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Müller MJ, Bosy-Westphal A. Metabolic profiling of liver fat-Limited insights by big data research so far. Obesity (Silver Spring) 2023; 31:898-899. [PMID: 36878668 DOI: 10.1002/oby.23713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 03/08/2023]
Affiliation(s)
- Manfred J Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Anja Bosy-Westphal
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
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Berg EA, Huang Z, Wang Y, Baidal JW, Fennoy I, Lavine JE, Zitsman J, Shen W. Magnetic Resonance Imaging to Assess Body Composition Change in Adolescents With Obesity After Sleeve Gastrectomy. J Pediatr Gastroenterol Nutr 2022; 75:761-767. [PMID: 36070531 PMCID: PMC9675718 DOI: 10.1097/mpg.0000000000003607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Metabolic and bariatric surgery is the most effective weight loss treatment for severe obesity. The number of adolescents undergoing sleeve gastrectomy is increasing. We investigated changes in body composition in adolescents undergoing sleeve gastrectomy 12-26 weeks post-operatively using whole-body magnetic resonance imaging (WB-MRI). METHODS This prospective cohort study assessed changes in adipose tissue compartments (ie, visceral, subcutaneous, and intermuscular) and muscle in 18 obese adolescents, ages 14-19, 89% female, with body mass index z -score of 2.6 ± 0.25 (range 2.16-3.2). All underwent WB-MRI 1.5-17 weeks pre-operatively and 12-26 weeks post-operatively. RESULTS Pre- and post-operative WB-MRI showed decreases in all adipose tissue compartments, as well as decreased skeletal muscle and liver fat fraction ( P < 0.0001). The post-operative percentage loss of adipose tissue in subcutaneous, visceral, and intermuscular compartments (89.0%, 5.8%, 5.2%, respectively) was similar to the pre-operative percentages of corresponding adipose tissue compartments (90.5%, 5.0%, 4.5%, respectively). Of note, participants with obstructive sleep apnea had significantly higher pre-operative volume of subcutaneous and intermuscular adipose tissue than participants without obstructive sleep apnea ( P = 0.003). CONCLUSIONS We found, contrary to what is reported to occur in adults, that pre-operative percentage loss of adipose tissue in subcutaneous, visceral, and intermuscular compartments was similar to the post-operative percentage loss of corresponding adipose tissue compartments in adolescents 12-26 weeks after sleeve gastrectomy.
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Affiliation(s)
- Elizabeth A. Berg
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center
| | - Zixing Huang
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center
| | - Youya Wang
- Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center
| | - Jennifer Woo Baidal
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center
| | - Ilene Fennoy
- Division of Pediatric Endocrinology, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center
| | - Joel E. Lavine
- Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center
| | - Jeffrey Zitsman
- Division of Pediatric Surgery, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center
| | - Wei Shen
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center
- Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center
- Columbia Magnetic Resonance Research Center (CMRRC), Columbia University
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Xie Y, Li S, Chen R, He R, Qian L, Zou J, Luo Y, Zhang Y, Ji M, Liu Y. Differences in Insulin Sensitivity, Secretion, and the Metabolic Clearance Rate of Glucose in Newly Diagnosed Type 2 Diabetes Mellitus Patients: The Influences of Body Mass Index and Fatty Liver. Metab Syndr Relat Disord 2022; 20:451-458. [PMID: 36260098 DOI: 10.1089/met.2021.0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
Background: Obesity and nonalcoholic fatty liver disease are strongly associated with type 2 diabetes mellitus (T2DM), affecting insulin sensitivity and β-cell function. They interact, exacerbating the development of hyperinsulinemia to T2DM. Methods: Through oral glucose tolerance and insulin secretion tests, the relationships between insulin sensitivity and secretion, glucose clearance, body mass index (BMI), and fatty liver were studied in newly diagnosed T2DM patients. The homeostasis model assessment of insulin resistance (HOMA-IR), homeostasis model assessment of β-cell function (HOMA-β), insulin sensitivity index (ISI), and metabolic clearance rate (MCR) of glucose were calculated to analyze insulin sensitivity and β-cell function. Results: There were no differences in HOMA-IR, HOMA-β, first-phase insulin secretion (1st PH), second-phase insulin secretion (2nd PH), ISI, or MCR between lean fatty liver and lean nonfatty liver patients. Both overweight/obesity (ow/ob) and patients with fatty liver increased HOMA-IR, and decreased ISI and MCR. In the ow/ob subgroup, patients with fatty liver had severe insulin resistance but greater HOMA-β, 1st PH, and 2nd PH than individuals with nonfatty liver. The difference in MCR between fatty liver and nonfatty liver groups was not significant. Conclusion: BMI and hepatic steatosis are independent determinants of increased insulin resistance and decreased MCR. However, it is steatosis, not BMI, related to the increase in insulin secretion.
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Affiliation(s)
- Yuan Xie
- Department of Endocrinology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, P.R. China
| | - Shaoqing Li
- Department of Endocrinology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, P.R. China
| | - Rourou Chen
- Department of Endocrinology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, P.R. China
| | - Rongbo He
- Department of Endocrinology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, P.R. China
| | - Li Qian
- Department of Endocrinology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, P.R. China
| | - Jing Zou
- Department of Endocrinology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, P.R. China
| | - Yan Luo
- Department of Endocrinology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, P.R. China
| | - Ying Zhang
- Department of Endocrinology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, P.R. China
| | - Minjun Ji
- Department of Pathogen Biology, Jiangsu Province Key Laboratory of Modern Pathogen Biology, Center for global health, Nanjing Medical University, Nanjing, P.R. China
| | - Yu Liu
- Department of Endocrinology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, P.R. China
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Bredella MA, Karzar NH, Singhal V, Bose A, Animashaun A, Mitchell DM, Yu EW, Misra M. Impact of sleeve gastrectomy on bone outcomes in adolescents vs. adults with obesity. Bone 2021; 149:115975. [PMID: 33901724 PMCID: PMC8217278 DOI: 10.1016/j.bone.2021.115975] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/03/2021] [Accepted: 04/19/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Sleeve gastrectomy (SG) is the most common metabolic and bariatric surgery (MBS) procedure in adolescents and adults. Only few studies have assessed bone outcomes following SG and it is unknown whether skeletal changes differ by age group. Recent studies have identified marrow adipose tissue (MAT) as a novel biomarker for bone quality with studies in adults showing high MAT in those with visceral adiposity and a reciprocal increase in MAT with bone loss. OBJECTIVE To determine the impact of SG on volumetric BMD (vBMD) and MAT in adolescents and adults with obesity. We hypothesized that SG would lead to a decrease in vBMD and increase in MAT but that these changes would be less pronounced in adolescents compared to adults. MATERIALS AND METHODS The study was IRB-approved and HIPAA-compliant. Written informed consent/assent was obtained. We examined 10 adolescents (mean age 17.8 ± 2.5 years, mean BMI 43.5 ± 5.6 kg/m2) and 10 sex, race, and BMI-matched adults (mean age 49.5 ± 13.6 years, mean BMI 43.7 ± 5.9 kg/m2), before and 12 months after SG. At baseline and 12 months, subjects underwent quantitative CT of the lumbar spine (L1-L2) to assess trabecular vBMD, single voxel proton MR spectroscopy at 3 T (PRESS pulse sequence without water suppression) at L1-L2 to quantify MAT, and MRI of the abdomen to assess visceral (VAT) and subcutaneous adipose tissue (SAT). RESULTS At baseline, adolescents had lower MAT (p = 0.0002) and higher vBMD (p = 0.050) compared to adults. Adolescents and adults lost 27.9 ± 6.5 vs. 25.0 ± 11.2% of body weight (p < 0.0001 for within group change), while there was no significant difference between groups (p = 0.455). There was a significant reduction in vBMD in adults (-3.9 ± 3.9%, p = 0.005) and a trend for a reduction in adolescents (-3.7 ± 7.5%, p = 0.119), with no significant difference between groups (p = 0.944). Lumbar MAT content increased in both adults and adolescents (p ≤ 0.034), while the difference was not significant between groups (p = 0.281). In adolescents and adults, 12-month percent change in weight and BMI was positively associated with % change in MAT (p ≤ 0.042). 12-month percent change in MAT was positively associated with 12-month % change in SAT in adolescents and 12-month percent change in VAT in adults (p ≤ 0.045). CONCLUSION SG in adolescents and adults with severe obesity is associated with a reduction in lumbar vBMD and an increase in lumbar MAT, although the reduction in adolescents did not reach statistical significance, with no significant differences in these endpoints between groups. Our results suggest detrimental effects of bariatric surgery on bone for patients across the life span.
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Affiliation(s)
- Miriam A Bredella
- Department of Radiology, Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America.
| | - Nazanin Hazhir Karzar
- Neuroendocrine Unit, Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Vibha Singhal
- Neuroendocrine Unit, Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America; Pediatric Endocrine Unit, Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America; MGH Weight Center, Boston, MA, United States of America
| | - Amita Bose
- Neuroendocrine Unit, Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Abisayo Animashaun
- Neuroendocrine Unit, Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Deborah M Mitchell
- Pediatric Endocrine Unit, Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America; Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Elaine W Yu
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Madhusmita Misra
- Neuroendocrine Unit, Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America; Pediatric Endocrine Unit, Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
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Selma-Gracia R, Haros CM, Laparra Llopis JM. Inclusion of Salvia hispanica L. and Chenopodium quinoa into bread formulations improves metabolic imbalances derived from a high-fat intake in hyperglycaemic mice. Food Funct 2021; 11:7994-8002. [PMID: 32841309 DOI: 10.1039/d0fo01453b] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
High-energy intake causes imbalances in nutrient homeostasis contributing to a high prevalence of metabolic chronic diseases. The extent to what metabolic imbalances can be ameliorated by the inclusion of immunonutritional ingredients obtained from flours favouring nutrient and calorie management remains poorly understood. Herein, it is demonstrated that partial replacement of wheat flour (WB) with that from Chenopodium quinoa varieties [red (RQ, 25% w/w) and white (WQ, 25% w/w)] as well as from Salvia hispanica L., [whole (Ch, 20% w/w) and semi-defatted (Ch_D, 20% w/w)] in bread formulations ameliorates the metabolic and inflammation consequences of high-fat diet consumption in hyperglycaemic animals. Feeding animals with bread formulations replacing wheat flour effectively reduced insulin resistance (by 2-fold, HOMAir). The reduction in starch content did not appear as a determinant of controlling HOMAir. Only animals fed with RQ and Ch diet displayed increased plasma levels of triglycerides, which significantly contributed to mitigate HFD-induced hepatic lipid peroxidation. The latter was increased in animals receiving Ch_D diet, where PUFAs were eliminated from chia's flour. Feeding with WQ and Ch samples caused an upward trend in hepatic TNF-α and IL-6 levels. Despite similarities between immunonutritional agonists in animals fed with RQ and WQ, IL-17 levels were quantified higher for animals fed with WQ. All bread formulations except Ch_D samples significantly increased the hepatic granulocyte-monocyte colony stimulation factor levels. These results indicated that replacement of wheat flour with that from quinoa and chia improved the metabolic imbalances in hyperglycaemic animals.
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Affiliation(s)
- Raquel Selma-Gracia
- Molecular Immunonutrition Group, Madrid Institute for Advanced Studies in Food (IMDEA-Food), Ctra. de Canto Blanco n° 8, 28049 Madrid, Spain. and Instituto de Agroquímica y Tecnología de Alimentos (IATA), Consejo Superior de Investigaciones Científicas (CSIC), Av. Agustín Escardino 7, Parque Científico, 46980 Paterna, Valencia, Spain.
| | - Claudia Monika Haros
- Instituto de Agroquímica y Tecnología de Alimentos (IATA), Consejo Superior de Investigaciones Científicas (CSIC), Av. Agustín Escardino 7, Parque Científico, 46980 Paterna, Valencia, Spain.
| | - José Moisés Laparra Llopis
- Molecular Immunonutrition Group, Madrid Institute for Advanced Studies in Food (IMDEA-Food), Ctra. de Canto Blanco n° 8, 28049 Madrid, Spain.
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Ziser K, Decker S, Stuber F, Herschbach A, Giel KE, Zipfel S, Ehehalt S, Junne F. Barriers to Behavior Change in Parents With Overweight or Obese Children: A Qualitative Interview Study. Front Psychol 2021; 12:631678. [PMID: 33841261 PMCID: PMC8034266 DOI: 10.3389/fpsyg.2021.631678] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 02/24/2021] [Indexed: 12/20/2022] Open
Abstract
Overweight and obesity among children and adolescents are global problems of our time. Due to their authority and role modeling, parents play an essential part in the efficacy of prevention and intervention programs. This study assessed the barriers that parents of overweight/obese children face in preventive and interventional health care utilization. Sixteen parents were qualitatively interviewed. A content analysis was performed, and barriers to change were allocated to their stage of change according to the transtheoretical model. Among the main barriers is the underestimation of health risks caused by overweight/obesity in association with diminished problem awareness. Parents seem not necessarily in need of theoretical knowledge for prevention and interventions. They do however need support in evaluating the weight status of their child and the knowledge of whom to turn to for help as well as specific and hands-on possibilities for change. The results extend past studies by adding specific barriers to change that parents commonly experience. Possibilities to address these barriers, e.g., through trainings at the pediatric practice or adoption of conversation techniques, are discussed. Future studies might identify subgroups experiencing specific barriers and thus be able to address these in an individualized way.
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Affiliation(s)
- Katrin Ziser
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Stefanie Decker
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Felicitas Stuber
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Anne Herschbach
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Stefan Ehehalt
- Public Health Department of Stuttgart, Stuttgart, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, Otto von Guericke University Magdeburg, Magdeburg, Germany
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Schneiders LDB, Brand C, Borfe L, Gaya AR, Brazo-Sayavera J, Renner JDP, Reuter CP. A Multicomponent Intervention Program With Overweight and Obese Adolescents Improves Body Composition and Cardiorespiratory Fitness, but Not Insulin Biomarkers. Front Sports Act Living 2021; 3:621055. [PMID: 33693430 PMCID: PMC7937702 DOI: 10.3389/fspor.2021.621055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 01/07/2021] [Indexed: 12/19/2022] Open
Abstract
Objective: To verify the effect of a multicomponent intervention with overweight/obese adolescents on physical fitness, body composition, and insulin biomarkers. Methods: A quasi-experimental study with 37 adolescents, aged 10 to 17 years, of both sexes, overweight and obese, allocated in two groups (Intervention—IG Group, n = 17; Control—GC Group, n = 20). The IGs were submitted to a multicomponent intervention for 6 months (three weekly sessions) consisting of physical exercises (sports, functional circuit, recreational, and water activities) and nutritional and psychological guidance. Participants were assessed before and after intervention on body composition [body mass index (BMI), body fat, waist circumference, and waist-to-hip ratio (WHR)], physical fitness [cardiorespiratory fitness (CRF) and abdominal strength], and biomarkers of insulin (glucose, insulin, evaluation of the homeostasis model of insulin, and resistin resistance). The prevalence of responders in both groups was obtained according to the theoretical model applied in previous studies similar to this one to determine the cutoff points for response to intervention. Poisson regression was used to verify the difference in the prevalence ratio (PR) of the interviewees between the groups. Results: The responders' prevalence between groups CG and IG showed significant differences for body fat (CG = 30.0%; IG = 70.6%; PR = 1.396; p < 0.001), WHR (CG = 30.0%; IG = 76.5%; PR = 1.730; p < 0.001), and CRF (CG = 15.0%; IG = 52.5%; PR = 1.580; p < 0.001). Conclusions: A 6-month multicomponent intervention program improved certain body composition parameters and the CRF of overweight and obese adolescents but did not improve insulin biomarkers. Clinical Trial Registration: Clinical Trials under Protocol ID: 54985316.0.0000.5343.
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Affiliation(s)
- Letícia de Borba Schneiders
- Postgraduate Program Master and Doctorate in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, Brazil
| | - Caroline Brand
- Postgraduate Program Master and Doctorate in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, Brazil
| | - Leticia Borfe
- Postgraduate Program Master and Doctorate in Human Movement Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Anelise Reis Gaya
- Postgraduate Program Master and Doctorate in Human Movement Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Javier Brazo-Sayavera
- Department of Sports and Computer Sciences, Universidad Pablo de Olavide, Seville, Spain
| | - Jane Dagmar Pollo Renner
- Postgraduate Program Master and Doctorate in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, Brazil
| | - Cézane Priscila Reuter
- Postgraduate Program Master and Doctorate in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, Brazil
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Chiyanika C, Chan DFY, Hui SCN, So H, Deng M, Yeung DKW, Nelson EAS, Chu WCW. The relationship between pancreas steatosis and the risk of metabolic syndrome and insulin resistance in Chinese adolescents with concurrent obesity and non-alcoholic fatty liver disease. Pediatr Obes 2020; 15:e12653. [PMID: 32351030 PMCID: PMC7507143 DOI: 10.1111/ijpo.12653] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 03/17/2020] [Accepted: 04/17/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The incidence of childhood obesity and associated comorbidities are on an increasing trend worldwide. More than 340 million children and adolescents aged between 5 and 19 years old were overweight or had obesity in 2016, from which over 124 million children and adolescents (6% of girls and 8% of boys) had obesity. OBJECTIVE To describe the relationship between pancreas steatosis, body fat and the risk of metabolic syndrome, insulin resistance in Hong Kong Chinese adolescents with both obesity and non-alcoholic fatty liver disease (NAFLD). METHODS Fifty two adolescents with obesity and NAFLD were analysed (14-18 years), stratified into fatty and non-fatty pancreas groups using chemical shift encoded MRI-pancreas proton density fat fraction ≥5%. Pancreatic, abdominal subcutaneous adipose tissue (SAT)/visceral adipose tissue (VAT) volumes, biochemical and anthropometric parameters were measured. Mann-Whitney U test, multiple linear/binary logistic regression analyses and odds ratios were used. RESULTS Fifty percent had fatty pancreas, 38% had metabolic syndrome and 81% had insulin resistance. Liver proton density fat fraction (PDFF) and VAT were independent predictors of insulin resistance (P = .006, .016). Pancreas and liver PDFF were both independent predictors of beta cells dysfunction (P = .015, .050) and metabolic syndrome (P = .021, .041). Presence of fatty pancreas in obesity was associated with insulin resistance (OR = 1.58, 95% CI = 0.39-6.4) and metabolic syndrome (OR = 1.70, 95% CI = 0.53-5.5). CONCLUSION A significant causal relationship exists between fatty pancreas, fatty liver, body fat and the risk of developing metabolic syndrome and insulin resistance. KEY POINTS Fatty pancreas is a common finding in adolescents with obesity, with a prevalence rate of 50% in this study cohort. Liver PDFF and VAT are independent predictors of insulin resistance while pancreas PDFF and liver PDFF are independent predictors of both beta cells dysfunction and metabolic syndrome. Presence of fatty pancreas at imaging should not be considered as a benign finding but rather as an imaging biomarker of emerging pancreatic metabolic and endocrine dysfunction.
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Affiliation(s)
- Chileka Chiyanika
- Department of Imaging and Interventional RadiologyThe Chinese University of Hong KongHong KongChina
| | - Dorothy F. Y. Chan
- Department of PaediatricsThe Chinese University of Hong KongHong KongChina
| | - Steve C. N. Hui
- Department of Imaging and Interventional RadiologyThe Chinese University of Hong KongHong KongChina,Russell H. Morgan Department of Radiology and Radiological ScienceThe Johns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Hung‐kwan So
- Department of Paediatrics and Adolescent MedicineThe University of Hong KongHong KongChina
| | - Min Deng
- Department of Imaging and Interventional RadiologyThe Chinese University of Hong KongHong KongChina
| | - David K. W. Yeung
- Department of Imaging and Interventional RadiologyThe Chinese University of Hong KongHong KongChina,Department of Clinical OncologyThe Chinese University of Hong KongHong KongChina
| | | | - Winnie C. W. Chu
- Department of Imaging and Interventional RadiologyThe Chinese University of Hong KongHong KongChina
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Abstract
PURPOSE OF REVIEW It is well known that obesity represents the main modifiable risk factor for insulin resistance in children and adolescents; obesity-induced insulin resistance in children is the most important risk factor for developing cardiovascular diseases and type 2 diabetes in adulthood. The mechanisms through which obesity causes insulin resistance are complex and not completely known to date. RECENT FINDINGS In children, global adiposity is the main factor determining insulin resistance. Excessive fatty acids play a determinant role in the pathogenesis of insulin resistance in obese children, inducing an increased production of acetyl-CoA in the liver and enhancing inflammation in adipose tissue. The aetiology of insulin resistance in polycystic ovary syndrome is multifactorial and still debated. SUMMARY The aim of this review is to present an updated frame and new insights of the numerous pathways involved in the development of insulin resistance in obese patients, focusing on the peculiarities of children and adolescents. Improving the knowledge of mechanisms through which obesity leads to insulin resistance is fundamental in order to recommend particular follow-up and possible treatment to specific categories of obese children and adolescents.
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Machann J, Stefan N, Wagner R, Fritsche A, Bell JD, Whitcher B, Häring HU, Birkenfeld AL, Nikolaou K, Schick F, Thomas EL. Normalized Indices Derived from Visceral Adipose Mass Assessed by Magnetic Resonance Imaging and Their Correlation with Markers for Insulin Resistance and Prediabetes. Nutrients 2020; 12:nu12072064. [PMID: 32664590 PMCID: PMC7400828 DOI: 10.3390/nu12072064] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 12/30/2022] Open
Abstract
Visceral adipose tissue (VAT) plays an important role in the pathogenesis of insulin resistance (IR), prediabetes and type 2 diabetes. However, VAT volume alone might not be the best marker for insulin resistance and prediabetes or diabetes, as a given VAT volume may impact differently on these metabolic traits based on body height, gender, age and ethnicity. In a cohort of 1295 subjects from the Tübingen Diabetes Family Study (TDFS) and in 9978 subjects from the UK Biobank (UKBB) undergoing magnetic resonance imaging for quantification of VAT volume, total adipose tissue (TAT) in the TDFS, total abdominal adipose tissue (TAAT) in the UKBB, and total lean tissue (TLT), VAT volume and several VAT-indices were investigated for their relationships with insulin resistance and glycemic traits. VAT-related indices were calculated by correcting for body height (VAT/m:VAT/body height; VAT/m2:VAT/(body height)2, and VAT/m3:VAT/(body height)3), TAT (%VAT), TLT (VAT/TLT) and weight (VAT/WEI), with closest equivalents used within the UKBB dataset. Prognostic values of VAT and VAT-related indices for insulin sensitivity, HbA1c levels and prediabetes/diabetes were analyzed for males and females. Males had higher VAT volume and VAT-related indices than females in both cohorts (p < 0.0001) and VAT volume has shown to be a stronger determinant for insulin sensitivity than anthropometric variables. Among the parameters uncorrected VAT and derived indices, VAT/m3 most strongly correlated negatively with insulin sensitivity and positively with HbA1c levels and prediabetes/diabetes in the TDFS (R2 = 0.375/0.305 for females/males for insulin sensitivity, 0.178/0.148 for HbA1c levels vs., e.g., 0.355/0.293 and 0.144/0.133 for VAT, respectively) and positively with HbA1c (R2 = 0.046/0.042) in the UKBB for females and males. Furthermore, VAT/m3 was found to be a significantly better determinant of insulin resistance or prediabetes than uncorrected VAT volume (p < 0.001/0.019 for females/males regarding insulin sensitivity, p < 0.001/< 0.001 for females/males regarding HbA1c). Evaluation of several indices derived from VAT volume identified VAT/m3 to correlate most strongly with insulin sensitivity and glucose metabolism. Thus, VAT/m3 appears to provide better indications of metabolic characteristics (insulin sensitivity and pre-diabetes/diabetes) than VAT volume alone.
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Affiliation(s)
- Jürgen Machann
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, 72076 Tübingen, Germany; (N.S.); (R.W.); (A.F.); (A.L.B.); (F.S.)
- German Center for Diabetes Research (DZD), 72076 Tübingen, Germany;
- Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
- Correspondence:
| | - Norbert Stefan
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, 72076 Tübingen, Germany; (N.S.); (R.W.); (A.F.); (A.L.B.); (F.S.)
- German Center for Diabetes Research (DZD), 72076 Tübingen, Germany;
- Department of Endocrinology, Diabetology and Nephrology, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Robert Wagner
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, 72076 Tübingen, Germany; (N.S.); (R.W.); (A.F.); (A.L.B.); (F.S.)
- German Center for Diabetes Research (DZD), 72076 Tübingen, Germany;
- Department of Endocrinology, Diabetology and Nephrology, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Andreas Fritsche
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, 72076 Tübingen, Germany; (N.S.); (R.W.); (A.F.); (A.L.B.); (F.S.)
- German Center for Diabetes Research (DZD), 72076 Tübingen, Germany;
- Department of Endocrinology, Diabetology and Nephrology, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Jimmy D. Bell
- Research Centre for Optimal Health, School of Life Sciences, University of Westminster, London W1W 6UW, UK; (J.D.B.); (B.W.); (E.L.T)
| | - Brandon Whitcher
- Research Centre for Optimal Health, School of Life Sciences, University of Westminster, London W1W 6UW, UK; (J.D.B.); (B.W.); (E.L.T)
| | | | - Andreas L. Birkenfeld
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, 72076 Tübingen, Germany; (N.S.); (R.W.); (A.F.); (A.L.B.); (F.S.)
- German Center for Diabetes Research (DZD), 72076 Tübingen, Germany;
- Department of Endocrinology, Diabetology and Nephrology, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, 72076 Tübingen, Germany;
| | - Fritz Schick
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, 72076 Tübingen, Germany; (N.S.); (R.W.); (A.F.); (A.L.B.); (F.S.)
- German Center for Diabetes Research (DZD), 72076 Tübingen, Germany;
- Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
| | - E. Louise Thomas
- Research Centre for Optimal Health, School of Life Sciences, University of Westminster, London W1W 6UW, UK; (J.D.B.); (B.W.); (E.L.T)
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11
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Wang L, Chen Y, Sui YC, Tan XQ, Zhou Z, Li N, Xu LP. Metformin Attenuates Liver Fat Content: Finding from Schizophrenia Patients with Olanzapine-induced Weight Gain. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2020; 18:67-74. [PMID: 31958907 PMCID: PMC7006974 DOI: 10.9758/cpn.2020.18.1.67] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/08/2019] [Accepted: 05/09/2019] [Indexed: 01/08/2023]
Abstract
Objective This study was performed to evaluate the efficacy of metformin on liver fat content (LFC) in first episode schizophrenia patients with olanzapine-induced weight gain, and the relationship between the change of LFC and the other metabolic indices. Methods In a double-blind study, the clinically stable inpatients with first-episode schizophrenia under olanzapine monotherapy who gained more than 7% of their baseline weight were randomly assigned to two groups; one with olanzapine plus metformin (1,000 mg/day) (metformin group) and the other with olanzapine plus placebo (placebo group) for 16 weeks. All patients continued to maintain the original olanzapine dosage. LFC was measured by magnetic resonance imaging at baseline and at the end of 16 weeks, respectively. At the same time, glucose and lipid metabolism, homeostasis model assessment of insulin resistance index (HOMA-IR) were measured respectively, analyzing the correlation between the change value of LFC and other indicators. Results Over the 16-week study period, LFC value in metformin group decreased compared with baseline. LFC change across the 16-week treatment period was −2.91% for the metformin group and 0.59% for the placebo group, with a between-group difference of −3.5% (95% confidence interval, −6.08 to −0.93; p = 0.009). Compared to baseline, in the metformin group, triglyceride and HOMA-IR reduced significantly, while high density lipoprotein cholesterol increased significantly at weeks 16. There was positive correlation between LFC changes and triglycerides, HOMA-IR changes significantly. Conclusion Metformin can significantly attenuate LFC in schizophrenia patients with olanzapine-induced weight gain. It may be related to the improvement of the part of the glucolipid metabolic indices.
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Affiliation(s)
- Li Wang
- Department of Psychiatry, No.102 Hospital of Chinese People's Liberation Army, Changzhou, China
| | - Yu Chen
- Department of Psychiatry, Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yun-Chuan Sui
- Department of Psychiatry, No.102 Hospital of Chinese People's Liberation Army, Changzhou, China
| | - Xing-Qi Tan
- Psychiatry Center, No.102 Hospital of Chinese People's Liberation Army, Changzhou, China
| | - Zhi Zhou
- Department of Radiology, No.102 Hospital of Chinese People's Liberation Army, Changz0hou, China
| | - Ning Li
- Department of Psychiatry, No.102 Hospital of Chinese People's Liberation Army, Changzhou, China
| | - Le-Ping Xu
- Department of Psychiatry, No.102 Hospital of Chinese People's Liberation Army, Changzhou, China
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12
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Mayerhofer E, Ratzinger F, Kienreich NE, Stiel A, Witzeneder N, Schrefl E, Greiner G, Wegscheider C, Graf I, Schmetterer K, Marculescu R, Szekeres T, Perkmann T, Fondi M, Wagner O, Esterbauer H, Mayerhofer M, Holocher-Ertl S, Wojnarowski C, Hoermann G. A Multidisciplinary Intervention in Childhood Obesity Acutely Improves Insulin Resistance and Inflammatory Markers Independent From Body Composition. Front Pediatr 2020; 8:52. [PMID: 32154197 PMCID: PMC7047334 DOI: 10.3389/fped.2020.00052] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 02/03/2020] [Indexed: 12/21/2022] Open
Abstract
Childhood obesity is an increasing health care problem associated with insulin resistance and low-level systemic inflammation, which can ultimately lead to diabetes. Evidence for efficacy of therapeutic intervention programs on the early development of obesity associated sequelae is moderate. This paper investigates the effect of a multidisciplinary short-term intervention program on insulin resistance and metaflammation in childhood obesity. Two hundred and 36 overweight or obese children and adolescents between the ages of 10 and 14 were included in a prospective 5 months intervention study, which included sports, psychotherapy, and nutritional counseling. Primary endpoints were the effects on body mass index standard deviation score (BMI-SDS) and homeostatic model assessment of insulin resistance (HOMA-IR), key secondary endpoints were the levels of C-reactive protein (CRP), leptin, and adiponectin. At baseline, a substantial proportion of participants showed signs of insulin resistance (mean HOMA-IR 5.5 ± 3.4) despite not meeting the diagnostic criteria for diabetes, and low-level inflammation (mean CRP 3.9 mg/l ± 3.8 mg/l). One hundred and 95 participants (83%) completed the program resulting in a significant reduction in BMI-SDS, HOMA-IR, CRP, and leptin and a significant increase in adiponectin (mean change compared to baseline -0.14, -0.85, -1.0 mg/l, -2.8 ng/ml, and 0.5 μg/ml, respectively; p < 0.001 each). Effects on BMI-SDS, HOMA-IR, CRP, and adiponectin were largely independent whereas leptin was positively correlated with BMI-SDS and total fat mass before and after intervention (r = 0.56 and 0.61, p < 0.001 each). Short-term multidisciplinary intervention successfully improved body composition, insulin sensitivity, low-level systemic inflammation, and the adipokine profile in childhood obesity. Our findings highlight the immediate connection between obesity and the pathophysiology of its sequelae, and emphasize the importance of early intervention. Continued lifestyle modification is likely necessary to consolidate and augment the long-term effects.
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Affiliation(s)
- Ernst Mayerhofer
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.,Department of Neurology and Neurophysiology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Franz Ratzinger
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Annika Stiel
- Austrian Social Health Insurance Fund, Vienna, Austria
| | - Nadine Witzeneder
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Eva Schrefl
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.,FH Wien, University of Applied Sciences, Vienna, Austria
| | - Georg Greiner
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Irene Graf
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.,Division of Hematology and Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Klaus Schmetterer
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Rodrig Marculescu
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Thomas Szekeres
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Thomas Perkmann
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Martina Fondi
- FH Wien, University of Applied Sciences, Vienna, Austria
| | - Oswald Wagner
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Harald Esterbauer
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Stefana Holocher-Ertl
- Psychology Institute of the University Outpatient Department for Children and Adolescents, Sigmund Freud Private University, Vienna, Austria
| | | | - Gregor Hoermann
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.,Central Institute of Medical and Chemical Laboratory Diagnostics, University Hospital Innsbruck, Innsbruck, Austria
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13
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Renner S, Blutke A, Dobenecker B, Dhom G, Müller TD, Finan B, Clemmensen C, Bernau M, Novak I, Rathkolb B, Senf S, Zöls S, Roth M, Götz A, Hofmann SM, Hrabĕ de Angelis M, Wanke R, Kienzle E, Scholz AM, DiMarchi R, Ritzmann M, Tschöp MH, Wolf E. Metabolic syndrome and extensive adipose tissue inflammation in morbidly obese Göttingen minipigs. Mol Metab 2018; 16:180-190. [PMID: 30017782 PMCID: PMC6157610 DOI: 10.1016/j.molmet.2018.06.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 06/16/2018] [Accepted: 06/25/2018] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The worldwide prevalence of obesity has increased to 10% in men and 15% in women and is associated with severe comorbidities such as diabetes, cancer, and cardiovascular disease. Animal models of obesity are central to experimental studies of disease mechanisms and therapeutic strategies. Diet-induced obesity (DIO) models in rodents have provided important insights into the pathophysiology of obesity and, in most instances, are the first in line for exploratory pharmacology studies. To deepen the relevance towards translation to human patients, we established a corresponding DIO model in Göttingen minipigs (GM). METHODS Young adult female ovariectomized GM were fed a high-fat/high-energy diet for a period of 70 weeks. The ration was calculated to meet the requirements and maintain body weight (BW) of lean adult minipigs (L-GM group) or increased stepwise to achieve an obese state (DIO-GM group). Body composition, blood parameters and intravenous glucose tolerance were determined at regular intervals. A pilot chronic treatment trial with a GLP1 receptor agonist was conducted in DIO-GM. At the end of the study, the animals were necropsied and a biobank of selected tissues was established. RESULTS DIO-GM developed severe subcutaneous and visceral adiposity (body fat >50% of body mass vs. 22% in L-GM), increased plasma cholesterol, triglyceride, and free fatty acid levels, insulin resistance (HOMA-IR >5 vs. 2 in L-GM), impaired glucose tolerance and increased heart rate when resting and active. However, fasting glucose concentrations stayed within normal range throughout the study. Treatment with a long-acting GLP1 receptor agonist revealed substantial reduction of food intake and body weight within four weeks, with increased drug sensitivity relative to observations in other DIO animal models. Extensive adipose tissue inflammation and adipocyte necrosis was observed in visceral, but not subcutaneous, adipose tissue of DIO-GM. CONCLUSIONS The Munich DIO-GM model resembles hallmarks of the human metabolic syndrome with extensive adipose tissue inflammation and adipocyte necrosis reported for the first time. DIO-GM may be used for evaluating novel treatments of obesity and associated comorbidities. They may help to identify triggers and mechanisms of fat tissue inflammation and mechanisms preventing complete metabolic decompensation despite morbid obesity.
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Affiliation(s)
- Simone Renner
- Chair for Molecular Animal Breeding and Biotechnology, Gene Center and Department of Veterinary Sciences, LMU Munich, Feodor-Lynen-Str. 25, 81377, Munich, Germany; Center for Innovative Medical Models (CiMM), Department of Veterinary Sciences, LMU Munich, Hackerstr. 27, 85764, Oberschleißheim, Germany; German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany.
| | - Andreas Blutke
- Institute of Veterinary Pathology, Center for Clinical Veterinary Medicine, LMU Munich, Veterinärstr. 13, 80539, Munich, Germany
| | - Britta Dobenecker
- Chair of Animal Nutrition and Dietetics, Department of Veterinary Sciences, LMU Munich, Schönleutnerstr. 8, 85764, Oberschleißheim, Germany
| | - Georg Dhom
- Chair for Molecular Animal Breeding and Biotechnology, Gene Center and Department of Veterinary Sciences, LMU Munich, Feodor-Lynen-Str. 25, 81377, Munich, Germany; Center for Innovative Medical Models (CiMM), Department of Veterinary Sciences, LMU Munich, Hackerstr. 27, 85764, Oberschleißheim, Germany
| | - Timo D Müller
- German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Institute for Diabetes and Obesity (IDO), Helmholtz Diabetes Center, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Division of Metabolic Diseases, Department of Medicine, Technische Universität, Ismaninger Str. 22, 81675, Munich, Germany
| | - Brian Finan
- German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Institute for Diabetes and Obesity (IDO), Helmholtz Diabetes Center, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Division of Metabolic Diseases, Department of Medicine, Technische Universität, Ismaninger Str. 22, 81675, Munich, Germany
| | - Christoffer Clemmensen
- German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Institute for Diabetes and Obesity (IDO), Helmholtz Diabetes Center, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Division of Metabolic Diseases, Department of Medicine, Technische Universität, Ismaninger Str. 22, 81675, Munich, Germany
| | - Maren Bernau
- Livestock Center of the Veterinary Faculty, LMU Munich, St.-Hubertus-Str. 12, 85764, Oberschleißheim, Germany
| | - Istvan Novak
- Chair for Molecular Animal Breeding and Biotechnology, Gene Center and Department of Veterinary Sciences, LMU Munich, Feodor-Lynen-Str. 25, 81377, Munich, Germany; Center for Innovative Medical Models (CiMM), Department of Veterinary Sciences, LMU Munich, Hackerstr. 27, 85764, Oberschleißheim, Germany
| | - Birgit Rathkolb
- Chair for Molecular Animal Breeding and Biotechnology, Gene Center and Department of Veterinary Sciences, LMU Munich, Feodor-Lynen-Str. 25, 81377, Munich, Germany; Center for Innovative Medical Models (CiMM), Department of Veterinary Sciences, LMU Munich, Hackerstr. 27, 85764, Oberschleißheim, Germany; German Mouse Clinic (GMC), Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany
| | - Steffanie Senf
- Clinic for Swine, Center for Clinical Veterinary Medicine, LMU Munich, Sonnenstr. 16, 85764, Oberschleißheim, Germany
| | - Susanne Zöls
- Clinic for Swine, Center for Clinical Veterinary Medicine, LMU Munich, Sonnenstr. 16, 85764, Oberschleißheim, Germany
| | - Mirjam Roth
- Animal aspects, 88400, Biberach an der Riss, Germany
| | - Anna Götz
- Institute for Diabetes and Obesity (IDO), Helmholtz Diabetes Center, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Department of Internal Medicine I, University Hospital RWTH Aachen, Pauwelstr. 30, 52074, Aachen, Germany
| | - Susanna M Hofmann
- German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Institute of Diabetes and Regeneration Research (IDR), Helmholtz Diabetes Center, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Medizinische Klinik und Poliklinik IV, Klinikum der LMU, Ziemssenstr, 180336, Munich, Germany
| | - Martin Hrabĕ de Angelis
- German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; German Mouse Clinic (GMC), Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Genome Analysis Center (GAC), Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health and Chair of Experimental Genetics, Technische Universität, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany
| | - Rüdiger Wanke
- Institute of Veterinary Pathology, Center for Clinical Veterinary Medicine, LMU Munich, Veterinärstr. 13, 80539, Munich, Germany
| | - Ellen Kienzle
- Chair of Animal Nutrition and Dietetics, Department of Veterinary Sciences, LMU Munich, Schönleutnerstr. 8, 85764, Oberschleißheim, Germany
| | - Armin M Scholz
- Livestock Center of the Veterinary Faculty, LMU Munich, St.-Hubertus-Str. 12, 85764, Oberschleißheim, Germany
| | - Richard DiMarchi
- Novo Nordisk Research Center Indianapolis, 5225 Exploration Drive, Indianapolis, IN, 46241, USA; Department of Chemistry, Indiana University, 800 E. Kirkwood Ave., Bloomington, IN, 47405-7102, USA
| | - Mathias Ritzmann
- Clinic for Swine, Center for Clinical Veterinary Medicine, LMU Munich, Sonnenstr. 16, 85764, Oberschleißheim, Germany
| | - Matthias H Tschöp
- German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Institute for Diabetes and Obesity (IDO), Helmholtz Diabetes Center, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Division of Metabolic Diseases, Department of Medicine, Technische Universität, Ismaninger Str. 22, 81675, Munich, Germany
| | - Eckhard Wolf
- Chair for Molecular Animal Breeding and Biotechnology, Gene Center and Department of Veterinary Sciences, LMU Munich, Feodor-Lynen-Str. 25, 81377, Munich, Germany; Center for Innovative Medical Models (CiMM), Department of Veterinary Sciences, LMU Munich, Hackerstr. 27, 85764, Oberschleißheim, Germany; German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Laboratory for Functional Genome Analysis (LAFUGA), Gene Center, LMU Munich, Feodor-Lynen-Str. 25, 81377, Munich, Germany
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14
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Body composition and insulin resistance in children. Eur J Clin Nutr 2018; 72:1239-1245. [DOI: 10.1038/s41430-018-0239-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 05/14/2018] [Indexed: 12/21/2022]
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15
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Płaczkowska S, Pawlik-Sobecka L, Kokot I, Piwowar A. Estimation of metabolic factors related to insulin resistance and metabolic syndrome in young people. Scandinavian Journal of Clinical and Laboratory Investigation 2018; 78:325-332. [PMID: 29741109 DOI: 10.1080/00365513.2018.1469787] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Civilizational developments occurring during recent decades have resulted in an increased incidence of a variety of metabolic disorders related to insulin resistance in younger people. The determination of decision limits for insulin resistance indices, especially among young people, is a significant challenge in clinical practice. The aim of this study was the estimation of metabolic factors related to their relationship to insulin resistance and metabolic syndrome (MS) features in young, apparently healthy people. Moreover, we evaluated the optimal decision limits for patients with MS identification for HOMA1-IR, HOMA2-IR, HOMA2 obtained from C-peptide concentrations. 349 apparently healthy people aged 18-31 (260 women and 89 men), were enrolled in this study. The present analysis of metabolic, anthropometric and clinical parameters observed them in clusters covering the criteria of MS recognition, but MS in this group was only partially related to insulin resistance. The HOMA1-IR decision limit estimation is likely to became be useful in the prognostication of metabolic disturbances in young, apparently healthy people. A measure of insulin resistance that can provide a reliable early prediction of MS is likely to provide an opportunity for instigating preventive measures of significant clinical utility.
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Affiliation(s)
- Sylwia Płaczkowska
- a Diagnostics Laboratory for Teaching and Research, Faculty of Pharmacy with Division of Laboratory Diagnostics , Wroclaw Medical University , Wroclaw , Poland
| | - Lilla Pawlik-Sobecka
- b Department of Laboratory Diagnostics, Faculty of Pharmacy with Division of Laboratory Diagnostics , Wroclaw Medical University , Wroclaw , Poland
| | - Izabela Kokot
- b Department of Laboratory Diagnostics, Faculty of Pharmacy with Division of Laboratory Diagnostics , Wroclaw Medical University , Wroclaw , Poland
| | - Agnieszka Piwowar
- c Department of Toxicology, Faculty of Pharmacy with Division of Laboratory Diagnostics , Wroclaw Medical University , Wroclaw , Poland
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16
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Arslanian S, Kim JY, Nasr A, Bacha F, Tfayli H, Lee S, Toledo FGS. Insulin sensitivity across the lifespan from obese adolescents to obese adults with impaired glucose tolerance: Who is worse off? Pediatr Diabetes 2018; 19:205-211. [PMID: 28726334 DOI: 10.1111/pedi.12562] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 06/06/2017] [Accepted: 06/20/2017] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Youth type 2 diabetes mellitus (T2DM) occurs decades earlier than adult T2DM and is characterized by high therapeutic failure rates and decreased response to insulin sensitizers suggesting a more severe disease process than in adults. To explain these observations, we hypothesized that insulin resistance is worse in obese youth than adults with impaired glucose tolerance (IGT), a state of high-risk for T2DM. As proof-of-concept, we compared insulin sensitivity between BMI-, sex-, and race-matched obese youth vs adults with IGT. METHODS This retrospective analysis of IGT youth and adults included 34 obese adolescents matched (2:1) for BMI, sex, and race to 17 adults. Hepatic and peripheral insulin sensitivity were measured by [6,6-2 H2 ]glucose and hyperinsulinemic-euglycemic clamp. Body composition (DEXA) and serum lipid profile were examined. RESULTS Despite similar percent body fat, obese adolescents had 2-fold higher fasting insulin concentration, lower hepatic (~53%) and peripheral (~42%) insulin sensitivity and lower HDL compared with adults (all P < .01). Surrogate estimate of insulin sensitivity, 1/fasting insulin was lower and HOMA-IR was higher in adolescents vs adults. Adults had a more atherogenic lipid profile with higher total-, LDL-, and non-HDL cholesterol. CONCLUSIONS Obese youth and adults with IGT differ in that youth are more insulin resistant than adults in spite of similar adiposity. This could potentially explain the earlier onset of T2DM in youth through an early and amplified burden on a β-cell destined to decompensate, and explicate their lower therapeutic response to insulin sensitizers.
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Affiliation(s)
- Silva Arslanian
- Division of Weight Management and Wellness, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.,Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Joon Young Kim
- Division of Weight Management and Wellness, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Alexis Nasr
- Division of Weight Management and Wellness, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Fida Bacha
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
| | - Hala Tfayli
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - SoJung Lee
- Division of Weight Management and Wellness, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Frederico G S Toledo
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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17
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杨 兴, 邵 孟, 周 琴, 夏 悦, 邹 和. [Association of waist-to-hip ratio with insulin resistance in non-diabetic normal-weight individuals: a cross-sectional study]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2017; 37:1540-1544. [PMID: 29180338 PMCID: PMC6779637 DOI: 10.3969/j.issn.1673-4254.2017.11.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To explore the relationship between waist-to-hip ratio (WHR) and insulin resistance(IR) in non-diabetic normal-weight individuals and investigate how this association differs between male and femalesubjects. METHODS From June to October, 2012, we performed a cross-sectional survey among 2142 community-based non-diabetic Chinese participants, who were divided into 4 groups according to the gender-specific quartiles of WHR. Homeostatic model assessment of insulin resistance (HOMA-IR), calculated as the product of fasting plasma glucose (mmol/L) and fasting insulin (mU/L) divided by 22.5, was used as the indicator of insulin resistance. Logistic regression models were used to explore the association of WHR with IR in these subjects. RESULTS In the unadjusted model, WHR was significantly associated with IR in women (OR=6.60, 95%CI: 2.86-15.26, P<0.001); the association was still significant (OR=3.28, 95%CI: 1.34-8.04, P=0.009) after adjustment for the potential confounders including the history of hypertension, coronary heartdisease, current smoker, physical inactivity, and body mass index. CONCLUSION WHR is independently associated with IR in non-diabetic Chinese women with normal body weight.
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Affiliation(s)
- 兴燕 杨
- />南方医科大学第三附属医院肾内科,广东 广州 510630Department of Nephrology, Institute of Nephrology and Urology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - 孟佼 邵
- />南方医科大学第三附属医院肾内科,广东 广州 510630Department of Nephrology, Institute of Nephrology and Urology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - 琴 周
- />南方医科大学第三附属医院肾内科,广东 广州 510630Department of Nephrology, Institute of Nephrology and Urology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - 悦 夏
- />南方医科大学第三附属医院肾内科,广东 广州 510630Department of Nephrology, Institute of Nephrology and Urology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - 和群 邹
- />南方医科大学第三附属医院肾内科,广东 广州 510630Department of Nephrology, Institute of Nephrology and Urology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
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18
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Abstract
Hepatic steatosis is an underlying feature of nonalcoholic fatty liver disease (NAFLD), which is the most common form of liver disease and is present in up to ∼70% of individuals who are overweight. NAFLD is also associated with hypertriglyceridaemia and low levels of HDL, glucose intolerance, insulin resistance and type 2 diabetes mellitus. Hepatic steatosis is a strong predictor of the development of insulin resistance and often precedes the onset of other known mediators of insulin resistance. This sequence of events suggests that hepatic steatosis has a causal role in the development of insulin resistance in other tissues, such as skeletal muscle. Hepatokines are proteins that are secreted by hepatocytes, and many hepatokines have been linked to the induction of metabolic dysfunction, including fetuin A, fetuin B, retinol-binding protein 4 (RBP4) and selenoprotein P. In this Review, we describe the factors that influence the development of hepatic steatosis, provide evidence of strong links between hepatic steatosis and insulin resistance in non-hepatic tissues, and discuss recent advances in our understanding of how steatosis alters hepatokine secretion to influence metabolic phenotypes through inter-organ communication.
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Affiliation(s)
- Ruth C R Meex
- Monash Biomedicine Discovery Institute, Metabolic Disease and Obesity Program and the Department of Physiology, Monash University, Wellington Road, Clayton, Victoria 3800, Australia
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands
| | - Matthew J Watt
- Monash Biomedicine Discovery Institute, Metabolic Disease and Obesity Program and the Department of Physiology, Monash University, Wellington Road, Clayton, Victoria 3800, Australia
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Phillips CM. Metabolically healthy obesity across the life course: epidemiology, determinants, and implications. Ann N Y Acad Sci 2016; 1391:85-100. [PMID: 27723940 DOI: 10.1111/nyas.13230] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 08/09/2016] [Accepted: 08/18/2016] [Indexed: 12/24/2022]
Abstract
In recent years, different subphenotypes of obesity have been described, including metabolically healthy obesity (MHO), in which a proportion of obese individuals, despite excess body fat, remain free of metabolic abnormalities and increased cardiometabolic risk. In the absence of a universally accepted set of criteria to classify MHO, the reported prevalence estimates vary widely. Our understanding of the determinants and stability of MHO over time and the associated cardiometabolic and mortality risks is improving, but many questions remain. For example, whether MHO is truly benign is debatable, and whether risk stratification of obese individuals on the basis of their metabolic health status may offer new opportunities for more personalized approaches in diagnosis, intervention, and treatment of diabetes remains speculative. Furthermore, as most of the research to date has focused on MHO in adults, little is known about childhood MHO. In this review, we focus on the epidemiology, determinants, stability, and health implications of MHO across the life course.
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Affiliation(s)
- Catherine M Phillips
- HRB Centre for Diet and Health Research, Department of Epidemiology and Public Health, University College Cork, Cork, Ireland; and HRB Centre for Diet and Health Research, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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20
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Wall-Medrano A, Ramos-Jiménez A, Hernandez-Torres RP, Villalobos-Molina R, Tapia-Pancardo DC, Jiménez-Flores JR, Méndez-Cruz AR, Murguía-Romero M, Gallardo-Ortíz IA, Urquídez-Romero R. Cardiometabolic risk in young adults from northern Mexico: Revisiting body mass index and waist-circumference as predictors. BMC Public Health 2016; 16:236. [PMID: 26956639 PMCID: PMC4782332 DOI: 10.1186/s12889-016-2896-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 02/19/2016] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND A body mass index (BMI) ≥30 kg/m(2) and a waist circumference (WC) ≥80 cm in women (WCF) or ≥90 cm in men (WCM) are reference cardiometabolic risk markers (CMM) for Mexicans adults. However, their reliability to predict other CMM (index tests) in young Mexicans has not been studied in depth. METHODS A cross-sectional descriptive study evaluating several anthropometric, physiological and biochemical CMM from 295 young Mexicans was performed. Sensitivity (Se), specificity (Sp) and Youden's index (J) of reference BMI/WC cutoffs toward other CMM (n = 14) were obtained and their most reliable cutoffs were further calculated at Jmax. RESULTS Prevalence, incidence and magnitude of most CMM increased along the BMI range (p < 0.01). BMI explained 81 % of WC's variance [Se (97 %), Sp (71 %), J (68 %), Jmax (86 %), BMI = 30 kg/m(2)] and 4-50 % of other CMM. The five most prevalent (≥71 %) CMM in obese subjects were high WC, low HDL-C, and three insulin-related CMM [Fasting insulin, HOMA-IR, and QUICKI]. For a BMI = 30 kg/m(2), J ranged from 16 % (HDL-C/LDL-C) to 68 % (WC), being moderately reliable (Jmax = 61-67) to predict high uric acid (UA), metabolic syndrome (MetS) and the hypertriglyceridemic-waist phenotype (HTGW). Corrected WCM/WCF were moderate-highly reliable (Jmax = 66-90) to predict HTGW, MetS, fasting glucose and UA. Most CMM were moderate-highly predicted at 27 ± 3 kg/m(2) (CI 95 %, 25-28), 85 ± 5 cm (CI 95 %, 82-88) and 81 ± 6cm (CI 95 %, 75-87), for BMI, WCM and WCF, respectively. CONCLUSION BMI and WC are good predictors of several CMM in the studied population, although at different cutoffs than current reference values.
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Affiliation(s)
- Abraham Wall-Medrano
- Instituto de Ciencias Biomédicas, Universidad Autónoma de Ciudad Juárez, Anillo Envolvente del Pronaf y Estocolmo, Ciudad Juárez, 32300, Chihuahua, México.
| | - Arnulfo Ramos-Jiménez
- Instituto de Ciencias Biomédicas, Universidad Autónoma de Ciudad Juárez, Anillo Envolvente del Pronaf y Estocolmo, Ciudad Juárez, 32300, Chihuahua, México.
| | - Rosa P Hernandez-Torres
- Facultad de Ciencias de la Cultura Física, Universidad Autónoma de Chihuahua, Chihuahua, México.
| | - Rafael Villalobos-Molina
- Unidad de Biomedicina, Universidad Nacional Autónoma de México, Tlalnepantla, México.
- Laboratorio Nacional en Salud: Diagnóstico Molecular y Efecto Ambiental en Enfermedades Crónico-Degenerativas, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México.
| | | | - J Rafael Jiménez-Flores
- Unidad de Biomedicina, Universidad Nacional Autónoma de México, Tlalnepantla, México.
- Laboratorio Nacional en Salud: Diagnóstico Molecular y Efecto Ambiental en Enfermedades Crónico-Degenerativas, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México.
| | - A René Méndez-Cruz
- Unidad de Biomedicina, Universidad Nacional Autónoma de México, Tlalnepantla, México.
- Laboratorio Nacional en Salud: Diagnóstico Molecular y Efecto Ambiental en Enfermedades Crónico-Degenerativas, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México.
| | - Miguel Murguía-Romero
- Unidad de Biomedicina, Universidad Nacional Autónoma de México, Tlalnepantla, México.
- Laboratorio Nacional en Salud: Diagnóstico Molecular y Efecto Ambiental en Enfermedades Crónico-Degenerativas, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México.
| | | | - René Urquídez-Romero
- Instituto de Ciencias Biomédicas, Universidad Autónoma de Ciudad Juárez, Anillo Envolvente del Pronaf y Estocolmo, Ciudad Juárez, 32300, Chihuahua, México.
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Baum T, Cordes C, Dieckmeyer M, Ruschke S, Franz D, Hauner H, Kirschke JS, Karampinos DC. MR-based assessment of body fat distribution and characteristics. Eur J Radiol 2016; 85:1512-8. [PMID: 26905521 DOI: 10.1016/j.ejrad.2016.02.013] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 02/03/2016] [Accepted: 02/09/2016] [Indexed: 12/14/2022]
Abstract
The assessment of body fat distribution and characteristics using magnetic resonance (MR) methods has recently gained significant attention as it further extends our pathophysiological understanding of diseases including obesity, metabolic syndrome, or type 2 diabetes mellitus, and allows more detailed insights into treatment response and effects of lifestyle interventions. Therefore, the purpose of this study was to review the current literature on MR-based assessment of body fat distribution and characteristics. PubMed search was performed to identify relevant studies on the assessment of body fat distribution and characteristics using MR methods. T1-, T2-weighted MR Imaging (MRI), Magnetic Resonance Spectroscopy (MRS), and chemical shift-encoding based water-fat MRI have been successfully used for the assessment of body fat distribution and characteristics. The relationship of insulin resistance and serum lipids with abdominal adipose tissue (i.e. subcutaneous and visceral adipose tissue), liver, muscle, and bone marrow fat content have been extensively investigated and may help to understand the underlying pathophysiological mechanisms and the multifaceted obese phenotype. MR methods have also been used to monitor changes of body fat distribution and characteristics after interventions (e.g. diet or physical activity) and revealed distinct, adipose tissue-specific properties. Lastly, chemical shift-encoding based water-fat MRI can detect brown adipose tissue which is currently the focus of intense research as a potential treatment target for obesity. In conclusion, MR methods reliably allow the assessment of body fat distribution and characteristics. Irrespective of the promising findings based on these MR methods the clinical usefulness remains to be established.
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Affiliation(s)
- Thomas Baum
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - Christian Cordes
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Michael Dieckmeyer
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Stefan Ruschke
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Daniela Franz
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Hans Hauner
- Else Kröner Fresenius Center for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; ZIEL Research Center for Nutrition and Food Sciences, Technische Universität München, Germany
| | - Jan S Kirschke
- Section of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
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22
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Meex RC, Hoy AJ, Morris A, Brown RD, Lo JCY, Burke M, Goode RJA, Kingwell BA, Kraakman MJ, Febbraio MA, Greve JW, Rensen SS, Molloy MP, Lancaster GI, Bruce CR, Watt MJ. Fetuin B Is a Secreted Hepatocyte Factor Linking Steatosis to Impaired Glucose Metabolism. Cell Metab 2015; 22:1078-89. [PMID: 26603189 DOI: 10.1016/j.cmet.2015.09.023] [Citation(s) in RCA: 166] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 08/04/2015] [Accepted: 09/23/2015] [Indexed: 12/18/2022]
Abstract
Liver steatosis is associated with the development of insulin resistance and the pathogenesis of type 2 diabetes. We tested the hypothesis that protein signals originating from steatotic hepatocytes communicate with other cells to modulate metabolic phenotypes. We show that the secreted factors from steatotic hepatocytes induce pro-inflammatory signaling and insulin resistance in cultured cells. Next, we identified 168 hepatokines, of which 32 were differentially secreted in steatotic versus non-steatotic hepatocytes. Targeted analysis showed that fetuin B was increased in humans with liver steatosis and patients with type 2 diabetes. Fetuin B impaired insulin action in myotubes and hepatocytes and caused glucose intolerance in mice. Silencing of fetuin B in obese mice improved glucose tolerance. We conclude that the protein secretory profile of hepatocytes is altered with steatosis and is linked to inflammation and insulin resistance. Therefore, preventing steatosis may limit the development of dysregulated glucose metabolism in settings of overnutrition.
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Affiliation(s)
- Ruth C Meex
- Monash Biomedicine Discovery Institute, Metabolic Disease and Obesity Program, and Biology of Lipid Metabolism Laboratory, Department of Physiology, Monash University, Clayton, VIC 3800, Australia
| | - Andrew J Hoy
- Monash Biomedicine Discovery Institute, Metabolic Disease and Obesity Program, and Biology of Lipid Metabolism Laboratory, Department of Physiology, Monash University, Clayton, VIC 3800, Australia
| | - Alexander Morris
- Monash Biomedicine Discovery Institute, Metabolic Disease and Obesity Program, and Biology of Lipid Metabolism Laboratory, Department of Physiology, Monash University, Clayton, VIC 3800, Australia
| | - Russell D Brown
- Monash Biomedicine Discovery Institute, Metabolic Disease and Obesity Program, and Biology of Lipid Metabolism Laboratory, Department of Physiology, Monash University, Clayton, VIC 3800, Australia
| | - Jennifer C Y Lo
- Monash Biomedicine Discovery Institute, Metabolic Disease and Obesity Program, and Biology of Lipid Metabolism Laboratory, Department of Physiology, Monash University, Clayton, VIC 3800, Australia
| | - Melissa Burke
- Biotechnology Research Laboratories, Department of Physiology, Monash University, Clayton, VIC 3800, Australia; Mill Hill Laboratory, The Francis Crick Institute, London NW7 1AA, UK
| | - Robert J A Goode
- Department of Biochemistry and Molecular Biology, Monash University, Clayton, VIC 3800, Australia
| | | | | | - Mark A Febbraio
- Baker IDI Heart and Diabetes Institute, Melbourne, VIC 3004, Australia; The Garvan Institute of Medical Research, Sydney, NSW 2010, Australia
| | - Jan Willem Greve
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Department of General Surgery, Maastricht, the Netherlands
| | - Sander S Rensen
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Department of General Surgery, Maastricht, the Netherlands
| | - Mark P Molloy
- Australian Proteome Analysis Facility, Macquarie University, Sydney, NSW 2109, Australia
| | | | - Clinton R Bruce
- Monash Biomedicine Discovery Institute, Metabolic Disease and Obesity Program, and Biology of Lipid Metabolism Laboratory, Department of Physiology, Monash University, Clayton, VIC 3800, Australia
| | - Matthew J Watt
- Monash Biomedicine Discovery Institute, Metabolic Disease and Obesity Program, and Biology of Lipid Metabolism Laboratory, Department of Physiology, Monash University, Clayton, VIC 3800, Australia.
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Gyllenhammer LE, Alderete TL, Toledo-Corral CM, Weigensberg M, Goran MI. Saturation of subcutaneous adipose tissue expansion and accumulation of ectopic fat associated with metabolic dysfunction during late and post-pubertal growth. Int J Obes (Lond) 2015; 40:601-6. [PMID: 26443340 PMCID: PMC4821774 DOI: 10.1038/ijo.2015.207] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 09/04/2015] [Accepted: 09/21/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND/OBJECTIVE Puberty is a period defined by large changes in adipose tissue accumulation and distribution; however, longitudinal patterns of ectopic fat development have not been shown. We have previously shown significant declines in beta-cell function (BCF) across puberty and hypothesize that accumulation of ectopic fat deposition, particularly hepatic fat, will predict this fall. SUBJECT/METHODS We conducted a longitudinal study and examined 2-year change in abdominal fat distribution and type 2 diabetes risk markers in 76 Hispanic children and young adults (16.1±0.5 years, 66% obese, 52% male, 51% post-pubertal). Subcutaneous abdominal adipose tissue (SAAT), visceral adipose tissue (VAT), hepatic fat fraction (HFF) and pancreatic fat fraction (PFF) were measured by 3-Tesla magnetic resonance imaging, and markers of type 2 diabetes risk were collected at fasting and during an oral glucose tolerance test (OGTT). RESULTS Baseline pubertal status significantly moderated the 2-year change in ectopic fat deposition, such that VAT, HFF and PFF increased in individuals during late and post-pubertal growth, whereas children earlier in their pubertal development decreased ectopic accumulation and had less VAT accumulation (VAT: pTanner*time=0.044, 0.31±0.08 l vs 0.03±0.10 l; HFF: pTanner*time=0.007, 1.34±0.87% vs -2.61±1.11%; PFF: pTanner*time<0.001, 1.61±0.39% vs -0.96±0.50%). Independent of pubertal status, the 2-year increase in HFF and VAT significantly associated with a decline in BCF (ß=-1.04, P=0.038; ß=-1.81, P=0.020) and metabolic function, while accumulation of SAAT significantly associated with BCF (ß=1.36, P=0.012) and metabolic improvement. HFF accumulation was the only depot to significantly predict clinical markers of type 2 diabetes risk, fasting glucose and HbA1c, and circulating free fatty acid levels (ß=1.00, P=0.034; ß=1.00, P=0.015; ß=01.01, P=0.024). CONCLUSIONS The accumulation of SAAT defends against type 2 diabetes risk and potentially ectopic fat accumulation. Intra-abdominal VAT and HFF accumulation both associate with metabolic decline and BCF, while HFF predicts an even greater number of metabolic risk features.
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Affiliation(s)
- L E Gyllenhammer
- Department of Preventive Medicine, Diabetes and Obesity Research Institute, University of Southern California, Los Angeles, CA, USA
| | - T L Alderete
- Department of Preventive Medicine, Diabetes and Obesity Research Institute, University of Southern California, Los Angeles, CA, USA
| | - C M Toledo-Corral
- Department of Public Health, California State University Los Angeles, Los Angeles, CA, USA
| | - M Weigensberg
- Department of Preventive Medicine, Diabetes and Obesity Research Institute, University of Southern California, Los Angeles, CA, USA
| | - M I Goran
- Department of Preventive Medicine, Diabetes and Obesity Research Institute, University of Southern California, Los Angeles, CA, USA
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Baskar S, Jhaveri S, Alkhouri N. Cardiovascular risk in pediatric nonalcoholic fatty liver disease: recent advances. ACTA ACUST UNITED AC 2015. [DOI: 10.2217/clp.15.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Proton density fat-fraction is an accurate biomarker of hepatic steatosis in adolescent girls and young women. Eur Radiol 2015; 25:2921-30. [PMID: 25916386 DOI: 10.1007/s00330-015-3724-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 03/18/2015] [Accepted: 03/19/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To compare complex quantitative magnetic resonance imaging (MRI) with MR spectroscopy (MRS) for quantification of hepatic steatosis (HS) and determine clinically significant MRI-based thresholds of HS in female youths. METHODS This prospective, cross-sectional study was conducted in 132 healthy females (11-22 years, mean 13.3 ± 2). Proton density fat-fraction (PDFF) was measured using complex quantitative MRI and MRS. Body mass index (BMI), fasting labs [glucose, insulin, alanine aminotransferase (ALT), and other metabolic markers] were obtained. Outcomes were measured using regression analysis, Spearman-rank correlation, and receiver operator characteristics (ROC) analysis. HS was defined as MRI-PDFF >5.6%. RESULTS HS was detected by MRI-PDFF in 15% of all subjects. Linear regression demonstrated excellent correlation and agreement [r(2) = 0.96, slope = 0.97 (95 %CI: 0.94-1.00), intercept = 0.78% (95 %CI: 0.58-0.98%)] between MRI-PDFF and MRS-PDFF. MRI-PDFF had a sensitivity of 100% (95 %CI: 0.79-1.00), specificity of 96.6% (95 %CI: 0.91-0.99), and a kappa index of 87% (95 %CI: 0.75-0.99) for identifying HS. In overweight subjects with HS, MRI-PDFF correlated with ALT (r = 0.84, p < 0.0001) and insulin (r = 0.833, p < 0.001), but not with BMI or WC. ROC analysis ascertained an optimal MRI-PDFF threshold of 3.5% for predicting metabolic syndrome (sensitivity = 76 %, specificity = 83 %). CONCLUSION Complex quantitative MRI demonstrates strong correlation and agreement with MRS to quantify hepatic triglyceride content in adolescent girls and young women. A low PDFF threshold is predictive of metabolic syndrome in this population. KEY POINTS • Confounder-corrected quantitative MRI (ccqMRI) effectively measures hepatic triglyceride content in adolescent girls. • MRS and ccqMRI strongly correlate in liver proton density fat-fraction (PDFF) detection. • A PDFF threshold of 3.5% may be predictive of paediatric metabolic syndrome.
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Lange T, Buechert M, Baumstark MW, Deibert P, Gerner S, Rydén H, Seufert J, Korsten-Reck U. Value of MRI and MRS fat measurements to complement conventional screening methods for childhood obesity. J Magn Reson Imaging 2015; 42:1214-22. [DOI: 10.1002/jmri.24919] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 04/01/2015] [Accepted: 04/01/2015] [Indexed: 12/11/2022] Open
Affiliation(s)
- Thomas Lange
- Department of Radiology; Medical Physics, University Medical Center Freiburg; Freiburg Germany
- Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg; Freiburg Germany
| | - Martin Buechert
- Department of Radiology; Medical Physics, University Medical Center Freiburg; Freiburg Germany
| | - Manfred W. Baumstark
- Department of Rehabilitative and Preventive Sports Medicine; University Medical Center Freiburg; Freiburg Germany
| | - Peter Deibert
- Department of Rehabilitative and Preventive Sports Medicine; University Medical Center Freiburg; Freiburg Germany
| | - Sarah Gerner
- Department of Rehabilitative and Preventive Sports Medicine; University Medical Center Freiburg; Freiburg Germany
| | - Henric Rydén
- Department of Radiology; Medical Physics, University Medical Center Freiburg; Freiburg Germany
| | - Jochen Seufert
- Department of Endocrinology and Diabetology; University Medical Center Freiburg; Freiburg Germany
| | - Ulrike Korsten-Reck
- Department of Rehabilitative and Preventive Sports Medicine; University Medical Center Freiburg; Freiburg Germany
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Bongers M, Stefan N, Fritsche A, Häring HU, Nikolaou K, Schick F, Machann J. Lebervolumen, Leberfettanteil und Körpergewicht im Verlauf einer Lebensstilinterventionsstudie. Radiologe 2015; 55:323-8. [DOI: 10.1007/s00117-014-2722-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Thomas S, Rouilly V, Patin E, Alanio C, Dubois A, Delval C, Marquier LG, Fauchoux N, Sayegrih S, Vray M, Duffy D, Quintana-Murci L, Albert ML. The Milieu Intérieur study - an integrative approach for study of human immunological variance. Clin Immunol 2015; 157:277-93. [PMID: 25562703 DOI: 10.1016/j.clim.2014.12.004] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 10/21/2014] [Accepted: 12/01/2014] [Indexed: 10/24/2022]
Abstract
The Milieu Intérieur Consortium has established a 1000-person healthy population-based study (stratified according to sex and age), creating an unparalleled opportunity for assessing the determinants of human immunologic variance. Herein, we define the criteria utilized for participant enrollment, and highlight the key data that were collected for correlative studies. In this report, we analyzed biological correlates of sex, age, smoking-habits, metabolic score and CMV infection. We characterized and identified unique risk factors among healthy donors, as compared to studies that have focused on the general population or disease cohorts. Finally, we highlight sex-bias in the thresholds used for metabolic score determination and recommend a deeper examination of current guidelines. In sum, our clinical design, standardized sample collection strategies, and epidemiological data analyses have established the foundation for defining variability within human immune responses.
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Affiliation(s)
- Stéphanie Thomas
- Center for Human Immunology, Institut Pasteur, Paris, France; Laboratory of Dendritic Cell Immunobiology, Department of Immunology, Institut Pasteur, Paris, France; INSERM U818, France
| | - Vincent Rouilly
- Center for Human Immunology, Institut Pasteur, Paris, France; Center for Bioinformatics, Institut Pasteur, Paris, France
| | - Etienne Patin
- Laboratory of Human Evolutionary Genetics, Department of Genomes & Genetics, Institut Pasteur, Paris, France; CNRS URA3012, France
| | - Cécile Alanio
- Center for Human Immunology, Institut Pasteur, Paris, France; Laboratory of Dendritic Cell Immunobiology, Department of Immunology, Institut Pasteur, Paris, France; INSERM U818, France
| | | | | | | | | | | | - Muriel Vray
- Unit of Emerging Diseases Epidemiology, Institut Pasteur, Paris, France
| | - Darragh Duffy
- Center for Human Immunology, Institut Pasteur, Paris, France; Laboratory of Dendritic Cell Immunobiology, Department of Immunology, Institut Pasteur, Paris, France; INSERM U818, France
| | - Lluis Quintana-Murci
- Laboratory of Human Evolutionary Genetics, Department of Genomes & Genetics, Institut Pasteur, Paris, France; CNRS URA3012, France.
| | - Matthew L Albert
- Center for Human Immunology, Institut Pasteur, Paris, France; Laboratory of Dendritic Cell Immunobiology, Department of Immunology, Institut Pasteur, Paris, France; INSERM U818, France; INSERM UMS20, France.
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Weber DR, Leonard MB, Shults J, Zemel BS. A comparison of fat and lean body mass index to BMI for the identification of metabolic syndrome in children and adolescents. J Clin Endocrinol Metab 2014; 99:3208-16. [PMID: 24926951 PMCID: PMC4154108 DOI: 10.1210/jc.2014-1684] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 06/05/2014] [Indexed: 02/08/2023]
Abstract
CONTEXT The use of body mass index (BMI) to assess risk for cardiometabolic disease in the pediatric population may be limited by a failure to differentiate between fat and lean body mass. OBJECTIVES The objectives of the study were to identify biologically based criteria for the definition of obesity using fat (FMI) and lean body mass index (LBMI) and to compare the ability of FMI and LBMI to BMI to identify the presence of metabolic syndrome (MetSyn). DESIGN This was a cross-sectional study using National Health and Nutrition Examination Survey 1999-2006 data. PARTICIPANTS A total of 3004 participants aged 12-20 years with dual-energy X-ray absorptiometry body composition and fasting laboratory data participated in the study. MAIN OUTCOME MEASURES Adjusted odds ratios for MetSyn according to FMI and LBMI status and area under the curve for the identification of MetSyn were measured. RESULTS Receiver-operating characteristic curve analyses identified the 80th percentile for FMI and the 74th percentile for LBMI as the optimal cut points for the identification of MetSyn. There was no difference in the area under the curve for FMI [0.867; 95% confidence interval (CI) 0.838-0.891] vs BMI (0.868; 95% CI 0.837-0.894) Z-scores for MetSyn discrimination. Separate multivariate regression models identified odds ratios for the identification of MetSyn of 6.2 (95% CI 3.3-11.5) for BMI-Z, 6.4 (95% CI 3.7-11.1) for FMI-Z, and 4.6 (95% CI 3.0-7.1) for LBMI-Z. Models containing both FMI-Z and LBMI-Z revealed that greater LBMI-Z was associated with greater odds of low high-density lipoprotein (1.5; 95% CI 1.2-1.9), high blood pressure (1.8; 95% CI 1.1-2.9), and insulin resistance (1.8; 95% CI 1.4-2.5), independent of FMI-Z. CONCLUSIONS The use of FMI and LBMI does not improve upon BMI for the identification of MetSyn in the pediatric population. Unexpectedly, higher LBMI was associated with greater odds of multiple cardiometabolic risk factors independent of FMI. The use of FMI and LBMI allow for the independent evaluation of relationships between body compartments and disease and warrants future research.
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Affiliation(s)
- David R Weber
- Department of Pediatrics (D.R.W., M.B.L., J.S., B.S.Z.), The Children's Hospital of Philadelphia, and Perelman School of Medicine (M.B.L., J.S., B.S.Z.), University of Pennsylvania, Philadelphia, Pennsylvania 19104
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