Fasting serum insulin in relation to fat distribution, serum lipid profile, and blood pressure in European women: the European Fat Distribution Study.

Samples of 38-year-old women were randomly selected from five European centers: Ede (The Netherlands), Warsaw (Poland), Gothenburg (Sweden), Verona (northern Italy), and Afragola (Naples-southern Italy). In total, 452 healthy women were studied. Anthropometric measurements were taken by one operator in each country after common training of all operators and blood parameters of all women were determined in one laboratory. Body mass index (BMI) was different among centers, mainly due to the higher values in southern Italy. Women from southern Europe had more central fat distribution than women from north European centers. Fasting serum insulin was higher in women from Poland and The Netherlands than in the other three centers. After adjustment for BMI, fasting insulin was significantly related to subscapular skinfold, subscapular to triceps skinfold ratio, waist circumference, and waist to thigh circumference ratio, although the partial correlations varied somewhat between the centers. In the pooled data, waist circumference showed the highest correlations with fasting serum insulin when adjusted for BMI. Fasting serum insulin showed significant partial correlations, adjusted for BMI, with lipid profile and blood pressure only in women from the two Italian centers. In the pooled data, fasting serum insulin was significantly positively correlated with serum triglycerides and total cholesterol and negatively to high-density lipoprotein (HDL) cholesterol and HDL/total cholesterol, independently of BMI and waist circumference. While blood pressure was not related to insulin in the pooled women, when adjusted for BMI and waist circumference; here as well, there were some differences in relationships between the centers.(ABSTRACT TRUNCATED AT 250 WORDS)

Androgenicity in relation to body fat distribution and metabolism in 38-year-old women--the European Fat Distribution Study.

We studied fat distribution and metabolic risk factors in 434 38-year old women selected from population registrars in 5 cities in different parts of Europe. In the present study we focussed on the geographical variation in serum concentrations of free testosterone and its relation to measures of obesity, fat distribution and indicators of cardiovascular risk (serum lipids, insulin, and blood pressure). There were significant differences in free testosterone levels (F = 5.4, p less than 0.001) with lowest levels in Polish women (mean +/- SEM: 1.56 +/- 0.08 pg/ml) and highest in women from Italy (2.07 +/- 0.12 pg/ml). In the pooled data, free testosterone levels were correlated with several anthropometric variables (strongest with subscapular/triceps ratio r = 0.27, with subscapular skinfold and waist/thigh circumference ratio r = 0.25 p-values less than 0.001). In addition, free testosterone was positively correlated with serum total cholesterol (r = 0.11), HDL/total cholesterol fraction (r = 0.12), serum insulin (r = 0.20) and diastolic blood pressure (r = 0.15). These associations remained significant after adjustment for body mass index and waist/thigh ratio (not for diastolic blood pressure) but were no longer significant after further adjustment for insulin levels. There were considerable differences in strength of the associations mentioned between the 5 centers. We conclude that degree of obesity, fat distribution and serum levels of free testosterone all, to a limited degree, contribute to the metabolic profile of randomly selected 38-year old women but that adjustment for such variables increases the differences in metabolic profiles between women from different centers of Europe.

Indicators of fat distribution, serum lipids, and blood pressure in European women born in 1948--the European Fat Distribution Study.

In the spring of 1986, the authors studied the relation between body mass index and anthropometric indicators of fat distribution to cardiovascular risk factors (serum lipids and blood pressure) in approximately 450 women aged 38 years randomly selected from population registers in five European centers. Waist circumference was, in univariate analysis, more strongly related to triglycerides (positive association) and high density lipoprotein (HDL) cholesterol (negative association) than to body mass index or any other anthropometric measurement. Among the centers, we observed considerable variation in the strength of the associations between anthropometric measurements and risk factors. After adjustment for body mass index, most associations between skinfolds and circumferences and risk factors were reduced to statistically nonsignificant levels, but in some centers there were independent contributions of circumferences or circumference ratios to serum lipids, but not to blood pressures. Adjustment for differences in body mass index and fat distribution between the centers did not reduce the differences in cardiovascular risk factors between the different centers but instead revealed that serum cholesterol levels were lowest in the centers of southern Europe (Italy) and that HDL cholesterol levels were higher. Blood pressure was highest in the Swedish women. We conclude that in some female populations, but not in others, indicators of fat distribution are related to serum lipids but not to blood pressure, independent of body mass index.