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Bunnell KM, Galdamez ME, Torriani M, Bredella MA. Breast adipose tissue attenuation as a novel imaging biomarker for cardiometabolic risk. Acta Radiol 2024; 65:167-172. [PMID: 36560894 DOI: 10.1177/02841851221146267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Certain adipose tissue depots infer higher cardiometabolic risk than body mass index (BMI). PURPOSE To assess breast adipose tissue (BrAT) attenuation as a novel imaging biomarker for cardiometabolic risk. MATERIAL AND METHODS We studied 151 women (mean age = 56 ± 1 years) across the weight spectrum. BrAT attenuation, abdominal adipose tissue cross-sectional areas (CSA), and attenuation were quantified using non-contrast computed tomography (CT) scans. Cardiometabolic risk factors were assessed from medical records. RESULTS BrAT attenuation was lower in obese women compared to lean women. BrAT attenuation was inversely associated with BMI, waist circumference, abdominal fat CSA, fasting glucose, and triglycerides (P ≤ 0.02), and positively associated with abdominal adipose tissue attenuation (P < 0.001). BrAT attenuation had a sensitivity of 90% but a specificity of only 35% in detecting the metabolic syndrome (area under the curve = 0.63). CONCLUSION BrAT attenuation is associated with cardiometabolic risk markers and could serve as an imaging biomarker for opportunistic risk assessment in patients undergoing CT examination of the chest.
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Affiliation(s)
- Katherine M Bunnell
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Marilyn E Galdamez
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Martin Torriani
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Miriam A Bredella
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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2
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Márquez Álvarez CDM, Gómez-Crisóstomo NP, De la Cruz-Hernández EN, El-Hafidi M, Pedraza-Chaverri J, Medina-Campos ON, Martínez-Abundis E. Chronic consumption of imbalance diets high in sucrose or fat induces abdominal obesity with different pattern of metabolic disturbances and lost in Langerhans cells population. Life Sci 2024; 336:122305. [PMID: 38030061 DOI: 10.1016/j.lfs.2023.122305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/15/2023] [Accepted: 11/23/2023] [Indexed: 12/01/2023]
Abstract
AIM Obesity is a worldwide health issue, associated with development of type 2 Diabetes Mellitus. The aim of this study is to analyze the effect of consumption of two hypercaloric diets on metabolic disturbance and beta cells damage. MAIN METHODS Male Wistar rats were subjected to twelve months consumption of three diets: a Control balanced diet (CTD, carbohydrates 58 %, proteins 29 %, lipids 13 %) and two hypercaloric diets, high in sucrose (HSD, carbohydrates 68 %, proteins 22 %, lipids 10 %) or high in fat (HFD, carbohydrates 31 %, proteins 14 %, lipids 55 %). Serum levels of glucose, triglycerides and free fatty acids were measured after zoometric parameters determination. Antioxidant enzymes activity and oxidative stress-marker were measured in pancreas tissue among histological analysis of Langerhans islets. KEY FINDINGS Although diets were hypercaloric, the amount of food consumed by rats decreased, resulting in an equal caloric consumption. The HSD induced hypertriglyceridemia and hyperglycemia with higher levels in free fatty acids (FFA, lipotoxicity); whereas HFD did not increased neither the triglycerides nor FFA, nevertheless the loss of islets' cell was larger. Both diets induced obesity with hyperglycemia and significant reduction in Langerhans islets size. SIGNIFICANCE Our results demonstrate that consumption of HSD induces more significant metabolic disturbances that HFD, although both generated pancreas damage; as well hypercaloric diet consumption is not indispensable to becoming obese; the chronic consumption of unbalanced diets (rich in carbohydrates or lipids) may lead to abdominal obesity with metabolic and functional disturbances, although the total amount of calories are similar.
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Affiliation(s)
- Corazón de María Márquez Álvarez
- Laboratorio de Investigación en Enfermedades Metabólicas e Infecciosas, División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Ranchería Sur, Cuarta Sección, C.P. 86650 Comalcalco, Tabasco, Mexico
| | - Nancy P Gómez-Crisóstomo
- Laboratorio de Investigación en Enfermedades Metabólicas e Infecciosas, División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Ranchería Sur, Cuarta Sección, C.P. 86650 Comalcalco, Tabasco, Mexico
| | - Erick N De la Cruz-Hernández
- Laboratorio de Investigación en Enfermedades Metabólicas e Infecciosas, División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Ranchería Sur, Cuarta Sección, C.P. 86650 Comalcalco, Tabasco, Mexico
| | - Mohammed El-Hafidi
- Departamento de Biomedicina Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, 14080 CDMX, Mexico
| | - José Pedraza-Chaverri
- Departamento de Biología, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico
| | - Omar Noel Medina-Campos
- Departamento de Biología, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico
| | - Eduardo Martínez-Abundis
- Laboratorio de Investigación en Enfermedades Metabólicas e Infecciosas, División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Ranchería Sur, Cuarta Sección, C.P. 86650 Comalcalco, Tabasco, Mexico.
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Magni V, Capra D, Cozzi A, Monti CB, Mobini N, Colarieti A, Sardanelli F. Mammography biomarkers of cardiovascular and musculoskeletal health: A review. Maturitas 2023; 167:75-81. [PMID: 36308974 DOI: 10.1016/j.maturitas.2022.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/09/2022] [Accepted: 10/10/2022] [Indexed: 11/07/2022]
Abstract
Breast density (BD) and breast arterial calcifications (BAC) can expand the role of mammography. In premenopause, BD is related to body fat composition: breast adipose tissue and total volume are potential indicators of fat storage in visceral depots, associated with higher risk of cardiovascular disease (CVD). Women with fatty breast have an increased likelihood of hypercholesterolemia. Women without cardiometabolic diseases with higher BD have a lower risk of diabetes mellitus, hypertension, chest pain, and peripheral vascular disease, while those with lower BD are at increased risk of cardiometabolic diseases. BAC, the expression of Monckeberg sclerosis, are associated with CVD risk. Their prevalence, 13 % overall, rises after menopause and is reduced in women aged over 65 receiving hormonal replacement therapy. Due to their distinct pathogenesis, BAC are associated with hypertension but not with other cardiovascular risk factors. Women with BAC have an increased risk of acute myocardial infarction, ischemic stroke, and CVD death; furthermore, moderate to severe BAC load is associated with coronary artery disease. The clinical use of BAC assessment is limited by their time-consuming manual/visual quantification, an issue possibly solved by artificial intelligence-based approaches addressing BAC complex topology as well as their large spectrum of extent and x-ray attenuations. A link between BD, BAC, and osteoporosis has been reported, but data are still inconclusive. Systematic, standardised reporting of BD and BAC should be encouraged.
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Affiliation(s)
- Veronica Magni
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milano, Italy.
| | - Davide Capra
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milano, Italy.
| | - Andrea Cozzi
- Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Italy.
| | - Caterina B Monti
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milano, Italy.
| | - Nazanin Mobini
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milano, Italy.
| | - Anna Colarieti
- Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Italy
| | - Francesco Sardanelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milano, Italy; Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Italy.
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4
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Cheng E, Caan BJ, Chen WY, Irwin ML, Prado CM, Cespedes Feliciano EM. Adipose tissue radiodensity and mortality among patients with nonmetastatic breast cancer. Clin Nutr 2022; 41:2607-2613. [PMID: 36306565 PMCID: PMC9722634 DOI: 10.1016/j.clnu.2022.09.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/02/2022] [Accepted: 09/26/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND & AIMS Computed tomography (CT) scans can measure quantity and distribution of adipose tissue, which are associated with breast cancer prognosis. As a novel prognostic marker, radiodensity of adipose tissue has been examined in multiple cancer types, but never in breast cancer. Lower density indicates larger adipocytes with greater lipid content, whereas higher density can reflect inflammation, fibrosis, vascularity, or even metabolic changes; and both may impact breast cancer prognosis. METHODS We included 2868 nonmetastatic patients with breast cancer diagnosed between January 2005 and December 2013 at Kaiser Permanente Northern California, an integrated healthcare system. From CT scans at diagnosis, we assessed the radiodensity of subcutaneous (SAT) and visceral adipose tissue (VAT) at the third lumbar vertebra and categorized their radiodensity into three levels: low (<1 standard deviation [SD] below the mean), middle (mean ± 1 SD), and high (>1 SD above the mean). Using multivariable Cox proportional hazards regression with adjustment for clinicopathological characteristics including body mass index, we calculated hazard ratios (HRs [95% confidence intervals]) for the associations of adipose tissue radiodensity with overall mortality and breast-cancer-specific mortality. RESULTS Median age at diagnosis of breast cancer was 56.0 years, most (63.3%) were non-Hispanic White and nearly half (45.6%) were stage II. Compared to middle SAT radiodensity, high SAT radiodensity was significantly associated with increased risk of overall mortality (HR: 1.45 [1.15-1.81]), non-significantly with breast-cancer-specific mortality (HR: 1.32 [0.95-1.84]). Neither low SAT radiodensity nor high or low VAT radiodensity was significantly associated with overall or breast-cancer-specific mortality. CONCLUSIONS High radiodensity of SAT at diagnosis of nonmetastatic breast cancer was associated with increased risk of overall mortality, independent of adiposity and other prognostic factors. Considering both radiodensity and quantity of adipose tissue at different locations could deepen understanding of the role of adiposity in breast cancer survival.
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Affiliation(s)
- En Cheng
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Bette J Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Wendy Y Chen
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, United States
| | - Melinda L Irwin
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Connecticut, United States
| | - Carla M Prado
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
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5
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Ueberreiter CS, Ueberreiter K, Mohrmann C, Herm J, Herold C. [Long-term evaluation after autologous fat transplantation for breast augmentation]. HANDCHIR MIKROCHIR P 2020; 53:149-158. [PMID: 32777824 DOI: 10.1055/a-1183-4338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background The transplantation of autologous fat is an increasingly common but not standardized procedure in aesthetic and reconstructive surgery. Until now only studies about the short-term results after transplantation with autologous fat have been published. In this publication we present our results of a long-term study after fat transplantation.Patients/Material and Methods 14 patients underwent an MRI investigation which was done before and 5-9 years (mean 6 years) years after aesthetic breast lipofilling according to BEAULI-protocol. The difference in volume was calculated with the open source software OsiriX. Two groups were analyzed separately to calculate the influence of body weight changes in final volume gain. In the first group patients with a stable BMI (increase of less than 1 kg/m2) were included. The second group includes patients with a BMI gain exceeding more than 1 kg/m2. The mean increase in BMI was 1,6 kg/m2 (minimum 0 - maximum 3,9). None of the patients lost weight.Results Depending on the desired amount of breast augmentation the patients underwent between one to four operations. An average of 176 ml fat was transplanted per breast and surgery. In the first group a mean volume survival of 74 % (IQR 58 % - 92 %) was observed. In the second group an increase of 135 % (IQR 105 % - 318 %) of the volume of transplanted fat was observed. After an intermediate weight loss one of the patients regained her initial weight.Conclusion In this study the transplantation of autologous fat renders good long-term results. There is a significant correlation between change of weight and fat transplant volume survival over the years. This also explains the very high increase in breast volume in some patients. Autologous fat transplantation seems to be a safe and efficient method for breast augmentation. For further statements studies with larger number of cases are necessary.
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Affiliation(s)
| | | | - Chris Mohrmann
- Klinikum Oldenburg AöR Anästhesiologie/Intensiv-/Notfallmedizin/Schmerztherapie
| | - Juliane Herm
- Charite Universitatsmedizin Berlin Center for Stroke Research Berlin
| | - Christian Herold
- DIAKO Bremen, Chirurgische Klinik, Sektion Plastische und Ästhetische Chirurgie
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Kościński K, Makarewicz R, Bartoszewicz Z. Stereotypical and Actual Associations of Breast Size with Mating-Relevant Traits. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:821-836. [PMID: 31562583 PMCID: PMC7058577 DOI: 10.1007/s10508-019-1464-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 05/04/2019] [Accepted: 05/07/2019] [Indexed: 06/10/2023]
Abstract
Breast size varies substantially among women and influences perception of the woman by other people with regard to her attractiveness and other characteristics that are important in social contexts, including mating. The theory of sexual selection predicts that physical criteria of partner selection should be markers of the candidate's desirable properties, mainly biological quality. Few studies, however, have examined whether breast size really signals biological quality or its components and whether observers accurately interpret these signals. Our first study encompassed 163 young women and aimed to establish actual correlates of breast size. The aim of the second study was to determine preferences and stereotypes related to breast size: 252-265 women and men evaluated female digital figures varying in, among other characteristics, breast size. Breast size (breast circumference minus chest circumference) was negatively associated with body asymmetry and positively associated with infections of the respiratory system, but did not correlate with infections of the digestive system, openness to casual sex, and testosterone and estradiol level. Women and men perceived breasts in a similar way to each other: the bigger the breasts the higher the reproductive efficiency, lactational efficiency, sexual desire, and promiscuity attributed to the woman. Nevertheless, large breasts were not regarded more attractive than average ones, though small breasts were the least attractive. In addition, big-breasted women were perceived as less faithful and less intelligent than women with average or small breasts. We discuss our results from the perspectives of evolutionary psychology, perceptual biases, and social stereotypes.
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Affiliation(s)
- Krzysztof Kościński
- Department of Human Evolutionary Ecology, Faculty of Biology, Adam Mickiewicz University, Umultowska 89, 61-614, Poznan, Poland.
| | - Rafał Makarewicz
- Department of Human Evolutionary Ecology, Faculty of Biology, Adam Mickiewicz University, Umultowska 89, 61-614, Poznan, Poland
| | - Zbigniew Bartoszewicz
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland
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7
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Maskarinec G, Ciba M, Ju D, Shepherd JA, Ernst T, Wu AH, Monroe KR, Lim U, Wilkens LR, Le Marchand L. Association of Imaging-Based Body Fat Distribution and Mammographic Density in the Multiethnic Cohort Adiposity Phenotype Study. Cancer Epidemiol Biomarkers Prev 2019; 29:352-358. [PMID: 31727725 DOI: 10.1158/1055-9965.epi-19-1060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 10/13/2019] [Accepted: 11/05/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND As the stronger association of obesity with postmenopausal breast cancer in Asian than white women may be due to body fat distribution, we examined the relation of adiposity measures with percent mammographic density (PMD), a strong predictor of breast cancer incidence. METHODS A total of 938 women from five ethnic groups (69.1 ± 2.7 years) in the Adiposity Phenotype Study (APS) underwent DXA and MRI imaging. PMD was assessed in routine mammograms using a computer-assisted method. Spearman correlation coefficients were computed and general linear models were applied to estimate regression coefficients (β) for PMD per 0.5 SD units of adiposity measures while adjusting for known confounders, including DXA total body fat. RESULTS For 701 (75%) of the participants (69.1 ± 2.7 years), valid mammograms were obtained. Whereas total body fat, the trunk-to-periphery fat ratio (TPFR), visceral fat (VAT), and subcutaneous fat (SAT) were inversely correlated with PMD (P < 0.0001), the VAT/SAT ratio correlated positively (r spearman = 0.10; P = 0.01). In fully adjusted models, PMD remained inversely related to TPFR and SAT and disappeared for VAT, while it was strengthened for VAT/SAT (β = 0.51; P = 0.009). This relation was stronger in Japanese Americans than other ethnic groups. CONCLUSIONS This is the first study to show an association of a high VAT/SAT ratio with greater PMD, a marker of breast cancer risk after taking into account total body fat. IMPACT The results indicate a link between the propensity to accumulate VAT and the amount of fat in the breast (1-PMD), which may influence the relation of obesity with breast cancer incidence.
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Affiliation(s)
| | - Michelle Ciba
- University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Dan Ju
- University of Pennsylvania, Philadelphia, Pennsylvania
| | | | | | - Anna H Wu
- University of Southern California, Los Angeles, California
| | | | - Unhee Lim
- University of Hawaii Cancer Center, Honolulu, Hawaii
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Lee JW, Kim SY, Lee HJ, Han SW, Lee JE, Lee SM. Prognostic Significance of Abdominal-to-Gluteofemoral Adipose Tissue Distribution in Patients with Breast Cancer. J Clin Med 2019; 8:jcm8091358. [PMID: 31480613 PMCID: PMC6781262 DOI: 10.3390/jcm8091358] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 08/22/2019] [Indexed: 12/24/2022] Open
Abstract
This study aimed to evaluate the association between abdominal-to-gluteofemoral adipose tissue (AT) distribution and recurrence-free survival (RFS) in breast cancer patients. Staging F-18 fluorodexoyglucose (FDG) positron emission tomography/computed tomography (PET/CT) images of 336 women with breast cancer were retrospectively analyzed. From CT images, the volume and CT-attenuation of visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (SAT), and gluteofemoral AT were measured and the ratio of abdomen-to-gluteofemoral AT volume (AG volume ratio) was calculated. The relationships between adipose tissue parameters and RFS were assessed. Through univariate analysis, abdominal SAT volume, gluteofemoral AT volume, and AG volume ratio were significantly associated with RFS. An increase in abdominal SAT volume and AG volume ratio were associated with an increased risk of recurrence, whereas increased gluteofemoral AT volume was associated with a decreased risk of recurrence. On multivariate analysis, abdominal SAT volume, gluteofemoral AT volume, and AG volume ratio were found to be significant predictors of RFS after adjusting for clinic-histological factors. Irrespective of obesity, patients with a high AG volume ratio showed a higher recurrence rate than those with a low AG volume ratio. Increased abdominal SAT volume and decreased gluteofemoral AT volume were related to poor RFS in breast cancer patients.
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Affiliation(s)
- Jeong Won Lee
- Department of Nuclear Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, 25 Simgok-ro 100 beon-gil, Seo-gu, Incheon 22711, Korea
| | - Sung Yong Kim
- Department of Surgery, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, Chungcheongnam-do 31151, Korea
| | - Hyun Ju Lee
- Department of Pathology, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, Chungcheongnam-do 31151, Korea
| | - Sun Wook Han
- Department of Surgery, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, Chungcheongnam-do 31151, Korea
| | - Jong Eun Lee
- Department of Surgery, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, Chungcheongnam-do 31151, Korea
| | - Sang Mi Lee
- Department of Nuclear Medicine, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, Chungcheongnam-do 31151, Korea.
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Carlson L, Flores Poccia V, Sun BZ, Mosley B, Kirste I, Rice A, Sridhar R, Kangarloo T, Vesper HW, Duke L, Botelho JC, Filie AC, Adams JM, Shaw ND. Early breast development in overweight girls: does estrogen made by adipose tissue play a role? Int J Obes (Lond) 2019; 43:1978-1987. [PMID: 31462689 PMCID: PMC6774855 DOI: 10.1038/s41366-019-0446-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 07/09/2019] [Accepted: 07/22/2019] [Indexed: 11/10/2022]
Abstract
Background Girls who are overweight/obese (OB) develop breast tissue but do not
undergo menarche (the first menstrual period) significantly earlier than
girls of normal weight (NW). It has been proposed that estrogen synthesized
by adipose tissue may be contributory, yet OB do not have higher serum
estrogen levels than NW matched on breast stage. We hypothesized that
estrogen synthesized locally, in mammary fat, may contribute to breast
development. This hypothesis would predict that breast development would be
more advanced than other estrogen-sensitive tissues as a function of obesity
and body fat. Methods 80 pre-menarchal girls (26 OB, 54 NW), aged 8.2–14.7 yrs,
underwent dual-energy x-ray absorptiometry to calculate percent body fat
(%BF), Tanner staging of the breast, breast ultrasound for morphological
staging, trans-abdominal pelvic ultrasound, hand x-ray (bone age), a blood
test for reproductive hormones, and urine collection to determine the
vaginal maturation index (VMI), an index of estrogen exposure in urogenital
epithelial cells. Results When controlling for breast morphological stage determined by
ultrasound, %BF was not associated with serum estrogen or gonadotropin (LH
and FSH) levels or on indices of systemic estrogen action (uterine volume,
endometrial thickness, bone age advancement, and VMI). Tanner breast stage
did not correlate with breast morphological stage and led to
misclassification of chest fatty tissue as breast tissue in some OB. Conclusions These studies do not support the hypothesis that estrogen derived
from total body fat or local (mammary) fat contributes to breast development
in overweight/obese girls.
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Affiliation(s)
- Lauren Carlson
- Clinical Research Branch, National Institutes of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, NC, USA
| | - Vanessa Flores Poccia
- Clinical Research Branch, National Institutes of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, NC, USA
| | - Bob Z Sun
- Clinical Research Branch, National Institutes of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, NC, USA
| | - Brittany Mosley
- Clinical Research Branch, National Institutes of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, NC, USA
| | - Imke Kirste
- Clinical Research Branch, National Institutes of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, NC, USA
| | - Annette Rice
- Clinical Research Branch, National Institutes of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, NC, USA
| | - Rithi Sridhar
- Clinical Research Branch, National Institutes of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, NC, USA
| | - Tairmae Kangarloo
- Reproductive Endocrine Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Hubert W Vesper
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lumi Duke
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Julianne C Botelho
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Armando C Filie
- Cytopathology Section, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Judy M Adams
- Reproductive Endocrine Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Natalie D Shaw
- Clinical Research Branch, National Institutes of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, NC, USA. .,Reproductive Endocrine Unit, Massachusetts General Hospital, Boston, MA, USA.
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Turicchi J, O'Driscoll R, Finlayson G, Beaulieu K, Deighton K, Stubbs RJ. Associations between the rate, amount, and composition of weight loss as predictors of spontaneous weight regain in adults achieving clinically significant weight loss: A systematic review and meta-regression. Obes Rev 2019; 20:935-946. [PMID: 30925026 DOI: 10.1111/obr.12849] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 02/20/2019] [Accepted: 02/22/2019] [Indexed: 02/06/2023]
Abstract
Weight regain following weight loss is common although little is known regarding the associations between amount, rate, and composition of weight loss and weight regain. Forty-three studies (52 groups; n = 2379) with longitudinal body composition measurements were identified in which weight loss (≥5%) and subsequent weight regain (≥2%) occurred. Data were synthesized for changes in weight and body composition. Meta-regression models were used to investigate associations between amount, rate, and composition of weight loss and weight regain. Individuals lost 10.9% of their body weight over 13 weeks composed of 19.6% fat-free mass, followed by a regain of 5.4% body weight over 44 weeks composed of 21.6% fat-free mass. Associations between the amount (P < 0.001) and rate (P = 0.049) of weight loss and their interaction (P = 0.042) with weight regain were observed. Fat-free mass (P = 0.017) and fat mass (P < 0.001) loss both predicted weight regain although the effect of fat-free mass was attenuated following adjustment. The amount (P < 0.001), but not the rate of weight loss (P = 0.150), was associated with fat-free mass loss. The amount and rate of weight loss were significant and interacting factors associated with weight regain. Loss of fat-free mass and fat mass explained greater variance in weight regain than weight loss alone.
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Affiliation(s)
- Jake Turicchi
- Appetite Control and Energy Balance Group, School of Psychology, University of Leeds, Leeds, UK
| | - Ruairi O'Driscoll
- Appetite Control and Energy Balance Group, School of Psychology, University of Leeds, Leeds, UK
| | - Graham Finlayson
- Appetite Control and Energy Balance Group, School of Psychology, University of Leeds, Leeds, UK
| | - Kristine Beaulieu
- Appetite Control and Energy Balance Group, School of Psychology, University of Leeds, Leeds, UK
| | - Kevin Deighton
- Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, UK
| | - R James Stubbs
- Appetite Control and Energy Balance Group, School of Psychology, University of Leeds, Leeds, UK
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Bradshaw PT, Feliciano EMC, Prado CM, Alexeeff S, Albers KB, Chen WY, Caan BJ. Adipose Tissue Distribution and Survival Among Women with Nonmetastatic Breast Cancer. Obesity (Silver Spring) 2019; 27:997-1004. [PMID: 31021535 PMCID: PMC6533153 DOI: 10.1002/oby.22458] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 02/07/2019] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Previous studies of breast cancer survival have not considered specific depots of adipose tissue such as subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT). METHODS This study assessed these relationships among 3,235 women with stage II and III breast cancer diagnosed between 2005 and 2013 at Kaiser Permanente Northern California and between 2000 and 2012 at Dana Farber Cancer Institute. SAT and VAT areas (in centimeters squared) were calculated from routine computed tomography scans within 6 (median: 1.2) months of diagnosis, covariates were collected from electronic health records, and vital status was assessed by death records. Hazard ratios (HRs) and 95% CIs were estimated using Cox regression. RESULTS SAT and VAT ranged from 19.0 to 891 cm2 and from 0.484 to 454 cm2 , respectively. SAT was related to increased risk of death (127-cm2 increase; HR [95% CI]: 1.13 [1.02-1.26]), but no relationship was found with VAT (78.18-cm2 increase; HR [95% CI]: 1.02 [0.91-1.14]). An association with VAT was noted among women with stage II cancer (stage II: HR: 1.17 [95% CI: 0.99-1.39]; stage III: HR: 0.90 [95% CI: 0.76-1.07]; P interaction < 0.01). Joint increases in SAT and VAT were associated with mortality above either alone (simultaneous 1-SD increase: HR 1.19 [95% CI: 1.05-1.34]). CONCLUSIONS SAT may be an underappreciated risk factor for breast cancer-related death.
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Affiliation(s)
- Patrick T. Bradshaw
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, California
| | | | - Carla M. Prado
- Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Stacey Alexeeff
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Kathleen B. Albers
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Wendy Y. Chen
- Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Bette J. Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, California
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12
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Xu YXZ, Mishra S. Obesity-Linked Cancers: Current Knowledge, Challenges and Limitations in Mechanistic Studies and Rodent Models. Cancers (Basel) 2018; 10:E523. [PMID: 30567335 PMCID: PMC6316427 DOI: 10.3390/cancers10120523] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/09/2018] [Accepted: 12/15/2018] [Indexed: 02/07/2023] Open
Abstract
The worldwide prevalence of obesity has doubled during the last 50 years, and according to the World Obesity Federation, one third of the people on Earth will be obese by the year 2025. Obesity is described as a chronic, relapsing and multifactorial disease that causes metabolic, biomechanical, and psychosocial health consequences. Growing evidence suggests that obesity is a risk factor for multiple cancer types and rivals smoking as the leading preventable cause for cancer incidence and mortality. The epidemic of obesity will likely generate a new wave of obesity-related cancers with high aggressiveness and shortened latency. Observational studies have shown that from cancer risk to disease prognosis, an individual with obesity is consistently ranked worse compared to their lean counterpart. Mechanistic studies identified similar sets of abnormalities under obesity that may lead to cancer development, including ectopic fat storage, altered adipokine profiles, hormone fluctuations and meta-inflammation, but could not explain how these common mechanisms produce over 13 different cancer types. A major hurdle in the mechanistic underpinning of obesity-related cancer is the lack of suitable pre-clinical models that spontaneously develop obesity-linked cancers like humans. Current approaches and animal models fall short when discerning the confounders that often coexist in obesity. In this mini-review, we will briefly survey advances in the different obesity-linked cancers and discuss the challenges and limitations in the rodent models employed to study their relationship. We will also provide our perspectives on the future of obesity-linked cancer research.
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Affiliation(s)
- Yang Xin Zi Xu
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 3P4, Canada.
| | - Suresh Mishra
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 3P4, Canada.
- Department of Internal Medicine, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 3P4, Canada.
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13
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Obesity and p16 INK4A Downregulation Activate Breast Adipocytes and Promote Their Protumorigenicity. Mol Cell Biol 2017. [PMID: 28630279 DOI: 10.1128/mcb.00101-17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Obesity is increasingly recognized as a risk factor for breast cancer development. However, the molecular basis of obesity-related breast carcinogenesis remains elusive. In this study, we have shown that obesity reduces the level of the tumor suppressor p16INK4A protein in breast adipocytes, which showed active features and strong procarcinogenic potential both in vitro and in orthotopic tumor xenografts compared to mature adipocytes from lean women. Furthermore, obesity triggered epithelial-to-mesenchymal transition (EMT) in breast ductal epithelial cells. Interestingly, specific downregulation of p16INK4A increased the expression/secretion levels of various adipokines, including leptin, and activated breast adipocytes from lean women. Consequently, like breast adipocytes from obese women, p16-deficient adipocytes induced EMT in normal primary breast luminal cells in a leptin-dependent manner and enhanced tumor growth. Additionally, we have shown that p16INK4A negatively controls leptin at the mRNA level through microRNAs 141 and 146b-5p (miR-141 and miR-146b-5p), which bind the leptin mRNA at a specific sequence in the 3' untranslated region (UTR). These results show that obesity activates breast stromal adipocytes through p16 downregulation, which upregulates leptin and promotes procarcinogenic processes.
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14
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Association between breast cancer, breast density, and body adiposity evaluated by MRI. Eur Radiol 2015; 26:2308-16. [PMID: 26489749 DOI: 10.1007/s00330-015-4058-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 09/12/2015] [Accepted: 10/06/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Despite the lack of reliable methods with which to measure breast density from 2D mammograms, numerous studies have demonstrated a positive association between breast cancer and breast density. The goal of this study was to study the association between breast cancer and body adiposity, as well as breast density quantitatively assessed from 3D MRI breast images. METHODS Breast density was calculated from 3D T1-weighted MRI images. The thickness of the upper abdominal adipose layer was used as a surrogate marker for body adiposity. We evaluated the correlation between breast density, age, body adiposity, and breast cancer. RESULTS Breast density was calculated for 410 patients with unilateral invasive breast cancer, 73 patients with ductal carcinoma in situ (DCIS), and 361 controls without breast cancer. Breast density was inversely related to age and the thickness of the upper abdominal adipose layer. Breast cancer was only positively associated with body adiposity and age. CONCLUSION Age and body adiposity are predictive of breast density. Breast cancer was not associated with breast density; however, it was associated with the thickness of the upper abdominal adipose layer, a surrogate marker for body adiposity. Our results based on a limited number of patients warrant further investigations. KEY POINTS • MRI breast density is negatively associated with body adiposity. • MRI breast density is negatively associated with age. • Breast cancer is positively associated with body adiposity. • Breast Cancer is not associated with MRI breast density.
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15
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Abstract
Excess body adiposity, commonly expressed as body mass index (BMI), is a risk factor for many common adult cancers. Over the past decade, epidemiological data have shown that adiposity-cancer risk associations are specific for gender, site, geographical population, histological subtype and molecular phenotype. The biological mechanisms underpinning these associations are incompletely understood but need to take account of the specificities observed in epidemiology to better inform future prevention strategies.
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Affiliation(s)
- Andrew G Renehan
- Institute of Cancer Sciences, Manchester Academic Health Science Centre, The Christie NHS Foundation Trust, University of Manchester, Wilmslow Road, Manchester M20 4BX, UK
| | - Marcel Zwahlen
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Finkenhubelweg 11, Bern CH-3012, Switzerland
| | - Matthias Egger
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Finkenhubelweg 11, Bern CH-3012, Switzerland
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16
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Uzun H, Bitik O, Baltu Y, Sönmez Ç, Öztürk Kaymak A. The Effects of Reduction Mammaplasty on Serum Leptin Levels and Insulin Resistance. Int J Endocrinol 2015; 2015:719824. [PMID: 26550014 PMCID: PMC4621362 DOI: 10.1155/2015/719824] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 10/04/2015] [Indexed: 11/21/2022] Open
Abstract
Background. The reduction mammaplasty has been a well-executed and known procedure in which considerable amount of fatty tissue is removed from the body. The authors aimed to show the effects of the reduction mammaplasty on serum leptin levels and insulin resistance. Methods. 42 obese female patients who had gigantomastia were operated on. We recorded patients' demographic and preoperative data, including age, weight, height, and body mass index. Fasting serum leptin, glucose, and insulin levels were noted. Homeostasis model assessment scores were calculated. At the postoperative 8th week, patients were reevaluated in terms of above parameters assessing the presence of any difference. Results. Serum leptin levels were decreased postoperatively and the decrease was statistically significant. We were able to show a decrease in homeostasis model assessment score, which indicated an increase in insulin sensitivity, and this change was statistically significant. A significant correlation between body mass index and leptin change was found postoperatively. Conclusion. Reduction mammaplasty is not solely an aesthetic procedure but it decreases serum leptin levels and increases insulin sensitivity, which may help obese women to reduce their cardiovascular risk.
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Affiliation(s)
- Hakan Uzun
- Department of Plastic Reconstructive and Aesthetic Surgery, Hacettepe University Faculty of Medicine, Sıhhiye, 06100 Ankara, Turkey
- *Hakan Uzun:
| | - Ozan Bitik
- Department of Plastic Reconstructive and Aesthetic Surgery, Hacettepe University Faculty of Medicine, Sıhhiye, 06100 Ankara, Turkey
| | - Yahya Baltu
- Department of Plastic Reconstructive and Aesthetic Surgery, Ankara Oncology Research and Training Hospital, Yenimahalle, 06200 Ankara, Turkey
| | - Çiğdem Sönmez
- Department of Biochemistry, Ankara Oncology Research and Training Hospital, Yenimahalle, 06200 Ankara, Turkey
| | - Ayşegül Öztürk Kaymak
- Department of Genetics, Ankara Oncology Research and Training Hospital, Yenimahalle, 06200 Ankara, Turkey
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17
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Gaudet MM, Carter BD, Patel AV, Teras LR, Jacobs EJ, Gapstur SM. Waist circumference, body mass index, and postmenopausal breast cancer incidence in the Cancer Prevention Study-II Nutrition Cohort. Cancer Causes Control 2014; 25:737-45. [DOI: 10.1007/s10552-014-0376-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 03/25/2014] [Indexed: 02/01/2023]
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18
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Ludwig UA, Klausmann F, Baumann S, Honal M, Hövener JB, König D, Deibert P, Büchert M. Whole-body MRI-based fat quantification: a comparison to air displacement plethysmography. J Magn Reson Imaging 2014; 40:1437-44. [PMID: 24449401 DOI: 10.1002/jmri.24509] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 10/14/2013] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To demonstrate the feasibility of an algorithm for MRI whole-body quantification of internal and subcutaneous fat and quantitative comparison of total adipose tissue to air displacement plethysmography (ADP). MATERIALS AND METHODS For comparison with ADP, whole-body MR data of 11 volunteers were obtained using a continuously moving table Dixon sequence. Resulting fat images were corrected for B1 related intensity inhomogeneities before fat segmentation. RESULTS The performed MR measurements of the whole body provided a direct comparison to ADP measurements. The segmentation of subcutaneous and internal fat in the abdomen worked reliably with an accuracy of 98%. Depending on the underlying model for fat quantification, the resultant MR fat masses represent an upper and a lower limit for the true fat masses. In comparison to ADP, the results were in good agreement with ρ ≥ 0.97, P < 0.0001. CONCLUSION Whole-body fat quantities derived noninvasively by using a continuously moving table Dixon acquisition were directly compared with ADP. The accuracy of the method and the high reproducibility of results indicate its potential for clinical applications.
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Affiliation(s)
- Ute A Ludwig
- Department of Radiology - Medical Physics, University Medical Center Freiburg, Freiburg, Germany
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19
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Karastergiou K, Fried SK. Multiple adipose depots increase cardiovascular risk via local and systemic effects. Curr Atheroscler Rep 2013; 15:361. [PMID: 23982264 PMCID: PMC3997174 DOI: 10.1007/s11883-013-0361-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Adipose tissue modifies the development of cardiovascular disease in a complex manner: obesity is a major risk factor, especially when accompanied by a central fat distribution. For that reason the characteristics of visceral adipose tissue have attracted most of the research interest thus far, and measurement of waist circumference is now recommended for everyday clinical practice. However, the direct, causative role of visceral fat in cardiometabolic disease remains to be established. Epidemiological and clinical studies show that accumulation of fat subcutaneously, in the gluteofemoral area, is protective against cardiovascular disease, but the exact molecular mechanisms remain unclear. In the last few years, imaging has allowed the study of smaller fat depots that may interact locally with important tissues: epicardial fat with the myocardium, perivascular fat with the vessel wall and the developing atherosclerotic plaque, and renal sinus fat with the renal artery. Unraveling the heterogeneous fat distribution and metabolic phenotypes in human obesity will facilitate optimal assessment of cardiovascular risk in overweight and obese individuals.
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Affiliation(s)
- Kalypso Karastergiou
- Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, Boston University, School of Medicine, 650 Albany St., EBRC-810, Boston, MA 02118, United States. Tel.: +1 617 638 7123; fax: +1 617 638 7124;
| | - Susan K. Fried
- Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, Boston University, School of Medicine, 650 Albany St., EBRC-810, Boston, MA 02118, United States
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20
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Migliaccio S, Greco EA, Fornari R, Donini LM, Di Luigi L, Lenzi A. Skeletal alterations in women affected by obesity. Aging Clin Exp Res 2013; 25 Suppl 1:S35-7. [PMID: 24061852 DOI: 10.1007/s40520-013-0090-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 07/05/2013] [Indexed: 01/09/2023]
Abstract
Obesity has always been considered a protective factor for the skeleton and for osteoporosis. However, new epidemiologic and clinical data have shown that high level of fat mass might be a risk factor for osteoporosis and fragility fractures. Further, increasing evidences seem to indicate that the different components of metabolic syndrome (i.e. hypertension, increased triglycerides, and reduced high-density lipoprotein cholesterol) are also potential risk factors for the development of low bone mineral density and osteoporosis.
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21
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Müller MJ, Bosy-Westphal A. Adaptive thermogenesis with weight loss in humans. Obesity (Silver Spring) 2013; 21:218-28. [PMID: 23404923 DOI: 10.1002/oby.20027] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Revised: 05/15/2012] [Accepted: 06/28/2012] [Indexed: 01/08/2023]
Abstract
UNLABELLED Adaptive thermogenesis (AT) with weight loss refers to underfeeding-associated fall in resting and non-resting energy expenditure (REE, non-REE); this is independent of body weight and body composition. In humans, the existence of AT was inconsistently shown and its clinical significance has been questioned. OBJECTIVES Discrepant findings are mainly due to different definitions of AT, the use of various and nonstandardized study protocols, and the limits of accuracy of methods to assess energy expenditure. With controlled underfeeding, AT takes more than 2 wk to develop. AT accounts to an average of 0.5 MJ (or 120 kcal) with a considerable between subject variance. DESIGN AND METHODS Low-sympathetic nervous system activity, 3,5,3'-tri-iodothyronine (T3) and leptin are likely to add to AT; however, the kinetic changes of their plasma levels with underfeeding differ from the time course of AT and controlled intervention studies substituting and titrating these hormones are rare in humans. AT in response to underfeeding is independent of thermogenesis in response to either diet or cold. Although fat-free mass (FFM) and, thus, liver, and skeletal muscle are considered as major sites of AT, cold-induced nonshivering thermogenesis relates to the metabolism of brown adipose tissue (BAT). In humans, diet-induced thermogenesis is related to postprandial substrate metabolism of FFM with a questionable role of BAT. Obviously, the REE component of AT differs from and its non-REE component with respect to organ contribution as well as mechanisms. Thus, AT cannot be considered as unique. CONCLUSIONS AT should be characterized based on individual components of daily energy expenditure, detailed body composition analyses, and mathematical modeling. The biological basis of AT as well as the influences of age, sex, obesity, stress, and inflammation remain to be established in humans.
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Affiliation(s)
- M J Müller
- Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel, Düsternbrooker Weg 17, 24105 Kiel, Germany.
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22
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Lee HO, Yim JE, Lee JS, Kim YS, Choue R. The association between measurement sites of visceral adipose tissue and cardiovascular risk factors after caloric restriction in obese Korean women. Nutr Res Pract 2013; 7:43-8. [PMID: 23424007 PMCID: PMC3572225 DOI: 10.4162/nrp.2013.7.1.43] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 10/25/2012] [Accepted: 11/12/2012] [Indexed: 12/28/2022] Open
Abstract
Quantities as well as distributions of adipose tissue (AT) are significantly related to cardiovascular disease (CVD) risk factors and can be altered with caloric restriction. This study investigated which cross-sectional slice location of AT is most strongly correlated with changes in CVD risk factors after caloric restriction in obese Korean women. Thirty-three obese pre-menopausal Korean women (32.4 ± 8.5 yrs, BMI 27.1 ± 2.3 kg/m(2)) participated in a 12 weeks caloric restriction program. Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) were measured using computed tomography (CT) scans at the sites of L2-L3, L3-L4, and L4-L5. Fasting serum levels of glucose, insulin, triglyceride, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), leptin and homeostasis model assessment-insulin resistance (HOMA-IR) were observed. Pearson's partial correlation coefficients were used to assess the relationship between AT measurement sites and changes in CVD risk factors after calorie restriction. When calories were reduced by 350 kcal/day for 12 weeks, body weight (-2.7%), body fat mass (-8.2%), and waist circumference (-5.8%) all decreased (P < 0.05). In addition, following caloric restriction, serum levels of glucose (-4.6%), TC (-6.2%), LDL-C (-5.3%), leptin (-17.6%) and HOMA-IR (-18.2%) decreased significantly (P < 0.05) as well. Changes in VAT at the level of L3-L4 were significantly greater than those at other abdominal sites, and these changes were correlated with changes in TC (P < 0.05), LDL-C (P < 0.001), SBP (P < 0.001) and HOMA-IR (P < 0.01). These results show that VAT at L3-L4 had a stronger correlation with CVD risk factors than with other AT measurement sites after caloric restriction.
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Affiliation(s)
- Hye-Ok Lee
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-701, Korea
- Department of Nutrition, Kyung Hee University Hospital at Gangdong, Seoul 134-727, Korea
| | - Jung-Eun Yim
- Department of Food and Nutrition, Changwon National University, Changwon 641-773, Korea
| | - Jeong-Sook Lee
- Department of Nutrition, Kyung Hee University Hospital at Gangdong, Seoul 134-727, Korea
| | - Young-Seol Kim
- Department of Endocrine and Metabolism, Kyung Hee Medical Center, Seoul 130-702, Korea
| | - Ryowon Choue
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-701, Korea
- Research Institute of Medical Nutrition, Kyung Hee University, Seoul 130-701, Korea
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23
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Müller MJ, Lagerpusch M, Enderle J, Schautz B, Heller M, Bosy-Westphal A. Beyond the body mass index: tracking body composition in the pathogenesis of obesity and the metabolic syndrome. Obes Rev 2012; 13 Suppl 2:6-13. [PMID: 23107255 DOI: 10.1111/j.1467-789x.2012.01033.x] [Citation(s) in RCA: 188] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Body composition is related to various physiological and pathological states. Characterization of individual body components adds to understand metabolic, endocrine and genetic data on obesity and obesity-related metabolic risks, e.g. insulin resistance. The obese phenotype is multifaceted and can be characterized by measures of body fat, leg fat, liver fat and skeletal muscle mass rather than by body mass index. The contribution of either whole body fat or fat distribution or individual fat depots to insulin resistance is moderate, but liver fat has a closer association with (hepatic) insulin resistance. Although liver fat is associated with visceral fat, its effect on insulin resistance is independent of visceral adipose tissue. In contrast to abdominal fat, appendicular or leg fat is inversely related to insulin resistance. The association between 'high fat mass + low muscle mass' (i.e. 'sarcopenic adiposity') and insulin resistance deserves further investigation and also attention in daily clinical practice. In addition to cross-sectional data, longitudinal assessment of body composition during controlled under- and overfeeding of normal-weight healthy young men shows that small decreases and increases in fat mass are associated with corresponding decreases and increases in insulin secretion as well as increases and decreases in insulin sensitivity. However, even under controlled conditions, there is a high intra- and inter-individual variance in the changes of (i) body composition; (ii) the 'body composition-glucose metabolism relationship' and (iii) glucose metabolism itself. Combining individual body components with their related functional aspects (e.g. the endocrine, metabolic and inflammatory profiles) will provide a suitable basis for future definitions of a 'metabolically healthy body composition'.
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Affiliation(s)
- M J Müller
- Institute of Human Nutrition and Food Science, Agrar- und Ernährungswissenschaftliche Fakultät, Christian-Albrechts-Universität zu Kiel,Düsternbrooker Weg 17-19, Kiel,Germany.
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