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Chen L, Xu T, Lou J, Zhang T, Wu S, Xie R, Xu J. The beneficial roles and mechanisms of estrogens in immune health and infection disease. Steroids 2024; 207:109426. [PMID: 38685461 DOI: 10.1016/j.steroids.2024.109426] [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: 10/22/2023] [Revised: 02/28/2024] [Accepted: 04/21/2024] [Indexed: 05/02/2024]
Abstract
Multiple epidemiologic studies have revealed that gender is considered one of the important factors in the frequency and severity of certain infectious diseases, in which estrogens may play a vital role. There is growing evidence that estrogens as female sex hormone can modulate multiple biological functions outside of the reproductive system, such as in brain and cardiovascular system. However, it is largely unknown about the roles and mechanisms of estrogens/estrogen receptors in immune health and infection disease. Thence, by reading a lot of literature, we summarized the regulatory mechanisms of estrogens/estrogen receptors in immune cells and their roles in certain infectious diseases with gender differences. Therefore, estrogens may have therapeutic potentials to prevent and treat these infectious diseases, which needs further clinical investigation.
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Affiliation(s)
- Lan Chen
- Department of Gastroenterology, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Ting Xu
- Department of Gastroenterology, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Jun Lou
- Department of Gastroenterology, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Ting Zhang
- Department of Gastroenterology, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Sheng Wu
- Department of Gastroenterology, Liupanshui People's Hospital, Liupanshui City 553000, Guizhou Province, China
| | - Rui Xie
- Department of Gastroenterology, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
| | - Jingyu Xu
- Department of Gastroenterology, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
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Ma L, Li Y, Li G, Sun J, Zhang X, Shi Z, Yan Y, Duan Y, Wang J, Li Z, Zhang L. Adiposity indicators exhibit depot- and sex-specific associations with multimorbidity onset: A cohort study of the UK Biobank. Diabetes Obes Metab 2024; 26:2890-2904. [PMID: 38686512 DOI: 10.1111/dom.15610] [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: 02/06/2024] [Revised: 03/31/2024] [Accepted: 04/07/2024] [Indexed: 05/02/2024]
Abstract
AIM This study investigated the depot- and sex-specific associations of adiposity indicators with incident multimorbidity and comorbidity pairs. MATERIALS AND METHODS We selected 382 678 adults without multimorbidity (≥2 chronic diseases) at baseline from the UK Biobank. General obesity, abdominal obesity and body fat percentage indices were measured. RESULTS Cox proportional hazard regression analyses of general obesity indices revealed that for every one-unit increase in body mass index, the risk of incident multimorbidity increased by 5.2% (95% confidence interval 5.0%-5.4%). A dose-response relationship was observed between general obesity degrees and incident multimorbidity. The analysis of abdominal obesity indices showed that for every 0.1 increment in waist-to-height ratio and waist-to-hip ratio, the risk of incident multimorbidity increased by 42.0% (37.9%-46.2%) and 27.9% (25.7%-30.0%), respectively. Central obesity, as defined by waist circumference, contributed to a 23.2% increased risk of incident multimorbidity. Hip circumference and hip-to-height ratio had protective effects on multimorbidity onset. Consistent findings were observed for males and females. Body fat percentage elevated 3% (0.2%-5.9%) and 5.3% (1.1%-9.7%) risks of incident multimorbidity in all adults and females, respectively. Arm fat percentages elevated 5.3% (0.8%-9.9%) and 19.4% (11.0%-28.5%) risks of incident multimorbidity in all adults and males, respectively. The general obesity indices, waist circumference, waist-to-height ratio, waist-to-hip ratio and central obesity increased the onset of comorbidity pairs, whereas hip circumference and hip-to-height ratio decreased the onset of comorbidity pairs. These adiposity indicators mainly affect diabetes mellitus-related comorbidity onset in males and hypertensive-related comorbidity onset in females. CONCLUSIONS Adiposity indicators are predictors of multimorbidity and comorbidity pairs and represent a promising approach for intervention.
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Affiliation(s)
- Lu Ma
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, China
| | - Ying Li
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Gaixia Li
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Jiajun Sun
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
- Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Xueli Zhang
- Medical Research Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Zumin Shi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Yating Yan
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Yutian Duan
- Clinical Medicine, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Jing Wang
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Zengbin Li
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Lei Zhang
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, China
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
- Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Victoria, Australia
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Junker D, Wu M, Reik A, Raspe J, Rupp S, Han J, Näbauer SM, Wiechert M, Somasundaram A, Burian E, Waschulzik B, Makowski MR, Hauner H, Holzapfel C, Karampinos DC. Impact of baseline adipose tissue characteristics on change in adipose tissue volume during a low calorie diet in people with obesity-results from the LION study. Int J Obes (Lond) 2024:10.1038/s41366-024-01568-6. [PMID: 38926461 DOI: 10.1038/s41366-024-01568-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 06/04/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND/OBJECTIVES Weight loss outcomes vary individually. Magnetic resonance imaging (MRI)-based evaluation of adipose tissue (AT) might help to identify AT characteristics that predict AT loss. This study aimed to assess the impact of an 8-week low-calorie diet (LCD) on different AT depots and to identify predictors of short-term AT loss using MRI in adults with obesity. METHODS Eighty-one adults with obesity (mean BMI 34.08 ± 2.75 kg/m², mean age 46.3 ± 10.97 years, 49 females) prospectively underwent baseline MRI (liver dome to femoral head) and anthropometric measurements (BMI, waist-to-hip-ratio, body fat), followed by a post-LCD-examination. Visceral and subcutaneous AT (VAT and SAT) volumes and AT fat fraction were extracted from the MRI data. Apparent lipid volumes based on MRI were calculated as approximation for the lipid contained in the AT. SAT and VAT volumes were subdivided into equidistant thirds along the craniocaudal axis and normalized by length of the segmentation. T-tests compared baseline and follow-up measurements and sex differences. Effect sizes on subdivided AT volumes were compared. Spearman Rank correlation explored associations between baseline parameters and AT loss. Multiple regression analysis identified baseline predictors for AT loss. RESULTS Following the LCD, participants exhibited significant weight loss (11.61 ± 3.07 kg, p < 0.01) and reductions in all MRI-based AT parameters (p < 0.01). Absolute SAT loss exceeded VAT loss, while relative apparent lipid loss was higher in VAT (both p < 0.01). The lower abdominopelvic third showed the most significant SAT and VAT reduction. The predictor of most AT and apparent lipid losses was the normalized baseline SAT volume in the lower abdominopelvic third, with smaller volumes favoring greater AT loss (p < 0.01 for SAT and VAT loss and SAT apparent lipid volume loss). CONCLUSIONS The LCD primarily reduces lower abdominopelvic SAT and VAT. Furthermore, lower abdominopelvic SAT volume was detected as a potential predictor for short-term AT loss in persons with obesity.
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Affiliation(s)
- Daniela Junker
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany.
| | - Mingming Wu
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Anna Reik
- Institute for Nutritional Medicine, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Johannes Raspe
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Selina Rupp
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Jessie Han
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Stella M Näbauer
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Meike Wiechert
- Institute for Nutritional Medicine, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Arun Somasundaram
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Egon Burian
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Birgit Waschulzik
- Institute of AI and Informatics in Medicine, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Marcus R Makowski
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Hans Hauner
- Institute for Nutritional Medicine, School of Medicine and Health, Technical University of Munich, Munich, Germany
- Else Kroener-Fresenius-Center of Nutritional Medicine, School of Life Sciences, Technical University of Munich, Freising, Germany
| | - Christina Holzapfel
- Institute for Nutritional Medicine, School of Medicine and Health, Technical University of Munich, Munich, Germany
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Fulda, Germany
| | - Dimitrios C Karampinos
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, Garching, Germany
- Munich Data Science Institute, Technical University of Munich, Garching, Germany
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4
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Li GF, Zhao PP, Xiao WJ, Karasik D, Xu YJ, Zheng HF. The paradox of bone mineral density and fracture risk in type 2 diabetes. Endocrine 2024:10.1007/s12020-024-03926-w. [PMID: 38922479 DOI: 10.1007/s12020-024-03926-w] [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: 04/24/2024] [Accepted: 06/07/2024] [Indexed: 06/27/2024]
Abstract
Fracture risk in type 2 diabetes (T2D) patients is paradoxically increased despite no decrease in areal bone mineraldensity (BMD). This phenomenon, known as the "diabetic bone paradox", has been attributed to various factorsincluding alterations in bone microarchitecture and composition, hyperinsulinemia and hyperglycemia, advancedglycation end products (AGEs), and comorbidities associated with T2D. Zhao et al. recently investigated therelationship between T2D and fracture risk using both genetic and phenotypic datasets. Their findings suggest thatgenetically predicted T2D is associated with higher BMD and lower fracture risk, indicating that the bone paradox isnot observed when confounding factors are controlled using Mendelian randomization (MR) analysis. However, inprospective phenotypic analysis, T2D remained associated with higher BMD and higher fracture risk, even afteradjusting for confounding factors. Stratified analysis revealed that the bone paradox may disappear when T2Drelatedrisk factors are eliminated. The study also highlighted the role of obesity in the relationship between T2Dand fracture risk, with BMI mediating a significant portion of the protective effect. Overall, managing T2D-relatedrisk factors may be crucial in preventing fracture risk in T2D patients.
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Affiliation(s)
- Guang-Fei Li
- The Second Affiliated Hospital of Soochow University, Osteoporosis Research Institute of Soochow University, Suzhou, Jiangsu, China
| | - Pian-Pian Zhao
- The Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, Hangzhou, Zhejiang, China
- Diseases & Population (DaP) Geninfo Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, China
| | - Wen-Jin Xiao
- The Second Affiliated Hospital of Soochow University, Osteoporosis Research Institute of Soochow University, Suzhou, Jiangsu, China
| | - David Karasik
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - You-Jia Xu
- The Second Affiliated Hospital of Soochow University, Osteoporosis Research Institute of Soochow University, Suzhou, Jiangsu, China.
| | - Hou-Feng Zheng
- The Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, Hangzhou, Zhejiang, China.
- Diseases & Population (DaP) Geninfo Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, China.
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Jiang CL, Lin FJ. Insights into the roles of Apolipoprotein E in adipocyte biology and obesity. Int J Obes (Lond) 2024:10.1038/s41366-024-01549-9. [PMID: 38839985 DOI: 10.1038/s41366-024-01549-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 05/13/2024] [Accepted: 05/17/2024] [Indexed: 06/07/2024]
Abstract
Apolipoprotein E (APOE) is a multifunctional protein expressed by various cell types, including hepatocytes, adipocytes, immune cells of the myeloid lineage, vascular smooth muscle cells, astrocytes, etc. Initially, APOE was discovered as an arginine-rich peptide within very-low-density lipoprotein, but it was subsequently found in triglyceride-rich lipoproteins in humans and other animals, where its presence facilitates the clearance of these lipoproteins from circulation. Recent epidemiolocal studies and experimental research in mice suggest a link between ApoE and obesity. The latest findings highlight the role of endogenous adipocyte ApoE in regulating browning of white adipose tissue, beige adipocyte differentiation, thermogenesis and energy homeostasis. This review focuses on the emerging evidence showing the involvement of ApoE in the regulation of obesity and its associated metabolic diseases.
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Affiliation(s)
- Chung-Lin Jiang
- Department of Biochemical Science and Technology, National Taiwan University, Taipei, Taiwan
| | - Fu-Jung Lin
- Department of Biochemical Science and Technology, National Taiwan University, Taipei, Taiwan.
- Research Center for Development Biology and Regenerative Medicine, National Taiwan University, Taipei, Taiwan.
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Ueno K, Kaneko H, Suzuki Y, Okada A, Matsuoka S, Fujiu K, Michihata N, Jo T, Takeda N, Morita H, Kamiya K, Ako J, Node K, Yasunaga H, Komuro I. Metabolic syndrome and cardiovascular disease in cancer survivors. J Cachexia Sarcopenia Muscle 2024; 15:1062-1071. [PMID: 38515400 PMCID: PMC11154793 DOI: 10.1002/jcsm.13443] [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: 09/21/2022] [Revised: 08/01/2023] [Accepted: 01/29/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND The risk of subsequent cardiovascular disease (CVD) is high in cancer survivors. Although metabolic syndrome is an established risk factor for CVD, its association with cancer survivors has not yet been established. This study aimed to clarify whether metabolic syndrome is associated with subsequent CVD risk in patients with cancer using a nationwide epidemiological dataset. METHODS We retrospectively analysed 53 510 patients with a history of breast, colorectal, or stomach cancer, which is reportedly a major site for developing cancer in Japan. Study participants were categorized into two groups based on the presence of metabolic syndrome, defined using the Japanese criteria (high waist circumference and ≥2 metabolic parameters including elevated blood pressure, elevated triglycerides, reduced high-density lipoprotein cholesterol, or elevated fasting plasma glucose). The clinical outcomes were collected between 2005 and 2021. The primary endpoint was defined as the composite CVD outcome, including myocardial infarction, angina pectoris, stroke, and heart failure. RESULTS The median patient age was 54 years, and 37.5% of the patients were men. Metabolic syndrome was observed in 5558 (10.4%) patients. Over a mean follow-up period of 973 ± 791 days, 3085 composite CVD outcomes were recorded. Multivariable Cox regression analyses showed that metabolic syndrome was associated with a greater risk of developing CVD events (HR = 1.29, 95% CI = 1.15-1.45). Metabolic syndrome was also associated with an increased risk of CVD in patients with a follow-up period ≥1 year (HR = 1.33, 95% CI = 1.15-1.53). This relationship was also observed when metabolic syndrome was defined according to the International Diabetes Federation criteria (HR = 1.34, 95% CI = 1.21-1.49) and the National Cholesterol Education Program Adult Treatment Panel III criteria (HR = 1.32, 95% CI = 1.19-1.46). Subgroup analyses showed that the relationship between metabolic syndrome and incident CVD was more pronounced in the non-obese participants than in the obese participants. CONCLUSIONS Metabolic syndrome is associated with a greater risk of developing CVD, even among cancer survivors.
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Grants
- 21AA2007 Ministry of Health, Labour and Welfare, Japan
- 21K08123 Ministry of Education, Culture, Sports, Science and Technology, Japan
- 21H03159 Ministry of Education, Culture, Sports, Science and Technology, Japan
- 20H03907 Ministry of Education, Culture, Sports, Science and Technology, Japan
- Ministry of Health, Labour and Welfare, Japan
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Affiliation(s)
- Kensuke Ueno
- Department of Cardiovascular MedicineUniversity of TokyoTokyoJapan
- Department of Rehabilitation Sciences, Graduate School of Medical SciencesKitasato UniversityKanagawaJapan
| | - Hidehiro Kaneko
- Department of Cardiovascular MedicineUniversity of TokyoTokyoJapan
- Department of Advanced CardiologyUniversity of TokyoTokyoJapan
| | - Yuta Suzuki
- Department of Cardiovascular MedicineUniversity of TokyoTokyoJapan
| | - Akira Okada
- Department of Prevention of Diabetes and Lifestyle‐Related Diseases, Graduate School of MedicineUniversity of TokyoTokyoJapan
| | - Satoshi Matsuoka
- Department of Cardiovascular MedicineUniversity of TokyoTokyoJapan
| | - Katsuhito Fujiu
- Department of Cardiovascular MedicineUniversity of TokyoTokyoJapan
- Department of Advanced CardiologyUniversity of TokyoTokyoJapan
| | | | - Taisuke Jo
- Department of Health Services ResearchUniversity of TokyoTokyoJapan
| | - Norifumi Takeda
- Department of Cardiovascular MedicineUniversity of TokyoTokyoJapan
| | - Hiroyuki Morita
- Department of Cardiovascular MedicineUniversity of TokyoTokyoJapan
| | - Kentaro Kamiya
- Department of Rehabilitation, School of Allied Health SciencesKitasato UniversityKanagawaJapan
| | - Junya Ako
- Department of Cardiovascular Medicine, School of MedicineKitasato UniversityKanagawaJapan
| | - Koichi Node
- Department of Cardiovascular MedicineSaga UniversitySagaJapan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public HealthUniversity of TokyoTokyoJapan
| | - Issei Komuro
- Department of Cardiovascular MedicineUniversity of TokyoTokyoJapan
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Minato-Inokawa S, Honda M, Tsuboi-Kaji A, Takeuchi M, Kitaoka K, Kurata M, Wu B, Kazumi T, Fukuo K. Associations of adipose insulin resistance index with leg (gluteofemoral) fat (inverse) and serum alanine aminotransferase (positive) in young Japanese women. Metabol Open 2024; 22:100289. [PMID: 38872905 PMCID: PMC11169472 DOI: 10.1016/j.metop.2024.100289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 05/29/2024] [Accepted: 05/29/2024] [Indexed: 06/15/2024] Open
Abstract
Aim Associations of the adipose tissue insulin resistance index (AT-IR, a product of fasting insulin and free fatty acid) with body fat distribution and the ratio of alanine to aspartate aminotransferase (ALT/AST), a marker of hepatosteatosis, were examined in the context of the metabolic syndrome. Methods Legs, the trunk and body fat by DXA, blood pressure (BP) and blood chemistry were measured in 284 young Japanese female university students and 148 middle-aged biological mothers whose BMI averaged <23 kg/m2. Results Young women had higher leg fat/body fat and lower trunk fat/body fat ratio (both p < 0.001) compared with middle-aged women but AT-IR did not differ between the two groups. We had multivariable linear regression analysis for AT-IR as a dependent variable including leg fat/body fat ratio, trunk fat/body fat ratio, fasting glucose, triglyceride, HDL cholesterol and systolic BP as independent variables. Leg fat/body fat ratio, fasting glucose and triglyceride (p = 0.013, 0.009 and 0.016, respectively) emerged as determinants of AT-IR in young women. Trunk fat/body fat ratio and fasting glucose (p = 0.003 and 0.019, respectively) emerged in middle-aged women. In a model which included ALT/AST as an additional independent variable, ALT/AST (p = 0.016) was the fourth independent determinant in young women and the single determinant of AT-IR in middle-aged women (p < 0.001). Conclusion In young Japanese women, adipose tissue insulin resistance was associated with reduced leg fat, a subtle partial lipodystrophy-like phenotype associated with reduced adipose tissue expandability. It was associated with elevated trunk (abdominal) fat in middle-aged women and with ALT/AST, a marker of hepatosteatosis, in two groups of Japanese women, suggesting ectopic fat deposition associated with reduced adipose tissue expandability.
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Affiliation(s)
- Satomi Minato-Inokawa
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Laboratory of Community Health and Nutrition, Department of Bioscience, Graduate School of Agriculture, Ehime University, Matsuyama, Ehime, Japan
| | - Mari Honda
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Health, Sports, and Nutrition, Faculty of Health and Welfare, Kobe Women's University, Kobe, Hyogo, Japan
| | - Ayaka Tsuboi-Kaji
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Nutrition, Osaka City Juso Hospital, Osaka, Japan
| | - Mika Takeuchi
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
| | - Kaori Kitaoka
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Advanced Epidemiology, Noncommunicable Disease (NCD) Epidemiology Research Center, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Miki Kurata
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Food Sciences and Nutrition, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
| | - Bin Wu
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Endocrinology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Tsutomu Kazumi
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Medicine, Kohan Kakogawa Hospital, Kakogawa, Hyogo, Japan
| | - Keisuke Fukuo
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Food Sciences and Nutrition, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
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Guglielmi V, Dalle Grave R, Leonetti F, Solini A. Female obesity: clinical and psychological assessment toward the best treatment. Front Endocrinol (Lausanne) 2024; 15:1349794. [PMID: 38765954 PMCID: PMC11099266 DOI: 10.3389/fendo.2024.1349794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/19/2024] [Indexed: 05/22/2024] Open
Abstract
Obesity is a heterogeneous condition which results from complex interactions among sex/gender, sociocultural, environmental, and biological factors. Obesity is more prevalent in women in most developed countries, and several clinical and psychological obesity complications show sex-specific patterns. Females differ regarding fat distribution, with males tending to store more visceral fat, which is highly correlated to increased cardiovascular risk. Although women are more likely to be diagnosed with obesity and appear more motivated to lose weight, as confirmed by their greater representation in clinical trials, males show better outcomes in terms of body weight and intra-abdominal fat loss and improvements in the metabolic risk profile. However, only a few relatively recent studies have investigated gender differences in obesity, and sex/gender is rarely considered in the assessment and management of the disease. This review summarizes the evidence of gender differences in obesity prevalence, contributing factors, clinical complications, and psychological challenges. In addition, we explored gender differences in response to obesity treatments in the specific context of new anti-obesity drugs.
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Affiliation(s)
- Valeria Guglielmi
- Unit of Internal Medicine and Obesity Center, Department of Systems Medicine, Policlinico Tor Vergata, University of Rome Tor Vergata, Rome, Italy
| | - Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, VR, Italy
| | - Frida Leonetti
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Anna Solini
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
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Rontogianni MO, Bouras E, Aglago EK, Freisling H, Murphy N, Cotterchio M, Hampe J, Lindblom A, Pai RK, Pharoah PDP, Phipps AI, van Duijnhoven FJB, Visvanathan K, van Guelpen B, Li CI, Brenner H, Pellatt AJ, Ogino S, Gunter MJ, Peters U, Christakoudi S, Tsilidis KK. Allometric versus traditional body-shape indices and risk of colorectal cancer: a Mendelian randomization analysis. Int J Obes (Lond) 2024; 48:709-716. [PMID: 38297030 PMCID: PMC11058311 DOI: 10.1038/s41366-024-01479-6] [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: 06/27/2023] [Revised: 01/12/2024] [Accepted: 01/18/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Traditional body-shape indices such as Waist Circumference (WC), Hip Circumference (HC), and Waist-to-Hip Ratio (WHR) are associated with colorectal cancer (CRC) risk, but are correlated with Body Mass Index (BMI), and adjustment for BMI introduces a strong correlation with height. Thus, new allometric indices have been developed, namely A Body Shape Index (ABSI), Hip Index (HI), and Waist-to-Hip Index (WHI), which are uncorrelated with weight and height; these have also been associated with CRC risk in observational studies, but information from Mendelian randomization (MR) studies is missing. METHODS We used two-sample MR to examine potential causal cancer site- and sex-specific associations of the genetically-predicted allometric body-shape indices with CRC risk, and compared them with BMI-adjusted traditional body-shape indices, and BMI. Data were obtained from UK Biobank and the GIANT consortium, and from GECCO, CORECT and CCFR consortia. RESULTS WHI was positively associated with CRC in men (OR per SD: 1.20, 95% CI: 1.03-1.39) and in women (1.15, 1.06-1.24), and similarly for colon and rectal cancer. ABSI was positively associated with colon and rectal cancer in men (1.27, 1.03-1.57; and 1.40, 1.10-1.77, respectively), and with colon cancer in women (1.20, 1.07-1.35). There was little evidence for association between HI and colon or rectal cancer. The BMI-adjusted WHR and HC showed similar associations to WHI and HI, whereas WC showed similar associations to ABSI only in women. CONCLUSIONS This large MR study provides strong evidence for a potential causal positive association of the allometric indices ABSI and WHI with CRC in both sexes, thus establishing the association between abdominal fat and CRC without the limitations of the traditional waist size indices and independently of BMI. Among the BMI-adjusted traditional indices, WHR and HC provided equivalent associations with WHI and HI, while differences were observed between WC and ABSI.
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Affiliation(s)
- Marina O Rontogianni
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Emmanouil Bouras
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - Elom Kouassivi Aglago
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, UK
| | - Heinz Freisling
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Neil Murphy
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Michelle Cotterchio
- Ontario Health (Cancer Care Ontario), Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Jochen Hampe
- Department of Medicine I, University Hospital Dresden, Technische Universität Dresden (TU Dresden), Dresden, Germany
| | - Annika Lindblom
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Rish K Pai
- Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Paul D P Pharoah
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Amanda I Phipps
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
| | | | - Kala Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bethany van Guelpen
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
| | - Christopher I Li
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
- Translational Research Program and Epidemiology Program, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Andrew J Pellatt
- Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Texas, TX, USA
| | - Shuji Ogino
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Program in Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Cancer Immunology and Cancer Epidemiology Programs, Dana-Farber Harvard Cancer Center, Boston, MA, USA
| | - Marc J Gunter
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, UK
| | - Ulrike Peters
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
| | - Sofia Christakoudi
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, UK
- Department of Inflammation Biology, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Konstantinos K Tsilidis
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, UK.
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10
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Poltronieri TS, Pérsico RS, Viana LV. Body adipose tissue depots and treatment outcomes for women with breast cancer: A systematic review. Clin Nutr 2024; 43:1033-1042. [PMID: 38547637 DOI: 10.1016/j.clnu.2024.03.010] [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: 03/30/2023] [Revised: 02/14/2024] [Accepted: 03/16/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND & AIMS Excessive adipose tissue is associated with poorer prognosis in women with breast cancer (BC). However, several body adiposity depots, such as visceral (VAT), subcutaneous (SAT), intermuscular (IMAT), and gluteofemoral adipose tissues (GFAT) may have heterogeneous metabolic roles and health effects in these patients. This systematic review aims to evaluate the impact of different body adipose tissue depots, assessed via computed tomography (CT), on treatment outcomes for women with BC. We hypothesize that distinct body adipose tissue depots may be associated differently with outcomes in patients with BC. METHODS A comprehensive bibliographical search was conducted using PubMed, Embase, Cochrane Library, Scopus, and Web of Science databases (until January 2024). The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale. RESULTS The final sample comprised 23 retrospective studies (n = 12,462), with fourteen presenting good quality. A lack of standardization in CT body adipose tissue depots measurement and outcome presentation precluded quantitative analysis. Furthermore, most included studies had heterogeneous clinical characteristics. Survival and treatment response were the most prevalent outcomes. VAT (n = 19) and SAT (n = 17) were the most frequently evaluated depots and their increase was associated with worse outcomes, mainly in terms of survival. IMAT (n = 4) presented contradictory findings and a higher GFAT (n = 1) was associated with better outcomes. CONCLUSION This systematic review found an association between increased VAT and SAT with worse outcomes in patients with BC. However, due to the heterogeneity of the included studies, further research with homogeneous methodologies is necessary to better understand the impact of body adipose tissue depots on treatment outcomes. Such knowledge could lead to improved care for this patient population.
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Affiliation(s)
- Taiara Scopel Poltronieri
- Programa de Pós-Graduação em Ciências Médicas, Endocrinologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Raquel Stocker Pérsico
- Programa de Pós-Graduação em Ciências Médicas, Endocrinologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Luciana Verçoza Viana
- Programa de Pós-Graduação em Ciências Médicas, Endocrinologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
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11
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Ramessur V, Hunma S, Joonas N, Ramessur BN, Schutz Y, Montani JP, Dulloo AG. Visceral-to-peripheral adiposity ratio: a critical determinant of sex and ethnic differences in cardiovascular risks among Asian Indians and African Creoles in Mauritius. Int J Obes (Lond) 2024:10.1038/s41366-024-01517-3. [PMID: 38615158 DOI: 10.1038/s41366-024-01517-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND/AIMS Coronary heart disease morbidity and mortality are higher in people of South Asian origin than in those of African origin. We investigated whether as young adults without diabetes, people in Mauritius of South Asian descent (Indians) would show a more adverse cardiovascular risk profile that those of predominantly African descent (Creoles), and whether this could be explained by ethnic differences in visceral adiposity or other fat distribution patterns. METHODS The study was conducted in 189 young non-physically active adults, with the following measurements conducted after an overnight fast: anthropometry (weight, height, waist circumference), whole-body and regional body composition by dual-energy x-ray absorptiometry, blood pressure, and blood assays for glycemic (glucose and HbA1c) and lipid profile (triglycerides and cholesterols). RESULTS The results indicate higher serum triglycerides and lower HDL cholesterol in men than in women, and in Indians than in Creoles (p < 0.001). No significant differences due to sex or ethnicity are observed in body mass index and waist circumference, but indices of visceral adiposity (visceral/android, visceral/subcutaneous) and visceral-to-peripheral adiposity ratio (visceral/gynoid, visceral/limb) were significantly higher in men than in women, and in Indians than in Creoles. The significant effects of sex and ethnicity on blood lipid profile were either completely abolished or reduced to a greater extent after adjusting for the ratio of visceral-to-peripheral adiposity than for visceral adiposity per se. CONCLUSIONS In young adults in Mauritius, Indians show a more adverse pattern of body fat distribution and blood lipid risk profile than Creoles. Differences in their fat distribution patterns, however, only partially explain their differential atherogenic lipid risk profile, amid a greater impact of visceral-to-peripheral adiposity ratio than that of visceral adiposity per se on sex and ethnic differences in cardiovascular risks; the former possibly reflecting the ratio of hazardous (visceral) adiposity and protective (peripheral) superficial subcutaneous adiposity.
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Affiliation(s)
- Vinaysing Ramessur
- Obesity Research Unit, Biochemistry Dept., Central Health Laboratory, Victoria Hospital, Ministry of Health & Wellness, Plaines Wilhems, Mauritius
- Department of Endocrinology, Metabolism & Cardiovascular System, Faculty of Science & Medicine, University of Fribourg, Fribourg, Switzerland
| | - Sadhna Hunma
- Obesity Research Unit, Biochemistry Dept., Central Health Laboratory, Victoria Hospital, Ministry of Health & Wellness, Plaines Wilhems, Mauritius
| | - Noorjehan Joonas
- Obesity Research Unit, Biochemistry Dept., Central Health Laboratory, Victoria Hospital, Ministry of Health & Wellness, Plaines Wilhems, Mauritius
| | - Bibi Nasreen Ramessur
- Obesity Research Unit, Biochemistry Dept., Central Health Laboratory, Victoria Hospital, Ministry of Health & Wellness, Plaines Wilhems, Mauritius
| | - Yves Schutz
- Department of Endocrinology, Metabolism & Cardiovascular System, Faculty of Science & Medicine, University of Fribourg, Fribourg, Switzerland
| | - Jean-Pierre Montani
- Department of Endocrinology, Metabolism & Cardiovascular System, Faculty of Science & Medicine, University of Fribourg, Fribourg, Switzerland
| | - Abdul G Dulloo
- Department of Endocrinology, Metabolism & Cardiovascular System, Faculty of Science & Medicine, University of Fribourg, Fribourg, Switzerland.
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12
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Zhao P, Sheng Z, Xu L, Li P, Xiao W, Yuan C, Xu Z, Yang M, Qian Y, Zhong J, Gu J, Karasik D, Zheng HF. Deciphering the complex relationship between type 2 diabetes and fracture risk with both genetic and observational evidence. eLife 2024; 12:RP89281. [PMID: 38591545 PMCID: PMC11003741 DOI: 10.7554/elife.89281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Abstract
The 'diabetic bone paradox' suggested that type 2 diabetes (T2D) patients would have higher areal bone mineral density (BMD) but higher fracture risk than individuals without T2D. In this study, we found that the genetically predicted T2D was associated with higher BMD and lower risk of fracture in both weighted genetic risk score (wGRS) and two-sample Mendelian randomization (MR) analyses. We also identified ten genomic loci shared between T2D and fracture, with the top signal at SNP rs4580892 in the intron of gene RSPO3. And the higher expression in adipose subcutaneous and higher protein level in plasma of RSPO3 were associated with increased risk of T2D, but decreased risk of fracture. In the prospective study, T2D was observed to be associated with higher risk of fracture, but BMI mediated 30.2% of the protective effect. However, when stratified by the T2D-related risk factors for fracture, we observed that the effect of T2D on the risk of fracture decreased when the number of T2D-related risk factors decreased, and the association became non-significant if the T2D patients carried none of the risk factors. In conclusion, the genetically determined T2D might not be associated with higher risk of fracture. And the shared genetic architecture between T2D and fracture suggested a top signal around RSPO3 gene. The observed effect size of T2D on fracture risk decreased if the T2D-related risk factors could be eliminated. Therefore, it is important to manage the complications of T2D to prevent the risk of fracture.
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Affiliation(s)
- Pianpian Zhao
- The affiliated Hangzhou first people’s hospital, School of Medicine, Westlake UniversityHangzhouChina
- Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, ChinaHangzhouChina
- Westlake Laboratory of Life Sciences and BiomedicineHangzhouChina
- Institute of Basic Medical Sciences, Westlake Institute for Advanced StudyHangzhouChina
| | - Zhifeng Sheng
- Health Management Center, The Second Xiangya Hospital of Central South UniversityChangshaChina
| | - Lin Xu
- Department of Orthopedics, Yantai Affiliated Hospital of Binzhou Medical UniversityYantaiChina
| | - Peng Li
- Department of Geratology, The Third People's Hospital of HangzhouHangzhouChina
| | - Wenjin Xiao
- Department of Endocrinology, Second Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Chengda Yuan
- Department of Dermatology, Hangzhou Hospital of Traditional Chinese MedicineHangzhouChina
| | - Zhanwei Xu
- Central Health Center of Mashenqiao TownTianjinChina
| | - Mengyuan Yang
- The affiliated Hangzhou first people’s hospital, School of Medicine, Westlake UniversityHangzhouChina
- Westlake Laboratory of Life Sciences and BiomedicineHangzhouChina
- Institute of Basic Medical Sciences, Westlake Institute for Advanced StudyHangzhouChina
| | - Yu Qian
- The affiliated Hangzhou first people’s hospital, School of Medicine, Westlake UniversityHangzhouChina
- Westlake Laboratory of Life Sciences and BiomedicineHangzhouChina
- Institute of Basic Medical Sciences, Westlake Institute for Advanced StudyHangzhouChina
| | - Jiadong Zhong
- The affiliated Hangzhou first people’s hospital, School of Medicine, Westlake UniversityHangzhouChina
- Westlake Laboratory of Life Sciences and BiomedicineHangzhouChina
- Institute of Basic Medical Sciences, Westlake Institute for Advanced StudyHangzhouChina
| | - Jiaxuan Gu
- The affiliated Hangzhou first people’s hospital, School of Medicine, Westlake UniversityHangzhouChina
- Westlake Laboratory of Life Sciences and BiomedicineHangzhouChina
- Institute of Basic Medical Sciences, Westlake Institute for Advanced StudyHangzhouChina
| | - David Karasik
- Azrieli Faculty of Medicine, Bar-Ilan UniversitySafedIsrael
| | - Hou-Feng Zheng
- The affiliated Hangzhou first people’s hospital, School of Medicine, Westlake UniversityHangzhouChina
- Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, ChinaHangzhouChina
- Westlake Laboratory of Life Sciences and BiomedicineHangzhouChina
- Institute of Basic Medical Sciences, Westlake Institute for Advanced StudyHangzhouChina
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13
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Hanna M, Wabnitz A, Grewal P. Sex and stroke risk factors: A review of differences and impact. J Stroke Cerebrovasc Dis 2024; 33:107624. [PMID: 38316283 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107624] [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: 09/01/2023] [Revised: 12/24/2023] [Accepted: 02/02/2024] [Indexed: 02/07/2024] Open
Abstract
OBJECTIVES There is an increase in stroke incidence risk over the lifetime of women, given their longer life expectancy. However, an alarming trend for sex disparities, particularly in certain stroke risk factors, shows a concerning need for focus on sex differences in stroke prevention and treatment for women. In this article, we are addressing sex differences in both traditional and sex-specific stroke risk factors. METHODS We searched PubMed from inception to December 2022 for articles related to sex differences and risk factors for stroke. We reviewed full-text articles for relevance and ultimately included 152 articles for this focused review. RESULTS Women are at increased risk for stroke from both traditional and non-traditional stroke risk factors. As women age, they have a higher disease burden of atrial fibrillation, increased risk of stroke related to diabetes, worsening lipid profiles, and higher prevalence of hypertension and obesity compared to men. Further, women carry sex hormone-specific risk factors for stroke, including the age of menarche, menopause, pregnancy, and its complications, as well as hormonal therapy. Men have a higher prevalence of tobacco use and atrial fibrillation, as well as an increased risk for stroke related to hyperlipidemia. Additionally, men have sex-specific risks related to low testosterone levels. CONCLUSIONS By identifying biological sex-specific risk factors for stroke, developing robust collaborations, researching, and applying the knowledge for risk reduction strategies, we can begin to tailor prevention and reduce the global burden of stroke morbidity and mortality.
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Affiliation(s)
- Mckay Hanna
- Department of Neurology, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Ashley Wabnitz
- Department of Neurology, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Parneet Grewal
- Department of Neurology, Medical University of South Carolina, Charleston, SC 29425, United States.
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14
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Hagberg CE, Spalding KL. White adipocyte dysfunction and obesity-associated pathologies in humans. Nat Rev Mol Cell Biol 2024; 25:270-289. [PMID: 38086922 DOI: 10.1038/s41580-023-00680-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2023] [Indexed: 02/10/2024]
Abstract
The prevalence of obesity and associated chronic diseases continues to increase worldwide, negatively impacting on societies and economies. Whereas the association between excess body weight and increased risk for developing a multitude of diseases is well established, the initiating mechanisms by which weight gain impairs our metabolic health remain surprisingly contested. In order to better address the myriad of disease states associated with obesity, it is essential to understand adipose tissue dysfunction and develop strategies for reinforcing adipocyte health. In this Review we outline the diverse physiological functions and pathological roles of human white adipocytes, examining our current knowledge of why white adipocytes are vital for systemic metabolic control, yet poorly adapted to our current obesogenic environment.
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Affiliation(s)
- Carolina E Hagberg
- Division of Cardiovascular Medicine, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kirsty L Spalding
- Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm, Sweden.
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15
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Alser M, Naja K, Elrayess MA. Mechanisms of body fat distribution and gluteal-femoral fat protection against metabolic disorders. Front Nutr 2024; 11:1368966. [PMID: 38590830 PMCID: PMC10999599 DOI: 10.3389/fnut.2024.1368966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/07/2024] [Indexed: 04/10/2024] Open
Abstract
Obesity is a major health problem that affects millions of individuals, and it is associated with metabolic diseases including insulin resistance (IR), type 2 diabetes (T2D), and cardiovascular diseases (CVDs). However, Body fat distribution (BFD) rather than crude obesity is now considered as a more accurate factor associated with these diseases. The factors affecting BFD vary, from genetic background, epigenetic factors, ethnicity, aging, hormonal changes, to lifestyle and medication consumptions. The main goal of controlling BFD comes from the fact that fat accumulation in different depots has a different effect on the overall health and metabolic health of individuals. It is well established that fat storage in the abdominal visceral depot is associated with metabolic disorder occurrence, while gluteal-femoral subcutaneous fat depot seems to be protective against these diseases. In this paper, we will summarize the factors affecting fat distribution. Then, we will present evidence connecting gluteal-femoral fat depot with protection against metabolic disorders including IR, T2D, and CVDs. Finally, we will list the suggested mechanisms that lead to this protective effect. The abstract is visualized in Graphical Abstract.
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Affiliation(s)
- Maha Alser
- Biomedical Research Center, Qatar University, Doha, Qatar
| | - Khaled Naja
- Biomedical Research Center, Qatar University, Doha, Qatar
| | - Mohamed A. Elrayess
- Biomedical Research Center, Qatar University, Doha, Qatar
- QU Health, Qatar University, Doha, Qatar
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16
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Wang J, Guan J, Huang L, Li X, Huang B, Feng J, Zhang Y, Zhang J. Sex differences in the associations between relative fat mass and all-cause and cardiovascular mortality: A population-based prospective cohort study. Nutr Metab Cardiovasc Dis 2024; 34:738-754. [PMID: 38161128 DOI: 10.1016/j.numecd.2023.10.034] [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: 08/01/2023] [Revised: 10/18/2023] [Accepted: 10/25/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND AND AIMS The novel sex-specific anthropometric equation relative fat mass (RFM) is a new estimator of whole-body fat %. The study aimed to investigate the predictive role of RFM in cardiometabolic abnormalities, cardiovascular disease (CVD), all-cause and cardiovascular mortality, and explored potential sex differences. METHODS AND RESULTS The study analyzed data from 26,754 adults in NHANES 1999-2010, with a median follow-up of 13.8 years. The correlation between RFM and body composition as well as fat distribution assessed by dual-energy X-ray absorptiometry was investigated. Weighted multivariable generalized linear models, Cox proportional hazards models and restricted cubic spline were applied to investigate the predictive role of RFM in metabolic markers, cardiovascular risk factors, CVD, all-cause and cardiovascular mortality. RFM exhibited a robust correlation with both whole-body fat % and trunk fat %. Higher RFM exhibited a stronger association with impaired glucose homeostasis, serum lipids, the incidence of hypertension, and coronary heart disease in males, while a stronger association with C-reactive protein in females. A U-shaped association between RFM and all-cause mortality was observed only in males. The hazard ratio (HR) of all-cause and cardiovascular mortality in males increased rapidly when RFM exceeded 30. However, in females, the HR of all-cause and cardiovascular mortality fluctuated until RFM exceeded 45, after which it increased rapidly. CONCLUSION RFM was a sex-specific estimator for both general and central obesity, sex-specific differences in predicting cardiometabolic abnormalities and adverse events using RFM might be partially attributed to differences in body composition and fat distribution between sexes.
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Affiliation(s)
- Jing Wang
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Jingyuan Guan
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Liyan Huang
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xinqing Li
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Boping Huang
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Jiayu Feng
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Yuhui Zhang
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
| | - Jian Zhang
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Clinical Research for Cardiovascular Medications, National Health Committee, Beijing 100037, China.
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17
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Magno S, Ceccarini G, Corvillo F, Pelosini C, Gilio D, Paoli M, Fornaciari S, Pandolfo G, Sanchez-Iglesias S, Nozal P, Curcio M, Sessa MR, López-Trascasa M, Araújo-Vilar D, Santini F. Clinical Characteristics of Patients With Acquired Partial Lipodystrophy: A Multicenter Retrospective Study. J Clin Endocrinol Metab 2024; 109:e932-e944. [PMID: 38061004 DOI: 10.1210/clinem/dgad700] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Indexed: 02/21/2024]
Abstract
BACKGROUND Barraquer-Simons syndrome (BSS) is a rare, acquired form of lipodystrophy characterized by progressive loss of upper body subcutaneous fat, which affects face, upper limbs, and trunk. The pathogenesis of the disease is not entirely known and may involve autoimmune mechanisms. AIM This study aimed to provide a comprehensive picture of the clinical, immunological, and metabolic features of a large cohort of patients with BSS. Our primary objectives included the validation of existing diagnostic tools, the evaluation of novel diagnostic approaches, and the exploration of potential disease triggers or genetic predispositions. SUBJECTS AND METHODS Twenty-six patients were diagnosed with BSS based on accepted criteria defined by international guidelines. Anthropometric parameters, biochemical tests, organ- and non-organ-specific autoantibodies, HLA status, and screening of the LMNB2 gene were performed. RESULTS Patients were predominantly females (73%); fat loss occurred mostly during childhood (77%) at a median age of 8 years. Among various anthropometric measures, the ratio between the proportion of fat mass in upper limbs and lower limbs showed the best predictive value for diagnosis. A total of 11.5% of patients had diabetes, 34.6% dyslipidemia, and 26.9% hepatic steatosis. Seventy-five percent of children and 50% of adults had C3 hypocomplementemia; 76% of patients were positive for 1 or more autoantibodies. HLA-DRB1 11:03 had higher allelic frequencies compared with the general population. A single variant in the LMNB2 gene was found in 1 patient. CONCLUSION BSS has a childhood onset and is often associated with autoimmune diseases. Skinfold thickness measurements and fat assessment by dual energy X-ray absorptiometry are useful tools to identify the disease. C3 hypocomplementemia and the presence of autoantibodies may be used as additional diagnostic supportive criteria but the prevalence of C3 hypocomplementemia may be lower than previously reported.
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Affiliation(s)
- Silvia Magno
- Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, Pisa 56124, Italy
| | - Giovanni Ceccarini
- Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, Pisa 56124, Italy
| | - Fernando Corvillo
- Complement Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), La Paz University Hospital, Paseo de la Castellana, Madrid 28046, Spain
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Madrid 28046, Spain
| | - Caterina Pelosini
- Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, Pisa 56124, Italy
- Chemistry and Endocrinology Laboratory, Department of Radiological, Nuclear and Laboratory Medicine, University Hospital of Pisa, Pisa 56124, Italy
| | - Donatella Gilio
- Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, Pisa 56124, Italy
| | - Melania Paoli
- Chemistry and Endocrinology Laboratory, Department of Radiological, Nuclear and Laboratory Medicine, University Hospital of Pisa, Pisa 56124, Italy
| | - Silvia Fornaciari
- Division of Transfusion Medicine and Transplant Biology, Department of Radiological, Nuclear and Laboratory Medicine, University Hospital of Pisa, Pisa 56124, Italy
| | - Giuseppe Pandolfo
- Department of Economics and Statistics, University of Naples Federico II, Naples 80138, Italy
| | - Sofia Sanchez-Iglesias
- Thyroid and Metabolic Diseases Unit (U.E.T.eM.), Centro Singular de Investigación en Medicina Molecular e Enfermidades Crónicas (CIMUS-IDIS), School of Medicine, Universidad de Santiago de Compostela, Santiago de Compostela 15700, Spain
| | - Pilar Nozal
- Immunology Unit, La Paz University Hospital, Madrid 28046, Spain
| | - Michele Curcio
- Division of Transfusion Medicine and Transplant Biology, Department of Radiological, Nuclear and Laboratory Medicine, University Hospital of Pisa, Pisa 56124, Italy
| | - Maria Rita Sessa
- Chemistry and Endocrinology Laboratory, Department of Radiological, Nuclear and Laboratory Medicine, University Hospital of Pisa, Pisa 56124, Italy
| | - Margarita López-Trascasa
- Complement Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), La Paz University Hospital, Paseo de la Castellana, Madrid 28046, Spain
- Department of Medicine, Universidad Autónoma de Madrid, Madrid 28046, Spain
| | - David Araújo-Vilar
- Thyroid and Metabolic Diseases Unit (U.E.T.eM.), Centro Singular de Investigación en Medicina Molecular e Enfermidades Crónicas (CIMUS-IDIS), School of Medicine, Universidad de Santiago de Compostela, Santiago de Compostela 15700, Spain
| | - Ferruccio Santini
- Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, Pisa 56124, Italy
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Chandrasekaran P, Weiskirchen R. The Role of Obesity in Type 2 Diabetes Mellitus-An Overview. Int J Mol Sci 2024; 25:1882. [PMID: 38339160 PMCID: PMC10855901 DOI: 10.3390/ijms25031882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/29/2024] [Accepted: 02/02/2024] [Indexed: 02/12/2024] Open
Abstract
Obesity or excessive weight gain is identified as the most important and significant risk factor in the development and progression of type 2 diabetes mellitus (DM) in all age groups. It has reached pandemic dimensions, making the treatment of obesity crucial in the prevention and management of type 2 DM worldwide. Multiple clinical studies have demonstrated that moderate and sustained weight loss can improve blood glucose levels, insulin action and reduce the need for diabetic medications. A combined approach of diet, exercise and lifestyle modifications can successfully reduce obesity and subsequently ameliorate the ill effects and deadly complications of DM. This approach also helps largely in the prevention, control and remission of DM. Obesity and DM are chronic diseases that are increasing globally, requiring new approaches to manage and prevent diabetes in obese individuals. Therefore, it is essential to understand the mechanistic link between the two and design a comprehensive approach to increase life expectancy and improve the quality of life in patients with type 2 DM and obesity. This literature review provides explicit information on the clinical definitions of obesity and type 2 DM, the incidence and prevalence of type 2 DM in obese individuals, the indispensable role of obesity in the pathophysiology of type 2 DM and their mechanistic link. It also discusses clinical studies and outlines the recent management approaches for the treatment of these associated conditions. Additionally, in vivo studies on obesity and type 2 DM are discussed here as they pave the way for more rigorous development of therapeutic approaches.
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Affiliation(s)
- Preethi Chandrasekaran
- UT Southwestern Medical Center Dallas, 5323 Harry Hines Blvd. ND10.504, Dallas, TX 75390-9014, USA
| | - Ralf Weiskirchen
- Institute of Molecular Pathobiochemistry, Experimental Gene Therapy and Clinical Chemistry (IFMPEGKC), Rheinisch-Westfälische Technische Hochschule (RWTH), University Hospital Aachen, D-52074 Aachen, Germany
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Wang HH, Chong M, Perrot N, Feiner J, Hess S, Yusuf S, Gerstein H, Paré G, Pigeyre M. Vaspin: A Novel Biomarker Linking Gluteofemoral Body Fat and Type 2 Diabetes Risk. Diabetes Care 2024; 47:259-266. [PMID: 38055934 DOI: 10.2337/dc23-1488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/06/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE To determine whether adiposity depots modulate vaspin levels and whether vaspin predicts type 2 diabetes (T2D) risk, through epidemiological and genetic analyses. RESEARCH DESIGN AND METHODS We assessed the relationship of plasma vaspin concentration with incident and prevalent T2D and adiposity-related variables in 1) the Prospective Urban and Rural Epidemiology (PURE) biomarker substudy (N = 10,052) and 2) the Outcome Reduction with Initial Glargine Intervention (ORIGIN) trial (N = 7,840), using regression models. We then assessed whether vaspin is causally associated with T2D and whether genetic variants associated with MRI-measured adiposity depots modulate vaspin levels, using two-sample Mendelian randomization (MR). RESULTS A 1-SD increase in circulating vaspin levels was associated with a 16% increase in incident T2D in the PURE cohort (hazard ratio 1.16; 95% CI 1.09-1.23; P = 4.26 × 10-7) and prevalent T2D in the ORIGIN cohort (odds ratio [OR] 1.16; 95% CI 1.07-1.25; P = 2.17 × 10-4). A 1-unit increase in BMI and triglyceride levels was associated with a 0.08-SD (95% CI 0.06-0.10; P = 2.04 × 10-15) and 0.06-SD (95% CI 0.04-0.08; P = 4.08 × 10-13) increase, respectively, in vaspin in the PURE group. Consistent associations were observed in the ORIGIN cohort. MR results reinforced the association between vaspin and BMI-adjusted T2D risk (OR 1.01 per 1-SD increase in vaspin level; 95% CI 1.00-1.02; P = 2.86 × 10-2) and showed that vaspin was increased by 0.10 SD per 1-SD decrease in genetically determined gluteofemoral adiposity (95% CI 0.02-0.18; P = 2.01 × 10-2). No relationships were found between subcutaneous or visceral adiposity and vaspin. CONCLUSIONS These findings support that higher vaspin levels are related to increased T2D risk and reduced gluteofemoral adiposity, positioning vaspin as a promising clinical predictor for T2D.
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Affiliation(s)
- Harry Hezhou Wang
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Michael Chong
- Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada
- Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario, Canada
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Pathology and Molecular Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Nicolas Perrot
- Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada
- Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario, Canada
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Pathology and Molecular Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - James Feiner
- Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada
- Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario, Canada
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Pathology and Molecular Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sibylle Hess
- Global Medical Diabetes, Sanofi, Frankfurt, Germany
| | - Salim Yusuf
- Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada
- Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Hertzel Gerstein
- Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada
- Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Guillaume Paré
- Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada
- Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario, Canada
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Pathology and Molecular Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Marie Pigeyre
- Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada
- Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
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Zhao MF, Zhang XG, Tang YP, Zhu YX, Nie HY, Bu DD, Fang L, Li CJ. Ketone bodies promote epididymal white adipose expansion to alleviate liver steatosis in response to a ketogenic diet. J Biol Chem 2024; 300:105617. [PMID: 38176653 PMCID: PMC10847776 DOI: 10.1016/j.jbc.2023.105617] [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: 08/13/2023] [Revised: 12/11/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024] Open
Abstract
Liver can sense the nutrient status and send signals to other organs to regulate overall metabolic homoeostasis. Herein, we demonstrate that ketone bodies act as signals released from the liver that specifically determine the distribution of excess lipid in epididymal white adipose tissue (eWAT) when exposed to a ketogenic diet (KD). An acute KD can immediately result in excess lipid deposition in the liver. Subsequently, the liver sends the ketone body β-hydroxybutyrate (BHB) to regulate white adipose expansion, including adipogenesis and lipogenesis, to alleviate hepatic lipid accumulation. When ketone bodies are depleted by deleting 3-hydroxy-3-methylglutaryl-CoA synthase 2 gene in the liver, the enhanced lipid deposition in eWAT but not in inguinal white adipose tissue is preferentially blocked, while lipid accumulation in liver is not alleviated. Mechanistically, ketone body BHB can significantly decrease lysine acetylation of peroxisome proliferator-activated receptor gamma in eWAT, causing enhanced activity of peroxisome proliferator-activated receptor gamma, the key adipogenic transcription factor. These observations suggest that the liver senses metabolic stress first and sends a corresponding signal, that is, ketone body BHB, to specifically promote eWAT expansion to adapt to metabolic challenges.
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Affiliation(s)
- Meng-Fei Zhao
- Model Animal Research Center, Medical School of Nanjing University, Nanjing University, Nanjing, China
| | - Xin-Ge Zhang
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, China
| | - Yi-Ping Tang
- Model Animal Research Center, Medical School of Nanjing University, Nanjing University, Nanjing, China
| | - Ying-Xi Zhu
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, China
| | - Hong-Yu Nie
- Model Animal Research Center, Medical School of Nanjing University, Nanjing University, Nanjing, China
| | - Dan-Dan Bu
- Model Animal Research Center, Medical School of Nanjing University, Nanjing University, Nanjing, China
| | - Lei Fang
- Model Animal Research Center, Medical School of Nanjing University, Nanjing University, Nanjing, China.
| | - Chao-Jun Li
- Model Animal Research Center, Medical School of Nanjing University, Nanjing University, Nanjing, China; State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, China.
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Ikeue K, Kusakabe T, Yamakage H, Ishii K, Satoh-Asahara N. A body shape index is useful for BMI-independently identifying Japanese patients with obesity at high risk of cardiovascular disease. Nutr Metab Cardiovasc Dis 2024; 34:387-394. [PMID: 37949708 DOI: 10.1016/j.numecd.2023.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/04/2023] [Accepted: 09/07/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND AND AIM Obesity with multiple metabolic syndrome (MetS) components and/or with skeletal muscle loss is at high risk of cardiovascular disease (CVD). This study aimed to clarify the utility of anthropometric indices for identifying patients with overweight/obese at high risk of CVD based on having multiple MetS components and skeletal muscle loss. METHODS & RESULTS This cross-sectional study included 188 overweight/obese (BMI ≥25 kg/m2, Japanese patients; 73 men and 115 women, mean age 55.7 years). First, we performed correlation analysis among seven anthropometric indices, body mass index (BMI), percentage body fat, waist circumference (WC), waist-to-hip ratio (WHpR), waist-to-height ratio (WHtR), a body shape index (ABSI), and body roundness index (BRI). Unlike the others, only ABSI was not correlated with BMI. Then, we conducted receiver operating characteristic analysis to assess the predictive abilities of anthropometric indices for having multiple MetS components. WC, WHpR, WHtR, BRI, and ABSI had significant predictive abilities for having multiple MetS components. Furthermore, multiple regression analysis showed that only ABSI had significantly negative associations with all sarcopenia-evaluated indices (skeletal muscle mass index [SMI], handgrip strength [HGS], and muscle quality [MQ]), irrespective of sex and age. Finally, an analysis of covariance showed that the high ABSI group had significantly lower SMI and HGS than the low ABSI group, irrespective of sex and age. CONCLUSION ABSI was deemed useful for BMI-independently identifying Japanese patients with overweight/obese at high risk of CVD based on having multiple MetS components and skeletal muscle loss. Clinical trials (the unique trial number and the name of the registry) ID: UMIN000042726.
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Affiliation(s)
- Kentaro Ikeue
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto 612-8555, Japan; Graduate School of Health and Sports Science, Doshisha University, 1-3 Tataramiyakodani, Kyotanabe, Kyoto, 610-0394, Japan
| | - Toru Kusakabe
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto 612-8555, Japan.
| | - Hajime Yamakage
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto 612-8555, Japan
| | - Kojiro Ishii
- Faculty of Health and Sports Science, Doshisha University, 1-3 Tataramiyakodani, Kyotanabe, Kyoto, 610-0394, Japan
| | - Noriko Satoh-Asahara
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto 612-8555, Japan
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Laganà AS, Myers SH, Forte G, Naem A, Krentel H, Allahqoli L, Alkatout I, Unfer V. Inositols in treating polycystic ovary syndrome and non-insulin dependent diabetes mellitus: now and the future. Expert Opin Drug Metab Toxicol 2024; 20:61-72. [PMID: 38226638 DOI: 10.1080/17425255.2024.2306851] [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: 10/13/2023] [Accepted: 01/15/2024] [Indexed: 01/17/2024]
Abstract
INTRODUCTION This Expert Opinion covers recent updates in the use of Inositol in polycystic ovary syndrome (PCOS) and type II diabetes and gives support to researchers and clinicians. AREAS COVERED This article discusses the role of Myo-Inositol (MI) and D-Chiro-Inositol (DCI) in physiological function, the use of MI in PCOS, the risks of using DCI in reproductive conditions, the 40:1 combination of MI/DCI in PCOS. Furthermore, we discuss the issues of insulin resistance and how α-lactalbumin may increase the intestinal bioavailability of MI. The paper then transitions to talk about the use of inositols in diabetes, including type II diabetes, Gestational Diabetes Mellitus (GDM), and double diabetes. Literature searches were performed with the use of PubMed, Google Scholar, and Web of Science between July and October 2023. EXPERT OPINION Inositol therapy has grown in the clinical field of PCOS, with it demonstrating an efficacy like that of metformin. The use of α-lactalbumin has further supported the use of MI, as issues with intestinal bioavailability have been largely overcome. In contrast, the effect of inositol treatment on the different PCOS phenotypes remains an outstanding question. The use of inositols in type II diabetes requires further study despite promising analogous data from GDM.
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Affiliation(s)
- Antonio Simone Laganà
- Unit of Obstetrics and Gynecology, "Paolo Giaccone" Hospital, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | | | | | - Antoine Naem
- Department of Obstetrics, Gynecology, Gynecologic Oncology and Senology, Bethesda Hospital Duisburg, Duisburg, Germany
- Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Harald Krentel
- Department of Obstetrics, Gynecology, Gynecologic Oncology and Senology, Bethesda Hospital Duisburg, Duisburg, Germany
| | - Leila Allahqoli
- Midwifery Department, Ministry of Health and Medical Education, Tehran, Iran
| | - Ibrahim Alkatout
- Campus Kiel, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Kiel, Germany
| | - Vittorio Unfer
- UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy
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Isacco L, Ennequin G, Boisseau N. Influence of the different hormonal status changes during their life on fat mass localisation in women: a narrative review. Arch Physiol Biochem 2023; 129:1229-1234. [PMID: 34111377 DOI: 10.1080/13813455.2021.1933045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 05/17/2021] [Indexed: 10/21/2022]
Abstract
CONTEXT Independently of the total body fat mass, upper body fat mass deposition is strongly associated with cardiometabolic comorbidities. The mechanisms underlying fat mass localisation are not fully understood, but evidences indicate sex-specific fat mass distribution. Currently, data on women are scarce and the link between hormonal status changes during their life and fat mass distribution is overlooked. METHOD For this narrative review, literature data were extracted from the PubMed and CENTRAL databases to examine the relationship between hormonal status and adipose tissue localisation in women. RESULTS Menopause strongly influences fat mass localisation, while the effect of the menstrual cycle phases, oral contraception use and pregnancy has not been unambiguously determined. CONCLUSION Reliable data are lacking on the relationship between hormonal variations throughout the lifespan and body fat mass localisation in women. Future studies should take into account the hormonal status of women to reduce the risk of cardiometabolic diseases.
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Affiliation(s)
- Laurie Isacco
- Université Clermont Auvergne, CRNH, AME2P, Clermont-Ferrand, France
- EA3920 Prognostic Markers and Regulatory Factors of Cardiovascular Diseases and Exercise Performance Health Innovation (EPSI) Platform, Univ. Bourgogne Franche-Comte, Besançon, France
| | - Gaël Ennequin
- Université Clermont Auvergne, CRNH, AME2P, Clermont-Ferrand, France
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Flynn S, Srikanthan P, Ravellette K, Inoue K, Watson K, Horwich T. Urinary cortisol and cardiovascular events in women vs. men: The multi-ethnic study of atherosclerosis. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2023; 36:100344. [PMID: 37982128 PMCID: PMC10655947 DOI: 10.1016/j.ahjo.2023.100344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/21/2023]
Abstract
Research suggests that women experience greater cardiovascular ischemic effects from stress than men. Visceral adiposity is an endocrine tissue that differs by sex and interacts with stress hormones. We hypothesized that urinary cortisol would be associated with increased cardiovascular events and change in coronary artery calcium score (CAC) in women, and these relationships would vary by central obesity. In the Multi-Ethnic Study of Atherosclerosis Stress Ancillary study, cortisol was quantified by 12-h overnight urine collection. Central obesity was estimated by waist-hip ratio (WHR). Multivariable Cox models estimated the relationship between cortisol and cardiovascular events and assessed for moderation by WHR. The relationship between cortisol and change in CAC Agatston score was assessed by Tobit regression models. 918 patients were analyzed with median follow up of 11 years. There was no association between urinary cortisol and cardiovascular events in the cohort. However, in individuals with below median WHR, higher urinary cortisol levels (upper tertile) were associated with higher cardiovascular event rates in the full cohort, women, and men, but not in groups with above median WHR. There was significant moderation by WHR in women, but not men, whereby the association between elevated cortisol and increased cardiovascular events diminished as WHR increased. Urinary cortisol was associated with increased change in CAC in women (P = 0.003) but not men, without moderation by WHR. Our study highlights associations between cortisol and subclinical atherosclerosis in women, and moderation of the relationship between cortisol and cardiovascular events by central obesity in both genders.
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Affiliation(s)
- Spencer Flynn
- David Geffen School of Medicine at UCLA, United States of America
| | | | | | - Kosuke Inoue
- Kyoto University Department of Social Epidemiology, Japan
| | - Karol Watson
- UCLA Division of Cardiology, United States of America
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Wang X, Peng H, Xia C, Zhou Y, Shen L, Cheng X, Yang C, Yang Y, Long L. Association of B vitamin intake and total homocysteine levels with all-cause and cause-specific mortality in central obesity. Nutrition 2023; 116:112189. [PMID: 37689015 DOI: 10.1016/j.nut.2023.112189] [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: 04/12/2023] [Revised: 06/26/2023] [Accepted: 08/06/2023] [Indexed: 09/11/2023]
Abstract
OBJECTIVES Future primary prevention strategies may benefit from understanding the connection between mortality in individuals with central obesity and modifiable lifestyle factors like dietary intake. This study sought to determine whether there was a separate relationship between folate, vitamin B6, and vitamin B12 intake and all-cause and cause-specific mortality in the US population with central obesity. METHODS The study analyzed data from the National Health and Nutrition Examination Survey between 1999 and 2016. Using the Cox proportional hazards model, the association between dietary intake of B vitamins and all-cause and cause-specific mortality was examined. A total of 7718 adults with central obesity were enrolled, with a mean age of 49.87 (SD = 0.25) y at baseline. RESULTS Folate intake was independently associated with a decreased incidence of all-cause mortality (adjusted hazard ratio = 0.71; 95% CI, 0.58-0.87). Furthermore, higher intake of vitamin B6 and vitamin B12 was inversely correlated with cardiovascular disease mortality (adjusted hazard ratio = 0.63; 95% CI, 0.40-0.98; and adjusted hazard ratio = 0.44; 95% CI, 0.29-0.65, respectively) and the finding reveal an interaction between homocysteine and vitamin B12 and folate on All-cause mortality CONCLUSIONS: The findings of this study suggest that vitamin B12 and folate intake may be protective factors in individuals with central obesity. It is important to consider both their total homocysteine level and body mass index in conjunction with these nutrients. Further research is needed to validate these findings.
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Affiliation(s)
- Xiao Wang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hongxia Peng
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China; Chengdu Shuangliu District Center for Disease Control and Prevention, Chengdu, Sichuan China
| | - Congying Xia
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yunfeng Zhou
- Department of Thoracic Surgery, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Liqing Shen
- Department of Pediatric Health and Maternal and Child Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan China
| | - Xinran Cheng
- Department of Endocrinology, Genetics and Metabolism, Chengdu Women's and Children's Central Hospital, Chengdu, Sichuan, China
| | - Chunxia Yang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yanfang Yang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lu Long
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
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Kuang M, Qiu J, Li D, Hu C, Zhang S, Sheng G, Zou Y. The newly proposed Metabolic Score for Visceral Fat is a reliable tool for identifying non-alcoholic fatty liver disease, requiring attention to age-specific effects in both sexes. Front Endocrinol (Lausanne) 2023; 14:1281524. [PMID: 38089634 PMCID: PMC10711077 DOI: 10.3389/fendo.2023.1281524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/10/2023] [Indexed: 12/18/2023] Open
Abstract
Objective The newly proposed Metabolic Visceral Fat Score (METS-VF) is considered a more effective measure for visceral adipose tissue (VAT) than other obesity indicators. This study aimed to reveal the association between METS-VF and non-alcoholic fatty liver disease (NAFLD), and its variations across age groups within both sexes. Methods Data from 14,251 medical examiners in the NAGALA project were employed in this study. 3D fitted surface plots were constructed based on multivariate logistic regression models to visualize the isolated and combined effects of aging and METS-VF on NAFLD. Receiver operating characteristic curve (ROC) analysis was conducted to compare the diagnostic performance of METS-VF with other VAT surrogate markers in predicting NAFLD. Results The results of multivariate logistic regression analysis showed that each unit increase in METS-VF was independently associated with a 333% and 312% increase in the odds of NAFLD in males and females, respectively. Additionally, the 3D fitted surface plot showed that age significantly influenced the association between METS-VF and the odds of NAFLD in both sexes, as follows: (i) In males, when METS-VF was less than 6.2, the METS-VF-related odds of NAFLD increased gradually with age in the 20-45 age group, reached a plateau in the 45-65 age group, and then decreased in the group above 65 years old; however, when male METS-VF exceeded 6.2, aging and METS-VF combined to further increase the odds of NAFLD in all age groups, particularly in the 45-65 age group. (ii) In females, aging seemed to reduce METS-VF-related odds of NAFLD in the 18-40 age group, but significantly increased it in the 40-60 age group, particularly for those with higher METS-VF levels. Further ROC analysis revealed that compared to other VAT surrogate markers, METS-VF showed the highest diagnostic accuracy for NAFLD in females, especially in those under 45 years of age [area under the curve (AUC) = 0.9256]. Conclusions This study firstly revealed a significant positive correlation between METS-VF and the odds of NAFLD, with METS-VF surpassing other VAT surrogate markers in NAFLD diagnosis. Moreover, age significantly influenced the METS-VF-related odds of NAFLD and METS-VF's diagnostic efficacy for NAFLD in both sexes.
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Affiliation(s)
- Maobin Kuang
- Department of Internal Medicine, Medical College of Nanchang University, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Jiajun Qiu
- Department of Internal Medicine, Medical College of Nanchang University, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Dongdong Li
- Department of Internal Medicine, Medical College of Nanchang University, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
- Department of Pulmonary and Critical Care Medicine, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Chong Hu
- Department of Gastroenterology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Shuhua Zhang
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Guotai Sheng
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Yang Zou
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
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Li F, Wang Z, Li S, Liu W, Li Y, Jiang C, Tian Y, Cui W, Zhang X, Zhang J, Xu Y. Association of body fat distribution with all-cause and cardiovascular mortality in US adults: a secondary analysis using NHANES. BMJ Open 2023; 13:e072752. [PMID: 37989359 PMCID: PMC10668279 DOI: 10.1136/bmjopen-2023-072752] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 09/11/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVE To investigate the association of fat and lean mass in specific regions with all-cause and cardiovascular-related mortality. DESIGN Population based cohort study. SETTING US National Health and Nutrition Examination Survey (2003-2006 and 2011-2018). PARTICIPANTS 22 652 US adults aged 20 years or older. EXPOSURES Fat and lean mass in specific regions obtained from the whole-body dual-energy X-ray absorptiometry. MAIN OUTCOME MEASURES All-cause and cardiovascular-related mortality. RESULTS During a median of 83 months of follow-up, 1432 deaths were identified. Associations between body composition metrics and mortality risks were evident above specific thresholds. For all-cause mortality, Android fat mass showed elevated HRs above 2.46 kg (HR: 1.17, 95% CI 1.02 to 1.34), while Android lean mass (ALM) had similar trends above 2.75 kg (HR: 1.17, 95% CI 1.03 to 1.33), and Android total mass above 5.75 kg (HR: 1.08, 95% CI 1.01 to 1.16). Conversely, lower HRs were observed below certain thresholds: Gynoid fat mass (GFM) below 3.71 kg (HR: 0.72, 95% CI 0.56 to 0.93), Gynoid lean mass below 6.44 kg (HR: 0.77, 95% CI 0.64 to 0.92), and Gynoid total mass below 11.78 kg (HR: 0.76, 95% CI 0.70 to 0.84). Notably, below 0.722 kg, the HR of visceral adipose tissue mass (VATM) was 1.25 (95% CI 1.04 to 1.48) for all-cause mortality, and above 3.18 kg, the HR of total abdominal fat mass was 2.41 (95% CI 1.15 to 5.05). Cardiovascular-related mortality exhibited associations as well, particularly for Android fat mass (AFM) above 1.78 kg (HR: 1.22, 95% CI 1.01 to 1.47) and below 7.16 kg (HR: 0.50, 95% CI 0.36 to 0.69). HRs varied for Gynoid total mass below and above 10.98 kg (HRs: 0.70, 95% CI 0.54 to 0.93, and 1.12, 95% CI 1.02 to 1.23). Android per cent fat, subcutaneous fat mass (SFM), AFM/GFM, and VATM/SFM were not statistically associated with all-cause mortality. Android per cent fat, Gynoid per cent fat, AFM/GFM, and VATM/SFM were not statistically associated with cardiovascular-related mortality. Conicity index showed that the ALM/GLM had the highest performance for all-cause and cardiovascular-related mortality with AUCs of 0.785, and 0.746, respectively. CONCLUSIONS The relationship between fat or lean mass and all-cause mortality varies by region. Fat mass was positively correlated with cardiovascular mortality, regardless of the region in which they located. ALM/GLM might be a better predictor of all-cause and cardiovascular-related mortality than other body components or body mass index.
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Affiliation(s)
- Fuhai Li
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Zhi Wang
- Department of Emergency Medicine, Qingdao Municipal Hospital (Group), Qingdao, Shandong, China
| | - Shaohua Li
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Wenheng Liu
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yan Li
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Chen Jiang
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yulong Tian
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Weining Cui
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Xuejuan Zhang
- Department of comprehensive internal medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shangdong, China
| | - Jidong Zhang
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yan Xu
- Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shangdong, China
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Szczerbinski L, Florez JC. Precision medicine of obesity as an integral part of type 2 diabetes management - past, present, and future. Lancet Diabetes Endocrinol 2023; 11:861-878. [PMID: 37804854 DOI: 10.1016/s2213-8587(23)00232-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/29/2023] [Accepted: 08/01/2023] [Indexed: 10/09/2023]
Abstract
Obesity is a complex and heterogeneous condition that leads to various metabolic complications, including type 2 diabetes. Unfortunately, for some, treatment options to date for obesity are insufficient, with many people not reaching sustained weight loss or having improvements in metabolic health. In this Review, we discuss advances in the genetics of obesity from the past decade-with emphasis on developments from the past 5 years-with a focus on metabolic consequences, and their potential implications for precision management of the disease. We also provide an overview of the potential role of genetics in guiding weight loss strategies. Finally, we propose a vision for the future of precision obesity management that includes developing an obesity-centred multidisease management algorithm that targets both obesity and its comorbidities. However, further collaborative efforts and research are necessary to fully realise its potential and improve metabolic health outcomes.
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Affiliation(s)
- Lukasz Szczerbinski
- Diabetes Unit, Endocrine Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Programs in Metabolism and Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA; Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland; Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland
| | - Jose C Florez
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Programs in Metabolism and Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA.
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Wang X, Zhu R, Han H, Jin J. Body Fat Distribution and Female Infertility: a Cross-Sectional Analysis Among US Women. Reprod Sci 2023; 30:3243-3252. [PMID: 37277689 DOI: 10.1007/s43032-023-01280-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/26/2023] [Indexed: 06/07/2023]
Abstract
At present, the effect of body fat distribution on female reproductive health is still inconclusive. The purpose of our study was to analyze the correlation between female infertility rates and the fat mass portion of the android region to the gynoid region (the A/G ratio) among US women of reproductive age. Female infertility is defined as a failure to get pregnant after 12 months of unprotected sexual activity. A total of 3434 women of reproductive age were included in this study as part of the 2013-2018 National Health and Nutrition Examination Survey (NHANES). The A/G ratio was used to assess the body fat distribution of participants. Based on the comprehensive study design and sample weights, it was determined that the A/G ratio was associated with female infertility primarily through logistic regression analyses. After adjusting for potential confounders, the multivariate regression analysis indicated an increase in the A/G ratio was correlated with an increase in the prevalence of female infertility (OR = 4.374, 95% CI:1.809-10.575). Subgroup analyses showed an increased prevalence of infertility in non-Hispanic Whites (P = 0.012), non-diabetic individuals (P = 0.008), individuals under 35 years old (P = 0.002), and individuals with secondary infertility (P = 0.01). The trend tests and smooth curve fitting illustrate a linear trend between the A/G ratio and female infertility. Future researches are warranted to confirm the causal relationship between body fat distribution and female infertility, which may provide an insight into future prevention and treatment of female infertility.
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Affiliation(s)
- Xinzhe Wang
- Department of Gynecology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, No.155, Hanzhong Road, Qinhuai District, Nanjing, 210000, Jiangsu Province, People's Republic of China
| | - Rui Zhu
- Department of Gynecology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, No.155, Hanzhong Road, Qinhuai District, Nanjing, 210000, Jiangsu Province, People's Republic of China
| | - Huawei Han
- Department of Orthopedics, The Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jing Jin
- Department of Gynecology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, No.155, Hanzhong Road, Qinhuai District, Nanjing, 210000, Jiangsu Province, People's Republic of China.
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Huang B, DePaolo J, Judy RL, Shakt G, Witschey WR, Levin MG, Gershuni VM. Relationships between body fat distribution and metabolic syndrome traits and outcomes: A mendelian randomization study. PLoS One 2023; 18:e0293017. [PMID: 37883456 PMCID: PMC10602264 DOI: 10.1371/journal.pone.0293017] [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: 06/08/2023] [Accepted: 10/04/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Obesity is a complex, multifactorial disease associated with substantial morbidity and mortality worldwide. Although it is frequently assessed using BMI, many epidemiological studies have shown links between body fat distribution and obesity-related outcomes. This study examined the relationships between body fat distribution and metabolic syndrome traits using Mendelian Randomization (MR). METHODS/FINDINGS Genetic variants associated with visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (ASAT), and gluteofemoral adipose tissue (GFAT), as well as their relative ratios, were identified from a genome wide association study (GWAS) performed with the United Kingdom BioBank. GWAS summary statistics for traits and outcomes related to metabolic syndrome were obtained from the IEU Open GWAS Project. Two-sample MR and BMI-controlled multivariable MR (MVMR) were performed to examine relationships between each body fat measure and ratio with the outcomes. Increases in absolute GFAT were associated with a protective cardiometabolic profile, including lower low density lipoprotein cholesterol (β: -0.19, [95% CI: -0.28, -0.10], p < 0.001), higher high density lipoprotein cholesterol (β: 0.23, [95% CI: 0.03, 0.43], p = 0.025), lower triglycerides (β: -0.28, [95% CI: -0.45, -0.10], p = 0.0021), and decreased systolic (β: -1.65, [95% CI: -2.69, -0.61], p = 0.0019) and diastolic blood pressures (β: -0.95, [95% CI: -1.65, -0.25], p = 0.0075). These relationships were largely maintained in BMI-controlled MVMR analyses. Decreases in relative GFAT were linked with a worse cardiometabolic profile, with higher levels of detrimental lipids and increases in systolic and diastolic blood pressures. CONCLUSION A MR analysis of ASAT, GFAT, and VAT depots and their relative ratios with metabolic syndrome related traits and outcomes revealed that increased absolute and relative GFAT were associated with a favorable cardiometabolic profile independently of BMI. These associations highlight the importance of body fat distribution in obesity and more precise means to categorize obesity beyond BMI.
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Affiliation(s)
- Brian Huang
- Department of Medicine, Massachusetts General Hospital, Boston, MA, United States of America
| | - John DePaolo
- Department of Surgery, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Renae L. Judy
- Department of Surgery, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Gabrielle Shakt
- Department of Surgery, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Walter R. Witschey
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Michael G. Levin
- Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, United States of America
| | - Victoria M. Gershuni
- Department of Surgery, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, PA, United States of America
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
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Su S, Fan J, Yang Y, Yang C, Jia X. Birth Weight, Cardiometabolic Factors, and Coronary Heart Disease: A Mendelian Randomization Study. J Clin Endocrinol Metab 2023; 108:e1245-e1252. [PMID: 37246707 DOI: 10.1210/clinem/dgad308] [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: 03/08/2023] [Revised: 04/25/2023] [Accepted: 05/26/2023] [Indexed: 05/30/2023]
Abstract
CONTEXT Observational studies have shown associations of birth weight (BW) with coronary heart disease (CHD), but results are inconsistent and do not distinguish the fetal or maternal effect of BW. OBJECTIVE This study aims to explore the causal association between BW and CHD, analyze the fetal and maternal contribution, and quantify mediating effects of cardiometabolic factors. METHODS Genetic variants from genome-wide association study summary-level data of own BW (N = 298 142), offspring BW (N = 210 267 mothers), and 16 cardiometabolic (anthropometric, glycemic, lipidemic, and blood pressure) factors were extracted as instrumental variables. We used two-sample Mendelian randomization study (MR) to estimate the causal effect of BW on CHD (60 801 cases and 123 504 controls from mixed ancestry) and explore the fetal and maternal contributions. Mediation analyses were conducted to analyze the potential mediating effects of 16 cardiometabolic factors using two-step MR. RESULTS Inverse variance weighted analysis showed that lower BW raised the CHD risk (β -.30; 95% CI: -0.40, -0.20) and consistent results were observed in fetal-specific/maternal-specific BW. We identified 5 mediators in the causal pathway from BW to CHD, including body mass index-adjusted hip circumference, triglycerides, fasting insulin, diastolic blood pressure, and systolic blood pressure (SBP), with mediated proportion ranging from 7.44% for triglycerides to 27.75% for SBP. Causality between fetal-specific and maternal-specific BW and CHD was mediated by glycemic factors and SBP, respectively. CONCLUSION Our findings supported that lower BW increased CHD risk and revealed that fetal-specific and maternal-specific BW may both contribute to this effect. The causality between BW and CHD was mediated by several cardiometabolic factors.
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Affiliation(s)
- Shuyao Su
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Jingwen Fan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yongli Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Chaojun Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiaocan Jia
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
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Lê S, Laurencin-Dalicieux S, Minty M, Assoulant-Anduze J, Vinel A, Yanat N, Loubieres P, Azalbert V, Diemer S, Burcelin R, Canceill T, Thomas C, Blasco-Baque V. Obesity Is Associated with the Severity of Periodontal Inflammation Due to a Specific Signature of Subgingival Microbiota. Int J Mol Sci 2023; 24:15123. [PMID: 37894804 PMCID: PMC10606428 DOI: 10.3390/ijms242015123] [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: 09/12/2023] [Revised: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023] Open
Abstract
The aim of this study was to analyze the link between periodontal microbiota and obesity in humans. We conducted a cohort study including 45 subjects with periodontitis divided into two groups: normo-weighted subjects with a body mass index (BMI) between 20 and 25 kg/m2 (n = 34) and obese subjects with a BMI > 30 kg/m2 (n = 11). Our results showed that obesity was associated with significantly more severe gingival inflammation according to Periodontal Inflamed Surface Area (PISA index). Periodontal microbiota taxonomic analysis showed that the obese (OB) subjects with periodontitis were characterized by a specific signature of subgingival microbiota with an increase in Gram-positive bacteria in periodontal pockets, associated with a decrease in microbiota diversity compared to that of normo-weighted subjects with periodontitis. Finally, periodontal treatment response was less effective in OB subjects with persisting periodontal inflammation, reflecting a still unstable periodontal condition and a risk of recurrence. To our knowledge, this study is the first exploring both salivary and subgingival microbiota of OB subjects. Considering that OB subjects are at higher periodontal risk, this could lead to more personalized preventive or therapeutic strategies for obese patients regarding periodontitis through the specific management of oral microbiota of obese patients.
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Affiliation(s)
- Sylvie Lê
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Sara Laurencin-Dalicieux
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- INSERM U1295, CERPOP, Epidémiologie et Analyse en Santé Publique, Risques, Maladies Chroniques et Handicaps, 37 Allées Jules Guesdes, 31000 Toulouse, France
| | - Matthieu Minty
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Justine Assoulant-Anduze
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Alexia Vinel
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- UMR 1297 Inserm, Team ESTER, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France
| | - Noor Yanat
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
| | - Pascale Loubieres
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Vincent Azalbert
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Swann Diemer
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Remy Burcelin
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Thibault Canceill
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Charlotte Thomas
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Vincent Blasco-Baque
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
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Kawamoto R, Kikuchi A, Ninomiya D, Kumagi T. Thigh-hip ratio is significantly associated with all-cause mortality among Japanese community-dwelling men. PLoS One 2023; 18:e0292287. [PMID: 37797075 PMCID: PMC10553839 DOI: 10.1371/journal.pone.0292287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/17/2023] [Indexed: 10/07/2023] Open
Abstract
Anthropometric evaluation is a simple yet essential indicator of muscle and fat mass when studying life prognosis in aging. This study aimed to investigate the contributions of anthropometric measurements, independent of body mass index, to measures of all-cause mortality. We examined data for 1,704 participants from the 2014 Nomura Cohort Study who attended follow-ups for the subsequent eight years (follow-up rate: 93.0%). Of these, 765 were male (aged 69 ± 11 years) and 939 were female (aged 69 ± 9 years). The Japanese Basic Resident Registry provided data on adjusted relative hazards for all-cause mortality. The data were subjected to a Cox regression analysis, wherein the time variable was age and the risk factors were gender, age, anthropometric index, smoking habits, drinking habits, exercise habits, cardiovascular history, hypertension, lipid levels, diabetes, renal function, and serum uric acid. Of the total number of participants, 158 (9.3%) were confirmed to have died, and of these, 92 were male (12.0% of all male participants) and 66 were female (7.0% of all female participants). The multivariable Cox regression analysis revealed that a smaller thigh-hip ratio predicted eight-year all-cause mortality in male participants, but only baseline body mass index was associated with all-cause mortality in female participants. Thigh-hip ratio is a useful predictor of death in Japanese community-dwelling men.
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Affiliation(s)
- Ryuichi Kawamoto
- Department of Community Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
- Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Seiyo, Ehime, Japan
| | - Asuka Kikuchi
- Department of Community Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
- Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Seiyo, Ehime, Japan
| | - Daisuke Ninomiya
- Department of Community Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
- Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Seiyo, Ehime, Japan
| | - Teru Kumagi
- Department of Community Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
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Christiansen MR, Kilpeläinen TO, McCaffery JM. Abdominal Obesity Genetic Variants Predict Waist Circumference Regain After Weight Loss. Diabetes 2023; 72:1424-1432. [PMID: 37494631 DOI: 10.2337/db23-0131] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/23/2023] [Indexed: 07/28/2023]
Abstract
Although many individuals are able to achieve weight loss, maintaining this loss over time is challenging. We aimed to study whether genetic predisposition to general or abdominal obesity predicts weight regain after weight loss. We examined the associations between genetic risk scores for higher BMI and higher waist-to-hip ratio adjusted for BMI (WHRadjBMI) with changes in weight and waist circumference up to 3 years after a 1-year weight loss program in participants (n = 822 women, n = 593 men) from the Look AHEAD (Action for Health in Diabetes) study who had lost ≥3% of their initial weight. Genetic predisposition to higher BMI or WHRadjBMI was not associated with weight regain after weight loss. However, the WHRadjBMI genetic score did predict an increase in waist circumference independent of weight change. To conclude, a genetic predisposition to higher WHRadjBMI predicts an increase in abdominal obesity after weight loss, whereas genetic predisposition to higher BMI is not predictive of weight regain. These results suggest that genetic effects on abdominal obesity may be more pronounced than those on general obesity during weight regain. ARTICLE HIGHLIGHTS Nearly all individuals who intentionally lose weight experience weight regain. Individuals with a higher genetic risk for abdominal adiposity experience increased regain in waist circumference after weight loss. Genetic predisposition to higher BMI does not predict weight regain after weight loss.
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Affiliation(s)
- Malene Revsbech Christiansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT
| | - Tuomas O Kilpeläinen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA
| | - Jeanne M McCaffery
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT
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Jin X, Liu J, Cao Q, Lin J, Wu G, Liu L, Jiang S, Zhou X, Li Z, Yang A. Normal-weight central obesity: implications for diabetes mellitus. Front Nutr 2023; 10:1239493. [PMID: 37810923 PMCID: PMC10556475 DOI: 10.3389/fnut.2023.1239493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023] Open
Abstract
Background Current guidelines for obesity prevention and control focus on body mass index (BMI) and rarely address central obesity. Few studies have been conducted on the association between normal-weight central obesity and the risk of diabetes mellitus (DM). Methods 26,825 participants from the National Health and Nutrition Examination Survey (NHANES) were included in our study. A weighted multivariate logistic regression model was used to analyze the relationship between different obesity patterns and the risk of DM. Results Our results suggest that normal-weight central obesity is associated with an increased risk of DM (OR: 2.37, 95% CI: 1.75-3.23) compared with normal-weight participants without central obesity. When stratified by sex, men with normal-weight central obesity, obesity and central obesity were found to have a similar risk of DM (OR: 3.83, 95% CI: 2.10-5.97; OR: 4.20, 95% CI: 3.48-5.08, respectively) and a higher risk than all other types of obesity, including men who were overweight with no central obesity (OR: 1.21, 95% CI: 0.96-1.51) and obese with no central obesity (OR: 0.53, 95% CI: 0.30-0.91). Conclusion Our results highlight the need for more attention in people with central obesity, even if they have a normal BMI.
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Affiliation(s)
- Xueshan Jin
- Nephropathy Center, The Affiliated Jiangmen TCM Hospital of Jinan University, Jiangmen, China
| | - Jiajun Liu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qiuyu Cao
- Nephropathy Center, The Affiliated Jiangmen TCM Hospital of Jinan University, Jiangmen, China
| | - Jiehua Lin
- Nephropathy Center, The Affiliated Jiangmen TCM Hospital of Jinan University, Jiangmen, China
| | - Guangfu Wu
- Nephropathy Center, The Affiliated Jiangmen TCM Hospital of Jinan University, Jiangmen, China
| | - Longhui Liu
- Nephropathy Center, The Affiliated Jiangmen TCM Hospital of Jinan University, Jiangmen, China
| | - Shan Jiang
- Nephropathy Center, The Affiliated Jiangmen TCM Hospital of Jinan University, Jiangmen, China
| | - Xin Zhou
- Nephropathy Center, The Affiliated Jiangmen TCM Hospital of Jinan University, Jiangmen, China
| | - Zhiqiang Li
- Nephropathy Center, The Affiliated Jiangmen TCM Hospital of Jinan University, Jiangmen, China
| | - Aicheng Yang
- Nephropathy Center, The Affiliated Jiangmen TCM Hospital of Jinan University, Jiangmen, China
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Cao X, He L, Sun R, Chen S. Gender-specific associations between abdominal adipose mass and bone mineral density in the middle-aged US population. BMC Musculoskelet Disord 2023; 24:715. [PMID: 37684622 PMCID: PMC10485967 DOI: 10.1186/s12891-023-06844-6] [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: 03/24/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
OBJECTIVES The relationship between abdominal adipose tissue and osteoporosis is poorly understood. The purpose of this study was to examine the associations of abdominal adipose tissue with bone mineral density (BMD) among a nationally representative sample of US middle-aged adults. MATERIAL AND METHODS This study included 1498 participants from the National Health and Nutrition Examination Survey 2013-2014 and 2017-2018. Dual-energy x-ray absorptiometry was used to measure BMD at the lumbar spine and femoral neck, as well as to assess abdominal adipose mass by categorizing total adipose tissue (TAT) into visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). Linear regression was used to assess the relationship between abdominal adipose tissue and BMD, and logistic regression and generalized additive model were used to assess the associations of abdominal adipose tissue with the development of low BMD. RESULTS In our study, men accounted for 51.3%, and the mean age and body mass index for men and women were 49.3 and 49.6 years, and 23.9 and 28.3 kg/m2, respectively. In the univariate model, we found that abdominal adipose mass was positively associated with BMD at femoral neck and spine in both genders. In the multivariate model, among men, a negative correlation was observed between TAT and SAT and BMD at the femoral neck. Additionally, higher masses of TAT, SAT, and VAT were found to significantly increase the risk of low BMD at both the femoral neck and lumbar spine. In contrast, there was no significant association between abdominal adipose mass and BMD in middle-aged women, regardless of menopausal status. CONCLUSIONS Our finding suggested that abdominal adipose tissue, regardless of its location (SAT or VAT), may have a negative impact on BMD in middle-aged men independently of body weight, but this relationship was not observed in women. Further research is needed to confirm these findings and investigate potential mechanisms underlying these associations.
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Affiliation(s)
- Xueqin Cao
- Department of Endocrinology, The Dushu Lake Hospital Affiliated to Soochow University, Chongwen Road No. 9, Suzhou, 215000, Jiangsu, China
| | - Leilei He
- Department of Obstetrics and Gynecology, The Dushu Lake Hospital Affiliated to Soochow University, Chongwen Road No. 9, Suzhou, 215000, Jiangsu, China
| | - Rong Sun
- Department of Endocrinology, The Dushu Lake Hospital Affiliated to Soochow University, Chongwen Road No. 9, Suzhou, 215000, Jiangsu, China
| | - Siyu Chen
- Department of Endocrinology, The Dushu Lake Hospital Affiliated to Soochow University, Chongwen Road No. 9, Suzhou, 215000, Jiangsu, China.
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Lempesis IG, Varrias D, Sagris M, Attaran RR, Altin ES, Bakoyiannis C, Palaiodimos L, Dalamaga M, Kokkinidis DG. Obesity and Peripheral Artery Disease: Current Evidence and Controversies. Curr Obes Rep 2023; 12:264-279. [PMID: 37243875 PMCID: PMC10220347 DOI: 10.1007/s13679-023-00510-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/09/2023] [Indexed: 05/29/2023]
Abstract
PURPOSE OF REVIEW Obesity is a significant public health problem and a major risk factor for the development and progression of atherosclerosis and its cardiovascular manifestations. Lower extremity peripheral artery disease (PAD) affects 3%-10% of the Western population and, if left untreated, can lead to devastating outcomes with both an increased risk of morbidity and mortality. Interestingly, the association between obesity and PAD remains debatable. Whereas it is well known that PAD and obesity frequently overlap in the same patients, many studies have demonstrated a negative association between obesity and PAD and a protective effect of obesity on disease development and progression, a phenomenon described as the "obesity paradox." Possible mechanisms for this paradox may include genetic background, as assessed by mendelian randomization studies, adipose tissue dysfunction, and body fat distribution rather than adiposity, while other factors, such as sex, ethnicity, sarcopenia in the elderly population, or aggressive treatment of co-existing metabolic conditions in individuals with obesity compared to those with normal weight, could have some impact as well. RECENT RINDINGS Few reviews and meta-analyses examining systematically the relationship between obesity and PAD exist. The impact of PAD development due to the presence of obesity remains largely controversial. However, the most current evidence, backed by a recent meta-analysis, suggests a potential protective role of a higher body mass index on PAD-related complications and mortality. In this review, we discuss the association between obesity and PAD development, progression, and management, and the potential pathophysiologic mechanisms linking the two diseases.
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Affiliation(s)
- Ioannis G Lempesis
- Department of Biologic Chemistry, School of Medicine, National and Kapodistrian, University of Athens, Mikras Asias 75, 115 27, Athens, Greece.
| | - Dimitrios Varrias
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Marios Sagris
- General Hospital of Nikaia, Piraeus, 184 54, Athens, Greece
| | - Robert R Attaran
- Section of Cardiovascular Medicine, Yale University/Yale New Haven Hospital, 06519, New Haven, CT, USA
| | - Elissa S Altin
- Section of Cardiovascular Medicine, Yale University/Yale New Haven Hospital, 06519, New Haven, CT, USA
| | - Christos Bakoyiannis
- Department of Surgery, Division of Vascular Surgery, Laikon General Hospital, National Kapodistrian University of Athens, 15772, Athens, Greece
| | - Leonidas Palaiodimos
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Maria Dalamaga
- Department of Biologic Chemistry, School of Medicine, National and Kapodistrian, University of Athens, Mikras Asias 75, 115 27, Athens, Greece
| | - Damianos G Kokkinidis
- Section of Cardiovascular Medicine, Yale University/Yale New Haven Hospital, 06519, New Haven, CT, USA
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Ahmad S, Drag MH, Mohamad Salleh S, Cai Z, Nielsen MO. Gene coexpression network analysis reveals perirenal adipose tissue as an important target of prenatal malnutrition in sheep. Physiol Genomics 2023; 55:392-413. [PMID: 37458462 PMCID: PMC10642927 DOI: 10.1152/physiolgenomics.00128.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 06/28/2023] [Accepted: 07/03/2023] [Indexed: 08/24/2023] Open
Abstract
We have previously demonstrated that pre- and early postnatal malnutrition in sheep induced depot- and sex-specific changes in adipose morphological features, metabolic outcomes, and transcriptome in adulthood, with perirenal (PER) as the major target followed by subcutaneous (SUB) adipose tissue. We aimed to identify coexpressed and hub genes in SUB and PER to identify the underlying molecular mechanisms contributing to the early nutritional programming of adipose-related phenotypic outcomes. Transcriptomes of SUB and PER of male and female adult sheep with different pre- and early postnatal nutrition histories were used to construct networks of coexpressed genes likely to be functionally associated with pre- and early postnatal nutrition histories and phenotypic traits using weighted gene coexpression network analysis. The modules from PER showed enrichment of cell cycle regulation, gene expression, transmembrane transport, and metabolic processes associated with both sexes' prenatal nutrition. In SUB (only males), a module of enriched adenosine diphosphate metabolism and development correlated with prenatal nutrition. Sex-specific module enrichments were found in PER, such as chromatin modification in the male network but histone modification and mitochondria- and oxidative phosphorylation-related functions in the female network. These sex-specific modules correlated with prenatal nutrition and adipocyte size distribution patterns. Our results point to PER as a primary target of prenatal malnutrition compared to SUB, which played only a minor role. The prenatal programming of gene expression and cell cycle, potentially through epigenetic modifications, might be underlying mechanisms responsible for observed changes in PER expandability and adipocyte-size distribution patterns in adulthood in both sexes.
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Affiliation(s)
- Sharmila Ahmad
- Department of Animal Science, Faculty of Agriculture, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Research Unit of Nutrition, Department of Animal and Veterinary Sciences, Aarhus University, Tjele, Denmark
| | - Markus Hodal Drag
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Zoo, Frederiksberg, Denmark
| | - Suraya Mohamad Salleh
- Department of Animal Science, Faculty of Agriculture, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Department of Animal Nutrition and Management, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Zexi Cai
- Centre for Quantitative Genetics and Genomics, Aarhus University, Tjele, Denmark
| | - Mette Olaf Nielsen
- Research Unit of Nutrition, Department of Animal and Veterinary Sciences, Aarhus University, Tjele, Denmark
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Abstract
In this review, we provide a brief synopsis of the connections between adipose tissue and metabolic health and highlight some recent developments in understanding and exploiting adipocyte biology. Adipose tissue plays critical roles in the regulation of systemic glucose and lipid metabolism and secretes bioactive molecules possessing endocrine, paracrine, and autocrine functions. Dysfunctional adipose tissue has a detrimental impact on metabolic health and is intimately involved in key aspects of metabolic diseases such as insulin resistance, lipid overload, inflammation, and organelle stress. Differences in the distribution of fat depots and adipose characteristics relate to divergent degrees of metabolic dysfunction found in metabolically healthy and unhealthy obese individuals. Thermogenic adipocytes increase energy expenditure via mitochondrial uncoupling or adenosine triphosphate-consuming futile substrate cycles, while functioning as a metabolic sink and participating in crosstalk with other metabolic organs. Manipulation of adipose tissue provides a wealth of opportunities to intervene and combat the progression of associated metabolic diseases. We discuss current treatment modalities for obesity including incretin hormone analogs and touch upon emerging strategies with therapeutic potential including exosome-based therapy, pharmacological activation of brown and beige adipocyte thermogenesis, and administration or inhibition of adipocyte-derived factors.
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Affiliation(s)
- Sung-Min An
- Division of Endocrinology, Department of Internal Medicine, University of California Davis School of Medicine, Davis, CA, USA
| | - Seung-Hee Cho
- Division of Endocrinology, Department of Internal Medicine, University of California Davis School of Medicine, Davis, CA, USA
| | - John C. Yoon
- Division of Endocrinology, Department of Internal Medicine, University of California Davis School of Medicine, Davis, CA, USA
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Horwitz A, Birk R. Adipose Tissue Hyperplasia and Hypertrophy in Common and Syndromic Obesity-The Case of BBS Obesity. Nutrients 2023; 15:3445. [PMID: 37571382 PMCID: PMC10421039 DOI: 10.3390/nu15153445] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/16/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Obesity is a metabolic state generated by the expansion of adipose tissue. Adipose tissue expansion depends on the interplay between hyperplasia and hypertrophy, and is mainly regulated by a complex interaction between genetics and excess energy intake. However, the genetic regulation of adipose tissue expansion is yet to be fully understood. Obesity can be divided into common multifactorial/polygenic obesity and monogenic obesity, non-syndromic and syndromic. Several genes related to obesity were found through studies of monogenic non-syndromic obesity models. However, syndromic obesity, characterized by additional features other than obesity, suggesting a more global role of the mutant genes related to the syndrome and, thus, an additional peripheral influence on the development of obesity, were hardly studied to date in this regard. This review summarizes present knowledge regarding the hyperplasia and hypertrophy of adipocytes in common obesity. Additionally, we highlight the scarce research on syndromic obesity as a model for studying adipocyte hyperplasia and hypertrophy, focusing on Bardet-Biedl syndrome (BBS). BBS obesity involves central and peripheral mechanisms, with molecular and mechanistic alternation in adipocyte hyperplasia and hypertrophy. Thus, we argue that using syndromic obesity models, such as BBS, can further advance our knowledge regarding peripheral adipocyte regulation in obesity.
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Affiliation(s)
| | - Ruth Birk
- Department of Nutrition, Faculty of Health Sciences, Ariel University, Ariel 40700, Israel;
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Marković S, Bulut T. Tendencies Toward Supernormality/Subnormality in Generating Attractive and Unattractive Female and Male Avatars: Gender Differences. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:2317-2336. [PMID: 36995537 DOI: 10.1007/s10508-023-02575-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 02/18/2023] [Accepted: 02/26/2023] [Indexed: 06/19/2023]
Abstract
In the present study, we investigated the differences in the experience of attractiveness and unattractiveness of human bodies. A total of 101 participants (55 females) were asked to create the most attractive and the most unattractive female and male figures using a computer animation. They performed this task by adjusting the size of six body parts: shoulders, breasts/chest, waist, hips, buttocks, and legs. Analyses indicated that attractive body parts were distributed normally with the peak shifted to moderately supernormal sizes, while unattractive body parts had mostly U-shaped or skewed distributions with extremes in super-supernormal and/or subnormal sizes. Generally, both male and female attractive bodies had prominent "sporty" look: supernormally wide shoulders and long legs. Gender differences showed that men prefer more supernomal masculine and feminine sizes, while women show an ambivalence toward both groups of traits. Principal components analysis revealed gender differences on the multitrait level: males focus on prominent masculine and feminine traits, while women focus on traits that make both male and female bodies more elongated and slender. Gender differences were in line with specific male and female positions in the partner selection process, while a certain tendency toward masculinization of the female body required the inclusion of social factors, such as the influence of the culture of a sporty and fit look.
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Affiliation(s)
- Slobodan Marković
- Faculty of Philosophy, Laboratory for Experimental Psychology and Department of Psychology, University of Belgrade, Čika Ljubina 18-20, 11000, Belgrade, Serbia.
| | - Tara Bulut
- Faculty of Philosophy, Laboratory for Experimental Psychology and Department of Psychology, University of Belgrade, Čika Ljubina 18-20, 11000, Belgrade, Serbia
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Tomasello L, Pitrone M, Guarnotta V, Giordano C, Pizzolanti G. Irisin: A Possible Marker of Adipose Tissue Dysfunction in Obesity. Int J Mol Sci 2023; 24:12082. [PMID: 37569456 PMCID: PMC10419191 DOI: 10.3390/ijms241512082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
Adipose tissue (AT) secretes pro- and anti-inflammatory cytokines involved in AT homeostasis, including tumor necrosis factor-α (TNFα) and irisin. The functionality of AT is based on a regulated equilibrium between adipogenesis and extracellular matrix (ECM) remodeling. We investigated the contributions of adipose progenitors (ASCs) and adipocytes (AMCs) to TNFα-induced ECM remodeling and a possible implication of irisin in AT impairment in obesity. ASCs and AMCs were exposed to TNFα treatment and nuclear factor-kappa (NF-kB) pathway was investigated: Tissue Inhibitor of Metalloproteinase (TIMP-1), Twist Family Transcription Factor 1 (TWIST-1), and peroxisome proliferator-activated receptor-γ (PPARγ) expression levels were analyzed. The proteolytic activity of matrix metalloproteinases (MMPs) -2 and -9 was analyzed by zymography, and the irisin protein content was measured by ELISA. In inflamed AMCs, a TIMP-1/TWIST-1 imbalance leads to a drop in PPARγ. Adipogenesis and lipid storage ability impairment come with local tissue remodeling due to MMP-9 overactivation. In vitro and ex vivo measurements confirm positive correlations among inflammation, adipose secreting irisin levels, and circulating irisin levels in patients with visceral obesity. Our findings identify the NF-kB downstream effectors as molecular initiators of AT dysfunction and suggest irisin as a possible AT damage and obesity predictive factor.
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Affiliation(s)
- Laura Tomasello
- Laboratory of Endocrinology and Regenenerative Medicine “Aldo Galluzzo”, Università di Palermo, 90133 Palermo, Italy; (M.P.); (V.G.); (C.G.)
- Dipartimento Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (Promise), Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, 90127 Palermo, Italy
| | - Maria Pitrone
- Laboratory of Endocrinology and Regenenerative Medicine “Aldo Galluzzo”, Università di Palermo, 90133 Palermo, Italy; (M.P.); (V.G.); (C.G.)
| | - Valentina Guarnotta
- Laboratory of Endocrinology and Regenenerative Medicine “Aldo Galluzzo”, Università di Palermo, 90133 Palermo, Italy; (M.P.); (V.G.); (C.G.)
- Dipartimento Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (Promise), Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, 90127 Palermo, Italy
| | - Carla Giordano
- Laboratory of Endocrinology and Regenenerative Medicine “Aldo Galluzzo”, Università di Palermo, 90133 Palermo, Italy; (M.P.); (V.G.); (C.G.)
- Dipartimento Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (Promise), Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, 90127 Palermo, Italy
- ATeN Center—Advanced Technologies Network Center, 90127 Palermo, Italy
| | - Giuseppe Pizzolanti
- Laboratory of Endocrinology and Regenenerative Medicine “Aldo Galluzzo”, Università di Palermo, 90133 Palermo, Italy; (M.P.); (V.G.); (C.G.)
- Dipartimento Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (Promise), Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, 90127 Palermo, Italy
- ATeN Center—Advanced Technologies Network Center, 90127 Palermo, Italy
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Liang Y, Chen P, Chen S, Liu D, Jiang F, Zhu Z, Dong K, Wei L, Hou X. A greater ratio of thigh subcutaneous fat to abdominal fat is associated with protection against non-alcoholic fatty liver disease. JHEP Rep 2023; 5:100730. [PMID: 37425213 PMCID: PMC10326700 DOI: 10.1016/j.jhepr.2023.100730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 02/15/2023] [Accepted: 02/28/2023] [Indexed: 07/11/2023] Open
Abstract
Background & Aims No prospective studies have examined the association between thigh subcutaneous fat distribution and non-alcoholic fatty liver disease (NAFLD). We investigated the associations of thigh subcutaneous fat distribution with incidence and remission of NAFLD in a community-based prospective cohort. Methods We followed 1,787 subjects, who underwent abdominal ultrasonography, abdominal and femoral magnetic resonance imaging scans, and anthropometric assessments. Associations of thigh subcutaneous fat area/abdominal fat area ratio and thigh circumference/waist circumference ratio with incidence and remission of NAFLD were estimated using the modified Poisson regression model. Results Over a mean 3.6-year follow-up, 239 incident cases of NAFLD and 207 regressed cases of NAFLD were identified. Increasing thigh subcutaneous fat area/abdominal fat area ratio was associated with a lower risk of incident NAFLD and a higher likelihood of remission of NAFLD [risk ratio (RR) per SD: 0.69, 95% CI 0.59-0.81; 1.20, 95% CI 1.07-1.34, respectively). Each one SD increase in thigh circumference/waist circumference ratio was associated with a 16% lower risk of incident NAFLD (RR 0.84, 95% CI 0.76-0.94) and a 22% higher likelihood of remission of NAFLD (RR 1.22, 95% CI 1.11-1.34). Additionally, the effects of thigh subcutaneous fat area/abdominal fat area ratio on the incidence and remission of NAFLD were mediated through adiponectin (14.9% and 26.6%), homeostasis model assessment of insulin resistance (9.5% and 23.9%), and triglyceride (7.5% and 19.1%). Conclusions These results demonstrated that a favourable fat distribution, characterised by a greater ratio of thigh subcutaneous fat to abdominal fat, had a protective role against NAFLD. Impact and implications The associations of thigh subcutaneous fat distribution with NAFLD incidence and remission have not been prospectively examined in a community-based cohort. Our findings suggest that greater thigh subcutaneous fat relative to a given amount of abdominal fat has a protective effect against NAFLD among the middle-aged and older Chinese populations.
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Affiliation(s)
- Yebei Liang
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
- Department of Geriatrics, Fujian Hypertension Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Peizhu Chen
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Siyu Chen
- Department of Endocrinology and Metabolism, Suzhou Dushu Lake Hospital (Dushu Lake Hospital Affiliated to Soochow University), Suzhou, Jiangsu, China
| | - Dan Liu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Fusong Jiang
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Zhijun Zhu
- General Practitioner Teams in Community Health Service Center of Nicheng, Pudong New District, Shanghai, China
| | - Keqing Dong
- General Practitioner Teams in Community Health Service Center of Nicheng, Pudong New District, Shanghai, China
| | - Li Wei
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Xuhong Hou
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
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He J, Huang M, Li N, Zha L, Yuan J. Genetic Association and Potential Mediators between Sarcopenia and Coronary Heart Disease: A Bidirectional Two-Sample, Two-Step Mendelian Randomization Study. Nutrients 2023; 15:3013. [PMID: 37447340 DOI: 10.3390/nu15133013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
OBJECTIVE To elucidate the bidirectional correlation of sarcopenia with coronary heart disease (CHD), as well as to investigate the mediating role of cardiometabolic factors and inflammatory biomarkers, a bidirectional two-sample, two-step Mendelian randomization (MR) study was conducted. METHODS Summary statistics were obtained from genome-wide association studies (GWAS). In our bidirectional two-sample MR, genetic variants associated with sarcopenia-related traits and CHD were instrumented for the estimation of bidirectional correlations. Besides, genetic variants associated with thirteen cardiometabolic factors and six inflammatory biomarkers were selected for further mediation analyses. To confirm the consistency of the results, several sensitivity analyses were carried out. RESULTS Genetically predicted higher appendicular lean mass (OR = 0.835, 95% CI: 0.790-0.882), left hand grip strength (OR = 0.703, 95% CI: 0.569-0.869), right hand grip strength (OR = 0.685, 95% CI: 0.555-0.844), and walking pace (OR = 0.321, 95% CI: 0.191-0.539) reduced CHD risk, while genetic predisposition to CHD did not affect any of the sarcopenia-related traits. Seven mediators were identified for the effects of appendicular lean mass on CHD, including waist-to-hip ratio, hip circumference, systolic blood pressure, low-density lipoprotein cholesterol, total cholesterol, triglycerides, and fasting insulin. The mediation proportion ranged from 10.23% for triglycerides to 35.08% for hip circumference. Hip circumference was found to mediate the relationships between both left (mediation proportion: 24.61%) and right-hand grip strength (24.14%) and CHD, and the link between walking pace and CHD was partially mediated by waist-to-hip ratio (31.15%) and body mass index (26.66%). CONCLUSION Our results showed that higher appendicular lean mass, hand grip strength, and walking pace reduced CHD risk, but the causal relationship was not bidirectional. Several mediators were found to mediate the causal pathways between sarcopenia-related traits and CHD, and intervention of these factors may be helpful in terms of CHD prevention in sarcopenia patients.
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Affiliation(s)
- Junyi He
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Provincial Engineering Research Center of Immunological Diagnosis and Therapy for Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Mingkai Huang
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Provincial Engineering Research Center of Immunological Diagnosis and Therapy for Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Nana Li
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Provincial Engineering Research Center of Immunological Diagnosis and Therapy for Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Lingfeng Zha
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Provincial Engineering Research Center of Immunological Diagnosis and Therapy for Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Jing Yuan
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Provincial Engineering Research Center of Immunological Diagnosis and Therapy for Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
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Boccara E, Golan S, Beeri MS. The association between regional adiposity, cognitive function, and dementia-related brain changes: a systematic review. Front Med (Lausanne) 2023; 10:1160426. [PMID: 37457589 PMCID: PMC10349176 DOI: 10.3389/fmed.2023.1160426] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/15/2023] [Indexed: 07/18/2023] Open
Abstract
Background Adiposity has been previously associated with cognitive impairment and Alzheimer's disease and related disorders (ADRD). Body mass index (BMI) is the most common measure of global adiposity, but inconsistent results were found since it is a global measurement. BMI does not represent regional fat distribution which differs between sexes, race, and age. Regional fat distribution may contribute differently to cognitive decline and Alzheimer's disease (AD)-related brain changes. Fat-specific targeted therapies could lead to personalized improvement of cognition. The goal of this systematic review is to explore whether regional fat depots, rather than central obesity, should be used to understand the mechanism underlying the association between adiposity and brain. Methods This systematic review included 33 studies in the English language, conducted in humans aged 18 years and over with assessment of regional adiposity, cognitive function, dementia, and brain measures. We included only studies that have assessed regional adiposity using imaging technics and excluded studies that were review articles, abstract only or letters to editor. Studies on children and adolescents, animal studies, and studies of patients with gastrointestinal diseases were excluded. PubMed, PsychInfo and web of science were used as electronic databases for literature search until November 2022. Results Based on the currently available literature, the findings suggest that different regional fat depots are likely associated with increased risk of cognitive impairment, brain changes and dementia, especially AD. However, different regional fat depots can have different cognitive outcomes and affect the brain differently. Visceral adipose tissue (VAT) was the most studied regional fat, along with liver fat through non-alcoholic fatty liver disease (NAFLD). Pancreatic fat was the least studied regional fat. Conclusion Regional adiposity, which is modifiable, may explain discrepancies in associations of global adiposity, brain, and cognition. Specific regional fat depots lead to abnormal secretion of adipose factors which in turn may penetrate the blood brain barrier leading to brain damage and to cognitive decline.
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Affiliation(s)
- Ethel Boccara
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel HaShomer, Israel
| | - Sapir Golan
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel HaShomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Schnaider Beeri
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel HaShomer, Israel
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Lempesis IG, Hoebers N, Essers Y, Jocken JWE, Dineen R, Blaak EE, Manolopoulos KN, Goossens GH. Distinct inflammatory signatures of upper and lower body adipose tissue and adipocytes in women with normal weight or obesity. Front Endocrinol (Lausanne) 2023; 14:1205799. [PMID: 37455922 PMCID: PMC10338223 DOI: 10.3389/fendo.2023.1205799] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/02/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Upper and lower body fat accumulation poses an opposing obesity-related cardiometabolic disease risk. Depot-differences in subcutaneous adipose tissue (SAT) function may underlie these associations. We aimed to investigate the inflammatory signatures of abdominal (ABD) and femoral (FEM) SAT in postmenopausal women with normal weight or obesity. Methods We included 23 postmenopausal women with normal weight (n = 13) or obesity (n = 10). In vivo secretion of adipokines from ABD and FEM SAT was measured using the arterio-venous balance technique. Adipokine gene expression and adipocyte morphology were examined in ABD and FEM SAT. Furthermore, adipokine expression and secretion were investigated in vitro using differentiated human primary ABD and FEM subcutaneous adipocytes derived from the study participants. Results Plasma leptin and plasminogen activator inhibitor (PAI)-1 concentrations were higher, and ABD and FEM adipocytes were larger in women with obesity than normal weight. No differences in adipocyte size and blood flow were apparent between ABD and FEM SAT. We found significant release of leptin and monocyte chemoattractant protein (MCP)-1 from ABD and FEM SAT, with higher fractional release of MCP-1 from ABD than FEM SAT. Gene expression of leptin, PAI-1, and tumor necrosis factor-α was lower in ABD than FEM SAT and higher in women with obesity than normal weight. In ABD adipocytes, interleukin-6, PAI-1, and leptin gene expression were higher, while adiponectin and dipeptidyl-peptidase-4 gene expression were lower than in FEM adipocytes. Finally, ABD adipocytes secreted less MCP-1 compared to FEM adipocytes. Discussion These findings demonstrate that upper and lower body SAT and adipocytes are characterized by distinct inflammatory signatures in postmenopausal women, which seem independent of adipocyte size.
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Affiliation(s)
- Ioannis G. Lempesis
- Institute of Metabolism and Systems Research (IMSR), College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands, Maastricht, Netherlands
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
| | - Nicole Hoebers
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands, Maastricht, Netherlands
| | - Yvonne Essers
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands, Maastricht, Netherlands
| | - Johan W. E. Jocken
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands, Maastricht, Netherlands
| | - Rosemary Dineen
- Institute of Metabolism and Systems Research (IMSR), College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
| | - Ellen E. Blaak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands, Maastricht, Netherlands
| | - Konstantinos N. Manolopoulos
- Institute of Metabolism and Systems Research (IMSR), College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
| | - Gijs H. Goossens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands, Maastricht, Netherlands
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Lempesis IG, Georgakopoulou VE. Physiopathological mechanisms related to inflammation in obesity and type 2 diabetes mellitus. World J Exp Med 2023; 13:7-16. [PMID: 37396883 PMCID: PMC10308320 DOI: 10.5493/wjem.v13.i3.7] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/15/2023] [Accepted: 04/10/2023] [Indexed: 06/16/2023] Open
Abstract
Overweight, obesity, and type 2 diabetes mellitus pose global health problems that are ever-increasing. A chronic low-grade inflammatory status and the presence of various pro-inflammatory markers either in circulation or within dysfunctional metabolic tissues are well established. The presence of these factors can, to some extent, predict disease development and progression. A central role is played by the presence of dysfunctional adipose tissue, liver dysfunction, and skeletal muscle dysfunction, which collectively contribute to the increased circulatory levels of proinflammatory factors. Weight loss and classical metabolic interventions achieve a decrease in many of these factors’ circulating levels, implying that a better understanding of the processes or even the modulation of inflammation may alleviate these diseases. This review suggests that inflammation plays a significant role in the development and progression of these conditions and that measuring inflammatory markers may be useful for assessing disease risk and development of future treatment methods.
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Affiliation(s)
- Ioannis G Lempesis
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Athens 11527, Greece
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Ma W, Zhu H, Yu X, Zhai X, Li S, Huang N, Liu K, Shirai K, Sheerah HA, Cao J. Association between android fat mass, gynoid fat mass and cardiovascular and all-cause mortality in adults: NHANES 2003-2007. Front Cardiovasc Med 2023; 10:1055223. [PMID: 37273879 PMCID: PMC10233278 DOI: 10.3389/fcvm.2023.1055223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 04/14/2023] [Indexed: 06/06/2023] Open
Abstract
Objectives Evidence of the relationship between android fat mass and gynoid fat mass with the mortality prediction is still limited. Current study analyzed the NHANES database to investigate the relationship between android fat mass, gynoid fat mass and CVD, with all-cause mortality. Method The study subjects were NHANES participants over 20 years old, two indicators of regional body composition, android fat and gynoid fat were measured by Dual Energy x-ray Absorptiometry (DEXA). The other various covariates data obtained from the NHANES questionnaire and laboratory measurements, including age, gender, education, race/ethnicity, uric acid, total serum cholesterol, albumin, Vitamin C, folate, alcohol drinking, smoking status, history of diabetes, and hypertension. Mortality status was ascertained from a linked mortality file prepared by the National Center for Health Statistics. The study population was divided quartiles based on the distribution of android fat mass and gynoid fat mass. The relationship between these two indicators with cardiovascular and all-cause mortality was investigated by using Cox regression. The covariates age, gender, smoking status, drinking status, history of diabetes, and history of hypertension were stratified. Results In the fully adjusted model, Q3 had the lowest HR in android fat mass and gynoid fat mass. When examining the relationship between android fat mass and CVD mortality, current smokers and drinkers had the lowest CVD risk in Q2 [smoking: 0.21 (0.08, 0.52), drinking: 0.14 (0.04, 0.50)]. In diabetic patients, compared with Q1, other groups with increased android fat mass can significantly reduce the risk of CVD [Q4: 0.17 (0.04, 0.75), Q3: 0.18 (0.03, 1.09), Q2: 0.27 (0.09, 0.83)]. In ≥60 years old and female, the greater the gynoid fat mass, the smaller the HR of all-cause mortality [Q4 for ≥60 years old: 0.57 (0.33, 0.96), Q4 for female: 0.37 (0.23, 0.58)]. People <60 years old had a lower risk of all-cause mortality with gynoid fat mass in Q3 than those ≥60 years old [<60 years: 0.50 (0.27, 0.91), ≥60 years: 0.65 (0.45, 0.95)]. Among subjects without hypertension, the group with the largest android fat mass had the lowest risk of CVD mortality, and the group with the largest gynoid fat mass had the lowest risk of all-cause mortality [Android fat mass: 0.36 (0.16, 0.81), gynoid fat mass: 0.57 (0.39, 0.85)]. Conclusion Moderate android fat mass and gynoid fat mass (Q3) had the most protective effect. Smokers and drinkers need to control their body fat. Being too thin is harmful to people with diabetes. Increased gynoid fat mass is a protective factor for all-cause mortality in older adults and females. Young people's gynoid fat mass is more protective in the moderate range than older people's. If no high blood pressure exists, people with more android and gynoid fat mass have a lower risk of CVD or all-cause mortality.
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Affiliation(s)
- Wenzhi Ma
- School of Public Health, Wuhan University, Wuhan, China
| | - Huiping Zhu
- School of Public Health, Capital Medical University, Beijing, China
| | - Xinyi Yu
- School of Public Health, Capital Medical University, Beijing, China
| | - Xiaobing Zhai
- Center for Artificial Intelligence Driven Drug Discovery, Faculty of Applied Sciences, Macao Polytechnic University, Macao, China
| | - Shiyang Li
- School of Public Health, Wuhan University, Wuhan, China
| | - Nian Huang
- School of Public Health, Wuhan University, Wuhan, China
| | - Keyang Liu
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Japan
| | - Kokoro Shirai
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Japan
| | - Haytham A. Sheerah
- Assistant Deputyship for International Collaborations, Ministry of Health, Riyadh, Saudi Arabia
| | - Jinhong Cao
- School of Management, Hubei University of Chinese Medicine, Wuhan, China
- Research Center for the Development of Chinese Medicine, Hubei Province Project of Key Research Institute of Humanities and Social Sciences at Universities, Wuhan, China
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Yang L, Huang H, Liu Z, Ruan J, Xu C. Association of the android to gynoid fat ratio with nonalcoholic fatty liver disease: a cross-sectional study. Front Nutr 2023; 10:1162079. [PMID: 37255941 PMCID: PMC10226647 DOI: 10.3389/fnut.2023.1162079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/27/2023] [Indexed: 06/01/2023] Open
Abstract
Background Nonalcoholic fatty liver disease (NAFLD) is becoming a severe global public health problem, and can developed into fibrotic nonalcoholic steatohepatitis (NASH), but its risk factors have not been fully identified. The objective of this study was to investigate the association between the android-to-gynoid fat ratio (A/G ratio) and the prevalence of NAFLD. Methods This cross-sectional study is based on the 2003-2006 and 2011-2018 cycles of the National Health and Nutrition Examination Survey and included 10,989 participants. Participants aged 20 and older without viral hepatitis or significant alcohol consumption were included. Dual-energy X-ray absorptiometry was used to assess body composition. NAFLD was diagnosed using the United States fatty liver index (US FLI). Multivariable logistic regression models were used to evaluate the association between the A/G ratio and NAFLD. Results The prevalence of NAFLD was 32.15% among the study population. Android percent fat and the A/G ratio were significantly higher in patients with NAFLD than in those without NAFLD [41.68% (0.25) vs. 32.80% (0.27), p < 0.001; 1.14 ± 0.01 vs. 0.94 ± 0.00, p < 0.001, respectively]. Logistic regression analysis showed that android percent fat was positively correlated to NAFLD (OR: 1.15, 95% CI: 1.11-1.18), while gynoid percent fat was negatively correlated to NAFLD (OR: 0.92, 95% CI: 0.90-0.94), and the A/G ratio was significantly associated with the prevalence of NAFLD (OR: 1.59, 95% CI: 1.38-1.82) and fibrotic NASH (OR: 2.01, 95% CI: 1.71-2.38). We also found that females had a notably diminished A/G ratio compared with males (0.91 vs. 1.12, p < 0.001). In addition, the female population proportion was negatively correlated with the A/G ratio, which may partly explain the lower prevalence of NAFLD in females. What is more, the OR value of the A/G ratio in the female subgroup was much higher than that in the male subgroup in all adjusted models. Conclusion A/G ratio is significantly associated with NAFLD and fibrotic NASH. Women have a lower A/G ratio than men, which may explain the sex difference in NAFLD prevalence. Furthermore, with a higher A/G ratio, the association between females and NAFLD are greatly elevated.
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Affiliation(s)
- Ling Yang
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hangkai Huang
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhening Liu
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiaqi Ruan
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chengfu Xu
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang Provincial Clinical Research Center for Digestive Diseases, Hangzhou, China
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50
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de Ritter R, Sep SJS, van Greevenbroek MMJ, Kusters YHAM, Vos RC, Bots ML, Kooi ME, Dagnelie PC, Eussen SJPM, Schram MT, Koster A, Brouwers MCG, van der Sangen NMR, Peters SAE, van der Kallen CJH, Stehouwer CDA. Sex differences in body composition in people with prediabetes and type 2 diabetes as compared with people with normal glucose metabolism: the Maastricht Study. Diabetologia 2023; 66:861-872. [PMID: 36805778 PMCID: PMC10036428 DOI: 10.1007/s00125-023-05880-0] [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: 05/27/2022] [Accepted: 11/22/2022] [Indexed: 02/23/2023]
Abstract
AIMS/HYPOTHESIS Obesity is a major risk factor for type 2 diabetes. However, body composition differs between women and men. In this study we investigate the association between diabetes status and body composition and whether this association is moderated by sex. METHODS In a population-based cohort study (n=7639; age 40-75 years, 50% women, 25% type 2 diabetes), we estimated the sex-specific associations, and differences therein, of prediabetes (i.e. impaired fasting glucose and/or impaired glucose tolerance) and type 2 diabetes (reference: normal glucose metabolism [NGM]) with dual-energy x-ray absorptiometry (DEXA)- and MRI-derived measures of body composition and with hip circumference. Sex differences were analysed using adjusted regression models with interaction terms of sex-by-diabetes status. RESULTS Compared with their NGM counterparts, both women and men with prediabetes and type 2 diabetes had more fat and lean mass and a greater hip circumference. The differences in subcutaneous adipose tissue, hip circumference and total and peripheral lean mass between type 2 diabetes and NGM were greater in women than men (women minus men [W-M] mean difference [95% CI]: 15.0 cm2 [1.5, 28.5], 3.2 cm [2.2, 4.1], 690 g [8, 1372] and 443 g [142, 744], respectively). The difference in visceral adipose tissue between type 2 diabetes and NGM was greater in men than women (W-M mean difference [95% CI]: -14.8 cm2 [-26.4, -3.1]). There was no sex difference in the percentage of liver fat between type 2 diabetes and NGM. The differences in measures of body composition between prediabetes and NGM were generally in the same direction, but were not significantly different between women and men. CONCLUSIONS/INTERPRETATION This study indicates that there are sex differences in body composition associated with type 2 diabetes. The pathophysiological significance of these sex-associated differences requires further study.
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Affiliation(s)
- Rianneke de Ritter
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands.
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands.
| | - Simone J S Sep
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Adelante, Center of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands
| | - Marleen M J van Greevenbroek
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Yvo H A M Kusters
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Rimke C Vos
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Leiden University Medical Center, Department of Public Health and Primary Care/LUMC-Campus, The Hague, the Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - M Eline Kooi
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Pieter C Dagnelie
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Simone J P M Eussen
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Miranda T Schram
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, the Netherlands
- MHeNs School for Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Annemarie Koster
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
| | - Martijn C G Brouwers
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | | | - Sanne A E Peters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- The George Institute for Global Health, Imperial College London, London, UK
| | - Carla J H van der Kallen
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
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