Endocrinology and Metabolism

Review Article

Obesity and Metabolism
Genetic and Environmental Factors Contributing to Visceral Adiposity in Asian Populations: Rachel Williams, Muthu Periasamy; Endocrinol Metab. 2020;35(4):681-695. Published online December 23, 2020; DOI: https://doi.org/10.3803/EnM.2020.772

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Obesity-associated metabolic illnesses are increasing at an alarming rate in Asian countries. A common feature observed in the Asian population is a higher incidence of abdominal obesity—the “skinny-fat” Asian syndrome. In this review, we critically evaluate the relative roles of genetics and environmental factors on fat distribution in Asian populations. While there is an upward trend in obesity among most Asian countries, it appears particularly conspicuous in Malaysia. We propose a novel theory, the Malaysian gene-environment multiplier hypothesis, which explains how ancestral variations in feast-and-famine cycles contribute to inherited genetic predispositions that, when acted on by modern-day stressors—most notably, urbanization, westernization, lifestyle changes, dietary transitions, cultural pressures, and stress—contribute to increased visceral adiposity in Asian populations. At present, the major determinants contributing to visceral adiposity in Asians are far from conclusive, but we seek to highlight critical areas for further research.

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Original Articles

Utility of the Visceral Adiposity Index and Hypertriglyceridemic Waist Phenotype for Predicting Incident Hypertension: Mohsen Janghorbani, Mohammad Reza Salamat, Ashraf Aminorroaya, Masoud Amini; Endocrinol Metab. 2017;32(2):221-229. Published online May 19, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.2.221

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Abstract PDF PubReader

Background

The aim of this study was to assess the utility of the visceral adiposity index (VAI) and the hypertriglyceridemic waist (HTGW) phenotype as possible hypertension (HTN) predictors in a high-risk population without diabetes and HTN.

Methods

Incident HTN over a 7-year follow-up was assessed among 1,375 first-degree non-diabetic and non-hypertensive relatives of consecutive patients with type 2 diabetes who were 30 to 70 years of age. HTN was defined as a blood pressure reading ≥140/90 mm Hg or the use of antihypertensive medications. We examined the incidence of HTN across VAI quintiles and four groups defined according to baseline fasting serum triglyceride (TG) levels and waist circumference (WC).

Results

The VAI and the HTGW phenotype at baseline were related to an increased risk for HTN. In comparison with the lowest VAI quintile, the highest VAI quintile showed a significant associated with HTN in an age- and gender-adjusted model (odds ratio [OR], 1.65; 95% confidence interval [CI], 1.07 to 2.55). Those with HTGW were 2.3 times (OR, 2.27; 95% CI, 1.54 to 3.35) more likely to develop HTN than those with a normal WC and normal TG levels.

Conclusion

Greater VAI values weakly predicted HTN, whereas the HTGW phenotype was a stronger predictor of incident HTN in an Iranian high-risk population.

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Response: Utility of the Visceral Adiposity Index and Hypertriglyceridemic Waist Phenotype for Predicting Incident Hypertension (Endocrinol Metab 2017;32:221-9, Mohsen Janghorbani et al.)
Mohsen Janghorbani
Endocrinology and Metabolism.2017; 32(4): 485. CrossRef
Letter: Utility of the Visceral Adiposity Index and Hypertriglyceridemic Waist Phenotype for Predicting Incident Hypertension (Endocrinol Metab 2017;32:221-9, Mohsen Janghorbani et al.)
Eun-Jung Rhee
Endocrinology and Metabolism.2017; 32(3): 396. CrossRef

The Effect of Fenofibrate and Exercise on Metabolic Syndrome and Hepatic Steatosis in OLETF Rats.: Kyung II Lee, Ji Min Kim, Ja Young Park, Ja Won Kim, Ji Young Mok, Mi Kyoung Park, Hye Jeong Lee, Sook Hee Hong, Wenjun Li, Duk Kyu Kim; J Korean Endocr Soc. 2007;22(3):192-202. Published online June 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.3.192

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Abstract PDF

BACKGROUND
The aim of this study is to verify the effects of fenofibrate monotherapy and fenofibrate combined with exercise for improving metabolic syndrome and hepatic steatosis. METHODS: Thirty-four weeks old OLETF rats (Otsuka Long-Evans Tokushima Fatty Rats, n = 20) were divided four groups: the regular diet group (n = 5, DD group), the exercise group (n = 5, DE group), the fenofibrate (100 mg/kg) treated group (n = 5, DF group) and the combination treatment group {fenofibrate and exercise (n = 5, EF group)}. After 5 weeks of treatment, blood was drawn for measuring the blood glucose, insulin, lipid and leptin levels. All the subjects were sacrificed for assessment of their body adiposity and hepatic steatosis. RESULTS: The total amount of food intake, body weight and total body weight of the rat were significantly decreased in the EF and DF groups compared to the DD group. The plasma triglyceride and glucose levels were significantly decreased in the EF and DF groups compared to the DD group. The HOMA-IR of EF, DF and DE groups were significantly decreased compared with that of the DD group. The plasma leptin levels of the EF and DF groups were significantly decreased compared with those of the DD and DE groups. The hepatic steatosis index was significantly decreased in the EF and DF groups compared to the DD and DE groups. CONCLUSION: Fenofibrate monotherapy was effective to control three major components (obesity, hypertriglyceridemia and hyperglycemia) of metabolic syndrome and hepatic steatosis in OLETF rats. Exercise combined with fenofibrate treatment showed an additional effect compared to that of fenofibrate monotherapy.

Citations

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Effect of Fenofibrate and Exercise on Metabolic Syndrome and Hepatic Steatosis
Bong Soo Cha, Jae Hyuk Lee
Journal of Korean Endocrine Society.2007; 22(3): 188. CrossRef

Association of Serum Adiponectin Levels with Insulin Resistance in Women with Polycystic Ovary Syndrome.: Young Sun Hong, Jee Young Oh, Eun Kyung Byun, Yeon Ah Sung; J Korean Endocr Soc. 2004;19(4):369-378. Published online August 1, 2004

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Abstract PDF: BACKGROUND
Polycystic ovary syndrome (PCOS) is known to be associated with obesity and insulin resistance. The exact mechanism of insulin resistance in PCOS is not completely understood, but there are several pieces of evidence suggesting humoral mediator involvement. Adiponectin, an adipocyte-secreted protein, could be a possible link between adiposity and insulin resistance. This study was performed to see whether the serum adiponectin levels are suppressed in woman with PCOS and if this is associated with the characteristic hormonal and metabolic features of PCOS. METHODS: 20 women with PCOS and 8 normal controls with regular cycles were recruited. The serum adiponectin levels were measured by RIA, and the fasting glucose to insulin ratio (GIR) used as an insulin sensitivity index. RESULTS: The patients with PCOS were classified as lean (BMI < 23 kg/m2, n=9) and obese groups (BMI 25 kg/m2, n=11) based on the WPRO criteria. The GIR was significantly lower in the obese compared to the control group. The adiponectin level was lower in women with PCOS than the controls, but without statistical significance. In 5 of the 20 patients, the GIR was higher than 0.30, which was the lowest limit in the controls, and the adiponectin level was significantly higher than in those patients with a lower GIR. The adiponectin level was significantly correlated with the BMI, subcutaneous and visceral fat areas, post challenge 2 hr glucose, fasting insulin, GIR and SHBG. After adjustment for BMI, adiponectin was significantly correlated with the GIR in all subjects, including the controls. CONCLUSION: The serum adiponectin level was associated with and related to adiposity in women with PCOS; however, adiponectin might be associated with insulin resistance independently from adiposity

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