Body Fat Percentage, Waist Circumference and Body Mass Index are Correlated with Nitric Oxide Levels in Young Adults with Central Obesity

Feriyandi Nauli, Nurhasanah Nurhasanah, Endang Mahati, Udin Bahrudin


Background: Central obesity stands for the corner-stone of cardio-metabolic health, while nitric oxide (NO) is a major regulator of cardiovascular function. To day, the correlation between serum NO metabolites nitrate/nitrite and the obesity components in young adults remains elusive. Thus, this current study was conducted to know the correlation between serum NO metabolites levels and body fat percentage, waist circumference (WC) as well as body mass index (BMI) in young adults with central obesity.

Materials and Methods: A cross-sectional study was conducted in Riau, Indonesia, involving 79 young adults aged 18-25 years, composing of 39 and 40 subjects with and without central obesity, respectively. Anthropometric measurements were performed to assess WC and BMI. Body fat percentage was measured using bioelectrical impedance analysis and serum NO metabolites levels were assessed using Griess methods.

Results: Levels of serum NO metabolites were significant higher in the subjects with central obesity (168.41±12.64 μmol/L) than that of normal subjects (70.57±44.99 μmol/L, p<0.001), but the levels were no significant different between male and female subjects. Serum NO metabolites levels were strongly correlated with total body fat (r=0.618, p<0.001), visceral fat (r=0.733, p<0.001), subcutaneous fat (r=0.547, p<0.001), WC (r=0.717, p<0.001) and BMI (r=0.788, p<0.001).

Conclusions: For young adults in Riau, Indonesia, levels of serum NO metabolites are higher in the central obesity group than that of the normal. In this population, body fat percentage, waist circumference and body mass index are correlated with serum nitric oxide metabolites levels.

Keywords: nitric oxide, body fat percentage, young adults, central obesity

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WHO/IASO/IOTF. The Asia-Pacific Perspective : Redefining Obesity and its treatment. Sydney: WHO; 2000, article.

WHO [Internet]. Obesity and overweight [updated 2018 Apr 1; cited 2019 Jul 21]. Available from:

Lim JU, Lee JH, Kim JS, Hwang Y Il, Kim TH, Lim SY, et al. Comparison of World Health Organization and Asia-Pacific body mass index classifications in COPD patients. Int J COPD. 2017; 12: 2465-75, CrossRef.

Shuster A, Patlas M, Pinthus JH, Mourtzakis M. The clinical importance of visceral adiposity: A critical review of methods for visceral adipose tissue analysis. Br J Radiol. 2012; 85(1009): 1-10, CrossRef.

Ramírez-Vélez R, Correa-Bautista JE, Martínez-Torres J, González-Ruíz K, González-Jiménez E, Schmidt-RioValle J, et al. Performance of two bioelectrical impedance analyses in the diagnosis of overweight and obesity in children and adolescents: The FUPRECOL Study. Nutrients. 2016; 8(10): 1-13, CrossRef.

Park KS, Lee DH, Lee J, Kim YJ, Jung KY, Kim KM, et al. Comparison between two methods of bioelectrical impedance analyses for accuracy in measuring abdominal visceral fat area. J Diabetes Complications. 2016; 30(2): 343-9, CrossRef.

Lu HK, Chen YY, Yeh C, Chuang CL, Chiang LM, Lai CL, et al. Discrepancies between leg-to-leg bioelectrical Impedance analysis and computerized tomography in abdominal visceral fat measurement. Sci Rep. 2017; 7(1): 1-8, CrossRef.

Day K, Kwok A, Evans A, Mata F, Verdejo-Garcia A, Hart K, et al. Comparison of a bioelectrical impedance device against the reference method dual energy X-ray absorptiometry and anthropometry for the evaluation of body composition in adults. Nutrients. 2018; 10(10): 1469, CrossRef.

Wang JG, Zhang Y, Chen HE, Li Y, Cheng XG, Xu L, et al. Comparison of two bioelectrical impedance analysis devices with dual energy x-ray absorptiometry and magnetic resonance imaging in the estimation of body composition. J Strength Cond Res. 2013; 27(1): 236-43, CrossRef.

Uppalapati A, Gogineni S, Espiritu JR. Association between body mass index (BMI) and fraction of exhaled nitric oxide (FeNO) levels in the National Health and Nutrition Examination Survey (NHANES) 2007–2010. Obes Res Clin Pract. 2016; 10(6): 652-8, CrossRef.

Ahmad A, Dempsey S, Daneva Z, Azam M, Li N, Li PL, et al. Role of nitric oxide in the cardiovascular and renal systems. Int J Mol Sci. 2018; 19(9): 2605, CrossRef.

Correia-Costa L, Sousa T, Morato M, Cosme D, Afonso J, Areias JC, et al. Oxidative stress and nitric oxide are increased in obese children and correlate with cardiometabolic risk and renal function. Br J Nutr. 2016; 116(5): 805-15, CrossRef.

Ghasemi A, Zahediasl S, Azizi F. Elevated nitric oxide metabolites are associated with obesity in women. Arch Iran Med. 2013; 16(9): 521-5, article.

Choi JW, Pai SH, Kim SK, Ito M, Park CS, Cha YN. Increases in nitric oxide concentrations correlate strongly with body fat in obese humans. Clin Chem. 2001; 47(6): 1106-9, CrossRef.

Fujita K, Wada K, Nozaki Y, Yoneda M, Endo H, Takahashi H, et al. Serum nitric oxide metabolite as a biomarker of visceral fat accumulation: Clinical significance of measurement for nitrate/nitrite. Med Sci Monit. 2011; 17(3): CR123-31, CrossRef.

Gruber HJ, Mayer C, Mangge H, Fauler G, Grandits N, Wilders-Truschnig M. Obesity reduces the bioavailability of nitric oxide in juveniles. Int J Obes. 2008; 32(5): 826-31, CrossRef.

Kondo T, Ueyama J, Imai R, Suzuki K, Ito Y. Association of abdominal circumference with serum nitric oxide concentration in healthy population. Environ Health Prev Med. 2006; 11(6): 321-5, CrossRef.

Purwadianti N, Oenzil F, Sulastri D. Hubungan antara indeks massa tubuh dengan kadar nitrit oksid pada masyarakat etnik Minangkabau di Kota Padang. J Kesehat Andalas. 2015; 4(2): 364-8, CrossRef.

Susilowati A, Akrom, Darmawan E. Profile of nitric oxide (NO) levels in Yogyakarta society. J Health Med Nursing. 2015: 17(2015): 38-42, article.

World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013; 310(20): 2191-4, CrossRef.

Bahadoran Z, Mirmiran P, Jeddi S, Carlström M, Azizi F, Ghasemi A. Circulating markers of nitric oxide homeostasis and cardiometabolic diseases: insights from population-based studies. Free Radic Res. 2019; 53(4): 359-76, CrossRef.

Olszanecka-Glinianowicz M, Zahorska-Markiewicz B, Janowska J, Zurakowski A. Serum concentrations of nitric oxide, tumor necrosis factor (TNF)-α and TNF soluble receptors in women with overweight and obesity. Metabolism. 2004; 53(10): 1268-73, CrossRef.

Codoñer-Franch P, Tavárez-Alonso S, Murria-Estal R, Megías-Vericat J, Tortajada-Girbés M, Alonso-Iglesias E. Nitric oxide production is increased in severely obese children and related to markers of oxidative stress and inflammation. Atherosclerosis. 2011; 215(2): 475-80, CrossRef.

Foroumandi E, Alizadeh M, Kheirouri S, Asghari Jafarabadi M. Exploring the role of body mass index in relationship of serum nitric oxide and advanced glycation end products in apparently healthy subjects. PLoS One. 2019; 14(3): e0213307, CrossRef.

Engeli S, Janke J, Gorzelniak K, Böhnke J, Ghose N, Lindschau C, et al. Regulation of the nitric oxide system in human adipose tissue. J Lipid Res. 2004; 45(9): 1640-8, CrossRef.

Sansbury BE, Hill BG. Regulation of obesity and insulin resistance by nitric oxide. Free Radic Biol Med. 2014; 73: 383-99, CrossRef.

Ghasemi A, Jeddi S. Anti-obesity and anti-diabetic effects of nitrate and nitrite. Nitric Oxide. 2017; 70(24): 9-24, CrossRef.

Khazan M, Hdayati M. The role of nitric oxide in health and diseases. Scimetr. 2014; 3(1): 1-10, CrossRef.

Caimi G, Hopps E, Montana M, Carollo C, Calandrino V, Incalcaterra E, et al. Nitric oxide metabolites (nitrite and nitrate) in several clinical condition. Clin Hemorheol Microcirc. 2014; 56(4): 359-69, CrossRef.

Carlström M, Liu M, Yang T, Zollbrecht C, Huang L, Peleli M, et al. Cross-talk between nitrate-nitrite-NO and NO synthase pathways in control of vascular NO homeostasis. Antioxid Redox Signal. 2015; 23(4): 295-306, CrossRef.

Jabłecka A, Bogdański P, Balcer N, Cieślewicz A, Skołuda A, Musialik K. The effect of oral L-arginine supplementation on fasting glucose, HbA1c, nitric oxide and total antioxidant status in diabetic patients with atherosclerotic peripheral arterial disease of lower extremities. Eur Rev Med Pharmacol Sci. 2012; 16(3): 342-50, article.

Mirmiran P, Bahadoran Z, Ghasemi A, Azizi F. The association of dietary l-arginine intake and serum nitric oxide metabolites in adults: a population-based study. Nutrients. 2016; 8(5): 331, CrossRef.

Alvares TS, Conte-Junior CA, Silva JT, Paschoalin VMF. Acute L-Arginine supplementation does not increase nitric oxide production in healthy subjects. Nutr Metab (Lond). 2012; 9(1): 54, CrossRef.

Meirelles CM, Matsuura C. Acute supplementation of L-arginine affects neither strength performance nor nitric oxide production. J Sports Med Phys Fitness. 2018; 58(3): 216-20, CrossRef.

Khalaf D, Krüger M, Wehland M, Infanger M, Grimm D. The effects of oral l-arginine and l-citrulline supplementation on blood pressure. Nutrients. 2019;11(7): 1679, CrossRef.

Ghasemi A, Zahedi Asl S, Mehrabi Y, Saadat N, Azizi F. Serum nitric oxide metabolite levels in a general healthy population: relation to sex and age. Life Sci. 2008; 83(9-10): 326-31, CrossRef.


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Cell and BioPharmaceutical Institute