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Joyeux MA, Pierre A, Barrois M, Hoeffel C, Devie A, Brugel M, Bertin E. Stomach size in anorexia nervosa: A new challenge? EUROPEAN EATING DISORDERS REVIEW 2024; 32:784-794. [PMID: 38520705 DOI: 10.1002/erv.3089] [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: 11/18/2023] [Revised: 02/27/2024] [Accepted: 03/11/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND & AIMS Changes in stomach size may impact eating behaviour. A recent study showed gastric dilatation in restrictive eating disorders using computed tomography scans. This study aimed to describe stomach size in the standing position in women with anorexia nervosa (AN). METHODS Women treated for AN at our institution were retrospectively included if they had undergone upper gastrointestinal radiography (UGR) after the diagnosis of AN. Two control groups (CG1 and CG2) were included, both comprising female patients: CG1 patients were not obese and underwent UGR for digestive symptoms of other aetiologies, and CG2 comprised obese individuals who had UGR before bariatric surgery. A UGR-based Stomach Size Index (SSI), calculated as the ratio of the length of the stomach to the distance between the upper end of the stomach and the top of the iliac crests, was measured in all three groups. Gastromegaly was defined as SSI >1.00. RESULTS 45 patients suffering from AN (28 with restrictive and 17 with binge/purge subtype), 10 CG1 and 20 CG2 subjects were included in this study. Stomach Size Index was significantly higher in AN (1.27 ± 0.24) than in CG1 (0.80 ± 0.11) and CG2 (0.68 ± 0.09); p < 0.001, but was not significantly different between patients with the restrictive and binge/purge subtypes. Gastromegaly was present in 82.2% of patients with AN and not present in the control groups. In patients with AN, gastromegaly was present in 12/15 patients without digestive symptoms (80.0%) and in 25/30 patients with digestive complaints (83.3%) at time of UGR (p = 0.99). In the AN group, no significant relationship was found between SSI and body mass index. CONCLUSION Gastromegaly is frequent in AN and could influence AN recovery. This anatomical modification could partially explain the alterations of gastric motility previously reported in AN.
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Affiliation(s)
- Marie-Alix Joyeux
- Department of Diabetes, Endocrinology and Nutrition, Robert-Debré Hospital, Reims, France
| | - Antoine Pierre
- Department of Diabetes, Endocrinology and Nutrition, Robert-Debré Hospital, Reims, France
| | - Marion Barrois
- Department of Diabetes, Endocrinology and Nutrition, Robert-Debré Hospital, Reims, France
| | - Christine Hoeffel
- Department of Radiology, Robert-Debré Hospital and Reims-Champagne-Ardenne University, Reims, France
- Reims-Champagne-Ardenne University, Reims, France
| | - Antoine Devie
- Department of Radiology, Robert-Debré Hospital and Reims-Champagne-Ardenne University, Reims, France
| | - Mathias Brugel
- Reims-Champagne-Ardenne University, Reims, France
- Gastroenterology and Digestive Oncology Department, Centre Hospitalier Côte Basque, Bayonne, France
| | - Eric Bertin
- Department of Diabetes, Endocrinology and Nutrition, Robert-Debré Hospital, Reims, France
- Reims-Champagne-Ardenne University, Reims, France
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2
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Flores-Opazo M, Kopinke D, Helmbacher F, Fernández-Verdejo R, Tuñón-Suárez M, Lynch GS, Contreras O. Fibro-adipogenic progenitors in physiological adipogenesis and intermuscular adipose tissue remodeling. Mol Aspects Med 2024; 97:101277. [PMID: 38788527 DOI: 10.1016/j.mam.2024.101277] [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: 02/01/2024] [Revised: 04/27/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024]
Abstract
Excessive accumulation of intermuscular adipose tissue (IMAT) is a common pathological feature in various metabolic and health conditions and can cause muscle atrophy, reduced function, inflammation, insulin resistance, cardiovascular issues, and unhealthy aging. Although IMAT results from fat accumulation in muscle, the mechanisms underlying its onset, development, cellular components, and functions remain unclear. IMAT levels are influenced by several factors, such as changes in the tissue environment, muscle type and origin, extent and duration of trauma, and persistent activation of fibro-adipogenic progenitors (FAPs). FAPs are a diverse and transcriptionally heterogeneous population of stromal cells essential for tissue maintenance, neuromuscular stability, and tissue regeneration. However, in cases of chronic inflammation and pathological conditions, FAPs expand and differentiate into adipocytes, resulting in the development of abnormal and ectopic IMAT. This review discusses the role of FAPs in adipogenesis and how they remodel IMAT. It highlights evidence supporting FAPs and FAP-derived adipocytes as constituents of IMAT, emphasizing their significance in adipose tissue maintenance and development, as well as their involvement in metabolic disorders, chronic pathologies and diseases. We also investigated the intricate molecular pathways and cell interactions governing FAP behavior, adipogenesis, and IMAT accumulation in chronic diseases and muscle deconditioning. Finally, we hypothesize that impaired cellular metabolic flexibility in dysfunctional muscles impacts FAPs, leading to IMAT. A deeper understanding of the biology of IMAT accumulation and the mechanisms regulating FAP behavior and fate are essential for the development of new therapeutic strategies for several debilitating conditions.
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Affiliation(s)
| | - Daniel Kopinke
- Department of Pharmacology and Therapeutics, University of Florida, Gainesville, 32610, FL, USA; Myology Institute, University of Florida College of Medicine, Gainesville, FL, USA.
| | | | - Rodrigo Fernández-Verdejo
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA; Laboratorio de Fisiología Del Ejercicio y Metabolismo (LABFEM), Escuela de Kinesiología, Facultad de Medicina, Universidad Finis Terrae, Chile.
| | - Mauro Tuñón-Suárez
- Laboratorio de Fisiología Del Ejercicio y Metabolismo (LABFEM), Escuela de Kinesiología, Facultad de Medicina, Universidad Finis Terrae, Chile.
| | - Gordon S Lynch
- Centre for Muscle Research, Department of Anatomy and Physiology, The University of Melbourne, Melbourne, Victoria, Parkville 3010, Australia.
| | - Osvaldo Contreras
- Developmental and Regenerative Biology Division, Victor Chang Cardiac Research Institute, Darlinghurst, NSW, 2010, Australia; School of Clinical Medicine, UNSW Sydney, Kensington, NSW 2052, Australia.
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Yang N, Zhuo J, Xie S, Qu Z, Li W, Li Z, Guo P, Gao M, Qin H, Han T. A Body Shape Index and Its Changes in Relation to All-Cause Mortality among the Chinese Elderly: A Retrospective Cohort Study. Nutrients 2023; 15:2943. [PMID: 37447269 DOI: 10.3390/nu15132943] [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: 05/16/2023] [Revised: 06/17/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
Although recent evidence has revealed that a body shape index (ABSI) is correlated with the incidence of death among different ethnicities, there remains a paucity of studies investigating the impact of ABSI on mortality within the Chinese elderly. Our objective was to ascertain the link between ABSI, as well as its alterations over time, and all-cause mortality among Chinese aged 65 y and above. A total of 3789 participants were enrolled from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Cox regressions and restricted cubic splines were employed to assess the association of ABSI and relative changes with all-cause mortality. When nonlinearity was detected, a restricted cubic spline regression was subsequently conducted to compute hazard ratios and 95% confidence intervals. The median survival time was 46 months, and 1342 individuals (35.4%) were reported to have died. ABSI contributed independently to rising death rates among Chinese old populations according to univariate and multivariate Cox regressions. Statistically significant associations were also found stratified by age, sex, and lifestyle. A U-shaped association of ABSI changes with all-cause mortality (p = 0.027) was observed, indicating that old adults with stable ABSI during the follow-up period experienced the lowest risk of mortality. After multivariable adjustment, participants with a 10% reduction in ABSI changes had an increased 9.4% risk of death, while participants with a 10% rise in ABSI changes had an increased 1.9% risk. ABSI and its changes are predictors for all-cause mortality among the elderly Chinese population, which emphasizes the clinical importance of monitoring ABSI and keeping it stable over time.
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Affiliation(s)
- Ning Yang
- Department of Clinical Nutrition, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Road, Shanghai 200072, China
- Shanghai Clinical Nutrition Quality Control Center, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Road, Shanghai 200072, China
| | - Jialu Zhuo
- Department of Clinical Nutrition, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Road, Shanghai 200072, China
- Shanghai Clinical Nutrition Quality Control Center, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Road, Shanghai 200072, China
| | - Suyi Xie
- Department of Medicine and Therapeutics, the Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
- Laboratory for Heart Failure + Circulation Research, Li Ka Shing Institute of Health Sciences, Gerald Choa Cardiac Research Centre, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, China
| | - Zhihua Qu
- Department of Clinical Nutrition, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Road, Shanghai 200072, China
- Shanghai Clinical Nutrition Quality Control Center, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Road, Shanghai 200072, China
| | - Wei Li
- Department of Clinical Nutrition, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Road, Shanghai 200072, China
- Shanghai Clinical Nutrition Quality Control Center, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Road, Shanghai 200072, China
| | - Zixiang Li
- Department of Clinical Nutrition, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Road, Shanghai 200072, China
- Shanghai Clinical Nutrition Quality Control Center, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Road, Shanghai 200072, China
| | - Panpan Guo
- Department of Clinical Nutrition, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Road, Shanghai 200072, China
- Shanghai Clinical Nutrition Quality Control Center, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Road, Shanghai 200072, China
| | - Mingbo Gao
- Department of Clinical Nutrition, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Road, Shanghai 200072, China
- Shanghai Clinical Nutrition Quality Control Center, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Road, Shanghai 200072, China
| | - Huanlong Qin
- Shanghai Clinical Nutrition Quality Control Center, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Road, Shanghai 200072, China
| | - Ting Han
- Department of Clinical Nutrition, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Road, Shanghai 200072, China
- Shanghai Clinical Nutrition Quality Control Center, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Road, Shanghai 200072, China
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Watke MA. Prediction of exophthalmos by body mass index for craniofacial reconstruction: consequences for cold cases. Forensic Sci Med Pathol 2023:10.1007/s12024-023-00649-8. [PMID: 37280468 DOI: 10.1007/s12024-023-00649-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2023] [Indexed: 06/08/2023]
Abstract
It is inconvenient for a forensic practitioner to gather population-specific data before performing a facial reconstruction. The inconvenience may defeat the point of creating the reconstruction. The objective of this study was to evaluate a non-population-dependent method of determining exophthalmos. The protrusion of the eyeball is known to vary with the contents of the orbital cavity based on bony orbital resorption or increased or decreased fat contents, as well as according to relative eyeball size. Of use are available statistics on body mass index, and this is discussed within the context of eyeball protrusion. A weak positive correlation (0.3263) between the body mass index of the country where the study originated, and the degree of exophthalmos was found. The results suggest that eyeball protrusion rates can be established according to body mass index, and this framework may be more useful considering conventional police practices.
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Ahn TR, Yoon YC, Kim HS, Kim K, Lee JH. Association Between Pelvic Bone Computed Tomography-Derived Body Composition and Patient Outcomes in Older Adults With Proximal Femur Fracture. Korean J Radiol 2023; 24:434-443. [PMID: 37133212 PMCID: PMC10157326 DOI: 10.3348/kjr.2022.0835] [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: 10/30/2022] [Revised: 02/22/2023] [Accepted: 03/13/2023] [Indexed: 05/04/2023] Open
Abstract
OBJECTIVE To investigate the association between pelvic bone computed tomography (CT)-derived body composition and patient outcomes in older adult patients who underwent surgery for proximal femur fractures. MATERIALS AND METHODS We retrospectively identified consecutive patients aged ≥ 65 years who underwent pelvic bone CT and subsequent surgery for proximal femur fractures between July 2018 and September 2021. Eight CT metrics were calculated from the cross-sectional area and attenuation of the subcutaneous fat and muscle, including the thigh subcutaneous fat (TSF) index, TSF attenuation, thigh muscle (TM) index, TM attenuation, gluteus maximus (GM) index, GM attenuation, gluteus medius and minimus (Gmm) index, and Gmm attenuation. The patients were dichotomized using the median value of each metric. Multivariable Cox regression and logistic regression models were used to determine the association between CT metrics with overall survival (OS) and postsurgical intensive care unit (ICU) admission, respectively. RESULTS A total of 372 patients (median age, 80.5 years; interquartile range, 76.0-85.0 years; 285 females) were included. TSF attenuation above the median (adjusted hazard ratio [HR], 2.39; 95% confidence interval [CI], 1.41-4.05), GM index below the median (adjusted HR, 2.63; 95% CI, 1.33-5.26), and Gmm index below the median (adjusted HR, 2.33; 95% CI, 1.12-4.55) were independently associated with shorter OS. TSF index (adjusted odds ratio [OR], 6.67; 95% CI, 3.13-14.29), GM index (adjusted OR, 3.45; 95% CI, 1.49-7.69), GM attenuation (adjusted OR, 2.33; 95% CI, 1.02-5.56), Gmm index (adjusted OR, 2.70; 95% CI, 1.22-5.88), and Gmm attenuation (adjusted OR, 2.22; 95% CI, 1.01-5.00) below the median were independently associated with ICU admission. CONCLUSION In older adult patients who underwent surgery for proximal femur fracture, low muscle indices of the GM and gluteus medius/minimus obtained from their cross-sectional areas on preoperative pelvic bone CT were significant prognostic markers for predicting high mortality and postsurgical ICU admission.
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Affiliation(s)
- Tae Ran Ahn
- Department of Radiology, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Young Cheol Yoon
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyun Su Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyunga Kim
- Biomedical Statistics Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Ji Hyun Lee
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Solomon N, Sailer A, Dixe de Oliveira Santo I, Pillai A, Heng LXX, Jha P, Katz DS, Zulfiqar M, Sugi M, Revzin MV. Sequelae of Eating Disorders at Imaging. Radiographics 2022; 42:1377-1397. [PMID: 35930473 DOI: 10.1148/rg.220018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Although eating disorders are common, they tend to be underdiagnosed and undertreated because social stigma tends to make patients less likely to seek medical attention and less compliant with medical treatment. Diagnosis is crucial because these disorders can affect any organ system and are associated with the highest mortality rate of any psychiatric disorder. Because of this, imaging findings, when recognized, can be vital to the diagnosis and management of eating disorders and their related complications. The authors familiarize the radiologist with the pathophysiology and sequelae of eating disorders and provide an overview of the related imaging findings. Some imaging findings associated with eating disorders are nonspecific, and others are subtle. The presence of these findings should alert the radiologist to correlate them with the patient's medical history and laboratory results and the clinical team's findings at the physical examination. The combination of these findings may suggest a diagnosis that might otherwise be missed. Topics addressed include (a) the pathophysiology of eating disorders, (b) the clinical presentation of patients with eating disorders and their medical complications and sequelae, (c) the imaging features associated with common and uncommon sequelae of eating disorders, (d) an overview of management and treatment of eating disorders, and (e) conditions that can mimic eating disorders (eg, substance abuse, medically induced eating disorders, and malnourishment in patients with cancer). Online supplemental material is available for this article. ©RSNA, 2022.
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Affiliation(s)
- Nadia Solomon
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (N.S., A.S., I.D.d.O.S., A.P., M.V.R.); Department of Science, Northern Arizona University, Flagstaff, Ariz (L.X.X.H.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (P.J., M.S.); Department of Radiology, New York University Long Island School of Medicine, Mineola, NY (D.S.K.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.Z.)
| | - Anne Sailer
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (N.S., A.S., I.D.d.O.S., A.P., M.V.R.); Department of Science, Northern Arizona University, Flagstaff, Ariz (L.X.X.H.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (P.J., M.S.); Department of Radiology, New York University Long Island School of Medicine, Mineola, NY (D.S.K.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.Z.)
| | - Irene Dixe de Oliveira Santo
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (N.S., A.S., I.D.d.O.S., A.P., M.V.R.); Department of Science, Northern Arizona University, Flagstaff, Ariz (L.X.X.H.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (P.J., M.S.); Department of Radiology, New York University Long Island School of Medicine, Mineola, NY (D.S.K.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.Z.)
| | - Aishwarya Pillai
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (N.S., A.S., I.D.d.O.S., A.P., M.V.R.); Department of Science, Northern Arizona University, Flagstaff, Ariz (L.X.X.H.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (P.J., M.S.); Department of Radiology, New York University Long Island School of Medicine, Mineola, NY (D.S.K.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.Z.)
| | - Lauren Xuan Xin Heng
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (N.S., A.S., I.D.d.O.S., A.P., M.V.R.); Department of Science, Northern Arizona University, Flagstaff, Ariz (L.X.X.H.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (P.J., M.S.); Department of Radiology, New York University Long Island School of Medicine, Mineola, NY (D.S.K.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.Z.)
| | - Priyanka Jha
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (N.S., A.S., I.D.d.O.S., A.P., M.V.R.); Department of Science, Northern Arizona University, Flagstaff, Ariz (L.X.X.H.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (P.J., M.S.); Department of Radiology, New York University Long Island School of Medicine, Mineola, NY (D.S.K.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.Z.)
| | - Douglas S Katz
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (N.S., A.S., I.D.d.O.S., A.P., M.V.R.); Department of Science, Northern Arizona University, Flagstaff, Ariz (L.X.X.H.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (P.J., M.S.); Department of Radiology, New York University Long Island School of Medicine, Mineola, NY (D.S.K.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.Z.)
| | - Maria Zulfiqar
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (N.S., A.S., I.D.d.O.S., A.P., M.V.R.); Department of Science, Northern Arizona University, Flagstaff, Ariz (L.X.X.H.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (P.J., M.S.); Department of Radiology, New York University Long Island School of Medicine, Mineola, NY (D.S.K.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.Z.)
| | - Mark Sugi
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (N.S., A.S., I.D.d.O.S., A.P., M.V.R.); Department of Science, Northern Arizona University, Flagstaff, Ariz (L.X.X.H.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (P.J., M.S.); Department of Radiology, New York University Long Island School of Medicine, Mineola, NY (D.S.K.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.Z.)
| | - Margarita V Revzin
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (N.S., A.S., I.D.d.O.S., A.P., M.V.R.); Department of Science, Northern Arizona University, Flagstaff, Ariz (L.X.X.H.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (P.J., M.S.); Department of Radiology, New York University Long Island School of Medicine, Mineola, NY (D.S.K.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.Z.)
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Xiao Y, Liu D, Cline MA, Gilbert ER. Chronic stress and adipose tissue in the anorexic state: endocrine and epigenetic mechanisms. Adipocyte 2020; 9:472-483. [PMID: 32772766 PMCID: PMC7480818 DOI: 10.1080/21623945.2020.1803643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Although adipose tissue metabolism in obesity has been widely studied, there is limited research on the anorexic state, where the endocrine system is disrupted by reduced adipose tissue mass and there are depot-specific changes in adipocyte type and function. Stress exposure at different stages of life can alter the balance between energy intake and expenditure and thereby contribute to the pathogenesis of anorexia nervosa. This review integrates information from human clinical trials to describe endocrine, genetic and epigenetic aspects of adipose tissue physiology in the anorexic condition. Changes in the hypothalamus-pituitary-thyroid, -adrenal, and -gonadal axes and their relationships to appetite regulation and adipocyte function are discussed. Because of the role of stress in triggering or magnifying anorexia, and the dynamic but also persistent nature of environmentally-induced epigenetic modifications, epigenetics is likely the link between stress and long-term changes in the endocrine system that disrupt homoeostatic food intake and adipose tissue metabolism. Herein, we focus on the adipocyte and changes in its function, including alterations reinforced by endocrine disturbance and dysfunctional adipokine regulation. This information is critical because of the poor understanding of anorexic pathophysiology, due to the lack of suitable research models, and the complexity of genetic and environmental interactions.
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Affiliation(s)
- Yang Xiao
- Department of Animal and Poultry Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Dongmin Liu
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Mark A. Cline
- Department of Animal and Poultry Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Elizabeth R. Gilbert
- Department of Animal and Poultry Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
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Yamamoto A, Kikuchi Y, Kusakabe T, Takano H, Sakurai K, Furui S, Oba H. Imaging spectrum of abnormal subcutaneous and visceral fat distribution. Insights Imaging 2020; 11:24. [PMID: 32056035 PMCID: PMC7018866 DOI: 10.1186/s13244-019-0833-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 12/17/2019] [Indexed: 12/19/2022] Open
Abstract
Adipose tissue plays multiple and complex roles not only in mechanical cushioning and energy storage but also as an important secretory organ that regulates energy balance and homeostasis multilaterally. Fat tissue is categorized into subcutaneous fat tissue (SCAT) or visceral fat tissue (VSA) depending on its distribution, with the two having different metabolic functions. Near-total lack of fat in congenital/acquired generalized lipodystrophy, cachexia, or any other severe malnutrition condition induces severe multi-organ dysfunction due to lack of production of leptin and other adipokines. Increased visceral fat tissue secondary to obesity, hypercortisolism, or multiple symmetric lipomatosis raises the risk of insulin resistance, cardiac complications, and airway or spinal canal stenosis, although the fat distribution pattern differs in each condition. Partial abnormal fat distribution conditions such as HIV/HAART therapy-associated lipodystrophy, familial partial lipodystrophies, and acquired partial lipodystrophy frequently show a mixture of lipoatrophy and lipohypertrophy with metabolic dysfunction. Characteristic imaging features in conditions with local abnormal fat distribution can provide information about a patient’s co-existent/unrecognized disease(s), past medical history, or lifestyle. Knowledge of characteristic abnormal fat distribution patterns can contribute to proper and timely therapeutic decision-making and patient education.
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Affiliation(s)
- Asako Yamamoto
- Department of Radiology, Teikyo University School of Medicine, 2-11-1 Kaga Itabashi-ku, Tokyo, 173-8606, Japan.
| | - Yoshinao Kikuchi
- Department of Pathology, Teikyo University School of Medicine, 2-11-1 Kaga Itabashi-ku, Tokyo, 173-8606, Japan
| | - Toru Kusakabe
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto, 612-8555, Japan
| | - Hideyuki Takano
- Department of Radiology, Chiba Cancer Center, 666-2 Nitonacho, Chuo-ku, Chiba-shi, Chiba, 260-8717, Japan
| | - Keita Sakurai
- Department of Radiology, Teikyo University School of Medicine, 2-11-1 Kaga Itabashi-ku, Tokyo, 173-8606, Japan
| | - Shigeru Furui
- Department of Radiology, Teikyo University School of Medicine, 2-11-1 Kaga Itabashi-ku, Tokyo, 173-8606, Japan
| | - Hiroshi Oba
- Department of Radiology, Teikyo University School of Medicine, 2-11-1 Kaga Itabashi-ku, Tokyo, 173-8606, Japan
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Louis F, Kitano S, Mano JF, Matsusaki M. 3D collagen microfibers stimulate the functionality of preadipocytes and maintain the phenotype of mature adipocytes for long term cultures. Acta Biomater 2019; 84:194-207. [PMID: 30502481 DOI: 10.1016/j.actbio.2018.11.048] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 11/26/2018] [Accepted: 11/27/2018] [Indexed: 12/28/2022]
Abstract
Although adipose tissue is one of the most abundant tissues of the human body, its reconstruction remains a competitive challenge. The conventional in vitro two or three-dimensional (2D or 3D) models of mature adipocytes unfortunately lead to their quick dedifferentiation after one week, and complete differentiation of adipose derived stem cells (ADSC) usually requires more than one month. In this context, we developed biomimetic 3D adipose tissues with high density collagen by mixing type I collagen microfibers with primary mouse mature adipocytes or human ADSC in transwells. These 3D-tissues ensured a better long-term maintained phenotype of unilocular mature adipocytes, compared to 2D, with a viability of 96 ± 2% at day 14 and a good perilipin immunostaining, - the protein necessary for stabilizing the fat vesicles. For comparison, in 2D culture, mature adipocytes released their fat until splitting their single adipose vesicle into several ones with significantly 4 times smaller size. Concerning ADSC, the adipogenic genes expression in 3D-tissues was found at least doubled throughout the differentiation (over 8 times higher for GLUT4 at day 21), along with it, almost 4 times larger fat vesicles were observed (10 ± 4 µm at day 14). Perilipin immunostaining and leptin secretion, the satiety protein, attested the significantly doubled better functionality of ADSC in 3D adipose tissues. These obtained long-term maintained phenotype and fast adipogenesis make this model relevant for either cosmetic/pharmaceutical assays or plastic surgery purposes. STATEMENT OF SIGNIFICANCE: Adipose tissue has important roles in our organism, providing energy from its lipids storage and secreting many vital proteins. However, its reconstruction in a functional in vitro adipose tissue is still a challenge. Mature adipocytes directly extracted from surgery liposuctions quickly lose their lipids after a week in vitro and the use of differentiated adipose stem cells is too time-consuming. We developed a new artificial fat tissue using collagen microfibers. These tissues allowed the maintenance of viable big unilocular mature adipocytes up to two weeks and the faster adipogenic differentiation of adipose stem cells. Moreover, the adipose functionality confirmed by perilipin and leptin assessments makes this model suitable for further applications in cosmetic/pharmaceutical drug assays or for tissue reconstruction.
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Affiliation(s)
- Fiona Louis
- Osaka University, Joint Research Laboratory (TOPPAN) for Advanced Cell Regulatory Chemistry, Graduate School of Engineering, Japan
| | - Shiro Kitano
- Osaka University, Joint Research Laboratory (TOPPAN) for Advanced Cell Regulatory Chemistry, Graduate School of Engineering, Japan
| | - João F Mano
- Department of Chemistry, CICECO-Aveiro Institute of Materials, University of Aveiro, Portugal
| | - Michiya Matsusaki
- Osaka University, Joint Research Laboratory (TOPPAN) for Advanced Cell Regulatory Chemistry, Graduate School of Engineering, Japan; Division of Applied Chemistry, Graduate School of Engineering, Osaka University, Japan; JST, PRESTO, Japan.
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Lee DC, Hoffmann PF, Kopperdahl DL, Keaveny TM. Phantomless calibration of CT scans for measurement of BMD and bone strength-Inter-operator reanalysis precision. Bone 2017; 103:325-333. [PMID: 28778598 PMCID: PMC5636218 DOI: 10.1016/j.bone.2017.07.029] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 06/01/2017] [Accepted: 07/21/2017] [Indexed: 01/22/2023]
Abstract
Patient-specific phantomless calibration of computed tomography (CT) scans has the potential to simplify and expand the use of pre-existing clinical CT for quantitative bone densitometry and bone strength analysis for diagnostic and monitoring purposes. In this study, we quantified the inter-operator reanalysis precision errors for a novel implementation of patient-specific phantomless calibration, using air and either aortic blood or hip adipose tissue as internal calibrating reference materials, and sought to confirm the equivalence between phantomless and (traditional) phantom-based measurements. CT scans of the spine and hip for 25 women and 15 men (mean±SD age of 67±9years, range 41-86years), one scan per anatomic site per patient, were analyzed independently by two analysts using the VirtuOst software (O.N. Diagnostics, Berkeley, CA). The scans were acquired at 120kVp, with a slice thickness/increment of 3mm or less, on nine different CT scanner models across 24 different scanners. The main parameters assessed were areal bone mineral density (BMD) at the hip (total hip and femoral neck), trabecular volumetric BMD at the spine, and vertebral and femoral strength by finite element analysis; other volumetric BMD measures were also assessed. We found that the reanalysis precision errors for all phantomless measurements were ≤0.5%, which was as good as for phantom calibration. Regression analysis indicated equivalence of the phantom- versus phantomless-calibrated measurements (slope not different than unity, R2≥0.98). Of the main parameters assessed, non-significant paired mean differences (n=40) between the two measurements ranged from 0.6% for hip areal BMD to 1.1% for mid-vertebral trabecular BMD. These results indicate that phantom-equivalent measurements of both BMD and finite element-derived bone strength can be reliably obtained from CT scans using patient-specific phantomless calibration.
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Affiliation(s)
| | | | | | - Tony M Keaveny
- Department of Mechanical Engineering, University of California, Berkeley, CA, USA; Department of Bioengineering, University of California, Berkeley, CA, USA.
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Ecklund K, Vajapeyam S, Mulkern RV, Feldman HA, O'Donnell JM, DiVasta AD, Gordon CM. Bone marrow fat content in 70 adolescent girls with anorexia nervosa: Magnetic resonance imaging and magnetic resonance spectroscopy assessment. Pediatr Radiol 2017; 47:952-962. [PMID: 28432403 PMCID: PMC5650065 DOI: 10.1007/s00247-017-3856-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 02/14/2017] [Accepted: 03/30/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Adolescents and women with anorexia nervosa have increased bone marrow fat and decreased bone formation, at least in part due to hormonal changes leading to preferential stem cell differentiation to adipocytes over osteoblasts. OBJECTIVE The purpose of this study was to evaluate marrow fat content and correlate with age and disease severity using knee MRI with T1 relaxometry (T1-R) and MR spectroscopy (MRS) in 70 adolescents with anorexia nervosa. MATERIALS AND METHODS We enrolled 70 girls with anorexia nervosa who underwent 3-T knee MRI with coronal T1-W images, T1-R and single-voxel proton MRS at 30 and 60 ms TE. Metaphyses were scored visually on the T1-W images for red marrow. Visual T1 score, T1 relaxometry values, MRS lipid indices and fat fractions were analyzed by regression on age, body mass index (BMI) and bone mineral density (BMD) as disease severity markers. MRS measures included unsaturated fat index, T2 water, unsaturated and saturated fat fractions. RESULTS All red marrow measures declined significantly with age. T1-R values were associated negatively with BMI and BMD for girls ≤16 years (P=0.03 and P=0.002, respectively) and positively for those≥17 years (P=0.05 and P=0.003, respectively). MRS identified a strong inverse association between T2 water and saturated fat fraction from 60 ms TE data (r=-0.85, P<0.0001). There was no association between unsaturated fat index and BMI or BMD. CONCLUSIONS The association between T1 and BMI and BMD among older girls suggests more marrow fat in those with severe anorexia nervosa. In contrast, the physiological association between marrow fat content and age remained dominant in younger patients. The strong association between T2 water and saturated fat may relate to the restricted mobility of water with increasing marrow fat.
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Affiliation(s)
- Kirsten Ecklund
- Department of Radiology, Boston Children's Hospital, 333 Longwood Ave., Boston, MA, 02115, USA.
| | - Sridhar Vajapeyam
- Department of Radiology, Boston Children's Hospital, 333 Longwood Ave., Boston, MA, 02115, USA
| | - Robert V Mulkern
- Department of Radiology, Boston Children's Hospital, 333 Longwood Ave., Boston, MA, 02115, USA
| | - Henry A Feldman
- Clinical Research Center, Boston Children's Hospital, Boston, MA, USA
| | | | - Amy D DiVasta
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Catherine M Gordon
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Tabari A, Torriani M, Miller KK, Klibanski A, Kalra MK, Bredella MA. Anorexia Nervosa: Analysis of Trabecular Texture with CT. Radiology 2016; 283:178-185. [PMID: 27797678 DOI: 10.1148/radiol.2016160970] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Purpose To determine indexes of skeletal integrity by using computed tomographic (CT) trabecular texture analysis of the lumbar spine in patients with anorexia nervosa and normal-weight control subjects and to determine body composition predictors of trabecular texture. Materials and Methods This cross-sectional study was approved by the institutional review board and compliant with HIPAA. Written informed consent was obtained. The study included 30 women with anorexia nervosa (mean age ± standard deviation, 26 years ± 6) and 30 normal-weight age-matched women (control group). All participants underwent low-dose single-section quantitative CT of the L4 vertebral body with use of a calibration phantom. Trabecular texture analysis was performed by using software. Skewness (asymmetry of gray-level pixel distribution), kurtosis (pointiness of pixel distribution), entropy (inhomogeneity of pixel distribution), and mean value of positive pixels (MPP) were assessed. Bone mineral density and abdominal fat and paraspinal muscle areas were quantified with quantitative CT. Women with anorexia nervosa and normal-weight control subjects were compared by using the Student t test. Linear regression analyses were performed to determine associations between trabecular texture and body composition. Results Women with anorexia nervosa had higher skewness and kurtosis, lower MPP (P < .001), and a trend toward lower entropy (P = .07) compared with control subjects. Bone mineral density, abdominal fat area, and paraspinal muscle area were inversely associated with skewness and kurtosis and positively associated with MPP and entropy. Texture parameters, but not bone mineral density, were associated with lowest lifetime weight and duration of amenorrhea in anorexia nervosa. Conclusion Patients with anorexia nervosa had increased skewness and kurtosis and decreased entropy and MPP compared with normal-weight control subjects. These parameters were associated with lowest lifetime weight and duration of amenorrhea, but there were no such associations with bone mineral density. These findings suggest that trabecular texture analysis might contribute information about bone health in anorexia nervosa that is independent of that provided with bone mineral density. © RSNA, 2016.
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Affiliation(s)
- Azadeh Tabari
- From the Department of Radiology (A.T., M.T., M.K.K., M.A.B.) and Neuroendocrine Unit (K.K.M., A.K.), Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Yawkey 6E, Boston, MA 02114
| | - Martin Torriani
- From the Department of Radiology (A.T., M.T., M.K.K., M.A.B.) and Neuroendocrine Unit (K.K.M., A.K.), Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Yawkey 6E, Boston, MA 02114
| | - Karen K Miller
- From the Department of Radiology (A.T., M.T., M.K.K., M.A.B.) and Neuroendocrine Unit (K.K.M., A.K.), Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Yawkey 6E, Boston, MA 02114
| | - Anne Klibanski
- From the Department of Radiology (A.T., M.T., M.K.K., M.A.B.) and Neuroendocrine Unit (K.K.M., A.K.), Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Yawkey 6E, Boston, MA 02114
| | - Mannudeep K Kalra
- From the Department of Radiology (A.T., M.T., M.K.K., M.A.B.) and Neuroendocrine Unit (K.K.M., A.K.), Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Yawkey 6E, Boston, MA 02114
| | - Miriam A Bredella
- From the Department of Radiology (A.T., M.T., M.K.K., M.A.B.) and Neuroendocrine Unit (K.K.M., A.K.), Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Yawkey 6E, Boston, MA 02114
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