- Email: [email protected]
MON-PP227: Influence of Abdominal Fat Distribution on the Muscle Strength of the Upper and Lower Extremities in Obese Patients
S212
Poster presentations
Results: The intervention group increased PAL from 1.74±0.17 to 1.93±0.20 (p < 0.0001) while spending 1310±44 min in sedentary to low activities (METs <3), 106±36 min in moderate (METs 3 6), and 24±12 min in vigorous activities (METs >6). The subjects decreased body mass ( 1.36±1.7 kg, p = 0.001) through adipose tissue mass loss (ATM) ( 1.61±1.3 kg, p = 0.0001) in comparison to baseline. Android to gynoid fat ratio (A/G) was significantly decreased during intervention (1.105 to 1.065, p = 0.001). The control group did not show any significant changes in activity, body mass, ATM nor A/G. EI was unchanged in both groups. Conclusion: Increasing PAL to 1.9 while keeping EI ad libitum over an 8-week period produces a prolonged negative energy balance with significant decrease in A/G fat ratio. Exercise may serve as a solo tool for enhancing metabolic health. Disclosure of Interest: None declared
MON-PP226 OBESITY HYPOVENTILATION SYNDROME M. Castro1 , L.M. Horie1 , C. Pompilio1 , D. Waitzberg1 . 1 Gastroenterology, Faculdade de Medicina da USP, Sao Paulo, Brazil Rationale: The hypoventilation obese syndrome (HOS) is usually defined as an association between obesity (BMI >30 kg/m2 ) and arterial hypercapnia during wakefulness (PaCO2 >45 mmHg). Many of the individuals with severe obesity presents HOS which is usually attributed to hypoventilation due to the reduction in the overall ventilation. However, recent studies have shown that elevated CO2 may be related to an increase of production (VCO2 ) and not to an impairment of ventilation. The aim of this study is to investigate the relationship between body mass index (BMI) and VCO2 production. Methods: 119 (36M/83F) severely obese patients were included. The volume of CO2 produced was assessed by indirect calorimetry (Deltatrac II model). Patients were divided into quartiles according to BMI. Quartile I 40 kg/m2 , quartile II 41 44.9 kg/m2 , quartile III 45 49.9 kg/m2 and quartile IV 50 kg/m2 . The results were analyzed by the Spearman correlation coefficient and the comparison between the BMI groups was evaluated using the Wilcoxon-Mann Whitney test. Results: The mean age was 42±12 years and BMI was 47±6.25 kg/m2 . We found a positive correlation (r = 0.512, p < 0.001 Spearman test) between BMI and the VCO2 . In subgroup analysis there were no difference between the VCO2 of Groups I and II compared to Group IV (p = 0.03 and p < 0.001, respectively Wilcoxon Mann Whitney test), as shown in Table 1. Table 1. CO2 volume according to BMI quartiles
VCO2 (mL/min)
Quartile I (n = 22)
Quartile II (n = 29)
Quartile III (n = 33)
Quartile IV (n = 35)
P value
236±53
230±31
261±43
286±50
<0.05
Values are expressed as mean±standard deviation, Wilcoxon Mann Whitney test.
Conclusion: The BMI correlates directly with the production of CO2 in patients with class III obesity suggesting that the more obese, hypercapnia can have other causes beyond the possible hypoventilation. Disclosure of Interest: None declared
MON-PP227 INFLUENCE OF ABDOMINAL FAT DISTRIBUTION ON THE MUSCLE STRENGTH OF THE UPPER AND LOWER EXTREMITIES IN OBESE PATIENTS L. Otten1 , U. Elbelt2 , J. Ordemann3 , E. Rothkegel4 , N. Stobaeus4 , K. Norman1 . 1 Forschungsgruppe Geriatrie am EGZB, 2 Medizinische Klinik f¨ ur Endokrinologie, Diabetes und Ern¨ ahrungsmedizin, 3 Zentrum f¨ ur Adipositas und Metabolische Chirurgie, 4 Medizinische Klinik f¨ ur Gastroenterologie, Infektiologie und Rheumatologie, Charit´ e Universit¨ atsmedizin Berlin, Berlin, Germany Rationale: In obese subjects, reduced muscle mass and muscle strength are associated with impaired functional and metabolic capacity. However, little is known about the relation between abdominal fat distribution and muscle strength. We investigated the relationship between abdominal fat distribution and maximum muscle strength in the upper and lower extremities in obese patients. Methods: Ambulant patients with a BMI30 kg/m2 were included in the study. Maximum isometric hand grip and knee extension strength were measured. Anthropometric parameters included height, weight, waist and hip circumference. Using bioelectric impedance analysis the ratio of fat-free mass (FFM) to fat mass (FM) was calculated. The influence of age, BMI, FFM/FM and waist circumference on grip strength and knee extension strength was investigated in a risk-adjusted regression analysis. Results: 155 obese patients (105 women, 45.1±14.6 years, BMI 43.5±8.2 kg/m2 ) were included in the study. Next to the established influence of age, the regression model revealed a significant positive influence of FFM/FM ratio on grip strength in women (b: 4.275, p < 0.018) and in men (b: 17.754, p < 0.008) but not on knee extension strength. In women, however, an increase in waist circumference was associated with an increased knee extension strength (b: 0.375, p < 0.001). This association was not seen in men; though, the small sample size must be considered. Waist circumference was not associated with grip strength. The multiple regression model showed no effect of BMI on grip or knee extension strength. Conclusion: An abdominal fat distribution could lead to increased leg strength not only due to the increased load but also the increased stimulation of balance and stability. In the evaluation of muscle strength in obese patients one should consider the relationship between abdominal obesity and the strength of the upper and lower extremities. Disclosure of Interest: None declared
MON-PP228 INTAKE OF FISH PROTEIN AND EFFECTS ON GLUCOSE REGULATION AND LIPID METABOLISM IN OBESE ZUCKER RATS L.A. Vikøren1 , O.A. Gudbrandsen1 , A. Drotningsvik1 , G. Mellgren1 , S.A. Mjøs1 . 1 University of Bergen, Bergen, Norway Rationale: Studies in rats and humans imply that fish protein may enhance glucose regulation and lipid metabolism, thus dietary intake of fish proteins may be of importance for overweight and obese humans and for future dietary advice.
Poster presentations
Results: The intervention group increased PAL from 1.74±0.17 to 1.93±0.20 (p < 0.0001) while spending 1310±44 min in sedentary to low activities (METs <3), 106±36 min in moderate (METs 3 6), and 24±12 min in vigorous activities (METs >6). The subjects decreased body mass ( 1.36±1.7 kg, p = 0.001) through adipose tissue mass loss (ATM) ( 1.61±1.3 kg, p = 0.0001) in comparison to baseline. Android to gynoid fat ratio (A/G) was significantly decreased during intervention (1.105 to 1.065, p = 0.001). The control group did not show any significant changes in activity, body mass, ATM nor A/G. EI was unchanged in both groups. Conclusion: Increasing PAL to 1.9 while keeping EI ad libitum over an 8-week period produces a prolonged negative energy balance with significant decrease in A/G fat ratio. Exercise may serve as a solo tool for enhancing metabolic health. Disclosure of Interest: None declared
MON-PP226 OBESITY HYPOVENTILATION SYNDROME M. Castro1 , L.M. Horie1 , C. Pompilio1 , D. Waitzberg1 . 1 Gastroenterology, Faculdade de Medicina da USP, Sao Paulo, Brazil Rationale: The hypoventilation obese syndrome (HOS) is usually defined as an association between obesity (BMI >30 kg/m2 ) and arterial hypercapnia during wakefulness (PaCO2 >45 mmHg). Many of the individuals with severe obesity presents HOS which is usually attributed to hypoventilation due to the reduction in the overall ventilation. However, recent studies have shown that elevated CO2 may be related to an increase of production (VCO2 ) and not to an impairment of ventilation. The aim of this study is to investigate the relationship between body mass index (BMI) and VCO2 production. Methods: 119 (36M/83F) severely obese patients were included. The volume of CO2 produced was assessed by indirect calorimetry (Deltatrac II model). Patients were divided into quartiles according to BMI. Quartile I 40 kg/m2 , quartile II 41 44.9 kg/m2 , quartile III 45 49.9 kg/m2 and quartile IV 50 kg/m2 . The results were analyzed by the Spearman correlation coefficient and the comparison between the BMI groups was evaluated using the Wilcoxon-Mann Whitney test. Results: The mean age was 42±12 years and BMI was 47±6.25 kg/m2 . We found a positive correlation (r = 0.512, p < 0.001 Spearman test) between BMI and the VCO2 . In subgroup analysis there were no difference between the VCO2 of Groups I and II compared to Group IV (p = 0.03 and p < 0.001, respectively Wilcoxon Mann Whitney test), as shown in Table 1. Table 1. CO2 volume according to BMI quartiles
VCO2 (mL/min)
Quartile I (n = 22)
Quartile II (n = 29)
Quartile III (n = 33)
Quartile IV (n = 35)
P value
236±53
230±31
261±43
286±50
<0.05
Values are expressed as mean±standard deviation, Wilcoxon Mann Whitney test.
Conclusion: The BMI correlates directly with the production of CO2 in patients with class III obesity suggesting that the more obese, hypercapnia can have other causes beyond the possible hypoventilation. Disclosure of Interest: None declared
MON-PP227 INFLUENCE OF ABDOMINAL FAT DISTRIBUTION ON THE MUSCLE STRENGTH OF THE UPPER AND LOWER EXTREMITIES IN OBESE PATIENTS L. Otten1 , U. Elbelt2 , J. Ordemann3 , E. Rothkegel4 , N. Stobaeus4 , K. Norman1 . 1 Forschungsgruppe Geriatrie am EGZB, 2 Medizinische Klinik f¨ ur Endokrinologie, Diabetes und Ern¨ ahrungsmedizin, 3 Zentrum f¨ ur Adipositas und Metabolische Chirurgie, 4 Medizinische Klinik f¨ ur Gastroenterologie, Infektiologie und Rheumatologie, Charit´ e Universit¨ atsmedizin Berlin, Berlin, Germany Rationale: In obese subjects, reduced muscle mass and muscle strength are associated with impaired functional and metabolic capacity. However, little is known about the relation between abdominal fat distribution and muscle strength. We investigated the relationship between abdominal fat distribution and maximum muscle strength in the upper and lower extremities in obese patients. Methods: Ambulant patients with a BMI30 kg/m2 were included in the study. Maximum isometric hand grip and knee extension strength were measured. Anthropometric parameters included height, weight, waist and hip circumference. Using bioelectric impedance analysis the ratio of fat-free mass (FFM) to fat mass (FM) was calculated. The influence of age, BMI, FFM/FM and waist circumference on grip strength and knee extension strength was investigated in a risk-adjusted regression analysis. Results: 155 obese patients (105 women, 45.1±14.6 years, BMI 43.5±8.2 kg/m2 ) were included in the study. Next to the established influence of age, the regression model revealed a significant positive influence of FFM/FM ratio on grip strength in women (b: 4.275, p < 0.018) and in men (b: 17.754, p < 0.008) but not on knee extension strength. In women, however, an increase in waist circumference was associated with an increased knee extension strength (b: 0.375, p < 0.001). This association was not seen in men; though, the small sample size must be considered. Waist circumference was not associated with grip strength. The multiple regression model showed no effect of BMI on grip or knee extension strength. Conclusion: An abdominal fat distribution could lead to increased leg strength not only due to the increased load but also the increased stimulation of balance and stability. In the evaluation of muscle strength in obese patients one should consider the relationship between abdominal obesity and the strength of the upper and lower extremities. Disclosure of Interest: None declared
MON-PP228 INTAKE OF FISH PROTEIN AND EFFECTS ON GLUCOSE REGULATION AND LIPID METABOLISM IN OBESE ZUCKER RATS L.A. Vikøren1 , O.A. Gudbrandsen1 , A. Drotningsvik1 , G. Mellgren1 , S.A. Mjøs1 . 1 University of Bergen, Bergen, Norway Rationale: Studies in rats and humans imply that fish protein may enhance glucose regulation and lipid metabolism, thus dietary intake of fish proteins may be of importance for overweight and obese humans and for future dietary advice.