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Starkoff BE, Nickerson BS. Emergence of imaging technology beyond the clinical setting: Utilization of mobile health tools for at-home testing. Nutr Clin Pract 2024; 39:518-529. [PMID: 38591753 DOI: 10.1002/ncp.11151] [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: 12/19/2023] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 04/10/2024] Open
Abstract
Body composition assessment plays a pivotal role in understanding health, disease risk, and treatment efficacy. This narrative review explores two primary aspects: imaging techniques, namely ultrasound (US) and dual-energy x-ray absorptiometry (DXA), and the emergence of artificial intelligence (AI) and mobile health apps in telehealth for body composition. Although US is valuable for assessing subcutaneous fat and muscle thickness, DXA accurately quantifies bone mineral content, fat mass, and lean mass. Despite their effectiveness, accessibility and cost remain barriers to widespread adoption. The integration of AI-powered image analysis may help explain tissue differentiation, whereas mobile health apps offer real-time metabolic monitoring and personalized feedback. New apps such as MeThreeSixty and Made Health and Fitness offer the advantages of clinic-based imaging techniques from the comfort of home. These innovations hold the potential for individualizing strategies and interventions, optimizing clinical outcomes, and empowering informed decision-making for both healthcare professionals and patients/clients. Navigating the intricacies of these emerging tools, critically assessing their validity and reliability, and ensuring inclusivity across diverse populations and conditions will be crucial in harnessing their full potential. By integrating advancements in body composition assessment, healthcare can move beyond the limitations of traditional methods and deliver truly personalized, data-driven care to optimize well-being.
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Affiliation(s)
- Brooke E Starkoff
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Brett S Nickerson
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA
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2
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Alja'nini Z, McNelis KM, Viswanathan S, Goddard GR, Merlino-Barr S, Collin M, Groh-Wargo S. Infant body composition assessment in the neonatal intensive care unit (NICU) using air displacement plethysmography: Strategies for implementation into clinical workflow. Clin Nutr ESPEN 2021; 43:212-222. [PMID: 34024517 DOI: 10.1016/j.clnesp.2021.04.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 04/03/2021] [Accepted: 04/10/2021] [Indexed: 11/19/2022]
Abstract
Nutritional management is integral to infant care in the neonatal intensive care unit (NICU). Recent research on body composition that specifically evaluated fat and fat-free mass has improved our understanding of infant growth and nutritional requirements. The need for body composition monitoring in infants is increasingly recognized as changes in fat mass and fat-free mass associated with early growth can impact clinical outcomes. With the availability of air displacement plethysmography (ADP) as a noninvasive method for assessing infant body composition and published normative gestational age- and sex-specific body composition curves, it is justifiable to integrate this innovation into routine clinical care. Here we describe our experiences in implementing body composition measurement using ADP in routine clinical care in different NICU settings.
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Affiliation(s)
- Zaineh Alja'nini
- Department of Pediatrics, MetroHealth Medical Center Affiliated with Case Western Reserve University, Cleveland, OH, USA.
| | - Kera Michelle McNelis
- Cincinnati Children's Hospital Medical Center, Department of Pediatrics, Perinatal Institute, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Sreekanth Viswanathan
- Division of Neonatology, Department of Pediatrics, Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando, FL, USA
| | - Gillian R Goddard
- Division of Pediatric and General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Stephanie Merlino-Barr
- Department of Pediatrics, MetroHealth Medical Center Affiliated with Case Western Reserve University, Cleveland, OH, USA
| | - Marc Collin
- Department of Pediatrics, MetroHealth Medical Center Affiliated with Case Western Reserve University, Cleveland, OH, USA
| | - Sharon Groh-Wargo
- Department of Pediatrics, MetroHealth Medical Center Affiliated with Case Western Reserve University, Cleveland, OH, USA
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3
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The role of body composition assessment in obesity and eating disorders. Eur J Radiol 2020; 131:109227. [DOI: 10.1016/j.ejrad.2020.109227] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/29/2020] [Accepted: 08/14/2020] [Indexed: 12/12/2022]
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4
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Simoni P, Guglielmi R, Aparisi Gómez MP. Imaging of body composition in children. Quant Imaging Med Surg 2020; 10:1661-1671. [PMID: 32742959 DOI: 10.21037/qims.2020.04.06] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Overweight and obesity in children and adolescents have become a worldwide public health concern with an ever-increasing prevalence. An excessive accumulation of intraabdominal fat tissue increases the risk of developing insulin resistance, diabetes, and cardiovascular diseases in adulthood. Body composition has a role in metabolism regulation in children and adolescents with differences between genders and age groups. Until recently, Air Displacement Plethysmography and Dual-energy X-ray Absorptiometry (DXA) have been the most common techniques used to assess body composition in children. Ultrasound (US) is an accurate, readily available, and radiation-free technique to quantify intra-abdominal fat in adults, but its use in children has not yet been validated. Computed tomography (CT) is a reliable tool to assess body composition, but its use in children should be avoided due to the significant radiation burden. Quantitative Magnetic Resonance Imaging (qMRI) provides an accurate measurement of body composition, through the quantification of the visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and brown adipose tissue (BAT), as well as lean mass. Furthermore, qMRI provides other significant estimates such as the Proton Density Fat-Fraction of the fat tissue. This review article aims to briefly describe the state of art of the advanced imaging techniques to provide a quantitative assessment of body composition in children and adolescents.
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Affiliation(s)
- Paolo Simoni
- Pediatric Imaging, Diagnostic Imaging Department, Queen Fabiola Children's University Hospital, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Riccardo Guglielmi
- Department of Radiology, St Gallen University Hospital, Kantonal Hospital Müsterlingen, Münsterlingen, Switzerland
| | - Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland City Hospital, Auckland, New Zealand.,Department of Radiology, Hospital Vithas Nueve de Octubre, Valencia, Spain
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Ponti F, De Cinque A, Fazio N, Napoli A, Guglielmi G, Bazzocchi A. Ultrasound imaging, a stethoscope for body composition assessment. Quant Imaging Med Surg 2020; 10:1699-1722. [PMID: 32742962 DOI: 10.21037/qims-19-1048] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Dysregulation of the human's energy balance, mediated by non-performing endocrine organs (liver, skeletal muscle and adipose tissue, above all), can be related to human metabolic disorders characterized by an impaired body composition (BC), such as obesity and sarcopenia. While it is possible to monitor the BC and its variations at different levels, the tissue-organ composition studies have been proven to provide the most clinically applicable information. Ultrasonography (US), a fast, non-invasive, low-cost and widely available technique, holds great potential in the study of BC, as it can directly measure muscles, organs, visceral and subcutaneous fat tissue in different sections of the abdomen and body, overcoming some limits of anthropometric evaluation and other imaging techniques. Purpose of this review article is to explore the technical aspects and the applied methods of US examination to assess the potential clinical role of this technique in the context of BC characterization, investigating four pivotal topics [abdominal fat compartments, subcutaneous adipose tissue (SAT), skeletal muscle, liver].
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Affiliation(s)
- Federico Ponti
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Antonio De Cinque
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.,Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - Nicola Fazio
- Technology Transfer Office, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Alessandro Napoli
- Department of Radiologic, Oncologic and Pathologic Science, La Sapienza University of Rome, Rome, Italy
| | - Giuseppe Guglielmi
- Department of Radiology, University of Foggia, Foggia, Italy.,Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, Foggia, Italy
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Guglielmi G, Bazzocchi A. Body composition imaging. Quant Imaging Med Surg 2020; 10:1576-1579. [PMID: 32742952 PMCID: PMC7378092 DOI: 10.21037/qims-2019-bc-13] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 06/15/2020] [Indexed: 01/29/2023]
Affiliation(s)
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Role of Ultrasonography in Estimating Muscle Mass in Sarcopenic Obesity. JPEN J Parenter Enteral Nutr 2020; 44:1398-1406. [DOI: 10.1002/jpen.1830] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/14/2020] [Accepted: 03/04/2020] [Indexed: 01/08/2023]
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Barbalho ER, da Rocha IMG, de Medeiros GOC, Friedman R, Fayh APT. Agreement between software programmes of body composition analyses on abdominal computed tomography scans of obese adults. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2020; 64:24-29. [PMID: 31576962 PMCID: PMC10522283 DOI: 10.20945/2359-3997000000174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 07/25/2019] [Indexed: 11/23/2022]
Abstract
Objective A large number of studies have used abdominal computed tomography (CT) to quantify body composition, and different software programmes have been used to perform these analyses. Thus, this comparison is important to enable researchers to know the performance of more accessible software. Subjects and methods Fifty-four abdominal CT scans of obese (BMI 30 to 39.9 kg/m2), sedentary adults (24-41 years) patients from a Brazilian single center were selected. Two software programs were compared: Slice-O-Matic (Tomovision, Canada) version 5.0 and OsiriX version 5.8.5. The body composition analysis were segmented using standard Hounsfield unit (HU) (adipose tissue: -190 to +30 and skeletal muscle: -29 to +150) and measured at the mid third lumbar vertebra (L3) level on a slice showing both transversal processes. Bland-Altman limits of agreement analyses were used to assess the level of agreement between Slice-O-Matic and OsiriX. Results A total of fifty-four participants were evaluated, with majority women (69%), mean of age 31.3 (SD 6.5) years and obesity grade I most prevalent (74.1%). The agreement, in Bland-Altman analysis, between Slice-O-Matic and OsiriX analisys for the muscle mass tissue, visceral adipose tissue and subcutaneous adipose tissue were excellent (≥ 0.954) with P-values < 0.001. Conclusion These findings show that Slice-O-Matic and OsiriX softwares agreement in measurements of skeletal muscle and adipose tissue and sarcopenia diagnosis in obese patients, suggesting good applicability in studies with body composition in this population and clinical practice.
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Affiliation(s)
- Erica Roberta Barbalho
- Programa de Pós-Graduação em Educação FísicaCentro de Ciências da SaúdeUniversidade Federal do Rio Grande do NorteNatalRNBrasilPrograma de Pós-Graduação em Educação Física, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, RN, Brasil
| | - Ilanna Marques Gomes da Rocha
- Programa de Pós-Graduação em NutriçãoCentro de Ciências da SaúdeUniversidade Federal do Rio Grande do NorteNatalRNBrasilPrograma de Pós-Graduação em Nutrição, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, RN, Brasil
| | - Galtieri Otávio Cunha de Medeiros
- Hospital Universitário Onofre LopesUniversidade Federal do Rio Grande do NorteNatalRNBrasilHospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte, Natal, RN, Brasil
| | - Rogerio Friedman
- Universidade Federal do Rio Grande do SulPorto AlegreRSBrasilUnidade Endócrina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Ana Paula Trussardi Fayh
- Programa de Pós-Graduação em Educação FísicaCentro de Ciências da SaúdeUniversidade Federal do Rio Grande do NorteNatalRNBrasilPrograma de Pós-Graduação em Educação Física, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, RN, Brasil
- Programa de Pós-Graduação em NutriçãoCentro de Ciências da SaúdeUniversidade Federal do Rio Grande do NorteNatalRNBrasilPrograma de Pós-Graduação em Nutrição, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, RN, Brasil
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Cremona A, Hayes K, O’Gorman CS, Laighin CN, Ismail KI, Donnelly AE, Hamilton J, Cotter A. Inter and intra-reliability of ultrasonography for the measurement of abdominal subcutaneous & visceral adipose tissue thickness at 12 weeks gestation. BMC Med Imaging 2019; 19:95. [PMID: 31847832 PMCID: PMC6916062 DOI: 10.1186/s12880-019-0393-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 11/08/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Excess abdominal adiposity cause metabolic disturbances, particularly in pregnancy. Methods of accurate measurement are limited in pregnancy due to risks associated with these procedures. This study outlines a non-invasive methodology for the measurement of adipose tissue in pregnancy and determines the intra- and inter-observer reliability of ultrasound (US) measurements of the two components of adipose tissue (subcutaneous (SAT) and visceral adipose tissue (VAT)) within a pregnant population. METHODS Thirty pregnant women were recruited at the end of their first trimester, from routine antenatal clinic at the University Maternity Hospital Limerick, Ireland. Measurements of adipose tissue thickness were obtained using a GE Voluson E8 employing a 1-5 MHz curvilinear array transducer. Two observers, employing methodological rigour in US technique, measured thickness of adipose tissue three times, and segmented the US image systematically in order to define measurements of SAT and VAT using specifically pre-defined anatomical landmarks. RESULTS Intra-observer and inter-observer precision was assessed using Coefficient of Variation (CV). Measurements of SAT and total adipose for both observers were < 5% CV and < 10% CV for VAT in measures by both observers. Inter-observer reliability was assessed by Limits of Agreement (LoA). LoA were determined to be - 0.45 to 0.46 cm for SAT and - 0.34 to 0.53 cm for VAT values. Systematic bias of SAT measurement was 0.01 cm and 0.10 cm for VAT. Inter-observer precision was also assessed by coefficient of variation (CV: SAT, 3.1%; VAT, 7.2%; Total adipose, 3.0%). CONCLUSION Intra-observer precision was found to be acceptable for measures of SAT, VAT and total adipose according to anthropometric criterion, with higher precision reported in SAT values than in VAT. Inter-observer reliability assessed by Limits-Of-Agreement (LoA) confirm anthropometrically reliable to 0.5 cm. Systematic bias was minimal for both measures, falling within 95% confidence intervals. These results suggest that US can produce reliable, repeatable and accurate measures of SAT and VAT during pregnancy.
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Affiliation(s)
- Alexandra Cremona
- Graduate Entry Medical School (GEMS), University of Limerick, Limerick, Ireland
- School of Allied Health (SAH), University of Limerick, Limerick, Ireland
- Institute of Nutrition & Dietetics (INDI), Dublin, Ireland
- Health Research Institute (HRI), University of Limerick, Limerick, Ireland
- Physical Education and Sport Sciences (PESS), University of Limerick, Limerick, Ireland
| | - Kevin Hayes
- Department of Statistics, University College Cork (UCC), Cork, Ireland
| | - Clodagh S. O’Gorman
- Graduate Entry Medical School (GEMS), University of Limerick, Limerick, Ireland
- Health Research Institute (HRI), University of Limerick, Limerick, Ireland
| | - Ciara Ní Laighin
- Graduate Entry Medical School (GEMS), University of Limerick, Limerick, Ireland
- University Maternity Hospital Limerick (UMHL), Limerick, Ireland
| | - Khadijah I. Ismail
- Graduate Entry Medical School (GEMS), University of Limerick, Limerick, Ireland
- University Maternity Hospital Limerick (UMHL), Limerick, Ireland
| | - Alan E. Donnelly
- Health Research Institute (HRI), University of Limerick, Limerick, Ireland
- Physical Education and Sport Sciences (PESS), University of Limerick, Limerick, Ireland
| | | | - Amanda Cotter
- Graduate Entry Medical School (GEMS), University of Limerick, Limerick, Ireland
- University Maternity Hospital Limerick (UMHL), Limerick, Ireland
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Stigall AN, Evans KD, Hunter RL, Spees CK. The Potential for Using Sonography to Measure Abdominal Adiposity in Children. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2019. [DOI: 10.1177/8756479319834929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The accumulation of abdominal adiposity has been associated with many risk factors in adults and children. Currently, body mass index (BMI) percentiles, computed tomography (CT), and dual X-ray absorptiometry (DXA) are widely used to evaluate body fat but are not widely acceptable for measuring visceral and subcutaneous adiposity. The aim of this study was to evaluate abdominal adiposity in children by the use of diagnostic medical sonography (DMS). Fifty-eight third graders were recruited for a 10-week interventional study. This cohort received baseline body composition and anthropometric measures, including height, weight, calculated BMI percentiles, blood pressure, bioelectric impedance, and DMS. The resulting data analysis provided a set of descriptive statistics. DMS may be a reliable, practical, and cost-effective method for measuring visceral and subcutaneous adiposity across varied body compositions of children.
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Affiliation(s)
- A. Nicole Stigall
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Kevin D. Evans
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Randee L. Hunter
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Colleen K. Spees
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
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Azzi AJ, Lafrenière AS, Gilardino M, Hemmerling T. Ultrasonography Technique in Abdominal Subcutaneous Adipose Tissue Measurement: A Systematic Review. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:877-888. [PMID: 30208232 DOI: 10.1002/jum.14789] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 07/16/2018] [Accepted: 07/17/2018] [Indexed: 06/08/2023]
Abstract
There are currently several reported techniques of sonographic subcutaneous adipose tissue (SAT) measurement described in the literature. This systematic review aims to report techniques of SAT measurement using ultrasonography. A systematic literature search was performed and identified 39 relevant articles using ultrasonography to quantify abdominal SAT. The following parameters were collected: type of measurement, ultrasound machine make/model, transducer frequency, external/internal landmarks, pressure applied on probe, special techniques and inter-/intraobserver reliability. Literature findings related to the above parameters were summarized. A summary of the most common techniques and parameters is provided, serving as a reference for a necessary standardized approach.
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Affiliation(s)
| | | | | | - Thomas Hemmerling
- Department of Anesthesia and Experimental Surgery, McGill University, Montreal, QC, Canada
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Ponti F, Santoro A, Mercatelli D, Gasperini C, Conte M, Martucci M, Sangiorgi L, Franceschi C, Bazzocchi A. Aging and Imaging Assessment of Body Composition: From Fat to Facts. Front Endocrinol (Lausanne) 2019; 10:861. [PMID: 31993018 PMCID: PMC6970947 DOI: 10.3389/fendo.2019.00861] [Citation(s) in RCA: 149] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 11/25/2019] [Indexed: 01/10/2023] Open
Abstract
The aging process is characterized by the chronic inflammatory status called "inflammaging", which shares major molecular and cellular features with the metabolism-induced inflammation called "metaflammation." Metaflammation is mainly driven by overnutrition and nutrient excess, but other contributing factors are metabolic modifications related to the specific body composition (BC) changes occurring with age. The aging process is indeed characterized by an increase in body total fat mass and a concomitant decrease in lean mass and bone density, that are independent from general and physiological fluctuations in weight and body mass index (BMI). Body adiposity is also re-distributed with age, resulting in a general increase in trunk fat (mainly abdominal fat) and a reduction in appendicular fat (mainly subcutaneous fat). Moreover, the accumulation of fat infiltration in organs such as liver and muscles also increases in elderly, while subcutaneous fat mass tends to decrease. These specific variations in BC are considered risk factors for the major age-related diseases, such as cardiovascular diseases, type 2 diabetes, sarcopenia and osteoporosis, and can predispose to disabilities. Thus, the maintenance of a balance rate of fat, muscle and bone is crucial to preserve metabolic homeostasis and a health status, positively contributing to a successful aging. For this reason, a detailed assessment of BC in elderly is critical and could be an additional preventive personalized strategy for age-related diseases. Despite BMI and other clinical measures, such as waist circumference measurement, waist-hip ratio, underwater weighing and bioelectrical impedance, are widely used as a surrogate measure for body adiposity, they barely reflect the distribution of body fat. Because of the great advantages offered by imaging tools in research and clinics, the attention of clinicians is now moving to powerful imaging techniques such as computed tomography, magnetic resonance imaging, dual-energy X-ray absorptiometry and ultrasound to obtain a more accurate estimation of BC. The aim of this review is to present the state of the art of the imaging techniques that are currently available to measure BC and that can be applied to the study of BC changes in the elderly, outlining advantages and disadvantages of each technique.
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Affiliation(s)
- Federico Ponti
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Aurelia Santoro
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- C.I.G. Interdepartmental Centre “L. Galvani”, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- *Correspondence: Aurelia Santoro
| | - Daniele Mercatelli
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Chiara Gasperini
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Maria Conte
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- C.I.G. Interdepartmental Centre “L. Galvani”, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Morena Martucci
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Luca Sangiorgi
- Department of Medical Genetics and Rare Orthopedic Disease & CLIBI Laboratory, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Claudio Franceschi
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- Department of Applied Mathematics, Institute of Information Technology, Mathematics and Mechanics (ITMM), Lobachevsky State University of Nizhny Novgorod-National Research University (UNN), Nizhny Novgorod, Russia
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Correlation between DXA and laboratory parameters in normal weight, overweight, and obese patients. Nutrition 2018; 61:143-150. [PMID: 30711863 DOI: 10.1016/j.nut.2018.10.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 09/18/2018] [Accepted: 10/19/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The aim of this study was to review the existence and types of correlations between body composition densitometric parameters and laboratory values associated to cardiometabolic risk. METHODS We retrospectively analyzed data from 316 individuals in the weight range from normality to super-obesity, submitted to total body dual-energy x-ray absorptiometry (DXA) scans and routine biochemistry at S.Orsola-Malpighi Hospital from June 2010 to March 2014. The study included 182 women, 45.8 ± 13.4 y of age, with a body mass index (BMI) of 31.5 (± 11) kg/m2 (group F) and 134 men, 45.4 ± 13.6 y of age, with a BMI of 27.6 (± 7.8) kg/m2 (group M). All patients underwent whole-body scan (Lunar iDXA, GE Healthcare, Madison, WI, USA) and laboratory analysis (blood fasting glucose, total cholesterol, high-density lipoprotein cholesterol, tricylglycerides [TGs], aspartate aminotransferase, and alanine aminotransferase). Correlation between laboratory values and total body and regional fat mass (including visceral adipose tissue [VAT] and subcutaneous adipose tissue in the android region), and lean mass parameters were analyzed with linear and stepwise regressions analysis (significance limit, P < 0.05). Receiver operating characteristic curves were performed to assess the accuracy of the best-fit DXA parameter (VAT) to identify at least one laboratory risk factor. RESULTS In both groups, BMI and densitometric parameters showed a linear correlation with fasting blood glucose and TG levels and an inverse correlation with high-density lipoprotein cholesterol (P < 0.05), whereas no correlation was observed with total cholesterol levels. The only densitometric parameter retained in the final model of stepwise multiple regression was VAT for fasting blood glucose (group F: β = 0.4627, P < 0.0001; group M: β = 0.6221, P < 0.0001) and TG levels (group F: β = 0.4931, P < 0.0001; group M: β = 0.1990, P < 0.0261) independently of BMI. The optimal cutoff points of VAT to identify the presence of at least one laboratory risk factor were >1395 g and >1479 cm3 for men and >1281 g and >1357 cm3 for women. CONCLUSIONS DXA analysis of VAT is associated with selected laboratory parameters used for the evaluation of cardiometabolic risk and could be per se a helpful parameter in the assessment of clinical risk.
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Stigall AN, Evans KD, Tatarski R, Pargeon RL, Spees C. Abdominal Adiposity Measured by Sonography as a Tool for Determining Disease Risk. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2018. [DOI: 10.1177/8756479318771552] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A preexperimental cohort study was conducted with 67 overweight cancer survivors. This cohort of participants was screened for baseline body composition and anthropometrics based on a variety of techniques, including body mass index (BMI), dual X-ray absorptiometry–percentage body fat (DXA-android %BF), diagnostic medical sonography (DMS), and waist circumference (WC). The combination of subcutaneous fat layer at the xyphoid and umbilicus compared with BMI, WC, and DXA-android %BF. These variables demonstrated moderately positive association and were statistically significant. A total maximum mean score of DMS measures of subcutaneous and visceral fat was also compared with BMI, WC, and DXA-android %BF. The aforementioned comparison had a moderately positive association and was statistically significant. The sonographic measure of mesentery fat was compared with WC and demonstrated a strongly positive strength of association and was statistically significant. Sonography may be an inexpensive, noninvasive, portable, and valid body composition measure for overweight patients.
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Affiliation(s)
- A. Nicole Stigall
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Kevin D. Evans
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Rachel Tatarski
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Rachel L. Pargeon
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Colleen Spees
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
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Upper and lower limbs composition: a comparison between anthropometry and dual-energy X-ray absorptiometry in healthy people. Arch Osteoporos 2017; 12:78. [PMID: 28921453 DOI: 10.1007/s11657-017-0374-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 08/30/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED The detection of changes in lean mass (LM) distribution can help to prevent disability. This study assessed the degree of association between anthropometric measurements and dual-energy X-ray absorptiometry (DXA) body composition (BC) parameters of the upper and lower limbs in a healthy general population and collected DXA age- and sex-specific values of BC that can be useful to build a reference standard. PURPOSE The primary aim of this study was to investigate the reliability of some widely available anthropometric measurements in the assessment of body composition (BC) at the limbs, especially in terms of muscle mass, in a large sample of healthy subjects of different age bands and sex, using fat mass (FM) and lean mass (LM) parameters derived by dual-energy X-ray absorptiometry (DXA) as the gold standard. The secondary aim was to collect DXA age- and sex-specific values of BC of left and right limbs (upper and lower) in a healthy Italian population to be used as reference standards. METHODS Two hundred fifty healthy volunteers were enrolled. Arm circumference (AC) and thigh circumference (ThC) were measured, and total and regional BC parameters were obtained by a whole-body DXA scan (Lunar iDXA, Madison, WI, USA; enCORE™ 2011 software version 13.6). RESULTS FM/LM showed only fair correlation with AC and ThC in females (r = 0.649 and 0.532, respectively); in males and in the total population, the correlation was low (r = 0.360 or lower, and p non-statistically significant). AC and ThC were not well representative of arms LM in both genders (females r = 0.452, males r = 0.530) independently of age. In general, men of all age groups showed higher values of LM and lean mass index (LMI) in both total and segmental upper and lower limbs. In males, the maximum LM and LMI were achieved in the fifth decade in both upper and lower limbs and then started to decrease with aging. In females, no significant modification with aging was identified in LM and LMI. CONCLUSION According to our results, anthropometry is not well representative of LM of arms in both genders, independently of age; therefore, a densitometric examination should be considered for a correct assessment of BC at limbs.
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Ponti F, Soverini V, Plazzi A, Aparisi Gómez MP, Mercatelli D, Guglielmi G, Battista G, Marchesini G, Bazzocchi A. DXA-assessed changes in body composition in obese women following two different weight loss programs. Nutrition 2017; 46:13-19. [PMID: 29290349 DOI: 10.1016/j.nut.2017.07.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 06/21/2017] [Accepted: 07/24/2017] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Changes in body composition during weight loss programs might have a significant effect on long-term results. The aim of this study was to test these changes by dual energy x-ray absorptiometry (DXA) in obese women enrolled into two different weight loss medical programs. METHODS We prospectively studied 71 women assigned to either an intensive 3-mo cognitive-behavioral therapy (CBT) or a 1-mo nutritional counseling plan (NCP). All patients underwent DXA whole-body scan before treatment and after 3, 6, and 12 mo. Fat mass (FM), non-bone lean mass (LM) and bone mineral content were assessed at whole-body and regional levels. Android visceral adipose tissue (VAT) also was estimated. RESULTS Twenty-three patients missed one or more follow-up controls and were excluded from the final analysis. Twenty-seven patients (body mass index [BMI] 41.9 ± 6.7 kg/m2) remained in the CBT group and 21 (BMI 33.4 ± 4 kg/m2) in the NCP group. The progressive decrease of BMI in both groups was associated with reduced whole-body and regional FM, which was more marked in CBT. During follow-up, a progressive decrease of total FM-to-LM and android FM-to-LM ratios were observed both in CBT (Δ12-mo versus baseline -7.8 ± 9.6% and -9.5 ± 12.7%, respectively; P < 0.01) and NCP (Δ12-mo versus baseline -5.9 ± 9.6% and -7 ± 13.4%, respectively; P < 0.05). VAT was the parameter showing the largest decrease (-14.2 ± 17.4% and -11.3 ± 18.2% at 12 mo, respectively in CBT and NCP; P < 0.05). CONCLUSIONS Lifestyle-induced weight loss is associated with selective changes in body composition parameters, regardless of initial BMI and treatment program, limiting sarcopenic obesity. DXA may quantify the metabolically healthier redistribution of total and regional FM and VAT.
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Affiliation(s)
- Federico Ponti
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola - Malpighi Hospital, Bologna, Italy; Diagnostic and Interventional Radiology, "Rizzoli" Orthopaedic Institute, Bologna, Italy
| | - Valentina Soverini
- Unit of Metabolic Diseases & Clinical Dietetics, University of Bologna. Sant'Orsola - Malpighi Hospital, Bologna, Italy
| | - Andrea Plazzi
- Unit of Metabolic Diseases & Clinical Dietetics, University of Bologna. Sant'Orsola - Malpighi Hospital, Bologna, Italy
| | - Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland City Hospital, Auckland, New Zealand; Department of Radiology, Hospital Nueve de Octubre, Valencia, Spain
| | - Daniele Mercatelli
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola - Malpighi Hospital, Bologna, Italy; Diagnostic and Interventional Radiology, "Rizzoli" Orthopaedic Institute, Bologna, Italy
| | - Giuseppe Guglielmi
- Department of Radiology, University of Foggia, Foggia, Italy; Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, Foggia, Italy
| | - Giuseppe Battista
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola - Malpighi Hospital, Bologna, Italy
| | - Giulio Marchesini
- Unit of Metabolic Diseases & Clinical Dietetics, University of Bologna. Sant'Orsola - Malpighi Hospital, Bologna, Italy
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, "Rizzoli" Orthopaedic Institute, Bologna, Italy.
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de França GVA, De Lucia Rolfe E, Horta BL, Gigante DP, Yudkin JS, Ong KK, Victora CG. Genomic ancestry and education level independently influence abdominal fat distributions in a Brazilian admixed population. PLoS One 2017; 12:e0179085. [PMID: 28582437 PMCID: PMC5459508 DOI: 10.1371/journal.pone.0179085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 05/23/2017] [Indexed: 01/07/2023] Open
Abstract
We aimed to identify the independent associations of genomic ancestry and education level with abdominal fat distributions in the 1982 Pelotas birth cohort study, Brazil. In 2,890 participants (1,409 men and 1,481 women), genomic ancestry was assessed using genotype data on 370,539 genome-wide variants to quantify ancestral proportions in each individual. Years of completed education was used to indicate socio-economic position. Visceral fat depth and subcutaneous abdominal fat thickness were measured by ultrasound at age 29–31y; these measures were adjusted for BMI to indicate abdominal fat distributions. Linear regression models were performed, separately by sex. Admixture was observed between European (median proportion 85.3), African (6.6), and Native American (6.3) ancestries, with a strong inverse correlation between the African and European ancestry scores (ρ = -0.93; p<0.001). Independent of education level, African ancestry was inversely associated with both visceral and subcutaneous abdominal fat distributions in men (both P = 0.001), and inversely associated with subcutaneous abdominal fat distribution in women (p = 0.009). Independent of genomic ancestry, higher education level was associated with lower visceral fat, but higher subcutaneous fat, in both men and women (all p<0.001). Our findings, from an admixed population, indicate that both genomic ancestry and education level were independently associated with abdominal fat distribution in adults. African ancestry appeared to lower abdominal fat distributions, particularly in men.
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Affiliation(s)
- Giovanny Vinícius Araújo de França
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil, Rua Marechal Deodoro, 1160–3° Piso, Bairro Centro—Pelotas, RS
- Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Hills R, Cambridge, United Kingdom
- * E-mail:
| | - Emanuella De Lucia Rolfe
- Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Hills R, Cambridge, United Kingdom
| | - Bernardo Lessa Horta
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil, Rua Marechal Deodoro, 1160–3° Piso, Bairro Centro—Pelotas, RS
| | - Denise Petrucci Gigante
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil, Rua Marechal Deodoro, 1160–3° Piso, Bairro Centro—Pelotas, RS
| | | | - Ken K. Ong
- Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Hills R, Cambridge, United Kingdom
| | - Cesar Gomes Victora
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil, Rua Marechal Deodoro, 1160–3° Piso, Bairro Centro—Pelotas, RS
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Gruszfeld D, Weber M, Gradowska K, Socha P, Grote V, Xhonneux A, Dain E, Verduci E, Riva E, Closa-Monasterolo R, Escribano J, Koletzko B. Association of early protein intake and pre-peritoneal fat at five years of age: Follow-up of a randomized clinical trial. Nutr Metab Cardiovasc Dis 2016; 26:824-832. [PMID: 27212617 DOI: 10.1016/j.numecd.2016.04.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Revised: 03/03/2016] [Accepted: 04/01/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS The double-blind randomized European Childhood Obesity Project (CHOP) demonstrated that reduced protein content in infant formula leads to a lower body mass index (BMI) up to six years of age. Here we aimed at assessing pre-peritoneal fat, a marker of visceral fat, in children participating in the CHOP trial. METHODS AND RESULTS Healthy term formula-fed infants in five European countries were randomized either to higher (n = 550) or lower (n = 540) protein formulas in the first year of life. Infants who were exclusively breastfed for at least three months (n = 588) were enrolled as an observational (non randomized) group. At age 5 years, subcutaneous fat (SC) and pre-peritoneal fat (PP) were measured by ultrasound in a subgroup of 275 children. The PP fat layer was thicker in the higher compared to the lower protein group (adjusted estimated difference: 0.058 cm, 95%CI 0.002; 0.115; p = 0.043), while SC fat was not different. Girls showed a thicker SC fat layer than boys. CONCLUSIONS Higher protein intake in formula-fed infants appears to enhance pre-peritoneal fat tissue accumulation at the age of 5 years, but not of subcutaneous fat, which may trigger adverse metabolic and health consequences.
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Affiliation(s)
- D Gruszfeld
- Children's Memorial Health Institute, Warsaw, Poland.
| | - M Weber
- Dr. von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany
| | - K Gradowska
- Children's Memorial Health Institute, Warsaw, Poland
| | - P Socha
- Children's Memorial Health Institute, Warsaw, Poland
| | - V Grote
- Dr. von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany
| | - A Xhonneux
- CHC Saint Vincent, Liège-Rocourt, Belgium
| | - E Dain
- University Children's Hospital Queen Fabiola, ULB, Brussels, Belgium
| | - E Verduci
- San Paolo Hospital, University of Milan, Italy
| | - E Riva
- San Paolo Hospital, University of Milan, Italy
| | | | - J Escribano
- Universitat Rovira i Virgili, IISPV, Reus, Spain
| | - B Koletzko
- Dr. von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany
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Affiliation(s)
- Giuseppe Guglielmi
- Department of Radiology, University of Foggia, Viale L. Pinto 1, 71100 Foggia, Italy; Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, Viale Cappuccini 1, 71013 San Giovanni Rotondo, Foggia, Italy.
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Rizzoli Orthopaedic Institute, Via G. C. Pupilli 1, 40136 Bologna, Italy
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Bazzocchi A, Filonzi G, Ponti F, Albisinni U, Guglielmi G, Battista G. Ultrasound: Which role in body composition? Eur J Radiol 2016; 85:1469-80. [PMID: 27235340 DOI: 10.1016/j.ejrad.2016.04.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 03/01/2016] [Accepted: 04/13/2016] [Indexed: 01/21/2023]
Abstract
Ultrasound is a non-invasive, fast, relatively inexpensive and available tool for estimating adiposity in clinical practice, and in several research settings. It does not expose patients to ionizing radiation risks, making the method ideal for the evaluation, and for follow-up studies. Several parameters and indexes based on adipose tissue thickness have been introduced and tested, and these have been correlated with clinical and laboratoristic parameters. Moreover, ultrasound can also be directed to the estimation of adipose tissue and intracellular fat indirectly, at cellular-molecular level: an opportunity for many radiologists who already and sometimes unconsciously perform "body composition" assessment when looking at the liver, at muscle as well as at other organs. However, standardized procedure and parameters are needing to improve accuracy and reproducibility. The purposes of this review are: 1) to provide a complete overview of the most used and shared measurements of adiposity; 2) to analyze technical conditions, accuracy, and clinical meaning of ultrasound in the study of body composition; 3) to provide some elements for the use of ultrasound in the evaluation of intra-cellular lipids accumulation, in two hot spots: liver and skeletal muscle.
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Affiliation(s)
- Alberto Bazzocchi
- Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Via G. C. Pupilli 1, 40136 Bologna, Italy.
| | - Giacomo Filonzi
- Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Via G. C. Pupilli 1, 40136 Bologna, Italy
| | - Federico Ponti
- Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Via G. C. Pupilli 1, 40136 Bologna, Italy; Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna. Sant'Orsola-Malpighi Hospital, Via G. Massarenti 9, 40138 Bologna, Italy
| | - Ugo Albisinni
- Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Via G. C. Pupilli 1, 40136 Bologna, Italy
| | - Giuseppe Guglielmi
- Department of Radiology, University of Foggia, Viale Luigi Pinto 1, 71100 Foggia, Italy; Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, Viale Cappuccini 1, 71013 San Giovanni Rotondo, Foggia, Italy
| | - Giuseppe Battista
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna. Sant'Orsola-Malpighi Hospital, Via G. Massarenti 9, 40138 Bologna, Italy
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Selovic A, Sarac J, Missoni S. Changes in adipose tissue distribution during pregnancy estimated by ultrasonography. J Matern Fetal Neonatal Med 2015; 29:2131-7. [DOI: 10.3109/14767058.2015.1077220] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
| | - Jelena Sarac
- Institute for Anthropological Research, Zagreb, Croatia
| | - Sasa Missoni
- Institute for Anthropological Research, Zagreb, Croatia
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22
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Morano S, Romagnoli E, Filardi T, Nieddu L, Mandosi E, Fallarino M, Turinese I, Dagostino MP, Lenzi A, Carnevale V. Short-term effects of glucagon-like peptide 1 (GLP-1) receptor agonists on fat distribution in patients with type 2 diabetes mellitus: an ultrasonography study. Acta Diabetol 2015; 52:727-32. [PMID: 25577244 DOI: 10.1007/s00592-014-0710-z] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 12/26/2014] [Indexed: 01/22/2023]
Abstract
AIMS Glucagon-like peptide 1 receptor agonists (GLP-1 RA) induce weight loss and reduction in adipose tissue, but the effects of GLP-1 RA on the distribution of fat deposits have been poorly investigated. METHODS In 25 patients with type 2 diabetes (16 females and 9 males, mean age 63.5 ± 8.8 years), treated with GLP-1 RA (exenatide, n. 12; liraglutide, n.13), both before and 3 months after starting treatment, an abdominal ultrasonographic scan, with Doppler of renal arteries, and echocardiography were performed. Subcutaneous fat width (peri-umbilical and sub-xiphoid), deep fat deposits (pre-aortic, peri-renal, and epicardial), and renal resistive index (RI) were evaluated. RESULTS GLP-1 RA induced highly significant (p < 0.001) decrease in BMI and in fat thickness at all the assessed sites, without differences between exenatide and liraglutide treatment. A slight decrease in RI (p = 0.055) was also found. The percent changes of fat thickness was different between sites (p < 0.025), and the changes in subcutaneous deposits showed no significant correlation (p = 0.064) with those of deep fat deposits. CONCLUSIONS A short course of treatment with GLP-1 RA, besides weight loss, induces a redistribution of adipose tissue deposits, possibly contributing to a better cardiovascular risk profile in patients with type 2 diabetes mellitus.
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Affiliation(s)
- Susanna Morano
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy,
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Bazzocchi A, Ponti F, Diano D, Moio A, Albisinni U, Pasquali R, Battista G. Abdominal adiposity by ultrasonography: a "pocket" database for reference standard in Italian people. Prim Care Diabetes 2014; 8:358-364. [PMID: 24636921 DOI: 10.1016/j.pcd.2014.02.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 02/15/2014] [Accepted: 02/16/2014] [Indexed: 01/09/2023]
Abstract
AIMS To provide a reference standard database of ultrasonographic parameters of abdominal adiposity in healthy people. METHODS Italian non-obese volunteers among blood donors were enrolled in 5 age bands (from 18 to 70 year-old) to reach the threshold of 25 males and 25 females per single band (total: 250). All subjects were measured for weight, height and waist circumference and underwent ultrasonography (US) by an expert radiologist for the assessment of several abdominal fat thicknesses (minimum and maximum subcutaneous fat thickness, maximum preperitoneal fat thickness, intrabdominal fat thickness, aorto-mesenteric thickness, and mesenteric fat thickness). In addition, US data were normalized per waist circumference. RESULTS From 30s to 50s no statistically significant differences were achieved between males and females for the adiposity markers of visceral fat, while a relevant divergence was proved from 60s to 70s. During ageing a marked increase of the visceral fat compartment was observed in males, while only the preperitoneal circumference was significantly modified in females. CONCLUSIONS This paper reports on US parameters of abdominal adiposity of healthy Italian adults, to be used as a reference for daily clinical practice. Data could be also considered as control group for future investigations on physiology, pathological conditions, and differences between countries.
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Affiliation(s)
- Alberto Bazzocchi
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola - Malpighi Hospital, Via G. Massarenti 9, 40138 Bologna, Italy; Diagnostic and Interventional Radiology, "Rizzoli" Orthopaedic Institute, Via G. C. Pupilli 1, 40136 Bologna, Italy
| | - Federico Ponti
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola - Malpighi Hospital, Via G. Massarenti 9, 40138 Bologna, Italy
| | - Danila Diano
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola - Malpighi Hospital, Via G. Massarenti 9, 40138 Bologna, Italy.
| | - Antonio Moio
- Diagnostic and Interventional Radiology, "Rizzoli" Orthopaedic Institute, Via G. C. Pupilli 1, 40136 Bologna, Italy
| | - Ugo Albisinni
- Diagnostic and Interventional Radiology, "Rizzoli" Orthopaedic Institute, Via G. C. Pupilli 1, 40136 Bologna, Italy
| | - Renato Pasquali
- Division of Endocrinology, Department of Clinical Medicine, University of Bologna, Sant'Orsola - Malpighi Hospital, Via G. Massarenti 9, 40138 Bologna, Italy
| | - Giuseppe Battista
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola - Malpighi Hospital, Via G. Massarenti 9, 40138 Bologna, Italy
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Kishore Mohan KB, Anburajan M. Justification of anthropometric empirical indicator (AEI) by digital chest and pelvic X-rays: a comparative scenario with DXA on obesity grounds. J Endocrinol Invest 2014; 37:547-57. [PMID: 24676879 DOI: 10.1007/s40618-014-0067-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 03/04/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Obesity is an abnormal accumulation of body fat directly proportional to reduced life expectancy. Treatment of this ailment should be preceded by proper and accurate assessment of the degree of obesity. OBJECTIVES The main objective is the justification of anthropometric empirical indicator (AEI) by the utilization of chest and pelvic radiographs, so that precise measurement of obesity on economical grounds can be manifested. Also, the subsequent objective is to establish a comparative scenario between dual energy X-ray absorptiometry (DXA) and novel, portable, bioelectric impedance analysis (BIA)-based body composition analyzer, MI-105 (Meditech International Inc. India). MATERIALS AND METHODS The cross-sectional design was adopted in the present study, in which 20 female participants from urban south India were involved. The measurements of body composition, anthropometry and chest (covering the region from neck to abdomen) as well as hip radiography of the studied population were acquired. RESULTS The higher significant difference of ≤0.001 was evidenced in all female studied population in the main body composition parameters measured by DXA and low-cost BIA. The same framework of significance is applicable to AEI, AEI (image morphed) and AEI (image automatic). CONCLUSION The novel-derived parameters: AEI (image morphed) and AEI (image automatic) can precisely gauge obesity and can be the effective alternatives for high-cost DXA. In addition, low-cost BIA-based body composition analyzer can also be the better substitute for DXA.
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Affiliation(s)
- K B Kishore Mohan
- Department of Biomedical Engineering, SRM University, Kattankulathur, Chennai, 603203, Tamil Nadu, India,
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Bazzocchi A, Diano D, Ponti F, Salizzoni E, Albisinni U, Marchesini G, Battista G. A 360-degree overview of body composition in healthy people: relationships among anthropometry, ultrasonography, and dual-energy x-ray absorptiometry. Nutrition 2013; 30:696-701. [PMID: 24800668 DOI: 10.1016/j.nut.2013.11.013] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 10/29/2013] [Accepted: 11/25/2013] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The aim of this study was to test the relationship between anthropometry, ultrasonography, and dual-energy x-ray absorptiometry (DXA) for the assessment of body composition in clinical practice. METHODS The study was carried out in Italian blood donor volunteers belonging to five different age groups (18-70 y old; 25 men and 25 women per group; N = 250 participants; n = 125 men, n = 125 women). A complete history was collected and routine blood analyses were performed to confirm healthy status. All participants were submitted to whole-body DXA (tricompartmental analysis, regional, and total body), ultrasonography (abdominal adiposity evaluation), and anthropometric measurements. DXA was used as gold standard and its biomarkers were taken as reference for fat-lean mass balance, central-peripheral fat distribution, central or visceral fat, and subcutaneous fat. RESULTS Anthropometric and ultrasound parameters were closely associated with most of DXA parameters. Composite markers representative of central and abdominal visceral fat compartments were significantly correlated with waist circumference, waist-to-hip ratio, and intra-abdominal fat thickness by ultrasound, in both men and women (P < 0.025). As expected, subcutaneous depots were significantly correlated with maximum subcutaneous fat thickness measured by ultrasonography (P < 0.025). CONCLUSIONS Both anthropometry and ultrasonography provide a reliable estimate of visceral adipose tissue in a non-obese population compared with DXA, whereas anthropometry prediction of subcutaneous adiposity is weak. Physicians should be aware of the limits of these techniques for the assessment of body composition.
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Affiliation(s)
- Alberto Bazzocchi
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy; Diagnostic and Interventional Radiology, "Rizzoli" Orthopaedic Institute, Bologna, Italy.
| | - Danila Diano
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - Federico Ponti
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - Eugenio Salizzoni
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - Ugo Albisinni
- Diagnostic and Interventional Radiology, "Rizzoli" Orthopaedic Institute, Bologna, Italy
| | - Giulio Marchesini
- Unit of Metabolic Diseases & Clinical Dietetics, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - Giuseppe Battista
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
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