Abstract
OBJECTIVE: Chronic positive energy balance leads to obesity, and the "excess" weight is usually described as consisting solely of adipose tissue (AT) or its two components, fat and fat-free mass (nonfat cell mass, extracellular fluid). This study aimed to clarify the nature of "obesity" tissue. METHODS: A total of 333 adults had AT, skin, skeletal muscle, bone, heart, liver, kidney, spleen, brain, and residual mass measured or derived using magnetic resonance imaging and dual-energy x-ray absorptiometry. First, associations between these components and AT were examined by developing multiple regression models. Next, obesity-tissue composition was developed by deriving mean component mass differences between participant groups with normal weight (BMI < 25 kg/m(2) ) and those with obesity (BMI > 29.9 kg/m(2) ); respective resting energy expenditures and metabolizable energy and protein contents were calculated. RESULTS: AT significantly predicted organ-tissue mass in 17 of 18 multiple regression models. In addition to AT and skeletal muscle, the following associations were found: skin, liver, and bone were main contributors to obesity-tissue composition; liver, kidneys, and heart to resting energy expenditure; and skin, liver, and bone to metabolizable energy and protein contents. A pronounced sexual dimorphism was present in all three models. CONCLUSIONS: Obesity is characterized not only by excess AT but by increases in the masses of other "companion" organs and tissues and their related metabolic properties.