women. Anthropometry measures included body mass index (BMI), WC, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and a body shape index (ABSI). The area under the curve (AUC) was used to assess their performance in detecting any two components of MetS (excluding WC). Optimal WC and VAT area cut-points were derived to compare their performance for diagnosing MetS and to compare to internationally recognised cut-points. Results The highest AUC for the prediction of MetS was recorded for VAT, followed by WHtR and WC (AUC, 0.767, 0.747 and 0.738 respectively), but these did not differ significantly (all p ≥ 0.192). In contrast, VAT was significantly better than BMI (p = 0.028), hip (p = 0.0004) and ABSI (p < 0.0001). The optimal WC (94.4 cm) and VAT area (174 cm2 based on the Youden’s index method and 175.50 cm2 based on the CTL approach) cut-points performed similarly in detecting MetS. Conclusion DXA-derived VAT and WC had the same overall performance in discriminating the presence of any 2 MetS components in high risk South African women. These findings support the current recommendations of using WC rather than VAT for MetS risk screening, as it is cheap, accessible and easy to measure.

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Adiposity Mediates the Association between the Dietary Inflammatory Index and Markers of Type 2 Diabetes Risk in Middle-Aged Black South African Women

Nutrients ◽

10.3390/nu11061246 ◽

2019 ◽

Vol 11 (6) ◽

pp. 1246 ◽

Cited By ~ 7

Author(s):

Asanda Mtintsilana ◽

Lisa K. Micklesfield ◽

Elin Chorell ◽

Tommy Olsson ◽

Nitin Shivappa ◽

...

Keyword(s):

Type 2 Diabetes ◽

South African ◽

Inflammatory Cytokines ◽

Central Obesity ◽

Fasting Glucose ◽

African Women ◽

Dietary Inflammatory Index ◽

Inflammatory Index ◽

South African Women

The dietary inflammatory index (DII®), a validated tool used to measure the inflammatory potential of the diet, has been associated with metabolic disorders in various settings, but not in African populations. The aim of this study was to investigate whether the DII is associated with markers of type 2 diabetes (T2D) risk, and if this association is mediated by adiposity and/or low-grade inflammation, in black South Africa women. Energy-adjusted-DII (E-DII) scores were calculated in 190 women (median age, 53 years) from the Birth-to-Twenty plus cohort using a validated food frequency questionnaire. Fasting glucose, insulin, HbA1c, and inflammatory cytokines were measured, and an oral glucose tolerance test performed. Basic anthropometry and dual-energy x-ray absorptiometry-derived body fat, including estimate of visceral adipose tissue (VAT) area, were measured. E-DII scores were associated with all markers of T2D risk, namely, fasting glucose and insulin, HbA1c, HOMA2-IR, two-hour glucose and Matsuda index (all p < 0.05). After adjusting for age, measures of adiposity, but not inflammatory cytokines, mediated the association between E-DII and markers of T2D risk (p < 0.05). Measures of central obesity had proportionally higher (range: 23.5–100%) mediation effects than total obesity (range: 10–60%). The E-DII is associated with T2D risk through obesity, in particular central obesity, among black middle-aged South African women.

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Circulating and Adipose Tissue Fatty Acid Composition in Black South African Women with Obesity: A Cross-Sectional Study

Nutrients ◽

10.3390/nu12061619 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1619

Author(s):

Pamela A. Nono Nankam ◽

Paul J. van Jaarsveld ◽

Elin Chorell ◽

Melony C. Fortuin-de Smidt ◽

Kevin Adams ◽

...

Keyword(s):

Fatty Acids ◽

Adipose Tissue ◽

Fatty Acid ◽

South African ◽

Body Fat ◽

Unsaturated Fatty Acids ◽

African Women ◽

Black South African ◽

Fa Composition ◽

South African Women

Background and Aims: During positive energy balance, excess lipid storage in subcutaneous adipose tissue (SAT) is associated with increased lipolysis. Elevated circulating fatty acid (FA) concentrations from both SAT lipolysis and dietary fat intake may result in visceral adipose tissue (VAT) accumulation, impairment of glucose metabolism, altogether increasing obesity-associated metabolic risks. We aimed to test the hypothesis that FA composition of red blood cell total phospholipids (RBC-TPL) and SAT is associated with body fat centralisation (VAT/SAT ratio) and insulin sensitivity (SI) in black South African women with obesity. Methods: Participants’ (n = 41) body fat composition and distribution, SI, and RBC-TPL, abdominal and gluteal SAT (gSAT) FA composition (gas-liquid chromatography) were measured. Results: RBC-TPL contained higher proportions of saturated fatty acids (SFAs) than SAT (p < 0.001), which were associated with lower SI (p < 0.05). Mono-unsaturated fatty acids (MUFAs) and stearoyl-CoA desaturase-1 (SCD1)-16 were lower, while poly-unsaturated fatty acids (PUFAs), and delta-5 and delta-6 desaturase indices were higher in RBC-TPL than SAT (p < 0.001). Interestingly, FA profiles differed between SAT depots with higher SFAs and lower MUFAs, SCD1-16 and SCD1-18 indices in abdominal compared to gluteal SAT (p < 0.01). In both SAT depots, higher SFAs and lower PUFAs (n-3 and n-6) correlated with lower VAT/SAT ratio; and lower PUFAs (n-3 and n-6) and higher total MUFA correlated with higher SI. Conclusion: Our findings confirm the relationships between the FA composition of RBC-TPL and SAT and metabolic risk in black women with obesity, which are dependent on both the FA class, and the tissue type/blood compartment in which they are distributed.

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Nutrient Patterns and Body Composition Parameters of Black South African Women

Nutrients ◽

10.3390/nu13010006 ◽

2020 ◽

Vol 13 (1) ◽

pp. 6

Author(s):

Caroline B. T. Makura-Kankwende ◽

Philippe J. Gradidge ◽

Nigel J. Crowther ◽

Shane A. Norris ◽

Tinashe Chikowore

Keyword(s):

Body Composition ◽

Adipose Tissue ◽

South African ◽

Body Fat ◽

Lean Mass ◽

African Women ◽

Whole Body ◽

Black South African ◽

Nutrient Patterns ◽

South African Women

Obesity is more prevalent in black South African women than men. However, little is known about the nutrient patterns associated with body composition indices in black African women. Principle Component Analysis (PCA) was applied to 25 nutrients derived from quantified food frequency questionnaires (QFFQs) in 498 middle aged black South African women. Three nutrient patterns, the plant driven, animal driven and Vitamin C, sugar and potassium driven nutrient patterns, accounted for 59% of the variance of nutrient intake. Linear models of the body composition parameters as outcome variables indicated that a standard deviation increase in the animal driven nutrient pattern was significantly associated with increases in body mass index (BMI) (1.29 kg·m−2 (95% CI, 0.54–2.04; p = 0.001), subcutaneous adipose tissue (SAT) (26.30 cm2 (7.97–44.63); p = 0.005), visceral adipose tissue (VAT) (9.88 cm2 (5.13–14.63); p < 0.001), VAT/SAT ratio (0.01 (0.00–0.02); p = 0.018), whole body fat mass index (0.74 kg·m−2 (0.25–1.22); p = 0.003), and whole body lean mass index (0.53 kg·m−2 (0.23–0.83); p = 0.001). An increase in plant driven nutrient pattern was significantly associated with an increase in SAT of 20.45 cm2 (0.47–40.43); p = 0.045. This study demonstrates that animal driven nutrient pattern, characterised by the consumption of more animal protein and fat nutrients, similar to the western diet is associated with increased body fat and lean mass.

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