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Zieff G, Cornwall J, Blue MN, Smith-Ryan AE, Stoner L. Ultrasound-based measurement of central adiposity: Key considerations and guidelines. Obes Rev 2024; 25:e13716. [PMID: 38418428 DOI: 10.1111/obr.13716] [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: 02/08/2023] [Revised: 12/05/2023] [Accepted: 01/12/2024] [Indexed: 03/01/2024]
Abstract
Central adiposity, which is visceral and subcutaneous adiposity in the abdominal region, is a known risk factor for developing chronic cardiometabolic diseases. Central adiposity can be measured relatively inexpensively using ultrasound. Ultrasound has been shown to be precise and reliable, with measurement accuracy comparable to computed tomography and magnetic resonance. Despite the advantages conferred by ultrasound, widespread adoption has been hindered by lack of reliable standard operating procedures. To consolidate the literature and bring clarity to the use of ultrasound-derived measures of central adiposity, this review outlines (i) the [patho]physiological importance of central adiposity to cardiometabolic disease risk; (ii) an overview of the history and main technical aspects of ultrasound methodology; (iii) key measurement considerations, including transducer selection, subject preparation, image acquisition, image analysis, and operator training; and (iv) guidelines for standardized ultrasound protocols for measuring central adiposity.
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Affiliation(s)
- Gabriel Zieff
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jon Cornwall
- Centre for Early Learning in Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Malia N Blue
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Abbie E Smith-Ryan
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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2
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Urata T, Kishino T, Watanabe K, Shibasaki S, Yotsukura M, Mori H, Kawamura N, Tanaka T, Osaka M, Matsushima S, Yamasaki S, Ohtsuka K, Ohnishi H, Watanabe T. Sonographically Measured Adipose Tissue Thickness Correlates with Laboratory Test Abnormalities Reflecting Metabolic State in Elderly Women. Metab Syndr Relat Disord 2021; 20:148-155. [PMID: 34962149 DOI: 10.1089/met.2021.0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Background: Accumulation of adipose tissue progresses to metabolic diseases. Sonography is a convenient modality for measuring the thickness of adipose tissue. The present study aimed to clarify the site of adipose tissue thickness that correlated best with laboratory test values reflecting metabolic abnormalities. Methods: Subjects comprised 37 elderly women with metabolic diseases or an almost healthy state (median age, 71 years; interquartile range, 62-78 years). Abdominal visceral adipose tissue (VAT), subcutaneous adipose tissue, peritoneal adipose tissue, perirenal adipose tissue, and epicardial adipose tissue (EAT) thicknesses were measured. Correlations were evaluated between laboratory test values and these adipose tissue thicknesses. Results: VAT thickness measured at the level of the umbilicus correlated positively with values of triglycerides (TGs) (r = 0.593, P = 0.0009) and hemoglobin A1c (r = 0.490, P = 0.0081) and negatively with the value of high-density lipoprotein cholesterol (r = -0.521, P = 0.0045), even after adjusting for body mass index. Significant positive correlations were also found between EAT thickness and TGs (r = 0.542, P = 0.0029). Conclusions: Among the adipose tissue thicknesses measured at several sites by sonography, VAT thickness correlated most closely with laboratory test values representing metabolic abnormalities in elderly women.
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Affiliation(s)
- Tsuyoshi Urata
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo, Japan
| | - Tomonori Kishino
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo, Japan.,Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan.,Department of Clinical Engineering, Kyorin University Faculty of Health Sciences, Mitaka, Tokyo, Japan
| | - Keiko Watanabe
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo, Japan
| | - Shohei Shibasaki
- Department of Medical Technology, Kyorin University Faculty of Health Sciences, Mitaka, Tokyo, Japan
| | - Masayuki Yotsukura
- Department of Clinical Engineering, Kyorin University Faculty of Health Sciences, Mitaka, Tokyo, Japan.,Department of Cardiology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Hideaki Mori
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Naohiro Kawamura
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Toshiaki Tanaka
- Department of Diabetes, Endocrinology and Metabolism, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Maiko Osaka
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo, Japan
| | - Satsuki Matsushima
- Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Satoko Yamasaki
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo, Japan.,Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan.,Department of Cardiology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Kouki Ohtsuka
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo, Japan.,Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Hiroaki Ohnishi
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo, Japan.,Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Takashi Watanabe
- Dean, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
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3
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Froelich MF, Fugmann M, Daldrup CL, Hetterich H, Coppenrath E, Saam T, Ferrari U, Seissler J, Popp D, Lechner A, Sommer NN. Measurement of total and visceral fat mass in young adult women: a comparison of MRI with anthropometric measurements with and without bioelectrical impedance analysis. Br J Radiol 2020; 93:20190874. [PMID: 32142376 PMCID: PMC10993227 DOI: 10.1259/bjr.20190874] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 02/26/2020] [Accepted: 03/03/2020] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE MRI is established for measurement of body fat mass (FM) and abdominal visceral adipose tissue (VAT). Anthropometric measurements and bioelectrical impedance analysis (BIA) have been proposed as surrogates to estimation by MRI. Aim of this work is to assess the predictive value of these methods for FM and VAT measured by MRI. METHODS Patients were selected from cohort study PPS-Diab (prediction, prevention and subclassification of Type 2 diabetes). Total FM and VAT were quantified by MRI and BIA together with clinical variables like age, waist and hip circumference and height. Least-angle regressions were utilized to select anthropometric and BIA parameters for their use in multivariable linear regression models to predict total FM and VAT. Bland-Altman plots, Pearson correlation coefficients, Wilcoxon signed-rank tests and univariate linear regression models were applied. RESULTS 116 females with 35 ± 3 years and a body mass index of 25.1 ± 5.3 kg/m2 were included into the analysis. A multivariable model revealed weight (β = 0.516, p < 0.001), height (β = -0.223, p < 0.001) and hip circumference (β = 0.156, p = 0.003) as significantly associated with total FM measured by MRI. A additional multivariable model also showed a significant predictive value of FMBIA (β = 0.583, p < 0.001) for FM. In addition, waist circumference (β = 0.054, p < 0.001), weight (β = 0.016, p = 0.031) in one model and FMBIA (β = 0.026, p = 0.018) in another model were significantly associated with VAT quantified by MRI. However, deviations reached more than 5 kg for total FM and more than 1 kg for VAT. CONCLUSION Anthropometric measurements and BIA show significant association with total FM and VAT. ADVANCES IN KNOWLEDGE As these measurements show significant deviations from the absolute measured values determined by MRI, MRI should be considered the gold-standard for quantification.
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Affiliation(s)
- Matthias F. Froelich
- Department of Radiology, University Hospital,
LMU Munich, Germany
- Institute of Clinical Radiology and Nuclear Medicine,
University Medical Center Mannheim,
Mannheim, Germany
| | - Marina Fugmann
- Diabetes Research Group, Medizinische Klinik und Poliklinik IV,
Klinikum der Universität München,
Ludwig-Maximilians-Universität München,
Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum
München, Munich,
Germany
- German Center for Diabetes Research (DZD),
Munich, Germany
| | | | - Holger Hetterich
- Department of Radiology, University Hospital,
LMU Munich, Germany
| | - Eva Coppenrath
- Department of Radiology, University Hospital,
LMU Munich, Germany
| | - Tobias Saam
- Department of Radiology, University Hospital,
LMU Munich, Germany
| | - Uta Ferrari
- Diabetes Research Group, Medizinische Klinik und Poliklinik IV,
Klinikum der Universität München,
Ludwig-Maximilians-Universität München,
Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum
München, Munich,
Germany
- German Center for Diabetes Research (DZD),
Munich, Germany
| | - Jochen Seissler
- Diabetes Research Group, Medizinische Klinik und Poliklinik IV,
Klinikum der Universität München,
Ludwig-Maximilians-Universität München,
Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum
München, Munich,
Germany
- German Center for Diabetes Research (DZD),
Munich, Germany
| | - Daniel Popp
- Department of Radiology, University Hospital,
LMU Munich, Germany
| | - Andreas Lechner
- Diabetes Research Group, Medizinische Klinik und Poliklinik IV,
Klinikum der Universität München,
Ludwig-Maximilians-Universität München,
Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum
München, Munich,
Germany
- German Center for Diabetes Research (DZD),
Munich, Germany
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4
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Abd Eldaim MA, Ibrahim FM, Orabi SH, Hassan A, El Sabagh HS. l-Carnitine-induced amelioration of HFD-induced hepatic dysfunction is accompanied by a reduction in hepatic TNF-α and TGF-β1. Biochem Cell Biol 2018; 96:713-725. [PMID: 29677453 DOI: 10.1139/bcb-2018-0074] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
In this study, we evaluated the possible mechanisms through which l-carnitine ameliorates the adverse effects from obesity in rats, induced with a high-fat diet (HFD). For this, 56 albino Wister rats were randomly assigned to 7 groups. The control group was fed a basal diet and injected with saline. The second group was fed the basal diet and injected with l-carnitine (200 mg/kg body mass, by intraperitoneal injection; i.p.). The third group were fed the HFD. The fourth group was fed the HFD and injected with l-carnitine (200 mg/kg body mass, i.p.) for 8 weeks. The fifth group was fed the HFD for 10 weeks. The sixth group were fed the HFD for 10 weeks and were also injected with l-carnitine (200 mg/kg body mass, i.p.) during the final 2 weeks. The seventh group was fed the HFD diet for 8 weeks then the basal diet for 2 weeks. The HFD induced significantly increased levels of hyperglycemia, lipid peroxidation, pathological changes, TNF-α and TGF-β1 protein expression in hepatic tissue, food intake, body weight gain, serum levels of total and non-high-density lipoprotein cholesterol, ketone bodies, triacylglycerol, urea, creatinine, AST, and ALT. However, the HFD diet significantly decreased serum levels of high-density lipoprotein (HDL) and hepatic levels of reduced glutathione. l-Carnitine ameliorated the effects of the HFD on the above-mentioned parameters. This study indicated that l-carnitine had protective and curative effects against HFD-induced hepatosteatosis by reducing hepatic oxidative stress and protein expression of TNF-α and TGF-β1.
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Affiliation(s)
- Mabrouk Attia Abd Eldaim
- Department of Biochemistry and Chemistry of Nutrition, Faculty of Veterinary Medicine, Menoufia University, Sheben Elkom, Egypt
- Division of Applied Biosciences, Graduate School of Agriculture, Kyoto University, 606-8502, Japan
| | - Fatma Mohamed Ibrahim
- Department of Biochemistry and Chemistry of Nutrition, Faculty of Veterinary Medicine, University of Sadat City, Sadat City, Egypt
| | - Saher Hassan Orabi
- Department of Biochemistry and Chemistry of Nutrition, Faculty of Veterinary Medicine, University of Sadat City, Sadat City, Egypt
| | - Azza Hassan
- Department of Pathology, Faculty of Veterinary Medicine, Cairo University, Cairo, Egypt
| | - Hesham Saad El Sabagh
- Department of Toxicology and Fronsic Medicine, Faculty of Veterinary Medicine, University of Sadat City, Sadat City, Egypt
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5
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Nassr AA, Shazly SA, Trinidad MC, El-Nashar SA, Marroquin AM, Brost BC. Body fat index: A novel alternative to body mass index for prediction of gestational diabetes and hypertensive disorders in pregnancy. Eur J Obstet Gynecol Reprod Biol 2018; 228:243-248. [PMID: 30014931 DOI: 10.1016/j.ejogrb.2018.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 07/02/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To evaluate the association of ultrasound measurement of maternal abdominal subcutaneous and pre-peritoneal fat thickness in relation to the subsequent diagnosis of gestational diabetes (GDM), and to assess the association of body fat index (BFI), compared to conventional body mass index (BMI), with respect to the development of some obstetric related complications. STUDY DESIGN A prospective study included non-diabetic pregnant women who were scheduled for fetal anatomic survey. Women underwent fat measurements and BFI (pre-peritoneal fat x subcutaneous fat/height) was calculated. They underwent routine glucose screening and diagnostic tests for GDM. Obstetric complications, mode of delivery, and delivery related events were reported. Multivariable logistic regression was used to test potential predictors for development of obesity-related complications. Primary outcome was development of GDM. Secondary outcomes included development of hypertensive disorders during pregnancy and need for cesarean delivery due to labor dystocia. The optimal cut-off points for continuous variables were obtained using a receiver operating characteristic (ROC) curve analyses. RESULTS 389 women met study criteria. Median gestational age at time of ultrasound evaluation was 19.1 weeks. Positive family history of diabetes (adjusted odds ratio "OR" 2.30, 95% CI 1.35-3.92), history of GDM (adjusted OR 6.87, 95% CI 3.03-15.61), subcutaneous fat≥13 mm (adjusted OR 4.63, 95% CI 1.60-13.38) and pre-peritoneal fat≥12 mm (adjusted OR 3.32, 95% CI 1.06-10.42) were significant predictors for development of GDM. ROC analysis demonstrated that a BFI > 0.5 was statistically superior to a BMI > 25 or 30 as a predictor of gestational diabetes (adjusted OR 6.24, 95% CI 1.86-20.96). A Similar ROC analysis demonstrated that a BFI > 0.8 was associated with a higher risk for the development of hypertensive disorders of pregnancy (adjusted OR 2.70 [95% CI 1.60-4.55]), and need for cesarean delivery (adjusted OR 2.01[95% CI 1.23-3.28]) than a BMI > 25 or 30. CONCLUSION Values obtained by ultrasound measurement of subcutaneous and pre-peritoneal fat are associated with development of GDM and hypertensive disorders in pregnancy. Our data suggest that BFI was a better predictor than BMI for development of GDM and hypertensive disorders in pregnancy and should be studied further.
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Affiliation(s)
- Ahmed A Nassr
- Division of Maternal Fetal Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA; Department of Obstetrics and Gynecology, Women's Health Hospital, Assiut University, Assiut, Egypt; Division of Maternal Fetal Medicine, Baylor College of Medicine, Houston, Texas, USA.
| | - Sherif A Shazly
- Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, MN, USA; Department of Obstetrics and Gynecology, Women's Health Hospital, Assiut University, Assiut, Egypt
| | - Mari C Trinidad
- Division of Maternal Fetal Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Sherif A El-Nashar
- Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Amber M Marroquin
- Division of Maternal Fetal Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Brian C Brost
- Division of Maternal Fetal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
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6
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Suraweera D, Fanous C, Jimenez M, Tong MJ, Saab S. Risk of Cardiovascular Events in Patients with Primary Biliary Cholangitis - Systematic Review. J Clin Transl Hepatol 2018; 6:119-126. [PMID: 29951355 PMCID: PMC6018312 DOI: 10.14218/jcth.2017.00064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 12/14/2017] [Accepted: 01/02/2018] [Indexed: 01/25/2023] Open
Abstract
Background and Aims: Hypercholesterolemia is a common finding in patients with primary biliary cholangitis (PBC) and is a well-defined risk factor for cardiovascular disease. However, studies have been mixed on whether PBC patients do, in fact, have higher cardiovascular risk. The aim of this study is to review the current literature and provide an evidence-based assessment of cardiovascular risk in PBC patients. Methods: We performed a systematic literature search on PubMed regarding patients with PBC and cardiovascular events from the database inception to July 1, 2017. A total of 33 articles fulfilling our inclusion criteria were found. Results: The majority of the studies evaluated yielded no statistically significant difference in cardiovascular disease in the PBC population compared to the general public. However, some reports found a statistically significantly increase in coronary artery disease. Several studies have looked at the specific lipid profile of patients with PBC with hypocholesteremia. While these lipid abnormalities differ by stage of disease, there is evidence to suggest that the specific lipid profile in PBC may have lower atherogenicity than in patients with hypercholesterolemia without PBC. Studies looking at patients with PBC with other risk factors for cardiovascular disease, such as hypertension and metabolic syndrome, have consistently found a higher risk for cardiovascular disease in these patients. Statin treatment is effective in reducing lipid levels and possibly improving endothelial inflammation in patients with PBC with hypercholesterolemia. Conclusions: There is not enough evidence to suggest an increased risk of cardiovascular disease in patients with PBC with hypercholesterolemia, except for those individuals with concomitant features of metabolic syndrome. In patients with PBC with no additional cardiovascular risk factors, individual risk/benefit discussion on lipid-lowering treatment should be considered.
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Affiliation(s)
| | - Christina Fanous
- Department of Surgery at the University of California at Los Angeles, Los Angeles, CA, USA
| | - Melissa Jimenez
- Department of Surgery at the University of California at Los Angeles, Los Angeles, CA, USA
| | | | - Sammy Saab
- Department of Surgery at the University of California at Los Angeles, Los Angeles, CA, USA
- Department of Medicine at the University of California at Los Angeles, Los Angeles, CA, USA
- *Correspondence to: Sammy Saab, Pfleger Liver Institute, UCLA Medical Center, 200 Medical Plaza, Suite 214, Los Angeles, CA 90095, USA. Tel: +1-310-206-6705, Fax: +1-310-206-4197, E-mail:
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7
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Woldemariam MM, Evans KD, Butwin AN, Pargeon RL, Volz KR, Spees C. Measuring Abdominal Visceral Fat Thickness With Sonography: A Methodologic Approach. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2018. [DOI: 10.1177/8756479317747210] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This methodological approach to assessing obesity is based on the prepilot work conducted on a small sample of men and women (25-58 years of age) in a laboratory setting. The use of skinfold calipers, body mass index, and sonographic imaging of adipose and visceral fat were obtained. In this pre-experimental work, the rigorous use of sonographic measures of visceral fat demonstrated better trend results than the other measurement tools. The sonographic methods employed were modeled after the work published by Hamagawa et al. All measurements were taken five times, and only the middle three were retained for mean data points. The data are compared and contrasted with a paucity of international studies using sonography to measure visceral adiposity. It is important to determine whether sonography could serve as a non-ionizing imaging technique for the assessment of body composition and a screening technique for cardiovascular disease prediction.
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Affiliation(s)
- Mulubrhan M. Woldemariam
- The College of Medicine, School of Health & Rehabilitation Sciences, Laboratory for Investigatory Imaging, The Ohio State University, Columbus, OH, USA
| | - Kevin D. Evans
- The College of Medicine, School of Health & Rehabilitation Sciences, Laboratory for Investigatory Imaging, The Ohio State University, Columbus, OH, USA
| | - Angela N. Butwin
- The College of Medicine, School of Health & Rehabilitation Sciences, Laboratory for Investigatory Imaging, The Ohio State University, Columbus, OH, USA
| | - Rachel L. Pargeon
- The College of Medicine, School of Health & Rehabilitation Sciences, Laboratory for Investigatory Imaging, The Ohio State University, Columbus, OH, USA
| | - Kevin R. Volz
- The College of Medicine, School of Health & Rehabilitation Sciences, Laboratory for Investigatory Imaging, The Ohio State University, Columbus, OH, USA
| | - Colleen Spees
- The College of Medicine, School of Health & Rehabilitation Sciences, Laboratory for Investigatory Imaging, The Ohio State University, Columbus, OH, USA
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8
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Jung JH, Jung MK, Kim KE, Kwon AR, Chae HW, Yoon CS, Kim HS, Kim DH. Ultrasound measurement of pediatric visceral fat thickness: correlations with metabolic and liver profiles. Ann Pediatr Endocrinol Metab 2016; 21:75-80. [PMID: 27462583 PMCID: PMC4960018 DOI: 10.6065/apem.2016.21.2.75] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 10/28/2015] [Accepted: 11/30/2015] [Indexed: 01/29/2023] Open
Abstract
PURPOSE Abdominal obesity is a fundamental factor underlying the development of metabolic syndrome. Because of radiation exposure and cost, computed tomography or dual-energy X-ray absorptiometry to evaluate abdominal adiposity are not appropriate in children. Authors evaluated whether ultrasound results could be an indicator of insulin resistance and nonalcoholic fatty liver disease (NAFLD). METHODS We enrolled 73 subjects (aged 6-16 years) who were evaluated abdominal adiposity by ultrasound. Subcutaneous fat thickness was defined as the measurement from the skin-fat interface to the linea alba, and visceral fat thickness (VFT) was defined as the thickness from the linea alba to the aorta. Anthropometric and biochemical metabolic parameters were also collected and compared. The subjects who met 2 criteria, radiologic confirmed fatty liver and alanine aminotransferase >40, were diagnosed with NAFLD. RESULTS There was a strong positive correlation between VFT and obesity. VFT was highly correlated with the homeostasis model assessment for insulin resistance score (r=0.403, P<0.001). The area under the curve for VFT as a predictor of NAFLD was 0.875 (95% confidence interval [CI], 0.787-0.964). VFT of 34.3 mm was found to be the discriminating cutoff for NAFLD (sensitivity, 84.6%; specificity, 71.2%, respectively). CONCLUSION Ultrasound could be useful in measuring VFT and assessing abdominal adiposity in children. Moreover, increased VFT might be an appropriate prognostic factor for insulin resistance and NAFLD.
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Affiliation(s)
- Jae Hwa Jung
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Mo Kyung Jung
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Ki Eun Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Ah Reum Kwon
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Wook Chae
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Choon Sik Yoon
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Ho Seong Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
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Bertoli S, Leone A, Vignati L, Spadafranca A, Bedogni G, Vanzulli A, Rodeschini E, Battezzati A. Metabolic correlates of subcutaneous and visceral abdominal fat measured by ultrasonography: a comparison with waist circumference. Nutr J 2016; 15:2. [PMID: 26732788 PMCID: PMC4702394 DOI: 10.1186/s12937-015-0120-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 12/28/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The relative contribution of visceral (VAT) and subcutaneous (SAT) adipose tissue to cardiometabolic disease is controversial. The aim of this study was to evaluate whether dissecting abdominal fat in VAT and SAT using US may detect stronger and more specific association with MS, MS components, hyperuricemia and altered liver enzymes compared to waist circumference. METHODS We performed a cross-sectional study on 2414 subjects aged 18 to 66 years (71 % women) followed at the International Center for the Assessment of Nutritional Status (ICANS, Milan, Italy). VAT and SAT were measured using ultrasonography. Multivariable logistic regression controlling for age and gender was used to evaluate the association of the parameters of interest (waist circumference (WC), VAT, SAT and VAT + SAT) with the MS (international harmonized definition), its components (high triglycerides, low HDL, high blood pressure, high glucose), high uric acid (≥7 mg/dl), high alanine transaminase (ALT, ≥ 30 U/l) and high gamma-glutamyl-transferase (GGT, ≥ 30 U/l). RESULTS VAT was independently associated with all the outcomes of interest, while SAT was independently associated with MS and only with high blood pressure and high ALT when we considered the single parameters of MS and NAFLD. VAT had the strongest association with high triglycerides, high ALT and high GGT. The VAT + SAT association had the strongest association with MS. WC had the strongest association with low HDL and high blood pressure. VAT and WC were similarly associated to high glucose and high uric acid. CONCLUSION US-determined VAT and SAT are both independently associated with MS. Moreover, to our knowledge, we are the first to show that VAT, being associated to all of the MS components in addition to hyperuricemia and altered liver enzymes, performs equally or better than WC except for high blood pressure and low HDL.
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Affiliation(s)
- Simona Bertoli
- Department of Food, Environmental and Nutritional Sciences (DEFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Via Botticelli 21, 20133, Milano, Italy.
| | - Alessandro Leone
- Department of Food, Environmental and Nutritional Sciences (DEFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Via Botticelli 21, 20133, Milano, Italy.
| | - Laila Vignati
- Department of Food, Environmental and Nutritional Sciences (DEFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Via Botticelli 21, 20133, Milano, Italy.
| | - Angela Spadafranca
- Department of Food, Environmental and Nutritional Sciences (DEFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Via Botticelli 21, 20133, Milano, Italy.
| | - Giorgio Bedogni
- Department of Food, Environmental and Nutritional Sciences (DEFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Via Botticelli 21, 20133, Milano, Italy.
| | - Angelo Vanzulli
- Division of Radiology, Ospedale Niguarda Cà Granda, Milan, Italy.
| | - Elena Rodeschini
- Department of Food, Environmental and Nutritional Sciences (DEFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Via Botticelli 21, 20133, Milano, Italy.
| | - Alberto Battezzati
- Department of Food, Environmental and Nutritional Sciences (DEFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Via Botticelli 21, 20133, Milano, Italy.
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10
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Radmard AR, Merat S, Kooraki S, Ashraf M, Keshtkar A, Sharafkhah M, Jafari E, Malekzadeh R, Poustchi H. Gallstone disease and obesity: a population-based study on abdominal fat distribution and gender differences. Ann Hepatol 2015. [PMID: 26256899 DOI: 10.1016/s1665-2681(19)30765-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Affiliation(s)
- Amir Reza Radmard
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences. Tehran, Iran
| | - Shahin Merat
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences. Tehran, Iran
| | - Soheil Kooraki
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences. Tehran, Iran
| | - Mahya Ashraf
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences. Tehran, Iran
| | - Abbas Keshtkar
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences. Tehran, Iran
| | - Maryam Sharafkhah
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences. Tehran, Iran
| | - Elham Jafari
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences. Tehran, Iran
| | - Reza Malekzadeh
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences. Tehran, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences. Tehran, Iran
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Shabestari AA, Bahrami-Motlagh H, Hosseinpanah F, Heidari K. Abdominal fat sonographic measurement compared to anthropometric indices for predicting the presence of coronary artery disease. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2013; 32:1957-1965. [PMID: 24154900 DOI: 10.7863/ultra.32.11.1957] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVES Sonography for measuring intra-abdominal fat is more accurate than anthropometric measurements. Computed tomographic (CT) angiography has become an accurate noninvasive method for detection of coronary artery disease (CAD). We examined the associations between both sonographic and anthropometric measurements of abdominal adiposity and the presence of CAD on CT angiography. METHODS We evaluated 83 consecutive patients (70% men; mean age ± SD, 56 ± 10.8 years) who were referred for CT angiography. Clinical and laboratory variables were determined, and CT angiography was performed using a 64-slice scanner. The severity of CAD was defined by visual assessment of any plaque, either calcified or noncalcified. Preperitoneal fat, subcutaneous fat, and visceral fat thicknesses were determined on sonography, and the abdominal fat index was calculated as the preperitoneal fat thickness-to-subcutaneous fat thickness ratio. RESULTS Coronary artery disease was detected in 56 patients (67%). Patients with CAD had higher visceral fat thickness (9.3 ± 2.0 versus 8.2 ± 2.2 cm; P = .035) and a higher waist-to-hip ratio (0.97 ± 0.07 versus 0.92 ± 0.07; P = .018) than those without CAD. The preperitoneal fat thickness, subcutaneous fat thickness, and abdominal fat index were not correlated with the CAD status. After adjusting for traditional cardiovascular risk factors, however, only a waist-to-hip ratio higher than 0.95 remained significantly associated with the presence of CAD (odds ratio, 4.03; 95% confidence interval, 1.2-13.4). CONCLUSIONS This study shows that sonographically based obesity measurements are not superior to anthropometric indices in predicting the presence of CAD.
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Affiliation(s)
- Abbas Arjmand Shabestari
- Department of Radiology, Loghman Hospital, Shahid Beheshti University of Medical Science, Makhsus Avenue, Tehran 13336 31152, Iran.
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12
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Bazzocchi A, Filonzi G, Ponti F, Amadori M, Sassi C, Salizzoni E, Albisinni U, Battista G. The role of ultrasonography in the evaluation of abdominal fat: analysis of technical and methodological issues. Acad Radiol 2013; 20:1278-85. [PMID: 24029060 DOI: 10.1016/j.acra.2013.07.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Revised: 07/23/2013] [Accepted: 07/24/2013] [Indexed: 12/13/2022]
Abstract
RATIONALE AND OBJECTIVES Ultrasonography (US) is becoming popular for the assessment of adiposity, but no one has studied this tool in the light of its potential limitations. Our purpose was to investigate the impact of technical conditions on the evaluation of abdominal fat by US. MATERIALS AND METHODS Forty-five healthy males and 45 healthy females were consecutively enrolled in the study, randomly assigned to three groups equally distributed by sex, and examined accordingly to three technical points: fasting state (before and after meal [A]), breathing (expiration and inspiration [B]), and US equipment from different generations: 2003 and 1998 (C). Two blinded radiologists performed US in the these opposite conditions, acquiring five parameters representative of subcutaneous and visceral adiposity in two times. Student's t-test and Lin's correlation coefficient were used for statistical analysis to assess differences in the measures as well as in inter- and intra-observer agreements. RESULTS The maximum and the only statistically significant changes were observed for intra-abdominal fat thickness regarding fasting state and breathing (Δ% = 24.1 ± 21.3 and Δ% = 9.2 ± 20.4, respectively; P < .0001). Reproducibility and repeatability, especially for visceral fat, were proved more stable in the following conditions: fasting state, expiration, and newer machine (2003). CONCLUSION This article provides essential information and "range of confidence" for variations that can be expected from using different conditions in the measurement of abdominal adiposity by US to be carefully addressed as well as considered by US users and by researchers involving this technique in the field of body composition.
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De Lucia Rolfe E, Modi N, Uthaya S, Hughes IA, Dunger DB, Acerini C, Stolk RP, Ong KK. Ultrasound estimates of visceral and subcutaneous-abdominal adipose tissues in infancy. J Obes 2013; 2013:951954. [PMID: 23710350 PMCID: PMC3654330 DOI: 10.1155/2013/951954] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 03/22/2013] [Accepted: 03/27/2013] [Indexed: 12/02/2022] Open
Abstract
Other imaging techniques to quantify internal-abdominal adiposity (IA-AT) and subcutaneous-abdominal adiposity (SCA-AT) are frequently impractical in infants. The aim of this study was twofold: (a) to validate ultrasound (US) visceral and subcutaneous-abdominal depths in assessing IA-AT and SCA-AT from MRI as the reference method in infants and (b) to analyze the association between US abdominal adiposity and anthropometric measures at ages 3 months and 12 months. Twenty-two infants underwent MRI and US measures of abdominal adiposity. Abdominal US parameters and anthropometric variables were assessed in the Cambridge Baby Growth Study (CBGS), n = 487 infants (23 girls) at age 3 months and n = 495 infants (237 girls) at 12 months. US visceral and subcutaneous-abdominal depths correlated with MRI quantified IA-AT (r = 0.48, P < 0.05) and SCA-AT (r = 0.71, P < 0.001) volumes, respectively. In CBGS, mean US-visceral depths increased by ~20 % between ages 3 and 12 months (P < 0.0001) and at both ages were lower in infants breast-fed at 3 months than in other infants. US-visceral depths at both 3 and 12 months were inversely related to skinfold thickness at birth (P = 0.03 and P = 0.009 at 3 and 12 months, resp.; adjusted for current skinfold thickness). In contrast, US-subcutaneous-abdominal depth at 3 months was positively related to skinfold thickness at birth (P = 0.004). US measures can rank infants with higher or lower IA-AT and SCA-AT. Contrasting patterns of association with visceral and subcutaneous-abdominal adiposities indicate that they may be differentially regulated in infancy.
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Affiliation(s)
- Emanuella De Lucia Rolfe
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, P.O. Box 285, Cambridge CB2 0QQ, UK.
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14
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Jain SK, Kahlon G, Morehead L, Dhawan R, Lieblong B, Stapleton T, Caldito G, Hoeldtke R, Levine SN, Bass PF. Effect of chromium dinicocysteinate supplementation on circulating levels of insulin, TNF-α, oxidative stress, and insulin resistance in type 2 diabetic subjects: randomized, double-blind, placebo-controlled study. Mol Nutr Food Res 2012; 56:1333-41. [PMID: 22674882 DOI: 10.1002/mnfr.201100719] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Revised: 02/22/2012] [Accepted: 03/19/2012] [Indexed: 12/23/2022]
Abstract
SCOPE Chromium and cysteine supplementation have been shown to improve glucose metabolism in animal studies. This study examined the hypothesis that chromium dinicocysteinate (CDNC), a complex of chromium and l-cysteine, is beneficial in lowering oxidative stress, vascular inflammation, and glycemia in type 2 diabetic subjects. METHODS AND RESULTS Type 2 diabetic subjects enrolled in this study were given placebo for 1 month for stabilization and then randomized into one of three groups: placebo (P), chromium picolinate (CP), or CDNC, after which they received daily oral supplementation for 3 months. Of the 100 patients enrolled in the study, 74 patients completed it. There were 25 patients in the P supplemented group, 25 in the CP supplemented and 24 in the CDNC supplemented group who completed the study. Blood markers of glycemia, vascular inflammation, HOMA insulin resistance, and oxidative stress were determined at randomization and after 3 months of supplementation with P, CP, or CDNC. There was a significant decrease at 3 months in insulin resistance (p = 0.02) and in the levels of protein oxidation (p = 0.02) and TNF-α (p = 0.01) in the CDNC supplemented cohort compared to baseline. However, there was no statistically significant change in these markers in the CP supplemented group compared to baseline. Insulin levels significantly decreased (p = 0.01) for subjects receiving CDNC but not CP. There was no significant impact of supplementation on HbA(1c) or glucose levels in either of the groups. CONCLUSION CDNC supplementation lowers insulin resistance by reducing blood levels of TNF-α, insulin, and oxidative stress in type 2 diabetic subjects. Therefore, CDNC supplementation has potential as an adjunct therapy for individuals with type 2 diabetes.
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Affiliation(s)
- Sushil K Jain
- Department of Pediatrics, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA.
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15
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Alempijevic T, Sokic-Milutinovic A, Pavlovic Markovic A, Jesic-Vukicevic R, Milicic B, Macut D, Popovic D, Tomic D. Assessment of metabolic syndrome in patients with primary biliary cirrhosis. Wien Klin Wochenschr 2012; 124:251-5. [PMID: 22531844 DOI: 10.1007/s00508-012-0162-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Accepted: 01/16/2012] [Indexed: 12/30/2022]
Abstract
BACKGROUND Primary biliary cirrhosis (PBC) is a chronic, progressive liver disease with elevated serum lipids. It remains unclear if hyperlipidemia increases the risk for atherosclerosis in PBC patients. Metabolic syndrome (MS) promotes the development of atherosclerotic cardiovascular disease due to abdominal obesity and insulin resistance. AIMS The aim of this study was to assess incidence and parameters of MS, as well as subcutaneous and visceral fat using noninvasive ultrasonographic measurement in patients with PBC in our population. METHODS We included 55 patients with PBC and 44 age- and sex-matched healthy controls (CG-control group). Anthropometric measurements (weight, height, and waist circumference), age, sex, and body mass index were recorded for patients and controls. Laboratory tests for assessing MS and liver function tests were analyzed. We used ultrasonography to determine subcutaneous and visceral fat diameter and area (SF, VF and SA, VA, respectively), as well as perirenal fat diameter (PF). RESULTS Patients with PBC had significantly higher levels of cholesterol and liver function tests. There were no statistically significant difference in serum insulin and HOMA levels, as well as incidence of MS was diagnosed in 30.9 % (17/55) PBC patients and 43.2 % (19/44) controls. We registered lower amount of VF (PBC:10.92 ± 3.63 mm, CG:16.84 ± 5.51 mm,p < 0.001), VA (PBC:403.64 ± 166.97 mm(2), CG:720.57 ± 272.50 mm(2),p < 0.001), and PF (PBC:7.03 ± 1.82 mm, CG 10.49 ± 2.70 mm,p < 0.001) in patients with PBC. CONCLUSION MS is not more frequent in patients with PBC compared with healthy volunteers in our population. Lower amount of VF could be related to lower risk for cardiovascular events in PBC patients.
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Bazzocchi A, Filonzi G, Ponti F, Sassi C, Salizzoni E, Battista G, Canini R. Accuracy, reproducibility and repeatability of ultrasonography in the assessment of abdominal adiposity. Acad Radiol 2011; 18:1133-43. [PMID: 21724427 DOI: 10.1016/j.acra.2011.04.014] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Revised: 03/30/2011] [Accepted: 04/09/2011] [Indexed: 12/20/2022]
Abstract
RATIONALE AND OBJECTIVES Despite improvements in the methods used in body composition analysis, some goals remain far from clinical practice. Among them, the most important is the quantification of intra-abdominal adipose tissue. Fat distribution is a key point in the assessment of cardiovascular and metabolic risk status. The aim of this study was to define the accuracy, reproducibility, and repeatability of ultrasonography in the evaluation of abdominal adiposity. MATERIALS AND METHODS Twenty-six nonobese patients (group A) who underwent computed tomographic (CT) abdominal imaging and 29 obese patients (group B) were enrolled. Patients from both groups were independently evaluated using ultrasound by three radiologists; computed tomography-like conditions were reproduced, and six main parameters of subcutaneous and internal adiposity were measured (as well as three derived indexes) with both linear and convex probes. In group A, the same measurements were also obtained on CT images. Time spent for every ultrasound session was recorded. Results were analyzed using Lin's concordance correlation (ρ), intraclass correlation, and linear regression analysis (and analysis of variance). RESULTS Three patients were excluded from group A after CT scans because of technical problems. Mesenteric fat thickness did not show significant correlations and reliability. Strong correlations between ultrasound and CT measurements were observed for all other visceral and subcutaneous parameters (ρ = 0.85-0.96). Intraobserver and interobserver agreement was excellent in both groups (repeatability: ρ = 0.83-0.99 for group A, ρ = 0.90-0.99 for group B; reproducibility: intraclass correlation coefficient = 0.90-0.99 for groups A and B). The mean time spent was 95 ± 21 seconds for group A (mean body mass index, 27.4 ± 2.4 kg/m(2)) and 129 ± 33 seconds for group B (mean body mass index, 37.3 ± 11.9 kg/m(2)). CONCLUSIONS Ultrasound is accurate, reproducible, and fast in the analysis of abdominal adiposity. It offers a regional, easy, and close-at-hand evaluation of subcutaneous and visceral fat compartments. This should be taken into consideration when clinical routine examinations are performed or to evaluate patients with specific metabolic diseases before and after treatment.
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Emmons RR, Garber CE, Cirnigliaro CM, Kirshblum SC, Spungen AM, Bauman WA. Assessment of measures for abdominal adiposity in persons with spinal cord injury. ULTRASOUND IN MEDICINE & BIOLOGY 2011; 37:734-741. [PMID: 21439716 DOI: 10.1016/j.ultrasmedbio.2011.02.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Revised: 01/25/2011] [Accepted: 02/03/2011] [Indexed: 05/30/2023]
Abstract
Ultrasound may be a useful tool to assess abdominal adiposity, but it has not been validated in the spinal cord injury (SCI) population. This study evaluated associations between abdominal ultrasound and other methods to assess adiposity in 24 men with SCI and 20 able-bodied (AB) men. Waist (WC) and hip circumference (HC) and waist-to-hip ratio (WHR) were measured. Trunk (TRK%), android (A%) and waist fat (W%) were determined by dual energy x-ray absorptiometry (DXA); ultrasonography determined abdominal subcutaneous (SF) and visceral fat (VF). The SCI group had greater TRK% (40.0 ± 9.6 vs. 32.0 ± 10.3), W% (47.0 ± 9.7 vs. 40.6 ± 9.4), A% (43.0 ± 9.8 vs. 35.8 ± 10.6) and WHR (0.99 ± 0.1 vs. 0.92 ± 0.06) than the AB group. WC and WHR correlated with VF in the SCI group. These associations suggest that ultrasound may be a useful tool in clinical practice for the measurement of VF in weight loss programs and for the assessment of cardiometabolic disorders.
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Affiliation(s)
- Racine R Emmons
- Department of Veterans Affairs, Rehabilitation Research and Development Center of Excellence for the Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center, Bronx, NY 10468, USA.
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Battaglia C, Battaglia B, Mancini F, Paradisi R, Fabbri R, Venturoli S. Ultrasonographic extended-view technique for evaluation of abdominal fat distribution in lean women with polycystic ovary syndrome. Acta Obstet Gynecol Scand 2011; 90:600-8. [DOI: 10.1111/j.1600-0412.2011.01124.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Soler GLN, Silva AWSM, Silva VCGD, Teixeira RDJ. Prevalência de esteatose hepática e consumo de álcool em participantes do Projeto Atividade Física na Vila. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2011. [DOI: 10.5712/rbmfc6(18)97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
A esteatose hepática é um achado cada vez mais frequente em exames de rastreamento por estudo de imagem. Tem sido descrita associação entre esteatose, obesidade, resistência à insulina e síndrome metabólica (SM). Também parece existir sinergismo entre esteatose hepática, álcool e fibrose hepática. O objetivo foi descrever a prevalência de esteatose e de etilismo nos participantes do Projeto “Atividade Física na Vila” e avaliar sua associação com a presença de obesidade e obesidade visceral. Foi realizada ultrassonografia abdominal em 69 participantes, 53,02±1,26 anos, sendo avaliados a presença e o grau de esteatose e as medidas da gordura subcutânea e visceral (GV). Foram excluídos os pacientes com hepatite viral e com etilismo significativo na anamnese ou após teste AUDIT. Após análise inicial, 60 pacientes foram avaliados quanto aos dados antropométricos e divididos em 2 grupos: com e sem esteatose. A prevalência de etilismo foi de 8,7%. A esteatose hepática foi observada em 37% dos pacientes sendo a maioria classificada como leve e moderada (91%). O grupo com esteatose apresentou aumento significativo de IMC (34,±8,7 versus 29,8±6,5kg/m2), cintura abdominal (102,6±12,7 versus 95,3±12,3cm), peso (85,8±18,7 versus 74,5±17,7kg) e GV (47,9±10,5 versus 36,0±12,7mm). A esteatose hepática é comum em obesos, especialmente naqueles com obesidade visceral. Sabemos que o álcool e a obesidade visceral podem estar envolvidos em seu mecanismo fisiopatológico. Por isso, os pacientes com esteatose hepática e consumo excessivo de álcool podem apresentar maior chance de evoluir desfavoravelmente para a cirrose e insuficiência hepática.
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21
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Ultrasound measurement of visceral fat in patients with primary biliary cirrhosis. VOJNOSANIT PREGL 2011; 68:739-43. [PMID: 22046877 DOI: 10.2298/vsp1109739a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background/Aim. Primary biliary cirrhosis (PBC) is a progressive, chronic
liver disease with elevated serum lipids, but it is unclear whether
hyperlipidemia in PBC patients is associated with atherosclerosis. Metabolic
syndrome promotes development of atherosclerotic cardiovascular disease
related to abdominal type obesity and insulin resistance. The aim of our
study was to assess abdominal adiposity in patients with PBC. Methods. The
study included 40 patients with PBC and 50 healthy controls. Age, sex and
anthropometric measurements (weight, height, body mass index and waist
circumference) were registered for all patients and controls. We used
ultrasonography to measure subcutaneous (SF) and visceral fat (VF) diameter,
subcutaneous area (SA) and visceral area (VA), as well as perirenal fat
diameter (PF). Results. Values of SF, VF and PF thicknesses in PBC patients
were 19.23 ? 5.85 mm, 10.92 ? 3.63 mm, and 7.03 ? 1.82 mm, respectively. In
controls these measurements were 22.73 ? 6.70 mm, 16.84 ? 5.51 mm and 10.50 ?
2.70 mm respectively. In PBC patients SA and VA were calculated to 983.64 ?
322.68 mm2 and 403.64 ? 166.97 mm2 and in controls 1124.89 ? 366.01 mm2 and
720.57 ? 272.50 mm2 respectrively. Significant difference was found for VF,
VA and RF values. Conclusions. Considering that the amount of visceral fat
plays an important role in development of metabolic syndrome and
cardiovascular diseases, we concluded that the lower amount of visceral fat
in PBC patients could be related to lower incidence of cardiovascular events,
despite hyperlipidemia.
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Hamagawa K, Matsumura Y, Kubo T, Hayato K, Okawa M, Tanioka K, Yamasaki N, Kitaoka H, Yabe T, Nishinaga M, Doi YL. Abdominal visceral fat thickness measured by ultrasonography predicts the presence and severity of coronary artery disease. ULTRASOUND IN MEDICINE & BIOLOGY 2010; 36:1769-1775. [PMID: 20870342 DOI: 10.1016/j.ultrasmedbio.2010.08.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Revised: 07/27/2010] [Accepted: 08/11/2010] [Indexed: 05/29/2023]
Abstract
Abdominal visceral fat plays a critical role in the pathogenesis of metabolic syndrome, which is a risk factor for coronary artery disease (CAD). Ultrasonography (US) distinctively quantifies visceral fat and subcutaneous fat. We measured the maximum preperitoneal visceral fat thickness (Vmax) and the minimum subcutaneous fat thickness (Smin) by US in 185 patients who underwent coronary angiography. Although the 144 patients with CAD had larger Vmax (8.8 ± 3.6 vs. 6.4 ± 2.8 mm; p < 0.001) than those without, there was no difference in Smin. Vmax of 6.9 mm or higher was an independent predictor of CAD (odds ratio, 3.710, p = 0.008) by multiple logistic regression analysis. Vmax significantly correlated with the number of diseased vessels. Assessment of abdominal visceral fat by US gives us incremental information beyond conventional risk factors for predicting CAD in routine clinical practice.
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Affiliation(s)
- Kosuke Hamagawa
- Department of Medicine and Geriatrics, Kochi Medical School, Kochi University, Oko-cho, Nankoku-shi, Kochi, Japan
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Martín B, Solanas-Barca M, García-Otín AL, Pampín S, Cofán M, Ros E, Rodríguez-Rey JC, Pocoví M, Civeira F. An NPC1L1 gene promoter variant is associated with autosomal dominant hypercholesterolemia. Nutr Metab Cardiovasc Dis 2010; 20:236-242. [PMID: 19747803 DOI: 10.1016/j.numecd.2009.03.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Revised: 03/19/2009] [Accepted: 03/20/2009] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS A substantial number of subjects with autosomal dominant hypercholesterolemia (ADH) do not have LDL receptor (LDLR) or apolipoprotein B (APOB) mutations. Some ADH subjects appear to hyperabsorb sterols from the intestine, thus we hypothesized that they could have variants of the Niemann-Pick C1-Like 1 gene (NPC1L1). NPC1L1 encodes a crucial protein involved in intestinal sterol absorption. METHODS AND RESULTS Four NPC1L1 variants (-133A>G, -18C>A, 1679C>G, 28650A>G) were analyzed in 271 (155 women and 116 men) ADH bearers without mutations in LDLR or APOB aged 30-70years and 274 (180 women and 94 men) control subjects aged 25-65years. The AC haplotype determined by the -133A>G and -18C>A variants was underrepresented in ADH subjects compared to controls (p=0.01). In the ADH group, cholesterol absorption/synthesis markers were significantly lower in AC homozygotes that in all others haplotypes. Electrophoretic mobility shift assay (EMSA) results revealed that the -133A-specific oligonucleotide produced a retarded band stronger than the -133G allele. Luciferase activity with NPC1L1 -133G variant was 2.5-fold higher than with the -133A variant. CONCLUSION The -133A>G polymorphism exerts a significant effect on NPC1L1 promoter activity. NPC1L1 promoter variants might explain in part the hypercholesterolemic phenotype of some subjects with nonLDLR/nonAPOB ADH.
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Affiliation(s)
- B Martín
- Departamento de Bioquímica y Biología Molecular y Celular, Universidad de Zaragoza, Zaragoza, Spain
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Mook-Kanamori DO, Holzhauer S, Hollestein LM, Durmus B, Manniesing R, Koek M, Boehm G, van der Beek EM, Hofman A, Witteman JCM, Lequin MH, Jaddoe VWV. Abdominal fat in children measured by ultrasound and computed tomography. ULTRASOUND IN MEDICINE & BIOLOGY 2009; 35:1938-1946. [PMID: 19800165 DOI: 10.1016/j.ultrasmedbio.2009.07.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2009] [Revised: 05/28/2009] [Accepted: 07/14/2009] [Indexed: 05/28/2023]
Abstract
The prevalence of childhood obesity is increasing rapidly. Visceral fat plays an important role in the pathogenesis of metabolic and cardiovascular diseases. Currently, computed tomography (CT) is broadly seen as the most accurate method of determining the amount of visceral fat. The main objective was to examine whether measures of abdominal visceral fat can be determined by ultrasound in children and whether CT can be replaced by ultrasound for this purpose. To assess whether preperitoneal fat thickness and area are good approximations of visceral fat at the umbilical level, we first retrospectively examined 47 CT scans of nonobese children (body mass index <30kg/m(2); median age 7.9 y [95% range 1.2 to 16.2]). Correlation coefficients between visceral and preperitoneal fat thickness and area were 0.58 (p<0.001) and 0.76 (p<0.001), respectively. Then, to assess how preperitoneal and subcutaneous fat thicknesses and areas measured by ultrasound compare with these parameters in CT, we examined 34 nonobese children (median age 9.5 [95% range 0.3 to 17.0]) by ultrasound and CT. Ultrasound measurements of preperitoneal and subcutaneous fat were correlated with CT measurements, with correlation coefficients ranging from 0.75-0.97 (all p<0.001). Systematic differences of up to 24.0cm(2) for preperitoneal fat area (95% confidence interval -29.9 to 77.9cm(2)) were observed when analyzing the results described by the Bland-Altman method. Our findings suggest that preperitoneal fat can be used as an approximation for visceral fat in children and that measuring abdominal fat with ultrasound in children is a valid method for epidemiological and clinical studies. However, the exact agreement between the ultrasound and CT scan was limited, which indicates that ultrasound should be used carefully for obtaining exact fat distribution measurements in individual children.
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Affiliation(s)
- D O Mook-Kanamori
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands
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Solanas-Barca M, Mateo-Gallego R, Calmarza P, Jarauta E, Bea AM, Cenarro A, Civeira F. Mutations in HFE causing hemochromatosis are associated with primary hypertriglyceridemia. J Clin Endocrinol Metab 2009; 94:4391-7. [PMID: 19820015 DOI: 10.1210/jc.2009-0814] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
CONTEXT Most cases of primary hypertriglyceridemia (HTG) are caused by the interaction of unknown polygenes and environmental factors. Elevated iron storage is associated with metabolic syndrome, diabetes, and obesity, and all of them are associated with HTG. OBJECTIVE The aim of the study was to analyze whether HFE mutations causing hereditary hemochromatosis (HH) are associated with primary HTG. DESIGN Genetic predisposition to HH was analyzed in a case-control study. SETTING The study was conducted at University Hospital Lipid Clinic. PARTICIPANTS We studied two groups: 1) the HTG group, composed of 208 patients; and 2) the control group, composed of 215 normolipemic subjects and 161 familial hypercholesterolemia patients. INTERVENTION Two HFE mutations (C282Y and H63D) were analyzed. MAIN OUTCOME MEASURE We measured HH genetic predisposition difference between groups. RESULTS HH genetic predisposition was 5.9 and 4.4 times higher in the HTG group than in the normolipemic (P = 0.02) and FH (P = 0.05) subjects, respectively. There were 35 cases (16.8%) of iron overload in the primary HTG group, 14 (6.5%) and nine (5.6%) in the normolipidemic and FH groups, respectively. A higher HH genetic predisposition and a different prevalence of iron overload in subjects with HH genetic predisposition among groups contributed to this higher prevalence. None of the four cases with the HFE genotype associated with high risk of HH in the control groups presented iron overload; however, in eight of 11 subjects (72.7%) with primary HTG and HH genetic predisposition, the iron overload was present. CONCLUSION Mutations in HFE gene, favoring iron overload and causing HH, could play an important role in the development of several phenotypes of primary HTG.
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Affiliation(s)
- María Solanas-Barca
- Unidad de Lípidos and Laboratorio de Investigación Molecular, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de la Salud (I+CS), 50009 Zaragoza, Spain
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Burillo E, Recalde D, Jarauta E, Fiddyment S, Garcia-Otin AL, Mateo-Gallego R, Cenarro A, Civeira F. Proteomic study of macrophages exposed to oxLDL identifies a CAPG polymorphism associated with carotid atherosclerosis. Atherosclerosis 2009; 207:32-7. [DOI: 10.1016/j.atherosclerosis.2009.03.054] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2009] [Revised: 03/25/2009] [Accepted: 03/25/2009] [Indexed: 11/25/2022]
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Holzhauer S, Zwijsen RML, Jaddoe VWV, Boehm G, Moll HA, Mulder PG, Kleyburg-Linkers VA, Hofman A, Witteman JCM. Sonographic assessment of abdominal fat distribution in infancy. Eur J Epidemiol 2009; 24:521-9. [PMID: 19639387 PMCID: PMC2744780 DOI: 10.1007/s10654-009-9368-1] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2009] [Accepted: 06/30/2009] [Indexed: 11/28/2022]
Abstract
There is growing evidence that not only the total amount of fat, but also the distribution of body fat determines risks for metabolic and cardiovascular disease. Developmental studies on factors influencing body fat distribution have been hampered by a lack of appropriate techniques for measuring intraabdominal fat in early life. Sonography, which is an established method for assessing abdominal fat distribution in adults, has not yet been evaluated in infants. To adapt the sonographic measurement of abdominal fat distribution to infants and study its reliability. The Generation R study, a population-based prospective cohort study. We included 212 one- and 227 two-year old Dutch infants in the present analysis. Sixty-two infants underwent replicate measurements to assess reproducibility. We developed a standardized protocol to measure the thickness of (1) subcutaneous and (2) preperitoneal fat in the upper abdomen of infants. To this end we defined infancy specific measurement areas to quantify fat thickness. Reproducibility of fat measurements was good to excellent with intraclass correlation coefficients of 0.93–0.97 for intra-observer agreement and of 0.89–0.95 for inter-observer agreement. We observed a pronounced increase in preperitoneal fat thickness in the second year of life while subcutaneous fat thickness increased only slightly, resulting in an altered body fat distribution. Gender did not significantly influence fat distribution in the first two years of life. Our age specific protocol for the sonographic measurement of central subcutaneous and preperitoneal fat is a reproducible method that can be instrumental for investigating fat distribution in early life.
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Affiliation(s)
- Susanne Holzhauer
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands.
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Tarantino G, Colicchio P, Conca P, Finelli C, Di Minno MND, Tarantino M, Capone D, Pasanisi F. Young adult obese subjects with and without insulin resistance: what is the role of chronic inflammation and how to weigh it non-invasively? J Inflamm (Lond) 2009; 6:6. [PMID: 19291292 PMCID: PMC2663560 DOI: 10.1186/1476-9255-6-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2009] [Accepted: 03/16/2009] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Obesity is a leading risk factor for metabolic syndrome whose further expression is non-alcoholic fatty liver disease. Metabolic syndrome is associated with a proinflammatory state that contributes to insulin resistance. Finally, a "metabolically benign obesity" that is not accompanied by insulin resistance has recently been postulated to exist. AIM To find whether any inflammation markers were independently associated with the presence of insulin resistance, evaluating specific anthropometric, ultrasonographic and laboratory parameters in a population of young adult obese subjects. METHODS Of forty two young individuals, divided into two groups (with or without insulin resistance), were studied serum C-reactive protein and fibrinogen as indexes of chronic pro-inflammatory status. Body mass index, waist circumference and metabolic syndrome presence were assessed as part of the metabolic evaluation. Ultrasonography weighted visceral and subcutaneous abdominal fat thickness, spleen size as longitudinal diameter and liver hyperechogenicity. RESULTS AND DISCUSSION Serum C-reactive protein and fibrinogen as well as spleen longitudinal diameter were significantly increased in the obese young with insulin resistance compared to non-insulin resistance group. Insulin resistance was significantly associated with hepatic steatosis score at sonography (r = 0.33, P = 0.03), spleen longitudinal diameter (r = 0.35, P = 0.02) and C-reactive protein (r = 0.38, P = 0.01), but not with body mass index, visceral or subcutaneous abdominal adipose tissue, waist circumference and fibrinogen (P = 0.18, 0.46, 0.33, 0.37 and 0.4, respectively). Steatosis score at sonography was well associated with spleen volume (rho = 0.40, P = 0.01) and C-reactive protein levels (rho = 0.49, P = 0.002). Metabolic syndrome was much more frequent in obese patients with insulin resistance. These findings show that in young adults the only abdominal adiposity without insulin resistance, plays a scarce role in determining hepatic steatosis as well as metabolic syndrome. CONCLUSION Increases in spleen size and CRP levels represent a reliable tool in diagnosing insulin resistance.
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Affiliation(s)
- Giovanni Tarantino
- Department of Clinical and Experimental Medicine, Federico II University Medical School of Naples, Italy
| | - Patrizia Colicchio
- Department of Clinical and Experimental Medicine, Federico II University Medical School of Naples, Italy
| | - Paolo Conca
- Department of Clinical and Experimental Medicine, Federico II University Medical School of Naples, Italy
| | - Carmine Finelli
- Department of Clinical and Experimental Medicine, Federico II University Medical School of Naples, Italy
| | | | - Marianna Tarantino
- Department of Biomorphological and Functional Sciences, Federico II University Medical School of Naples, Italy
| | - Domenico Capone
- Department of Neurosciences, Unit of Clinical Pharmacology, Federico II University Medical School of Naples, Italy
| | - Fabrizio Pasanisi
- Department of Clinical and Experimental Medicine, Federico II University Medical School of Naples, Italy
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Simonsen L, Enevoldsen LH, Stallknecht B, Bülow J. Effects of local α2-adrenergic receptor blockade on adipose tissue lipolysis during prolonged systemic adrenaline infusion in normal man. Clin Physiol Funct Imaging 2008; 28:125-31. [DOI: 10.1111/j.1475-097x.2007.00781.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Meriño-Ibarra E, Cenarro A, Martín P, García-Otín AL, Goicoechea J, Guallar A, Calvo L, Civeira F. [Sensitivity and specificity of metabolic syndrome criteria for insulin resistance diagnosis in Spanish population]. Med Clin (Barc) 2007; 128:168-71. [PMID: 17298777 DOI: 10.1157/13098390] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVE Metabolic syndrome (MS) is an abdominal obesity and insulin resistance (IR)-related syndrome associated with a high cardiovascular risk. Recently, the International Diabetes Federation (IDF) has proposed a modification of the Adult Treatment Panel III (ATP III) diagnostic criteria. However, the sensitivity of these new criteria has not been established. The aim of the present study was to define the sensitivity and specificity of the different criteria used for the diagnosis of the MS in our population. SUBJECTS AND METHOD We studied in 177 healthy subjects, 68 men and 109 women, the body mass index, waist circumference (WC), blood pressure, glucose, insulin, lipids and apolipoproteins A1 and B. The HOMA index was used as an IR indicator. IR was considered with an HOMA index > or = 3.8. RESULTS Subjects with IR showed higher age, systolic blood pressure, triglycerides and apo B, and lower HDL cholesterol. A WC > or = 102 cm in men and > or = 88 cm in women (ATP III criteria) had a low sensitivity for IR (29.4% and 44.7% respectively), with high specificity (81% and 90%). A WC > or = 94 cm in men and > or = 80 cm in women (IDF criteria) showed good sensitivity (73.5% and 73.7% respectively) but less specificity (57.1% and 53.3%). The IDF criteria showed better sensitivity than ATP III, without substantial change in the specificity for the different HOMA cut-off points. CONCLUSIONS ATP III criteria had low sensitivity in our population. The new criteria (WC > or = 94 cm in men and > or = 80 cm in women, and blood glucose > or = 100 mg/dL) improve three-fold the diagnostic sensitivity and, therefore, seems to be more useful for detecting IR in our country.
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Affiliation(s)
- Erardo Meriño-Ibarra
- Laboratorio de Investigación Molecular, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, España
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