Fat distribution affects PCOS metabolism regardless of body weight
Fat distribution affects PCOS metabolism regardless of body weight
Source: Fertility and Sterility 2003; 79: 1358-64
Intra-abdominal fat distribution may be important in women with PCOS regardless of whether they are obese.
Women with polycystic ovary syndrome (PCOS) tend to exhibit abnormal fat distribution even if they are not obese, perhaps indicating an increased risk of metabolic disorders, research indicates.
"Visceral fat accumulation has been reported to be closely related to the development of metabolic disorders, such as glucose intolerance, insulin resistance, and abnormal lipid metabolism associated with obesity," explain Dr. Basak Yildirim (Pamukkale University Hospital, Denizli, Turkey) and colleagues.
They used ultrasound to measure subcutaneous and intra-abdominal visceral and preperitoneal fat thickness in 30 nonobese women with PCOS, and a control group of lean women with regular menstrual cycles. Glucose tolerance, insulin sensitivity, serum hormones, and lipid profiles were also assessed.
The average preperitoneal and visceral fat thickness was significantly greater in the women with PCOS than the controls, and PCOS was associated with glucose intolerance, hyperinsulinemia, and dyslipidemia. Furthermore, preperitoneal and visceral fat thickness correlated positively with triglyceride levels and hyperinsulinemia, and negatively with high-density lipoprotein levels in the women with PCOS.
"These results suggest that visceral fat accumulation may be an early marker of metabolic disorders in nonobese patients with PCOS," Yildirim et al conclude. They propose that ultrasonographic measurement of visceral adipose tissue be added to metabolic screening in such patients.
Posted: 9 July 2003
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I am in the normal range for BMI. Does anyone know how I can check on my intra-abdominal visceral and preperitoneal fat? Will the Ob/Gyn perform this ultraound?
__________________ Kristin (25) Husband (29)
TTC since January '08
Diagnosed with PCOS 3/19/08
Sx: Acne, regular BMI but midsection additional weight, ovarian cysts, increased LH and testosterone.
Rx: Clomid - Day 5-9 starting 3/19 (us on 3/25 *follies still too small.)
Natural Treatments: Acupuncture and Herbal Supplements
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I am in the normal range for BMI. Does anyone know how I can check on my intra-abdominal visceral and preperitoneal fat? Will the Ob/Gyn perform this ultraound?
I'm not sure, but I 'think' a dexascan can determine where fat is...
BTW:
ARTICLE: Thin people may be fat inside, some doctors say
LONDON (AP) — If it really is what's on the inside that counts, then a lot of thin people might be in trouble.
Some doctors now think that the internal fat surrounding vital organs like the heart, liver or pancreas — invisible to the naked eye — could be as dangerous as the more obvious external fat that bulges underneath the skin.
"Being thin doesn't automatically mean you're not fat," said Dr. Jimmy Bell, a professor of molecular imaging at Imperial College, London. Since 1994, Bell and his team have scanned nearly 800 people with MRI machines to create "fat maps" showing where people store fat.
According to the data, people who maintain their weight through diet rather than exercise are likely to have major deposits of internal fat, even if they are otherwise slim. "The whole concept of being fat needs to be redefined," said Bell, whose research is funded by Britain's Medical Research Council.
Without a clear warning signal — like a rounder middle — doctors worry that thin people may be lulled into falsely assuming that because they're not overweight, they're healthy.
"Just because someone is lean doesn't make them immune to diabetes or other risk factors for heart disease," said Dr. Louis Teichholz, chief of cardiology at Hackensack University Medical Center in New Jersey, who was not involved in Bell's research.
Even people with normal Body Mass Index scores — a standard obesity measure that divides your weight by the square of your height — can have surprising levels of fat deposits inside.
Of the women scanned by Bell and his colleagues, as many as 45% of those with normal BMI scores (20 to 25) actually had excessive levels of internal fat. Among men, the percentage was nearly 60%.
Relating the news to what Bell calls "TOFIs" — people who are "thin outside, fat inside" — is rarely uneventful. "The thinner people are, the bigger the surprise," he said, adding the researchers even found TOFIs among people who are professional models.
According to Bell, people who are fat on the inside are essentially on the threshold of being obese. They eat too many fatty, sugary foods — and exercise too little to work it off — but they are not eating enough to actually be fat. Scientists believe we naturally accumulate fat around the belly first, but at some point, the body may start storing it elsewhere.
Still, most experts believe that being of normal weight is an indicator of good health, and that BMI is a reliable measurement.
"BMI won't give you the exact indication of where fat is, but it's a useful clinical tool," said Dr. Toni Steer, a nutritionist at Britain's Medical Research Council.
Doctors are unsure about the exact dangers of internal fat, but some suspect it contributes to the risk of heart disease and diabetes. They theorize that internal fat disrupts the body's communication systems. The fat enveloping internal organs might be sending the body mistaken chemical signals to store fat inside organs like the liver or pancreas. This could ultimately lead to insulin resistance, type 2 diabetes, or heart disease.
Experts have long known that fat, active people can be healthier than their skinny, inactive counterparts. "Normal-weight persons who are sedentary and unfit are at much higher risk for mortality than obese persons who are active and fit," said Dr. Steven Blair, an obesity expert at the University of South Carolina.
For example, despite their ripples of fat, super-sized Sumo wrestlers probably have a better metabolic profile than some of their slim, sedentary spectators, Bell said. That's because the wrestlers' fat is primarily stored under the skin, not streaking throughout their vital organs and muscles.
The good news is that internal fat can be easily burned off through exercise or even by improving your diet. "Even if you don't see it on your bathroom scale, caloric restriction and physical exercise have an aggressive effect on visceral fat," said Dr. Bob Ross, an obesity expert at Queen's University in Canada.
Because many factors contribute to heart disease, Teichholz says it's difficult to determine the precise danger of internal fat — though it certainly doesn't help.
"Obesity is a risk factor, but it's lower down on the totem pole of risk factors," he said, explaining that whether or not people smoke, their family histories and blood pressure and cholesterol rates are more important determinants than both external and internal fat.
When it comes to being fit, experts say there is no short-cut. "If you just want to look thin, then maybe dieting is enough," Bell said. "But if you want to actually be healthy, then exercise has to be an important component of your lifestyle."
Copyright 2007 The Associated Press. All rights reserved.
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Hey, SoulCysters! Need to eat more veggies, but can't find recipes??
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Hello, I'm a newbie. Very interesting topic! I have a calculated BMI of 21, and have no waist, all the fat I carry is in my middle. I was recently 'assessed' at my local gym and they had a set of scales there that apparently can read body fat content through infra-red or something - anyway, the scales said my BMI was 25! The coach was confused he said they were usually pretty accurate but he couldn't understand where all my fat was!!
I've also read about the waist/hip ratio being a more reliable indicator of general 'fat' status than BMI. Mine was 0.82 - apparently anything over 0.8 means you are carrying too much weight on your middle. I'm quite active and I eat a healthy diet. I haven't been tested for IR but maybe that is it....
Welcome, Annie! I don't really believe in the waist/hip ratio thing for everyone, because I have pretty narrow hips, so my waist/hip ratio is 27:32 = .84. In my case, I just happen to have small hips, rather than a more "normal" hip size for my height of 36 inches or so.
Despite that, I still don't doubt that I may have increased visceral fat deposition that may cause problems. Perhaps some day I'll find out. Interesting articles, Kat -- thanks.
__________________ Whitney, 33
After soy, Femara, Follistim, an ectopic pregnancy, and IVF, FINALLY BFP 8/08 -- twins -- but lost baby B at 7 weeks Preterm labor at 25 weeks... baby boy is here safely at 36w3d!
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Wow this is soooo me. I'm thin-ish (5'8" and 140 lbs) but I have a pudgy tummy, high cholestorol, and intense cravings for sugary foods. I'm not getting this test, but I bet I'm fat on the inside.
__________________ Jen (30) Mom to Lily To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts. and furbaby Bailey
BFP formula: met/prednisone/femara 5mg
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This is very interesting info! More stuff to worry about. I know that it is common for PCOS women to have weight in their tummy, but I actually have my weight in my hips, butt, thigh area, and actually have a smaller waist. I am a thin cyster, but I have disproportionate fat in that area and a lot of cellulite. I go to the gym, and ride a machine for an hour, 5 days a week, but the fat doesn't look any better. Is this genetic, or PCOS?
__________________ Me(30) DH(31) 5/02 (tgthr since 9/00) DS1 Natural 8/03 (before pcos symptom called no AF & before DX) 5mg femara/1500 metformin/ prog DD1 4/07 while ttc#3: 3-5mg femara/ 2-100mg clomid 2 chemical pgs m/c IVF twins: 1/09 DD2 & DS2 Happy Family of 6 as of August 2009
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Penny -- usually cellulite on a thin person is genetic. Sucks, I know! Very tough to get rid of. I have a friend with that problem, totally skinny everywhere else. Her mom was exactly the same. She's had liposuction but it grew back!
__________________ Whitney, 33
After soy, Femara, Follistim, an ectopic pregnancy, and IVF, FINALLY BFP 8/08 -- twins -- but lost baby B at 7 weeks Preterm labor at 25 weeks... baby boy is here safely at 36w3d!
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Tummy- I thought it might be genetic, bc my sister has it, too, but I thought maybe PCOSers might be prone, you know, since we're screwed up in soo many other ways hee hee
__________________ Me(30) DH(31) 5/02 (tgthr since 9/00) DS1 Natural 8/03 (before pcos symptom called no AF & before DX) 5mg femara/1500 metformin/ prog DD1 4/07 while ttc#3: 3-5mg femara/ 2-100mg clomid 2 chemical pgs m/c IVF twins: 1/09 DD2 & DS2 Happy Family of 6 as of August 2009
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I too am thin with a BMI of 20. I am 5'5 and a half and 121 pounds. However I do have a large proportion of my body fat on my stomach and I find it difficult to shift it. So now it's all starting to make sense, thanks for your arcticle!
I too am thin with a BMI of 20. I am 5'5 and a half and 121 pounds. However I do have a large proportion of my body fat on my stomach and I find it difficult to shift it.
After reading that article I now understand what is going on with my body. I have always been a thin cyster and not really experience many weight issues, food cravings or anything...until recently. I have gained about 5lbs of body fat (BMI went from 19 to 23) and it all seems to be in my tummy. The guy at my gym was amazed when he saw me the other day, he joked saying 'havent been in the gym lately?' oops...I have been almost every day! I don't really have 'cravings', but once I do eat something with sugar I will continue to eat more. I am very petite so any weight gain in any area shows instantly, UGH!
thanks for those articles! I never would have even thought of being fat inside. It kind of gives me more incentive to start being more healthy...can you imagine fat growing around your organs and everything? I'll definately be fitting some work out time into my schedule.
__________________ "Time, it fades away precious as a song cause some day we'll be gone"
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"Our God isn't God if he fits inside our heads"
"A great civilization is not conquered from without until it has destroyed itself within"
~Will Durant
Fat distribution affects PCOS metabolism regardless of body weight 
hee hee
