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Ashby-Thompson M, Heshka S, Rizkalla B, Zurlo R, Lemos T, Janumala I, Goodpaster B, DeLany J, Courcoulas A, Strain G, Pomp A, Kang P, Lin S, Thornton J, Gallagher D. Validity of dual-energy x-ray absorptiometry for estimation of visceral adipose tissue and visceral adipose tissue change after surgery-induced weight loss in women with severe obesity. Obesity (Silver Spring) 2022; 30:1057-1065. [PMID: 35384351 PMCID: PMC10001428 DOI: 10.1002/oby.23415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/08/2022] [Accepted: 02/22/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Reliable and simple methods to quantify visceral adipose tissue (VAT) and VAT changes are needed. This study investigated the validity of dual-energy x-ray absorptiometry (DXA) compared with magnetic resonance imaging (MRI) for estimating VAT cross sectionally and longitudinally after surgery-induced weight loss in women with severe obesity. METHODS Women with obesity (n = 36; mean age 43 [SD 10] years; 89% White) with DXA and MRI before bariatric surgery (T0) at 12 (T12) and 24 months (T24) post surgery were included. CoreScan (GE Healthcare, Chicago, Illinois) estimated VAT from 20% of the distance between the top of the iliac crest and the base of the skull. MRI VAT (total VAT) was measured from the base of the heart to the sacrum/coccyx on a whole-body scan. RESULTS Mean DXA VAT was 45% of MRI VAT at T0, 46% at T12, and 68% at T24. DXA underestimated change in MRI VAT between T0 and T12 by 26.1% (0.81 kg, p = 0.03) and by 71.7% (0.43 kg, p < 0.001) between T12 and T24. The relationship between DXA VAT and MRI VAT differed between T12 and T24 (p value for interaction = 0.03). CONCLUSIONS CoreScan lacks validity for comparing VAT across individuals or for estimating the size of changes within individuals; however, within the limits of measurement error, it may provide a useful indicator of whether some VAT change has occurred within an individual.
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Affiliation(s)
- Maxine Ashby-Thompson
- New York Nutrition Obesity Research Center, Columbia University Medical Center, New York, New York, USA
- Division of Molecular Genetics, Deparent of Pediatrics, Columbia University Irving Medical Center, Columbia University, New York, New York, USA
| | - Stanley Heshka
- New York Nutrition Obesity Research Center, Columbia University Medical Center, New York, New York, USA
| | - Bridgette Rizkalla
- New York Nutrition Obesity Research Center, Columbia University Medical Center, New York, New York, USA
- Division of Endocrinology, Dept. of Medicine, Columbia University Medical Center, New York, New York, USA
| | - Rosalie Zurlo
- Division of Endocrinology, Dept. of Medicine, Columbia University Medical Center, New York, New York, USA
- Morsani College of Medicine, University of South Florida, Tampa, FL
| | - Thaisa Lemos
- New York Nutrition Obesity Research Center, Columbia University Medical Center, New York, New York, USA
| | - Isaiah Janumala
- New York Nutrition Obesity Research Center, Columbia University Medical Center, New York, New York, USA
| | - Bret Goodpaster
- AdventHealth Orlando, Translational Research Institute, Orlando, Florida, USA
| | - James DeLany
- AdventHealth Orlando, Translational Research Institute, Orlando, Florida, USA
| | - Anita Courcoulas
- Deparent of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Gladys Strain
- Division of Metabolic and Bariatric Surgery, Weill Cornell Medical College, New York, New York, USA
| | - Alfons Pomp
- Deparent of Surgery, University of Montréal, Montréal Quebec, Canada
| | - Patrick Kang
- New York Radiology Partners, New York, New York, USA
| | - Susan Lin
- New York Nutrition Obesity Research Center, Columbia University Medical Center, New York, New York, USA
- Center for Family and Community Medicine, Columbia University Medical Center, Columbia University, New York, New York, USA
| | - John Thornton
- New York Nutrition Obesity Research Center, Columbia University Medical Center, New York, New York, USA
| | - Dympna Gallagher
- New York Nutrition Obesity Research Center, Columbia University Medical Center, New York, New York, USA
- Division of Endocrinology, Dept. of Medicine, Columbia University Medical Center, New York, New York, USA
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Kiconco S, Teede HJ, Earnest A, Loxton D, Joham AE. Menstrual cycle regularity as a predictor for heart disease and diabetes: Findings from a large population-based longitudinal cohort study. Clin Endocrinol (Oxf) 2022; 96:605-616. [PMID: 34817084 DOI: 10.1111/cen.14640] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/25/2021] [Accepted: 11/13/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Menstrual cycle regularity underpins the diagnosis of polycystic ovary syndrome (PCOS), which is linked to adverse cardio-metabolic profile. However, links between menstrual disorders and metabolic conditions are often under-appreciated and not considered when assessing cardio-metabolic risk in women. We aimed to assess the risk of diabetes and heart disease in women with irregular menstrual cycles and those whose cycles were regular. METHODS This was a community based longitudinal cohort study. We utilized the 1946 to 1951 birth cohort database (N = 13,714) of the Australian Longitudinal Study on Women's Health (ALSWH) over a 20-year follow-up period. Data were analysed using Cox regression models. RESULTS Women with irregular menstrual cycles had 20% higher risk of developing heart disease [adjusted hazard ratio [HR]: 1.20, 95% confidence interval [CI]: 1.01-1.43) compared with those with regular menstrual cycles. We also observed 17% higher risk of diabetes (HR: 1.17, 95% CI: 1.00-1.38) in women who had irregular menstrual cycles than in women who had regular menstrual cycles. The diabetes risk was 30% higher (HR: 1.30, 95% CI: 1.09-1.55) if women had irregular cycles and did not use hormone replacement therapy, but this was not significant on adjustment for all covariates. CONCLUSION Having irregular menstrual cycles appears to be an early indicator for heart disease and diabetes. These findings suggest that irregular cycles among women in their forties may be linked to adverse cardio-metabolic outcomes. These women may benefit from screening and prevention strategies as recommended by related guidelines such as the international evidence-based guideline for the assessment and management of PCOS.
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Affiliation(s)
- Sylvia Kiconco
- School of Public Health and Preventive Medicine, Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Helena J Teede
- School of Public Health and Preventive Medicine, Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
- Department of Endocrinology and Diabetes, Monash Health, Clayton, Victoria, Australia
| | - Arul Earnest
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Deborah Loxton
- Research Centre for Generational Health and Ageing, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Anju E Joham
- School of Public Health and Preventive Medicine, Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
- Department of Endocrinology and Diabetes, Monash Health, Clayton, Victoria, Australia
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Abdominal obesity and association with sociodemographic, behavioral and clinical data in climacteric women assisted in primary care. PLoS One 2020; 15:e0237336. [PMID: 32790774 PMCID: PMC7425907 DOI: 10.1371/journal.pone.0237336] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 07/23/2020] [Indexed: 12/02/2022] Open
Abstract
This study aims to investigate the prevalence and factors associated with abdominal obesity in climacteric women assisted at Family Health Strategy units of the city of Montes Claros, State of Minas Gerais, Brazil. It is a cross-sectional analytical study. The women were selected by probabilistic sampling from August 2014 to August 2015. A questionnaire containing information referring to sociodemographic and economic characteristics, behavioral characteristics and clinical data was used. To estimate abdominal obesity, the measure of circumference ≥ 88 cm was considered. To analyze the association between abdominal obesity and the independent variables, a bivariate analysis was performed by means of Pearson’s chi-square test (p≤0.25). Subsequently, a multiple Poisson regression analysis with robust variance was performed, through which prevalence ratios with level of significance of 5% (p<0.05) were obtained. A total of 805 women were evaluated, aged 40 to 65 years, and the prevalence of women with abdominal obesity was 62.4%. The mean and median of abdominal circumference were 93.0 cm. The associated variables were being sedentary (PR = 1.44) or irregularly active (PR = 1.39), presenting altered total cholesterol (PR = 1.21), and being hypertensive (PR = 1.31). The abdominal obesity in climacteric women was associated with physical inactivity, total cholesterol and arterial hypertension. The measurement of abdominal circumference must be valued and adopted in the routine of professionals who work in Primary Care.
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Gudmundsdottir SL, Flanders WD, Augestad LB. Physical activity and cardiovascular risk factors at menopause: the Nord-Trøndelag health study. Climacteric 2013; 16:438-46. [PMID: 23347190 DOI: 10.3109/13697137.2013.768231] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Lowered physical activity levels may partially explain changes in metabolic risk factors in women after menopause. OBJECTIVES To evaluate the association between physical activity and metabolic risk factors at baseline and after 11 years, as well as the change in that association over time in women who were premenopausal and ≥ 40 years at baseline. METHODS Subjects in a Norwegian population-based health survey answered questionnaires and had body and serum measurements during 1995-1997 (HUNT 2) and in a follow-up study during 2006-2008 (HUNT 3). Repeated-measures analyses were used to estimate the association between physical activity and metabolic factors, adjusting for age, smoking status, education, alcohol intake, and parity. Adjustment for hormonal treatment and medication was made, as appropriate. RESULTS In women remaining premenopausal, a higher physical activity score in HUNT 3 was associated with lower weight (p < 0.01) and waist-hip ratio (p < 0.01) and higher high density lipoprotein (HDL) cholesterol in HUNT 3 (p < 0.01). In women that were postmenopausal by the time of follow-up, a higher physical activity score in HUNT 3 was associated with lower weight (p < 0.01), waist-hip ratio (p < 0.01), triglycerides (p < 0.01), and higher total cholesterol (p < 0.05), HDL cholesterol (p < 0.01), and diastolic blood pressure (p < 0.05) in HUNT 3. The association of total physical activity score with weight and waist-hip ratio was stronger in HUNT 3 than in HUNT 2 (p < 0.01). CONCLUSION Increased physical activity may reduce the risk of adverse outcomes and use of pharmacological management in women of menopausal age.
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Affiliation(s)
- S L Gudmundsdottir
- Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
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