scholarly journals Body Composition and Ectopic Lipid Changes With Biochemical Control of Acromegaly

2017 ◽  
Vol 102 (11) ◽  
pp. 4218-4225 ◽  
Author(s):  
Miriam A Bredella ◽  
Melanie Schorr ◽  
Laura E Dichtel ◽  
Anu V Gerweck ◽  
Brian J Young ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Composition ◽  
Magnetic Resonance ◽  
Muscle Mass ◽  
Glucose Homeostasis ◽  
Gonadal Steroids ◽  
Fasting Insulin ◽  
Biochemical Control ◽  
Ectopic Lipids ◽  
Active Acromegaly

Abstract Context Acromegaly is characterized by growth hormone (GH) and insulinlike growth factor-1 (IGF-1) hypersecretion, and GH and IGF-1 play important roles in regulating body composition and glucose homeostasis. Objective The purpose of our study was to investigate body composition including ectopic lipids, measures of glucose homeostasis, and gonadal steroids in patients with active acromegaly compared with age-, body mass index (BMI)−, and sex-matched controls and to determine changes in these parameters after biochemical control of acromegaly. Design Cross-sectional study of 20 patients with active acromegaly and 20 healthy matched controls. Prospective study of 16 patients before and after biochemical control of acromegaly. Main Outcome Measures Body composition including ectopic lipids by magnetic resonance imaging/proton magnetic resonance spectroscopy; measures of glucose homeostasis by an oral glucose tolerance test; gonadal steroids. Results Patients with active acromegaly had lower mean intrahepatic lipid (IHL) and higher mean fasting insulin and insulin area under the curve (AUC) values than controls. Men with acromegaly had lower mean total testosterone, sex hormone−binding globulin, and estradiol values than male controls. After therapy, homeostasis model assessment of insulin resistance, fasting insulin level, and insulin AUC decreased despite an increase in IHL and abdominal and thigh adipose tissues and a decrease in muscle mass. Conclusions Patients with acromegaly were characterized by insulin resistance and hyperinsulinemia but lower IHL compared with age-, BMI-, and sex-matched healthy controls. Biochemical control of acromegaly improved insulin resistance but led to a less favorable anthropometric phenotype with increased IHL and abdominal adiposity and decreased muscle mass.

scholarly journals Body Composition Changes with Long-term Pegvisomant Therapy of Acromegaly

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Adriana P Kuker ◽  
Wei Shen ◽  
Zhezhen Jin ◽  
Simran Singh ◽  
Jun Chen ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Composition ◽  
Magnetic Resonance ◽  
Whole Body ◽  
Resonance Spectroscopy ◽  
Model Assessment ◽  
Long Term Effects ◽  
Body Composition Change ◽  
Active Acromegaly

Abstract Context In active acromegaly, the lipolytic and insulin antagonistic effects of growth hormone (GH) excess alter adipose tissue (AT) deposition, reduce body fat, and increase insulin resistance. This pattern reverses with surgical therapy. Pegvisomant treats acromegaly by blocking GH receptor (GHR) signal transduction and lowering insulin-like growth factor 1 (IGF-1) levels. The long-term effects of GHR antagonist treatment of acromegaly on body composition have not been studied. Methods We prospectively studied 21 patients with active acromegaly who were starting pegvisomant. Body composition was examined by whole body magnetic resonance imaging, proton magnetic resonance spectroscopy of liver and muscle and dual-energy x-ray absorptiometry, and endocrine and metabolic markers were measured before and serially during 1.0 to 13.4 years of pegvisomant therapy. The data of patients with acromegaly were compared with predicted and to matched controls. Results Mass of visceral AT (VAT) increased to a peak of 187% (1.56-229%) (P < .001) and subcutaneous AT (SAT) to 109% (–17% to 57%) (P = .04) of baseline. These remained persistently and stably increased, but did not differ from predicted during long-term pegvisomant therapy. Intrahepatic lipid rose from 1.75% to 3.04 % (P = .04). Although lean tissue mass decreased significantly, skeletal muscle (SM) did not change. IGF-1 levels normalized, and homeostasis model assessment insulin resistance and HbA1C were lowered. Conclusion Long-term pegvisomant therapy is accompanied by increases in VAT and SAT mass that do not differ from predicted, stable SM mass and improvements in glucose metabolism. Long-term pegvisomant therapy does not produce a GH deficiency-like pattern of body composition change.

scholarly journals Body composition and risk for metabolic alterations in female adolescents

2014 ◽  
Vol 32 (2) ◽  
pp. 207-215 ◽  
Author(s):  
Eliane Rodrigues de Faria ◽  
Cristiana Araújo Gontijo ◽  
Sylvia do Carmo C. Franceschini ◽  
Maria do Carmo G. Peluzio ◽  
Silvia Eloiza Priore
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Body Composition ◽  
Density Lipoprotein ◽  
Female Adolescents ◽  
Fasting Insulin ◽  
Height Ratio ◽  
Metabolic Alterations ◽  
Waist To Height Ratio ◽  
Body Fat Percent

OBJECTIVE: To study anthropometrical and body composition variables as predictors of risk for metabolic alterations and metabolic syndrome in female adolescents.METHODS: Biochemical, clinical and corporal composition data of 100 adolescents from 14 to 17 years old, who attended public schools in Viçosa, Southeastern Brazil, were collected.RESULTS: Regarding nutritional status, 83, 11 and 6% showed eutrophia, overweight/obesity and low weight, respectively, and 61% presented high body fat percent. Total cholesterol presented the highest percentage of inadequacy (57%), followed by high-density lipoprotein (HDL - 50%), low-density lipoprotein (LDL - 47%) and triacylglycerol (22%). Inadequacy was observed in 11, 9, 3 and 4% in relation to insulin resistance, fasting insulin, blood pressure and glycemia, respectively. The highest values of the fasting insulin and the Homeostasis Model Assessment-Insulin Resistance(HOMA-IR) were verified at the highest quartiles of body mass index (BMI), waist perimeter, waist-to-height ratio and body fat percent. Body mass index, waist perimeter, and waist-to-height ratio were the better predictors for high levels of HOMA-IR, blood glucose and fasting insulin. Waist-to-hip ratio was associated to arterial hypertension diagnosis. All body composition variables were effective in metabolic syndrome diagnosis.CONCLUSIONS: Waist perimeter, BMI and waist-to-height ratio showed to be good predictors for metabolic alterations in female adolescents and then should be used together for the nutritional assessment in this age range.

scholarly journals Increased intramyocellular lipid accumulation in HIV-infected women with fat redistribution

2006 ◽  
Vol 100 (2) ◽  
pp. 609-614 ◽  
Author(s):  
Martin Torriani ◽  
Bijoy J. Thomas ◽  
Robert B. Barlow ◽  
Jamie Librizzi ◽  
Sara Dolan ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Composition ◽  
Magnetic Resonance ◽  
Subcutaneous Fat ◽  
Abdominal Fat ◽  
Whole Body ◽  
Resonance Spectroscopy ◽  
Intramyocellular Lipid ◽  
Fat Redistribution ◽  
Visceral Abdominal Fat

The human immunodeficiency virus (HIV)-lipodystrophy syndrome is associated with fat redistribution and metabolic abnormalities, including insulin resistance. Increased intramyocellular lipid (IMCL) concentrations are thought to contribute to insulin resistance, being linked to metabolic and body composition variables. We examined 46 women: HIV infected with fat redistribution ( n = 25), and age- and body mass index-matched HIV-negative controls ( n = 21). IMCL was measured by 1H-magnetic resonance spectroscopy, and body composition was assessed with computed tomography, dual-energy X-ray absorptiometry (DEXA), and magnetic resonance imaging. Plasma lipid profile and markers of glucose homeostasis were obtained. IMCL was significantly increased in tibialis anterior [135.0 ± 11.5 vs. 85.1 ± 13.2 institutional units (IU); P = 0.007] and soleus [643.7 ± 61.0 vs. 443.6 ± 47.2 IU, P = 0.017] of HIV-infected subjects compared with controls. Among HIV-infected subjects, calf subcutaneous fat area (17.8 ± 2.3 vs. 35.0 ± 2.5 cm2, P < 0.0001) and extremity fat by DEXA (11.8 ± 1.1 vs. 15.6 ± 1.2 kg, P = 0.024) were reduced, whereas visceral abdominal fat (125.2 ± 11.3 vs. 74.4 ± 12.3 cm2, P = 0.004), triglycerides (131.1 ± 11.0 vs. 66.3 ± 12.3 mg/dl, P = 0.0003), and fasting insulin (10.8 ± 0.9 vs. 7.0 ± 0.9 μIU/ml, P = 0.004) were increased compared with control subjects. Triglycerides ( r = 0.39, P = 0.05) and extremity fat as percentage of whole body fat by DEXA ( r = −0.51, P = 0.01) correlated significantly with IMCL in the HIV but not the control group. Extremity fat (β = −633.53, P = 0.03) remained significantly associated with IMCL among HIV-infected patients, controlling for visceral abdominal fat, abdominal subcutaneous fat, and antiretroviral medications in a regression model. These data demonstrate increased IMCL in HIV-infected women with a mixed lipodystrophy pattern, being most significantly associated with reduced extremity fat. Further studies are necessary to determine the relationship between extremity fat loss and increased IMCL in HIV-infected women.

scholarly journals Sarcopenic Obesity and Cognitive Functioning: The Mediating Roles of Insulin Resistance and Inflammation?

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
M. E. Levine ◽  
E. M. Crimmins
Keyword(s):  
Insulin Resistance ◽  
Older Adults ◽  
Body Composition ◽  
Cognitive Functioning ◽  
Cognitive Performance ◽  
Muscle Mass ◽  
Significant Proportion ◽  
Age Related ◽  
Older Subjects ◽  
The Relationship

This study examined the influence of insulin resistance and inflammation on the association between body composition and cognitive performance in older adults, aged 60–69 and aged 70 and older. Subjects included 1127 adults from NHANES 1999–2002. Body composition was categorized based on measurements of muscle mass and waist circumference as sarcopenic nonobese, nonsarcopenic obese, sarcopenic obese, and normal. Using OLS regression models, our findings suggest body composition is not associated with cognitive functioning in adults ages 60–69; however, for adults aged 70 and over, sarcopenia and obesity, either independently or concurrently, were associated with worse cognitive functioning relative to non-sarcopenic non-obese older adults. Furthermore, insulin resistance accounted for a significant proportion of the relationship between cognitive performance and obesity, with or without sarcopenia. Additionally, although high CRP was significantly associated with poorer cognitive functioning in adults ages 60–69, it did not influence the association between body composition and cognitive performance. This study provides evidence that age-related physiological maladaptations, such as metabolic deregulation, which are associated with abdominal fat, may simultaneously contribute to lower cognition and muscle mass, reflecting a degradation of multiple physiological systems.

scholarly journals Exercise Alone Reduces Insulin Resistance in Obese Children Independently of Changes in Body Composition

2007 ◽  
Vol 92 (11) ◽  
pp. 4230-4235 ◽  
Author(s):  
Lana M. Bell ◽  
Katie Watts ◽  
Aris Siafarikas ◽  
Alisha Thompson ◽  
Nirubasini Ratnam ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Composition ◽  
Insulin Sensitivity ◽  
Exercise Training ◽  
Outcome Measures ◽  
Dual Energy ◽  
Fasting Insulin ◽  
Obese Children ◽  
X Ray ◽  
Exercise Training Program

Abstract Context: The number of obese children with insulin resistance and type 2 diabetes is increasing, but the best management strategy is not clear. Objective: The objective of this study was to assess the effect of a structured 8-wk exercise training program on insulin resistance and changes in body composition in obese children. Design: The study was 8 wk of structured supervised exercise intervention with outcome measures before and after the exercise period. Subjects: Fourteen obese children (12.70 ± 2.32 yr; eight male, six female) with high fasting insulin levels were enrolled into the study. Intervention: Intervention consisted of 8 wk of supervised circuit-based exercise training, composed of three fully supervised 1-h sessions per week. Outcome Measures: Outcome measures were assessed pretraining program and posttraining program and included insulin sensitivity (euglycemic-hyperinsulinemic clamp studies), fasting insulin and glucose levels, body composition using dual energy x-ray absorptiometry scan, lipid profile, and liver function tests. Results: Insulin sensitivity improved significantly after 8 wk of training (Mlbm 8.20 ± 3.44 to 10.03 ± 4.33 mg/kg·min, P &lt; 0.05). Submaximal exercise heart rate responses were significantly lower following the training (P &lt; 0.05), indicating an improvement in cardiorespiratory fitness. Dual energy x-ray absorptiometry scans revealed no differences in lean body mass or abdominal fat mass. Conclusion: An 8-wk exercise training program increases insulin sensitivity in obese children, and this improvement occurred in the presence of increased cardiorespiratory fitness but is independent of measurable changes in body composition.

scholarly journals Changes in Plasma Levels of N-Arachidonoyl Ethanolamine and N-Palmitoylethanolamine following Bariatric Surgery in Morbidly Obese Females with Impaired Glucose Homeostasis

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Akhila Mallipedhi ◽  
Sarah L. Prior ◽  
Gareth Dunseath ◽  
Richard M. Bracken ◽  
Jonathan Barry ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Bariatric Surgery ◽  
Glucose Homeostasis ◽  
Fasting Glucose ◽  
Morbidly Obese ◽  
Fasting Insulin ◽  
C Peptide ◽  
Specific Analysis ◽  
Obese Subjects ◽  
Gender Specific

Aim. We examined endocannabinoids (ECs) in relation to bariatric surgery and the association between plasma ECs and markers of insulin resistance.Methods. A study of 20 participants undergoing bariatric surgery. Fasting and 2-hour plasma glucose, lipids, insulin, and C-peptide were recorded preoperatively and 6 months postoperatively with plasma ECs (AEA, 2-AG) and endocannabinoid-related lipids (PEA, OEA).Results. Gender-specific analysis showed differences in AEA, OEA, and PEA preoperatively with reductions in AEA and PEA in females postoperatively. Preoperatively, AEA was correlated with 2-hour glucose (r=0.55,P=0.01), HOMA-IR (r=0.61,P=0.009), and HOMA %S (r=-0.71,P=0.002). OEA was correlated with weight (r=0.49,P=0.03), waist circumference (r=0.52,P=0.02), fasting insulin (r=0.49,P=0.04), and HOMA-IR (r=0.48,P=0.05). PEA was correlated with fasting insulin (r=0.49,P=0.04). 2-AG had a negative correlation with fasting glucose (r=-0.59,P=0.04).Conclusion. Gender differences exist in circulating ECs in obese subjects. Females show changes in AEA and PEA after bariatric surgery. Specific correlations exist between different ECs and markers of obesity and insulin and glucose homeostasis.

scholarly journals Associations of −308G/APolymorphism ofTumor Necrosis Factor(TNF)–αGene and Serum TNF-αLevels with Measures of Obesity, Intra-Abdominal and Subcutaneous Abdominal Fat, Subclinical Inflammation and Insulin Resistance in Asian Indians in North India

2011 ◽  
Vol 31 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Naval K. Vikram ◽  
Surya Prakash Bhatt ◽  
Bharat Bhushan ◽  
Kalpana Luthra ◽  
Anoop Misra ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Composition ◽  
Asian Indians ◽  
Abdominal Fat ◽  
North India ◽  
Fasting Insulin ◽  
Necrosis Factor Alpha ◽  
Tnf Α ◽  
Hs Crp ◽  
Necrosis Factor

Objectives:Obesity is associated with high levels proinflammatory cytokines like tumour necrosis factor alpha (TNF-α), which may play an important role in the genesis of insulin resistance. We evaluated the relationship of −308G/Apolymorphism ofTNF-αgene with obesity and insulin resistance in Asian Indians in north India.Methods:This cross-sectional study included 151 apparently healthy individuals (79 males, 72 females) 18–50 yrs of age from New Delhi, India. Body composition by dual-energy x-ray absorptiometry (DEXA) and abdominal fat by magnetic resonance imaging (MRI) were measured. Biochemical measurements included OGTT, lipids, fasting insulin, hs-CRP and TNF-αlevels. We analysed −308G/Apolymorphism ofTNF-αgene and studied its association with obesity and biochemical parameters.Results:At comparable BMI, abdominal obesity was more prevalent in females (50%) as compared to males (20%). The wild genotype (GG) was present in 78.8%, GA in 17.9%, andAAin 3.3% subjects. Measures of body composition, abdominal fat distribution, lipids, insulin, hs-CRP and TNF-αlevels were not influenced by the presence of −308G/Apolymorphism. Serum TNF-αlevels correlated significantly with fasting insulin in both genders.Conclusion:TNF-αlevels correlate with fasting insulin but not with indicators of body composition in Asian Indians. The −308G/Apolymorphism ofTNF-αgene is not associated with differences in the serum levels of TNF-αin Asian Indians.

Both macronutrient food composition and fasting insulin resistance affect postprandial glycemic responses in senior subjects

2021 ◽  
Author(s):  
Cristina Galarregui ◽  
Santiago Navas-Carretero ◽  
Carlos J. Gonzalez-Navarro ◽  
J. Alfredo Martinez ◽  
M. Angeles Zulet ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Risk Factor ◽  
Glucose Homeostasis ◽  
Postprandial Glucose ◽  
Food Composition ◽  
Postprandial Hyperglycemia ◽  
Metabolic Responses ◽  
Fasting Insulin

Introduction: Postprandial hyperglycemia is a risk factor for type 2 diabetes. Insulin resistance (IR) might affect metabolic responses in non-fasting states. Dietary intake and food composition influence postprandial glucose homeostasis....

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