Body Fat Distribution and Inflammation Among Obese Older Adults With and Without Metabolic Syndrome

Authors

  • Annemarie Koster,

    Corresponding author
    1. Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland, USA
    2. School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
      (kostera@mail.nih.gov)
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  • Sari Stenholm,

    1. Clinical Research Branch, National Institute on Aging, Baltimore, Maryland, USA
    2. Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Turku, Finland
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  • Dawn E. Alley,

    1. Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
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  • Lauren J. Kim,

    1. Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland, USA
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  • Eleanor M. Simonsick,

    1. Clinical Research Branch, National Institute on Aging, Baltimore, Maryland, USA
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  • Alka M. Kanaya,

    1. Division of General Internal Medicine, University of California, San Francisco, California, USA
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  • Marjolein Visser,

    1. Department of Health Sciences and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University, Amsterdam, The Netherlands
    2. Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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  • Denise K. Houston,

    1. Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
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  • Barbara J. Nicklas,

    1. Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
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  • Frances A. Tylavsky,

    1. Department of Preventive Medicine, University of Tennessee College of Medicine, Memphis, Tennessee, USA
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  • Suzanne Satterfield,

    1. Department of Preventive Medicine, University of Tennessee College of Medicine, Memphis, Tennessee, USA
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  • Bret H. Goodpaster,

    1. Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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  • Luigi Ferrucci,

    1. Clinical Research Branch, National Institute on Aging, Baltimore, Maryland, USA
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  • Tamara B. Harris,

    1. Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland, USA
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  • For the Health ABC Study


(kostera@mail.nih.gov)

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/m2), 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.

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