MedicalResearch.com Interview with:
Kalypso Karastergiou, MD, PhD
Assistant Professor, Medicine, Endocrinology, Diabetes and Bone Disease
Diabetes, Obesity and Metabolism Institute
Icahn School of Medicine at Mount Sinai
MedicalResearch.com: What is the background for this study?
Response: Multiple studies, epidemiological as well as clinical, have established that body shape is an important and independent predictor of cardiovascular and metabolic disease risk and ultimately total mortality. Subjects that preferentially store weight in the abdominal area (often described as android, upper-body or apple-shape obesity) are at increased risk, whereas those who preferentially store weight in the lower body, in the gluteofemoral area (gynoid, lower-body or pear-shape), appear to be protected. The former is more common in men, whereas the latter in women, especially premenopausal women.
The overarching questions in the field are:
- What factors determine body shape?
- Why are subjects with lower-body shape protected?
- Can we exploit the physiological and pathophysiological mechanisms involved to improve stratification, prevention or treatment of obesity and related diseases?
MedicalResearch.com: What are the main findings?
Response: Up to date, studies in body shape have focused on the distribution of the adipose (fat) tissue.
This report seeks to expand the investigation to other tissues as well. During the period from 1999-2006, 14,005 participants in the National Health and Nutrition Examination Survey (which represents the United States population), 20-69 years old, had a DXA test that allows total and regional estimation of fat, lean and bone tissue mass.
This preliminary analysis shows that body shape is determined by coordinated changes in the head, trunk and limbs that involve the fat, as well as the other tissues.
MedicalResearch.com: What should readers take away from your report?
Response: This is an observational study that doesn’t allow us to draw conclusion as to cause and effect or prediction of future risk. It does suggest that body shape is a whole-body feature with systematic, coordinated changes in all body compartments and tissues.
The observations should be replicated in other populations and in prospective studies.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: This report generates more questions than it answers.
- First of all, are there differences in the function of tissues that determine body shape between subjects with upper- versus lower body shape?
- Which tissues drive differences in physiology and disease risk?
- Can we identify the underlying molecular pathways?
- Does any of these pathways represent a viable mechanistic target to prevent or treat disease and improve quality of life?
Dislosures: The study is partly funded by grants from the MSHS Translational Science Hub at Icahn School of Medicine at Mount Sinai (KL2TR001435) and the Einstein-Sinai Diabetes Research Center in New York City.
Citation: ADA 2019 abstract
277-OR: Lean Tissues as Novel Determinants of Pear vs. Apple Body Shape and Metabolic Health in Humans
Diabetes 2019 Jun; 68(Supplement 1): -.https://doi.org/10.2337/db19-277-OR
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