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Non-Energy-Restricted Low-Carbohydrate Diet Combined with Exercise Intervention Improved Cardiometabolic Health in Overweight Chinese Females. Nutrients 2019; 11:nu11123051. [PMID: 31847246 PMCID: PMC6950598 DOI: 10.3390/nu11123051] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 12/10/2019] [Indexed: 12/18/2022] Open
Abstract
This study aimed to examine the effects of four weeks of a low-carbohydrate diet (LC) and incorporated exercise training on body composition and cardiometabolic health. Fifty-eight overweight/obese Chinese females (age: 21.2 ± 3.3 years, body mass index (BMI): 25.1 ± 2.8 kg/m2) were randomly assigned to the control group (CON, n = 15), the LC control group (LC-CON, n = 15), the LC and high-intensity interval training group (LC-HIIT, n = 15), or the LC and moderate-intensity continuous training group (LC-MICT, n = 13). Subjects consumed a four week LC, whereas LC-HIIT and LC-MICT received extra training 5 d/week (LC-HIIT: 10 × 6 s cycling interspersed with 9 s rest, MICT: 30 min continuous cycling at 50–60% VO2peak). After intervention, the three LC groups demonstrated significant reductions in body weight (−2.85 kg in LC-CON, −2.85 kg in LC-HIIT, −2.56 kg in LC-MICT, p < 0.001, η2 = 0.510), BMI (p < 0.001, η2 = 0.504) and waist-to-hip ratio (p < 0.001, η2 = 0.523). Groups with extra training (i.e., LC-HIIT and LC-MICT) improved VO2peak by 14.8 and 17.3%, respectively. However, fasting glucose and blood lipid levels remained unchanged in all groups. Short-term LC is a useful approach to improve body composition in overweight/obese Chinese females. Incorporated exercise training has no additional effects on weight loss, but has additional benefits on cardiorespiratory fitness, and HIIT is more time efficient than the traditional MICT (2.5 min vs. 30 min).
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52
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Promoting Cardiovascular Health in Midlife Women. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2019. [DOI: 10.1007/s13669-019-00275-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Takahashi S, Shimizu S, Nagai S, Watanabe H, Nishitani Y, Kurisu Y. Characteristics of sarcopenia after distal gastrectomy in elderly patients. PLoS One 2019; 14:e0222412. [PMID: 31509590 PMCID: PMC6738640 DOI: 10.1371/journal.pone.0222412] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 08/28/2019] [Indexed: 01/06/2023] Open
Abstract
Presence of preoperative sarcopenia is a risk factor for postoperative complications. However, there are few reports on the presence of sarcopenia and its characteristics following gastrectomy. Sarcopenia is closely related to quality of life in elderly people. To date, the main purpose of follow-up after gastrectomy is surveillance for early detection of recurrence and secondary cancer. However, henceforth, quality of life in elderly gastric cancer patients after gastrectomy must also be evaluated. The present study aimed to investigate sarcopenia during a 1-year postoperative course in elderly gastric cancer patients and examine their characteristics. The subjects were 50 patients aged ≥70 years who underwent laparoscopy-assisted distal gastrectomy for gastric cancer and who experienced no recurrence 1 year postoperatively. Height, weight, serum albumin levels, food intake amount, grip strength, gait speed, visceral fat area, and appendicular skeletal muscle mass index were measured preoperatively and 6 months and 1 year postoperatively. Sarcopenia, obesity, and visceral obesity were diagnosed. Compared with preoperatively, indicators other than height decreased 6 months postoperatively. Compared with 6 months postoperatively, body weight, amount of food intake, and visceral fat area increased by 1 year postoperatively, unlike appendicular skeletal muscle mass index. The frequency of sarcopenia increased 6 months postoperatively compared with preoperatively; this frequency remained almost unchanged 1 year postoperatively compared with 6 months postoperatively. Further, the frequency of visceral obesity increased 1 year postoperatively compared with 6 months postoperatively. Weight increased after > 6 months postoperatively; however, most of the weight increase was in terms of fat and not muscle. We emphasize the importance of considering postoperative sarcopenia and visceral obesity. In particular, sarcopenia and visceral obesity should be carefully monitored after increases in body mass index and food consumption.
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Affiliation(s)
- Sadamu Takahashi
- Department of Surgery, National Hospital Organization Hamada Medical Center, Asai-tyou, Hamada, Japan
- * E-mail:
| | - Shota Shimizu
- Department of Surgery, National Hospital Organization Hamada Medical Center, Asai-tyou, Hamada, Japan
| | - Satoshi Nagai
- Department of Surgery, National Hospital Organization Hamada Medical Center, Asai-tyou, Hamada, Japan
| | - Hiroshi Watanabe
- Department of Surgery, National Hospital Organization Hamada Medical Center, Asai-tyou, Hamada, Japan
| | - Yuuko Nishitani
- Department of Surgery, National Hospital Organization Hamada Medical Center, Asai-tyou, Hamada, Japan
| | - Yasuro Kurisu
- Department of Surgery, National Hospital Organization Hamada Medical Center, Asai-tyou, Hamada, Japan
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Neeland IJ, Ross R, Després JP, Matsuzawa Y, Yamashita S, Shai I, Seidell J, Magni P, Santos RD, Arsenault B, Cuevas A, Hu FB, Griffin B, Zambon A, Barter P, Fruchart JC, Eckel RH. Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: a position statement. Lancet Diabetes Endocrinol 2019; 7:715-725. [PMID: 31301983 DOI: 10.1016/s2213-8587(19)30084-1] [Citation(s) in RCA: 644] [Impact Index Per Article: 128.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 12/24/2018] [Accepted: 01/11/2019] [Indexed: 02/06/2023]
Abstract
Findings from epidemiological studies over the past 30 years have shown that visceral adipose tissue, accurately measured by CT or MRI, is an independent risk marker of cardiovascular and metabolic morbidity and mortality. Emerging evidence also suggests that ectopic fat deposition, including hepatic and epicardial fat, might contribute to increased atherosclerosis and cardiometabolic risk. This joint position statement from the International Atherosclerosis Society and the International Chair on Cardiometabolic Risk Working Group on Visceral Obesity summarises the evidence for visceral adiposity and ectopic fat as emerging risk factors for type 2 diabetes, atherosclerosis, and cardiovascular disease, with a focus on practical recommendations for health professionals and future directions for research and clinical practice. We discuss the measurement of visceral and ectopic fat, pathophysiology and contribution to adverse health outcomes, response to treatment, and lessons from a public health programme targeting visceral and ectopic fat. We identify knowledge gaps and note the need to develop simple, clinically applicable tools to be able to monitor changes in visceral and ectopic fat over time. Finally, we recognise the need for public health messaging to focus on visceral and ectopic fat in addition to excess bodyweight to better combat the growing epidemic of obesity worldwide.
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Affiliation(s)
- Ian J Neeland
- Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Robert Ross
- School of Medicine, Division of Endocrinology and Metabolism, Queen's University, Kingston, ON, Canada
| | - Jean-Pierre Després
- Quebec Heart and Lung Institute Research Centre, Quebec City, QC, Canada; Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec City, QC, Canada.
| | - Yuji Matsuzawa
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka, Japan
| | - Shizuya Yamashita
- Departments of Cardiovascular Medicine and Community Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Iris Shai
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Jaap Seidell
- Department of Health Sciences and the EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, Netherlands
| | - Paolo Magni
- Department of Pharmacological and Biomolecular Sciences, Universita' degli Studi di Milano, Milan, Italy
| | - Raul D Santos
- Lipid Clinic Heart Institute, University of São Paulo, Medical School Hospital and Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Benoit Arsenault
- Quebec Heart and Lung Institute Research Centre, Quebec City, QC, Canada; Department of Medicine, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Ada Cuevas
- Department of Clinical Nutrition and Metabolism, Clínica Las Condes, Santiago, Chile
| | - Frank B Hu
- Departments of Nutrition and Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Bruce Griffin
- Department of Nutritional Sciences, University of Surrey, Guildford, UK
| | - Alberto Zambon
- Department of Medicine, University of Padua, Padova, Italy
| | - Philip Barter
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | | | - Robert H Eckel
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado School of Medicine, Aurora, CO, USA
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Wei J, Liu X, Xue H, Wang Y, Shi Z. Comparisons of Visceral Adiposity Index, Body Shape Index, Body Mass Index and Waist Circumference and Their Associations with Diabetes Mellitus in Adults. Nutrients 2019; 11:nu11071580. [PMID: 31336951 PMCID: PMC6683101 DOI: 10.3390/nu11071580] [Citation(s) in RCA: 116] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/09/2019] [Accepted: 07/10/2019] [Indexed: 12/21/2022] Open
Abstract
The associations between visceral adiposity index (VAI), body shape index and diabetes in adults were inconsistent. We assessed the predictive capacity of VAI and body shape index for diabetes by comparing them with body mass index (BMI) and waist circumference (WC). We used the data of 5838 Chinese men and women aged ≥18 years from the 2009 China Health and Nutrition Survey. Multivariate logistic regression analysis was performed to examine the independent associations between Chinese VAI (CVAI) or body shape index and diabetes. The predictive power of the two indices was assessed using the receiver-operating characteristic (ROC) curve analysis, and compared with those of BMI and WC. Both CVAI and body shape index were positively associated with diabetes. The odds ratios for diabetes were 4.9 (2.9–8.1) and 1.8 (1.2–2.8) in men, and 14.2 (5.3–38.2) and 2.0 (1.3–3.1) in women for the highest quartile of CVAI and body shape index, respectively. The area under the ROC (AUC) and Youden index for CVAI was the highest among all four obesity indicators, whereas BMI and WC are better indicators for diabetes screening. Higher CVAI and body shape index scores are independently associated with diabetes risk. CVAI has a higher overall diabetes diagnostic ability than BMI, WC and body shape index in Chinese adults. BMI and WC, however, are more appealing as screening indicators considering their easy use.
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Affiliation(s)
- Junxiang Wei
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
- Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Xin Liu
- Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Hong Xue
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Youfa Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
- Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Zumin Shi
- Human Nutrition Department, Qatar University, Doha 2713, Qatar.
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56
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Soares FHR, Furstenberger AB, Carvalho LCDS, Melo MYS, Lima JG, de Sousa MBC. Can body mass index identify cardiac autonomic dysfunction in women who are apparently healthy? Women Health 2019; 60:168-178. [PMID: 31096889 DOI: 10.1080/03630242.2019.1613472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We investigated the extent to which obesity could identify autonomic dysfunction of heart control in a cross-sectional study with 65 women (aged 18-45 years), categorized as eutrophic, overweight or obese. We collected anthropometric measures and measures of heart rate variability (HRV) between March 2015 and March 2017. Low frequency in normalized units (LF(nu)) over 46 was considered a marker of autonomic imbalance and high frequency in normalized units (HF(nu)) below 38 a marker of depressed vagal modulation. Overweight (mean difference MΔHF(nu) = -13.11 [95% confidence interval (CI) of difference, -25.88, -0.34], Hedges's g = 0.65, common language effect size (CL) = 68.1%) and obese (MΔHF(nu) = -21.22 [95% CI, -31.89, -10.55], Hedges's g = 1.17, CL = 79.2%) women presented depressed vagal modulation compared to eutrophic women. Autonomic imbalance increased as body mass index increased (eutrophic-to-overweight MΔLF(nu) = 13.06 [95% CI, 1.65, 24.47], g = 0.65, CL = 67.9%, and overweight-to-obese MΔLF(nu) = 21.07 [95% CI, 10.32, 31.82], g = 1.15, CL 78.9%). The odds ratio for depressed HF(nu) among overweight women was 2.36 (95% CI 0.77, 7.29) and 2.18 among obese women (95% CI 0.79, 5.99), as well as 9.17 (95% CI 2.62, 32.04) and 17.39 for increased LF(nu) (95% CI 2.13, 141.76), respectively. The parasympathetic activity is diminished and autonomic imbalance of the cardiac control increased with increasing BMI categories.
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Affiliation(s)
| | | | | | | | - Josivan Gomes Lima
- Health Science Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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57
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Vyas V, Lambiase P. Obesity and Atrial Fibrillation: Epidemiology, Pathophysiology and Novel Therapeutic Opportunities. Arrhythm Electrophysiol Rev 2019; 8:28-36. [PMID: 30918664 PMCID: PMC6434511 DOI: 10.15420/aer.2018.76.2] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Obesity is already a major global public health issue, implicated in a vast array of conditions affecting multiple body systems. It is now also firmly established as an independent risk factor in the incidence and progression of AF. The rapidly rising morbidity, mortality and healthcare costs associated with AF despite implementation of the three pillars of AF management — anticoagulation, rate control and rhythm control — suggest other strategies need to be considered. Compelling data has unveiled novel insights into adipose tissue biology and its effect on arrhythmogenesis while secondary prevention strategies targeting obesity as part of a comprehensive risk factor management programme have been demonstrated to be highly effective. Here, the authors review the epidemiological basis of the obesity—AF relationship, consider its underlying pathophysiology and discuss new therapeutic opportunities on the horizon.
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Affiliation(s)
- Vishal Vyas
- Barts and The London School of Medicine and Dentistry London, UK.,Queen Mary University of London London, UK.,Barts Heart Centre, St Bartholomew's Hospital London, UK
| | - Pier Lambiase
- Barts Heart Centre, St Bartholomew's Hospital London, UK.,Institute of Cardiovascular Science, University College London London, UK
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58
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Shinar S, Berger H, De Souza LR, Ray JG. Difference in Visceral Adipose Tissue in Pregnancy and Postpartum and Related Changes in Maternal Insulin Resistance. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:667-673. [PMID: 30171627 DOI: 10.1002/jum.14737] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 05/30/2018] [Accepted: 06/05/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To measure the difference between first-trimester and postpartum visceral adipose tissue (VAT), the agreement of this difference with change in body mass index, and whether a difference in VAT is associated with insulin resistance or glucose mishandling. METHODS Prospective study of 93 women with singleton pregnancies without a history of diabetes. Visceral adipose tissue depth was sonographically assessed at 11 to 14 weeks and at 6 to 12 weeks postpartum. Metabolic measures, sampled at 24 to 28 weeks and 6 to 12 weeks postpartum, included homeostatic model assessment of insulin resistance, insulin sensitivity index composite, and area under the 75-g oral glucose tolerance test curve. RESULTS First-trimester VAT depth explained only 37% (95% confidence interval [CI], 22-52) of the variation in postpartum VAT depth. There was limited agreement between the net change in postpartum minus first-trimester VAT depth and that same net change for body mass index (Cohen's kappa, 0.26; 95% CI, 0.05-0.47). Those with a net gain in VAT depth demonstrated poorer insulin sensitivity index postpartum than women with a net regression in VAT depth-a difference of -2.0 (95% CI, -3.3 to -0.69). CONCLUSION Sonographic assessment of postpartum VAT is feasible and may provide insight to metabolic changes between pregnancy and postpartum, beyond body mass index.
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Affiliation(s)
- Shiri Shinar
- Department of Obstetrics and Gynecology, St. Michael's Hospital, Toronto, ON, Canada
| | - Howard Berger
- Department of Obstetrics and Gynecology, St. Michael's Hospital, Toronto, ON, Canada
- Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, ON, Canada
| | - Leanne R De Souza
- Department of Obstetrics and Gynecology, St. Michael's Hospital, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Joel G Ray
- Department of Obstetrics and Gynecology, St. Michael's Hospital, Toronto, ON, Canada
- Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
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59
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Wander PL, Hayashi T, Sato KK, Uehara S, Hikita Y, Leonetti DL, Kahn SE, Fujimoto WY, Boyko EJ. Design and validation of a novel estimator of visceral adipose tissue area and comparison to existing adiposity surrogates. J Diabetes Complications 2018; 32:1062-1067. [PMID: 30236542 PMCID: PMC6174110 DOI: 10.1016/j.jdiacomp.2018.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 07/30/2018] [Accepted: 09/06/2018] [Indexed: 10/28/2022]
Abstract
AIMS Visceral adiposity measured by computed tomography (CT) as intra-abdominal fat area (IAFA) predicts metabolic diseases. Existing adiposity surrogates have not been systematically compared to a regression-based model derived in individuals of Japanese ancestry. We developed and validated a method to estimate IAFA in individuals of Japanese ancestry and compared it to existing adiposity surrogates. METHODS We assessed age, BMI, waist circumference (WC), fasting lipids, glucose, smoking status, grip strength, mid-thigh circumference (MTC), humeral length, leg length, and IAFA by single-slice CT at the umbilicus for 622 Japanese Americans. We used stepwise linear regression to predict IAFA and termed the predicted value the Estimate of Visceral Adipose Tissue Area (EVA). For men, the final model included age, BMI, WC, high-density lipoprotein cholesterol (HDLc), glucose, and MTC; for women, age, BMI, WC, HDLc, low-density lipoprotein cholesterol, glucose, and MTC. We compared goodness-of-fit (R2) from linear regression models and mean-squared errors (MSE) from k-fold cross-validation to compare the ability of EVA to estimate IAFA compared to an estimate by Després et al., waist-to-height ratio, WC, deep abdominal adipose tissue index, BMI, lipid accumulation product, and visceral adiposity index (VAI). We classified low/high IAFA using area under receiver-operating characteristic curves (AUROC) for IAFA dichotomized at the 75th percentile. RESULTS EVA gave the least MSE and greatest R2 (men: 1244, 0.61; women: 581, 0.72). VAI gave the greatest MSE and smallest R2 (mean 2888, 0.08; women 1734, 0.14). CONCLUSIONS EVA better predicts IAFA in Japanese-American men and women compared to existing surrogates for adiposity.
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Affiliation(s)
- Pandora L Wander
- Department of Medicine, University of Washington, Seattle, WA, United States of America; Veterans Affairs Puget Sound Health Care System, Seattle, WA, United States of America.
| | - Tomoshige Hayashi
- Department of Medicine, University of Washington, Seattle, WA, United States of America; Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kyoko Kogawa Sato
- Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Shinichiro Uehara
- Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan
| | | | - Donna L Leonetti
- Department of Anthropology, University of Washington, Seattle, WA, United States of America
| | - Steven E Kahn
- Department of Medicine, University of Washington, Seattle, WA, United States of America; Veterans Affairs Puget Sound Health Care System, Seattle, WA, United States of America
| | - Wilfred Y Fujimoto
- Department of Medicine, University of Washington, Seattle, WA, United States of America
| | - Edward J Boyko
- Department of Medicine, University of Washington, Seattle, WA, United States of America; Veterans Affairs Puget Sound Health Care System, Seattle, WA, United States of America
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Fitness versus adiposity in cardiovascular disease risk. Eur J Clin Nutr 2018; 73:225-230. [PMID: 30297762 DOI: 10.1038/s41430-018-0333-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 09/12/2018] [Indexed: 11/09/2022]
Abstract
Obesity and low cardiorespiratory fitness are both established predictors of cardiovascular disease morbidity and mortality. Whether the protective effects of fitness outweigh the deleterious effects of obesity, however, remains a topic of debate. To extend knowledge of the relative influence of fitness and fatness on cardiovascular disease outcomes, however, attention must be paid to measurement quality. Eliminating inherent bias of self-report and including the highest quality assessments of cardiorespiratory fitness and fatness simultaneously are imperative for head-to-head comparisons. Studies must move beyond body mass index and total body fat percentage to differentiate the heterogenous effects of various adipose tissue depots on cardiovascular risk. Imaging techniques that measure visceral adiposity and other risk-laden ectopic adipose depots while also quantifying cardioprotective adipose depots such as lower body subcutaneous fat and even non-adipose tissues such as skeletal muscle may further illuminate the influence of body composition on cardiovascular health. This review underscores key studies within a large body of literature that provide the foundation for the fit-vs.-fat debate in the context of cardiovascular disease risk, and identifies important considerations for future research.
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Nadeem B, Bacha R, Gilani SA. Correlation of Subcutaneous Fat Measured on Ultrasound with Body Mass Index. J Med Ultrasound 2018; 26:205-209. [PMID: 30662152 PMCID: PMC6314101 DOI: 10.4103/jmu.jmu_34_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 02/27/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Body mass index (BMI) is used for the assessment of obesity and overweight worldwide. When body fat is increased BMI is also increased. Ultrasound is a reliable method to assess body fat. We have selected only one suprapubic region for the assessment of fat which is very easy to measure even in routine pelvic and abdominal ultrasound examination. During our routine examination, we can measure abdominal fat and inform the patient about his/her health state regarding obesity. It was a hypothesis that increases in abdominal subcutaneous fat will increase in BMI. OBJECTIVE The objective is to correlate subcutaneous fats measured on ultrasound with BMI. MATERIALS AND METHODS It was a cross-sectional study, which was performed in Gilani ultrasound center, Lahore, Pakistan. A total of 384 participants were included with simple random sampling technique. Individuals of 16-60 years age of both genders were included in that study. Pregnant ladies, athletes, children, and elderly participants were not included in that study. Toshiba (Xario) and Mindray (Z5) ultrasound machine were used for subcutaneous fats measurement. Participants were scanned in the supine position. Subcutaneous fats were measured on the suprapubic region in three different trials. Compression was avoided. Compression artifacts were avoided by applying more quantity of gel between transducer and skin. Stadiometer was used for the measurement of weight and height. To calculate BMI, Quetelet index was used. BMI was calculated with that formula BMI = weight (kg) divided by height (m2). RESULTS The result was made by calculation of mean and standard deviation. We calculated Pearson correlation between BMI and subcutaneous fats measured on ultrasound at the suprapubic region. It showed a significant high correlation between BMI and subcutaneous fat (P = 0.0000 which is < 0.001). CONCLUSION There is a significantly high correlation between BMI and subcutaneous fat measured on ultrasound. Ultrasound is a reliable method to assess subcutaneous fat. It can be a predictor of obesity like BMI.
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Affiliation(s)
- Baby Nadeem
- University Institute of Radiological Sciences and Medical Imaging Technologies, Lahore, Pakistan
| | - Raham Bacha
- University Institute of Radiological Sciences and Medical Imaging Technologies, Lahore, Pakistan
| | - Syed Amir Gilani
- University Institute of Radiological Sciences and Medical Imaging Technologies, Lahore, Pakistan
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The Effect of Training on Knowledge, Attitude, and Practice in Patients with Hypertension; The Application of the Expanded Chronic Care Model: A Clinical Trial Study. IRANIAN RED CRESCENT MEDICAL JOURNAL 2018. [DOI: 10.5812/ircmj.61693] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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63
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Patel VB, Shah S, Verma S, Oudit GY. Epicardial adipose tissue as a metabolic transducer: role in heart failure and coronary artery disease. Heart Fail Rev 2018; 22:889-902. [PMID: 28762019 DOI: 10.1007/s10741-017-9644-1] [Citation(s) in RCA: 142] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Obesity and diabetes are strongly associated with metabolic and cardiovascular disorders including dyslipidemia, coronary artery disease, hypertension, and heart failure. Adipose tissue is identified as a complex endocrine organ, which by exerting a wide array of regulatory functions at the cellular, tissue and systemic levels can have profound effects on the cardiovascular system. Different terms including "epicardial," "pericardial," and "paracardial" have been used to describe adipose tissue deposits surrounding the heart. Epicardial adipose tissue (EAT) is a unique and multifaceted fat depot with local and systemic effects. The functional and anatomic proximity of EAT to the myocardium enables endocrine, paracrine, and vasocrine effects on the heart. EAT displays a large secretosome, which regulates physiological and pathophysiological processes in the heart. Perivascular adipose tissue (PVAT) secretes adipose-derived relaxing factor, which is a "cocktail" of cytokines, adipokines, microRNAs, and cellular mediators, with a potent effect on paracrine regulation of vascular tone, vascular smooth muscle cell proliferation, migration, atherosclerosis-susceptibility, and restenosis. Although there are various physiological functions of the EAT and PVAT, a phenotypic transformation can lead to a major pathogenic role in various cardiovascular diseases. The equilibrium between the physiological and pathophysiological properties of EAT is very delicate and susceptible to the influences of intrinsic and extrinsic factors. Various adipokines secreted from EAT and PVAT have a profound effect on the myocardium and coronary arteries; targeting these adipokines could be an important therapeutic approach to counteract cardiovascular disease.
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Affiliation(s)
- Vaibhav B Patel
- Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, AB, T6G 2S2, Canada
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada
- Department of Physiology and Pharmacology and Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Saumya Shah
- Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, AB, T6G 2S2, Canada
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada
| | - Subodh Verma
- Division of Cardiac Surgery, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
- Department of Surgery, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Gavin Y Oudit
- Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, AB, T6G 2S2, Canada.
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada.
- Department of Physiology, University of Alberta, Edmonton, Canada.
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Marzetti M, Brunton T, McCreight L, Pearson E, Docherty S, Gandy SJ. Quantitative MRI evaluation of whole abdomen adipose tissue volumes in healthy volunteers-validation of technique and implications for clinical studies. Br J Radiol 2018; 91:20180025. [PMID: 29565651 PMCID: PMC6221768 DOI: 10.1259/bjr.20180025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 02/27/2018] [Accepted: 03/15/2018] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To explore "whole abdomen" MRI methods for quantifying adipose tissue volumes and to establish associations with body mass index (BMI) and measurement reproducibility-relative to existing "partial abdomen" methods. METHODS 15 healthy volunteers were scanned on a 3T MRI scanner using a double-echo three-point-Dixon gradient echo sequence. Whole abdomen volumes were acquired via three separate scans ("supine 1", "supine 2" and "prone"). Segmentation was applied to derive (i) "whole abdomen" visceral (VAT) and subcutaneous adipose tissue (SCAT) volumes, and (ii) "partial abdomen" volumes at the lumbar spine (L3 to L5). Root-mean-square coefficients of variation (RMS CoV) were calculated to quantify the variability of each measurement. RESULTS "Whole abdomen" measurements were found to correlate better with BMI (r2max = 0.74) than "partial abdomen" volumes (r2max = 0.66). Total adipose tissue (TAT) measurements correlated better with BMI (r2max = 0.74) than SCAT (r2max = 0.43) or VAT (r2max = 0.33) for both methods. Scan-to-scan RMS CoV's for "whole abdomen" VAT and SCAT measurements were 4.16 and 3.61% compared to 6.31 and 5.07% for "partial abdomen" measurements. CONCLUSION "Whole abdomen" measures of abdominal adiposity are better correlated with BMI and demonstrate better scan-to-scan reproducibility than "partial abdomen" measures. It is recommended that "whole abdomen" measures be used in longitudinal MRI radiology investigations, where small volume changes may occur. Advances in knowledge: Whole abdomen adipose tissue volumes can be measured and quantified using commercial MRI sequences and post-processing software. These methods are better correlated with BMI and are more reproducible than partial abdomen measures.
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Affiliation(s)
| | - Tracy Brunton
- NHS Tayside Clinical Radiology, Ninewells Hospital, Dundee, UK
| | - Laura McCreight
- Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital, Dundee, UK
| | - Ewan Pearson
- Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital, Dundee, UK
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Menai M, Charreire H, Galan P, Simon C, Nazare JA, Perchoux C, Weber C, Enaux C, Hercberg S, Fezeu L, Oppert JM. Differential Associations of Walking and Cycling with Body Weight, Body Fat and Fat Distribution - the ACTI-Cités Project. Obes Facts 2018; 11:221-231. [PMID: 29929198 PMCID: PMC6103342 DOI: 10.1159/000488532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 03/19/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Research on the associations between walking and cycling with obesity-related phenotypes is growing but relies mostly on the use of BMI. The purpose of this study was to analyze associations of walking and cycling behaviors assessed separately with various obesity markers in French adults. METHODS In 12,776 adult participants (71.3% women) of the on-going NutriNet Santé web-cohort, we assessed by self-report past-month walking and cycling (for commuting, errands and leisure), and obesity measures were taken during a visit at a clinical center (weight, height, waist circumference, and percent body fat by bioimpedance). RESULTS In analyses not taking into account other types of physical activity (household, leisure), walking more than 2.5 h/week was associated in women with lower weight (-1.8 kg), waist circumference (-1.7 cm) and percent body fat (-1.1%) (all p < 0.001). Cycling more than 1.5 h/week was associated in men and women with lower weight (-4.3 and -1.4 kg, respectively), waist circumference (-4.4 and -2.1 cm, respectively), and percent body fat (-2.5 and -1.9 % respectively) (all p < 0.001). Results were unaltered when analyses were further adjusted on household and leisure physical activity. CONCLUSION These results show important differences between walking and cycling in their association with obesity markers in men and women. These findings provide some evidence for the need to consider separately walking and cycling when designing public health measures for prevention of obesity in adults.
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Affiliation(s)
- Mehdi Menai
- Université Paris 13, Sorbonne Paris Cité - EREN (Equipe de Recherche en Epidémiologie Nutritionnelle), U1153 Inserm, Inra, Cnam, Centre de Recherche en Epidémiologie et Biostatistiques; CRNH IdF, Bobigny, France
| | - Hélène Charreire
- Université Paris 13, Sorbonne Paris Cité - EREN (Equipe de Recherche en Epidémiologie Nutritionnelle), U1153 Inserm, Inra, Cnam, Centre de Recherche en Epidémiologie et Biostatistiques; CRNH IdF, Bobigny, France
- Université Paris Est, LabUrba, Département de Géographie, UPEC, Créteil, France
| | - Pilar Galan
- Université Paris 13, Sorbonne Paris Cité - EREN (Equipe de Recherche en Epidémiologie Nutritionnelle), U1153 Inserm, Inra, Cnam, Centre de Recherche en Epidémiologie et Biostatistiques; CRNH IdF, Bobigny, France
| | - Chantal Simon
- Carmen, Inserm U1060/Université de Lyon 1/INRA U1235 Lyon, Lyon, France
| | - Julie-Anne Nazare
- Carmen, Inserm U1060/Université de Lyon 1/INRA U1235 Lyon, Lyon, France
| | - Camille Perchoux
- Carmen, Inserm U1060/Université de Lyon 1/INRA U1235 Lyon, Lyon, France
- Luxembourg Institute of Socio-Economic Research, Esch/Alzette, Luxembourg
| | | | - Christophe Enaux
- Laboratoire Image, Ville et Environnement, Université de Strasbourg, Strasbourg, France
| | - Serge Hercberg
- Université Paris 13, Sorbonne Paris Cité - EREN (Equipe de Recherche en Epidémiologie Nutritionnelle), U1153 Inserm, Inra, Cnam, Centre de Recherche en Epidémiologie et Biostatistiques; CRNH IdF, Bobigny, France
- Department of Public Health, Hôpital Avicenne (AP-HP), Bobigny, France
| | - Léopold Fezeu
- Université Paris 13, Sorbonne Paris Cité - EREN (Equipe de Recherche en Epidémiologie Nutritionnelle), U1153 Inserm, Inra, Cnam, Centre de Recherche en Epidémiologie et Biostatistiques; CRNH IdF, Bobigny, France
| | - Jean-Michel Oppert
- Université Paris 13, Sorbonne Paris Cité - EREN (Equipe de Recherche en Epidémiologie Nutritionnelle), U1153 Inserm, Inra, Cnam, Centre de Recherche en Epidémiologie et Biostatistiques; CRNH IdF, Bobigny, France
- Sorbonne Université, Department of Nutrition Pitié-Salpêtrière Hospital (AP-HP), Center for Research on Human Nutrition Ile-de-France (CRNH IdF), Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
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Association between abdominal adiposity and 20-year subsequent aortic stiffness in an initially healthy population-based cohort. J Hypertens 2018; 36:2077-2084. [PMID: 29878971 DOI: 10.1097/hjh.0000000000001796] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Aortic stiffness is a feature of arterial aging and is associated with dismal cardiovascular prognosis. We examined whether central and general adiposity is an independent predictor of accelerated aortic stiffening 20 years later in initially healthy midlife individuals. METHODS Participants from the STANISLAS cohort study (826 initially healthy participants aged 30-60 from the Lorraine region in France) underwent clinical and biological measurements at baseline (1994-1995) and after ≈20 years (2011-2016). Adiposity measurements included waist circumference/BMI ratio, BMI, waist circumference, and 'body shape index' [waist circumference/(BMI height)]. Real carotid-femoral pulse wave velocity (cfPWV) was measured at end of follow-up. Our primary analysis was to test the association between waist circumference/BMI ratio and cfPWV. RESULTS In a multiple linear regression model adjusted for sex, age and mean arterial pressure, waist circumference -to-BMI ratio was positively associated (for 1SD increase) with higher cfPWV [regression coefficient β = 0.32, 95% confidence interval (CI) 0.19-0.45, P < 0.001]. The cfPWV was less strongly associated with body shape index (β = 0.17, 95% CI 0.022-0.32, P < 0.05) and negatively associated with BMI (-0.20, 95% CI -0.31 to -0.093, P < 0.001) and waist circumference (-0.14, 95% CI -0.28 to 0.00, P < 0.05). Sensitivity analyses demonstrated that the risk of cfPWV associated with waist circumference-to-BMI ratio remained significant after adjustment for heart rate, metabolic risk factors and inflammatory markers. CONCLUSION Central adiposity (and more specifically waist circumference-to-BMI ratio) is an independent predictor of 20-year subsequent aortic stiffness in initially healthy midlife subjects.
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Barazzoni R, Gortan Cappellari G, Semolic A, Ius M, Zanetti M, Gabrielli A, Vinci P, Guarnieri G, Simon G. Central adiposity markers, plasma lipid profile and cardiometabolic risk prediction in overweight-obese individuals. Clin Nutr 2018; 38:1171-1179. [PMID: 29779870 DOI: 10.1016/j.clnu.2018.04.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 04/13/2018] [Accepted: 04/25/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND Waist circumference (WC) is the currently recommended marker of central fat for cardiometabolic risk screening. Alternative surrogate markers have been recently proposed to better reflect the metabolic impact of central fat accumulation per se, based on WC normalization by height (Weight-to-Height Ratio - WtoH; Body Roundness Index - BRI) or body mass index (BMI) without (A Body Shape Index - ABSI) or with inclusion of plasma triglyceride and HDL-cholesterol concentrations (Visceral Adiposity Index - VAI). METHODS We investigated associations between WtoH, BRI, ABSI or VAI and insulin resistance (HOMA-index) or metabolic syndrome (MetS) in a general population cohort from the North-East Italy Mo.Ma. study (n = 1965, age = 49 ± 13 years, BMI = 26.7 ± 5.2 kg/m2). Baseline values were also evaluated as predictors of future insulin resistance and MetS in overweight-obese individuals undergoing 5-year follow-up (Ow-Ob) (n = 263; age = 54 ± 9, BMI = 30,7 ± 4,1). RESULTS Compared to WC or BMI, basal WtoH and BRI were similarly associated with baseline HOMA and MetS prevalence after multiple adjustments (P < 0.001) and all markers similarly predicted 5-year HOMA and MetS (P < 0.001). Under basal conditions, superimposable results were observed for VAI whereas ABSI was less accurate or unable to identify baseline HOMA and MetS (p < 0.05 vs WtoH-BRI-VAI-WC-BMI). VAI had highest 5-year risk predictive value in Ow-Ob [ROC Area Under the Curve (AUC) VAI > WtoH-BRI-WC-BMI; p < 0.05] while no predictive value was in contrast observed for ABSI (ROC AUC ABSI < WtoH-BRI-WC-BMI; p < 0.05). Using alternate formulae with plasma lipid inclusion in ABSI and removal from VAI calculations completely reversed their 5-year predictive value and AUC. CONCLUSIONS The current findings do not support replacement of WC with height-normalized anthropometric central fat surrogate markers to predict cardiometabolic risk in the general and overweight-obese population. BMI-normalization impairs risk assessment unless plasma lipid concentrations are available and included in calculations.
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Affiliation(s)
- Rocco Barazzoni
- Dept. of Medical, Surgical and Health Sciences, University of Trieste, Italy; Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Trieste, Italy.
| | - Gianluca Gortan Cappellari
- Dept. of Medical, Surgical and Health Sciences, University of Trieste, Italy; Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Trieste, Italy
| | - Annamaria Semolic
- Dept. of Medical, Surgical and Health Sciences, University of Trieste, Italy; Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Trieste, Italy
| | - Mario Ius
- Dept. of Medical, Surgical and Health Sciences, University of Trieste, Italy; Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Trieste, Italy
| | - Michela Zanetti
- Dept. of Medical, Surgical and Health Sciences, University of Trieste, Italy; Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Trieste, Italy
| | | | - Pierandrea Vinci
- Dept. of Medical, Surgical and Health Sciences, University of Trieste, Italy; Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Trieste, Italy
| | - Gianfranco Guarnieri
- Dept. of Medical, Surgical and Health Sciences, University of Trieste, Italy; Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Trieste, Italy
| | - Giorgio Simon
- Azienda per l'Assistenza Sanitaria n. 5, Pordenone, Italy
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Paley CA, Johnson MI. Abdominal obesity and metabolic syndrome: exercise as medicine? BMC Sports Sci Med Rehabil 2018; 10:7. [PMID: 29755739 PMCID: PMC5935926 DOI: 10.1186/s13102-018-0097-1] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/26/2018] [Indexed: 12/18/2022]
Abstract
Background Metabolic syndrome is defined as a cluster of at least three out of five clinical risk factors: abdominal (visceral) obesity, hypertension, elevated serum triglycerides, low serum high-density lipoprotein (HDL) and insulin resistance. It is estimated to affect over 20% of the global adult population. Abdominal (visceral) obesity is thought to be the predominant risk factor for metabolic syndrome and as predictions estimate that 50% of adults will be classified as obese by 2030 it is likely that metabolic syndrome will be a significant problem for health services and a drain on health economies. Evidence shows that regular and consistent exercise reduces abdominal obesity and results in favourable changes in body composition. It has therefore been suggested that exercise is a medicine in its own right and should be prescribed as such. Purpose of this review This review provides a summary of the current evidence on the pathophysiology of dysfunctional adipose tissue (adiposopathy). It describes the relationship of adiposopathy to metabolic syndrome and how exercise may mediate these processes, and evaluates current evidence on the clinical efficacy of exercise in the management of abdominal obesity. The review also discusses the type and dose of exercise needed for optimal improvements in health status in relation to the available evidence and considers the difficulty in achieving adherence to exercise programmes. Conclusion There is moderate evidence supporting the use of programmes of exercise to reverse metabolic syndrome although at present the optimal dose and type of exercise is unknown. The main challenge for health care professionals is how to motivate individuals to participate and adherence to programmes of exercise used prophylactically and as a treatment for metabolic syndrome.
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Affiliation(s)
- Carole A Paley
- 1Research & Development (Ward 12), Airedale NHS Foundation Trust, Skipton Road, Steeton, Keighley, West Yorkshire BD20 6TD UK.,2School of Clinical and Applied Sciences, Leeds Beckett University, Portland Building, City Campus, Leeds, LS1 3HE UK
| | - Mark I Johnson
- 2School of Clinical and Applied Sciences, Leeds Beckett University, Portland Building, City Campus, Leeds, LS1 3HE UK
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Neeland IJ, Poirier P, Després JP. Cardiovascular and Metabolic Heterogeneity of Obesity: Clinical Challenges and Implications for Management. Circulation 2018; 137:1391-1406. [PMID: 29581366 PMCID: PMC5875734 DOI: 10.1161/circulationaha.117.029617] [Citation(s) in RCA: 460] [Impact Index Per Article: 76.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The prevalence of obesity has increased globally over the last 2 decades. Although the body mass index has been a convenient and simple index of obesity at the population level, studies have shown that obesity defined by body mass index alone is a remarkably heterogeneous condition with varying cardiovascular and metabolic manifestations across individuals. Adipose tissue is an exquisitely active metabolic organ engaged in cross-talk between various systems; perturbation of adipose tissue results in a pathological response to positive caloric balance in susceptible individuals that directly and indirectly contributes to cardiovascular and metabolic disease. Inadequate subcutaneous adipose tissue expansion in the face of dietary triglycerides leads to visceral and ectopic fat deposition, inflammatory/adipokine dysregulation, and insulin resistance. Conversely, preferential fat storage in the lower body depot may act as a metabolic buffer and protect other tissues from lipotoxicity caused by lipid overflow and ectopic fat. Translational, epidemiological, and clinical studies over the past 30 years have clearly demonstrated a strong link between visceral and ectopic fat and the development of a clinical syndrome characterized by atherogenic dyslipidemia, hyperinsulinemia/glucose intolerance, hypertension, atherosclerosis, and adverse cardiac remodeling/heart failure. This relationship is even more nuanced when clinical entities such as metabolically healthy obesity phenotype and the obesity paradox are considered. Although it is clear that the accumulation of visceral/ectopic fat is a major contributor to cardiovascular and metabolic risk above and beyond the body mass index, implementation of fat distribution assessment into clinical practice remains a challenge. Anthropometric indexes of obesity are easily implemented, but newer imaging-based methods offer improved sensitivity and specificity for measuring specific depots. Lifestyle, pharmacological, and surgical interventions allow a multidisciplinary approach to overweight/obesity that may improve outcomes and align with a public health message to combat the growing epidemic of obesity worldwide and to build healthier lives free of cardiovascular diseases.
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Affiliation(s)
- Ian J Neeland
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (I.J.N.)
| | - Paul Poirier
- Québec Heart and Lung Institute, Université Laval, Canada (P.P., J.-P.D.)
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Liu Y, Cromeens BP, Wang Y, Fisher K, Johnson J, Chakroff J, Besner GE. Comparison of Different In Vivo Incubation Sites to Produce Tissue-Engineered Small Intestine. Tissue Eng Part A 2018; 24:1138-1147. [PMID: 29383981 DOI: 10.1089/ten.tea.2017.0313] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The objective of this study was to compare the impact of different in vivo incubation sites on the production of tissue-engineered small intestine (TESI). MATERIALS AND METHODS Green fluorescent protein transgenic rat pups (3-5 days) were used as donors of intestinal organoids. Harvested intestine was exposed to enzymatic digestion to release intestinal stem cell-containing organoids. Organoids were purified, concentrated, and seeded onto tubular polyglycolic acid scaffolds. Seeded scaffolds were implanted in each of five locations in recipient female nude rats: wrapped with omentum, wrapped with intestinal mesentery, wrapped with uterine horn membrane, attached to the abdominal wall, and inserted into the subcutaneous space. After 4 weeks of in vivo incubation, specimens from each site were explanted for evaluation. RESULTS Wrapping seeded scaffolds with vascularized membranes produced TESI with variable lengths of vascularized pedicles, with the longest pedicle length from uterine horn membrane, the shortest pedicle length from intestinal mesentery, and intermediate length from omentum. The quantity of TESI, as expressed by volume and neomucosal length, was identical in TESI produced by wrapping with any of the three membranes. The smallest quantity of TESI was found in TESI produced from insertion into the subcutaneous space, with an intermediate quantity of TESI produced from attachment to the abdominal wall. Periodic acid-Schiff and immunofluorescence (IF) staining confirmed the presence of all intestinal epithelial cell lineages in TESI produced at all incubation sites. Additional IF staining demonstrated the presence of enteric nervous system components and blood vessels. Wrapping of seeded scaffolds with vascularized membranes significantly increased the density of blood vessels in the TESI produced. CONCLUSION Wrapping of seeded scaffolds in vascularized membranes produced the largest quantity and highest quality of TESI. Attaching seeded scaffolds to the abdominal wall produced an intermediate quantity of TESI, but the quality was still comparable to TESI produced in vascularized membranes. Insertion of seeded scaffolds into the subcutaneous space produced the smallest quantity and lowest quality of TESI. In summary, wrapping seeded scaffolds with vascularized membranes is favorable for the production of TESI, and wrapping with omentum may produce TESI that is most easily anastomosed with host intestine.
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Affiliation(s)
- Yanchun Liu
- 1 Department of Pediatric Surgery, The Research Institute at Nationwide Children's Hospital , Columbus, Ohio
| | - Barrett P Cromeens
- 1 Department of Pediatric Surgery, The Research Institute at Nationwide Children's Hospital , Columbus, Ohio
| | - Yijie Wang
- 1 Department of Pediatric Surgery, The Research Institute at Nationwide Children's Hospital , Columbus, Ohio
| | - Kelli Fisher
- 1 Department of Pediatric Surgery, The Research Institute at Nationwide Children's Hospital , Columbus, Ohio
| | - Jed Johnson
- 2 Nanofiber Solutions, Inc. , Hilliard, Ohio
| | | | - Gail E Besner
- 1 Department of Pediatric Surgery, The Research Institute at Nationwide Children's Hospital , Columbus, Ohio
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Wynchank D, Bijlenga D, Lamers F, Kooij JJS, Bron TI, Beekman ATF, Penninx BWJH. The Association Between Metabolic Syndrome, Obesity-Related Outcomes, and ADHD in Adults With Comorbid Affective Disorders. J Atten Disord 2018; 22:460-471. [PMID: 27422611 DOI: 10.1177/1087054716659137] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE ADHD may predispose to obesity, a metabolic syndrome component. Affective disorders are also associated with MetSyn and ADHD. This study examined whether ADHD confers any added risk of MetSyn and obesity-related associations in a large sample with varying stages of affective disorders. METHOD Participants included 2,303 adults from the Netherlands Study of Depression and Anxiety. Three groups were compared (controls, those with depressive/anxiety disorders without ADHD; and those with depressive/anxiety disorders and ADHD) for presence of MetSyn risk factors, body mass index, and waist-hip ratio. ADHD symptoms were identified by using a T-score > 65 (Conners Adult ADHD Rating Scale). RESULTS Multivariable analyses were additionally adjusted for sociodemographic, lifestyle, health factors, and affective disorders. Analyses showed no significant association between MetSyn, obesity-related variables, and comorbid ADHD. High Inattention and Hyperactivity/Impulsivity symptoms were not associated with MetSyn. CONCLUSION This study did not confirm that MetSyn and obesity-related parameters are increased in comorbid ADHD.
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Affiliation(s)
- Dora Wynchank
- 1 PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands
| | - Denise Bijlenga
- 1 PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands
| | - Femke Lamers
- 2 VU University Medical Center, Amsterdam, The Netherlands
| | | | - Tannetje I Bron
- 1 PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands
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Seimon RV, Wild-Taylor AL, Gibson AA, Harper C, McClintock S, Fernando HA, Hsu MSH, da Luz FQ, Keating SE, Johnson NA, Grieve SM, Markovic TP, Caterson ID, Byrne NM, Sainsbury A. Less Waste on Waist Measurements: Determination of Optimal Waist Circumference Measurement Site to Predict Visceral Adipose Tissue in Postmenopausal Women with Obesity. Nutrients 2018; 10:nu10020239. [PMID: 29461494 PMCID: PMC5852815 DOI: 10.3390/nu10020239] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/01/2018] [Accepted: 02/14/2018] [Indexed: 11/16/2022] Open
Abstract
With obesity being a leading cause of preventable death, it is vital to understand how best to identify individuals with greater risk of metabolic disease, especially those with high visceral adipose tissue (VAT). This study aimed to determine whether three commonly used waist circumference (WC) measurement sites could provide accurate estimations of VAT, as determined by magnetic resonance imaging (MRI), which is a gold standard for measuring VAT, in postmenopausal women with obesity. VAT volume was measured by MRI of the total abdomen in 97 women aged 57.7 ± 0.4 years (mean ± SEM), mean body mass index 34.5 ± 0.2 kg/m2. WC was measured at the midpoint between the lowest rib and the iliac crest (WCmid), the narrowest point of the torso (WCnarrow), and at the level of the umbilicus (WCumbilicus). WC differed significantly according to measurement site, with WCnarrow (102.1 ± 0.7 cm) < WCmid (108.3 ± 0.7 cm) < WCumbilicus (115.7 ± 0.8 cm) (p < 0.001). WCmid, WCnarrow and WCumbilicus were all significantly correlated with VAT, as measured by MRI (r = 0.581, 0.563 and 0.390, respectively; p < 0.001 for all), but the relationships between WCmid or WCnarrow and VAT determined by MRI were stronger than for WCumbilicus. Measurement of either WCmid or WCnarrow provides valid estimates of VAT in postmenopausal women with obesity, with WCnarrow being favoured in light of its greater ease and speed of measurement in this population.
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Affiliation(s)
- Radhika V. Seimon
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
- Correspondence: ; Tel.: +61-2-8627-1918; Fax: +61-2-8627-0141
| | - Anthony L. Wild-Taylor
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Alice A. Gibson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Claudia Harper
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Sally McClintock
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Hamish A. Fernando
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Michelle S. H. Hsu
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Felipe Q. da Luz
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
- School of Psychology, Faculty of Science, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Shelley E. Keating
- School of Human Movement and Nutrition Sciences, Centre for Research on Exercise, Physical Activity and Health, The University of Queensland, Brisbane, QLD 4072, Australia;
| | - Nathan A. Johnson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW 2050, Australia
| | - Stuart M. Grieve
- Sydney Translational Imaging Laboratory, Heart Research Institute, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia;
- Department of Radiology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Tania P. Markovic
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Ian D. Caterson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Nuala M. Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia;
| | - Amanda Sainsbury
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
- School of Psychology, Faculty of Science, The University of Sydney, Camperdown, NSW 2050, Australia
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Raposo L, Severo M, Santos AC. Adiposity cut-off points for cardiovascular disease and diabetes risk in the Portuguese population: The PORMETS study. PLoS One 2018; 13:e0191641. [PMID: 29377924 PMCID: PMC5788377 DOI: 10.1371/journal.pone.0191641] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 01/09/2018] [Indexed: 11/18/2022] Open
Abstract
Objectives The contribution of adiposity to cardiovascular and diabetes risk justifies the inclusion of an adiposity measure, usually waist circumference, in the definition of metabolic syndrome. However, waist circumference thresholds differ across populations. Our aim was to assess which adiposity measure performs the best in identifying the metabolic syndrome in a sample of Portuguese participants and to estimate cut-off values for these measures. Methods Data were obtained from a cross-sectional study (PORMETS study) conducted in Portugal between 2007 and 2009. A representative sample of non-institutionalized adults, comprising 3,956 participants, aged 18 years and older, was evaluated. A structured questionnaire was administered, collecting information on personal medical history, socio-demographics and behavioral characteristics. Anthropometrics, blood pressure and venous blood samples were also obtained. Metabolic syndrome was defined according to the Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology recommended criteria. Elevated cardiometabolic risk was considered when two or more of the four criteria of metabolic syndrome were present, excluding the waist circumference component. A receiver operating characteristic curve was used to estimate cut-off points. Results This study found that waist-to-height ratio, waist circumference and body adiposity index performed better than other adiposity measures, such as body mass index. The estimated cut-off points for waist-to-height ratio, waist circumference and body adiposity index in women and men were 0.564 / 89 cm / 27.4 and 0.571 / 93.5 cm / 25.5, respectively. Conclusion As waist circumference is currently used as the adiposity measure in the definition of metabolic syndrome and as no relevant differences were observed between this measure and waist-to-height ratio, it is likely that no modification to the metabolic syndrome definition needs to be proposed. Moreover, this study also confirmed the applicability of European cut-off points in the Portuguese population.
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Affiliation(s)
- Luís Raposo
- Insulin Resistance Study Group of the Portuguese Society of Endocrinology, Diabetes and Metabolism, Lisboa, Portugal
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- * E-mail:
| | - Milton Severo
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Ana Cristina Santos
- Insulin Resistance Study Group of the Portuguese Society of Endocrinology, Diabetes and Metabolism, Lisboa, Portugal
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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Zhang J, Zhu W, Qiu L, Huang L, Fang L. Sex- and Age-Specific Optimal Anthropometric Indices as Screening Tools for Metabolic Syndrome in Chinese Adults. Int J Endocrinol 2018; 2018:1067603. [PMID: 30310390 PMCID: PMC6166375 DOI: 10.1155/2018/1067603] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 08/26/2018] [Accepted: 09/03/2018] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To compare the predictive ability of six anthropometric indices for identification of metabolic syndrome (MetS) and to determine their optimal cut-off points among Chinese adults. METHODS A total of 59,029 participants were enrolled. Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), a body shape index (ABSI), body roundness index (BRI), and conicity index (CI) were measured. Receiver-operating characteristic curves analyses were performed to determine the discriminatory power of these indices for the identification of cardiometabolic risks and diagnosis of MetS. The differences in the area under the curve (AUC) values among the indices were evaluated. The Youden index was used to determine the optimal cut-off points. RESULTS WHtR and BRI exhibited the highest AUC values for identifying MetS and most cardiometabolic risk factors in both sexes, whereas ABSI showed the lowest AUC value. The general optimal cut-off points in women were 23.03 kg/m2 for BMI, 77.25 cm for WC, 0.490 for WHtR, and 3.179 for BRI; those in men were 24.64 kg/m2 for BMI, 87.25 cm for WC, 0.510 for WHtR, and 3.547 for BRI. The AUC values and cut-off points of the indices were also analyzed in each age and BMI category. CONCLUSIONS In Chinese adults, WHtR and BRI showed a superior predictive power for MetS in both sexes, which can be used as simple and effective screening tools for cardiometabolic risks and MetS in clinical practice.
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Affiliation(s)
- Jia Zhang
- Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wenhua Zhu
- Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lifeng Qiu
- Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lijuan Huang
- Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lizheng Fang
- Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Lévesque V, Poirier P, Després JP, Alméras N. Relation Between a Simple Lifestyle Risk Score and Established Biological Risk Factors for Cardiovascular Disease. Am J Cardiol 2017; 120:1939-1946. [PMID: 28965712 DOI: 10.1016/j.amjcard.2017.08.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 07/25/2017] [Accepted: 08/08/2017] [Indexed: 12/21/2022]
Abstract
Although cardiovascular disease (CVD) and diabetes mellitus are largely lifestyle driven, lifestyle metrics are not used in clinical practice. This study examined the relevance of using a simple lifestyle risk score designed for primary care medicine by testing its ability to predict biological CVD risk factors in a cohort of 3,712 individuals involved in a workplace health evaluation or management program ("Grand Défi Entreprise" project). Using a lifestyle risk score based on waist circumference, fitness, nutritional quality, and physical activity level, employees were categorized into 3 distinct estimated lifestyle risk levels (low, intermediate, and high). A biological CVD risk score was also calculated, which included high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), cholesterol-to-HDL-C ratio, blood pressure, hemoglobin glycated levels, and medication use. Diastolic blood pressure, TG levels, and the cholesterol-to-HDL-C ratio increased across categories of lifestyle risk score, whereas HDL-C decreased (p <0.05). Calculated Framingham and diabetes risk scores as well as the prevalence of hypertriglyceridemic waist phenotype also increased across categories of lifestyle risk score (p <0.05). Finally, 1-way analysis of variance revealed that the biological risk score significantly increased across the lifestyle risk score categories (p <0.0001). Our study provides evidence that lifestyle variables can be measured and targeted in clinical practice.
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Affiliation(s)
- Valérie Lévesque
- Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Quebec, Canada; Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Quebec, Canada
| | - Paul Poirier
- Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Quebec, Canada; Faculty of Pharmacy, Université Laval, Québec, Quebec, Canada
| | - Jean-Pierre Després
- Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Quebec, Canada; Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Quebec, Canada
| | - Natalie Alméras
- Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Quebec, Canada; Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Quebec, Canada.
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Graves KY, Nowakowski ACH. Childhood Socioeconomic Status and Stress in Late Adulthood: A Longitudinal Approach to Measuring Allostatic Load. Glob Pediatr Health 2017; 4:2333794X17744950. [PMID: 29226194 PMCID: PMC5714076 DOI: 10.1177/2333794x17744950] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 10/20/2017] [Indexed: 01/31/2023] Open
Abstract
Objectives: This study examines how the effects of childhood socioeconomic status (SES) may carry on into late adulthood. Methods: We examine how childhood SES affects both perceived stress and allostatic load, which is a cumulative measure of the body’s biologic response to chronic stress. We use the National Social Life, Health, and Aging Project, Waves 1 and 2, and suggest a novel method of incorporating a longitudinal allostatic load measure. Results: Individuals who grew up in low SES households have higher allostatic load scores in late adulthood, and this association is mediated mostly by educational attainment. Discussion: The longitudinal allostatic load measure shows similar results to the singular measures and allows us to include 2 time points into one outcome measure. Incorporating 2 separate time points into one measure is important because allostatic load is a measure of cumulative physiological dysregulation, and longitudinal data provide a more comprehensive measure.
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Affiliation(s)
- Katelyn Y Graves
- School of Physician Assistant Practice/Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, USA
| | - Alexandra C H Nowakowski
- Department of Geriatrics/Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Orlando Regional Campus, Orlando, FL, USA
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Kawada T. Bariatric Surgery in Patients With Type 2 Diabetes Mellitus. Ann Surg 2017; 266:e58. [PMID: 29136970 DOI: 10.1097/sla.0000000000001379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan
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Soguel L, Durocher F, Tchernof A, Diorio C. Adiposity, breast density, and breast cancer risk: epidemiological and biological considerations. Eur J Cancer Prev 2017; 26:511-520. [PMID: 27571214 PMCID: PMC5627530 DOI: 10.1097/cej.0000000000000310] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 01/29/2016] [Indexed: 12/16/2022]
Abstract
Excess total body fat and abdominal adipose tissue are recognized risk factors for metabolic diseases but also for some types of cancers, including breast cancer. Several biological mechanisms in connection with local and systemic effects of adiposity are believed to be implicated in breast cancer development, and may involve breast fat. Breast adipose tissue can be studied through mammography by looking at breast density features such as the nondense area mainly composed of fat, or the percent breast density, which is the proportion of fibroglandular tissue in relation to fat. The relation between adiposity, breast density features, and breast cancer is complex. Studies suggest a paradoxical association as adiposity and absolute nondense area correlate positively with each other, but in contrast to adiposity, absolute nondense area seems to be associated negatively with breast cancer risk. As breast density is one of the strongest risk factors for breast cancer, it is therefore critical to understand how these factors interrelate. In this review, we discuss these relations by first presenting how adiposity measurements and breast density features are linked to breast cancer risk. Then, we used a systematic approach to capture the literature to review the relation between adiposity and breast density features. Finally, the role of adipose tissue in carcinogenesis is discussed briefly from a biological perspective.
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Affiliation(s)
- Ludivine Soguel
- Departments of Social and Preventive Medicine
- CHU de Québec Research Center
- Department of Nutrition and Dietetics, University of Applied Sciences Western Switzerland (HES-SO) Geneva, 25 rue des Caroubiers, Carouge, Switzerland
| | - Francine Durocher
- Molecular Medicine, Cancer Research Center, Laval University, 2325 rue de l’Université
- CHU de Québec Research Center, CHUL, 2724 Laurier Boulevard
| | - André Tchernof
- CHU de Québec Research Center, CHUL, 2724 Laurier Boulevard
- Department of Nutrition, Laval University, 2425 rue de l’Agriculture, Quebec City, Quebec, Canada
| | - Caroline Diorio
- Departments of Social and Preventive Medicine
- CHU de Québec Research Center
- Deschênes-Fabia Center for Breast Diseases, Saint-Sacrement Hospital, 1050 Chemin Ste-Foy
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The relationship between obesity and hypertension: an updated comprehensive overview on vicious twins. Hypertens Res 2017; 40:947-963. [DOI: 10.1038/hr.2017.75] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/07/2017] [Accepted: 04/14/2017] [Indexed: 02/07/2023]
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Szulc P, Duboeuf F, Chapurlat R. Age-Related Changes in Fat Mass and Distribution in Men-the Cross-Sectional STRAMBO Study. J Clin Densitom 2017; 20:472-479. [PMID: 27601161 DOI: 10.1016/j.jocd.2016.08.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 08/05/2016] [Accepted: 08/11/2016] [Indexed: 12/26/2022]
Abstract
Data on age-related differences in fat mass and distribution in men are scarce. We performed a cross-sectional analysis of age-related differences in fat distribution in men. In a cohort of 1133 men aged 20-87 yr, body composition was assessed using a Hologic Discovery A device. We assessed fat mass (FM) and FM indices adjusted for height. Interindividual variability was calculated as standard deviation, interquartile range, and difference between the 95th and 5th percentiles in 5-yr age groups. After adjustment for lifestyle factors, the FM and FM index of appendicular, gynoid, central, android, and subcutaneous abdominal compartments increased with age. Their variability did not vary with age. Visceral FM was 181% higher in men aged >80 yr compared to men aged 20-30 yr, and the variability increased with age. FM in the central, android, subcutaneous abdominal, and visceral compartments correlated with age significantly more strongly before the age of 70 than after this age. The relative differences between the elderly and younger men were greater for visceral FM than for subcutaneous (abdominal and appendicular) fat. The interindividual variability in visceral FM is higher in elderly men. The association between visceral FM and age is stronger before the age of 70.
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Affiliation(s)
- Pawel Szulc
- INSERM UMR 1033, University of Lyon, Hospices Civils de Lyon, Lyon, France.
| | - François Duboeuf
- INSERM UMR 1033, University of Lyon, Hospices Civils de Lyon, Lyon, France
| | - Roland Chapurlat
- INSERM UMR 1033, University of Lyon, Hospices Civils de Lyon, Lyon, France
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Aron-Wisnewsky J, Sokolovska N, Liu Y, Comaneshter DS, Vinker S, Pecht T, Poitou C, Oppert JM, Bouillot JL, Genser L, Dicker D, Zucker JD, Rudich A, Clément K. The advanced-DiaRem score improves prediction of diabetes remission 1 year post-Roux-en-Y gastric bypass. Diabetologia 2017; 60:1892-1902. [PMID: 28733906 DOI: 10.1007/s00125-017-4371-7] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 06/08/2017] [Indexed: 12/18/2022]
Abstract
AIMS/HYPOTHESIS Not all people with type 2 diabetes who undergo bariatric surgery achieve diabetes remission. Thus it is critical to develop methods for predicting outcomes that are applicable for clinical practice. The DiaRem score is relevant for predicting diabetes remission post-Roux-en-Y gastric bypass (RYGB), but it is not accurate for all individuals across the entire spectrum of scores. We aimed to develop an improved scoring system for predicting diabetes remission following RYGB (the Advanced-DiaRem [Ad-DiaRem]). METHODS We used a retrospective French cohort (n = 1866) that included 352 individuals with type 2 diabetes followed for 1 year post-RYGB. We developed the Ad-DiaRem in a test cohort (n = 213) and examined its accuracy in independent cohorts from France (n = 134) and Israel (n = 99). RESULTS Adding two clinical variables (diabetes duration and number of glucose-lowering agents) to the original DiaRem and modifying the penalties for each category led to improved predictive performance for Ad-DiaRem. Ad-DiaRem displayed improved area under the receiver operating characteristic curve and predictive accuracy compared with DiaRem (0.911 vs 0.856 and 0.841 vs 0.789, respectively; p = 0.03); thus correcting classification for 8% of those initially misclassified with DiaRem. With Ad-DiaRem, there were also fewer misclassifications of individuals with mid-range scores. This improved predictive performance was confirmed in independent cohorts. CONCLUSIONS/INTERPRETATION We propose the Ad-DiaRem, which includes two additional clinical variables, as an optimised tool with improved accuracy to predict diabetes remission 1 year post-RYGB. This tool might be helpful for personalised management of individuals with diabetes when considering bariatric surgery in routine care, ultimately contributing to precision medicine.
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Affiliation(s)
- Judith Aron-Wisnewsky
- Institute of Cardiometabolism and Nutrition (ICAN), Nutrition Department, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 46-83 Boulevard de l'Hôpital, F-75013, Paris, France
- Team 6 Nutriomics, UPMC Université Paris 06 and Inserm, UMR_S 1166, Sorbonne Universités, Paris, France
| | - Nataliya Sokolovska
- Institute of Cardiometabolism and Nutrition (ICAN), Nutrition Department, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 46-83 Boulevard de l'Hôpital, F-75013, Paris, France
- Team 6 Nutriomics, UPMC Université Paris 06 and Inserm, UMR_S 1166, Sorbonne Universités, Paris, France
| | - Yuejun Liu
- Institute of Cardiometabolism and Nutrition (ICAN), Nutrition Department, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 46-83 Boulevard de l'Hôpital, F-75013, Paris, France
- Team 6 Nutriomics, UPMC Université Paris 06 and Inserm, UMR_S 1166, Sorbonne Universités, Paris, France
| | | | - Shlomo Vinker
- Central Headquarters, Clalit Health Services, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tal Pecht
- Department of Clinical Biochemistry and Pharmacology at the Faculty of Health Sciences and the National Institute of Biotechnology in the Negev (NIBN), Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Christine Poitou
- Institute of Cardiometabolism and Nutrition (ICAN), Nutrition Department, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 46-83 Boulevard de l'Hôpital, F-75013, Paris, France
- Team 6 Nutriomics, UPMC Université Paris 06 and Inserm, UMR_S 1166, Sorbonne Universités, Paris, France
| | - Jean-Michel Oppert
- Institute of Cardiometabolism and Nutrition (ICAN), Nutrition Department, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 46-83 Boulevard de l'Hôpital, F-75013, Paris, France
| | - Jean-Luc Bouillot
- Surgery Department, Assistance Publique - Hôpitaux de Paris, Ambroise Paré Hospital, Boulogne-Billancourt, France
| | - Laurent Genser
- Hepato-biliary and Digestive Surgery Department, Assistance Publique - Hôpitaux de Paris, Pitié-Salpétrière Hospital, Paris, France
| | - Dror Dicker
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Internal Medicine D and Obesity Clinic, Hasharon Hospital - Rabin Medical Center, Petach-Tikva, Israel
| | - Jean-Daniel Zucker
- Institute of Cardiometabolism and Nutrition (ICAN), Nutrition Department, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 46-83 Boulevard de l'Hôpital, F-75013, Paris, France
- Team 6 Nutriomics, UPMC Université Paris 06 and Inserm, UMR_S 1166, Sorbonne Universités, Paris, France
- Unité Mixte Internationale Modélisation Math. et Info. des Systèmes Complexes, UMMISCO UMI 209 IRD/UPMC, Paris, France
| | - Assaf Rudich
- Department of Clinical Biochemistry and Pharmacology at the Faculty of Health Sciences and the National Institute of Biotechnology in the Negev (NIBN), Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Karine Clément
- Institute of Cardiometabolism and Nutrition (ICAN), Nutrition Department, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 46-83 Boulevard de l'Hôpital, F-75013, Paris, France.
- Team 6 Nutriomics, UPMC Université Paris 06 and Inserm, UMR_S 1166, Sorbonne Universités, Paris, France.
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Phillips J, McBride CA, Morris E, Crocker AM, Bernstein I. Adiposity, but not Obesity, Is Associated With Arterial Stiffness in Young Nulliparous Women. Reprod Sci 2017; 25:909-915. [PMID: 28862065 DOI: 10.1177/1933719117728797] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Subclinical vascular dysfunction is increasingly recognized as an independent risk factor for cardiovascular events and adverse pregnancy outcomes. The evidence linking indices of obesity and vascular dysfunction is mixed. As an example, some data suggest that adiposity may be a better predictor of endothelial dysfunction than body mass index (BMI). The aim of the current study is to compare the association of obesity, as evaluated by BMI, and a direct measure of body fat to biophysical parameters of vascular function including flow-mediated vasodilation and pulse wave velocity (PWV) in healthy nulliparous reproductive-age women. This is a secondary analysis of data collected as a prospective study of prepregnancy physiology in healthy, nulliparous women. Body mass index was calculated as weight (kg)/height (m2). Total and android body fat were calculated by dual-energy X-ray absorptiometry. Brachial PWV and flow-mediated vasodilation were assessed ultrasonographically. Seventy-nine women were evaluated. Mean BMI was 24.4 (5.4) kg/m2, and 15% of women were obese (BMI ≥ 30 kg/m2). In contrast, 39% were considered to have excess adiposity, with ≥39% android body fat. Brachial PWV was associated with increased adiposity, but not obesity. We found no differences in flow-mediated dilation associated with either BMI or body fat. Adiposity may be superior to BMI in identifying women with vascular dysfunction at increased risk of adverse pregnancy outcome and cardiovascular disease. Proper identification may allow implementation of prevention strategies to improve perinatal outcomes and maternal health.
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Affiliation(s)
| | | | - Erin Morris
- 1 University of Vermont, Burlington, VT, USA
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Three novel obese indicators perform better in monitoring management of metabolic syndrome in type 2 diabetes. Sci Rep 2017; 7:9843. [PMID: 28852155 PMCID: PMC5574991 DOI: 10.1038/s41598-017-10446-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 08/09/2017] [Indexed: 12/13/2022] Open
Abstract
The present study evaluated the performance of three novel obese indicators, visceral adiposity index (VAI), lipid accumulation product (LAP) and waist circumference-triglyceride index (WTI), for identifying metabolic syndrome(MetS) in type 2 diabetes. A cross-sectional study was conducted on 711 type 2 diabetes in Qinhuangdao. The MetS was defined as the definition of Chinese Diabetes Society. Receiver operating characteristic curve analyses were performed to assess the accuracy of three obese indicators as diagnostic tests for MetS. The prevalence of MetS was 71.3%. In men, among all three obese indicators, the LAP had the highest area under curve (AUC) value (AUC = 0.894), followed by VAI (AUC = 0.860) and WTI (AUC = 0.855). In women, among all three obese indicators, the LAP had the highest AUC value (AUC = 0.906), followed by WTI (AUC = 0.887) and VAI (AUC = 0.881). However. there was no significant difference between the three obese indicators(P > 0.05). Three obese indicators were effective indicators for the screening of MetS, LAP and WTI are more simple.
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Correa-Bautista JE, González-Ruíz K, Vivas A, Triana-Reina HR, Martínez-Torres J, Prieto-Benavides DH, Carrillo HA, Ramos-Sepúlveda JA, Afanador-Rodríguez MI, Villa-González E, García-Hermoso A, Ramírez-Vélez R. Comparison of Three Adiposity Indexes and Cutoff Values to Predict Metabolic Syndrome Among University Students. Metab Syndr Relat Disord 2017; 15:363-370. [PMID: 28570830 DOI: 10.1089/met.2017.0016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
PURPOSE Obesity and high body fat are related to diabetes and metabolic syndrome (MetS) in all ethnic groups. Based on the International Diabetes Federation (IDF) definition of MetS, the aim of the present study was to compare body adiposity indexes (BAIs) and to assess their various cutoff values for the prediction of MetS in university students from Colombia. METHODS A cross-sectional study was conducted on 886 volunteers (51.9% woman; age mean 21.4 years). Anthropometric characteristics (height, weight, waist circumference [WC], and hip circumference [HC]) were measured, and body composition was assessed by bioelectrical impedance analysis. MetS was defined as including ≥3 of the metabolic abnormalities (WC, high-density lipoprotein cholesterol [HDL-C], triglycerides, fasting glucose, and systolic and diastolic blood pressure [BP]) in the definition provided by the IDF. The BAIs (i.e., BAI-HC [BAI], BAI-WC [BAI-w], and [BAI-p]) were calculated from formulas taking into account, height, weight, and WC, and for the visceral adiposity indexes, a formula, including WC, HDL-C, and triglycerides, was used. RESULTS The overall prevalence of MetS was 5.9%, higher in men than in women. The most prevalent components were low HDL-C, high triglyceride levels, WC, and BP levels. The receiver operating characteristic curves analysis showed that BAI, BAI-w, and BAI-p could be useful tools to predict MetS in this population. CONCLUSION For women, the optimal MetS threshold was found to be 30.34 (area under curve [AUC] = 0.720-0.863), 19.10 (AUC = 0.799-0.925), and 29.68 (AUC = 0.779-0.901), for BAI, BAI-w, and BAI-p, respectively. For men, the optimal MetS threshold was found to be 27.83 (AUC = 0.726-0.873), 21.48 (AUC = 0.755-0.906), and 26.18 (AUC = 0.766-0.894), for BAI, BAI-w, and BAI-p, respectively. The three indexes can be useful tools to predict MetS according to the IDF criteria in university students from Colombia. Data on larger samples are needed.
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Affiliation(s)
- Jorge Enrique Correa-Bautista
- 1 Centro de Estudios para la Medición de la Actividad Física "CEMA", Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario , Bogotá, Colombia
| | - Katherine González-Ruíz
- 2 Grupo de Ejercicio Físico y Deportes, Vicerrectoría de Investigaciones, Universidad Manuela Beltrán , Bogotá, Colombia
| | - Andrés Vivas
- 2 Grupo de Ejercicio Físico y Deportes, Vicerrectoría de Investigaciones, Universidad Manuela Beltrán , Bogotá, Colombia
| | | | - Javier Martínez-Torres
- 3 Grupo GICAEDS, Facultad de Cultura Física, Deporte y Recreación, Universidad Santo Tomás , Bogotá, Colombia
| | - Daniel Humberto Prieto-Benavides
- 1 Centro de Estudios para la Medición de la Actividad Física "CEMA", Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario , Bogotá, Colombia
| | - Hugo Alejandro Carrillo
- 4 Grupo GRINDER, Programa de Educación Física y Deportes, Universidad del Valle , Santiago de Cali, Colombia
| | | | | | - Emilio Villa-González
- 6 PROFITH "PROmoting FITness and Health through Physical Activity" Research Group, Department of Physical Education and Sport, School of Sport Sciences, University of Granada , Granada, Spain
| | - Antonio García-Hermoso
- 7 Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile , USACH, Santiago, Chile
| | - Robinson Ramírez-Vélez
- 1 Centro de Estudios para la Medición de la Actividad Física "CEMA", Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario , Bogotá, Colombia
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Borel AL, Nazare JA, Baillot A, Alméras N, Tremblay A, Bergeron J, Poirier P, Després JP. Cardiometabolic risk improvement in response to a 3-yr lifestyle modification program in men: contribution of improved cardiorespiratory fitness vs. weight loss. Am J Physiol Endocrinol Metab 2017; 312:E273-E281. [PMID: 28028035 DOI: 10.1152/ajpendo.00278.2016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 12/06/2016] [Accepted: 12/27/2016] [Indexed: 12/16/2022]
Abstract
Our objective was to examine the respective contributions of changes in visceral adiposity, subcutaneous adiposity, liver fat, and cardiorespiratory fitness (CRF) to the improvements in cardiometabolic risk markers in response to a 3-yr healthy eating/physical activity lifestyle intervention. Ninety-four out of 144 viscerally obese healthy men completed a 3-yr lifestyle intervention. Body weight, body composition, and fat distribution were assessed by anthropometry and DEXA/computed tomography. CRF, adipokines, lipoprotein/lipid profile, and 75 g of oral glucose tolerance were assessed. CRF and visceral and subcutaneous adiposity significantly improved over the 3-yr intervention, with a nadir in year 1 and a partial regain in year 3 Liver fat (estimated by insulin hepatic extraction) stabilized from year 1 to year 3, whereas HOMA-IR, ISI-Matsuda index, and adiponectin continued to improve. Multivariate analysis revealed that both visceral adiposity and estimated liver fat reductions contributed to the improved ISI-Matsuda index observed over 3 yr (r2 = 0.28, P < 0.001). Three-year changes in fat mass and CRF were independently associated with changes in visceral fat (adjusted r2 = 0.40, P < 0.001), whereas only changes in CRF were associated with changes in estimated liver fat (adjusted r2 = 0.18, P < 0.001). A long-term (3 yr) healthy eating/physical activity intervention in men improves several cardiometabolic risk markers over the long term (3 yr) despite a partial body weight regain observed between year 1 and year 3 The improvement in CRF contributes to visceral and estimated liver fat losses over the long term, which in turn explain the benefits of the lifestyle intervention on cardiometabolic risk profile.
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Affiliation(s)
- Anne-Laure Borel
- Grenoble Alpes University Hospital, Endocrinology Department, Grenoble, France
- Grenoble Alpes University, Hypoxia Physiopathology (HP2), Laboratory Institut National de la Santé et de la Recherche Médicale (INSERM) U1042, Grenoble, France
| | - Julie-Anne Nazare
- Centre de Recherche en Nutrition Humaine Rhône-Alpes, Centre Européen de Nutrition pour la Santé, Cardiovasculaire, Métabolisme, Diabétologie et Nutrition INSERM U1060 U060, University of Lyon, Lyon, France
| | - Aurélie Baillot
- Nursing Department, Université du Québec en Outaouais, Gatineau, Quebec, Canada
| | - Natalie Alméras
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
| | - Angelo Tremblay
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
| | - Jean Bergeron
- Endocrinology and Nephrology Unit, Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec City, Quebec, Canada; and
| | - Paul Poirier
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada
- Faculty of Pharmacy, Université Laval, Quebec City, Quebec, Canada
| | - Jean-Pierre Després
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada;
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
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87
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Ozoya OO, Siegel EM, Srikumar T, Bloomer AM, DeRenzis A, Shibata D. Quantitative Assessment of Visceral Obesity and Postoperative Colon Cancer Outcomes. J Gastrointest Surg 2017; 21:534-542. [PMID: 28101721 PMCID: PMC5560865 DOI: 10.1007/s11605-017-3362-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 01/04/2017] [Indexed: 01/31/2023]
Abstract
BACKGROUND Quantitative computed tomography (CT) assessment of visceral adiposity may be superior to body mass index (BMI) as a predictor of surgical morbidity. We sought to examine the association of CT measures of obesity and BMI with short-term postoperative outcomes in colon cancer patients. METHODS In this retrospective study, 110 patients treated with colectomy for stage I-III colon cancer were classified as obese or non-obese by preoperative CT-based measures of adiposity or BMI [obese: BMI ≥ 30 kg/m2, visceral fat area (VFA) to subcutaneous fat area ratio (V/S) ≥0.4, and VFA > 100 cm2]. Postoperative morbidity and mortality rates were compared. RESULTS Obese patients, by V/S and VFA but not BMI, were more likely to be male and have preexisting hypertension and diabetes. The overall complication rate was 25.5%, and there were no mortalities. Obese patients by VFA (with a trend for V/S but not BMI) were more likely to develop postoperative complications as compared to patients classified as non-obese: VFA (30.5 vs.10.7%, p = 0.03), V/S (29.2 vs. 9.5%, p = 0.05), and BMI (32.4 vs. 21.9%, p = 0.23). CONCLUSIONS Elevated visceral obesity quantified by CT is associated with the presence of key metabolic comorbidities and increased postoperative morbidity and may be superior to BMI for risk stratification.
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Affiliation(s)
- Oluwatobi. O. Ozoya
- Cancer Epidemiology, Moffitt Cancer Center, Tampa FL,Department of Global Health, College of Public Health, University of
South Florida, Tampa, FL
| | - Erin M. Siegel
- Cancer Epidemiology, Moffitt Cancer Center, Tampa FL,Health Research Informatics, Moffitt Cancer Center, Tampa, FL
| | - Thejal Srikumar
- Cancer Epidemiology, Moffitt Cancer Center, Tampa FL,Morsani College of Medicine, University of South Florida, Tampa,
FL
| | | | | | - David Shibata
- Department of Surgery, UT West Cancer Center, University of
Tennessee Health Science Center, Memphis, TN
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Cova I, Pomati S, Maggiore L, Forcella M, Cucumo V, Ghiretti R, Grande G, Muzio F, Mariani C. Nutritional status and body composition by bioelectrical impedance vector analysis: A cross sectional study in mild cognitive impairment and Alzheimer's disease. PLoS One 2017; 12:e0171331. [PMID: 28187148 PMCID: PMC5302822 DOI: 10.1371/journal.pone.0171331] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 01/18/2017] [Indexed: 01/22/2023] Open
Abstract
AIMS Analysis of nutritional status and body composition in Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI). METHODS A cross-sectional study was performed in a University-Hospital setting, recruiting 59 patients with AD, 34 subjects with MCI and 58 elderly healthy controls (HC). Nutritional status was assessed by anthropometric parameters (body mass index; calf, upper arm and waist circumferences), Mini Nutritional Assessment (MNA) and body composition by bioelectrical impedance vector analysis (BIVA). Variables were analyzed by analysis of variance and subjects were grouped by cognitive status and gender. RESULTS Sociodemographic variables did not differ among the three groups (AD, MCI and HC), except for females' age, which was therefore used as covariate in a general linear multivariate model. MNA score was significantly lower in AD patients than in HC; MCI subjects achieved intermediate scores. AD patients (both sexes) had significantly (p<0.05) higher height-normalized impedance values and lower phase angles (body cell mass) compared with HC; a higher ratio of impedance to height was found in men with MCI with respect to HC. With BIVA method, MCI subjects showed a significant displacement on the RXc graph on the right side indicating lower soft tissues (Hotelling's T2 test: men = 10.6; women = 7.9;p < 0,05) just like AD patients (Hotelling's T2 test: men = 18.2; women = 16.9; p<0,001). CONCLUSION Bioelectrical parameters significantly differ from MCI and AD to HC; MCI showed an intermediate pattern between AD and HC. Longitudinal studies are required to investigate if BIVA could reflect early AD-changes in body composition in subjects with MCI.
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Affiliation(s)
- Ilaria Cova
- Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, Department of Clinical Sciences, ASST Fatebenefratelli-Sacco, “Luigi Sacco” University Hospital, Milan, Italy
- * E-mail:
| | - Simone Pomati
- Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, Department of Clinical Sciences, ASST Fatebenefratelli-Sacco, “Luigi Sacco” University Hospital, Milan, Italy
| | - Laura Maggiore
- Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, Department of Clinical Sciences, ASST Fatebenefratelli-Sacco, “Luigi Sacco” University Hospital, Milan, Italy
| | - Marica Forcella
- Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, Department of Clinical Sciences, ASST Fatebenefratelli-Sacco, “Luigi Sacco” University Hospital, Milan, Italy
| | - Valentina Cucumo
- Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, Department of Clinical Sciences, ASST Fatebenefratelli-Sacco, “Luigi Sacco” University Hospital, Milan, Italy
| | - Roberta Ghiretti
- Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, Department of Clinical Sciences, ASST Fatebenefratelli-Sacco, “Luigi Sacco” University Hospital, Milan, Italy
| | - Giulia Grande
- Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, Department of Clinical Sciences, ASST Fatebenefratelli-Sacco, “Luigi Sacco” University Hospital, Milan, Italy
| | - Fulvio Muzio
- Dietetic and Clinical Nutrition Unit, ASST Fatebenefratelli-Sacco, "Luigi Sacco" University Hospital, Milan, Italy
| | - Claudio Mariani
- Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, Department of Clinical Sciences, ASST Fatebenefratelli-Sacco, “Luigi Sacco” University Hospital, Milan, Italy
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Ando T, Yamazaki E, Ogusa E, Ishii Y, Yamamoto W, Motohashi K, Tachibana T, Hagihara M, Matsumoto K, Tanaka M, Hashimoto C, Koharazawa H, Fujimaki K, Taguchi J, Fujita H, Kanamori H, Fujisawa S, Nakajima H. Body mass index is a prognostic factor in adult patients with acute myeloid leukemia. Int J Hematol 2017; 105:623-630. [DOI: 10.1007/s12185-017-2183-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 01/12/2017] [Accepted: 01/12/2017] [Indexed: 11/29/2022]
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90
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Abdominal Adiposity, Not Cardiorespiratory Fitness, Mediates the Exercise-Induced Change in Insulin Sensitivity in Older Adults. PLoS One 2016; 11:e0167734. [PMID: 27936206 PMCID: PMC5147957 DOI: 10.1371/journal.pone.0167734] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 11/18/2016] [Indexed: 11/19/2022] Open
Abstract
Abdominal obesity and low cardiorespiratory fitness (CRF) are associated with insulin resistance in older adults. Exercise is associated with improvement in insulin sensitivity. Whether this association is mediated by change in CRF and/or abdominal obesity is unclear. The current study is a secondary analysis of data from a randomized controlled trial in Kingston, Ontario. Sedentary older adults (60–80 years) (N = 80) who completed the exercise (N = 59) or control (N = 21) conditions for 6 months were included. CRF was measured using a treadmill test, adipose tissue (AT) by magnetic resonance imaging, and insulin sensitivity by hyperinsulinemic-euglycemic clamp. Waist circumference (WC) was measured at the iliac crest. Mediation analyses were used to assess whether abdominal AT and/or CRF mediated the exercise-induced change in insulin sensitivity. By comparison to controls, reduction (mean ± SD) was observed for visceral (-0.4 ± 0.4 kg) and abdominal subcutaneous (-0.4 ± 0.4) AT depots, WC (-4.1 ± 3.2 cm) and BMI (-0.9 ± 0.8 kg/m2) (p < 0.05). Insulin sensitivity (4.2 ± 5.2 M/I) and CRF (0.2 ± 0.3 L/min) improved in the exercise group (p < 0.05). All AT variables, BMI and WC were mediators of the change in insulin sensitivity (p < 0.05). After adjustment for change in total AT, abdominal AT remained a mediator with an effect ratio of 0.79 (p < 0.05), whereas total AT was not significant when adjusted for abdominal AT (p > 0.05). The effect ratio for change in WC and BMI combined (0.63, p<0.05) was greater than either alone. In conclusion, CRF did not mediate the exercise-induced change in insulin sensitivity in older adults. Abdominal adiposity was a strong mediator independent of change in total adiposity.
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91
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Moreno B, Crujeiras AB, Bellido D, Sajoux I, Casanueva FF. Obesity treatment by very low-calorie-ketogenic diet at two years: reduction in visceral fat and on the burden of disease. Endocrine 2016; 54:681-690. [PMID: 27623967 DOI: 10.1007/s12020-016-1050-2] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 07/04/2016] [Indexed: 02/06/2023]
Abstract
The long-term effect of therapeutic diets in obesity treatment is a challenge at present. The current study aimed to evaluate the long-term effect of a very low-calorie-ketogenic (VLCK) diet on excess adiposity. Especial focus was set on visceral fat mass, and the impact on the individual burden of disease. A group of obese patients (n = 45) were randomly allocated in two groups: either the very low-calorie-ketogenic diet group (n = 22), or a standard low-calorie diet group; (n = 23). Both groups received external support. Adiposity parameters and the cumulative number of months of successful weight loss (5 or 10 %) over a 24-month period were quantified. The very low-calorie-ketogenic diet induced less than 2 months of mild ketosis and significant effects on body weight at 6, 12, and 24 months. At 24 months, a trend to regress to baseline levels was observed; however, the very low-calorie-ketogenic diet induced a greater reduction in body weight (-12.5 kg), waist circumference (-11.6 cm), and body fat mass (-8.8 kg) than the low-calorie diet (-4.4 kg, -4.1 cm, and -3.8 kg, respectively; p < 0.001). Interestingly, a selective reduction in visceral fat measured by a specific software of dual-energy x-ray absorptiometry (DEXA)-scan (-600 g vs. -202 g; p < 0.001) was observed. Moreover, the very low-calorie-ketogenic diet group experienced a reduction in the individual burden of obesity because reduction in disease duration. Very low-calorie-ketogenic diet patients were 500 months with 5 % weight lost vs. the low-calorie diet group (350 months; p < 0.001). In conclusion, a very low-calorie-ketogenic diet was effective 24 months later, with a decrease in visceral adipose tissue and a reduction in the individual burden of disease.
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Affiliation(s)
- Basilio Moreno
- Division of Endocrinology and Nutrition, Hospital G Universitario Gregorio Marañon, Madrid, Spain
| | - Ana B Crujeiras
- Laboratory of Molecular and Cellular Endocrinology, Instituto de Investigación Sanitaria (IDIS), Complejo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela University (USC), Santiago de Compostela, Spain
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Santiago de Compostela, Spain
| | - Diego Bellido
- Division of Endocrinology, Complejo Hospitalario Universitario de Ferrol and Coruña University, Ferrol, Spain
| | - Ignacio Sajoux
- Medical Department Pronokal, Protein Supplies SL, Barcelona, Spain
| | - Felipe F Casanueva
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Santiago de Compostela, Spain.
- Division of Endocrinology, Department of Medicine, Complejo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela University, Santiago de Compostela, Spain.
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92
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A indicator of visceral adipose dysfunction to evaluate metabolic health in adult Chinese. Sci Rep 2016; 6:38214. [PMID: 27905531 PMCID: PMC5131270 DOI: 10.1038/srep38214] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 11/07/2016] [Indexed: 12/18/2022] Open
Abstract
Visceral adipose dysfunction is a major cause of metabolic disorders. However, there is lack of a clinical index for prediction of visceral fat dysfunction in Asians. The present study aims to establish a visceral adiposity index for evaluation of metabolic health status in Chinese, the largest Asian ethnic group. 485 subjects were recruited from Lianqian Community, Xiamen and received abdominal computed tomography(CT) for visceral fat area. A Chinese visceral adiposity index (CVAI) was created using multivariate linear regression analyses, and was further validated in 6495 subjects recruited from Changfeng Community, Shanghai. CVAI was well associated with visceral obesity (r = 0.68, P < 0.001) and HOMA-IR (r = 0.60, P < 0.001). The AUROCs were 0.89(0.88–0.90), 0.72(0.71–0.73), 0.69(0.68–0.71) and 0.67(0.65–0.68) for determination of metabolic syndrome, hypertension, diabetes and prediabetes, respectively. CVAI was more valuable compared to BMI and waist circumference in evaluation of metabolic risks (all P < 0.001), even in subjects with metabolically unhealthy normal weight (MUNW) and metabolically healthy obese/overweight (MHO). This study demonstrates that CVAI is a reliable and applicable index for evaluation of visceral fat dysfunction in Chinese. It might be used to evaluate metabolic health status in Asians.
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93
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Coffey JC, O'Leary DP. The mesentery: structure, function, and role in disease. Lancet Gastroenterol Hepatol 2016; 1:238-247. [PMID: 28404096 DOI: 10.1016/s2468-1253(16)30026-7] [Citation(s) in RCA: 172] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 07/05/2016] [Accepted: 07/06/2016] [Indexed: 12/22/2022]
Abstract
Systematic study of the mesentery is now possible because of clarification of its structure. Although this area of science is in an early phase, important advances have already been made and opportunities uncovered. For example, distinctive anatomical and functional features have been revealed that justify designation of the mesentery as an organ. Accordingly, the mesentery should be subjected to the same investigatory focus that is applied to other organs and systems. In this Review, we summarise the findings of scientific investigations of the mesentery so far and explore its role in human disease. We aim to provide a platform from which to direct future scientific investigation of the human mesentery in health and disease.
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Affiliation(s)
- J Calvin Coffey
- Graduate Entry Medical School, 4i Centre for Interventions in Infection, Inflammation and Immunity, University Hospital Limerick, University of Limerick, Limerick, Ireland.
| | - D Peter O'Leary
- Graduate Entry Medical School, 4i Centre for Interventions in Infection, Inflammation and Immunity, University Hospital Limerick, University of Limerick, Limerick, Ireland
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Ethnic and sex-specific cut-off values for adult obesity in the Suriname Health Study. Obes Res Clin Pract 2016; 12:336-345. [PMID: 27720693 DOI: 10.1016/j.orcp.2016.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 08/25/2016] [Accepted: 09/26/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Sex-specific body mass index (BMI) and waist circumference (WC) cut-off values have been validated for a limited number of ethnic groups. We aimed to derive these cut-off values for Amerindians, Creoles, Hindustani, Javanese, Maroons and Mixed living in Suriname. METHODS Data from individuals aged 20-65, in the Suriname Health Study was used to derive optimal cut-off values for BMI and WC for the prediction of hypertension (n=4910) and cardio-metabolic risk (n=2924). Results from the analysis with Receiver Operating Curves were calculated and compared these with recommended values. RESULTS The area under the ROC curve was consistently higher for WC compared to BMI among Creoles, Hindustani, Maroons and Mixed. The BMI cut-off values ranged from 24.8kg/m2 for Creole men and 26.9kg/m2 for Maroon women to 28.4kg/m2 and 30.2kg/m2 for Amerindian men and women, respectively. The WC cut-off values ranged from 80.7cm for Maroon men, 86.7cm for Javanese women to 90.8cm for Hindustani men and 95.7cm for Amerindian women. Optimal BMI cut-off values approximated Asian cut-off values from the World Health Organization whilst those of WC for men approximated and for women exceeded cut-off values from the International Diabetes Federation. CONCLUSION In most ethnic groups, we found better discriminatory power for WC compared to BMI in the relation with cardiovascular risk factors. The estimated BMI and WC cut-off values differed between ethnic groups. Further studies are needed to identify cut-off values related to the future risk of cardiovascular disease and mortality.
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95
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Antonopoulos AS, Oikonomou EK, Antoniades C, Tousoulis D. From the BMI paradox to the obesity paradox: the obesity-mortality association in coronary heart disease. Obes Rev 2016; 17:989-1000. [PMID: 27405510 DOI: 10.1111/obr.12440] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 05/15/2016] [Accepted: 05/23/2016] [Indexed: 12/13/2022]
Abstract
Despite a strong association between body weight and mortality in the general population, clinical evidence suggests better clinical outcome of overweight or obese individuals with established coronary heart disease. This finding has been termed the 'obesity paradox', but its existence remains a point of debate, because it is mostly observed when body mass index (BMI) is used to define obesity. Inherent limitations of BMI as an index of adiposity, as well as methodological biases and the presence of confounding factors, may account for the observed findings of clinical studies. In this review, our aim is to present the data that support the presence of a BMI paradox in coronary heart disease and then explore whether next to a BMI paradox a true obesity paradox exists as well. We conclude by attempting to link the obesity paradox notion to available translational research data supporting a 'healthy', protective adipose tissue phenotype. © 2016 World Obesity.
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Affiliation(s)
- A S Antonopoulos
- 1st Cardiology Department, Hippokration Hospital, Athens Medical School, Athens, Greece. .,Division of Cardiovascular Medicine, University of Oxford, Oxford, UK.
| | - E K Oikonomou
- 1st Cardiology Department, Hippokration Hospital, Athens Medical School, Athens, Greece.,Division of Cardiovascular Medicine, University of Oxford, Oxford, UK
| | - C Antoniades
- Division of Cardiovascular Medicine, University of Oxford, Oxford, UK
| | - D Tousoulis
- 1st Cardiology Department, Hippokration Hospital, Athens Medical School, Athens, Greece
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Miles MP, Horrigan LC, Jay SE, Brown KM, Porter JW, Steward AN. Concentric and eccentric exercise, glycemic responses to a postexercise meal, and inflammation in women with high versus low waist circumference. Appl Physiol Nutr Metab 2016; 41:1262-1270. [PMID: 27841026 DOI: 10.1139/apnm-2016-0281] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Carbohydrate ingestion and level of concentric versus eccentric muscle activity may alter exercise-induced health benefits for individuals who have high waist circumference as a metabolic risk factor. The purpose of this study was to determine whether metabolic and inflammation responses to an exercise recovery meal differ between women with lower (Lo-WC, <80 cm) compared with higher (Hi-WC) waist circumference when the exercise is primarily concentric (uphill walking; UPHILL) versus primarily eccentric (downhill walking; DOWNHILL). Recreationally active women (age, 18-39 years; body mass index, 19-35.4 m·kg-2; Lo-WC, n = 13; Hi-WC, n = 10) completed UPHILL, DOWNHILL, and resting (CONTROL) conditions followed 30 min later by a mixed meal tolerance test (MMTT) with carbohydrates to protein ratio of 4:1, and blood glucose, insulin, and inflammation markers were compared across conditions. Compared with Lo-WC, the Hi-WC group had higher (p < 0.05) (i) insulin during the MMTT in CONTROL (mean ± SE; 48.5 ± 8.2 vs 22.9 ± 2.8 pmol·L-1), (ii) baseline (0.7 ± 0.4 vs 2.0 ± 1.7 pg·mL-1) interleukin-6 (IL-6), and (iii) IL-6 responses 8 h after UPHILL and CONTROL. Both groups had (i) increases in IL-6 at 0 h after UPHILL and at 8 h after DOWNHILL, and (ii) lower glycemic responses in UPHILL. Women with Hi-WC had higher IL-6 at rest and delayed increases in IL-6 after a high-carbohydrate meal in all conditions. This is consistent with an inflammation response to the meal and or uphill walking exercise. However, both concentrically and eccentrically biased exercises offered benefits to insulin responses to a high carbohydrate meal for Hi-WC.
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Affiliation(s)
- Mary P Miles
- Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA.,Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA
| | - Laura C Horrigan
- Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA.,Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA
| | - Sara E Jay
- Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA.,Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA
| | - Karen M Brown
- Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA.,Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA
| | - Jay W Porter
- Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA.,Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA
| | - Andrea N Steward
- Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA.,Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA
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97
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Alkaabi J, Gariballa S, Sharma C, Yasin J, Essa AA, Ali H, Souid AK. Inflammatory markers and cardiovascular risks among overweight-obese Emirati women. BMC Res Notes 2016; 9:355. [PMID: 27440160 PMCID: PMC4955260 DOI: 10.1186/s13104-016-2160-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 07/13/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The prevalence of abdominal obesity among women in UAE is exceptionally high. However, its impact on cardiovascular health has not been adequately investigated. The aims of this study were to investigate: (1) correlations between inflammatory and oxidative biomarkers vs. anthropometric and metabolic measures; (2) rates of dyslipidemia, diabetes, and hypertension and (3) risks of cardiovascular disease. METHODS One hundred ten "healthy" overweight/obese Emirati women attending nutrition counselling clinics were randomly recruited. All participants had completed questionnaire, physical examination and laboratory assessment. RESULTS The participants' mean ± SD of age, body mass-index, waist circumference were 39 ± 9 years, 34 ± 6 kg/m(2) and 100 ± 13 cm respectively. Among the studied women 45 % met diagnostic criteria for metabolic syndrome showing a positive correlation of hsCRP with BMI (p = 0.002), body fat (p = 0.002) and waist circumference (p = 0.018). There was positive correlation of IL-6 with waist circumference (p = 0.019) and adiponectin with HDL (p = 0.007). Prevalence of HDL <1.3 mmol/L or triglycerides ≥1.7 mmol/L were 82 %, dysglycemia 31 %, and hypertension 27 and 37 % of women had either 'high' or 'moderate' calculated cardiovascular 10-year risk score. CONCLUSION The levels of inflammatory and oxidative stress markers were highly prevalent among overweight/obese Emirati women and this may predispose to increasing cardiovascular risks at relatively young age. Thus effective strategies to impact cardiovascular burden and conducting outcome studies assessing the increased risk of cardiovascular disease and addressing obesity prevention among women are urgently needed.
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Affiliation(s)
- Juma Alkaabi
- />Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, P.O. Box 17666, Al-Ain, United Arab Emirates
| | - Salah Gariballa
- />Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, P.O. Box 17666, Al-Ain, United Arab Emirates
| | - Charu Sharma
- />Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, P.O. Box 17666, Al-Ain, United Arab Emirates
| | - Javed Yasin
- />Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, P.O. Box 17666, Al-Ain, United Arab Emirates
| | - Awad Al Essa
- />Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, P.O. Box 17666, Al-Ain, United Arab Emirates
| | - Habiba Ali
- />Department of Nutrition and Health, UAE University, Al-Ain, United Arab Emirates
| | - Abdul-Kader Souid
- />Department of Pediatrics, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
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98
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Yun KE, Nam GE, Lim J, Park HS, Chang Y, Jung HS, Kim CW, Ko BJ, Chung EC, Shin H, Ryu S. Waist Gain Is Associated with a Higher Incidence of Nonalcoholic Fatty Liver Disease in Korean Adults: A Cohort Study. PLoS One 2016; 11:e0158710. [PMID: 27420035 PMCID: PMC4946777 DOI: 10.1371/journal.pone.0158710] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 06/21/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND We examined the relationship between changes in waist circumference (WC) and the incidence of nonalcoholic fatty liver disease (NAFLD). METHODS A cohort study of 37,130 men and women were followed-up annually or biennially. Differences in WC between baseline and subsequent measurements were categorized in quartiles: first (WC loss), second (no change in WC as the reference), third and highest quartiles (WC gain). The presence of fatty liver was determined using ultrasound. Parametric Cox modeling was used to estimate the adjusted hazard ratios (aHR) and 95% confidence intervals (CIs) of the incidence of NAFLD. RESULTS During 127,324.4 person-years of follow-up, 6249 participants developed NAFLD. Despite adjusting for possible confounders, the risk of development of NAFLD increased with increasing quartiles of WC change in a dose-response manner (p for trend < 0.001). Compared with the reference, WC loss was associated with a lower risk of NAFLD (men: aHR 0.79 [95% CI: 0.73-0.87]; women: 0.72 [0.63-0.81]), and the highest quartile (WC gain) was associated with a higher risk of NAFLD (men: 1.30 [1.19-1.42]; women: 1.48 [1.31-1.67]). CONCLUSION Waist gain appears to increase the risk of developing NAFLD, independently of the baseline body mass index and WC.
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Affiliation(s)
- Kyung Eun Yun
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Ga Eun Nam
- Department of Family Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan-si, South Korea
| | - Jisun Lim
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hye Soon Park
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Yoosoo Chang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Hyun-Suk Jung
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Chan-Won Kim
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Byung-Joon Ko
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Eun Chul Chung
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, South Korea
| | - Hocheol Shin
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seungho Ryu
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
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99
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Akinyemiju T, Meng Q, Vin-Raviv N. Association between body mass index and in-hospital outcomes: Analysis of the nationwide inpatient database. Medicine (Baltimore) 2016; 95:e4189. [PMID: 27428218 PMCID: PMC4956812 DOI: 10.1097/md.0000000000004189] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
IMPORTANCE Over one-third of American adults (36%) are obese and more than two-thirds (69%) are overweight. The impact of obesity on hospitalization outcomes is not well understood. OBJECTIVE To examine the association between body mass index (BMI) and overall, cancer, chronic obstructive pulmonary disease (COPD), asthma, and cardiovascular disease (CVD)-specific in-hospital mortality; postsurgical complications; and hospital length of stay (LOS). DESIGN Cross-sectional study. SETTING Representative sample of US hospitals included in the Health Cost and Utilization Project Nationwide Inpatient Sample database. PARTICIPANTS We obtained data for patients admitted with a primary diagnosis of cancer, COPD, asthma, and CVD. MAIN OUTCOME In-hospital mortality, postsurgical complications, and hospital LOS. RESULTS A total of 800,417 patients were included in this analysis. A higher proportion of Blacks (26.8%; 12.5%) and Whites (23.3%; 8.7%) had BMI of 40 to 49.9 and ≥50, respectively, compared with Hispanics (20.4%; 7.3%). Compared with normal BMI patients, the odds of in-hospital mortality increased 3.6-fold (odds ratio [OR] 3.62, 95% confidence interval [CI]: 3.37-3.89) for preobese patients, 6.5-fold (OR: 6.52, 95% CI: 5.79-7.34) for patients with BMI: 30 to 31.9, 7.5-fold (OR: 7.57, 95% CI: 6.67-8.59) for patients with BMI: 34 to 35.9, and 1.6- fold (OR: 1.77, 95% CI: 1.56-1.79) for patients with BMI ≥ 50. Compared with normal BMI patients, preobese and overweight patients had shorter hospital stays (β preobese: -1.58, 95% CI: -1.63, -1.52); however, no clear trends were observed for postsurgical complications. CONCLUSIONS The majority of hospitalized patients in this analysis had a BMI > 30, and higher BMI was associated with increased risk of mortality and longer hospital stay.
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Affiliation(s)
- Tomi Akinyemiju
- Department of Epidemiology, University of Alabama at Birmingham
- Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama
- Correspondence: Tomi Akinyemiju, Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama (e-mail: )
| | - Qingrui Meng
- Department of Epidemiology, University of Alabama at Birmingham
| | - Neomi Vin-Raviv
- University of Northern Colorado Cancer Rehabilitation Institute, Greeley, Colorado
- School of Social Work, College of Health and Human Sciences, Colorado State University, Fort Collins, Colorado, USA
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100
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Ferolla SM, Couto CA, Costa-Silva L, Armiliato GNA, Pereira CAS, Martins FS, Ferrari MDLA, Vilela EG, Torres HOG, Cunha AS, Ferrari TCA. Beneficial Effect of Synbiotic Supplementation on Hepatic Steatosis and Anthropometric Parameters, But Not on Gut Permeability in a Population with Nonalcoholic Steatohepatitis. Nutrients 2016; 8:nu8070397. [PMID: 27367724 PMCID: PMC4963873 DOI: 10.3390/nu8070397] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 06/10/2016] [Accepted: 06/20/2016] [Indexed: 02/06/2023] Open
Abstract
Nonalcoholic fatty liver disease is the most prevalent chronic liver disease in Western countries; it can progress to nonalcoholic steatohepatitis (NASH), cirrhosis and hepatocarcinoma. The importance of gut-liver-adipose tissue axis has become evident and treatments targeting gut microbiota may improve inflammatory and metabolic parameters in NASH patients. In a randomized, controlled clinical trial, involving 50 biopsy-proven NASH patients, we investigated the effects of synbiotic supplementation on metabolic parameters, hepatic steatosis, intestinal permeability, small intestinal bacterial overgrowth (SIBO) and lipopolysaccharide (LPS) serum levels. Patients were separated into two groups receiving Lactobacillus reuteri with guar gum and inulin for three months and healthy balanced nutritional counseling versus nutritional counseling alone. Before and after the intervention we assessed steatosis by magnetic resonance imaging, intestinal permeability by lactulose/mannitol urinary excretion and SIBO by glucose breath testing. NASH patients presented high gut permeability, but low prevalence of SIBO. After the intervention, only the synbiotic group presented a reduction in steatosis, lost weight, diminished BMI and waist circumference measurement. Synbiotic did not improve intestinal permeability or LPS levels. We concluded that synbiotic supplementation associated with nutritional counseling seems superior to nutritional counseling alone for NASH treatment as it attenuates steatosis and may help to achieve weight loss.
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Affiliation(s)
- Silvia M Ferolla
- Departamento de ClínicaMédica, Faculdade de Medicina, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil.
| | - Cláudia A Couto
- Departamento de ClínicaMédica, Faculdade de Medicina, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil.
| | - Luciana Costa-Silva
- Departamento de Anatomia e Imagem, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil.
| | - Geyza N A Armiliato
- Departamento de ClínicaMédica, Faculdade de Medicina, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil.
| | - Cristiano A S Pereira
- Departamento de ClínicaMédica, Faculdade de Medicina, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil.
| | - Flaviano S Martins
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte31270-901, Brazil.
| | - Maria de Lourdes A Ferrari
- Departamento de ClínicaMédica, Faculdade de Medicina, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil.
| | - Eduardo G Vilela
- Departamento de ClínicaMédica, Faculdade de Medicina, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil.
| | - Henrique O G Torres
- Departamento de ClínicaMédica, Faculdade de Medicina, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil.
| | - Aloísio S Cunha
- Departamento de ClínicaMédica, Faculdade de Medicina, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil.
| | - Teresa C A Ferrari
- Departamento de ClínicaMédica, Faculdade de Medicina, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil.
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