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Dorilleau C, Kanagaratnam L, Charlot I, Hittinger A, Bertin E, Salmon JH, Geoffroy M. "The least significant change on bone mineral density scan increased in patients with higher degrees of obesity". Aging Clin Exp Res 2024; 36:98. [PMID: 38652346 DOI: 10.1007/s40520-024-02736-4] [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] [Received: 02/09/2024] [Accepted: 03/15/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND The least significant change (LSC) threshold of 0.03 g/cm² is used to interpret bone mineral density (BMD) scans in the general population. Our working hypothesis was that the current LSC threshold would not be applicable in obese populations. AIMS The aim of this study was to calculate the LSC in an obese population. METHODS We performed an interventional study among 120 obesity patients, in whom two measurements of BMD were performed at 3 sites. Pairs of measures were used to calculate the LSC, using the Bland and Altman method. RESULTS We calculated that the LSC was 0.046 g/cm² at the lumbar spine, 0.069 g/cm² at the femoral neck, and 0.06 g/cm² at the total hip. We also calculated the LSC for each class of obesity and observed an increase in LSC with increasing body mass index (BMI). We calculated a LSC of 0.05 g/cm² in patients with class 2 or class 3 obesity, whereas the LSC in patients with class 1 obesity is similar to the threshold used in the general population. DISCUSSION In obese population, like BMD, LSC is higher than the threshold value of the general population, and increases with increasing BMI. CONCLUSION LSC of 0.05 g/cm² could be used in clinical practice in patients with class 2 or 3 obesity. These findings should help to improve the interpretation of BMD scans in these patients and optimize their management. TRIAL REGISTRATION NUMBER Comité de Protection des Personnes Ile-de France VII, France.
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Affiliation(s)
- Claire Dorilleau
- Rheumatology Department, University Hospital Center of Reims, 45 Rue Cognacq-Jay, Reims, Reims, 51092, France
| | - Lukshe Kanagaratnam
- Department of Clinical Research and Innovation, University Hospital Center of Reims, Reims, France
- Faculty of Medicine, URCA - University of Reims Champagne Ardenne, Reims, France
| | - Isabelle Charlot
- Rheumatology Department, University Hospital Center of Reims, 45 Rue Cognacq-Jay, Reims, Reims, 51092, France
| | - Ambre Hittinger
- Rheumatology Department, University Hospital Center of Reims, 45 Rue Cognacq-Jay, Reims, Reims, 51092, France
| | - Eric Bertin
- Performance, Health, Metrology, Society Laboratory (PSMS, EA 7507) of Reims Champagne-Ardenne University and Clinical Nutrition Transversal Unit (UTNC) of Reims University Hospital, Endocrinology Nutrition Department, University Hospital Center of Reims, Reims, France
- Faculty of Medicine, URCA - University of Reims Champagne Ardenne, Reims, France
| | - Jean-Hugues Salmon
- Rheumatology Department, University Hospital Center of Reims, 45 Rue Cognacq-Jay, Reims, Reims, 51092, France
- Faculty of Medicine, URCA - University of Reims Champagne Ardenne, Reims, France
| | - Marion Geoffroy
- Rheumatology Department, University Hospital Center of Reims, 45 Rue Cognacq-Jay, Reims, Reims, 51092, France.
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Waterfield S, Richardson TG, Davey Smith G, O’Keeffe LM, Bell JA. Life course effects of genetic susceptibility to higher body size on body fat and lean mass: prospective cohort study. Int J Epidemiol 2023; 52:1377-1387. [PMID: 36952292 PMCID: PMC10555894 DOI: 10.1093/ije/dyad029] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 02/27/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND/OBJECTIVES Different genetic variants are associated with larger body size in childhood vs adulthood. Whether and when these variants predominantly influence adiposity are unknown. We examined how genetic variants influence total body fat and total lean mass trajectories. METHODS Data were from the Avon Longitudinal Study of Parents and Children birth cohort (N = 6926). Sex-specific genetic risk scores (GRS) for childhood and adulthood body size were generated, and dual-energy X-ray absorptiometry scans measured body fat and lean mass six times between the ages of 9 and 25 years. Multilevel linear spline models examined associations of GRS with fat and lean mass trajectories. RESULTS In males, the sex-specific childhood and adulthood GRS were associated with similar differences in fat mass from 9 to 18 years; 8.3% [95% confidence interval (CI) 5.1, 11.6] and 7.5% (95% CI 4.3, 10.8) higher fat mass at 18 years per standard deviation (SD) higher childhood and adulthood GRS, respectively. In males, the sex-combined childhood GRS had stronger effects at ages 9 to 15 than the sex-combined adulthood GRS. In females, associations for the sex-specific childhood GRS were almost 2-fold stronger than the adulthood GRS from 9 to 18 years: 10.5% (95% CI 8.5, 12.4) higher fat mass at 9 years per SD higher childhood GRS compared with 5.1% (95% CI 3.2, 6.9) per-SD higher adulthood GRS. In females, the sex-combined GRS had similar effects, with slightly larger effect estimates. Lean mass effect sizes were much smaller. CONCLUSIONS Genetic variants for body size are more strongly associated with adiposity than with lean mass. Sex-combined childhood variants are more strongly associated with increased adiposity until early adulthood. This may inform future studies that use genetics to investigate the causes and impact of adiposity at different life stages.
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Affiliation(s)
- Scott Waterfield
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Cancer Research UK Integrative Cancer Epidemiology Programme, University of Bristol, Bristol, UK
| | - Tom G Richardson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Linda M O’Keeffe
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- School of Public Health, University College Cork, Cork, Ireland
| | - Joshua A Bell
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Lampenius I, Harjutsalo V, Parente EB, Groop PH. Associations between alcohol consumption and body fat distribution in type 1 diabetes. Diabetes Res Clin Pract 2023; 204:110891. [PMID: 37657645 DOI: 10.1016/j.diabres.2023.110891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/01/2023] [Accepted: 08/29/2023] [Indexed: 09/03/2023]
Abstract
AIM To evaluate the associations between alcohol consumption and body fat distribution in type 1 diabetes (T1D). METHODS DXA assessed the body composition of 548 adults with T1D from the Finnish Diabetic Nephropathy Study. Visceral fat mass (VFM) ≥ 0.7% of body weight for women and ≥ 1.1% for men defined central obesity (CO), whereas body fat mass (BFM) ≥ 40.4% for women and ≥ 31.8% for men defined general obesity (GO). Alcohol consumption data were collected via questionnaires. One standard dose = 12 g of pure alcohol. Participants were classified as abstainers, low-risk, moderate-risk and high-risk alcohol consumers. We used linear and logistic regression models for analyses. RESULTS The higher the alcohol consumption the higher the VFM% (r2 = 0.23, β = 0.083, p = 0.04) in both sexes. BFM% presented a similar pattern in men (r2 = 0.12, β = 0.160, p = 0.01), but not in women. One weekly dose increase of alcohol consumption increases the odds of CO by 3% (OR 1.03, p = 0.037), but not GO. The odds of CO (OR 7.3, p = 0.003) and GO (OR 5.3, p = 0.007) increase with high-risk, but not with low- and moderate-risk consumptions. CONCLUSIONS In adults with T1D, alcohol consumption is linearly associated with VFM% regardless of sex, whereas the association with BFM% is sex-dependent.
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Affiliation(s)
- Ina Lampenius
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Valma Harjutsalo
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Erika B Parente
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Per-Henrik Groop
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Diabetes, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
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Parente EB, Ahola AJ, Kumar A, Lehto M, Groop PH. The relationship between FGF23 and body composition according to albuminuria stage in type 1 diabetes. Diabetes Res Clin Pract 2023; 198:110620. [PMID: 36914006 DOI: 10.1016/j.diabres.2023.110620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/28/2023] [Accepted: 03/08/2023] [Indexed: 03/15/2023]
Abstract
AIMS Fibroblast growth factor 23 (FGF23) and obesity are linked to kidney disease. However, the relationship between FGF23 and body composition is unclear. Associations between FGF23 and body composition were investigated in type 1 diabetes from the Finnish Diabetic Nephropathy Study according to albuminuria stages. METHODS Data were available from 306 adults with type 1 diabetes (229 normal albumin excretion rate, T1Dnormo; 38 microalbuminuria, T1Dmicro; 39 macroalbuminuria, T1Dmacro), and 36 controls. Serum FGF23 was measured by ELISA. Body composition was assessed with dual-energy X-ray absorptiometry. Associations between body composition and serum FGF23 were investigated using linear regression models. RESULTS Compared with T1Dnormo, individuals with more advanced kidney disease were older, had longer diabetes duration, higher serum hsCRP, and higher FGF23 concentration. However, FGF23 concentration was comparable between T1Dnormo and controls. Adjusted for potential confounders, in T1Dmicro, FGF23 was positively associated with the percentages of total fat, visceral fat, and android fat tissues, while negative associations between FGF23 and lean tissue were observed. FGF23 was not associated with body composition in T1Dnormo, T1Dmacro, and controls. CONCLUSIONS In type 1 diabetes, the relationship between FGF23 and body composition is dependent on albuminuria stages.
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Affiliation(s)
- Erika B Parente
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Department of Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland
| | - Aila J Ahola
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Department of Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland
| | - Anmol Kumar
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Department of Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland
| | - Markku Lehto
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Department of Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland
| | - Per-Henrik Groop
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Department of Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland; Department of Diabetes, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
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Mesinovic J, Rodriguez AJ, Cervo MM, Gandham A, Xu CL, Glavas C, de Courten B, Zengin A, Ebeling PR, Scott D. Vitamin D supplementation and exercise for improving physical function, body composition and metabolic health in overweight or obese older adults with vitamin D deficiency: a pilot randomized, double-blind, placebo-controlled trial. Eur J Nutr 2023; 62:951-964. [PMID: 36333495 PMCID: PMC9638202 DOI: 10.1007/s00394-022-03038-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Vitamin D supplementation may have non-skeletal health benefits and enhance exercise responsiveness, particularly in those with low vitamin D levels. We determined whether, compared with placebo, vitamin D supplementation taken prior to and during a 12-week exercise program improves physical function, body composition or metabolic health, in overweight and obese older adults with vitamin D deficiency. METHODS Fifty overweight or obese older adults (mean ± SD age: 60 ± 6 years; BMI 30.6 ± 5.7 kg/m2) with vitamin D deficiency (25-hydroxyvitamin D [25(OH)D] < 50 nmol/L) were recruited. Participants were randomly allocated to receive either vitamin D3 (4000 IU/day) or matching placebo for 24 weeks. Between weeks 12 and 24, all participants completed multi-modal exercise three days per week while continuing with vitamin D/placebo. Mean changes in physical function (primary outcome: gait speed), body composition and biochemical parameters at weeks 12 and 24 were compared between groups. RESULTS Vitamin D supplementation, with or without exercise, had no effect on gait speed. From baseline to week 12, vitamin D supplementation increased serum 25(OH)D levels (placebo: 2.5 ± 14.7 nmol/L; treatment: 43.4 ± 18.4 nmol/L; P < 0.001) and reduced stair climb times (placebo: 0.3 ± 1.0 s; treatment: - 0.2 ± 1.0 s; P = 0.046). From 12 to 24 weeks, vitamin D supplementation combined with exercise decreased waist circumference (placebo: 1.3 ± 7.3 cm; treatment: - 3.0 ± 6.1 cm; P = 0.02) and waist-to-hip ratio (placebo: 0.01 ± 0.05; treatment: - 0.03 ± 0.05; P = 0.01) relative to placebo. Vitamin D supplementation, with or without exercise, had no effect on other physical function, body composition or metabolic health outcomes. CONCLUSION Vitamin D supplementation had no effect on most physical function, body composition or metabolic health parameters when taken alone, or during exercise, in overweight or obese older adults with vitamin D deficiency. Vitamin D-related improvements in stair climb times and waist circumference suggest that future trials should explore the effects of vitamin D on muscle power, and its effects on body composition when combined with exercise, in populations with moderate or severe vitamin D deficiency.
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Affiliation(s)
- Jakub Mesinovic
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, VIC, 3068, Australia. .,School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia.
| | - Alexander J. Rodriguez
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, VIC 3068 Australia ,School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | - Mavil May Cervo
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, VIC 3068 Australia
| | - Anoohya Gandham
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, VIC 3068 Australia
| | - Cecilia L.H. Xu
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, VIC 3068 Australia
| | - Costas Glavas
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, VIC 3068 Australia ,School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia
| | - Barbora de Courten
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, VIC 3068 Australia
| | - Ayse Zengin
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, VIC 3068 Australia
| | - Peter R. Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, VIC 3068 Australia
| | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, VIC 3068 Australia ,School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia
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Vikberg S, Björk S, Nordström A, Nordström P, Hult A. Feasibility of an Online Delivered, Home-Based Resistance Training Program for Older Adults – A Mixed Methods Approach. Front Psychol 2022; 13:869573. [PMID: 35726270 PMCID: PMC9206532 DOI: 10.3389/fpsyg.2022.869573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPhysical inactivity and low muscle mass are risk factors for falls, fractures and overall poor health. However, physical activity is reduced with increased age and only a fraction of older adults engages in resistance training (RT). Thus, strategies that facilitate RT among older adults are needed. The aim of the present study was to evaluate the effectiveness and user experience, and explore barriers and motivators toward an online delivered, home-based RT program in older adults with low muscle mass.MethodsThirty men and women, 70–71 years of age with low muscle mass were assigned home-based RT with online exercise videos (3 times/week, 45 min/session for 10 weeks) accompanied with an initial supervised try-out session. Quantitative outcome measures included changes in lean body mass and physical function. Semi structured one-to-one interviews with a subset of the participants (n = 8) were also conducted to generate a greater understanding of the participants experience of the digitally supported RT. The material was transcribed and analyzed with qualitative content analysis.ResultsTwenty-seven participants (90%) completed the trial. Lean body mass increased by 0.39 kg (95% CI: 0.06–0.72, p < 0.05) and chair stand time improved by 1.6 s (95% CI: 0.8–2.3, p < 0.001). No significant improvements were seen for balance or gait speed. The theme “Engaging in Digital Resistance Training with Personal Adaptation Leads to a Sense of Strength and Vitality” captured the participants experience of the intervention, where a sense of how the body was changing toward a more active lifestyle was described. Instructions, feedback, and intrinsic motivation were identified as key elements for compliance.ConclusionThe online delivered RT program for older adults with low muscle mass was feasible based on high compliance, user satisfaction, increased lean mass and improved chair-stand time. The participant experiences may explain the high compliance to the intervention and effects on outcomes. Based on these results, online delivered RT could be an accessible exercise routine for older adults with low muscle mass. More research is needed to verify the present findings and assess changes in a long-term perspective.
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Affiliation(s)
- Sanna Vikberg
- Department of Health Sciences, Swedish Winter Sports Research Centre, Mid Sweden University, Östersund, Sweden
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Sabine Björk
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
- Department of Nursing, Umeå University, Umeå, Sweden
- Umeå School of Sport Sciences, Umeå University, Umeå, Sweden
| | - Anna Nordström
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
- School of Sports Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Peter Nordström
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Andreas Hult
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
- Umeå School of Sport Sciences, Umeå University, Umeå, Sweden
- Department of Community Medicine and Rehabilitation, Section of Sports Medicine, Umeå University, Umeå, Sweden
- *Correspondence: Andreas Hult,
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Murata H, Yagi T, Midorikawa T, Torii S, Takai E, Taguchi M. Comparison between DXA and MRI for the Visceral Fat Assessment in Athletes. Int J Sports Med 2022; 43:625-631. [PMID: 35108730 PMCID: PMC9200478 DOI: 10.1055/a-1717-1619] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The use of dual-energy X-ray absorptiometry (DXA) may be invalid for assessing athletes with larger bodies, larger lean body mass, and thicker trunks. This study compared the athletes' visceral adipose tissue (VAT) assessed using DXA and magnetic resonance imaging (MRI). Eighty-two Japanese male collegiate athletes from 18 sports participated in this study. VAT was assessed using the dual-energy scan that coincided with the 4th lumbar vertebra. The sum of eight magnetic resonance slices corresponding to the region of the dual-energy scan was used for comparison. The VAT volume was higher with the dual-energy scan than with MRI (difference: 35 cm3, p<0.01). A significant correlation was noted between the volumes measured using both modalities (r=0.88, p<0.01). Magnetic resonance-derived volumes less than 600 cm3 showed a stronger significant correlation with dual-energy-derived volumes. However, magnetic resonance-derived VAT volumes exceeding 600 cm3 were not significantly correlated with dual-energy-derived volumes. In conclusion, VAT volumes derived from DXA were larger and significantly correlated with those derived from MRI across a wide range of values. Methods using DXA for assessing the visceral fat volume may require adjustment to estimate abdominal visceral fat volume in athletes, with care taken when using such methods for heavyweight athletes.
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Affiliation(s)
- Hiroko Murata
- Waseda Institute of Sports Nutrition, Waseda University, Tokorozawa, Japan.,Department of Health and Nutrition, Jumonji University, Saitama, Japan
| | - Tomoyoshi Yagi
- Graduate school of Sport Sciences, Waseda University, Saitama, Japan
| | | | - Suguru Torii
- Waseda Institute of Sports Nutrition, Waseda University, Tokorozawa, Japan.,Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Eri Takai
- Waseda Institute of Sports Nutrition, Waseda University, Tokorozawa, Japan.,Sports Medical Center, Japan Institute of Sports Sciences, Tokyo, Japan
| | - Motoko Taguchi
- Waseda Institute of Sports Nutrition, Waseda University, Tokorozawa, Japan.,Faculty of Sport Sciences, Waseda University, Saitama, Japan
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Parente EB, Harjutsalo V, Forsblom C, Groop PH. Waist-Height Ratio and the Risk of Severe Diabetic Eye Disease in Type 1 Diabetes: A 15-Year Cohort Study. J Clin Endocrinol Metab 2022; 107:e653-e662. [PMID: 34508598 PMCID: PMC8764342 DOI: 10.1210/clinem/dgab671] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Obesity prevalence has increased in type 1 diabetes (T1D). However, the relationship between body composition and severe diabetic eye disease (SDED) is unknown. OBJECTIVE To investigate the associations between body composition and SDED in adults with T1D. METHODS From 5401 adults with T1D in the Finnish Diabetic Nephropathy Study, we assessed 3468, and 437 underwent dual-energy X-ray absorptiometry for body composition analysis. The composite outcome was SDED, defined as proliferative retinopathy, laser treatment, antivascular endothelial growth factor treatment, diabetic maculopathy, vitreous hemorrhage, and vitrectomy. Logistic regression analysis evaluated the associations between body composition and SDED. Multivariable Cox regression analysis assessed the associations between the anthropometric measures and SDED. Subgroup analysis was performed by stages of albuminuria. The relevance ranking of each variable was based on the z statistic. RESULTS During a median follow-up of 14.5 (interquartile range 7.8-17.5) years, 886 SDED events occurred. Visceral/android fat ratio was associated with SDED [odds ratio (OR) 1.40, z = 3.13], as well as the percentages of visceral (OR 1.80, z = 2.45) and android fat (OR 1.28, z = 2.08) but not the total body fat percentage. Waist-height ratio (WHtR) showed the strongest association with the SDED risk [hazard ratio (HR) = 1.28, z = 3.73], followed by the waist (HR 1.01, z = 3.03), body mass index (HR 1.03, z = 2.33), and waist-hip ratio (HR 1.15, z = 2.22). The results were similar in normo- and microalbuminuria but not significant in macroalbuminuria. A WHtR ≥ 0.5 increased the SDED risk by 28% at the normo- and microalbuminuria stages. CONCLUSIONS WHtR, a hallmark of central obesity, is associated with SDED in individuals with T1D.
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Affiliation(s)
- Erika B Parente
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Valma Harjutsalo
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- National Institute for Health and Welfare, Helsinki, Finland
| | - Carol Forsblom
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Per-Henrik Groop
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Correspondence: Per-Henrik Groop, MD, DMSc, Folkhälsan Research Center, Biomedicum Helsinki, FIN-00014 University of Helsinki, Finland. E-mail:
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Lundblad MW, Johansson J, Jacobsen BK, Grimsgaard S, Andersen LF, Wilsgaard T, Hopstock LA. Secular and longitudinal trends in body composition: The Tromsø Study, 2001 to 2016. Obesity (Silver Spring) 2021; 29:1939-1949. [PMID: 34523258 DOI: 10.1002/oby.23267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Overweight, defined as excessive fat mass, is a long-standing worldwide public health challenge. Traditional anthropometric measures used to identify overweight and obesity do not assess body composition. The aim of this study was to examine population trends in general and abdominal fat mass during the past two decades. METHODS This study included participants from one or more consecutive surveys of the population-based Tromsø Study, including Tromsø 5 (conducted in 2001, n = 1,662, age 40-84 years), Tromsø 6 (2007-2008, n = 901, age 40-88 years), and Tromsø 7 (2015-2016, n = 3,670, age 40-87 years), with total body dual-energy x-ray absorptiometry scans. Trends in total fat and visceral adipose tissue (VAT) were analyzed by generalized estimation equation models in strata of sex and age groups. RESULTS Total fat and VAT mass increased during 2001 to 2016, with a larger increase during 2007 to 2016 than from 2001 to 2007 and among the youngest age group (40-49 years), particularly in women. Women had higher total fat mass than men, whereas men had higher VAT mass than women. CONCLUSIONS General and abdominal dual-energy x-ray absorptiometry-derived fat mass increased during the past two decades in this general population. Of particular concern is the more pronounced increase in the past decade and in the younger age groups.
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Affiliation(s)
| | - Jonas Johansson
- Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Bjarne K Jacobsen
- Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
- Department of Community Medicine, Centre for Sami Health Research, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Sameline Grimsgaard
- Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | | | - Tom Wilsgaard
- Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Laila A Hopstock
- Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
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10
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Lundblad MW, Jacobsen BK, Johansson J, Grimsgaard S, Andersen LF, Hopstock LA. Anthropometric measures are satisfactory substitutes for the DXA-derived visceral adipose tissue in the association with cardiometabolic risk-The Tromsø Study 2015-2016. Obes Sci Pract 2021; 7:525-534. [PMID: 34631131 PMCID: PMC8488451 DOI: 10.1002/osp4.517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Body mass index (BMI) increases while cardiometabolic risk factors decrease in individuals in high-income countries. This paradoxical observation raises the question of whether current measures of overweight and obesity properly identify cardiometabolic risk. METHODS A total of 3675 participants (59% women) aged 40-84 years with whole-body dual-energy x-ray absorptiometry scans from the seventh survey of the Tromsø Study were included to examine the association between visceral adipose tissue (VAT) in grams and BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Further, their association with single cardiometabolic risk factors (blood pressure, triglycerides, total cholesterol, high-density lipoprotein [HDL] cholesterol, glycated hemoglobin, high-sensitivity C-reactive protein), modified single components from the ATP Ⅲ criteria for metabolic syndrome (hypertension, diabetes, high triglycerides, and low HDL cholesterol), and metabolic syndrome were examined. RESULTS VAT mass was strongly correlated with BMI (r ≥ 0.77), WC (r ≥ 0.80), WHR (r ≥ 0.58), and WHtR (r ≥ 0.78). WC was the strongest predictor for VAT (area under the curve: 0.90). Compared to anthropometric measures, the associations between VAT and metabolic syndrome as well as single components of metabolic syndrome were statistically significantly stronger, but the clinical differences were likely minor. CONCLUSION Although VAT mass showed statistically stronger associations with cardiometabolic risk compared to traditional anthropometrics, the clinical importance was likely small. Simple, clinically available tools seem to satisfactory substitute for VAT to identify cardiometabolic risk.
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Affiliation(s)
- Marie W. Lundblad
- Department of Community MedicineUiT The Arctic University of NorwayTromsøNorway
| | - Bjarne K. Jacobsen
- Department of Community MedicineUiT The Arctic University of NorwayTromsøNorway
- Department of Community MedicineCentre for Sami Health ResearchUiT The Arctic University of NorwayTromsøNorway
| | - Jonas Johansson
- Department of Community MedicineUiT The Arctic University of NorwayTromsøNorway
| | - Sameline Grimsgaard
- Department of Community MedicineUiT The Arctic University of NorwayTromsøNorway
| | | | - Laila A. Hopstock
- Department of Community MedicineUiT The Arctic University of NorwayTromsøNorway
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11
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Parente EB, Dahlström EH, Harjutsalo V, Inkeri J, Mutter S, Forsblom C, Sandholm N, Gordin D, Groop PH. The Relationship Between Body Fat Distribution and Nonalcoholic Fatty Liver in Adults With Type 1 Diabetes. Diabetes Care 2021; 44:1706-1713. [PMID: 34031143 DOI: 10.2337/dc20-3175] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/18/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Obesity, which is associated with nonalcoholic fatty liver (NAFL), has increased among people with type 1 diabetes. Therefore, we explored the associations between body fat distribution and NAFL in this population. RESEARCH DESIGN AND METHODS This study included 121 adults with type 1 diabetes from the Finnish Diabetic Nephropathy (FinnDiane) Study for whom NAFL was determined by magnetic resonance imaging. Body composition was assessed by dual-energy X-ray absorptiometry. Genetic data concerning PNPLA3 rs738409 and TM6SF2 rs58542926 were available as a directly genotyped polymorphism. Associations between body fat distribution, waist-to-height ratio (WHtR), BMI, and NAFL were explored using logistic regression. A receiver operating characteristic (ROC) curve was used to determine the WHtR and BMI thresholds with the highest sensitivity and specificity to detect NAFL. RESULTS Median age was 38.5 (33-43.7) years, duration of diabetes was 21.2 (17.9-28.4) years, 52.1% were women, and the prevalence of NAFL was 11.6%. After adjusting for sex, age, duration of diabetes, and PNPLA3 rs738409, the volume (P = 0.03) and percentage (P = 0.02) of visceral adipose tissue were associated with NAFL, whereas gynoid, appendicular, and total adipose tissues were not. The area under the curve between WHtR and NAFL was larger than BMI and NAFL (P = 0.04). The WHtR cutoff of 0.5 showed the highest sensitivity (86%) and specificity (55%), whereas the BMI of 26.6 kg/m2 showed 79% sensitivity and 57% specificity. CONCLUSIONS Visceral adipose tissue is associated with NAFL in adults with type 1 diabetes, and WHtR may be considered when screening for NAFL in this population.
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Affiliation(s)
- Erika B Parente
- Folkhälsan Research Center, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Abdominal Center, Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Emma H Dahlström
- Folkhälsan Research Center, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Abdominal Center, Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Valma Harjutsalo
- Folkhälsan Research Center, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Abdominal Center, Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,National Institute for Health and Welfare, Helsinki, Finland
| | - Jussi Inkeri
- Folkhälsan Research Center, Helsinki, Finland.,HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Stefan Mutter
- Folkhälsan Research Center, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Abdominal Center, Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Carol Forsblom
- Folkhälsan Research Center, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Abdominal Center, Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Niina Sandholm
- Folkhälsan Research Center, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Abdominal Center, Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Daniel Gordin
- Folkhälsan Research Center, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Abdominal Center, Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Joslin Diabetes Center, Harvard Medical School, Boston, MA
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12
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Henriksen HB, Alavi DH, Blomhoff R. Precision of Lunar Dual-energy X-ray Absorptiometry (iDXA) in measuring body composition among colorectal cancer patients and healthy subjects. Clin Nutr ESPEN 2021; 44:316-323. [PMID: 34330484 DOI: 10.1016/j.clnesp.2021.05.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 05/17/2021] [Accepted: 05/23/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND & AIMS High quality and precise methods are needed when monitoring changes in body composition among colorectal cancer (CRC) patients and healthy subjects. The aim of this study was to estimate precision of the Dual-energy X-ray absorptiometry (Lunar iDXA, GE Healthcare software enCORE version 16) in measuring body composition in CRC patients and healthy subjects. METHODS Precision error of iDXA in measuring body composition was investigated in the current study. Thirty CRC patients and 30 healthy subjects, including both men and women underwent two consecutive whole-body DXA scan with repositioning. Precision estimates of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) in the abdominal region, and total fat mass (FM), fat-free mass (FFM), lean mass (LM), bone mineral density (BMD) and bone mineral content (BMC) were calculated. RESULTS Precision error expressed as coefficient of variation (% CV) of VAT and SAT were estimated to be 3.56% and 3.28% among CRC patients, and 5.30% and 3.46% among healthy subjects. Estimated precision errors for body masses in the total region ranged between 0.49-1.01% and 0.40-0.88% in CRC patients and healthy subjects, respectively. Least significant change (LSC) in VAT mass, SAT mass, FM and LM were 140.9 g, 121.4 g, 637.0 g and 701.0 g, respectively, among CRC patients. Among healthy subjects the LSC in VAT, SAT, FM and LM were 80.93 g, 98.90 g, 484.0 g and 618.0 g, respectively. Only minor and non-significant differences between the two consecutive measurements for each body compartment were observed within both populations, and we found no systematic bias in the distribution of the differences. CONCLUSION The Lunar iDXA demonstrated high precision in body composition measurements among both CRC patients and healthy subjects. Hence, iDXA is a useful tool in clinical following-up and interventions targeted towards changes in body composition.
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Affiliation(s)
- Hege Berg Henriksen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
| | - Dena Helene Alavi
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Rune Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway; Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
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13
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Ballin M, Nordström P, Niklasson J, Nordström A. Associations of Visceral Adipose Tissue and Skeletal Muscle Density With Incident Stroke, Myocardial Infarction, and All-Cause Mortality in Community-Dwelling 70-Year-Old Individuals: A Prospective Cohort Study. J Am Heart Assoc 2021; 10:e020065. [PMID: 33870709 PMCID: PMC8200751 DOI: 10.1161/jaha.120.020065] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/15/2021] [Indexed: 12/13/2022]
Abstract
Background Aging leads to increased visceral adipose tissue (VAT) and reduced skeletal muscle density. To which extent these are associated with the risk of stroke, myocardial infarction (MI), and all-cause mortality in older adults is unknown. Methods and Results A total of 3294 70-year-old individuals (49.6% women) underwent a health examination in Umeå, Sweden, during 2012 to 2018. VAT and muscle density were measured using dual-energy x-ray absorptiometry and peripheral quantitative computed tomography. Cases of stroke, MI, and all-cause mortality were collected through national registers. Cox regressions were used to calculate hazard ratios (HRs) and 95% CIs per SD greater VAT and per SD lower muscle density. During a mean follow-up of 3.6 years, there were 108 cases of stroke or MI, and 97 deaths. Greater VAT (adjusted HR [aHR], 1.56; 95% CI, 1.09-2.22), but not lower muscle density (aHR, 1.14; 95% CI, 0.97-1.34), was associated with increased risk of stroke or MI. Neither VAT (aHR, 0.95; 95% CI, 0.65-1.41) nor muscle density (aHR, 1.11; 95% CI, 0.92-1.34) was associated with all-cause mortality. The association of VAT with stroke or MI was only significant in men (aHR, 1.86; 95% CI, 1.19-2.91) but not women (aHR, 0.60; 95% CI, 0.25-1.42) (Pinteraction=0.038). Conclusions With the limitation of being an observational study, these findings suggest that VAT is an important obesity-related predictor of cardiovascular risk in 70-year-old men, and by implication, that decreasing VAT may potentially reduce their risk of cardiovascular disease.
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Affiliation(s)
- Marcel Ballin
- Unit of Geriatric MedicineDepartment of Community Medicine and RehabilitationUmeå UniversityUmeåSweden
- Section of Sustainable HealthDepartment of Public Health and Clinical MedicineUmeå UniversityUmeåSweden
| | - Peter Nordström
- Unit of Geriatric MedicineDepartment of Community Medicine and RehabilitationUmeå UniversityUmeåSweden
| | - Johan Niklasson
- Unit of Geriatric MedicineDepartment of Community Medicine and RehabilitationUmeå UniversityUmeåSweden
| | - Anna Nordström
- Section of Sustainable HealthDepartment of Public Health and Clinical MedicineUmeå UniversityUmeåSweden
- School of Sport SciencesUiT The Arctic University of NorwayTromsøNorway
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14
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Thamnirat K, Taweerat P, Permpongkosol S, Kamolnate N, Kositwattanarerk A, Utamakul C, Chamroonrat W, Sritara C. Precision and Effects of a Small Meal on DXA-Derived Visceral Adipose Tissue, Appendicular Lean Mass, and Other Body Composition Estimates In Nonobese Elderly Men. J Clin Densitom 2021; 24:308-318. [PMID: 32446653 DOI: 10.1016/j.jocd.2020.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/03/2020] [Accepted: 04/06/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Information on precision errors and the least significant change (LSC) of dual energy X-ray absorptiometry (DXA)-derived body composition estimates is scarce, particularly for the appendicular lean mass (ALM) and appendicular lean mass index (ALMI). Overnight fasting is recommended for body composition measurements but has not been well tolerated by some elderly patients. This study aimed to establish precision errors and LSC values of body composition estimates in all regions-including visceral adipose tissue (VAT) and ALM-and the ALMI to assess the effect of a small meal on body composition and to estimate the changes it incurred. METHODOLOGY Our institutional review board approved the study protocol. Altogether, 36 non-obese men aged ≥60 years, having given written informed consent, underwent body composition assessment after fasting overnight except for water. They underwent DXA scans three times, each time with repositioning (to simulate the clinical setting), the last after consuming a standardized meal (210-250 g and 200 cc of water). RESULTS Precision errors and LSC values of DXA-derived body composition estimates in these elderly men tended to be higher than those in reports on younger subjects. Coefficients of variation (CVs (%)) of total bone mass (Tb.BMC) and total lean mass (Tb.LM) were <1%, whereas those of total fat mass (Tb.FM) and total %fat mass (Tb.%FM) were <2%, with LSCs of 45.8 g, 706.52 g, 731.4 g, and 1.15%, respectively. The CVs (LSC) of VAT, ALM, and ALMI were 8.9% (150.65 g), 0.93% (501 g), and 0.94% (0.19), respectively. After meal consumption, the mean changes in Tb.FM, Tb.BMC, and Tb.LM were -100, -8.2, and 440 g, respectively. CONCLUSIONS Effects of a small meal on most parameters were trivial, including those for VAT, ALM, and ALMI, where changes were not statistically significant. None exceeded the LSC of ALM and ALMI, suggesting that a small meal is allowable before these measurements.
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Affiliation(s)
- Kanungnij Thamnirat
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pollawat Taweerat
- Department of Diagnostic Radiology and Nuclear Medicine, Suratthani Cancer Hospital, Suratthani, Thailand
| | - Sompol Permpongkosol
- Department of Surgery, Faculty of Medicine Ramathibodi Hospital Mahidol University, Bangkok, Thailand
| | - Natechanok Kamolnate
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Arpakorn Kositwattanarerk
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chirawat Utamakul
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wichana Chamroonrat
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chanika Sritara
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
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15
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Age- and sex-specific visceral fat reference cutoffs and their association with cardio-metabolic risk. Int J Obes (Lond) 2021; 45:808-817. [PMID: 33473174 DOI: 10.1038/s41366-021-00743-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 10/27/2020] [Accepted: 01/04/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Although excess visceral fat (VAT) is associated with numerous cardio-metabolic risk factors, measurement of this fat depot has historically been difficult. Recent dual X-ray absorptiometry approaches have provided an accessible estimate of VAT that has shown acceptable validity against gold standard methods. The aims of this study were to (i) evaluate DXA measured VAT as a predictor of elevated blood lipids and blood pressure and (ii) calculate thresholds associated with these cardio-metabolic risk factors. SUBJECTS/METHODS The sample comprised 1482 adults (56.4% women) aged 18-66 years. Total body scans were performed using a GE Lunar Prodigy, and VAT analyses were enabled through Corescan software (v 16.0). Blood pressure and blood lipids were measured by standard procedures. Regression models assessed how VAT mass was associated with each cardio-metabolic risk factor compared to other body composition measures. Measures of sensitivity and specificity were used to determine age- and sex-specific cut points for VAT mass associated with high cardio-metabolic risk. RESULTS Similar to waist circumference, VAT mass was a strong predictor of cardio-metabolic risk especially in men over age 40. Four cut-offs for VAT mass were proposed, above which the cardio-metabolic risk increased: 700 g in women <40 yrs; 800 g in women 40+ yrs; 1000g in men <40 yrs; and 1200 g in men 40+ yrs. In general, these cut-offs discriminated well between those with high and low cardio-metabolic risk. CONCLUSIONS In both sexes, DXA measured VAT was associated with traditional cardio-metabolic risk factors, particularly high blood pressure in those 40+ yrs and low HDL < 40 yrs. These reference values provide a simple, accessible method to assess cardio-metabolic risk in adults.
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16
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Waist-height ratio and waist are the best estimators of visceral fat in type 1 diabetes. Sci Rep 2020; 10:18575. [PMID: 33122731 PMCID: PMC7596092 DOI: 10.1038/s41598-020-75667-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 10/01/2020] [Indexed: 02/08/2023] Open
Abstract
Visceral fat is associated with cardiovascular and kidney disease. However, the relationship between body composition and anthropometric measures in type 1 diabetes is unknown. Using z-statistics, we ranked the ability of body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), waist-height ratio (WHtR) and a body shape index (ABSI) to capture measures of body composition from 603 Dual-energy-X-Ray-Absorptiometry scans of adults with type 1 diabetes. Albuminuria was defined as urinary albumin excretion rate of at least 30 mg/24 h. Women with albuminuria had higher visceral fat mass % (VFM%) (0.9 vs. 0.5%, p = 0.0017) and lower appendicular lean mass % (AppLM%) (25.4 vs 26.4%, p = 0.03) than those without. Men with albuminuria had higher VFM% (1.5 vs. 1.0%, p = 0.0013) and lower AppLM% (30.0 vs 32.3, p < 0.0001) than those without. In men, WHtR estimated VFM% best (z-statistics = 21.1), followed by WC (z = 19.6), BMI (z = 15.1), WHR (z = 14.6) and ABSI (z = 10.1). In women, the ranking was WC (z = 28.9), WHtR (z = 27.3), BMI (z = 20.5), WHR (z = 12.7) and ABSI (z = 10.5). Overall, the ranking was independent of albuminuria. Adults with type 1 diabetes and albuminuria have greater VFM% and lower AppLM% than those without. WHtR and WC best estimate the VFM% in this population, independently of albuminuria and sex.
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17
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Goldberg EK, Fung EB. Precision of the Hologic DXA in the Assessment of Visceral Adipose Tissue. J Clin Densitom 2020; 23:664-672. [PMID: 30992223 PMCID: PMC6754313 DOI: 10.1016/j.jocd.2019.03.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/15/2019] [Accepted: 03/18/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Visceral fat, also known as visceral adipose tissue (VAT), has been the focus of intensive research over the past several yr, as ground breaking studies have investigated its possible role in predicting long-term cardiac dysfunction, hypertension, and diabetes. Historically, magnetic resonance imaging and computed tomography were the instruments of choice for visceral fat quantification. However, with the introduction of visceral fat assessment software for Dual-energy X-ray Absorptiometry (DXA) scanners, DXA's use for VAT assessment has become increasingly common. To effectively utilize DXA in future VAT research studies, information about their precision and accuracy must be known. This study provides novel information regarding the precision of the Hologic Horizon DXA scanner in the assessment of VAT. METHODS Sixty individuals (32.7 ± 17.1 yr, 51% male, 40% with body mass index (BMI) > 25 kg/m2) above the age of 16 years were recruited to participate in this study. Subjects found to be pregnant, have a lumbar vertebral compression fracture, nonremovable metal implants in the abdomen, or scoliosis/lordosis/kyphosis were excluded from the study. All subjects underwent 3 consecutive whole body scans on a Hologic Horizon A DXA scanner. RESULTS VAT mass ranged from 102 g to 1454 g. VAT precision improved with increasing BMI (p = 0.025): coefficient of variation (%CV) was 15.2% for underweight subjects (n = 2), 7.1% for healthy subjects (n = 34), 6.4% for overweight subjects (n = 18), and 4.7% for obese subjects (n = 6). CONCLUSIONS VAT measurement by Hologic DXA displays a satisfactory level of precision in individuals with a BMI of >18.5 kg/m2. Precision was found to be higher in those with the greatest risk of cardio-metabolic dysfunction (individuals with high VAT). Due to its low cost, brief examination time, noninvasiveness, and limited radiation exposure, DXA may be considered the tool of choice for VAT determination in future studies.
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Affiliation(s)
| | - Ellen B Fung
- Children's Hospital Oakland Research Institute, Oakland, CA, USA; Department of Hematology, UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA.
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18
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Comparison of abdominal visceral adipose tissue measurements in adolescents between magnetic resonance imaging and dual-energy X-ray absorptiometry. Int J Obes (Lond) 2020; 45:104-108. [PMID: 32499526 PMCID: PMC7714708 DOI: 10.1038/s41366-020-0621-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/05/2020] [Accepted: 05/22/2020] [Indexed: 11/08/2022]
Abstract
Excess abdominal visceral adipose tissue (VAT) is associated with cardiometabolic risk factors in adolescents. VAT is mainly measured using Magnetic Resonance Imaging (MRI), yet dual-energy x-ray absorptiometry (DXA) is more affordable and available. The purpose was to compare adolescent VAT values obtained by MRI and DXA. A sample of 330 adolescents 10-16 years of age were recruited (52.3% female, 58.5% White). Abdominal VAT was measured using a General Electric (GE) Discovery MRI scanner with imaging software. A whole-body DXA (GE iDXA) scan was performed, and software calculated VAT within the android region. Wilcoxon signed-rank t-tests were used to determine differences between VAT values, within sex, race (White, African American, and Other race), and BMI categories (normal weight, overweight, and obese). VAT values from MRI and DXA were significantly correlated (r = 0.78, p < 0.001). Average VAT from MRI (0.54 ± 0.43 kg) was significantly higher than VAT from DXA (0.33 ± 0.39 kg) in the overall sample (p < 0.001) and within all subgroups (p < 0.001). All standardized values between the two measurements fell within ±1.96 standard deviations, and differences between the methods were not associated with level of VAT. In this sample, DXA values were correlated with MRI values, but DXA consistently underestimated VAT compared with MRI.
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19
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Ballin M, Hult A, Björk S, Lundberg E, Nordström P, Nordström A. Web-based exercise versus supervised exercise for decreasing visceral adipose tissue in older adults with central obesity: a randomized controlled trial. BMC Geriatr 2020; 20:173. [PMID: 32398024 PMCID: PMC7216357 DOI: 10.1186/s12877-020-01577-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 05/06/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Visceral adipose tissue (VAT) is a strong risk factor for cardiovascular disease and increases with age. While supervised exercise (SE) may be an effective approach, web-based exercise (WE) have other advantages such as being more readily accessible. Therefore, we evaluated the effects of WE on VAT, body composition and cardiometabolic risk markers in centrally obese older adults and compared the effects of WE to SE. We also explored the feasibility of WE. METHODS In a randomized controlled trial conducted in Umeå, Sweden during January 2018 - November 2018, N = 77, 70-year-old men and women with central obesity (> 1 kg VAT for women, > 2 kg for men) were randomized to an intervention group (n = 38) and a wait-list control group (n = 39). The intervention group received 10 weeks of SE while the wait-list control group lived as usual. Following a 10-week wash-out-period, the wait-list control group received 10 weeks of WE. The primary outcome was changes in VAT. Secondary outcomes included changes in fat mass (FM), lean body mass (LBM), blood lipids, fasting blood glucose. Additionally, we explored the feasibility of WE defined as adherence and participant experiences. RESULTS WE had no significant effect on VAT (P = 0.5), although it decreased FM by 450 g (95% confidence interval [CI], 37 to 836, P < 0.05). The adherence to WE was 85% and 87-97% of the participants rated aspects of the WE intervention > 4 on a scale of 1-5. Comparing SE to WE, there was no significant difference in decrease of VAT (Cohen's δ effect size [ES], 0.5, 95% CI, - 24 to 223, P = 0.11), although SE decreased FM by 619 g (ES, 0.5, 95% CI, 22 to 1215, P < 0.05) compared to WE. CONCLUSIONS Ten weeks of vigorous WE is insufficient to decrease VAT in centrally obese older adults, but sufficient to decrease FM while preserving LBM. The high adherence and positive experiences of the WE intervention implies that it could serve as an alternative exercise strategy for older adults with central obesity, with increased availability for a larger population. TRIAL REGISTRATION ClinicalTrials.gov (NCT03450655), retrospectively registered February 28, 2018.
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Affiliation(s)
- Marcel Ballin
- Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, 901 87, Umeå, Sweden. .,Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.
| | - Andreas Hult
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.,Department of Community Medicine and Rehabilitation, Section of Sports Medicine, Umeå University, Umeå, Sweden
| | - Sabine Björk
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.,Umeå School of Sport Sciences, Umeå University, Umeå, Sweden
| | - Emmy Lundberg
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Peter Nordström
- Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, 901 87, Umeå, Sweden
| | - Anna Nordström
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.,School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Jospe MR, Roy M, Brown RC, Haszard JJ, Meredith-Jones K, Fangupo LJ, Osborne H, Fleming EA, Taylor RW. Intermittent fasting, Paleolithic, or Mediterranean diets in the real world: exploratory secondary analyses of a weight-loss trial that included choice of diet and exercise. Am J Clin Nutr 2020; 111:503-514. [PMID: 31879752 DOI: 10.1093/ajcn/nqz330] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 12/11/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Intermittent fasting (IF) and Paleolithic (Paleo) diets produce weight loss in controlled trials, but minimal evidence exists regarding long-term efficacy under free-living conditions without intense dietetic support. OBJECTIVES This exploratory, observational analysis examined adherence, dietary intake, weight loss, and metabolic outcomes in overweight adults who could choose to follow Mediterranean, IF, or Paleo diets, and standard exercise or high-intensity interval training (HIIT) programs, as part of a 12-mo randomized controlled trial investigating how different monitoring strategies influenced weight loss (control, daily self-weighing, hunger training, diet/exercise app, brief support). METHODS A total of 250 overweight [BMI (in kg/m2) ≥27] healthy adults attended an individualized dietary education session (30 min) relevant to their self-selected diet. Dietary intake (3-d weighed diet records), weight, body composition, blood pressure, physical activity (0, 6, and 12 mo), and blood indexes (0 and 12 mo) were assessed. Mean (95% CI) changes from baseline were estimated using regression models. No correction was made for multiple tests. RESULTS Although 54.4% chose IF, 27.2% Mediterranean, and 18.4% Paleo diets originally, only 54% (IF), 57% (Mediterranean), and 35% (Paleo) participants were still following their chosen diet at 12 mo (self-reported). At 12 mo, weight loss was -4.0 kg (95% CI: -5.1, -2.8 kg) in IF, -2.8 kg (-4.4, -1.2 kg) in Mediterranean, and -1.8 kg (-4.0, 0.5 kg) in Paleo participants. Sensitivity analyses showed that, due to substantial dropout, these may be overestimated by ≤1.2 kg, whereas diet adherence increased mean weight loss by 1.1, 1.8, and 0.3 kg, respectively. Reduced systolic blood pressure was observed with IF (-4.9 mm Hg; -7.2, -2.6 mm Hg) and Mediterranean (-5.9 mm Hg; -9.0, -2.7 mm Hg) diets, and reduced glycated hemoglobin with the Mediterranean diet (-0.8 mmol/mol; -1.2, -0.4 mmol/mol). However, the between-group differences in most outcomes were not significant and these comparisons may be confounded due to the nonrandomized design. CONCLUSIONS Small differences in metabolic outcomes were apparent in participants following self-selected diets without intensive ongoing dietary support, even though dietary adherence declined rapidly. However, results should be interpreted with caution given the exploratory nature of analyses. This trial was registered with the Australian New Zealand Clinical Trials Registry as ACTRN12615000010594 at https://www.anzctr.org.au.
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Affiliation(s)
- Michelle R Jospe
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Melyssa Roy
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Rachel C Brown
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | | | | | - Louise J Fangupo
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Hamish Osborne
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
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Triggiani AI, Valenzano A, Trimigno V, Di Palma A, Moscatelli F, Cibelli G, Messina G. Heart rate variability reduction is related to a high amount of visceral adiposity in healthy young women. PLoS One 2019; 14:e0223058. [PMID: 31553779 PMCID: PMC6760781 DOI: 10.1371/journal.pone.0223058] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 09/12/2019] [Indexed: 12/19/2022] Open
Abstract
Several heart rate variability (HRV) studies show abnormalities in autonomic nervous control in obese and overweight subjects. However, some of the results appear to be controversial. Here we investigate the HRV profile in seventy adult normotensive women and its association with general and visceral adiposity. Specifically, we recorded the electrocardiographic (ECG) activity in subjects during a supine resting state for five minutes in a quiet room late in the morning. Total fat mass (TFM) and visceral adipose tissue (VAT) were instead estimated using dual-energy X-ray absorptiometry (DXA). Finally, we used simple a linear regression analysis of frequency and time-domain parameters to study the relationship between HRV and adiposity. Our data showed an overall reduction of the HRV related to an increase of TFM although this regression appeared significant only for high frequencies (HF). When the linear regression was applied between HRV variables and VAT, the slope of the line increases, thus unveiling a statistically significant relation (i.e. the more VAT, the lower HRV). Finally, a control analysis showed that age does not alter the relation between HRV and VAT when used as a confounding factor in multiple regression. To conclude, these findings point to abnormal activity of the autonomic nervous system (ANS) in subjects with an excess of VAT and represent a starting point to determine a non-invasive index of cardiac wellness for clinical and nutritional application.
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Affiliation(s)
- Antonio Ivano Triggiani
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
- * E-mail:
| | - Anna Valenzano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Valentina Trimigno
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonella Di Palma
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Fiorenzo Moscatelli
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giuseppe Cibelli
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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22
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Ballin M, Lundberg E, Sörlén N, Nordström P, Hult A, Nordström A. Effects of Interval Training on Visceral Adipose Tissue in Centrally Obese 70-Year-Old Individuals: A Randomized Controlled Trial. J Am Geriatr Soc 2019; 67:1625-1631. [PMID: 31012497 DOI: 10.1111/jgs.15919] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 03/13/2019] [Accepted: 03/13/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To investigate the effects of 10 weeks of progressive vigorous-intensity interval training as a single intervention on body composition among 70-year-old individuals with central obesity. DESIGN Randomized controlled trial (ClinicalTrials.gov registration No. NCT03450655). SETTING Community-dwelling 70-year-old men and women living in the Umeå municipality in Sweden. PARTICIPANTS Seventy-seven 70-year-old men and women with central obesity (greater than 1 kg visceral adipose tissue [VAT] for women and greater than 2 kg VAT for men). INTERVENTION Participants allocated to the intervention group were offered a 10-week progressive concurrent exercise program performed three times per week. All participants in both groups had received tailored lifestyle recommendations focused on diet and physical activity at one occasion within 12 months prior to trial initiation. MEASUREMENTS The primary outcome was changes in VAT, and secondary outcomes included changes in total fat mass (FM), total lean body mass (LBM), and body mass index. RESULTS Comparing the groups, there were no significant differences in decrease of VAT mass (P = .10), although the intervention group significantly decreased FM by 716 g (P = .01) and gained LBM by 508 g (P = .03), compared to the control group. Furthermore, the effects of the training were significantly greater in the male subcohort (P < .05 for interaction), with positive effects also on VAT and FM, where men in the intervention group decreased VAT by 175 g (P < .05) and FM by 1364 g (P = .004), compared to the male controls. CONCLUSIONS The present trial demonstrates that 10 weeks of progressive vigorous interval training is sufficient to significantly decrease FM in older adults with central obesity, with positive effects also on LBM. J Am Geriatr Soc 67:1625-1631, 2019.
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Affiliation(s)
- Marcel Ballin
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.,Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Emmy Lundberg
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.,Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Niklas Sörlén
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.,Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Peter Nordström
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Andreas Hult
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Anna Nordström
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.,Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden.,School of Sport Sciences, The Arctic University of Norway, Tromsø, Norway
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