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Murphy J, Dera A, Morais JA, Tsoukas MA, Khor N, Sazonova T, Almeida LG, Cooke AB, Daskalopoulou SS, Tam BT, Santosa S. Age of obesity onset affects subcutaneous adipose tissue cellularity differently in the abdominal and femoral region. Obesity (Silver Spring) 2024; 32:1508-1517. [PMID: 39045668 DOI: 10.1002/oby.24059] [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: 03/21/2023] [Revised: 04/18/2024] [Accepted: 04/19/2024] [Indexed: 07/25/2024]
Abstract
OBJECTIVE We aimed to examine the effect of age of obesity onset, sex, and their interaction on abdominal and femoral subcutaneous adipose tissue (SAT) morphology (degree of adipocyte hyperplasia or hypertrophy). METHODS In this cross-sectional study, we isolated adipocytes via collagenase digestion from abdominal and femoral SAT biopsies taken from male and female adults with childhood-onset obesity (CO; n = 8 males, n = 16 females) or adult-onset obesity (AO; n = 8 males, n = 13 females). Regional body composition was measured with dual-energy x-ray absorptiometry and a single-slice abdominal computed tomography scan. Mean adipocyte size was measured in abdominal and femoral SAT and was used to quantify morphology in android and gynoid subcutaneous fat, respectively. RESULTS Abdominal SAT morphology was more hyperplastic in females with CO than females with AO (p = 0.004) but did not differ between males with CO and males with AO (p = 0.996). Conversely, femoral SAT morphology was more hypertrophic in males and females with CO than those with AO. CONCLUSIONS Age of obesity onset appears to affect SAT morphology differently in the abdominal and femoral regions of male and female adults. Our findings challenge the notion that SAT is uniformly hyperplastic in CO and hypertrophic in AO.
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Affiliation(s)
- Jessica Murphy
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, Québec, Canada
- Metabolism, Obesity, and Nutrition Laboratory, School of Health, Concordia University, Montréal, Québec, Canada
- Centre de recherche - Axe maladies chroniques, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Ile de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
| | - Abdulrahman Dera
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, Québec, Canada
- Metabolism, Obesity, and Nutrition Laboratory, School of Health, Concordia University, Montréal, Québec, Canada
- Centre de recherche - Axe maladies chroniques, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Ile de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
| | - José A Morais
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, Québec, Canada
- Division of Geriatric Medicine, Department of Medicine, McGill University, McGill University Health Centre (MUHC) - Montréal General Hospital, Montréal, Québec, Canada
| | - Michael A Tsoukas
- Division of Endocrinology and Metabolism, Department of Medicine, McGill University, Royal Victoria Hospital, MUHC Glen Site, Montréal, Québec, Canada
| | - Natalie Khor
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, Québec, Canada
- Metabolism, Obesity, and Nutrition Laboratory, School of Health, Concordia University, Montréal, Québec, Canada
| | - Taisiia Sazonova
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, Québec, Canada
- Metabolism, Obesity, and Nutrition Laboratory, School of Health, Concordia University, Montréal, Québec, Canada
| | - Lucas Guimarães Almeida
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, Québec, Canada
- Metabolism, Obesity, and Nutrition Laboratory, School of Health, Concordia University, Montréal, Québec, Canada
- Centre de recherche - Axe maladies chroniques, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Ile de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
| | - Alexandra B Cooke
- Division of Experimental Medicine, Department of Medicine, McGill University, MUHC Glen Site, Montréal, Québec, Canada
| | - Stella S Daskalopoulou
- Division of Experimental Medicine, Department of Medicine, McGill University, MUHC Glen Site, Montréal, Québec, Canada
- Cardiovascular Health Across the Lifespan (CHAL) Program, Research Institute of the McGill University Health Centre (MUHC), Montréal, Québec, Canada
- Division of Internal Medicine, Department of Medicine, McGill University, Royal Victoria Hospital, MUHC Glen Site, Montréal, Québec, Canada
| | - Bjorn T Tam
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, Québec, Canada
- Metabolism, Obesity, and Nutrition Laboratory, School of Health, Concordia University, Montréal, Québec, Canada
- Department of Sport, Physical Education, and Health, Faculty of Social Sciences, Hong Kong Baptist University, Kowloon Tong, China
| | - Sylvia Santosa
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, Québec, Canada
- Metabolism, Obesity, and Nutrition Laboratory, School of Health, Concordia University, Montréal, Québec, Canada
- Centre de recherche - Axe maladies chroniques, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Ile de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
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Pei Q, Song Y, Huang Z, Yu H, Xu H, Ye X, Gao L, Gong J, Tian X. Effects of gender-affirming hormone therapy on body fat: a retrospective case‒control study in Chinese transwomen. Lipids Health Dis 2024; 23:146. [PMID: 38760846 PMCID: PMC11100057 DOI: 10.1186/s12944-024-02131-y] [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: 02/26/2024] [Accepted: 05/06/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND There is insufficient research on how gender-affirming hormone therapy (GAHT) affects body fat modifications in transwomen from China. It is unclear whether hormone therapy affects the prevalence of obesity and blood lipid levels within this population. The current research aimed to assess how GAHT and treatment duration had an impact on the change in and redistribution of body fat in Chinese transwomen. METHODS This study included 40 transwomen who had not received GAHT and 59 who had. Body fat, blood lipid, and blood glucose levels were measured. GAHT is mainly a pharmacologic (estrogen and anti-androgen) treatment. The study also stratified participants based on the duration of GAHT to assess its impact on body fat distribution. The duration of GAHT was within one year, one to two years, two to three years, or more than three years. RESULTS After receiving GAHT, total body fat increased by 19.65%, and the percentage of body fat increased by 17.63%. The arm, corrected leg, and leg regions showed significant increases in fat content (+ 24.02%, + 50.69%, and + 41.47%, respectively) and percentage (+ 25.19%, + 34.90%, and + 30.39%, respectively). The total visceral fat content decreased (-37.49%). Based on the diagnostic standards for a body mass index ≥ 28 or total body fat percentage ≥ 25% or 30%, the chance of developing obesity did not change significantly. Blood glucose levels significantly increased (+ 12.31%). Total cholesterol levels (-10.45%) decreased significantly. Fat changes in those who received GAHT for one to two years were significantly different from those who did not receive GAHT. CONCLUSION After receiving GAHT, total body fat and regional fat increased in Chinese transwomen, and the body fat distribution changed from masculine to feminine, especially during the first two years. However, neither the increase in total body fat percentage nor the decrease in visceral fat content didn't bring about significant changes in the incidence of obesity, nor did triglycerides or low-density lipoprotein-cholesterol.
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Affiliation(s)
- Qin Pei
- School of Nursing, Jinan University, No. 601, West Huangpu Avenue, Guangzhou, Guangdong, 510632, China
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, No. 613, West Huangpu Avenue, Guangzhou, Guangdong, 510630, China
| | - Yuwei Song
- Central Laboratory, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Zhongwei Huang
- Department of Obstetrics and Gynaecology, National University Health Systems, Singapore, Singapore
| | - Hongkun Yu
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, No. 613, West Huangpu Avenue, Guangzhou, Guangdong, 510630, China
| | - Hao Xu
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, No. 613, West Huangpu Avenue, Guangzhou, Guangdong, 510630, China
| | - Xunda Ye
- Central Laboratory, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Lvfen Gao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, No. 613, West Huangpu Avenue, Guangzhou, Guangdong, 510630, China.
| | - Jian Gong
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, No. 613, West Huangpu Avenue, Guangzhou, Guangdong, 510630, China.
| | - Xiaoying Tian
- School of Nursing, Jinan University, No. 601, West Huangpu Avenue, Guangzhou, Guangdong, 510632, China.
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Pettersson S, Kalén A, Gustafsson M, Grau S, Caspers A. Off- to in-season body composition adaptations in elite male and female endurance and power event athletics competitors: an observational study. BMC Sports Sci Med Rehabil 2024; 16:90. [PMID: 38649926 PMCID: PMC11034045 DOI: 10.1186/s13102-024-00877-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Monitoring elite athletes' body composition (BC) is vital for health and optimizing performance in sports emphasizing leanness, such as athletics. This study aims to investigate and compare sex- and event-specific off-to in-season BC changes in endurance and power event athletics competitors. METHODS Elite male and female endurance athletes (> 800 m runners; n = 21) and power event athletes (sprinters, jumpers; n = 32) underwent dual-energy X-ray absorptiometry (DXA) scans for whole and regional lean mass (LM), fat mass (FM), bone mineral content (BMC), and density (BMD) during off-season (September-October) and in-season (April-May). Linear mixed models tested between-group off-season differences in BC, within-group off-season to in-season changes, and between-group differences in change. To assess meaningful or least significant changes (LSC) in BC, DXA precision errors were determined from two consecutive total body scans in a subsample of athletes (n = 30). RESULTS Male athletes (n = 26) gained significantly (p < 0.05) more body mass (BM; mean difference 1.5 [95% confidence interval (CI):0.5-2.4] kg), LM (843 [95% CI:-253:1459] g), and trunk LM (756 [-502:1156] g) than female athletes (n = 27). The proportion of changes in athlete's BC exceeding the LSC threshold for LM and trunk LM were 70% and 65% in males, and 48% and 26% in females. Significant (p < 0.05) within-group off-season to in-season increases in LM were found for male endurance and power athletes, and female power athletes. All groups significantly increased BMD (p < 0.05). Only male and female power athletes had significant in- to-off-season increases in BMC. 80% of all athletes who had a meaningful increase in BMC belonged to the power event group. No significant within- or between group change in FM was observed. CONCLUSIONS The present study found that male athletes gained more BM, LM and trunk LM than females. Within-group increases in regional and whole-body LM and BMC were predominantly found among power event competitors. Incorporating individual meaningful changes alongside traditional statistics provided additional insights into sex and event-group differences. Future research on elite athletic event groups should include DXA measurements closer to major outdoor-season competitions, coupled with site-specific measures (ultrasound, MRI) for better detection of subtle changes in LM and FM.
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Affiliation(s)
- Stefan Pettersson
- Center for Health and Performance, Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
- Swedish Olympic Committee, Sofiatornet, Olympiastadion, Stockholm, Sweden.
| | - Anton Kalén
- Swedish Olympic Committee, Sofiatornet, Olympiastadion, Stockholm, Sweden
- Department of Computer Science, Electrical and Space Engineering, Luleå University of Technology, Luleå, Sweden
| | - Mikael Gustafsson
- Center for Health and Performance, Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - Stefan Grau
- Center for Health and Performance, Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
- Department of Sports Medicine, University Clinic Tübingen, Tübingen, Germany
| | - Andreas Caspers
- Center for Health and Performance, Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
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Zhang Y, Chen GC, Sotres-Alvarez D, Perreira KM, Daviglus ML, Pirzada A, Gallo LC, Llabre MM, Cai J, Xue X, Isasi CR, Kaplan R, Qi Q. General or Central Obesity and Mortality Among US Hispanic and Latino Adults. JAMA Netw Open 2024; 7:e2351070. [PMID: 38227314 PMCID: PMC10792478 DOI: 10.1001/jamanetworkopen.2023.51070] [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: 08/28/2023] [Accepted: 11/01/2023] [Indexed: 01/17/2024] Open
Abstract
Importance The Hispanic and Latino population is the second largest ethnic group in the US, but associations of obesity parameters with mortality in this population remain unclear. Objective To investigate the associations of general and central obesity with mortality among US Hispanic and Latino adults. Design, Setting, and Participants The Hispanic Community Health Study/Study of Latinos is an ongoing, multicenter, population-based cohort study with a multistage probability sampling method performed in Hispanic and Latino adults aged 18 to 74 years with a baseline between January 1, 2008, and December 31, 2011. Active follow-up for this analyses extended from baseline through February 17, 2022. All analyses accounted for complex survey design (ie, stratification and clustering) and sampling weights to generate estimates representing the noninstitutionalized, 18- to 74-year-old Hispanic or Latino populations from selected communities. Exposures Body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), body fat percentage, waist circumference (WC), and waist to hip ratio (WHR). Main Outcome and Measure Deaths were ascertained via death certificates, the National Death Index, and active follow-up. Results Of 15 773 adults (mean [SE] age, 40.9 [0.3] years; 52.8% female), 686 deaths occurred during a median (IQR) follow-up of 10.0 (9.9-10.2) years. When adjusting for sociodemographic, lifestyle, and family history covariates, hazard ratios (HRs) for mortality were 1.55 (95% CI, 1.08-2.22) for a BMI of 35.0 or greater vs 18.5 to 24.9, 1.22 (95% CI, 0.92-1.64) for the highest vs lowest body fat percentage groups (defined according to sex-, age-, and Hispanic or Latino background-specific BMI distribution), 1.35 (95% CI, 0.98-1.85) for WC greater than 102 cm (men) or 88 cm (women) vs 94 cm (men) or 80 cm (women) or less, and 1.91 (95% CI, 1.28-2.86) for WHR of 0.90 (men) or 0.85 (women) or greater vs less than 0.90 (men) or 0.85 (women). Only WHR was associated with mortality with additional adjustment for major comorbidities (HR, 1.75; 95% CI, 1.17-2.62). The association of WHR with mortality was stronger among women compared with men (P = .03 for interaction), and the association between BMI and mortality was stronger among men (P = .02 for interaction). The positive association between severe obesity (BMI ≥ 35.0) and mortality was observed only among adults with WHR of 0.90 (men) or 0.85 (women) or greater but not among those with WHR below 0.90 (men) or 0.85 (women) (P = .005 for interaction) who had greater hip circumference. Conclusions and Relevance In this cohort of US Hispanic and Latino adults, WHR was independently associated with higher all-cause mortality regardless of BMI and prevalent comorbidities. These findings suggest that prioritizing clinical screening and intervention for WHR in this population may be an important public health strategy, with sex-specific strategies potentially being needed.
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Affiliation(s)
- Yanbo Zhang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Guo-Chong Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Krista M. Perreira
- Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill
| | | | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois, Chicago
| | - Linda C. Gallo
- Department of Psychology, San Diego State University, San Diego, California
| | - Maria M. Llabre
- Department of Psychology, University of Miami, Miami, Florida
| | - Jianwen Cai
- Department of Biostatistics, Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Xiaonan Xue
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Carmen R. Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Robert Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Qibin Qi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
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Novaes JFD, Filgueiras MDS, Suhett LG, Silva MA, Albuquerque FMD, Priulli É, Oliveira LLD, Peluzio MDCG. Associations of adiposity and adipokine concentrations with anti- and oxidative markers in Brazilian children. Nutrition 2023; 109:111993. [PMID: 36933280 DOI: 10.1016/j.nut.2023.111993] [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: 10/10/2022] [Revised: 01/23/2023] [Accepted: 01/27/2023] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the association of body fat, anti- and inflammatory adipokines with anti- and oxidative markers. METHODS We conducted a cross-sectional study with 378 schoolchildren ages 8 to 9 y in Viçosa, Minas Gerais, Brazil. We obtained information on sociodemographic and lifestyle characteristics via questionnaires, measured height and weight, and estimated body fat by dual energy x-ray absorptiometry. Blood sample was collected to analyze the adipokines (adiponectin, leptin, chemerin, and retinol-binding protein 4) by enzyme-linked immunosorbent assay based on the sandwich principle; and anti- and oxidant markers (plasma ferric reducing antioxidant power [FRAP], superoxide dismutase [SOD], and malondialdehyde [MDA]) by enzymatic methods. Concentrations of anti- and oxidant markers were compared by percent body fat quartiles and adipokine concentrations terciles using of linear regression adjusted for potential confounders. RESULTS Total and central body fat were positively associated with FRAP. Every 1 standard deviation (SD) of total fat was associated with 4.8 higher FRAP (95% confidence interval [CI], 2.7-7). Additionally, every 1 SD of truncal, android, and gynoid fat were associated with, respectively, 5, 4.6, and 4.6 higher FRAP (95% CI, 2.9-7.1; 2.6-6.7; and 2.4-6.8, respectively). However, adiponectin was inversely associated with FRAP; every adiponectin SD was related to -2.2 lower FRAP (95% CI, -3.9 to -0.5). Chemerin was positively associated with SOD [5.4 (95% CI, 1.9-8.8) SOD units per chemerin SD]. CONCLUSIONS The body fat measures and adiposity-related inflammation (chemerin) were positively associated with antioxidative markers in children, whereas the adiponectin (anti-inflammatory marker) was inversely associated with FRAP (antioxidative marker).
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Affiliation(s)
| | | | - Lara Gomes Suhett
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, United States
| | | | | | - Érica Priulli
- Department of Nutrition and Health, Universidade Federal de Viçosa, Minas Gerais, Brazil
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Hou YC, Liu YM, Liao MT, Zheng CM, Lu CL, Liu WC, Hung KC, Lin SM, Lu KC. Indoxyl sulfate mediates low handgrip strength and is predictive of high hospitalization rates in patients with end-stage renal disease. Front Med (Lausanne) 2023; 10:1023383. [PMID: 36817773 PMCID: PMC9932816 DOI: 10.3389/fmed.2023.1023383] [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: 08/19/2022] [Accepted: 01/17/2023] [Indexed: 02/05/2023] Open
Abstract
Background and aims Sarcopenia has a higher occurrence rate in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) than in the general population. Low handgrip strength-and not sarcopenia per se-is associated with clinical outcomes in patients with CKD, including cardiovascular mortality and hospitalization. The factors contributing to low handgrip strength are still unknown. Accordingly, this study aimed to determine whether uremic toxins influence low handgrip strength in patients with CKD. Materials and methods This cohort study lasted from August 2018 to January 2020. The participants were divided into three groups: the control group [estimated glomerular filtration rate (eGFR) ≥ 60 ml/min], an advanced CKD group (eGFR = 15-60 ml/min), and an ESRD group (under maintenance renal replacement therapy). All participants underwent handgrip strength measurement, dual-energy X-ray absorptiometry, and blood sampling for myokines (irisin, myostatin, and interleukin 6) and indoxyl sulfate. Sarcopenia was defined according to the Asian Working Group for Sarcopenia consensus as low appendicular skeletal muscle index (appendicular skeletal muscle/height2 of < 7.0 kg/m2 in men and < 5.4 kg/m2 in women) and low handgrip strength (< 28 kg in men and < 18 kg in women). Results Among the study participants (control: n = 16; CKD: n = 17; and ESRD: n = 42), the ESRD group had the highest prevalence of low handgrip strength (41.6 vs. 25% and 5.85% in the control and CKD groups, respectively; p < 0.05). The sarcopenia rate was similar among the groups (12.5, 17.6, and 19.5% for the control, CKD, and ESRD groups, respectively; p = 0.864). Low handgrip strength was associated with high hospitalization rates within the total study population during the 600-day follow-up period (p = 0.02). The predictions for cardiovascular mortality and hospitalization were similar among patients with and without sarcopenia (p = 0.190 and p = 0.094). The serum concentrations of indoxyl sulfate were higher in the ESRD group (227.29 ± 92.65 μM vs. 41.97 ± 43.96 μM and 6.54 ± 3.45 μM for the CKD and control groups, respectively; p < 0.05). Myokine concentrations were similar among groups. Indoxyl sulfate was associated with low handgrip strength in univariate and multivariate logistic regression models [univariate odds ratio (OR): 3.485, 95% confidence interval (CI): 1.372-8.852, p = 0.001; multivariate OR: 8.525, 95% CI: 1.807-40.207, p = 0.007]. Conclusion Handgrip strength was lower in the patients with ESRD, and low handgrip strength was predictive of hospitalization in the total study population. Indoxyl sulfate contributed to low handgrip strength and counteracted the benefits of myokines in patients with CKD.
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Affiliation(s)
- Yi-Chou Hou
- Division of Nephrology, Department of Internal Medicine, Cardinal Tien Hospital, New Taipei City, Taiwan
- School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Yueh-Min Liu
- Department of Nursing, Ching Kuo Institute of Management and Health, Keelung, Taiwan
| | - Min-Ter Liao
- Department of Pediatrics, Taoyuan Armed Forces General Hospital, Hsinchu, Taiwan
- Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan
| | - Cai-Mei Zheng
- Division of Nephrology, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
- Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
- Taipei Medical University-Research Center of Urology and Kidney (TMU-RCUK), School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Chien-Lin Lu
- School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
- Division of Nephrology, Department of Medicine, Fu Jen Catholic University Hospital, School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Wen-Chih Liu
- Division of Nephrology, Department of Internal Medicine, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
- Department of Biology and Anatomy, National Defense Medical Center, Taipei City, Taiwan
| | - Kuo-Chin Hung
- Division of Nephrology, Department of Medicine, Min-Sheng General Hospital, Taoyuan City, Taiwan
| | - Shyh-Min Lin
- Division of Radiology, Department of Medicine, Cardinal Tien Hospital, New Taipei City, Taiwan
| | - Kuo-Cheng Lu
- School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
- Division of Nephrology, Department of Medicine, Fu Jen Catholic University Hospital, School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
- Division of Nephrology, Department of Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
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Valsdottir TD, Øvrebø B, Kornfeldt TM, Litleskare S, Johansen EI, Henriksen C, Jensen J. Effect of aerobic exercise and low-carbohydrate high-fat diet on glucose tolerance and android/gynoid fat in overweight/obese women: A randomized controlled trial. Front Physiol 2023; 14:1056296. [PMID: 36760521 PMCID: PMC9902511 DOI: 10.3389/fphys.2023.1056296] [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: 09/28/2022] [Accepted: 01/09/2023] [Indexed: 01/25/2023] Open
Abstract
The study was designed to compare the effects of weight loss induced by a low-carbohydrate-high-fat diet or a normal diet, with and without exercise, on glucose tolerance measured as area under the curve (AUC), and android (A) and gynoid (G) fat distribution. The study was registered at clinicaltrials.gov; NCT04100356. In total, 57 women classified as overweight or obese (age 40 ± 3.5 years, body mass index 31.1 ± 2.6 kg/m2) were randomly assigned and completed a 10-week intervention using a low-carbohydrate high-fat diet or a normal diet, with or without aerobic interval exercise. An equal deficit of 700 kcal/day was prescribed, either restricting the diet only, or moderately restricting diet and including three 50-min high-intensity bicycle sessions per week. There were thus four groups: normal diet (NORM); low-carbohydrate-high-fat diet (LCHF); normal diet with exercise (NORM-EX); and low-carbohydrate-high-fat diet with exercise (LCHF-EX). Linear mixed models was used to assess differences between groups. With all groups pooled, the intervention resulted in a weight loss of 6.7 ± 2.5% (p < 0.001). The intervention did not result in differences between groups in AUC glucose, nor in fasting glucose or indicis for insulin resistance such as Homeostatic Model Assessment, Matsuda Insulin Sensitivity Index, insulinogenic index and disposition index. Post-intervention android fat was lower in LCHF than NORM (3,223 ± 727 vs. 2,533 ± 535 g, p = 0.041). LCHF reached a lower A/G ratio than NORM (0.94 ± 0.12 vs. 1.04 ± 0.09, p = 0.011) and LCHF-EX (0.94 ± 0.12 vs. 1.09 ± 0.09, p < 0.001) after the intervention. LCHF resulted in lower android fat mass compared to NORM and the lowest A/G ratio compared to the other matched groups, but with no accompanying improvement in AUC glucose. In conclusion, although all groups achieved improvements in glucose tolerance, no superior effect was observed with the LCHF diet, neither with nor without exercise.
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Affiliation(s)
- Thorhildur Ditta Valsdottir
- Institute of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway,Department of Health Sciences, Kristiania University College, Oslo, Norway,*Correspondence: Thorhildur Ditta Valsdottir,
| | - Bente Øvrebø
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Thea Martine Kornfeldt
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Sigbjørn Litleskare
- Department of Sports and Physical Education, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Egil Ivar Johansen
- Department of Health Sciences, Kristiania University College, Oslo, Norway
| | - Christine Henriksen
- Institute of Basic Medical Sciences, Department of Nutrition, Faculty of Medicine University of Oslo, Oslo, Norway
| | - Jørgen Jensen
- Department of Health Sciences, Kristiania University College, Oslo, Norway
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Wang Y, Zhu L, James-Todd T, Sun Q. Urinary polycyclic aromatic hydrocarbon excretion and regional body fat distribution: evidence from the U.S. National Health and Nutrition Examination Survey 2001-2016. Environ Health 2022; 21:75. [PMID: 35945606 PMCID: PMC9364531 DOI: 10.1186/s12940-022-00890-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 07/24/2022] [Indexed: 05/06/2023]
Abstract
BACKGROUND Polycyclic aromatic hydrocarbons (PAHs) are environmental pollutants that may contribute to the etiology of obesity. However, it is unclear whether PAHs from environmental sources are associated with regional body fat distribution, and whether the association varies across racial/ethnic groups who may have differential PAH exposure patterns. OBJECTIVES To examine correlations between PAHs and body fat distribution, and potential racial/ethnic differences among U.S. adults. METHODS Ten PAHs were measured in spot urine samples from 2691 non-smoking adults (age ≥ 20 years) in the NHANES 2001-2016. Dual-energy X-ray absorptiometry was used to measure fat mass percent (FM%). Partial Pearson correlation coefficients (r) with multivariable adjustment were used to assess PAH-FM% associations. RESULTS In the total population, 1-naphthalene, 3-fluorene, and 1-pyrene were inversely correlated with total FM% or trunk FM% (adjusted r ranged: - 0.06 to - 0.08), while 2-naphthalene, 9-fluorene, and 4-phenanthrene were positively correlated with the FM% measurements (r: 0.07-0.11). PAH levels are highest among non-Hispanic Blacks, followed by Hispanics and Whites and some of the correlations were different by these races/ethnicities. Among non-Hispanic Whites, no PAH was correlated with FM%. In contrast, 9-fluorene was positively correlated with total FM% (r = 0.20) and trunk FM% (r = 0.22) among Blacks, and 4-phenanthrene was positively correlated with total FM% (r = 0.23) and trunk FM% (r = 0.24) among Hispanics (P-interaction: 0.010-0.025). DISCUSSION In this US adult population, certain PAHs are significantly associated with higher body fat contents among non-Hispanic Blacks and Hispanics but not non-Hispanic Whites, suggesting that minority groups might be particularly susceptible to PAH's obesogenic effects or the effects of other factors that determine the PAH exposure levels. Alternatively, differences in body composition may contribute to differential PAH metabolism in minority groups. Future studies are warranted to explore the racial/ethnic disparity in PAH exposures, drivers of these exposure differences, and mechanisms through which PAHs may influence body composition by races/ethnicities.
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Affiliation(s)
- Yeli Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Lu Zhu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Tamarra James-Todd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Qi Sun
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.
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9
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Barale M, Massano M, Bioletto F, Maiorino F, Pusterla A, Mazzetti R, Trentini L, Bonora S, Di Perri G, Ghigo E, Procopio M. Sex-specific fat mass ratio cutoff value identifies a high prevalence of cardio-metabolic disorders in people living with HIV. Nutr Metab Cardiovasc Dis 2022; 32:1936-1943. [PMID: 35680489 DOI: 10.1016/j.numecd.2022.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS HIV-associated lipodystrophy syndrome (HALS) contributes to the increased cardiovascular risk connoting people living with HIV (PLHIV). HALS recognition, based on clinical ground, may be inaccurate urging an objective instrumental diagnosis. The aim of this study is to search for the DXA-derived fat mass ratio (FMR) threshold, among those suggested for the diagnosis of HALS, able to identify PLHIV at high cardiovascular risk. METHODS AND RESULTS In a cross-sectional analysis of 101 PLHIV (age 53 ± 11 years, men 55%) and 101 age- and sex-matched uninfected controls, DXA-derived FMR and anthropometric as well as cardio-metabolic parameters were assessed. PLHIV showed a higher FMR (1.15 ± 0.42 vs 0.95 ± 0.18, p < 0.01) together with a greater cardio-metabolic derangement than controls, in spite of lower BMI (24.3 ± 4.3 vs 26.9 ± 4.0 kg/m2, p < 0.01) and fat mass index (FMI, 6.6 ± 3.0 vs 9.2 ± 3.1 kg/m2, p < 0.01). Particularly, PLHIV with HALS (n = 28), defined as those with a FMR above 1.260 and 1.329 for men and women, respectively, had a greater prevalence of type 2 diabetes mellitus (18% vs 1%), insulin resistance (68% vs 27%), hypertriglyceridemia (50% vs 29%), hypertension (61% vs 30%) and metabolic syndrome (32% vs 10%) than those without HALS (p < 0.05 for all comparisons) and controls. At multivariate analyses, FMR in PLHIV was significantly associated (p < 0.05) with fasting glucose (β [95%CI] = 0.5, [0.1-0.9]), insulin (44.6, [14.9-74.2]), HOMA-IR (1.6, [0.5-2.7]), triglycerides (1.0, [ 0.2-1.8]) and HDL-cholesterol (-2.1, [-3.9/-0.4]) levels. CONCLUSION Sex-specific FMR thresholds, proposed for diagnosis of HALS, could represent new indices of cardio-metabolic derangement in PLHIV.
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Affiliation(s)
- M Barale
- Division of Endocrinology, Diabetology and Metabolic Diseases, Department of General and Specialty Medicine, Molinette Hospital, University of Turin - Cso Dogliotti, 14-10126, Turin, Italy.
| | - M Massano
- Division of Endocrinology, Diabetology and Metabolic Diseases, Department of General and Specialty Medicine, Molinette Hospital, University of Turin - Cso Dogliotti, 14-10126, Turin, Italy
| | - F Bioletto
- Division of Endocrinology, Diabetology and Metabolic Diseases, Department of General and Specialty Medicine, Molinette Hospital, University of Turin - Cso Dogliotti, 14-10126, Turin, Italy
| | - F Maiorino
- Division of Endocrinology, Diabetology and Metabolic Diseases, Department of General and Specialty Medicine, Molinette Hospital, University of Turin - Cso Dogliotti, 14-10126, Turin, Italy
| | - A Pusterla
- Division of Endocrinology, Diabetology and Metabolic Diseases, Department of General and Specialty Medicine, Molinette Hospital, University of Turin - Cso Dogliotti, 14-10126, Turin, Italy
| | - R Mazzetti
- Radiology Unit, Department of Diagnostic Imaging and Interventional Radiology, Molinette Hospital, University of Turin - Cso Dogliotti, 14-10126, Turin, Italy
| | - L Trentini
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin - Corso Svizzera, 164-10149, Turin, Italy
| | - S Bonora
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin - Corso Svizzera, 164-10149, Turin, Italy
| | - G Di Perri
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin - Corso Svizzera, 164-10149, Turin, Italy
| | - E Ghigo
- Division of Endocrinology, Diabetology and Metabolic Diseases, Department of General and Specialty Medicine, Molinette Hospital, University of Turin - Cso Dogliotti, 14-10126, Turin, Italy
| | - M Procopio
- Division of Endocrinology, Diabetology and Metabolic Diseases, Department of General and Specialty Medicine, Molinette Hospital, University of Turin - Cso Dogliotti, 14-10126, Turin, Italy
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10
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Zhu Y, Wang Z, Maruyama H, Onoda K, Huang Q. Body Fat Percentage and Normal-Weight Obesity in the Chinese Population: Development of a Simple Evaluation Indicator Using Anthropometric Measurements. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074238. [PMID: 35409919 PMCID: PMC8998592 DOI: 10.3390/ijerph19074238] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/29/2022] [Accepted: 03/29/2022] [Indexed: 02/06/2023]
Abstract
Few studies explore the associations between body fat percentage (BFP) prediction and evaluation indicators for Chinese with normal-weight obesity. We aimed to explore convenient and cost-free BFP evaluation indicators to routinely monitor BFP status in Chinese patients with normal-weight obesity. Participants (N = 164) were divided into three groups according to body mass index (BMI) and BFP: normal-weight lean, normal-weight obese, and overweight and obese. Differences in body composition and circumference were compared to examine the relationship between BFP and circumference, determine a simple evaluation indicator reflecting BFP, and identify cutoff values for normal-weight obesity circumference. Significant differences in body composition and circumference were observed among the three groups. The correlation between thigh/height, hip/height, (hip + waist)/height, and BFP was stronger than that with BMI. The (hip + waist)/height ratio was the indicator most reflective of BFP (95% confidence interval: 3.004−9.018, p = 0.013), and a ratio above 1.115 (95% confidence interval: 0.936−0.992, p < 0.001) was predictive of normal-weight obesity. Furthermore, we suggest that the upper value for a normal BMI in Chinese individuals be lowered to 23.4 kg/m2 (95% confidence interval: 0.984−0.999, p < 0.001). The (hip + waist)/height ratio can be used with body mass index for a more accurate evaluations of BFP abnormalities and health risks.
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Affiliation(s)
- Yuetong Zhu
- Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Tochigi 324-8501, Japan;
| | - Zimin Wang
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto 606-8397, Japan
- Correspondence: ; Tel.: +81-070-3610-1857
| | - Hitoshi Maruyama
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare, Tochigi 324-8501, Japan; (H.M.); (K.O.)
| | - Ko Onoda
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare, Tochigi 324-8501, Japan; (H.M.); (K.O.)
| | - Qiuchen Huang
- Department of Physical Therapy, School of Rehabilitation Medicine, Capital Medical University, Beijing 100069, China;
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11
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Fitch AK, Bays HE. Obesity definition, diagnosis, bias, standard operating procedures (SOPs), and telehealth: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022. OBESITY PILLARS (ONLINE) 2022; 1:100004. [PMID: 37990702 PMCID: PMC10661988 DOI: 10.1016/j.obpill.2021.100004] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 12/20/2021] [Indexed: 11/23/2023]
Abstract
Background The Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) regarding definition, diagnosis, bias, standard operating procedures (SOPs) and telehealth is intended to provide clinicians an overview of obesity medicine and provide basic organizational tools towards establishing, directing, managing, and maintaining an obesity medical practice. Methods This CPS is based upon published scientific citations, clinical perspectives of OMA authors, and peer review by Obesity Medicine Association leadership. Results OMA has defined obesity as: "A chronic, progressive, relapsing, and treatable multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences." While body mass index may be sufficiently diagnostic for populations and many patients, accurate diagnosis of adiposity in an individual may require anthropometric assessments beyond body weight alone (e.g., waist circumference, percent body fat, and android/visceral fat). Obesity complications can be categorized as "sick fat disease" (adiposopathy) and/or "fat mass disease." Obesity complications predominantly of fat mass origins include sleep apnea and orthopedic conditions. Obesity complications due to adiposopathic endocrinopathies and/or immunopathies include cardiovascular disease, cancer, elevated blood sugar, elevated blood pressure, dyslipidemia, fatty liver, and alterations in sex hormones in both males (i.e., hypogonadism) and females (i.e., polycystic ovary syndrome). Obesity treatment begins with proactive steps to avoid weight bias, including patient-appropriate language, office equipment, and supplies. To help manage obesity and its complications, this CPS provides a practical template for an obesity medicine practice, creation of standard operating procedures, and incorporation of the OMA "ADAPT" method in telehealth (Assessment, Diagnosis, Advice, Prognosis, and Treatment). Conclusions The OMA CPS regarding "Obesity Definition, Diagnosis, Bias, Standard Operating Procedures (SOPs), and Telehealth" is one in a series of OMA CPSs designed to assist clinicians care for patients with the disease of obesity.
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Affiliation(s)
- Angela K. Fitch
- Massachusetts General Hospital Weight Center, Harvard Medical School, 50 Staniford Street Suite 430, Boston, MA, 02114, USA
| | - Harold E. Bays
- Louisville Metabolic and Atherosclerosis Research Center, University of Louisville School of Medicine, 3288 Illinois Avenue, Louisville, KY, 40213, USA
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12
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Exercise Training Combined with Calanus Oil Supplementation Improves the Central Cardiodynamic Function in Older Women. Nutrients 2021; 14:nu14010149. [PMID: 35011022 PMCID: PMC8747381 DOI: 10.3390/nu14010149] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 12/12/2022] Open
Abstract
The aim of this study was to investigate the possible beneficial effects of exercise training (ET) with omega-3/Calanus oil supplementation on cardiorespiratory and adiposity parameters in elderly women. Fifty-five women (BMI: 19–37 kg/m2, 62–80 years old) were recruited and randomly assigned to the 4 month intervention with ET and omega-3 supplementation (Calanus oil, ET-Calanus) or ET and the placebo (sunflower oil; ET-Placebo). The body composition was determined by dual-energy X-ray absorptiometry (DXA), and cardiorespiratory parameters were measured using spiroergometry and PhysioFlow hemodynamic testing. Both interventions resulted in an increased lean mass whereas the fat mass was reduced in the leg and trunk as well as the android and gynoid regions. The content of trunk fat (in percent of the total fat) was lower and the content of the leg fat was higher in the ET-Calanus group compared with the ET-Placebo. Although both interventions resulted in similar improvements in cardiorespiratory fitness (VO2max), it was explained by an increased peripheral oxygen extraction (a-vO2diff) alone in the ET-Placebo group whereas increased values of both a-vO2diff and maximal cardiac output (COmax) were observed in the ET-Calanus group. Changes in COmax were associated with changes in systemic vascular resistance, circulating free fatty acids, and the omega-3 index. In conclusion, Calanus oil supplementation during a 4 month ET intervention in elderly women improved the cardiorespiratory function, which was due to combined central and peripheral cardiodynamic mechanisms.
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13
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LoMauro A, Landoni CV, Fraschini P, Molteni F, Aliverti A, Bertoli S, De Amicis R. Eat, breathe, sleep with Osteogenesis Imperfecta. Orphanet J Rare Dis 2021; 16:435. [PMID: 34663416 PMCID: PMC8522055 DOI: 10.1186/s13023-021-02058-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/30/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Although Osteogenesis Imperfecta (OI) affects the connective tissue causing extremely brittle bones with consequent skeletal deformities, it is important to go beyond bones. Indeed, the quality of life in OI does not only depend on bones status, as OI might affect also other important functions. We have therefore implemented a multidisciplinary study to assess lung function, breathing pattern, sleep quality and nutritional status in 27 adult OI type III and IV patients (median age: 34.6 years; 19 women; 14 type III). RESULTS According to nocturnal oxygen desaturation, two groups were identified: 13 patients with (OI_OSA, incidence: 48.2%) and 14 without (no_OSA) obstructive sleep apnea. The former was characterized by higher spinal and ribcage deformity, by more restrictive lung function, by paradoxical thoracic breathing in supine position, by rapid and shallow breathing, by higher body mass index, by longer neck and waist circumferences; by higher abdominal volume and by greater percentage of body fat mass, particularly localized in the trunk. The best predictor of OI_OSA was the negative value of the supine ribcage contribution to tidal volume, followed by the ratio between the neck and the waist circumferences with body height and the supine thoraco-abdominal volumes phase shift angle. CONCLUSIONS The pathophysiology of OI ensued a dangerous vicious circle, in which breathing, sleep and nutritional status are tightly linked, and they might all end up in negatively affecting the quality of life. The vicious circle is fed by some intrinsic characteristics of the disease (thoracic, cranial and mandibular deformities) and some bad daily habits of the patients (i.e. physical inactivity and low dietary quality). The former impacts on restricting the respiratory function, the latter makes Olers more prone to experience overweight or obesity. The main consequence is a high incidence of obstructive sleep apnea, which remains an underdiagnosed disorder in individuals with severe OI who are obese, with a neck to height ratio over than 31.6%, and characterized by paradoxical breathing in supine position. A multidisciplinary approach, including evaluations of breathing, sleep and nutrition, is required to better manage the disease and fulfil the maximizing well-being of OI patients.
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Affiliation(s)
- Antonella LoMauro
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Piazza Leonardo Da Vinci, 20133, Milano, Italy.
| | | | - Paolo Fraschini
- IRCCS "Eugenio Medea" - Rehabilitation Unit, Bosisio Parini (LC), Italy
| | - Franco Molteni
- Valduce Hospital - Villa Beretta Rehabilitation Centre, Lecco, Italy
| | - Andrea Aliverti
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Piazza Leonardo Da Vinci, 20133, Milano, Italy
| | - Simona Bertoli
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy
- Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Ramona De Amicis
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy
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14
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Christakoudi S, Tsilidis KK, Evangelou E, Riboli E. Association of body-shape phenotypes with imaging measures of body composition in the UK Biobank cohort: relevance to colon cancer risk. BMC Cancer 2021; 21:1106. [PMID: 34654381 PMCID: PMC8518225 DOI: 10.1186/s12885-021-08820-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 09/30/2021] [Indexed: 02/07/2023] Open
Abstract
Background Body mass index (BMI), waist and hip circumference are strongly correlated and do not reflect body composition. A Body Shape Index (ABSI) and Hip Index (HI) define waist and hip size among individuals with the same weight and height and would thus reflect body density. We examined differences in body composition between body-shape phenotypes defined with ABSI and HI and used this information to propose explanations for associations between body-shape phenotypes and colon cancer risk. Methods We used data from the UK Biobank Resource for 15,520 men, 16,548 women with dual-emission X-ray absorptiometry (DXA) measurements; 3997 men, 4402 women with magnetic resonance imaging (MRI) measurements; 200,289 men, 230,326 women followed-up for colon cancer. We defined body-shape phenotypes as: large-ABSI-small-HI (“apple”), small-ABSI-large-HI (“pear”), small-ABSI-small-HI (“slim”), large-ABSI-large-HI (“wide”). We evaluated differences in body composition in linear models and associations with colon cancer risk in Cox proportional hazards models adjusted for confounders and explored heterogeneity by BMI. Results Among individuals with the same height and weight, visceral adipose tissue (VAT) was lowest for “pear” and highest for “apple”, while abdominal subcutaneous adipose tissue (ASAT) was lowest for “slim” and highest for “wide” phenotype. In the gynoid region, differences between “apple” and “pear” phenotypes were accounted for mainly by fat mass in women but by lean mass in men. In men, lean mass was inversely associated with waist size, while the pattern of gynoid fat resembled ASAT in women. Lean and fat mass were higher for higher BMI, but not hand grip strength. Compared to normal weight “pear”, the risk of colon cancer in men (1029 cases) was higher for “apple” phenotype for normal weight (hazard ratio HR = 1.77; 95% confidence interval: 1.16–2.69) and comparably for overweight and obese, higher for “wide” phenotype for overweight (HR = 1.60; 1.14–2.24) and comparably for obese, but higher for “slim” phenotype only for obese (HR = 1.98; 1.35–2.88). Associations with colon cancer risk in women (889 cases) were weaker. Conclusions ABSI-by-HI body-shape phenotypes provide information for body composition. Colon cancer risk in men appears related to ASAT quantity for “slim” and “wide” but to factors determining VAT accumulation for “apple” phenotype. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08820-6.
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Affiliation(s)
- Sofia Christakoudi
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk place, London, W2 1PG, UK. .,MRC Centre for Transplantation, King's College London, Great Maze Pond, London, SE1 9RT, UK.
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk place, London, W2 1PG, UK.,Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Evangelos Evangelou
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk place, London, W2 1PG, UK.,Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk place, London, W2 1PG, UK
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Thomas AL, Alarcon PC, Divanovic S, Chougnet CA, Hildeman DA, Moreno-Fernandez ME. Implications of Inflammatory States on Dysfunctional Immune Responses in Aging and Obesity. FRONTIERS IN AGING 2021; 2:732414. [PMID: 35822048 PMCID: PMC9261339 DOI: 10.3389/fragi.2021.732414] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/25/2021] [Indexed: 12/16/2022]
Abstract
Aging and obesity are two conditions characterized by chronic, low-grade inflammation. While both conditions are also associated with dysfunctional immune responses, the shared and distinct underlying mechanisms are just starting to be uncovered. In fact, recent findings have suggested that the effects of obesity on the immune system can be thought of as a state of accelerated aging. Here we propose that chronic, low-grade inflammation seen in obesity and aging is complex, affects multiple cell types, and results in an altered basal immune state. In aging, part of this altered state is the emergence of regulatory immune populations that lead to further immune dysfunction in an attempt to reduce chronic inflammation. While in obesity, part of the altered state is the effect of expanding adipose tissue on immune cell function. Thus, in this review, we compare, and contrast altered immune states in aging and obesity and discuss their potential contribution to a shared clinical problem- decreased vaccine responsiveness.
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Affiliation(s)
- Alyssa L. Thomas
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Division of Immunobiology Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Immunology Graduate Program and Medical Scientist Training Program, Cincinnati Children's Hospital Medical Center and The University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Pablo C. Alarcon
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Division of Immunobiology Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Immunology Graduate Program and Medical Scientist Training Program, Cincinnati Children's Hospital Medical Center and The University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Medical Scientist Training Program, Cincinnati Children’s Hospital Medical Center and The University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Senad Divanovic
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Division of Immunobiology Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Immunology Graduate Program and Medical Scientist Training Program, Cincinnati Children's Hospital Medical Center and The University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Medical Scientist Training Program, Cincinnati Children’s Hospital Medical Center and The University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Center for Inflammation and Tolerance, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Claire A. Chougnet
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Division of Immunobiology Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Immunology Graduate Program and Medical Scientist Training Program, Cincinnati Children's Hospital Medical Center and The University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - David A. Hildeman
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Division of Immunobiology Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Immunology Graduate Program and Medical Scientist Training Program, Cincinnati Children's Hospital Medical Center and The University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Medical Scientist Training Program, Cincinnati Children’s Hospital Medical Center and The University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Center for Transplant Immunology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Maria E. Moreno-Fernandez
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Division of Immunobiology Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
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16
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Christakoudi S, Tsilidis KK, Evangelou E, Riboli E. A Body Shape Index (ABSI), hip index, and risk of cancer in the UK Biobank cohort. Cancer Med 2021; 10:5614-5628. [PMID: 34196490 PMCID: PMC8366087 DOI: 10.1002/cam4.4097] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/21/2021] [Accepted: 06/07/2021] [Indexed: 12/16/2022] Open
Abstract
Abdominal size is associated positively with the risk of some cancers but the influence of body mass index (BMI) and gluteofemoral size is unclear because waist and hip circumference are strongly correlated with BMI. We examined associations of 33 cancers with A Body Shape Index (ABSI) and hip index (HI), which are independent of BMI by design, and compared these with waist and hip circumference, using multivariable Cox proportional hazards models in UK Biobank. During a mean follow-up of 7 years, 14,682 incident cancers were ascertained in 200,289 men and 12,965 cancers in 230,326 women. In men, ABSI was associated positively with cancers of the head and neck (hazard ratio HR = 1.14; 95% confidence interval 1.03-1.26 per one standard deviation increment), esophagus (adenocarcinoma, HR = 1.27; 1.12-1.44), gastric cardia (HR = 1.31; 1.07-1.61), colon (HR = 1.18; 1.10-1.26), rectum (HR = 1.13; 1.04-1.22), lung (adenocarcinoma, HR = 1.16; 1.03-1.30; squamous cell carcinoma [SCC], HR = 1.33; 1.17-1.52), and bladder (HR = 1.15; 1.04-1.27), while HI was associated inversely with cancers of the esophagus (adenocarcinoma, HR = 0.89; 0.79-1.00), gastric cardia (HR = 0.79; 0.65-0.96), colon (HR = 0.92; 0.86-0.98), liver (HR = 0.86; 0.75-0.98), and multiple myeloma (HR = 0.86; 0.75-1.00). In women, ABSI was associated positively with cancers of the head and neck (HR = 1.27; 1.10-1.48), esophagus (SCC, HR = 1.37; 1.07-1.76), colon (HR = 1.08; 1.01-1.16), lung (adenocarcinoma, HR = 1.17; 1.06-1.29; SCC, HR = 1.40; 1.20-1.63; small cell, HR = 1.39; 1.14-1.69), kidney (clear-cell, HR = 1.25; 1.03-1.50), and post-menopausal endometrium (HR = 1.11; 1.02-1.20), while HI was associated inversely with skin SCC (HR = 0.91; 0.83-0.99), post-menopausal kidney cancer (HR = 0.77; 0.67-0.88), and post-menopausal melanoma (HR = 0.90; 0.83-0.98). Unusually, ABSI was associated inversely with melanoma in men (HR = 0.89; 0.82-0.96) and pre-menopausal women (HR = 0.77; 0.65-0.91). Waist and hip circumference reflected associations with BMI, when examined individually, and provided biased risk estimates, when combined with BMI. In conclusion, preferential positive associations of ABSI or inverse of HI with several major cancers indicate an important role of factors determining body shape in cancer development.
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Affiliation(s)
- Sofia Christakoudi
- Department of Epidemiology and BiostatisticsSchool of Public HealthImperial College LondonNorfolk Place, LondonUK
- MRC Centre for TransplantationKing’s College LondonLondonUK
| | - Konstantinos K. Tsilidis
- Department of Epidemiology and BiostatisticsSchool of Public HealthImperial College LondonNorfolk Place, LondonUK
- Department of Hygiene and EpidemiologyUniversity of Ioannina School of MedicineIoanninaGreece
| | - Evangelos Evangelou
- Department of Epidemiology and BiostatisticsSchool of Public HealthImperial College LondonNorfolk Place, LondonUK
- Department of Hygiene and EpidemiologyUniversity of Ioannina School of MedicineIoanninaGreece
| | - Elio Riboli
- Department of Epidemiology and BiostatisticsSchool of Public HealthImperial College LondonNorfolk Place, LondonUK
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Cirnigliaro CM, La Fountaine MF, Hobson JC, Kirshblum SC, Dengel DR, Spungen AM, Bauman WA. Predicting Cardiometabolic Risk From Visceral Abdominal Adiposity in Persons With Chronic Spinal Cord Injury. J Clin Densitom 2021; 24:442-452. [PMID: 34001430 DOI: 10.1016/j.jocd.2021.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 03/26/2021] [Accepted: 03/29/2021] [Indexed: 01/19/2023]
Abstract
Persons with spinal cord injury (SCI) have increased adiposity that may predispose to cardiovascular disease compared to those who are able-bodied (AB). The purpose of this study was to determine the relationships between dual energy X-ray absorptiometry (DXA)-derived visceral adipose tissue (VAT) and biomarkers of lipid metabolism and insulin resistance in persons with chronic SCI. A prospective observational study in participants with chronic SCI and age- and gender-matched AB controls. The study was conducted at a Department of Veterans Affairs Medical Center and Private Rehabilitation Hospital. The quantification of DXA-derived VAT volume (VATvol) and blood-derived markers of lipid and carbohydrate metabolism were determined in 100 SCI and 51 AB men. The VATvol was acquired from a total body DXA scan and analyzed using iDXA enCore CoreScan software (GE Lunar). Blood samples were collected for the serum lipid profile and plasma and glucose concentrations, with the latter two values used to calculate a measure of insulin resistance. In the SCI and AB groups, VAT% was significantly correlated with most cardiometabolic biomarkers. The results of the binary logistic regression analysis revealed that participants who had a VATvol above the cutoff value of 1630 cm3 were 3.1-, 4.8-, 5.6-, 19.2-, and 16.7-times more likely to have high serum triglycerides (R2N= 0.09, p = 0.014), low serum high density lipoprotein cholesterol (R2N = 0.16, p < 0.001), HOMA2-IR (R2N = 0.18, p < 0.001), metabolic syndrome (R2N = 0.25, p < 0.001), and a 10-yr Framingham Risk Score ≥ 10% (R2N = 0.16, p = 0.001), respectively, when compared to participants below this VATvol cutoff value. Our findings reveal that persons with chronic SCI have a higher VATvol than that of AB controls, and VATvol correlates directly with biomarkers of lipid and carbohydrate metabolism that are strong predictors of cardiometabolic disorders.
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Affiliation(s)
- Christopher M Cirnigliaro
- Department of Veterans Affairs Rehabilitation Research & Development Service, National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA.
| | - Michael F La Fountaine
- Department of Veterans Affairs Rehabilitation Research & Development Service, National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA; Department of Physical Therapy, School of Health and Medical Sciences, Seton Hall University, South Orange, NJ; Departments of Medical Sciences and Neurology, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, NJ, USA
| | - Joshua C Hobson
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA
| | - Steven C Kirshblum
- Kessler Institute for Rehabilitation, West Orange, NJ; Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ
| | - Donald R Dengel
- School of Kinesiology, University of Minnesota, Minneapolis, MN
| | - Ann M Spungen
- Medical Service, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA; Department of Veterans Affairs Rehabilitation Research & Development Service, National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA; Departments of Medicine and Rehabilitation and Human Performance, Icahn School of Medicine at Mount, Sinai, New York, NY, USA
| | - William A Bauman
- Medical Service, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA; Department of Veterans Affairs Rehabilitation Research & Development Service, National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA; Departments of Medicine and Rehabilitation and Human Performance, Icahn School of Medicine at Mount, Sinai, New York, NY, USA
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18
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Determinants of Peak Fat Oxidation Rates During Cycling in Healthy Men and Women. Int J Sport Nutr Exerc Metab 2021; 31:227-235. [PMID: 33588373 DOI: 10.1123/ijsnem.2020-0262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/23/2020] [Accepted: 11/19/2020] [Indexed: 11/18/2022]
Abstract
This study explored lifestyle and biological determinants of peak fat oxidation (PFO) during cycle ergometry, using duplicate measures to account for day-to-day variation. Seventy-three healthy adults (age range: 19-63 years; peak oxygen consumption [V˙O2peak]: 42.4 [10.1] ml·kg BM-1·min-1; n = 32 women]) completed trials 7-28 days apart that assessed resting metabolic rate, a resting venous blood sample, and PFO by indirect calorimetry during an incremental cycling test. Habitual physical activity (combined heart rate accelerometer) and dietary intake (weighed record) were assessed before the first trial. Body composition was assessed 2-7 days after the second identical trial by dual-energy X-ray absorptiometry scan. Multiple linear regressions were performed to identify determinants of PFO (mean of two cycle tests). A total variance of 79% in absolute PFO (g·min-1) was explained with positive coefficients for V˙O2peak (strongest predictor), FATmax (i.e the % of V˙O2peak that PFO occurred at), and resting fat oxidation rate (g·min-1), and negative coefficients for body fat mass (kg) and habitual physical activity level. When expressed relative to fat-free mass, 64% of variance in PFO was explained: positive coefficients for FATmax (strongest predictor), V˙O2peak, and resting fat oxidation rate, and negative coefficients for male sex and fat mass. This duplicate design revealed that biological and lifestyle factors explain a large proportion of variance in PFO during incremental cycling. After accounting for day-to-day variation in PFO, V˙O2peak and FATmax were strong and consistent predictors of PFO.
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Greater Loss of Central Adiposity from Low-Carbohydrate versus Low-Fat Diet in Middle-Aged Adults with Overweight and Obesity. Nutrients 2021; 13:nu13020475. [PMID: 33572489 PMCID: PMC7911139 DOI: 10.3390/nu13020475] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/18/2021] [Accepted: 01/25/2021] [Indexed: 01/12/2023] Open
Abstract
The objective of this study is to determine whether middle-aged adults prescribed a low carbohydrate-high fat (LCHF) or low fat (LF) diet would have greater loss of central fat and to determine whether the insulin resistance (IR) affects intervention response. A total of 50 participants (52.3 ± 10.7 years old; 36.6 ± 7.4 kg/m2 BMI; 82% female) were prescribed either a LCHF diet (n = 32, carbohydrate: protein: fat of 5%:30%:65% without calorie restriction), or LF diet (n = 18, 63%:13–23%: 10–25% with calorie restriction of total energy expenditure—500 kcal) for 15 weeks. Central and regional body composition changes from dual-x-ray absorptiometry and serum measures were compared using paired t-tests and ANCOVA with paired contrasts. IR was defined as homeostatic model assessment (HOMA-IR) > 2.6. Compared to the LF group, the LCHF group lost more android (15.6 ± 11.2% vs. 8.3 ± 8.1%, p < 0.01) and visceral fat (18.5 ± 22.2% vs. 5.1 ± 15.8%, p < 0.05). Those with IR lost more android and visceral fat on the LCHF verses LF group (p < 0.05). Therefore, the clinical prescription to a LCHF diet may be an optimal strategy to reduce disease risk in middle-aged adults, particularly those with IR.
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Harindhanavudhi T, Yang Y, Hodges JS, Pruett TL, Kirchner V, Beilman GJ, Bellin MD. Body Composition is Associated With Islet Function After Pancreatectomy and Islet Autotransplantation for Pancreatitis. J Clin Endocrinol Metab 2021; 106:e496-e506. [PMID: 33124670 PMCID: PMC7823238 DOI: 10.1210/clinem/dgaa790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Indexed: 02/06/2023]
Abstract
CONTEXT Body composition in total pancreatectomy with islet autotransplantation (TPIAT) has never been studied. OBJECTIVE Determine whether presurgical body composition is associated with islet function and insulin sensitivity after TPIAT. METHODS In 88 adults undergoing TPIAT (median age 41.0 years, IQR 32.8-48.0), beta-cell function and insulin sensitivity were assessed using mixed meal tolerance test and frequent sample intravenous glucose tolerance test before surgery and 12 and 18 months afterward. Body composition was measured by dual x-ray absorptiometry. Analyses used linear and logistic regression. RESULTS Before surgery, 8 individuals (9.1%) were underweight, 40 (45.5%) normal weight, 20 (22.7%) overweight, and 20 (22.7%) obese. Overweight/obese patients had higher area under the curve C-peptide and lower insulin sensitivity index. Baseline body weight was positively associated with first-phase insulin secretion (AIRg) at 12 months (average 38.5 [SE 17.1] mU/L/min higher per extra kg; P = 0.03) and 18 months (38.3 [18.5]; P = 0.04), while baseline lean mass was inversely associated with AIRg at 12 months (-0.05 [0.02] per extra kg; P = 0.01) and 18 months (-0.05 [0.02]; P = 0.03). Percent gynoid fat was inversely associated with disposition index at 18 months (-206.0 [97.2] per extra percent; P = 0.04). Percent body fat and percent gynoid fat were associated with glucose effectiveness index at 18 months (1.9 × 10-3 [0.9 × 10-3] per extra percent; P = 0.04 and -1.96 × 10-3 [0.8 × 10-3]; P = 0.02, respectively). Insulin independence was not significantly associated with body weight or composition. CONCLUSIONS Half of these chronic pancreatitis patients were overweight/obese; underweight was uncommon. Preoperative body weight and composition were associated with islet function but not insulin independence after TPIAT.
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Affiliation(s)
- Tasma Harindhanavudhi
- Division of Diabetes and Endocrinology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
- Correspondence and Reprint Requests: Tasma Harindhanavudhi, MD, 420 Delaware Street S.E., MMC 101 Minneapolis, MN 55455, USA. E-mail:
| | - Yi Yang
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - James S Hodges
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Timothy L Pruett
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Varvara Kirchner
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Gregory J Beilman
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Melena D Bellin
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
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21
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Impact of Pulse Wave Velocity and Parameters Reflecting Android Type Fat Distribution on Left Ventricular Diastolic Dysfunction in Patients with Chronic Coronary Syndromes. J Clin Med 2020; 9:jcm9123924. [PMID: 33287316 PMCID: PMC7761650 DOI: 10.3390/jcm9123924] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 11/27/2020] [Accepted: 12/01/2020] [Indexed: 01/12/2023] Open
Abstract
Background: Left ventricular diastolic dysfunction (LVDD) is caused by a decreased left ventricle relaxation and is associated with an increased risk of symptomatic heart failure (HF) and excessive mortality. Aim: To evaluate the frequency and factors related to LVDD in the population with chronic coronary syndromes (CCS). Methods: 200 patients (mean age 63.18 ± 8.12 years, 75.5% male) with CCS were included. LVDD was diagnosed based on the recent echocardiography guidelines. Results: LVDD was diagnosed in 38.5% of CCS population. From the studied factors, after adjustment for age, sex, and N-terminal pro-brain natriuretic peptide (NT-proBNP), LVDD associated positively with android/gynoid (A/G) fat mass ratio, left ventricular mass index (LVMI), and negatively with Z-score and left ventricular ejection fraction (LVEF). In stepwise backward logistic regression analysis, the strongest factors associated with LVDD were pulse wave velocity value, handgrip strength and waist to hip ratio (WHR). Conclusions: LVDD is common among CCS patients and it is associated with parameters reflecting android type fat distribution regardless of NT-proBNP and high-sensitivity troponin T concentrations. Deterioration in diastolic dysfunction is linked with increased aortic stiffness independently of age and sex. Further studies evaluating the effects of increasing physical fitness and lowering abdominal fat accumulations on LVDD in CCS patients should be considered.
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22
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Williams R, Periasamy M. Genetic and Environmental Factors Contributing to Visceral Adiposity in Asian Populations. Endocrinol Metab (Seoul) 2020; 35:681-695. [PMID: 33397033 PMCID: PMC7803598 DOI: 10.3803/enm.2020.772] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 12/12/2020] [Indexed: 12/20/2022] Open
Abstract
Obesity-associated metabolic illnesses are increasing at an alarming rate in Asian countries. A common feature observed in the Asian population is a higher incidence of abdominal obesity-the "skinny-fat" Asian syndrome. In this review, we critically evaluate the relative roles of genetics and environmental factors on fat distribution in Asian populations. While there is an upward trend in obesity among most Asian countries, it appears particularly conspicuous in Malaysia. We propose a novel theory, the Malaysian gene-environment multiplier hypothesis, which explains how ancestral variations in feast-and-famine cycles contribute to inherited genetic predispositions that, when acted on by modern-day stressors-most notably, urbanization, westernization, lifestyle changes, dietary transitions, cultural pressures, and stress-contribute to increased visceral adiposity in Asian populations. At present, the major determinants contributing to visceral adiposity in Asians are far from conclusive, but we seek to highlight critical areas for further research.
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Affiliation(s)
- Rachel Williams
- Department of Internal Medicine, University of Central Florida (UCF) College of Medicine, Burnett School of Biomedical Sciences, Orlando, FL, USA
| | - Muthu Periasamy
- Department of Internal Medicine, University of Central Florida (UCF) College of Medicine, Burnett School of Biomedical Sciences, Orlando, FL, USA
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23
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Elstgeest LEM, Schaap LA, Heymans MW, Hengeveld LM, Naumann E, Houston DK, Kritchevsky SB, Simonsick EM, Newman AB, Farsijani S, Visser M, Wijnhoven HAH. Sex-and race-specific associations of protein intake with change in muscle mass and physical function in older adults: the Health, Aging, and Body Composition (Health ABC) Study. Am J Clin Nutr 2020; 112:84-95. [PMID: 32520344 PMCID: PMC7326591 DOI: 10.1093/ajcn/nqaa099] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/16/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Protein intake recommendations advise ≥0.8 g/kg body weight (BW)/d, whereas experts propose a higher intake for older adults (1.0-1.2 g/kg BW/d). It is unknown whether optimal protein intake differs by sex or race. OBJECTIVES We examined the shape of sex- and race-specific associations of dietary protein intake with 3- and 6-y changes in appendicular lean mass (aLM) and gait speed and also 6-y incidence of mobility limitation in community-dwelling older men and women. METHODS We used data on men (n = 1163) and women (n = 1237) aged 70-81 y of the Health, Aging, and Body Composition Study. Protein intake was assessed using an FFQ (1998-1999). aLM and gait speed were measured at baseline and at 3 and 6 y. Difficulty walking one-quarter mile or climbing stairs was measured every 6 mo over 6 y. Prospective associations were evaluated with linear and Cox regression models, comparing fit of models with and without spline functions. All analyses were stratified by sex and additionally by race. RESULTS Mean ± SD protein intake was 0.94 ± 0.36 g/kg adjusted body weight (aBW)/d in men and 0.95 ± 0.36 g/kg aBW/d in women. There were no strong indications of nonlinear associations. In women, higher protein intake was associated with less aLM loss over 3 y (adjusted B per 0.1 g/kg aBW/d: 39.4; 95% CI: 11.6, 67.2), specifically in black women, but not over 6 y or with gait speed decline. In men, protein intake was not associated with changes in aLM and gait speed. Higher protein intake was associated with a lower risk of mobility limitation in men (adjusted HR per 1.0 g/kg aBW/d: 0.55; 95% CI: 0.34, 0.91) and women (adjusted HR: 0.56; 95% CI: 0.33, 0.94), specifically white women. CONCLUSIONS Associations between protein intake and physical outcomes may vary by sex and race. Therefore, it is important to consider sex and race in future studies regarding protein needs in older adults.
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Affiliation(s)
- Liset E M Elstgeest
- Department of Health Sciences, Faculty of Science, Vrije University Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Laura A Schaap
- Department of Health Sciences, Faculty of Science, Vrije University Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam UMC – Location VU University Medical Center, Amsterdam, the Netherlands
| | - Linda M Hengeveld
- Department of Health Sciences, Faculty of Science, Vrije University Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Elke Naumann
- Department of Nutrition and Health, HAN University of Applied Sciences, Nijmegen, the Netherlands
- European Federation of the Associations of Dietitians (EFAD), The Hague, the Netherlands
| | - Denise K Houston
- Sticht Center for Healthy Aging and Alzheimer's Prevention and Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Stephen B Kritchevsky
- Sticht Center for Healthy Aging and Alzheimer's Prevention and Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Samaneh Farsijani
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Vrije University Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, Vrije University Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
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Cheng SH, Kuo YJ, Lin JCF, Chang WC, Wu CC, Chu YL, Lee CH, Chen YP, Lin CY. Fat distribution may predict intra- or extra-capsular hip fracture in geriatric patients after falling. Injury 2020; 51:414-419. [PMID: 31870609 DOI: 10.1016/j.injury.2019.12.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 11/10/2019] [Accepted: 12/16/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Hip fractures can be divided into intra-capsular and extra-capsular fracture based on fracture location; these two types of fracture have different pathogeneses, treatments and prognoses. Many factors influence the patterns of hip fractures, including the injury mechanism, areal bone mineral density and the geometry of the hip. However, the relationship between body composition and hip fracture pattern has not yet been discussed. In this investigation, an analysis of the body compositions of geriatric patients with hip fractures were conducted to identify differences between fat and muscle distributions between patients with intra- and extra-capsular hip fractures. MATERIAL AND METHODS From December 2017 to February 2019, 139 patients with a hip fracture were prospectively enrolled in this study. The groups of patients that were diagnosed as having intra- and extra-capsular hip fractures were compared in terms of patient demographics, pre-operative laboratory data, bone mineral density (BMD) and body composition including muscle and fat distributions obtained using dual-energy X-ray absorptiometry (DXA) . RESULTS Eighty-six and 53 patients were diagnosed with intra-capsular and extra-capsular hip fractures, respectively. A significantly higher serum glucose level, a lower hemoglobin level, a lower T-score level in the proximal femur region, a lower T-score of all parts of interest, and a lower percentage fat content on the region of bilateral proximal hips (gynoid region) and in the lower limb region, were observed in patients with an extra-capsular hip fracture than in those with an intra-capsular hip fracture. However, with all confounding factors controlled for, only the T-score at the proximal femur, percentage fat content in the region of bilateral proximal hips and the ratio of android fat content to gynoid fat content (A/G ratio) are the most relevant factors in predicting the patterns of hip fracture in geriatric patients after falling. CONCLUSION This work demonstrates that lower fat content in the region of bilateral proximal hips and a lower BMD on the proximal femur may predict greater vulnerability of geriatric patients to extra-capsular rather than intra-capsular hip fracture after a falling accident.
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Affiliation(s)
- Shih-Hao Cheng
- Department of Orthopedic Surgery, Cheng Hsin General Hospital, Taipei, Taiwan; Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yi-Jie Kuo
- Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Orthopedic Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jeff Chien-Fu Lin
- Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Statistics, National Taipei University, Taipei, Taiwan
| | - Wei-Chun Chang
- Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Chun Wu
- Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yo-Lun Chu
- Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chian-Her Lee
- Bone and Joint Research Center, Department of Orthopedics and Traumatology, Taipei Medical University Hospital, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yu-Pin Chen
- Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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Choi HN, Choue R, Park Y, Yim JE. Onion Peel Extract Increases Erythrocyte Membrane n-3 Fatty Acids in Overweight and Obese Korean Subjects. J Med Food 2019; 23:37-42. [PMID: 31855493 DOI: 10.1089/jmf.2018.4366] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The association between obesity and erythrocyte fatty acids (FAs) has been suggested; however, there have been no studies on the effects of onion peel extract (OPE) on the composition of erythrocyte FAs. This study aimed to investigate the effects of OPE on the composition of erythrocyte FAs in overweight and obese subjects. This was a randomized, double-blind, and placebo-controlled trial conducted in overweight and obese Korean subjects. The placebo and OPE groups were taking placebo capsule or OPE capsule twice per day for 12 weeks. Body composition and fat distribution were measured using dual-energy X-ray absorptiometry. The OPE group showed significantly reduced body weight, body mass index, body fat mass, and percentage of body fat mass. After 12 weeks, eicosapentaenoic acid and monounsaturated FAs of the placebo group were significantly lower at baseline. Consumption of OPE ameliorated the decreasing polyunsaturated n-3 polyunsaturated FA (PUFA) n-3 and increasing PUFA n-6, which prevented an increased n-6/n-3 ratio. The changes in arm fat percentage (ARFATP), trunk fat percentage, and total fat percentage (FATP) were negatively correlated with the change in PUFA n-3. In addition, increased erythrocyte docosahexaenoic acid was associated with decreased ARFATP and FATP. These results suggest that OPE has beneficial effects on obesity by regulating erythrocyte n-6/n-3 ratio and preventing fat accumulation in various body regions.
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Affiliation(s)
- Ha-Neul Choi
- Department of Food and Nutrition, Changwon National University, Changwon, Korea
| | - Ryowon Choue
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin, Korea
| | - Yongsoon Park
- Department of Food and Nutrition, Hanyang University, Seoul, Korea
| | - Jung-Eun Yim
- Department of Food and Nutrition, Changwon National University, Changwon, Korea
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Nieto-Martínez R, González-Rivas JP, Ugel E, Marulanda MI, Durán M, Mechanick JI, Aschner P. External validation of the Finnish diabetes risk score in Venezuela using a national sample: The EVESCAM. Prim Care Diabetes 2019; 13:574-582. [PMID: 31202539 DOI: 10.1016/j.pcd.2019.04.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 04/16/2019] [Accepted: 04/26/2019] [Indexed: 12/16/2022]
Abstract
AIMS To evaluate the performance of the Latin American Finnish Diabetes Risk Score (LA-FINDRISC) compared with the original O-FINDRISC in general population. To establish the best cut-off to detect unknown type 2 diabetes (uT2D) and prediabetes. METHODS The EVESCAM was a national population-based, cross-sectional, randomized cluster sampling study, which assessed 3454 adults from July 2014 to January 2017. Those with self-report of diabetes were excluded; a total of 3061 subjects were analyzed. Waist circumference adapted for Latin America was the difference between the LA-FINDRISC and the O-FINDRISC. The area under the curve (AUC), sensitivity, and specificity were calculated. RESULTS The prevalence of uT2D and prediabetes were 3.3% and 38.5%. The AUC with the LA-FINDRISC vs. the O-FINDRISC were: for uT2D, 0.722 vs. 0.729 in men (p=0.854) and 0.724 vs. 0.732 in women (p=0.896); for prediabetes (impaired fasting glucose [IFG] + impaired glucose tolerance [IGT], 0.590 vs. 0.587 in men (p=0.887) and 0.621 vs. 0.627 in women (p=0.777); for IFG, 0.582 vs. 0.580 in men (p=0.924) and 0.607 vs. 0.617 in women (p=0.690); for IGT, 0.691 vs. 0.692 in men (p=0.971) and 0.672 vs. 0.671 in women (p=0.974). Using the LA-FINDRISC, the best cut-offs to detect uT2D were 9 in men and 10 in women and to detect IGT was 9 in both genders. CONCLUSION LA-FINDRISC has similar performance than O-FINDRISC in Venezuelan adults and showed a good performance to detect uT2D and IGT, but not IFG. The best cut-offs to detect glucose alterations were established.
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Affiliation(s)
- Ramfis Nieto-Martínez
- South Florida Veterans Affairs Foundation for Research & Education and Geriatric Research, Education and Clinical Center (GRECC), Miami VA Healthcare System, Miami, FL, USA; Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA; Department of Physiology, School of Medicine, University Centro-Occidental "Lisandro Alvarado" and Cardio-Metabolic Unit 7, Barquisimeto, Venezuela; Foundation for Clinical, Public Health, and Epidemiological Research of Venezuela (FISPEVEN), Caracas, Venezuela.
| | - Juan P González-Rivas
- Foundation for Clinical, Public Health, and Epidemiological Research of Venezuela (FISPEVEN), Caracas, Venezuela; The Andes Clinic of Cardio-Metabolic Studies, Mérida, Venezuela
| | - Eunice Ugel
- Foundation for Clinical, Public Health, and Epidemiological Research of Venezuela (FISPEVEN), Caracas, Venezuela; Department of Preventive Medicine, School of Medicine, Universidad Centro-Occidental "Lisandro Alvarado", Barquisimeto, Venezuela
| | - Maria Ines Marulanda
- Foundation for Clinical, Public Health, and Epidemiological Research of Venezuela (FISPEVEN), Caracas, Venezuela; Endocrine Associates of Florida, Research Department, Orlando, FL, USA; Internal Medicine Department, Universidad de Carabobo and Guerra Méndez Medical Center, Valencia, Venezuela
| | - Maritza Durán
- Foundation for Clinical, Public Health, and Epidemiological Research of Venezuela (FISPEVEN), Caracas, Venezuela; Internal Medicine Department, Avila Clinic, Caracas, Venezuela
| | - Jeffrey I Mechanick
- Divisions of Cardiology and Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Pablo Aschner
- Javeriana University, San Ignacio University Hospital, Colombian Diabetes Association, Bogotá, Colombia
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Gomes GK, Franco CM, Nunes PRP, Orsatti FL. High-Frequency Resistance Training Is Not More Effective Than Low-Frequency Resistance Training in Increasing Muscle Mass and Strength in Well-Trained Men. J Strength Cond Res 2019; 33 Suppl 1:S130-S139. [PMID: 29489727 DOI: 10.1519/jsc.0000000000002559] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Gomes, GK, Franco, CM, Nunes, PRP, and Orsatti, FL. High-frequency resistance training is not more effective than low-frequency resistance training in increasing muscle mass and strength in well-trained men. J Strength Cond Res 33(7S): S130-S139, 2019-We studied the effects of 2 different weekly frequency resistance training (RT) protocols over 8 weeks on muscle strength and muscle hypertrophy in well-trained men. Twenty-three subjects (age: 26.2 ± 4.2 years; RT experience: 6.9 ± 3.1 years) were randomly allocated into the 2 groups: low-frequency resistance training (LFRT, n = 12) or high-frequency resistance training (HFRT, n = 11). The LFRT performed a split-body routine, training each specific muscle group once a week. The HFRT performed a total-body routine, training all muscle groups every session. Both groups performed the same number of sets (10-15 sets) and exercises (1-2 exercise) per week, 8-12 repetitions maximum (70-80% of 1 repetition maximum [1RM]), 5 times per week. Muscle strength (bench press and squat 1RM) and lean tissue mass (dual-energy x-ray absorptiometry) were assessed before and at the end of the study. Results showed that both groups improved (p < 0.001) muscle strength {LFRT and HFRT: bench press = 5.6 kg (95% confidence interval [CI]: 1.9-9.4) and 9.7 kg (95% CI: 4.6-14.9) and squat = 8.0 kg (95% CI: 2.7-13.2) and 12.0 kg (95% CI: 5.1-18.1), respectively} and lean tissue mass (p = 0.007) (LFRT and HFRT: total body lean mass = 0.5 kg [95% CI: 0.0-1.1] and 0.8 kg [95% CI: 0.0-1.6], respectively) with no difference between groups (bench press, p = 0.168; squat, p = 0.312, and total body lean mass, p = 0.619). Thus, HFRT and LFRT are similar overload strategies for promoting muscular adaptation in well-trained subjects when the sets and intensity are equated per week.
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Affiliation(s)
- Gederson K Gomes
- Exercise Biology Research Group (BioEx), Federal University of Triangulo Mineiro (UFTM), Uberaba, Brazil
| | - Cristiane M Franco
- Exercise Biology Research Group (BioEx), Federal University of Triangulo Mineiro (UFTM), Uberaba, Brazil
| | - Paulo Ricardo P Nunes
- Exercise Biology Research Group (BioEx), Federal University of Triangulo Mineiro (UFTM), Uberaba, Brazil
| | - Fábio L Orsatti
- Exercise Biology Research Group (BioEx), Federal University of Triangulo Mineiro (UFTM), Uberaba, Brazil.,Department of Sport Sciences, Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
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Klaver M, de Mutsert R, Wiepjes CM, Twisk JWR, den Heijer M, Rotteveel J, Klink DT. Early Hormonal Treatment Affects Body Composition and Body Shape in Young Transgender Adolescents. J Sex Med 2019; 15:251-260. [PMID: 29425666 DOI: 10.1016/j.jsxm.2017.12.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 12/08/2017] [Accepted: 12/14/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Transgender adolescents aspiring to have the body characteristics of the affirmed sex can receive hormonal treatment. However, it is unknown how body shape and composition develop during treatment and whether transgender persons obtain the desired body phenotype. AIM To examine the change in body shape and composition from the start of treatment with gonadotropin-releasing hormone agonists (GnRHa) until 22 years of age and to compare these measurements at 22 years with those of age-matched peers. METHODS 71 transwomen (birth-assigned boys) and 121 transmen (birth-assigned girls) who started treatment from 1998 through 2014 were included in this retrospective study. GnRHa treatment was started and cross-sex hormonal treatment was added at 16 years of age. Anthropometric and whole-body dual-energy x-ray absorptiometry data were retrieved from medical records. Linear mixed model regression was performed to examine changes over time. SD scores (SDS) were calculated to compare body shape and composition with those of age-matched peers. OUTCOMES Change in waist-hip ratio (WHR), total body fat (TBF), and total lean body mass (LBM) during hormonal treatment. SDS of measures of body shape and composition compared with age-matched peers at 22 years of age. RESULTS In transwomen, TBF increased (+10%, 95% CI = 7-11) while total LBM (-10%, 95% CI = -11 to -7) and WHR (-0.04, 95% CI = -0.05 to -0.02) decreased. Compared with ciswomen, SDS at 22 years of age were +0.3 (95% CI = 0.0-0.5) for WHR, and 0.0 (95% CI = -0.2 to 0.3) for TBF. Compared with cismen, SDS were -1.0 (95% CI = -1.3 to -0.7) for WHR, and +2.2 (95% CI = 2.2-2.4) for TBF. In transmen, TBF decreased (-3%, 95% CI = -4 to -1), while LBM (+3%, 95% CI = 1-4) and WHR (+0.03, 95% CI = 0.01-0.04) increased. Compared with ciswomen, SDS at 22 years of age were +0.6 (95% CI = 0.4-0.8) for WHR, and -1.1 (95% CI = -1.4 to -0.9) for TBF. Compared with cismen, SDS were -0.5 (95% CI = -0.8 to -0.3) for WHR, and +1.8 (95% CI = 1.6-1.9) for TBF. CLINICAL IMPLICATIONS Knowing body shape and composition outcomes at 22 years of age will help care providers in counseling transgender youth on expectations of attaining the desired body phenotype. STRENGTHS AND LIMITATIONS This study presents the largest group of transgender adults to date who started treatment in their teens. Despite missing data, selection bias was not found. CONCLUSIONS During treatment, WHR and body composition changed toward the affirmed sex. At 22 years of age, transwomen compared better to age-matched ciswomen than to cismen, whereas transmen were between reference values for ciswomen and cismen. Klaver M, de Mutsert R, Wiepjes CM, et al. Early Hormonal Treatment Affects Body Composition and Body Shape in Young Transgender Adolescents. J Sex Med 2018;15:251-260.
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Affiliation(s)
- Maartje Klaver
- Department of Endocrinology and Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University and Medical Center, Leiden, the Netherlands
| | - Chantal M Wiepjes
- Department of Endocrinology and Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
| | - Jos W R Twisk
- Department of Clinical Epidemiology, VU University, Amsterdam, The Netherlands
| | - Martin den Heijer
- Department of Endocrinology and Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
| | - Joost Rotteveel
- Department of Pediatrics, Division of Endocrinology, VU University Medical Center, Amsterdam, The Netherlands
| | - Daniël T Klink
- Department of Pediatrics, Division of Endocrinology, VU University Medical Center, Amsterdam, The Netherlands; Department of Pediatrics, Division of Pediatric Endocrinology, Ghent University Hospital, Ghent, Belgium.
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Chang HC, Lin YC, Ng SH, Cheung YC, Wang CH, Chen FP, Chang HP, Sung CM, Fan CM, Yeh KY, Wu JS. Effect of Chemotherapy on Dual-Energy X-ray Absorptiometry (DXA) Body Composition Precision Error in Head and Neck Cancer Patients. J Clin Densitom 2019; 22:437-443. [PMID: 30172603 DOI: 10.1016/j.jocd.2018.07.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 07/26/2018] [Accepted: 07/26/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND Precision error in dual-energy X-ray absorptiometry (DXA) is defined as difference in results due to instrumental and technical factors given no biologic change. The aim of this study is to compare precision error in DXA body composition scans in head and neck cancer patients before and 2 months after chemotherapy. METHODOLOGY A total of 34 male head and neck cancer patients with normal body mass index (BMI) were prospectively enrolled and all patients received 2 consecutive DXA scans both before and after 2 months of chemotherapy for a total of 4 scans. The precision error of 3 DXA body composition values (lean mass, fat mass, and bone mineral content) was calculated for total body and 5 body regions (arms, legs, trunk, android, and gynoid). Precision errors before and after treatment were compared using generalized estimating equation model. RESULTS There was no significant change in precision error for the DXA total body composition values following chemotherapy; lean mass (0.33%-0.40%, p = 0.179), total fat mass (1.39%-1.70%, p = 0.259) and total bone mineral content (0.42%-0.56%, p = 0.243). However, there were significant changes in regional precision error; trunk lean mass (1.19%-1.77%, p = 0.014) and android fat mass (2.17%-3.72%, p = 0.046). CONCLUSIONS For head and neck cancer patients, precision error of DXA total body composition values did not change significantly following chemotherapy; however, there were significant changes in fat mass in the android and lean mass in the trunk. Caution should be exercised when interpreting longitudinal DXA body composition data in those body parts.
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Affiliation(s)
- Ho-Chuen Chang
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taiwan
| | - Yu-Ching Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taiwan; Keelung Osteoporosis Prevention and Treatment Center, Keelung, Taiwan
| | - Shu-Hang Ng
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taiwan
| | - Yun-Chung Cheung
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taiwan
| | - Cheng-Hsu Wang
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Keelung, Taiwan
| | - Fang-Ping Chen
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University, Keelung, Taiwan; Keelung Osteoporosis Prevention and Treatment Center, Keelung, Taiwan
| | - Hui-Ping Chang
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taiwan
| | - Chen-Ming Sung
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taiwan
| | - Chih-Ming Fan
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taiwan
| | - Kun-Yun Yeh
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Keelung, Taiwan.
| | - Jim S Wu
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, USA
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Halper A, Sanchez B, Hodges JS, Dengel DR, Petryk A, Sarafoglou K. Use of an aromatase inhibitor in children with congenital adrenal hyperplasia: Impact of anastrozole on bone mineral density and visceral adipose tissue. Clin Endocrinol (Oxf) 2019; 91:124-130. [PMID: 31070802 DOI: 10.1111/cen.14009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/07/2019] [Accepted: 05/08/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Anastrozole, an aromatase inhibitor, has been used off-label in males with short stature to delay bone maturation. No studies have examined anastrozole's effect on bone mineral density (BMD) or body composition in children with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. Our objective was to evaluate anastrozole's effect on BMD and visceral adipose tissue (VAT) in children with CAH. DESIGN Total body BMD (TBMD) and L2-L4 BMD Z-scores were adjusted for height-for-age Z-scores (TBMDHAZ and L2-L4HAZ ). Hydrocortisone doses (mg/m2 /d) were averaged over the previous year. Comparison of treated vs not treated with anastrozole used linear regression adjusting for age, pubertal status, sex, CAH type, years on hydrocortisone, BMI Z-scores and bone age Z-scores. PATIENTS We compared 25 children with CAH treated with anastrozole (mean age 11.3 [SD 3.0] years, 56% males) vs 31 children with CAH not treated with anastrozole (13.5 [SD 4.6], 29%). Participants underwent a pubertal exam, bone age X-ray and dual X-ray absorptiometry (DXA) scan. RESULTS Average bone age Z-score of 4.3 SDs on beginning anastrozole decreased to 1.9 SDs at time of DXA exam (P = 0.0004) 5.2 (SD 2.2) years later. TBMD Z-scores (P = 0.51), L2-L4 BMD Z-scores (P = 0.66), VAT (P = 0.38), TBMDHAZ Z-scores (P = 0.66) and L2-L4HAZ Z-scores (P = 0.41) did not differ between children treated vs not treated with anastrozole. CONCLUSION Anastrozole significantly reduced bone age advancement in children with CAH and advanced bone age (>2SDs) without adverse effects on BMD or VAT. Longitudinal studies of anastrozole in children with CAH are needed to validate these findings.
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Affiliation(s)
- Alyssa Halper
- Massachusetts General Hospital, Boston, Massachusetts
| | - Belen Sanchez
- University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota
| | - James S Hodges
- University of Minnesota Division of Biostatistics, Minneapolis, Minnesota
| | - Donald R Dengel
- University of Minnesota School of Kinesiology, Minneapolis, Minnesota
| | - Anna Petryk
- University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota
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Stigall AN, Hunter RL, Evans KD, Spees CK. A Longitudinal Study to Assess Abdominal Adiposity by Sonography, DXA, and BMI. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2019. [DOI: 10.1177/8756479319848746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- A. Nicole Stigall
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Randee L. Hunter
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Kevin D. Evans
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Colleen K. Spees
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
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Bantle AE, Bosch TA, Dengel DR, Wang Q, Mashek DG, Chow LS. DXA-Determined Regional Adiposity Relates to Insulin Resistance in a Young Adult Population with Overweight andObesity. J Clin Densitom 2019; 22:287-292. [PMID: 30064815 PMCID: PMC6391218 DOI: 10.1016/j.jocd.2018.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 05/31/2018] [Accepted: 06/01/2018] [Indexed: 01/01/2023]
Abstract
Obesity is a well-established risk factor for insulin resistance and type 2 diabetes mellitus, and body fat distribution has important implications for this metabolic risk. In this cross-sectional study, we used dual X-ray absorptiometry body composition data from 123 young adult participants with overweight or obesity, and correlatedwith 2 indices of insulin resistance calculated from oral glucose tolerance tests. Participants were 70% women, with mean (standard error) age 30.1 (0.6) yr, body mass index (BMI) 34.0 (0.6) kg/m2, homeostatic model assessment of insulin resistance (HOMA-IR) of 2.1 (0.2), and Matsuda insulin sensitivity index (Matsuda ISI) of 5.8 (0.4). In women, the strongest correlations were observed with the android-to-gynoid ratio (r = 0.52, p < 0.001 for HOMA-IR; r = -0.46, p < 0.001 for Matsuda ISI), and these correlations remained significant after adjustment for BMI. For men, the strongest correlations were with android fat mass (r = 0.40, p = 0.01 for HOMA-IR; r = -0.37, p = 0.02 for Matsuda ISI). Visceral adipose tissue was correlated with HOMA-IR and Matsuda ISI in women, and only with Matsuda ISI in men. BMI correlated with HOMA-IR and with Matsuda ISI in both women and men. Regional adiposity determined by dual X-ray absorptiometry correlates with indices of insulin resistance in sedentary young adults with overweight and obesity.
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Affiliation(s)
- Anne E Bantle
- Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
| | - Tyler A Bosch
- College of Education and Human Development, University of Minnesota, Minneapolis, MN, USA
| | - Donald R Dengel
- School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
| | - Qi Wang
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
| | - Douglas G Mashek
- Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, University of Minnesota, Minneapolis, MN, USA; Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota, Minneapolis, MN, USA
| | - Lisa S Chow
- Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
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Hwang CL, Bishop J, Ching J, Elokda A, da Silva ALG, Laddu D, Phillips SA. Precision Measurements to Assess Baseline Status and Efficacy of Healthy Living Medicine. Prog Cardiovasc Dis 2019; 62:55-59. [PMID: 30610884 DOI: 10.1016/j.pcad.2018.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 12/28/2018] [Indexed: 01/07/2023]
Abstract
Precision medicine recently has gained popularity, calling for more individualized approaches to prevent and/or reduce chronic-disease risk and to reduce non-communicable diseases such as cardiovascular disease (CVD). Encompassed under Precision medicine initiatives is the concept of healthy living medicine (HLM), which emphasizes the promotion of lifestyle and behavioral practices including physical activity and healthy dietary pattern. Precision measurements have the potential to improve the understanding of how risk factors influence disease trajectory, and further inform on how to precisely tailor clinical strategies to manage risk factors to prevent disease manifestation, and refine therapies according the patient's demographic, environment, and disease etiology. The purpose of this review is to summarize the application of established and emerging measurements that may be used in HLM to manage and optimize care in CVD prevention.
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Affiliation(s)
- Chueh-Lung Hwang
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Jennifer Bishop
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Jerry Ching
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Ahmed Elokda
- Department of Rehabilitation Sciences, Florida Gulf Coast University, Fort Myers, FL, United States of America
| | - Andréa Lúcia Gonçalves da Silva
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America; Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America; Department of Physical Education and Health, Physiotherapy` Course at University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS, Brazil
| | - Deepika Laddu
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America; Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Shane A Phillips
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America; Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America.
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Leary MP, Roy SJ, Lim J, Park W, Ferrari R, Eaves J, Machin DR, Tanaka H. Nonfat milk attenuates acute hyperglycemia in individuals with android obesity: A randomized control trial. Food Sci Nutr 2018; 6:2104-2112. [PMID: 30510711 PMCID: PMC6261169 DOI: 10.1002/fsn3.767] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 07/05/2018] [Accepted: 07/10/2018] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Elevated android body fat increases the risk of developing cardiometabolic diseases. Postprandial hyperglycemia contributes to the proatherogenic metabolic state evident in android adiposity. Due to the insulinotropic effect of milk-derived proteins, postprandial hyperglycemia has been shown to be reduced with the addition of dairy products. The purpose of this study was to determine whether one serving of nonfat milk added to an oral glucose tolerance test (OGTT) could attenuate postprandial hyperglycemia in individuals with elevated android adiposity and whether these improvements would be associated with metabolic and/or peripheral hemodynamic effects. METHODS In this placebo-controlled, randomized, crossover experimental study, 29 overweight/obese adults (26 ± 1 year) consumed an OGTT beverage (75 g glucose) combined with either nonfat milk (227 g) or a placebo control (12 g lactose + 8 g protein + 207 g water) that was matched for both carbohydrate and protein quantities. RESULTS In the whole sample, blood glucose and insulin concentrations increased over time in both trials with no significant differences between trials. Relative increases in peak blood glucose response were significantly related to android body fat (p < 0.05). The subjects in the highest tertiles of android body fat displayed attenuated hyperglycemic responses as well as improvements in flow-mediated dilation (FMD) after milk intake. CONCLUSIONS A single serving of nonfat milk may attenuate acute hyperglycemia in individuals with elevated android body fat offering a simple and convenient option for managing elevations in blood glucose.
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Affiliation(s)
- Miriam P. Leary
- Cardiovascular Aging Research LaboratoryDepartment of Kinesiology and Health EducationThe University of Texas at AustinAustinTexas
| | - Stephen J. Roy
- Cardiovascular Aging Research LaboratoryDepartment of Kinesiology and Health EducationThe University of Texas at AustinAustinTexas
| | - Jisok Lim
- Cardiovascular Aging Research LaboratoryDepartment of Kinesiology and Health EducationThe University of Texas at AustinAustinTexas
| | - Wonil Park
- Cardiovascular Aging Research LaboratoryDepartment of Kinesiology and Health EducationThe University of Texas at AustinAustinTexas
| | - Rodrigo Ferrari
- Cardiovascular Aging Research LaboratoryDepartment of Kinesiology and Health EducationThe University of Texas at AustinAustinTexas
| | - Jared Eaves
- Cardiovascular Aging Research LaboratoryDepartment of Kinesiology and Health EducationThe University of Texas at AustinAustinTexas
| | - Daniel R. Machin
- Cardiovascular Aging Research LaboratoryDepartment of Kinesiology and Health EducationThe University of Texas at AustinAustinTexas
| | - Hirofumi Tanaka
- Cardiovascular Aging Research LaboratoryDepartment of Kinesiology and Health EducationThe University of Texas at AustinAustinTexas
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Walia P, Goldstein RL, Teylan M, Lazzari AA, Hart JE, Tun CG, Garshick E. Associations between vitamin D, adiposity, and respiratory symptoms in chronic spinal cord injury. J Spinal Cord Med 2018; 41:667-675. [PMID: 28992807 PMCID: PMC6217502 DOI: 10.1080/10790268.2017.1374020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Context/Objective Persons with chronic spinal cord injury (SCI) have an increased risk of respiratory-related morbidity and mortality and chronic respiratory symptoms are clinical markers of future respiratory disease. Therefore, we sought to assess potentially modifiable factors associated with respiratory symptoms, with a focus on circulating vitamin D and measures of body fat. Design Cross-sectional study. Setting Veterans Affairs Medical Center. Participants Three hundred forty-three participants (282 men and 61 women) with chronic SCI participating in an epidemiologic study to assess factors influencing respiratory health recruited from VA Boston and the community. Methods Participants provided a blood sample, completed a respiratory health questionnaire, and underwent dual x-ray absorptiometry (DXA) to assess % body fat. Logistic regression was used to assess cross-sectional associations between respiratory symptoms and plasma vitamin D and measures of body fat with adjustment for a number of potential confounders. Outcome Measures Chronic cough, chronic phlegm, any wheeze, persistent wheeze. Results After adjustment for a number of confounders (including smoking), participants with greater %-android, gynoid, trunk, or total body fat had increased odds ratios for any wheeze and suggestive associations with persistent wheeze, but not with chronic cough or phlegm. Vitamin D levels were not associated with any of the respiratory symptoms. Conclusion Increased body fat, but not vitamin D, was associated with wheeze in chronic SCI independent of a number of covariates.
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Affiliation(s)
- Palak Walia
- Research and Development Service, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Rebekah L. Goldstein
- Research and Development Service, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Merilee Teylan
- Research and Development Service, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Antonio A. Lazzari
- Divison of Primary Care and Rheumatology Section, VA Boston Healthcare System, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Carlos G. Tun
- Department of Physical Medicine and Rehabilitation, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Eric Garshick
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA,Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, Boston, Massachusetts, USA,Correspondence to: Eric Garshick, MD, VA Boston Health Care System, West Roxbury, MA, USA.
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Nemeth A, Segrestin B, Leporq B, Seyssel K, Faraz K, Sauvinet V, Disse E, Valette PJ, Laville M, Ratiney H, Beuf O. 3D Chemical Shift-Encoded MRI for Volume and Composition Quantification of Abdominal Adipose Tissue During an Overfeeding Protocol in Healthy Volunteers. J Magn Reson Imaging 2018; 49:1587-1599. [PMID: 30328237 DOI: 10.1002/jmri.26532] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/14/2018] [Accepted: 09/14/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Overweight and obesity are major worldwide health concerns characterized by an abnormal accumulation of fat in adipose tissue (AT) and liver. PURPOSE To evaluate the volume and the fatty acid (FA) composition of the subcutaneous adipose tissue (SAT) and the visceral adipose tissue (VAT) and the fat content in the liver from 3D chemical-shift-encoded (CSE)-MRI acquisition, before and after a 31-day overfeeding protocol. STUDY TYPE Prospective and longitudinal study. SUBJECTS Twenty-one nonobese healthy male volunteers. FIELD STRENGTH/SEQUENCE A 3D spoiled-gradient multiple echo sequence and STEAM sequence were performed at 3T. ASSESSMENT AT volume was automatically segmented on CSE-MRI between L2 to L4 lumbar vertebrae and compared to the dual-energy X-ray absorptiometry (DEXA) measurement. CSE-MRI and MR spectroscopy (MRS) data were analyzed to assess the proton density fat fraction (PDFF) in the liver and the FA composition in SAT and VAT. Gas chromatography-mass spectrometry (GC-MS) analyses were performed on 13 SAT samples as a FA composition countermeasure. STATISTICAL TESTS Paired t-test, Pearson's correlation coefficient, and Bland-Altman plots were used to compare measurements. RESULTS SAT and VAT volumes significantly increased (P < 0.001). CSE-MRI and DEXA measurements were strongly correlated (r = 0.98, P < 0.001). PDFF significantly increased in the liver (+1.35, P = 0.002 for CSE-MRI, + 1.74, P = 0.002 for MRS). FA composition of SAT and VAT appeared to be consistent between localized-MRS and CSE-MRI (on whole segmented volume) measurements. A significant difference between SAT and VAT FA composition was found (P < 0.001 for CSE-MRI, P = 0.001 for MRS). MRS and CSE-MRI measurements of the FA composition were correlated with the GC-MS results (for ndb: rMRS/GC-MS = 0.83 P < 0.001, rCSE-MRI/GC-MS = 0.84, P = 0.001; for nmidb: rMRS/GC-MS = 0.74, P = 0.006, rCSE-MRI/GC-MS = 0.66, P = 0.020) DATA CONCLUSION: The follow-up of liver PDFF, volume, and FA composition of AT during an overfeeding diet was demonstrated through different methods. The CSE-MRI sequence associated with a dedicated postprocessing was found reliable for such quantification. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:1587-1599.
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Affiliation(s)
- Angeline Nemeth
- Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F69621, Lyon, France
| | - Bérénice Segrestin
- Centre de Recherche en Nutrition Humaine Rhône-Alpes (CRNH-RA), Centre Hospitalier Lyon Sud, Pierre-Bénite, Lyon, France.,Institut National de la Santé et de la Recherche Médicale Unit 1060, CarMeN Laboratory, Lyon 1 University, Oullins, France
| | - Benjamin Leporq
- Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F69621, Lyon, France
| | - Kevin Seyssel
- Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Khuram Faraz
- Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F69621, Lyon, France
| | - Valérie Sauvinet
- Centre de Recherche en Nutrition Humaine Rhône-Alpes (CRNH-RA), Centre Hospitalier Lyon Sud, Pierre-Bénite, Lyon, France
| | - Emmanuel Disse
- Centre de Recherche en Nutrition Humaine Rhône-Alpes (CRNH-RA), Centre Hospitalier Lyon Sud, Pierre-Bénite, Lyon, France.,Institut National de la Santé et de la Recherche Médicale Unit 1060, CarMeN Laboratory, Lyon 1 University, Oullins, France
| | - Pierre-Jean Valette
- Hospices Civils de Lyon, Département d'imagerie digestive, CHU Edouard Herriot, Lyon, France
| | - Martine Laville
- Centre de Recherche en Nutrition Humaine Rhône-Alpes (CRNH-RA), Centre Hospitalier Lyon Sud, Pierre-Bénite, Lyon, France.,Institut National de la Santé et de la Recherche Médicale Unit 1060, CarMeN Laboratory, Lyon 1 University, Oullins, France
| | - Hélène Ratiney
- Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F69621, Lyon, France
| | - Olivier Beuf
- Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F69621, Lyon, France
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Sustained Impairment of Lurasidone Clearance After Discontinuation of Posaconazole: Impact of Obesity, and Implications for Patient Safety. J Clin Psychopharmacol 2018; 38:289-295. [PMID: 29851709 DOI: 10.1097/jcp.0000000000000892] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE/BACKGROUND The antipsychotic agent lurasidone (Latuda®) is metabolized by Cytochrome P450-3A (CYP3A) enzymes. Coadministration with strong CYP3A inhibitors (such as ketoconazole, posaconazole, and ritonavir) is contraindicated due to the risk of sedation and movement disorders from high levels of lurasidone. This study evaluated the time-course of recovery from the posaconazole drug interaction, and the effect of obesity on the recovery process. METHODS/PROCEDURES Healthy normal-weight volunteers (n = 11, mean body mass index, BMI, = 23.1 kg/m) and otherwise healthy obese subjects (n = 13, mean BMI = 49.3 kg/m) received single doses of lurasidone in the baseline control condition, again during coadministration of posaconazole, and at 4 additional time points during the 2 weeks after posaconazole discontinuation. FINDINGS/RESULTS With posaconazole coadministration, lurasidone area under the concentration curve (AUC) increased by an arithmetic mean factor of 6.2 in normals, and by 4.9 in obese subjects. Post-treatment washout of posaconazole was slow in normals (mean half-life 31 hours), and further prolonged in obese subjects (53 hours). Recovery of lurasidone AUC toward baseline was correspondingly slow, and was incomplete. AUC remained significantly elevated above baseline both in normals (factor of 2.1) and obese subjects (factor of 3.4) even at 2 weeks after stopping posaconazole. IMPLICATIONS/CONCLUSIONS Product labeling does not address the necessary delay after discontinuation of a strong CYP3A inhibitor before lurasidone can be safely administered. We recommend requiring normal-weight and obese patients to limit the dosage of lurasidone, or undergo a washout period, for two and three weeks, respectively, after discontinuation of posaconazole.
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Halper A, Sanchez B, Hodges JS, Kelly AS, Dengel D, Nathan BM, Petryk A, Sarafoglou K. Bone mineral density and body composition in children with congenital adrenal hyperplasia. Clin Endocrinol (Oxf) 2018; 88:813-819. [PMID: 29460378 PMCID: PMC5980722 DOI: 10.1111/cen.13580] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 02/02/2018] [Accepted: 02/14/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Children with congenital adrenal hyperplasia (CAH) are exposed to fluctuating cortisol and androgen levels. The effects these hormonal states have on bone mineral density (BMD) and body composition are not well studied. The study's objective was to compare BMD and body composition, including visceral adipose tissue (VAT) and Android:Gynoid (A:G) ratio, in children with CAH vs healthy age-matched, sex-matched and BMI-matched controls. DESIGN Total body BMD (TBMD) Z-scores were adjusted for height-for-age Z-scores (TBMDHAZ). Hydrocortisone dose (mg/m2/d) was averaged over the past year. Bone age Z-scores were used as a surrogate for long-term androgen exposure in cases. Statistical analyses comparing cases and controls accounted for matched groups using mixed linear models. PATIENTS Forty-two cases with CAH (average age 12.3 years [SE 3]; 17 males) and 101 controls underwent a dual-energy X-ray absorptiometry scan. RESULTS Children with CAH had lower TBMD (0.81 vs 1.27, P = .003) and TBMDHAZ Z-scores (-0.51 vs -0.01, P = .001) than controls. In CAH cases, TBMD and TBMDHAZ Z-scores were positively correlated with bone age Z-scores (r = .63, P < .0001; r = .51, P = .001, respectively) but were not associated with HC dose. VAT and the A:G ratio did not differ significantly between children with CAH and controls and neither was associated with HC dose.VAT was not associated with bone age Z-score. CONCLUSION Lower BMD was observed in CAH cases compared with controls although no differences in body composition were identified. Among CAH cases, increased chronic androgen exposure, as measured by bone age Z-scores, was associated with higher BMD but was not associated with VAT.
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Affiliation(s)
- Alyssa Halper
- Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA
| | - Belen Sanchez
- Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA
| | - James S. Hodges
- University of Minnesota Division of Biostatistics, Minneapolis, MN, USA
| | - Aaron S. Kelly
- Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA
| | - Donald Dengel
- University of Minnesota School of Kinesiology, Minneapolis, MN, USA
| | - Brandon M. Nathan
- Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA
| | - Anna Petryk
- Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA
| | - Kyriakie Sarafoglou
- Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA
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Abstract
BACKGROUND Obesity and depression are common comorbid conditions. The objective of the study was to evaluate the effect of obesity on the pharmacokinetics of the serotonergic antidepressant vortioxetine. METHODS Vortioxetine pharmacokinetics were evaluated in 16 otherwise healthy obese volunteers (mean weight, 119 kg; mean body mass index (BMI) 41.8 kg/m) and in 14 normal-weight subjects (mean weight, 68 kg; mean BMI, 23.0 kg/m) matched for age. All subjects received a single 5-mg oral dose of vortioxetine once daily for 29 days. Pre-dose plasma vortioxetine concentrations were measured during the 29 days of dosing, and during a 4-week washout period after the last dose. Full 24-hour profiles were obtained after the first and last doses. RESULTS Vortioxetine accumulated extensively over the 29 days; the accumulation ratio was not significantly different between obese and control groups (means: 5.24 and 4.46, respectively). Steady-state concentration (Css) and steady-state clearance also did not differ between groups. However mean washout half-life (T1/2) was significantly prolonged in obese vs. control subjects (3.26 days vs. 2.21 days, P < 0.01). Up to 89% of the individual variability in T1/2 was explained by the product of Css and numeric indicators of the degree of obesity. CONCLUSIONS The half-life of vortioxetine washout after discontinuation of therapy is significantly prolonged in obese individuals compared to normal weight controls. To avoid a potential risk of serotonin syndrome, obese patients who plan to change their medication from vortioxetine to a monoamine oxidase inhibitor (MAOI) should extend the time between vortioxetine discontinuation and MAOI initiation beyond what is recommended in the product label.
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40
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Stigall AN, Evans KD, Tatarski R, Pargeon RL, Spees C. Abdominal Adiposity Measured by Sonography as a Tool for Determining Disease Risk. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2018. [DOI: 10.1177/8756479318771552] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A preexperimental cohort study was conducted with 67 overweight cancer survivors. This cohort of participants was screened for baseline body composition and anthropometrics based on a variety of techniques, including body mass index (BMI), dual X-ray absorptiometry–percentage body fat (DXA-android %BF), diagnostic medical sonography (DMS), and waist circumference (WC). The combination of subcutaneous fat layer at the xyphoid and umbilicus compared with BMI, WC, and DXA-android %BF. These variables demonstrated moderately positive association and were statistically significant. A total maximum mean score of DMS measures of subcutaneous and visceral fat was also compared with BMI, WC, and DXA-android %BF. The aforementioned comparison had a moderately positive association and was statistically significant. The sonographic measure of mesentery fat was compared with WC and demonstrated a strongly positive strength of association and was statistically significant. Sonography may be an inexpensive, noninvasive, portable, and valid body composition measure for overweight patients.
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Affiliation(s)
- A. Nicole Stigall
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Kevin D. Evans
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Rachel Tatarski
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Rachel L. Pargeon
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Colleen Spees
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
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Klaver M, de Blok CJM, Wiepjes CM, Nota NM, Dekker MJHJ, de Mutsert R, Schreiner T, Fisher AD, T'Sjoen G, den Heijer M. Changes in regional body fat, lean body mass and body shape in trans persons using cross-sex hormonal therapy: results from a multicenter prospective study. Eur J Endocrinol 2018; 178:163-171. [PMID: 29183889 DOI: 10.1530/eje-17-0496] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 10/31/2017] [Accepted: 11/22/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Cross-sex hormonal therapy (CHT) in trans persons affects their total body fat and total lean body mass. However, it is unknown how separate body regions are affected and whether these changes alter body shape. Therefore, the aim of this study was to determine the effects on body fat and lean body mass in separate body regions and on body shape after one year of CHT. DESIGN AND METHODS In a multicenter prospective study at university hospitals, 179 male-to-female gender dysphoric persons, referred to as transwomen, and 162 female-to-male gender dysphoric persons, referred to as transmen, were included. All underwent whole-body dual-energy X-ray absorptiometry and anthropometric measurements before and after one year of CHT. RESULTS In transwomen, increases in body fat ranged from +18% (95% CI: 13%;23%) in the android region to +42% (95% CI: 37%;46%) in the leg region and +34% (95% CI: 29%;38%) in the gynoid region. In transmen, changes in body fat ranged from -16% (95% CI: -19;-14%) in the leg region and -14% in the gynoid region (95% CI: -16%;-12) to no change in the android region (+1%, 95% CI: -3%;5%). Waist-to-hip ratio (WHR) decreased in transwomen (-0.03, 95% CI: -0.04;-0.02) mainly due to an increase in hip circumference (+3.2 cm, 95% CI: 2.3;4.0). Transmen have a decrease in hip circumference (-1.9 cm, 95% CI: -3.1;-0.7) resulting in an increase in WHR (+0.01, 95% CI: 0.00;0.02). CONCLUSIONS CHT causes a more feminine body fat distribution and a lower WHR in transwomen and a more masculine body fat distribution with a lower hip circumference in transmen.
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Affiliation(s)
- M Klaver
- Department of Endocrinology and Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, the Netherlands
| | - C J M de Blok
- Department of Endocrinology and Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, the Netherlands
| | - C M Wiepjes
- Department of Endocrinology and Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, the Netherlands
| | - N M Nota
- Department of Endocrinology and Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, the Netherlands
| | - M J H J Dekker
- Department of Endocrinology and Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, the Netherlands
| | - R de Mutsert
- Department of Clinical Epidemiology, Leiden University and Medical Center, Leiden, the Netherlands
| | - T Schreiner
- Department of Endocrinology, Oslo University Hospital, Oslo, Norway
| | - A D Fisher
- Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - G T'Sjoen
- Department of Endocrinology & Center for Sexuology and Gender, Ghent University Hospital, Ghent, Belgium
| | - M den Heijer
- Department of Endocrinology and Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, the Netherlands
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Vasan SK, Osmond C, Canoy D, Christodoulides C, Neville MJ, Di Gravio C, Fall CHD, Karpe F. Comparison of regional fat measurements by dual-energy X-ray absorptiometry and conventional anthropometry and their association with markers of diabetes and cardiovascular disease risk. Int J Obes (Lond) 2017; 42:850-857. [PMID: 29151596 PMCID: PMC5965665 DOI: 10.1038/ijo.2017.289] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 10/06/2017] [Accepted: 11/06/2017] [Indexed: 01/05/2023]
Abstract
Background/Objectives: Fat distribution is a strong and independent predictor of type 2 diabetes (T2D) and cardiovascular disease (CVD) and is usually determined using conventional anthropometry in epidemiological studies. Dual-energy X-ray absorptiometry (DXA) can measure total and regional adiposity more accurately. Nonetheless, whether DXA provides more precise estimates of cardiovascular risk in relation to total and regional adiposity is not known. We determined the strength of the associations between DXA- and conventional anthropometry determined fat distribution and T2D and CVD risk markers. Subjects/Methods: Waist (WC) and hip circumference (HC) and DXA was used to measure total and regional adiposity in 4950 (2119 men) participants aged 29–55 years from the Oxford Biobank without pre-existing T2D or CVD. Cross-sectional associations were compared between WC and HC vs. DXA-determined regional adiposity (all z-score normalised) with impaired fasting glucose, hypertriglyceridemia, hypertension and insulin resistance (IR). Results: Following adjustment for total adiposity, upper body adiposity measurements showed consistently increased risk of T2D and CVD risk markers except for abdominal subcutaneous fat in both sexes, and arm fat in men, which showed protective associations. Among upper adiposity depots, visceral fat mass showed stronger odds ratios (OR) ranging from 1.69 to 3.64 compared with WC 1.07–1.83. Among lower adiposity depots, HC showed modest protection for IR in both sexes (men: OR 0.80 (95% confidence interval 0.67, 0.96); women: 0.69 (0.56, 0.86)), whereas gynoid fat and in particular leg fat showed consistent and strong protective effects for all outcomes in both men and women. The differential effect of body fat distribution on CVD and T2D were more pronounced at higher levels of total adiposity. Conclusions: Compared with DXA, conventional anthropometry underestimates the associations of regional adiposity with T2D and CVD risk markers. After correcting for overall adiposity, greater subcutaneous fat mass in particular in the lower body is protective relative to greater android or visceral adipose tissue mass.
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Affiliation(s)
- S K Vasan
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK
| | - C Osmond
- MRC Life-course Epidemiology Unit, University of Southampton, Southampton, UK
| | - D Canoy
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - C Christodoulides
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK
| | - M J Neville
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK.,NIHR Oxford Biomedical Centre, Oxford University Hospital Trust and University of Oxford, Oxford, UK
| | - C Di Gravio
- MRC Life-course Epidemiology Unit, University of Southampton, Southampton, UK
| | - C H D Fall
- MRC Life-course Epidemiology Unit, University of Southampton, Southampton, UK
| | - F Karpe
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK.,NIHR Oxford Biomedical Centre, Oxford University Hospital Trust and University of Oxford, Oxford, UK
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Vaysse C, Lømo J, Garred Ø, Fjeldheim F, Lofteroed T, Schlichting E, McTiernan A, Frydenberg H, Husøy A, Lundgren S, Fagerland MW, Richardsen E, Wist EA, Muller C, Thune I. Inflammation of mammary adipose tissue occurs in overweight and obese patients exhibiting early-stage breast cancer. NPJ Breast Cancer 2017. [PMID: 28649659 PMCID: PMC5460134 DOI: 10.1038/s41523-017-0015-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Growing evidence indicates that adiposity is associated with breast cancer risk and negatively affects breast cancer recurrence and survival, a paracrine role of mammary adipose tissue being very likely in this process. In contrast to other adipose depots, occurrence of a sub-inflammatory state of mammary adipose tissue defined by dying adipocytes surrounded by macrophages forming crown-like structures in overweight and obese subjects, remains only partially described. In a general population of breast cancer patients (107 patients) mostly undergoing breast-conserving surgery, we found a positive association between patient's body composition, breast adipocytes size, and presence of crown-like structures in mammary adipose tissue close to the tumor. Overweight (BMI: 25.0-29.9 kg/m2) and obese (BMI ≥ 30.0 kg/m2) patients have 3.2 and 6.9 times higher odds ratio of crown-like structures respectively, compared with normal weight patients. The relatively small increase in adipocyte size in crown-like structures positive vs. negative patients suggests that mammary adipose tissue inflammation might occur early during hypertrophy. Our results further highlight that body mass index is an adequate predictor of the presence of crown-like structures in mammary adipose tissue among postmenopausal women, whereas in premenopausal women truncal fat percentage might be more predictive, suggesting that mammary adipose tissue inflammation is more likely to occur in patients exhibiting visceral obesity. Finally, the presence of crown-like structures was positively associated with systemic markers such as the Triglyceride/High-density lipoprotein-cholesterol ratio serum C-reactive protein and glucose/(HbA1c) glycated Haemoglobin. These compelling results demonstrate that excess adiposity, even in overweight patients, is associated with mammary adipose tissue inflammation, an event that could contribute to breast cancer development and progression.
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Affiliation(s)
- Charlotte Vaysse
- The Cancer Center, Oslo University Hospital, Oslo, Norway.,Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS, UPS, Toulouse, France
| | - Jon Lømo
- Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - Øystein Garred
- Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - Frøydis Fjeldheim
- The Cancer Center, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Trygve Lofteroed
- The Cancer Center, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ellen Schlichting
- Department of Breast and Endocrine Surgery, Oslo University Hospital, Oslo, Norway
| | - Anne McTiernan
- Fred Hutchinson Cancer Research Center, Public Health Sciences Division, Seattle, WA USA
| | | | - Anders Husøy
- The Cancer Center, Oslo University Hospital, Oslo, Norway
| | - Steinar Lundgren
- Department of Oncology, St. Olavs University Hospital, Trondheim, Norway
| | - Morten W Fagerland
- Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital Oslo, Oslo, Norway.,Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Elin Richardsen
- Department of Medical Biology, Department of Clinical Pathology, UiT The Arctic University of Norway, University of North Norway, Tromsø, Norway
| | - Erik A Wist
- The Cancer Center, Oslo University Hospital, Oslo, Norway
| | - Catherine Muller
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS, UPS, Toulouse, France
| | - Inger Thune
- The Cancer Center, Oslo University Hospital, Oslo, Norway.,Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
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Imboden MT, Swartz AM, Finch HW, Harber MP, Kaminsky LA. Reference standards for lean mass measures using GE dual energy x-ray absorptiometry in Caucasian adults. PLoS One 2017; 12:e0176161. [PMID: 28426779 PMCID: PMC5398591 DOI: 10.1371/journal.pone.0176161] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 04/06/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To develop reference values by age and sex for LM measures using GE-Healthcare DXA systems. METHODS A de-identified sample was obtained from Ball State University's Clinical Exercise Physiology Laboratory and University of Wisconsin-Milwaukee's Physical Activity & Health Research Laboratory. DXA scans of 2,076 women and 1,251 men were completed using a GE Lunar Prodigy or iDXA. Percentiles (%ile) were calculated for all variables of interest (LM, LMI, %LM, and ALMI) and a factorial ANOVA was used to assess differences for each variable between 10-year age groups and sex, as well as the interaction between age and sex. RESULTS Men had higher mean total LM, %LM, LMI, and ALMI than women (p<0.01), across all age groups. All LM variables decreased significantly over the 5 decades in men, however in women only total LM, %LM, and ALMI decreased from the youngest to oldest age groups (p<0.01). CONCLUSION These reference values provide for a more accurate interpretation of GE-Healthcare DXA-derived LM measurements offering clinicians and researchers with an initial resource to aid in the early detection and assessment of LM deficits.
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Affiliation(s)
- Mary T. Imboden
- Ball State University, Muncie, Indiana, United States of America
- * E-mail:
| | - Ann M. Swartz
- University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, United States of America
| | - Holmes W. Finch
- Ball State University, Muncie, Indiana, United States of America
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Imboden MT, Welch WA, Swartz AM, Montoye AHK, Finch HW, Harber MP, Kaminsky LA. Reference standards for body fat measures using GE dual energy x-ray absorptiometry in Caucasian adults. PLoS One 2017; 12:e0175110. [PMID: 28388669 PMCID: PMC5384668 DOI: 10.1371/journal.pone.0175110] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 03/21/2017] [Indexed: 11/21/2022] Open
Abstract
Background Dual energy x-ray absorptiometry (DXA) is an established technique for the measurement of body composition. Reference values for these variables, particularly those related to fat mass, are necessary for interpretation and accurate classification of those at risk for obesity-related health complications and in need of lifestyle modifications (diet, physical activity, etc.). Currently, there are no reference values available for GE-Healthcare DXA systems and it is known that whole-body and regional fat mass measures differ by DXA manufacturer. Objective To develop reference values by age and sex for DXA-derived fat mass measurements with GE-Healthcare systems. Methods A de-identified sample of 3,327 participants (2,076 women, 1,251 men) was obtained from Ball State University’s Clinical Exercise Physiology Laboratory and University of Wisconsin-Milwaukee’s Physical Activity & Health Research Laboratory. All scans were completed using a GE Lunar Prodigy or iDXA and data reported included percent body fat (%BF), fat mass index (FMI), and ratios of android-to-gynoid (A/G), trunk/limb, and trunk/leg fat measurements. Percentiles were calculated and a factorial ANOVA was used to determine differences in the mean values for each variable between age and sex. Results Normative reference values for fat mass variables from DXA measurements obtained from GE-Healthcare DXA systems are presented as percentiles for both women and men in 10-year age groups. Women had higher (p<0.01) mean %BF and FMI than men, whereas men had higher (p<0.01) mean ratios of A/G, trunk/limb, and trunk/leg fat measurements than women. Conclusion These reference values provide clinicians and researchers with a resource for interpretation of DXA-derived fat mass measurements specific to use with GE-Healthcare DXA systems.
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Affiliation(s)
- Mary T. Imboden
- Ball State University, Muncie, Indiana, United States of America
- * E-mail:
| | - Whitney A. Welch
- University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, United States of America
| | - Ann M. Swartz
- University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, United States of America
| | | | - Holmes W. Finch
- Ball State University, Muncie, Indiana, United States of America
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Eiras S, Varela-Román A, Andrade MC, Castro A, González-Ferreiro R, Viñuela JE, Fernández-Trasancos Á, Carreira MC, Álvarez E, Casanueva FF, González-Juanatey JR. Non classical Monocytes Levels, Increased by Subcutaneous Fat-Secretome, Are Associated with Less Rehospitalization after Heart Failure Admission. J Cardiovasc Transl Res 2016; 10:16-26. [DOI: 10.1007/s12265-016-9724-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 12/15/2016] [Indexed: 02/04/2023]
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Carter S, Clifton PM, Keogh JB. The effects of intermittent compared to continuous energy restriction on glycaemic control in type 2 diabetes; a pragmatic pilot trial. Diabetes Res Clin Pract 2016; 122:106-112. [PMID: 27833048 DOI: 10.1016/j.diabres.2016.10.010] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 10/01/2016] [Accepted: 10/12/2016] [Indexed: 01/06/2023]
Abstract
AIMS Weight loss improves glycaemic control in type 2 diabetes mellitus (T2DM). However, as achieving and maintaining weight loss is difficult, alternative strategies are needed. Our primary aim was to investigate the effects of intermittent energy restriction (IER) compared to continuous energy restriction (CER) on glycated haemoglobin A1c (HbA1c). Secondary aims were to assess effects on weight loss, body composition, medication changes and subjective measures of appetite. Using a 2-day IER method, we expected equal improvements to HbA1c and weight in both groups. METHOD Sixty-three overweight or obese participants (BMI 35.2±5kg/m2) with T2DM (HbA1c 7.4±1.3%) (57mmol/mol) were randomised to a 2-day severe energy restriction (1670-2500kJ/day) with 5days of habitual eating, compared to a moderate CER diet (5000-6500kJ/day) for 12weeks. RESULTS At 12weeks HbA1c (-0.7±0.9% P<0.001) and percent body weight reduction (-5.9±4% P<0.001) was similar in both groups with no group by time interaction. Similar reductions were also seen for medication dosages, all measures of body composition and subjective reports of appetite. CONCLUSIONS In this pilot trial, 2days of IER compared with CER resulted in similar improvements in glycaemic control and weight reduction offering a suitable alternative treatment strategy.
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Affiliation(s)
- S Carter
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia
| | - P M Clifton
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.
| | - J B Keogh
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia
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Orosomucoid as prognosis factor associated with inflammation in acute or nutritional status in chronic heart failure. Int J Cardiol 2016; 228:488-494. [PMID: 27875723 DOI: 10.1016/j.ijcard.2016.11.134] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 11/06/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Inflammation and nutritional state are involved in the pathogenesis of heart failure (HF). OBJECTIVE To study the contribution of alpha-1-acid-glycoprotein (AGP) to these factors and its prognostic value in acute (AHF) or chronic HF (CHF). METHODS The observational study has included 147 patients (mean age 70years, 62% men) admitted to a cardiology department for HF and followed-up for an average 326.6±140.8days. Blood AGP values were measured by Enzyme-Linked ImmunoSorbent Assay. Monocytes subsets were determined with CD14 and CD16 antibodies by flow cytometry and body composition was measured by dual-energy X-ray absorptiometry. The regulation of tumor necrosis factor (TNF-α) and leptin by AGP in epicardial adipose tissue (EAT) were analyzed by real time polymerase chain reaction. RESULTS High AGP, that was associated with CD14+CD16+ monocytes, and proBNP levels at the discharge were indicators of rehospitalization for HF in AHF patients. However, low AGP levels determined a worse nutritional state in CHF patients. The leptin levels were downregulated by high AGP concentration in epicardial fat. CONCLUSION AGP is a dual indicator in HF because high levels are predictors of adverse outcomes in AHF but low levels are related to the worse nutritional status in CHF. The regulation of leptin by AGP in epicardial fat might suggest a new pathway as protective mechanism in CHF.
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Denton N, Karpe F. Measuring body composition and regional fat mass accurately. PRACTICAL DIABETES 2016. [DOI: 10.1002/pdi.2043] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Nathan Denton
- Oxford Centre for Diabetes; Endocrinology and Metabolism; University of Oxford UK
| | - Fredrik Karpe
- Oxford Centre for Diabetes; Endocrinology and Metabolism; University of Oxford UK
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Dual-energy X-ray absorptiometry body composition in patients with secondary osteoporosis. Eur J Radiol 2016; 85:1493-8. [PMID: 27048946 DOI: 10.1016/j.ejrad.2016.03.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 03/18/2016] [Accepted: 03/19/2016] [Indexed: 12/25/2022]
Abstract
Due to the tight relationship between bone and soft tissues, there has been an increased interest in body composition assessment in patients with secondary osteoporosis as well as other pathological conditions. Dual-energy X-ray absorptiometry (DXA) is primarily devoted to the evaluation of bone mineral status, but continuous scientific advances of body composition software made DXA a rapid and easily available technique to assess body composition in terms of fat mass and lean mass. As a result, the International Society for Clinical Densitometry (ISCD) recently developed Official Positions regarding the use of this technique for body composition analysis. According to ISCD paper, indications are mainly limited to three conditions: HIV patients treated with antiretroviral agents associated with a risk of lipoatrophy; obese patients undergoing treatment for high weight loss; patients with sarcopenia or muscle weakness. Nevertheless, there are several other interesting clinical applications that were not included in the ISCD position paper, such as body composition assessment in patients undergoing organ transplantation, pulmonary disease as well as all those chronic condition that may lead to malnutrition. In conclusion, DXA body composition offers new diagnostic and research possibilities for a variety of diseases; due to its high reproducibility, DXA has also the potential to monitor body composition changes with pharmacological, nutritional or physic therapeutic interventions. ISCD addressed and recommended a list of clinical condition, but the crescent availability of DXA scans and software improvements may open the use of DXA to other indication in the next future. This article provides an overview of DXA body composition indications in the management of secondary osteoporosis and other clinical indications in adults.
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