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Stein MJ, Fischer B, Bohmann P, Ahrens W, Berger K, Brenner H, Günther K, Harth V, Heise JK, Karch A, Klett-Tammen CJ, Koch-Gallenkamp L, Krist L, Lieb W, Meinke-Franze C, Michels KB, Mikolajczyk R, Nimptsch K, Obi N, Peters A, Pischon T, Schipf S, Schmidt B, Stang A, Thierry S, Willich SN, Wirkner K, Leitzmann MF, Sedlmeier AM. Differences in Anthropometric Measures Based on Sex, Age, and Health Status. DEUTSCHES ARZTEBLATT INTERNATIONAL 2024; 121:207-213. [PMID: 38377337 DOI: 10.3238/arztebl.m2024.0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/22/2024] [Accepted: 01/22/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Obesity is a worldwide health problem. We conducted detailed analyses of anthropometric measures in a comprehensive, population-based, current cohort in Germany. METHODS In the German National Cohort (NAKO), we analyzed cross-sectional data on body mass index (BMI), waist and hip circumference, subcutaneous (SAT) and visceral adipose tissue (VAT) as measured by ultrasound, and body fat percentage. The data were stratified by sex, age, and self-reported physicians' diagnoses of cardiovascular diseases (CVD), metabolic diseases (MetD), cardiometabolic diseases (CMD), and cancer. RESULTS Data were available from 204 751 participants (age, 49.9 ± 12.8 years; 50.5% women). Body size measures generally increased with age. Men had a higher BMI, larger waist circumference, and more VAT than women, while women had a larger hip circumference, more SAT, and a higher body fat percentage than men. For example, the mean BMI of participants over age 60 was 28.3 kg/m2 in men and 27.6 kg/m2 in women. CVD, MetD, and CMD were associated with higher anthropometric values, while cancer was not. For example, the mean BMI was 25.3 kg/m2 in healthy women, 29.4 kg/m2 in women with CMD, and 25.4 kg/m2 in women with cancer. CONCLUSION Obesity is widespread in Germany, with notable differences between the sexes in anthro - pometric values. Obesity was more common in older participants and those with chronic diseases other than cancer. Elevated values were especially common in multimorbid individuals.
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Affiliation(s)
- Michael J Stein
- Department of Epidemiology and Preventive Medicine, University of Regensburg; Department of Epidemiology and Preventive Medicine, Center for Translational Oncology, University Hospital Regensburg and Bavarian Cancer Research Center (BZKF), Regensburg; Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany; Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Institute for Occupational and Maritime Medicine Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department for Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany; Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany; Institute of Epidemiology, Kiel University, Kiel, Germany; Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany; Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany; Institute for Medical Epidemiology, Biometrics, and Informatics, Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany; Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany; Institute of Epidemiology, Helmholtz Munich, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Medical Faculty, Ludwig-Maximilians-Universität München, Munich, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany; Biobank Technology Platform, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany; Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Institute for Medical Informatics, Biometry and Epidemiology, Essen University Hospital, University of Duisburg-Essen, Germany; NAKO Study Center, Department of Diagnostic and Interventional Radiology and Neuroradiology, Augsburg University Hospital, Augsburg, Germany; LIFE-Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
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Battisti S, Pedone C, Tramontana F, Napoli N, Alhamar G, Russo E, Agnoletti V, Paolucci E, Galgani M, Giampalma E, Paviglianiti A, Strollo R. Abdominal adipose tissue distribution assessed by computed tomography and mortality in hospitalised patients with COVID-19: a retrospective longitudinal cohort study. Endocrine 2024; 83:597-603. [PMID: 37736820 DOI: 10.1007/s12020-023-03530-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/07/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Visceral adiposity has been associated with an increased risk of critical illness in COVID-19 patients. However, if it also associates to a poor survival is still not well established. The aim of the study was to assess the relationship between abdominal fat distribution and COVID-19 mortality. METHODS In this six-month longitudinal cohort study, abdominal visceral (VAT) and subcutaneous adipose tissues (SAT) were measured by computed tomography in a cohort of 174 patients admitted to the emergency department with a diagnosis of COVID-19, during the first wave of pandemic. The primary exposure and outcome measures were VAT and SAT at hospital admission, and death at 30 and 180 days, respectively. RESULTS Overall survival was not different according to VAT (p = 0.94), SAT (p = 0.32) and VAT/SAT ratio (p = 0.64). However, patients in the lowest SAT quartile (thickness ≤ 11.25 mm) had a significantly reduced survival compared to those with thicker SAT (77 vs. 94% at day 30; 74 vs. 91% at day 180, p = 0.01). Similarly, a thinner SAT was associated with lower survival in Intensive Care Unit (ICU) admitted patients, independently of sex or age (p = 0.02). The VAT/SAT ratio showed a non-linear increased risk of ICU admission, which plateaued out and tended for inversion at values greater than 1.9 (p = 0.001), although was not associated with increased mortality rate. CONCLUSIONS In our cohort, visceral adiposity did not increase mortality in patients with COVID-19, but low SAT may be associated with poor survival.
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Affiliation(s)
- Sofia Battisti
- Radiology Department, AUSL Romagna M. Bufalini Hospital, Cesena, Italy
- Radiology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
- Department of Experimental, Diagnostic and Specialty Medicine - DIMES, Alma Mater Studiorum-Università di Bologna, S.Orsola-Malpighi Hospital, Bologna, Italy
| | - Claudio Pedone
- Department of Medicine and Surgery, Research Unit of Geriatrics, Università Campus Bio-Medico di Roma, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Operative Research Unit of Geriatrics, Rome, Italy
| | - Flavia Tramontana
- Department of Medicine and Surgery, Research Unit of Endocrinology & Diabetes, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Nicola Napoli
- Department of Medicine and Surgery, Research Unit of Endocrinology & Diabetes, Università Campus Bio-Medico di Roma, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Ghadeer Alhamar
- Department of Medicine and Surgery, Research Unit of Endocrinology & Diabetes, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Emanuele Russo
- Anesthesia and Intensive Care Unit, AUSL Romagna, M.Bufalini Hospital, Cesena, Italy
| | - Vanni Agnoletti
- Anesthesia and Intensive Care Unit, AUSL Romagna, M.Bufalini Hospital, Cesena, Italy
| | - Elisa Paolucci
- Internal Medicine Unit, AUSL Romagna, M.Bufalini Hospital, Cesena, Italy
| | - Mario Galgani
- Department of Molecular Medicine and Medical Biotechnology, University of Naples "Federico II", Naples, Italy
- Institute for Endocrinology and Experimental Oncology "G. Salvatore", Consiglio Nazionale delle Ricerche (C.N.R.), Naples, Italy
| | | | - Annalisa Paviglianiti
- Department of Medicine and Surgery, Research Unit of Endocrinology & Diabetes, Università Campus Bio-Medico di Roma, Rome, Italy
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, 08908, Barcelona, Spain
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), 08908, Barcelona, Spain
| | - Rocky Strollo
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
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Lee YS, Song SH, Wu TC, Wu SL, Huang CF. Correlation of hepatic transient elastography measurements and abdominal adiposity in children: A cross-sectional study. Pediatr Neonatol 2023; 64:631-636. [PMID: 36967291 DOI: 10.1016/j.pedneo.2022.12.018] [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: 07/29/2022] [Revised: 11/16/2022] [Accepted: 12/08/2022] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Transient elastography is a non-invasive assessment of steatosis (measured as the controlled attenuation parameter, [CAP]) and fibrosis (measured as liver stiffness measurement, [LSM]) in patients with pediatric non-alcoholic fatty liver disease (NAFLD). Abdominal adiposity is considered the most important factor for metabolic dysregulation including NAFLD. However, there is lack of a correlation between transient elastography measurements and abdominal adiposity. Accordingly, this study aimed to assess the correlation between transient elastography measurements and abdominal adiposity in children. METHODS This cross-sectional study included 137 children who visited the Taipei Veterans General Hospital. Hepatic steatosis (CAP) and fibrosis (LSM), were assessed by transient elastography. Abdominal adiposity including subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and preperitoneal adipose tissue (PPT) was assessed using abdominal sonography. The correlation between transient elastography measurements and abdominal adiposity was assessed using multiple linear regression. RESULTS In total, 137 children were included in this study. SAT and VAT were significantly associated with CAP, whereas SAT was significantly associated with LSM. An increment of 1 mm in SAT increased CAP and LSM by 5.56 dB/m and 0.06 kPa, respectively. CONCLUSION Certain abdominal adiposities, especially SAT, are significantly associated with CAP and LSM, as determined by transient elastography. Simple abdominal adiposity measured using sonography may be useful for the early detection of pediatric NAFLD.
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Affiliation(s)
- Yii-Shiuan Lee
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shih-Hsi Song
- Department of Pediatrics, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan
| | - Tzee-Chung Wu
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shang-Liang Wu
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ching-Feng Huang
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Defense Medical Center, Taipei, Taiwan.
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Harutyunyan R, Gilardino MS, Papanastasiou VW, Jeffries SD, Hemmerling TM. Ultrasound Calculation of Fat Volume for Liposuction: A Clinical Software Validation. Aesthet Surg J 2023; 43:1150-1158. [PMID: 37099036 DOI: 10.1093/asj/sjad121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Fat manipulation procedures such as liposuction contain a degree of subjectivity primarily guided by the surgeon's visual or tactile perception of the underlying fat. Currently, there is no cost-effective, direct method to objectively measure fat depth and volume in real time. OBJECTIVES Utilizing innovative ultrasound-based software, the authors aimed to validate fat tissue volume and distribution measurements in the preoperative setting. METHODS Eighteen participants were recruited to evaluate the accuracy of the new software. Recruited participants underwent ultrasound scans within the preoperative markings of the study area before surgery. Ultrasound-estimated fat profiles were generated with the in-house software and compared directly with the intraoperative aspirated fat recorded after gravity separation. RESULTS Participants' mean age and BMI were 47.6 (11.3) years and 25.6 (2.3) kg/m2, respectively. Evaluation of trial data showed promising results following the use of a Bland Altman agreement analysis. For the 18 patients and 44 volumes estimated, 43 of 44 measurements fell within a confidence interval of 95% when compared with the clinical lipoaspirate (dry) volumes collected postsurgery. The bias was estimated at 9.15 mL with a standard deviation of 17.08 mL and 95% confidence interval between -24.34 mL and 42.63 mL. CONCLUSIONS Preoperative fat assessment measurements agreed significantly with intraoperative lipoaspirate volumes. The pilot study demonstrates, for the first time, a novel companion tool with the prospect of supporting surgeons in surgical planning, measuring, and executing the transfer of adipose tissues. LEVEL OF EVIDENCE: 4
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Kimball AL, Petrie MA, McCue PM, Johnson KA, Shields RK. Impaired Glucose Tolerance and Visceral Adipose Tissue Thickness among Lean and Non-Lean People with and without Spinal Cord Injury. J Funct Morphol Kinesiol 2023; 8:123. [PMID: 37606417 PMCID: PMC10443282 DOI: 10.3390/jfmk8030123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/15/2023] [Accepted: 08/17/2023] [Indexed: 08/23/2023] Open
Abstract
After spinal cord injury (SCI), multiple adaptations occur that influence metabolic health and life quality. Prolonged sitting and inactivity predispose people with SCI to body composition changes, such as increased visceral adipose tissue (VAT) thickness, which is often associated with impaired glucose tolerance. Our goal is to understand whether VAT is an index of leanness, and, secondarily, whether mobility methods influence glucose tolerance for people living with SCI. A total of 15 people with SCI and 20 people without SCI had fasting oral glucose tolerance tests (OGTT) and VAT thickness (leanness) measured during a single session. Glucose was 51% and 67% greater for individuals with SCI relative to those without SCI after 60 and 120 min of an OGTT (p < 0.001). Glucose area under the curve (AUC) was 28%, 34%, and 60% higher for non-lean people with SCI than lean people with SCI and non-lean and lean people without SCI, respectively (p = 0.05, p = 0.009, p < 0.001). VAT was associated with glucose AUC (R2 = 0.23, p = 0.004). Taken together, these findings suggest that leanness, as estimated from VAT, may be an important consideration when developing rehabilitation programs to influence metabolism among people with SCI.
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Affiliation(s)
| | | | | | | | - Richard K. Shields
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, The University of Iowa, Iowa City, IA 52242, USA; (A.L.K.); (M.A.P.); (P.M.M.); (K.A.J.)
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Valenzuela PL, Carrera-Bastos P, Castillo-García A, Lieberman DE, Santos-Lozano A, Lucia A. Obesity and the risk of cardiometabolic diseases. Nat Rev Cardiol 2023; 20:475-494. [PMID: 36927772 DOI: 10.1038/s41569-023-00847-5] [Citation(s) in RCA: 72] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/08/2023] [Indexed: 03/18/2023]
Abstract
The prevalence of obesity has reached pandemic proportions, and now approximately 25% of adults in Westernized countries have obesity. Recognized as a major health concern, obesity is associated with multiple comorbidities, particularly cardiometabolic disorders. In this Review, we present obesity as an evolutionarily novel condition, summarize the epidemiological evidence on its detrimental cardiometabolic consequences and discuss the major mechanisms involved in the association between obesity and the risk of cardiometabolic diseases. We also examine the role of potential moderators of this association, with evidence for and against the so-called 'metabolically healthy obesity phenotype', the 'fatness but fitness' paradox or the 'obesity paradox'. Although maintenance of optimal cardiometabolic status should be a primary goal in individuals with obesity, losing body weight and, particularly, excess visceral adiposity seems to be necessary to minimize the risk of cardiometabolic diseases.
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Affiliation(s)
- Pedro L Valenzuela
- Physical Activity and Health Research Group (PaHerg), Research Institute of Hospital 12 de Octubre ("i + 12"), Madrid, Spain.
- Department of Systems Biology, University of Alcalá, Alcalá de Henares, Spain.
| | - Pedro Carrera-Bastos
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | | | - Daniel E Lieberman
- Department of Human Evolutionary Biology, Harvard University, Cambridge, MA, USA
| | - Alejandro Santos-Lozano
- Physical Activity and Health Research Group (PaHerg), Research Institute of Hospital 12 de Octubre ("i + 12"), Madrid, Spain
- Department of Health Sciences, European University Miguel de Cervantes, Valladolid, Spain
| | - Alejandro Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain.
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.
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Lutke Schipholt IJ, Scholten-Peeters GGM, Koop MA, Bonnet P, Bontkes HJ, Coppieters MW. Systemic neuroimmune responses in people with non-specific neck pain and cervical radiculopathy, and associations with clinical, psychological, and lifestyle factors. Front Mol Neurosci 2022; 15:1003821. [PMID: 36311017 PMCID: PMC9608367 DOI: 10.3389/fnmol.2022.1003821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/20/2022] [Indexed: 08/09/2023] Open
Abstract
Neuroimmune responses remain understudied in people with neck pain. This study aimed to (1) compare a broad range of systemic neuroimmune responses in people with non-specific neck pain (N = 112), cervical radiculopathy (N = 25), and healthy participants (N = 23); and (2) explore their associations with clinical, psychological and lifestyle factors. Quantification of systemic neuroimmune responses involved ex vivo serum and in vitro evoked-release levels of inflammatory markers, and characterization of white blood cell phenotypes. Inflammatory indices were calculated to obtain a measure of total immune status and were considered the main outcomes. Differences between groups were tested using analyses of covariance (ANCOVA) and multivariable regression models. Compared to healthy participants, the ex vivo pro-inflammatory index was increased in people with non-specific neck pain (β = 0.70, p = 0.004) and people with cervical radiculopathy (β = 0.64, p = 0.04). There was no difference between non-specific neck pain and cervical radiculopathy (β = 0.23, p = 0.36). Compared to non-specific neck pain, people with cervical radiculopathy showed lower numbers of monocytes (β = -59, p = 0.01). There were no differences between groups following in vitro whole blood stimulation (p ≥ 0.23) or other differences in the number and phenotype of white blood cells (p ≥ 0.07). The elevated ex vivo neuroimmune responses in people with non-specific neck pain and radiculopathy support the contention that these conditions encompass inflammatory components that can be measured systemically. There were multiple significant associations with clinical, psychological and lifestyle factors, such as pain intensity (β = 0.25) and anxiety (β = 0.23) in non-specific neck pain, visceral adipose tissue (β = 0.43) and magnification (β = 0.59) in cervical radiculopathy, and smoking (β = 0.59) and visceral adipose tissue (β = 0.52) in healthy participants. These associations were modified by sex, indicating different neuroimmune associations for females and males.
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Affiliation(s)
- Ivo J. Lutke Schipholt
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Laboratory Medical Immunology, Department of Clinical Chemistry, Amsterdam University Medical Center, Amsterdam, Netherlands
- Department of Rehabilitation Medicine, Amsterdam University Medical Centre, Amsterdam, Netherlands
| | - Gwendolyne G. M. Scholten-Peeters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Meghan A. Koop
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Laboratory Medical Immunology, Department of Clinical Chemistry, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Petra Bonnet
- Laboratory Medical Immunology, Department of Clinical Chemistry, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Hetty J. Bontkes
- Laboratory Medical Immunology, Department of Clinical Chemistry, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Michel W. Coppieters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
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Gadalla AAEH, El-Dayem SM, Fayed ERH, El-Bohy AEMM. Role of Ultrasonography Compared to Computed Tomography in Measurement of Visceral Adipose Tissue and Subcutaneous Adipose Tissue in Diabetic Overweight and Obese Adolescents. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Ultrasound is considered as a suitable, accurate, safe, available technique to measure abdominal adipose tissue of low cost compared to other imaging modalities as CT and MRI. It is superior to BMI as a monitor for diabesity because of it is ability to differentiate between visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) in wide epidemiological studies.
Results: The correlation between the ultrasound and CT measurements was high with correlation coefficient 0.921 and 0.988 for VAT and SAT respectively. Also there was high significant correlation between the BMI and US and CT measurements of VAT and SAT in all studied groups with correlation coefficient ranging from 0.514 to 0.956.
Conclusion: Ultrasound provides reproducible and valid estimates of VAT and SAT and represents a useful method to assess abdominal fat in large scale epidemiological studies.
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Lutke Schipholt IJ, Scholten-Peeters G, Bontkes H, Coppieters MW. Neuroimmune responses following joint mobilisation and manipulation in people with persistent neck pain: a protocol for a randomised placebo-controlled trial. BMJ Open 2022; 12:e055748. [PMID: 35260459 PMCID: PMC8905979 DOI: 10.1136/bmjopen-2021-055748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Joint mobilisation and manipulation often results in immediate pain relief in people with neck pain. However, the biological mechanisms behind pain relief are largely unknown. There is preliminary evidence that joint mobilisation and manipulation lessens the upregulated neuroimmune responses in people with persistent neck pain. METHODS AND ANALYSIS This study protocol describes a randomised placebo-controlled trial to investigate whether joint mobilisation and manipulation influence neuroimmune responses in people with persistent neck pain. People with persistent neck pain (N=100) will be allocated, in a randomised and concealed manner, to the experimental or control group (ratio 3:1). Short-term (ie, baseline, immediately after and 2 hours after the intervention) neuroimmune responses will be assessed, such as inflammatory marker concentration following in vitro stimulation of whole blood cells, systemic inflammatory marker concentrations directly from blood samples, phenotypic analysis of peripheral blood mononuclear cells and serum cortisol. Participants assigned to the experimental group (N=75) will receive cervical mobilisations targeting the painful and/or restricted cervical segments and a distraction manipulation of the cervicothoracic junction. Participants assigned to the control group (N=25) will receive a placebo mobilisation and placebo manipulation. Using linear mixed models, the short-term neuroimmune responses will be compared (1) between people in the experimental and control group and (2) within the experimental group, between people who experience a good outcome and those with a poor outcome. Furthermore, the association between the short-term neuroimmune responses and pain relief following joint mobilisation and manipulation will be tested in the experimental group. ETHICS AND DISSEMINATION This trial is approved by the Medical Ethics Committee of Amsterdam University Medical Centre, location VUmc (Approval number: 2018.181). TRIAL REGISTRATION NUMBER NL6575 (trialregister.nl.
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Affiliation(s)
- Ivo J Lutke Schipholt
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Clinical Chemistry, Laboratory Medical Immunology, Amsterdam UMC, Location VU Medical Centre, Amsterdam, Netherlands
| | - Gwendolyne Scholten-Peeters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Hetty Bontkes
- Department of Clinical Chemistry, Laboratory Medical Immunology, Amsterdam UMC, Location VU Medical Centre, Amsterdam, Netherlands
| | - Michel W Coppieters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Queensland, Australia
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Boksem E, Schotman JM, Joosten FBM, van Borren MMGJ, de Boer H. Prediction of total body electrical resistance normal values based on limb muscle thickness assessed by ultrasound. Eur J Clin Nutr 2021; 75:1267-1274. [PMID: 33462458 DOI: 10.1038/s41430-020-00837-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 11/10/2020] [Accepted: 12/07/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Recently, a new model has been proposed to assess hydration in patients by measurement of total body electrical resistance (TBER), with results expressed in ohm rather than in liter body water. According to this approach, hydration is considered to be normal if TBER is within the normal range. As TBER is inversely related to the size of the limb muscle compartment, this relationship can be used to calculate the patient-specific TBER normal value (TBERnorm). The present study investigates whether the prediction of TBERnorm can be improved by the use of ultrasound (US) instead of anthropometrically derived parameters of limb muscularity. METHODS In total, 129 healthy subjects (60 men and 69 women) ranging in age from 18 to 75 yr, and in BMI from 17.4 to 52.0 kg/m2 were included in the study. Arm muscle cross-sectional area assessed by anthropometry (AMAcaliper) was compared with mean muscle thickness (MMT) of arm and leg assessed by B-mode US. RESULTS MMT correlated stronger with TBER than AMA, and reduced the standard error of the estimate (SEE) by 15% in men and by 26% in women. Muscularity was overestimated by AMAcaliper due to a systematic error directly proportional to subcutaneous fat layer thickness. The gender independent relation between MMT and TBERnorm is described by the equation: TBERnorm = 705-75.4⋅MMT (R2 = 0.85, SEE = 22.3 Ω/m, P < 0.001). CONCLUSIONS US-based measurement of limb muscularity provides a more precise prediction of TBERnorm, in particular in obese subjects, and is recommended as the method of choice.
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Affiliation(s)
- E Boksem
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, The Netherlands
| | - J M Schotman
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, The Netherlands.
| | - F B M Joosten
- Department of Radiology, Rijnstate Hospital, Arnhem, The Netherlands
| | - M M G J van Borren
- Department of Clinical Chemistry, Rijnstate Hospital, Arnhem, The Netherlands
| | - H de Boer
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, The Netherlands
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Rønn PF, Andersen GS, Lauritzen T, Christensen DL, Aadahl M, Carstensen B, Grarup N, Jørgensen ME. Abdominal visceral and subcutaneous adipose tissue and associations with cardiometabolic risk in Inuit, Africans and Europeans: a cross-sectional study. BMJ Open 2020; 10:e038071. [PMID: 32928857 PMCID: PMC7490939 DOI: 10.1136/bmjopen-2020-038071] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Abdominal fat has been identified as a risk marker of cardiometabolic disease independent of overall adiposity. However, it is not clear whether there are ethnic disparities in this risk. We investigated the associations of visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue (SAT) with cardiometabolic risk factors in three ethnic diverse populations of Inuit, Africans and Europeans. DESIGN Cross-sectional pooled study. SETTING Greenland, Kenya and Denmark. METHODS A total of 5113 participants (2933 Inuit, 1397 Africans and 783 Europeans) from three studies in Greenland, Kenya and Denmark were included. Measurements included abdominal fat distribution assessed by ultrasound, oral glucose tolerance test, hepatic insulin resistance, blood pressure and lipids. The associations were analysed using multiple linear regressions. RESULTS Across ethnic group and gender, an increase in VAT of 1 SD was associated with higher levels of hepatic insulin resistance (ranging from 14% to 28%), triglycerides (8% to 16%) and lower high-density lipoprotein cholesterol (HDL-C, -1.0 to -0.05 mmol/L) independent of body mass index. VAT showed positive associations with most of the other cardiometabolic risk factors in Inuit and Europeans, but not in Africans. In contrast, SAT was mainly associated with the outcomes in Inuit and Africans. Of notice was that higher SAT was associated with higher HDL-C in African men (0.11 mmol/L, 95% CI: 0.03 to 0.18) and with lower HDL-C in Inuit (-0.07 mmol/L, 95% CI: -0.12 to -0.02), but not in European men (-0.02 mmol/L, 95% CI: -0.09 to 0.05). Generally weaker associations were observed for women. Furthermore, the absolute levels of several of the cardiometabolic outcomes differed between the ethnic groups. CONCLUSIONS VAT and SAT were associated with several of the cardiometabolic risk factors beyond overall adiposity. Some of these associations were specific to ethnicity, suggesting that ethnicity plays a role in the pathway from abdominal fat to selected cardiometabolic risk factors.
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Affiliation(s)
- Pernille Falberg Rønn
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Department of Public Health, Centre for Arctic Health, Aarhus University, Aarhus, Denmark
| | | | - Torsten Lauritzen
- Department of Public Health, General Practice, Aarhus University, Aarhus, Denmark
| | - Dirk Lund Christensen
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark
| | - Mette Aadahl
- Center for Clinical Research and Prevention, Frederiksberg and Bispebjerg Hospital, Frederiksberg, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bendix Carstensen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Niels Grarup
- Novo Nordisk Foundation, Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Kobenhavn, Denmark
| | - Marit Eika Jørgensen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- Greenland University, Nuuk, Greenland
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12
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21st Century Advances in Multimodality Imaging of Obesity for Care of the Cardiovascular Patient. JACC Cardiovasc Imaging 2020; 14:482-494. [PMID: 32305476 DOI: 10.1016/j.jcmg.2020.02.031] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 02/26/2020] [Accepted: 02/28/2020] [Indexed: 12/19/2022]
Abstract
Although obesity is typically defined by body mass index criteria, this does not differentiate true body fatness, as this includes both body fat and muscle. Therefore, other fat depots may better define cardiometabolic and cardiovascular disease (CVD) risk imposed by obesity. Data from translational, epidemiological, and clinical studies over the past 3 decades have clearly demonstrated that accumulation of adiposity in the abdominal viscera and within tissue depots lacking physiological adipose tissue storage capacity (termed "ectopic fat") is strongly associated with the development of a clinical syndrome characterized by atherogenic dyslipidemia, hyperinsulinemia/glucose intolerance/type 2 diabetes mellitus, hypertension, atherosclerosis, and abnormal cardiac remodeling and heart failure. This state-of-the-art paper discusses the impact of various body fat depots on cardiometabolic parameters and CVD risk. Specifically, it reviews novel and emerging imaging techniques to evaluate adiposity and the risk of cardiometabolic diseases and CVD.
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13
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Fischer B, Sedlmeier AM, Hartwig S, Schlett CL, Ahrens W, Bamberg F, Baurecht H, Becher H, Berger K, Binder H, Bohn B, Carr PR, Castell S, Franzke CW, Fricke J, Gastell S, Greiser KH, Günther K, Jaeschke L, Kaaks R, Kemmling Y, Krist L, Kuß O, Legath N, Lieb W, Linseisen J, Löffler M, Michels KB, Mikolajczyk R, Niedermaier T, Norman K, Obi N, Peters A, Pischon T, Schikowski T, Schipf S, Schmidt B, Schulze MB, Stang A, Stojicic J, Tiller D, Völzke H, Waniek S, Leitzmann MF. [Anthropometric measures in the German National Cohort-more than weight and height]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:290-300. [PMID: 32020361 DOI: 10.1007/s00103-020-03096-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
High levels of adiposity in the population have a major impact on various diseases, but previous epidemiologic studies have largely been restricted to simple anthropometric measures such as the body mass index (BMI), an imperfect predictor of disease risk. There is a critical need for the use of improved measures of relative weight and body composition in large-scale, population-based research.The current article presents initial descriptive results of body composition and fat distribution based on the midterm baseline dataset of the German National Cohort, which included 101,817 participants who were examined in 18 study centers in Germany between March 2014 and March 2017. The anthropometric measures encompassed body weight, height, waist and hip circumference, bioelectrical impedance analysis (BIA), sonography of abdominal adipose tissue, 3D-body scanning, and magnetic resonance imaging.BMI analyses showed that 46.2% of men and 29.7% of women were overweight and 23.5% of men and 21.2% of women were obese. On average, women in almost all age groups demonstrated more subcutaneous adipose tissue layer thickness than men. The mean values of visceral adipose tissue layer thickness, on the other hand, were higher among men than among women in all age groups and increased continuously across age groups in both sexes.The comprehensive assessment of body composition and fat distribution provides novel future opportunities for detailed epidemiologic analyses of overweight and adiposity in relation to the development of chronic diseases.
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Affiliation(s)
- Beate Fischer
- Institut für Epidemiologie und Präventivmedizin, Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
| | - Anja M Sedlmeier
- Institut für Epidemiologie und Präventivmedizin, Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
| | - Saskia Hartwig
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Christopher L Schlett
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Wolfgang Ahrens
- Leibniz Institut für Präventionsforschung und Epidemiologie, BIPS, Bremen, Deutschland
- Institut für Statistik, Fachbereich Mathematik und Informatik, Universität Bremen, Bremen, Deutschland
| | - Fabian Bamberg
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Hansjörg Baurecht
- Institut für Epidemiologie und Präventivmedizin, Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
| | - Heiko Becher
- Institut für Medizinische Biometrie und Epidemiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Klaus Berger
- Institut für Epidemiologie und Sozialmedizin, Universität Münster, Münster, Deutschland
| | - Hans Binder
- Interdisziplinäres Zentrum für Bioinformatik (IZBI), Universität Leipzig, Leipzig, Deutschland
| | | | - Prudence R Carr
- Abteilung Klinische Epidemiologie und Alternsforschung, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
| | - Stefanie Castell
- Abteilung Epidemiologie, Helmholtz Zentrum für Infektionsforschung (HZI), Braunschweig, Deutschland
| | - Claus-Werner Franzke
- Institut für Prävention und Tumorepidemiologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Julia Fricke
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Sylvia Gastell
- NAKO Studienzentrum, Deutsches Institut für Ernährungsforschung (DIfE), Nuthetal, Deutschland
| | - Karin Halina Greiser
- Abteilung Epidemiologie von Krebserkrankungen, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
| | - Kathrin Günther
- Leibniz Institut für Präventionsforschung und Epidemiologie, BIPS, Bremen, Deutschland
| | - Lina Jaeschke
- Forschergruppe Molekulare Epidemiologie, Max-Delbrück-Centrum für Molekulare Medizin in der Helmholtz-Gemeinschaft (MDC), Berlin, Deutschland
| | - Rudolf Kaaks
- Abteilung Epidemiologie von Krebserkrankungen, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
| | - Yvonne Kemmling
- Abteilung Epidemiologie, Helmholtz Zentrum für Infektionsforschung (HZI), Braunschweig, Deutschland
| | - Lilian Krist
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Oliver Kuß
- Institut für Biometrie und Epidemiologie, Deutsches Diabetes-Zentrum (DDZ), Leibniz-Zentrum für Diabetes-Forschung, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Nicole Legath
- Institut für Epidemiologie und Sozialmedizin, Universität Münster, Münster, Deutschland
| | - Wolfgang Lieb
- Institut für Epidemiologie, Christian-Albrechts-Universität zu Kiel, Kiel, Deutschland
| | - Jakob Linseisen
- Lehrstuhl für Epidemiologie, UNIKA-T Augsburg, LMU München, Augsburg, Deutschland
- SFG Klinische Epidemiologie, Helmholtz Zentrum München, Neuherberg, Deutschland
| | - Markus Löffler
- Institut für Medizinische Informatik, Statistik und Epidemiologie (IMISE), Universität Leipzig, Leipzig, Deutschland
| | - Karin B Michels
- Institut für Prävention und Tumorepidemiologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Rafael Mikolajczyk
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Tobias Niedermaier
- Abteilung Klinische Epidemiologie und Alternsforschung, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
| | - Kristina Norman
- AG Ernährung und Körperzusammensetzung, Forschungsgruppe Geriatrie, Charité - Universitätsmedizin, Berlin, Deutschland
- Abteilung Ernährung und Gerontologie, Deutsches Institut für Ernährungsforschung (DIfE), Nuthetal, Deutschland
| | - Nadia Obi
- Institut für Medizinische Biometrie und Epidemiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Annette Peters
- Institut für Epidemiologie, Helmholtz Zentrum München, Neuherberg, Deutschland
| | - Tobias Pischon
- Forschergruppe Molekulare Epidemiologie, Max-Delbrück-Centrum für Molekulare Medizin in der Helmholtz-Gemeinschaft (MDC), Berlin, Deutschland
- Charité - Universitätsmedizin Berlin, Berlin, Deutschland
- Partnerstandort Berlin, Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Berlin, Deutschland
- MDC/BIH Biobank, Max-Delbrück-Centrum für Molekulare Medizin in der Helmholtz-Gemeinschaft (MDC) und Berlin Institute of Health (BIH), Berlin, Deutschland
| | - Tamara Schikowski
- IUF - Leibniz Institut für umweltmedizinische Forschung, Düsseldorf, Deutschland
| | - Sabine Schipf
- Institut für Community Medicine, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - Börge Schmidt
- Institut für Medizinische Informatik, Biometrie und Epidemiologie (IMIBE), Universitätsklinikum Essen, Essen, Deutschland
| | - Matthias B Schulze
- Abteilung Molekulare Epidemiologie, Deutsches Institut für Ernährungsforschung (DIfE), Nuthetal, Deutschland
| | - Andreas Stang
- Institut für Medizinische Informatik, Biometrie und Epidemiologie (IMIBE), Universitätsklinikum Essen, Essen, Deutschland
| | - Jelena Stojicic
- Institut für Epidemiologie, Helmholtz Zentrum München, Neuherberg, Deutschland
| | - Daniel Tiller
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Henry Völzke
- Institut für Community Medicine, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - Sabina Waniek
- Institut für Epidemiologie, Christian-Albrechts-Universität zu Kiel, Kiel, Deutschland
| | - Michael F Leitzmann
- Institut für Epidemiologie und Präventivmedizin, Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
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14
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Krauze A, Nowak J, Słoboda K, Mlosek RK, Dobruch-Sobczak K, Woźniak W, Ciostek P. Sex and body mass index implications on gluteofemoral subcutaneous tissue morphology visualized by ultrasonography - preliminary study. J Ultrason 2019; 19:105-112. [PMID: 31355581 PMCID: PMC6750335 DOI: 10.15557/jou.2019.0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 06/28/2019] [Indexed: 11/28/2022] Open
Abstract
Introduction Since the protective value of gluteofemoral subcutaneous adipose tissue against cardiovascular risk factors has already been described in scientific reports, it is important to pay more attention to its evaluation. Aim of the study The purpose of this study was to evaluate sex and body mass index implications on gluteofemoral subcutaneous tissue morphology visualized by ultrasonography. Material and method A population of 40 participants between 20–50 years of age was examined. All individuals underwent the ultrasound examination of subcutaneous adipose tissue in three locations: anterior, posterior and lateral side of a thigh in the 1/3 distal part. All examinations were collected, and the following parameters were evaluated: thickness of subcutaneous adipose tissue in general, thickness of superficial and deep subcutaneous adipose tissue. Results The study revealed significant differences in the architecture of subcutaneous adipose tissue between male and female subgroups. In the group of males, a significantly thinner layer of not only subcutaneous adipose tissue in general (0.65 vs. 1.67 cm, p <0.0001), but also in its main compartments was observed. Moreover, we observed strong positive correlation between body mass index and all subcutaneous adipose tissue layers in the female subgroup. Interestingly, there was no relation between the thickness of the subcutaneous adipose tissue layers between subgroups with a decreased and normal body mass index and an increased body mass index. Conclusions The presented data indicates that sex is an important factor in the determination of subcutaneous adipose tissue architecture of a thigh. The ultrasound examination of this structure can be a useful prognostic tool in the assessment of cardiovascular risk.
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Affiliation(s)
- Agnieszka Krauze
- Department of Diagnostic Imaging , II Medical Faculty , Medical University of Warsaw , Warsaw , Poland
| | - Justyna Nowak
- Department of Cardiology, Hypertension and Internal Diseases, II Medical Faculty, Medical University of Warsaw , Warsaw , Poland
| | - Katarzyna Słoboda
- Department of Diagnostic Imaging , II Medical Faculty , Medical University of Warsaw , Warsaw , Poland
| | - Robert Krzysztof Mlosek
- Department of Diagnostic Imaging , II Medical Faculty , Medical University of Warsaw , Warsaw , Poland
| | - Katarzyna Dobruch-Sobczak
- Department of Diagnostic Imaging , II Medical Faculty , Medical University of Warsaw , Warsaw , Poland
| | - Witold Woźniak
- First Department of General and Vascular Surgery , II Medical Faculty , Medical University of Warsaw , Warsaw , Poland
| | - Piotr Ciostek
- First Department of General and Vascular Surgery , II Medical Faculty , Medical University of Warsaw , Warsaw , Poland
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15
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Murphy J, Bacon SL, Morais JA, Tsoukas MA, Santosa S. Intra-Abdominal Adipose Tissue Quantification by Alternative Versus Reference Methods: A Systematic Review and Meta-Analysis. Obesity (Silver Spring) 2019; 27:1115-1122. [PMID: 31131996 DOI: 10.1002/oby.22494] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 02/28/2019] [Indexed: 01/11/2023]
Abstract
OBJECTIVE This meta-analysis aimed to assess the agreement between intra-abdominal adipose tissue (IAAT) quantified by alternative methods and the reference standards, computed tomography (CT) and magnetic resonance imaging (MRI). METHODS MEDLINE and EMBASE electronic databases were systematically searched to identify studies that quantified IAAT thickness, area, or volume by a comparator method and CT or MRI. Using an inverse variance weighted approach (random-effects model), the mean differences and 95% limits of agreement (LoA) were pooled between methods. RESULTS The meta-analysis included 24 studies using four comparator methods. The pooled mean differences were -0.3 cm (95% LoA: -3.4 to 3.2 cm; P = 0.400) for ultrasound and -11.6 cm2 (95% LoA: -43.1 to 19.9 cm2 ; P = 0.004) for bioelectrical impedance analysis. Dual-energy x-ray absorptiometry (DXA) quantified both IAAT area and volume with mean differences of 8.1 cm2 (95% LoA: -98.9 to 115.1 cm2 ; P = 0.061) and 10 cm3 (95% LoA: -280 to 300 cm3 ; P = 0.808), respectively. CONCLUSIONS Ultrasound and DXA measure IAAT with minimal bias from CT or MRI, while bioelectrical impedance analysis systematically underestimates IAAT. However, with the exception of DXA for IAAT volume, the wide LoA caution against clinical or research use of the comparator methods and emphasize the need to optimize alternatives to the reference standards.
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Affiliation(s)
- Jessica Murphy
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Quebec, Canada
- Metabolism, Obesity and Nutrition Laboratory, PERFORM Centre, Concordia University, Montreal, Quebec, Canada
- Centre de recherche - Axe maladies chroniques, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Ile-de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
| | - Simon L Bacon
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Quebec, Canada
- Centre de recherche - Axe maladies chroniques, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Ile-de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
- Montreal Behavioural Medicine Centre, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Ile-de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
| | - José A Morais
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Quebec, Canada
- Division of Geriatric Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
- Division of Endocrinology and Metabolism, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Michael A Tsoukas
- Division of Endocrinology and Metabolism, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Sylvia Santosa
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Quebec, Canada
- Metabolism, Obesity and Nutrition Laboratory, PERFORM Centre, Concordia University, Montreal, Quebec, Canada
- Centre de recherche - Axe maladies chroniques, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Ile-de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
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16
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Linder N, Schaudinn A, Langenhan K, Krenzien F, Hau HM, Benzing C, Atanasov G, Schmelzle M, Kahn T, Busse H, Bartels M, Neumann U, Wiltberger G. Power of computed-tomography-defined sarcopenia for prediction of morbidity after pancreaticoduodenectomy. BMC Med Imaging 2019; 19:32. [PMID: 31029093 PMCID: PMC6487009 DOI: 10.1186/s12880-019-0332-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 04/11/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The goal of our study was to evaluate the current approach in prediction of postoperative major complications after pancreaticoduodenectomy (PD), especially symptomatic pancreatic fistula (POPF), using parameters derived from computed tomography (CT). METHODS Patients after PD were prospectively collected in a database of the local department of surgery and all patients with CT scans available were assessed in this study. CT parameters were measured at the level of the intervertebral disc L3/L4 and consisted of the areas of the visceral adipose tissue (AVAT), the diameters of the pancreatic parenchyma (DPP) and the pancreatic duct (DPD), the areas of ventral abdominal wall muscle (AMVEN), psoas muscle (AMPSO), paraspinal muscle (AMSPI), total muscle (AMTOT), as well as the mean muscle attenuation (MA) and skeletal muscle index (SMI). Mann-Whitney-U Test for two independent samples and binary logistic regression were used for statistical analysis. RESULTS One hundred thirty-nine patients (55 females, 84 males) were included. DPD was 2.9 mm (Range 0.7-10.7) on median and more narrow in patients with complications equal to or greater stadium IIIb (p < 0.04) and severe POPF (p < 0.01). DPP median value was 17 (6.9-37.9) mm and there was no significant difference regarding major complications or POPF. AVAT showed a median value of 127.5 (14.5-473.0) cm2 and was significantly larger in patients with POPF (p < 0.01), but not in cases of major complications (p < 0.06). AMPSO, AMSPI, AMVEN and AMTOT showed no significant differences between major complications and POPF. MA was both lower in groups with major complications (p < 0.01) and POPF (p < 0.01). SMI failed to differentiate between patients with or without major complications or POPF. CONCLUSION Besides the known factors visceral obesity and narrowness of the pancreatic duct, the mean muscle attenuation can easily be examined on routine preoperative CT scans and seems to be promising parameter to predict postoperative complications and POPF.
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Affiliation(s)
- Nicolas Linder
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany
| | - Alexander Schaudinn
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany
| | - Katharina Langenhan
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany
| | - Felix Krenzien
- Department of Surgery, Campus Virchow and Campus Mitte, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Hans-Michael Hau
- Department of Visceral, Transplantation, Thoracic, and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Christian Benzing
- Department of Surgery, Campus Virchow and Campus Mitte, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Georgi Atanasov
- Department of Surgery, Campus Virchow and Campus Mitte, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Moritz Schmelzle
- Department of Surgery, Campus Virchow and Campus Mitte, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Kahn
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany
| | - Harald Busse
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany
| | - Michael Bartels
- Department of General- and Visceral Surgery, Helios Clinic Leipzig, Leipzig, Germany
| | - Ulf Neumann
- Department of General, Visceral, and Transplantation Surgery, University Hospital of RWTH Aachen, Aachen, Germany
| | - Georg Wiltberger
- Department of General, Visceral, and Transplantation Surgery, University Hospital of RWTH Aachen, Aachen, Germany
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Rodrigues-Krause J, Farinha JB, Ramis TR, Macedo RCO, Boeno FP, Dos Santos GC, Vargas J, Lopez P, Grazioli R, Costa RR, Pinto RS, Krause M, Reischak-Oliveira A. Effects of dancing compared to walking on cardiovascular risk and functional capacity of older women: A randomized controlled trial. Exp Gerontol 2018; 114:67-77. [PMID: 30389581 DOI: 10.1016/j.exger.2018.10.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 10/18/2018] [Accepted: 10/20/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Aging is characterized by reductions in lean mass simultaneously to increases in visceral adipose tissue, elevating cardiovascular risk (CVR) and physical dependence. Dancing has been recommended for improving fall-risk and CVR, however, comparisons with traditional exercises are limited. This study aimed to compare the effects of dancing with walking on CVR and functionality of older women. METHODS Thirty sedentary women (65 ± 5 years, BMI 27 ± 4 kg/m2) were randomized into three groups (n = 10/group): dancing, walking or stretching (active control). All interventions lasted 8 weeks (60 min sessions): dancing/walking 3×/week, stretching 1×/week. Dancing: several styles, no partner. Walking: treadmill, 60% peak oxygen consumption (VO2peak). Stretching: large muscle groups, no discomfort. Before and after interventions assessments: VO2peak (primary outcome), total cholesterol, HDL-C, LDL-C, glucose, insulin, CRP, TNF-α, waist and hip circumferences, visceral adipose tissue (VAT), muscle thickness, maximal muscle strength/power, static and dynamic balance, gait ability, flexibility, chair-raise and level of physical activity (PA). STATISTICS generalized estimating equations, post-hoc LSD (p < 0.05), SPSS 22.0. RESULTS (Mean-CI): (before vs after): group vs time interaction showed increases in VO2peak (mL·kg-1·min-1) for dancing 23.3 (20.8-25.8) vs 25.6 (23.4-27.8), and walking 23.4 (21.3-25.5) vs 27.0 (25.4-28.6), with no differences for stretching 23.5 (21.3-25.7) vs 23.0 (21.0-24.9). Lower body muscle power and static balance also improved for dancing and walking, but not for stretching. Main time effect showed improvements in CRP, TNF-α, LDL-C, HDL-C, VAT, waist, hip, chair raise, flexibility and level of daily PA for all groups. CONCLUSION Dancing induced similar increases in VO2peak, lower body muscle power and static balance as walking, while the stretching group remained unchanged. Pooled effects showed improvements in body composition, lipid and inflammatory profile, which are supported by increased PA levels. TRIAL REGISTRATION NCT03262714.
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Affiliation(s)
- Josianne Rodrigues-Krause
- Federal University of Rio Grande do Sul, School of Physical Education, Physiotherapy and Dance, Porto Alegre, RS, Brazil.
| | - Juliano Boufleur Farinha
- Federal University of Rio Grande do Sul, School of Physical Education, Physiotherapy and Dance, Porto Alegre, RS, Brazil
| | - Thiago Ronzales Ramis
- Federal University of Rio Grande do Sul, School of Physical Education, Physiotherapy and Dance, Porto Alegre, RS, Brazil
| | - Rodrigo Cauduro Oliveira Macedo
- Federal University of Rio Grande do Sul, School of Physical Education, Physiotherapy and Dance, Porto Alegre, RS, Brazil; Santa Cruz do Sul University (UNISC), Santa Cruz, RS, Brazil
| | - Francesco Pinto Boeno
- Federal University of Rio Grande do Sul, School of Physical Education, Physiotherapy and Dance, Porto Alegre, RS, Brazil
| | - Gabriela Cristina Dos Santos
- Federal University of Rio Grande do Sul, School of Physical Education, Physiotherapy and Dance, Porto Alegre, RS, Brazil
| | - João Vargas
- Federal University of Rio Grande do Sul, School of Physical Education, Physiotherapy and Dance, Porto Alegre, RS, Brazil
| | - Pedro Lopez
- Federal University of Rio Grande do Sul, School of Physical Education, Physiotherapy and Dance, Porto Alegre, RS, Brazil
| | - Rafael Grazioli
- Federal University of Rio Grande do Sul, School of Physical Education, Physiotherapy and Dance, Porto Alegre, RS, Brazil
| | - Rochelle Rocha Costa
- Federal University of Rio Grande do Sul, School of Physical Education, Physiotherapy and Dance, Porto Alegre, RS, Brazil
| | - Ronei Silveira Pinto
- Federal University of Rio Grande do Sul, School of Physical Education, Physiotherapy and Dance, Porto Alegre, RS, Brazil
| | - Mauricio Krause
- Laboratory of Inflammation, Metabolism and Exercise Research (LAPIMEX), Department of Physiology, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; Laboratory of Cellular Physiology, Department of Physiology, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Alvaro Reischak-Oliveira
- Federal University of Rio Grande do Sul, School of Physical Education, Physiotherapy and Dance, Porto Alegre, RS, Brazil
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18
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Carbone F, Nulli Migliola E, Bonaventura A, Vecchié A, De Vuono S, Ricci MA, Vaudo G, Boni M, Dallegri F, Montecucco F, Lupattelli G. High serum levels of C-reactive protein (CRP) predict beneficial decrease of visceral fat in obese females after sleeve gastrectomy. Nutr Metab Cardiovasc Dis 2018; 28:494-500. [PMID: 29502925 DOI: 10.1016/j.numecd.2018.01.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 01/10/2018] [Accepted: 01/25/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND & AIMS Gender-related differences represent an emerging investigation field to better understand obesity heterogeneity and paradoxically associated cardiovascular (CV) risk. Here, we investigated if high-sensitivity C-reactive protein (hs-CRP) might differently affect adiposity and predict the clinical response to bariatric surgery in obese males and females. METHODS AND RESULTS In 110 morbidly obese patients undergoing laparoscopic sleeve gastrectomy, hs-CRP as well as anthropometric assessment of adiposity, completed by electric bioimpedance and ultrasonography quantification of visceral fat area (VFA), were measured before and one year after surgery. As compared to males, obese female showed less severe overweight and prevalent subcutaneous fat deposition, but higher circulating hs-CRP. In obese females, hs-CRP was associated with VFA at baseline, independently of body mass index (BMI) and visceral adiposity index (OR 1.022 [95% CI 1.001-1.044]; p = 0.039). Based on decreases and increases in hs-CRP levels after surgery, two distinct subgroups of females were identified. Post-surgery decreases in hs-CRP was predominantly observed in patients with higher baseline levels of hs-CRP and associated with greater reduction of weight, BMI, fat and lean mass, VFA and visceral to subcutaneous fat ratio. Finally, we observed that high baseline values of hs-CRP were able to predict VFA reduction one-year after surgery, independently of BMI and visceral adiposity index (VAI) loss (OR 1.031 [95% CI 1.009-1.053]; p = 0.005). CONCLUSION In obese females, hs-CRP levels might be a promising biomarker of visceral fat amount and dysfunction, in addition to predict the effectiveness of bariatric surgery in terms of loss of VFA one-year after surgery.
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Affiliation(s)
- F Carbone
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa School of Medicine, 6 viale Benedetto XV, 16132, Genoa, Italy.
| | - E Nulli Migliola
- Internal Medicine Department, "Santa Maria della Misericordia" Hospital, University of Perugia, Piazzale Menghini, Sant'Andrea delle Fratte, 06132, Perugia, Italy
| | - A Bonaventura
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa School of Medicine, 6 viale Benedetto XV, 16132, Genoa, Italy
| | - A Vecchié
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa School of Medicine, 6 viale Benedetto XV, 16132, Genoa, Italy
| | - S De Vuono
- Internal Medicine Department, "Santa Maria della Misericordia" Hospital, University of Perugia, Piazzale Menghini, Sant'Andrea delle Fratte, 06132, Perugia, Italy
| | - M A Ricci
- Internal Medicine Department, "Santa Maria della Misericordia" Hospital, University of Perugia, Piazzale Menghini, Sant'Andrea delle Fratte, 06132, Perugia, Italy
| | - G Vaudo
- Internal Medicine Department, "Santa Maria della Misericordia" Hospital, University of Perugia, Piazzale Menghini, Sant'Andrea delle Fratte, 06132, Perugia, Italy
| | - M Boni
- Surgery Department, San Giovanni Battista Hospital, Via Massimo Arcamone, 06034, Foligno, Italy
| | - F Dallegri
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa School of Medicine, 6 viale Benedetto XV, 16132, Genoa, Italy; Ospedale Policlinico San Martino, 10 Largo Benzi, 16132, Genoa, Italy
| | - F Montecucco
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa School of Medicine, 6 viale Benedetto XV, 16132, Genoa, Italy; Ospedale Policlinico San Martino, 10 Largo Benzi, 16132, Genoa, Italy; Centre of Excellence for Biomedical Research (CEBR), University of Genoa, 9 viale Benedetto XV, 16132, Genoa, Italy
| | - G Lupattelli
- Internal Medicine Department, "Santa Maria della Misericordia" Hospital, University of Perugia, Piazzale Menghini, Sant'Andrea delle Fratte, 06132, Perugia, Italy
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19
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Jena D, Choudhury AK, Mangaraj S, Singh M, Mohanty BK, Baliarsinha AK. Study of Visceral and Subcutaneous Abdominal Fat Thickness and Its Correlation with Cardiometabolic Risk Factors and Hormonal Parameters in Polycystic Ovary Syndrome. Indian J Endocrinol Metab 2018; 22:321-327. [PMID: 30090722 PMCID: PMC6063187 DOI: 10.4103/ijem.ijem_646_17] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
AIM OF THE STUDY This study aimed to compare the different adiposity parameters, namely visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) between patients with polycystic ovary syndrome (PCOS) and controls. In addition, it aimed to correlate these adiposity indices with hormonal parameters as well as cardiovascular (CV) risk factors in patients with PCOS. MATERIALS AND METHODS Newly diagnosed PCOS patients of reproductive age group according to Rotterdam criteria were included. Age- and body mass index (BMI)-matched healthy females with normal menstrual cycles were taken as controls. All the study participants underwent detailed clinical, biochemical, and hormonal evaluation. Transabdominal ultrasound (US) was performed for detailed ovary imaging and assessment of adiposity (SAT and VAT) parameters. RESULTS A total of 58 PCOS patients and 40 age- and BMI-matched controls were included. PCOS patients had significantly higher levels of androgens (P < 0.001), elevated highly sensitive C-reactive protein (P = 0.007), and higher degree of insulin resistance (P < 0.001) than controls. PCOS patients had a mean SAT of 2.37 ± 0.7 cm and mean VAT of 8.65 ± 1.78 cm. These parameters were significantly higher than controls who had a mean SAT of 2.01 ± 0.7 cm (P = 0.014) and mean VAT of 7.4 ± 1.89 cm (P = 0.003), despite both groups having similar BMI. Among PCOS cohort, VAT correlated positively with total testosterone (r = 0.295, P = 0.025) and negatively with dehydroepiandrosterone sulfate (r = -0.210, P = 0.114). However, no significant correlation was observed between SAT and androgens in PCOS group. CONCLUSION PCOS patients, whether obese or nonobese, had elevated visceral adiposity than controls. VAT correlated positively with adverse CV risk factors and testosterone in PCOS patients. Hence, a simple and inexpensive ultrasonography screening of visceral fat may identify women who have adverse metabolic profile and enhanced CV risk.
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Affiliation(s)
- Debarchan Jena
- Department of Endocrinology, S.C.B Medical College, Cuttack, India
| | | | | | - Mamata Singh
- Department of Radiology, S.C.B Medical College, Cuttack, India
| | - Binoy Kumar Mohanty
- Department of Endocrinology, M.K.C.G Medical College, Berhampur, Odisha, India
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20
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Kawada T. Bariatric Surgery in Patients With Type 2 Diabetes Mellitus. Ann Surg 2017; 266:e58. [PMID: 29136970 DOI: 10.1097/sla.0000000000001379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan
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21
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Visceral adipose tissue but not subcutaneous adipose tissue is associated with urine and serum metabolites. PLoS One 2017; 12:e0175133. [PMID: 28403191 PMCID: PMC5389790 DOI: 10.1371/journal.pone.0175133] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 03/21/2017] [Indexed: 12/27/2022] Open
Abstract
Obesity is a complex multifactorial phenotype that influences several metabolic pathways. Yet, few studies have examined the relations of different body fat compartments to urinary and serum metabolites. Anthropometric phenotypes (visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), the ratio between VAT and SAT (VSR), body mass index (BMI), waist circumference (WC)) and urinary and serum metabolite concentrations measured by nuclear magnetic resonance spectroscopy were measured in a population-based sample of 228 healthy adults. Multivariable linear and logistic regression models, corrected for multiple testing using the false discovery rate, were used to associate anthropometric phenotypes with metabolites. We adjusted for potential confounding variables: age, sex, smoking, physical activity, menopausal status, estimated glomerular filtration rate (eGFR), urinary glucose, and fasting status. In a fully adjusted logistic regression model dichotomized for the absence or presence of quantifiable metabolite amounts, VAT, BMI and WC were inversely related to urinary choline (ß = -0.18, p = 2.73*10−3), glycolic acid (ß = -0.20, 0.02), and guanidinoacetic acid (ß = -0.12, p = 0.04), and positively related to ethanolamine (ß = 0.18, p = 0.02) and dimethylamine (ß = 0.32, p = 0.02). BMI and WC were additionally inversely related to urinary glutamine and lactic acid. Moreover, WC was inversely associated with the detection of serine. VAT, but none of the other anthropometric parameters, was related to serum essential amino acids, such as valine, isoleucine, and phenylalanine among men. Compared to other adiposity measures, VAT demonstrated the strongest and most significant relations to urinary and serum metabolites. The distinct relations of VAT, SAT, VSR, BMI, and WC to metabolites emphasize the importance of accurately differentiating between body fat compartments when evaluating the potential role of metabolic regulation in the development of obesity-related diseases, such as insulin resistance, type 2 diabetes, and cardiovascular disease.
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22
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Rønn PF, Andersen GS, Lauritzen T, Christensen DL, Aadahl M, Carstensen B, Jørgensen ME. Ethnic differences in anthropometric measures and abdominal fat distribution: a cross-sectional pooled study in Inuit, Africans and Europeans. J Epidemiol Community Health 2017; 71:536-543. [DOI: 10.1136/jech-2016-207813] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 12/13/2016] [Accepted: 12/16/2016] [Indexed: 01/27/2023]
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Seven E, Thuesen BH, Linneberg A, Jeppesen JL. Abdominal Adiposity Distribution Quantified by Ultrasound Imaging and Incident Hypertension in a General Population. Hypertension 2016; 68:1115-1122. [DOI: 10.1161/hypertensionaha.116.07306] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 08/12/2016] [Indexed: 01/04/2023]
Abstract
Abdominal obesity is a major risk factor for hypertension. However, different distributions of abdominal adipose tissue may affect hypertension risk differently. The main purpose of this study was to explore the association of subcutaneous abdominal adipose tissue (SAT) and visceral adipose tissue (VAT) with incident hypertension in a population-based setting. We hypothesized that VAT, rather than SAT, would be associated with incident hypertension. VAT and SAT were determined by ultrasound imagining in 3363 randomly selected Danes (mean age 49 years, 56% women, mean body mass index 25.8 kg/m
2
). We constructed multiple logistic regression models to compute standardized odds ratios with 95% confidence intervals per SD increase in SAT and VAT. Of the 2119 normotensive participants at baseline, 1432, with mean SAT of 2.8 cm and mean VAT of 5.7 cm, returned 5 years later for a follow-up examination and among them 203 had developed hypertension. In models including both VAT and SAT, the Framingham Hypertension Risk Score variables (age, sex, smoking status, family history of hypertension, and baseline blood pressure) and glycated hemoglobin, odds ratio (95% confidence interval) for incident hypertension for 1 SD increase in VAT and SAT was 1.27 (1.08–1.50,
P
=0.004) and 0.97 (0.81–1.15,
P
=0.70), respectively. Adjusting for body mass index instead of SAT attenuated the association between VAT and incident hypertension, but it was still significant (odds ratio, 1.22 [1.01–1.48,
P
=0.041] for each SD increase in VAT). In conclusion, ultrasound-determined VAT, but not SAT, was associated with incident hypertension in a random sample of Danish adults.
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Affiliation(s)
- Ekim Seven
- From the Research Centre for Prevention and Health, The Capital Region of Denmark, Copenhagen (E.S., B.H.T., A.L.); Department of Internal Medicine, Hvidovre Hospital Glostrup, University of Copenhagen, Glostrup, Denmark (E.S., J.L.J.); Department of Clinical Experimental Research, Rigshospitalet, Denmark (A.L.); and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (A.L., J.L.J.)
| | - Betina H. Thuesen
- From the Research Centre for Prevention and Health, The Capital Region of Denmark, Copenhagen (E.S., B.H.T., A.L.); Department of Internal Medicine, Hvidovre Hospital Glostrup, University of Copenhagen, Glostrup, Denmark (E.S., J.L.J.); Department of Clinical Experimental Research, Rigshospitalet, Denmark (A.L.); and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (A.L., J.L.J.)
| | - Allan Linneberg
- From the Research Centre for Prevention and Health, The Capital Region of Denmark, Copenhagen (E.S., B.H.T., A.L.); Department of Internal Medicine, Hvidovre Hospital Glostrup, University of Copenhagen, Glostrup, Denmark (E.S., J.L.J.); Department of Clinical Experimental Research, Rigshospitalet, Denmark (A.L.); and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (A.L., J.L.J.)
| | - Jørgen L. Jeppesen
- From the Research Centre for Prevention and Health, The Capital Region of Denmark, Copenhagen (E.S., B.H.T., A.L.); Department of Internal Medicine, Hvidovre Hospital Glostrup, University of Copenhagen, Glostrup, Denmark (E.S., J.L.J.); Department of Clinical Experimental Research, Rigshospitalet, Denmark (A.L.); and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (A.L., J.L.J.)
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24
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Jean-Luc Gradidge P, Norris SA, Jaff NG, Crowther NJ. Metabolic and Body Composition Risk Factors Associated with Metabolic Syndrome in a Cohort of Women with a High Prevalence of Cardiometabolic Disease. PLoS One 2016; 11:e0162247. [PMID: 27589387 PMCID: PMC5010252 DOI: 10.1371/journal.pone.0162247] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 08/21/2016] [Indexed: 12/18/2022] Open
Abstract
Background The aetiology of the metabolic syndrome and the inter-relationship between risk factors for this syndrome are poorly understood. The purpose of this investigation was to determine the risk factors for metabolic syndrome and their interactions in a cohort of women with a high prevalence of metabolic syndrome. Materials and Methods Abdominal and whole body composition (ultrasound and dual-energy X-ray absorptiometry), blood pressure, and cardiometabolic and demographic factors were measured in a cross-sectional study of 702 black African women from Soweto, Johannesburg. Data was analysed using multivariate logistic regression. Results Metabolic syndrome was present in 49.6% of the study cohort. Logistic regression analysis demonstrated that adiponectin (odds ratio [95% CIs]: 0.84 [0.77, 0.92], p<0.0005) and abdominal subcutaneous fat (0.56 [0.39, 0.79], p = 0.001) reduced metabolic syndrome risk whilst insulin resistance (1.31 [1.16, 1.48], p<0.0005) and trunk fat-free soft-tissue mass (1.34 [1.10, 1.61], p = 0.002) increased risk. Within this group of risk factors, the relationship of adiponectin with metabolic syndrome risk, when analysed across adiponectin hexiles, was the least affected by adjustment for the other risk factors. Conclusions Adiponectin has a significant protective role against metabolic syndrome and is independent of other risk factors. The protective and possible augmentive effects of abdominal subcutaneous fat and lean trunk mass, respectively on metabolic syndrome risk demonstrate the existence of novel interactions between body composition and cardiometabolic disease.
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Affiliation(s)
- Philippe Jean-Luc Gradidge
- Centre for Exercise Science and Sports Medicine (CESSM), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- * E-mail:
| | - Shane A. Norris
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicole G. Jaff
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nigel J. Crowther
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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25
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Kawada T, Andou T, Fukumitsu M. Waist circumference, visceral abdominal fat thickness and three components of metabolic syndrome. Diabetes Metab Syndr 2016; 10:4-6. [PMID: 26376586 DOI: 10.1016/j.dsx.2015.08.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The relationships between the waist circumference (WC), visceral adipose tissue (VAT) thickness and three components of metabolic syndrome (MetS) were explored to verify which of the obesity indices might be superior. METHODS A cross-sectional study was conducted of 1256 subjects (840 males and 416 females) aged 26-89 years, who were individuals undergoing intensive health checkup. The three components of MetS examined were high blood pressure, glucose intolerance and dyslipidemia. Receiver-operating characteristic (ROC) curve analysis and multiple logistic regression analysis were used for the analyses. RESULTS The mean values of the WC and VAT thickness were significantly higher in the subject group positive for each of the metabolic syndrome components than in the subject group that was negative for all the components (p<0.001). ROC curve analysis showed that the WC showed an advantage over the VAT thickness only for predicting high blood pressure in men. Logistic regression analysis revealed increase of the odds ratios of the WC for glucose intolerance (p<0.001), high blood pressure (p<0.001) and dyslipidemia (p<0.01) in men. In contrast, the odds ratio of the VAT thickness was significantly increased only for dyslipidemia (p<0.01) in men. In women, the odds ratios of the WC for glucose intolerance (p<0.01) and dyslipidemia (p<0.001) were significantly increased, and odds ratio of the VAT thickness for high blood pressure (p<0.01) was significantly increased. CONCLUSION This survey presented an advantage of WC over VAT thickness as an obesity index for identifying all the three components of metabolic syndrome, although sex differences in the study outcomes were found.
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Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Japan.
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26
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Schlecht I, Fischer B, Behrens G, Leitzmann MF. Relations of Visceral and Abdominal Subcutaneous Adipose Tissue, Body Mass Index, and Waist Circumference to Serum Concentrations of Parameters of Chronic Inflammation. Obes Facts 2016; 9:144-57. [PMID: 27241125 PMCID: PMC5644901 DOI: 10.1159/000443691] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 12/23/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Different measures of body fat composition may vary in their relations to parameters of chronic inflammation. METHODS We assessed the relations of visceral (VAT) and subcutaneous adipose tissue (SAT), BMI, and waist circumference (WC) to serum concentrations of high-sensitive C-reactive protein (hs-CRP), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), resistin, and adiponectin in 97 healthy adults using multivariate linear regression models, adjusted for age, sex, smoking, physical activity, menopausal status, and use of aspirin or non-steroidal anti-inflammatory drugs (NSAIDs). Parameters of chronic inflammation were mutually adjusted. RESULTS VAT (β = 0.34), SAT (β = 0.43), BMI (β = 0.40), and WC (β = 0.47) were all significantly associated with hs-CRP. BMI was additionally inversely related to adiponectin (β = -0.29). In exploratory subgroup analyses defined by gender, BMI, smoking, and use of aspirin or NSAIDs, VAT was the strongest indicator for increased levels of IL-6, SAT was the most consistent indicator for increased levels of hs-CRP, and BMI was the most consistent indicator for decreased levels of adiponectin. WC showed to be a weak indicator for increased levels of hs-CRP and decreased levels of adiponectin. CONCLUSION VAT, SAT, BMI, and WC show distinct associations with parameters of chronic inflammation. Whether these differences reflect differential metabolic risks requires clarification by longitudinal studies.
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Affiliation(s)
- Inga Schlecht
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
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27
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Scheuer SH, Færch K, Philipsen A, Jørgensen ME, Johansen NB, Carstensen B, Witte DR, Andersen I, Lauritzen T, Andersen GS. Abdominal Fat Distribution and Cardiovascular Risk in Men and Women With Different Levels of Glucose Tolerance. J Clin Endocrinol Metab 2015; 100:3340-7. [PMID: 26120787 DOI: 10.1210/jc.2014-4479] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
CONTEXT Regional fat distribution rather than overall obesity has been recognized as important to understanding the link between obesity and cardiovascular disease. OBJECTIVE We examined the associations of abdominal visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue (SAT) with cardiovascular risk factors in a Caucasian population of men and women with normal glucose tolerance, prediabetes, or screen-detected diabetes. DESIGN, SETTING, AND PARTICIPANTS The study was based on cross-sectional analysis of data from 1412 adults age 45-80 years. VAT and SAT were assessed by ultrasound. The associations of VAT and SAT with blood pressure and lipids were examined by linear regression analysis adjusted for age, sex, smoking, alcohol, physical activity, glucose tolerance status (GTS), medication use, and body mass index. Effect modification by GTS and sex was examined, and stratified analyses performed. RESULTS Independent of SAT and overall obesity, VAT was associated with higher triglyceride and lower high-density lipoprotein (HDL) cholesterol levels in both men and women and additionally associated with higher total cholesterol in men. SAT was independently associated with higher total cholesterol and low-density lipoprotein cholesterol levels in both sexes, and SAT was additionally associated with higher triglyceride and lower HDL cholesterol levels in women and with higher blood pressure in participants with diabetes. CONCLUSION Both abdominal VAT and SAT are independent of overall obesity associated with cardiovascular risk in a population of men and women at low to high risk of diabetes or with screen-detected diabetes.
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Affiliation(s)
- Stine H Scheuer
- Steno Diabetes Center (S.H.S., K.F., A.P., M.E.J., N.B.J., B.C., G.S.A.), 2820 Gentofte, Denmark; Danish Diabetes Academy (N.B.J., D.R.W.), 5000 Odense, Denmark; Institute of Public Health, Section of General Practice (D.R.W., T.L.), Aarhus University, 8000 Aarhus, Denmark; Section of Social Medicine, Department of Public Health (I.A.), University of Copenhagen, 1123 Copenhagen, Denmark
| | - Kristine Færch
- Steno Diabetes Center (S.H.S., K.F., A.P., M.E.J., N.B.J., B.C., G.S.A.), 2820 Gentofte, Denmark; Danish Diabetes Academy (N.B.J., D.R.W.), 5000 Odense, Denmark; Institute of Public Health, Section of General Practice (D.R.W., T.L.), Aarhus University, 8000 Aarhus, Denmark; Section of Social Medicine, Department of Public Health (I.A.), University of Copenhagen, 1123 Copenhagen, Denmark
| | - Annelotte Philipsen
- Steno Diabetes Center (S.H.S., K.F., A.P., M.E.J., N.B.J., B.C., G.S.A.), 2820 Gentofte, Denmark; Danish Diabetes Academy (N.B.J., D.R.W.), 5000 Odense, Denmark; Institute of Public Health, Section of General Practice (D.R.W., T.L.), Aarhus University, 8000 Aarhus, Denmark; Section of Social Medicine, Department of Public Health (I.A.), University of Copenhagen, 1123 Copenhagen, Denmark
| | - Marit E Jørgensen
- Steno Diabetes Center (S.H.S., K.F., A.P., M.E.J., N.B.J., B.C., G.S.A.), 2820 Gentofte, Denmark; Danish Diabetes Academy (N.B.J., D.R.W.), 5000 Odense, Denmark; Institute of Public Health, Section of General Practice (D.R.W., T.L.), Aarhus University, 8000 Aarhus, Denmark; Section of Social Medicine, Department of Public Health (I.A.), University of Copenhagen, 1123 Copenhagen, Denmark
| | - Nanna B Johansen
- Steno Diabetes Center (S.H.S., K.F., A.P., M.E.J., N.B.J., B.C., G.S.A.), 2820 Gentofte, Denmark; Danish Diabetes Academy (N.B.J., D.R.W.), 5000 Odense, Denmark; Institute of Public Health, Section of General Practice (D.R.W., T.L.), Aarhus University, 8000 Aarhus, Denmark; Section of Social Medicine, Department of Public Health (I.A.), University of Copenhagen, 1123 Copenhagen, Denmark
| | - Bendix Carstensen
- Steno Diabetes Center (S.H.S., K.F., A.P., M.E.J., N.B.J., B.C., G.S.A.), 2820 Gentofte, Denmark; Danish Diabetes Academy (N.B.J., D.R.W.), 5000 Odense, Denmark; Institute of Public Health, Section of General Practice (D.R.W., T.L.), Aarhus University, 8000 Aarhus, Denmark; Section of Social Medicine, Department of Public Health (I.A.), University of Copenhagen, 1123 Copenhagen, Denmark
| | - Daniel R Witte
- Steno Diabetes Center (S.H.S., K.F., A.P., M.E.J., N.B.J., B.C., G.S.A.), 2820 Gentofte, Denmark; Danish Diabetes Academy (N.B.J., D.R.W.), 5000 Odense, Denmark; Institute of Public Health, Section of General Practice (D.R.W., T.L.), Aarhus University, 8000 Aarhus, Denmark; Section of Social Medicine, Department of Public Health (I.A.), University of Copenhagen, 1123 Copenhagen, Denmark
| | - Ingelise Andersen
- Steno Diabetes Center (S.H.S., K.F., A.P., M.E.J., N.B.J., B.C., G.S.A.), 2820 Gentofte, Denmark; Danish Diabetes Academy (N.B.J., D.R.W.), 5000 Odense, Denmark; Institute of Public Health, Section of General Practice (D.R.W., T.L.), Aarhus University, 8000 Aarhus, Denmark; Section of Social Medicine, Department of Public Health (I.A.), University of Copenhagen, 1123 Copenhagen, Denmark
| | - Torsten Lauritzen
- Steno Diabetes Center (S.H.S., K.F., A.P., M.E.J., N.B.J., B.C., G.S.A.), 2820 Gentofte, Denmark; Danish Diabetes Academy (N.B.J., D.R.W.), 5000 Odense, Denmark; Institute of Public Health, Section of General Practice (D.R.W., T.L.), Aarhus University, 8000 Aarhus, Denmark; Section of Social Medicine, Department of Public Health (I.A.), University of Copenhagen, 1123 Copenhagen, Denmark
| | - Gregers S Andersen
- Steno Diabetes Center (S.H.S., K.F., A.P., M.E.J., N.B.J., B.C., G.S.A.), 2820 Gentofte, Denmark; Danish Diabetes Academy (N.B.J., D.R.W.), 5000 Odense, Denmark; Institute of Public Health, Section of General Practice (D.R.W., T.L.), Aarhus University, 8000 Aarhus, Denmark; Section of Social Medicine, Department of Public Health (I.A.), University of Copenhagen, 1123 Copenhagen, Denmark
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Lee SH, Kim D, Baek MY, Tchah H, Kim YS, Ryoo E, Kim YM. Abdominal Subcutaneous Fat Thickness Measured by Ultrasonography Correlates with Hyperlipidemia and Steatohepatitis in Obese Children. Pediatr Gastroenterol Hepatol Nutr 2015; 18:108-14. [PMID: 26157696 PMCID: PMC4493243 DOI: 10.5223/pghn.2015.18.2.108] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 05/12/2015] [Accepted: 05/25/2015] [Indexed: 01/02/2023] Open
Abstract
PURPOSE The aim of this study is to evaluate the relationship between abdominal subcutaneous fat thickness measured by ultrasonography (US) and serum lipid profile and liver transaminases in obese children. METHODS One hundred and sixty-six children diagnosed with obesity from May 2001 to December 2013 were included in this study. Data on serum lipid profile and liver transaminases were collected from clinical records. Abdominal subcutaneous fat thickness and grade of hepatic steatosis were evaluated by US. RESULTS Of the 166 children, 107 were diagnosed with hepatic steatosis by US, 46 with grade I, 56 with grade II, and five children with grade III. According to the grade of hepatic steasosis, the average values of midline abdominal subcutaneous fat thickness and right flank abdominal subcutaneous fat thickness measured 2.9±0.8 cm and 1.9±0.7 cm in the normal group, 3.3±0.8 cm and 2.0±0.7 cm in grade I, 3.8±0.8 cm and 2.3±0.8 cm in grade II, and 4.1±0.8 cm and 2.8±1.4 cm in grade III, respectively. Abdominal subcutaneous fat thickness correlated with grade of hepatic steatosis (p<0.01). In addition, abdominal subcutaneous fat thickness correlated with concentration of serum lipids and liver transaminases in the age group of 12-14 years (p<0.01). CONCLUSION Abdominal subcutaneous fat thickness measured by US can be used as a reliable predictor of possible hyperlipidemia and steatohepatitis in children, especially during the adolescent stage.
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Affiliation(s)
- Sung Hyun Lee
- Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea
| | - Dongwan Kim
- Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea
| | - Min Young Baek
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Hann Tchah
- Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea
| | - Yeon Sun Kim
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Eell Ryoo
- Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea
| | - Yun Mi Kim
- Department of Nursing, Gachon University, Incheon, Korea
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