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Lababidi H, Lababidi G, Rifai MA, Nasir K, Al-Kindi S. Cardiovascular disease in Arab Americans: A literature review of prevalence, risk factors, and directions for future research. Am J Prev Cardiol 2024; 18:100665. [PMID: 38634110 PMCID: PMC11021916 DOI: 10.1016/j.ajpc.2024.100665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/26/2024] [Accepted: 04/04/2024] [Indexed: 04/19/2024] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of mortality worldwide. Recent evidence suggests Arab Americans, individuals with ancestry from Arabic-speaking countries, have an elevated risk for CVD compared to other ethnicities in the US. However, research focusing specifically on CVD in this population is limited. This literature review synthesizes studies investigating CVD prevalence, risk factors, and outcomes in Arab Americans. Multiple studies found higher rates of coronary heart disease, cerebrovascular disease, and hypertension compared to non-Hispanic White participants. The prevalence of type 2 diabetes, a major CVD risk factor, was also markedly higher, ranging from 16 % to 41 % in Arab Americans based on objective measures. Possible explanations include high rates of vitamin D deficiency, genetic factors, and poor diabetes control. Other metabolic factors like dyslipidemia and obesity did not consistently differ from general population estimates. Psychosocial factors may further increase CVD risk, including acculturative stress, discrimination, low health literacy, and barriers to healthcare access. Smoking, especially waterpipe use, was more prevalent in Arab American men. Though heterogenous, Arab Americans overall appear to have elevated CVD risk, warranting tailored screening and management. Culturally appropriate educational initiatives on CVD prevention are greatly needed. Future directions include better characterizing CVD prevalence across Arab American subgroups, delineating genetic and environmental factors underlying increased diabetes susceptibility, and testing culturally tailored interventions to mitigate CVD risks. In summary, this review highlights concerning CVD disparities in Arab Americans and underscores the need for group-specific research and preventive strategies.
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Affiliation(s)
- Hossam Lababidi
- Houston Methodist DeBakey Heart and Vascular Institute, Houston Methodist Hospital, 6550 Fannin St, Houston, TX 77030, United States
| | - Ghena Lababidi
- Medical program, American University of Beirut, United States
| | - Mahmoud Al Rifai
- Houston Methodist DeBakey Heart and Vascular Institute, Houston Methodist Hospital, 6550 Fannin St, Houston, TX 77030, United States
| | - Khurram Nasir
- Houston Methodist DeBakey Heart and Vascular Institute, Houston Methodist Hospital, 6550 Fannin St, Houston, TX 77030, United States
| | - Sadeer Al-Kindi
- Houston Methodist DeBakey Heart and Vascular Institute, Houston Methodist Hospital, 6550 Fannin St, Houston, TX 77030, United States
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Garg UK, Mathur N, Sahlot R, Tiwari P, Sharma B, Saxena A, Jainaw RK, Agarwal L, Gupta S, Mathur SK. Abdominal fat depots and their association with insulin resistance in patients with type 2 diabetes. PLoS One 2023; 18:e0295492. [PMID: 38064530 PMCID: PMC10707599 DOI: 10.1371/journal.pone.0295492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 11/25/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Asian-Indians show thin fat phenotype, characterized by predominantly central deposition of excess fat. The roles of abdominal subcutaneous fat (SAT), intra-peritoneal adipose tissue, and fat depots surrounding the vital organs (IPAT-SV) and liver fat in insulin resistance (IR), type-2 diabetes (T2D) and metabolic syndrome (MetS) in this population are sparsely investigated. AIMS AND OBJECTIVES Assessment of liver fat, SAT and IPAT-SV by MRI in subjects with T2D and MetS; and to investigate its correlation with IR, specifically according to different quartiles of HOMA-IR. METHODS Eighty T2D and the equal number of age sex-matched normal glucose tolerant controls participated in this study. Abdominal SAT, IPAT-SV and liver fat were measured using MRI. IR was estimated by the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). RESULTS T2D and MetS subjects have higher quantity liver fat and IPAT-SV fat than controls (P = 9 x 10-4 and 4 x 10-4 for T2D and 10-4 and 9 x 10-3 for MetS subjects respectively). MetS subjects also have higher SAT fat mass (P = 0.012), but not the BMI adjusted SAT fat mass (P = 0.48). Higher quartiles of HOMA-IR were associated with higher BMI, W:H ratio, waist circumference, and higher liver fat mass (ANOVA Test P = 0.020, 0.030, 2 x 10-6 and 3 x 10-3 respectively with F-values 3.35, 3.04, 8.82, 4.47 respectively). In T2D and MetS subjects, HOMA-IR showed a moderately strong correlation with liver fat (r = 0.467, P < 3 x 10-5 and r = 0.493, P < 10-7), but not with SAT fat and IPAT-SV. However, in MetS subjects IPAT-SV fat mass showed borderline correlation with IR (r = 0.241, P < 0.05), but not with the BMI adjusted IPAT-SV fat mass (r = 0.13, P = 0.26). In non-T2D and non-MetS subjects, no such correlation was seen. On analyzing the correlation between the three abdominal adipose compartment fat masses and IR according to its severity, the correlation with liver fat mass becomes stronger with increasing quartiles of HOMA-IR, and the strongest correlation is seen in the highest quartile (r = 0.59, P < 10-3). On the other hand, SAT fat mass tended to show an inverse relation with IR with borderline negative correlation in the highest quartile (r = -0.284, P < 0.05). IPAT-SV fat mass did not show any statistically significant correlation with HOMA-IR, but in the highest quartile it showed borderline, but statistically insignificant positive correlation (P = 0.07). CONCLUSION In individuals suffering from T2D and MetS, IR shows a trend towards positive and borderline negative correlation with liver fat and SAT fat masses respectively. The positive trend with liver fat tends to become stronger with increasing quartile of IR. Therefore, these findings support the theory that possibly exhaustion of protective compartment's capacity to store excess fat results in its pathological deposition in liver as ectopic fat.
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Affiliation(s)
- Umesh Kumar Garg
- Department of Endocrinology, Sawai Man Singh Medical College and Hospital, Jaipur, India
| | - Nitish Mathur
- Department of Endocrinology, Sawai Man Singh Medical College and Hospital, Jaipur, India
| | - Rahul Sahlot
- Department of Endocrinology, Sawai Man Singh Medical College and Hospital, Jaipur, India
| | - Pradeep Tiwari
- Department of Endocrinology, Sawai Man Singh Medical College and Hospital, Jaipur, India
- Department of Chemistry, School of Basic Sciences, Manipal University Jaipur, Jaipur, India
| | - Balram Sharma
- Department of Endocrinology, Sawai Man Singh Medical College and Hospital, Jaipur, India
| | - Aditya Saxena
- Department of Computer Engineering & Applications, GLA University, Mathura, India
| | - Raj Kamal Jainaw
- Department of Surgery, Sawai Man Singh Medical College and Hospital, Jaipur, India
| | - Laxman Agarwal
- Department of Surgery, Sawai Man Singh Medical College and Hospital, Jaipur, India
| | - Shalu Gupta
- Department of Surgery, Sawai Man Singh Medical College and Hospital, Jaipur, India
| | - Sandeep Kumar Mathur
- Department of Endocrinology, Sawai Man Singh Medical College and Hospital, Jaipur, India
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Schneider D, Eggebrecht T, Linder A, Linder N, Schaudinn A, Blüher M, Denecke T, Busse H. Abdominal fat quantification using convolutional networks. Eur Radiol 2023; 33:8957-8964. [PMID: 37436508 PMCID: PMC10667157 DOI: 10.1007/s00330-023-09865-w] [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: 12/20/2022] [Revised: 04/21/2023] [Accepted: 05/03/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVES To present software for automated adipose tissue quantification of abdominal magnetic resonance imaging (MRI) data using fully convolutional networks (FCN) and to evaluate its overall performance-accuracy, reliability, processing effort, and time-in comparison with an interactive reference method. MATERIALS AND METHODS Single-center data of patients with obesity were analyzed retrospectively with institutional review board approval. Ground truth for subcutaneous (SAT) and visceral adipose tissue (VAT) segmentation was provided by semiautomated region-of-interest (ROI) histogram thresholding of 331 full abdominal image series. Automated analyses were implemented using UNet-based FCN architectures and data augmentation techniques. Cross-validation was performed on hold-out data using standard similarity and error measures. RESULTS The FCN models reached Dice coefficients of up to 0.954 for SAT and 0.889 for VAT segmentation during cross-validation. Volumetric SAT (VAT) assessment resulted in a Pearson correlation coefficient of 0.999 (0.997), relative bias of 0.7% (0.8%), and standard deviation of 1.2% (3.1%). Intraclass correlation (coefficient of variation) within the same cohort was 0.999 (1.4%) for SAT and 0.996 (3.1%) for VAT. CONCLUSION The presented methods for automated adipose-tissue quantification showed substantial improvements over common semiautomated approaches (no reader dependence, less effort) and thus provide a promising option for adipose tissue quantification. CLINICAL RELEVANCE STATEMENT Deep learning techniques will likely enable image-based body composition analyses on a routine basis. The presented fully convolutional network models are well suited for full abdominopelvic adipose tissue quantification in patients with obesity. KEY POINTS • This work compared the performance of different deep-learning approaches for adipose tissue quantification in patients with obesity. • Supervised deep learning-based methods using fully convolutional networks were suited best. • Measures of accuracy were equal to or better than the operator-driven approach.
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Affiliation(s)
- Daniel Schneider
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstr. 20, Haus 4, 04103, Leipzig, Germany
- Innovation Center Computer-Assisted Surgery (ICCAS), University of Leipzig, Semmelweisstr. 14, 04103, Leipzig, Germany
| | - Tobias Eggebrecht
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstr. 20, Haus 4, 04103, Leipzig, Germany
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, Leipzig University Medical Center, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Germany
| | - Anna Linder
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstr. 20, Haus 4, 04103, Leipzig, Germany
| | - Nicolas Linder
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstr. 20, Haus 4, 04103, Leipzig, Germany
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, Leipzig University Medical Center, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Germany
| | - Alexander Schaudinn
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstr. 20, Haus 4, 04103, Leipzig, Germany
| | - Matthias Blüher
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, Leipzig University Medical Center, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Germany
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Center Munich at the University of Leipzig and University Hospital Leipzig, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Germany
| | - Timm Denecke
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstr. 20, Haus 4, 04103, Leipzig, Germany
| | - Harald Busse
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstr. 20, Haus 4, 04103, Leipzig, Germany.
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Baptista LS, Silva KR, Jobeili L, Guillot L, Sigaudo-Roussel D. Unraveling White Adipose Tissue Heterogeneity and Obesity by Adipose Stem/Stromal Cell Biology and 3D Culture Models. Cells 2023; 12:1583. [PMID: 37371053 DOI: 10.3390/cells12121583] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
The immune and endocrine dysfunctions of white adipose tissue are a hallmark of metabolic disorders such as obesity and type 2 diabetes. In humans, white adipose tissue comprises distinct depots broadly distributed under the skin (hypodermis) and as internal depots (visceral). Depot-specific ASCs could account for visceral and subcutaneous adipose tissue properties, by regulating adipogenesis and immunomodulation. More importantly, visceral and subcutaneous depots account for distinct contributions to obesity and its metabolic comorbidities. Recently, distinct ASCs subpopulations were also described in subcutaneous adipose tissue. Interestingly, the superficial layer closer to the dermis shows hyperplastic and angiogenic capacities, whereas the deep layer is considered as having inflammatory properties similar to visceral. The aim of this focus review is to bring the light of recent discoveries into white adipose tissue heterogeneity together with the biology of distinct ASCs subpopulations and to explore adipose tissue 3D models revealing their advantages, disadvantages, and contributions to elucidate the role of ASCs in obesity development. Recent advances in adipose tissue organoids opened an avenue of possibilities to recreate the main cellular and molecular events of obesity leading to a deep understanding of this inflammatory disease besides contributing to drug discovery. Furthermore, 3D organ-on-a-chip will add reproducibility to these adipose tissue models contributing to their translation to the pharmaceutical industry.
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Affiliation(s)
- Leandra S Baptista
- Numpex-bio, Campus UFRJ Duque de Caxias Prof Geraldo Cidade, Universidade Federal do Rio de Janeiro, Rio de Janeiro 25240005, Brazil
| | - Karina R Silva
- Laboratory of Stem Cell Research, Histology and Embryology Department, Biology Institute, State University of Rio de Janeiro, Rio de Janeiro 20550900, Brazil
- Teaching and Research Division, National Institute of Traumatology and Orthopedics, Rio de Janeiro 20940070, Brazil
| | - Lara Jobeili
- Laboratory of Tissue Biology and Therapeutic Engineering, University of Lyon, Claude Bernard University Lyon 1, CNRS, LBTI UMR 5305, 69367 Lyon, France
| | - Lucile Guillot
- Laboratory of Tissue Biology and Therapeutic Engineering, University of Lyon, Claude Bernard University Lyon 1, CNRS, LBTI UMR 5305, 69367 Lyon, France
- Urgo Research Innovation and Development, 21300 Chenôve, France
| | - Dominique Sigaudo-Roussel
- Laboratory of Tissue Biology and Therapeutic Engineering, University of Lyon, Claude Bernard University Lyon 1, CNRS, LBTI UMR 5305, 69367 Lyon, France
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Angiotensin II Inhibits Insulin Receptor Signaling in Adipose Cells. Int J Mol Sci 2022; 23:ijms23116048. [PMID: 35682723 PMCID: PMC9181642 DOI: 10.3390/ijms23116048] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/20/2022] [Accepted: 05/20/2022] [Indexed: 11/17/2022] Open
Abstract
Angiotensin II (Ang II) is a critical regulator of insulin signaling in the cardiovascular system and metabolic tissues. However, in adipose cells, the regulatory role of Ang II on insulin actions remains to be elucidated. The effect of Ang II on insulin-induced insulin receptor (IR) phosphorylation, Akt activation, and glucose uptake was examined in 3T3-L1 adipocytes. In these cells, Ang II specifically inhibited insulin-stimulated IR and insulin receptor substrate-1 (IRS-1) tyrosine-phosphorylation, Akt activation, and glucose uptake in a time-dependent manner. These inhibitory actions were associated with increased phosphorylation of the IR at serine residues. Interestingly, Ang II-induced serine-phosphorylation of IRS was not detected, suggesting that Ang II-induced desensitization begins from IR regulation itself. PKC inhibition by BIM I restored the inhibitory effect of Ang II on insulin actions. We also found that Ang II promoted activation of several PKC isoforms, including PKCα/βI/βII/δ, and its association with the IR, particularly PKCβII, showed the highest interaction. Finally, we also found a similar regulatory effect of Ang II in isolated adipocytes, where insulin-induced Akt phosphorylation was inhibited by Ang II, an effect that was prevented by PKC inhibitors. These results suggest that Ang II may lead to insulin resistance through PKC activation in adipocytes.
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Nobarani S, Alaei-Shahmiri F, Aghili R, Malek M, Poustchi H, Lahouti M, Khamseh ME. Visceral Adipose Tissue and Non-alcoholic Fatty Liver Disease in Patients with Type 2 Diabetes. Dig Dis Sci 2022; 67:1389-1398. [PMID: 33788095 DOI: 10.1007/s10620-021-06953-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 03/12/2021] [Indexed: 12/11/2022]
Abstract
AIM To explore the association of visceral adipose tissue (VAT) area and non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM). METHODS This was a cross-sectional study comprising 100 patients with T2DM and 100 non-T2DM individuals, matched for age, sex, and body mass index (BMI). Transient elastography was used to assess hepatic steatosis and liver stiffness measurements (LSM). Controlled attenuation parameter (CAP) was used to quantify hepatic steatosis. To distinguish grades of hepatic steatosis, cutoff values were as follows: S1 ≥ 302, S2 ≥ 331, and S3 ≥ 337 dB/m. Moreover, VAT area was measured by dual-energy X-ray absorptiometry in accordance with validated protocols. RESULTS CAP score was significantly higher in participants with T2DM (294.61 ± 3.82 vs. 269.86 ± 3.86 dB/ m; P < 0.001). Furthermore, 42% of participants with T2DM had hepatic steatosis (S > S1: 302 dB/m), while this figure was 26% in non-T2DM group (P < 0.003). The mean liver stiffness measurement was also significantly higher in patients with T2DM (5.53 vs. 4.79 kPa; P < 0.001). VAT area was greater in patients with T2DM compared to non-T2DM individuals: 163.79 ± 47.98 cm2 versus 147.49 ± 39.09 cm2, P = 0.009. However, total and truncal fat mass were not different between the two groups. Age, BMI, waist circumference, ALT, CAP, and LSM were significantly associated with VAT area. BMI and VAT area were the important determinants of steatosis in both groups of participants with and without T2DM. Moreover, the VAT area was associated with the severity of hepatic steatosis and liver stiffness, independent of anthropometric measures of obesity. CONCLUSION VAT area is a major determinant of the severity of hepatic steatosis and liver stiffness in patient with T2DM.
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Affiliation(s)
- Sohrab Nobarani
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, No. 10, Firoozeh St., South Vali-asr Ave., Vali-Asr Sq., Tehran, Iran
| | - Fariba Alaei-Shahmiri
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, No. 10, Firoozeh St., South Vali-asr Ave., Vali-Asr Sq., Tehran, Iran
| | - Rokhsareh Aghili
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, No. 10, Firoozeh St., South Vali-asr Ave., Vali-Asr Sq., Tehran, Iran
| | - Mojtaba Malek
- Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Lahouti
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, No. 10, Firoozeh St., South Vali-asr Ave., Vali-Asr Sq., Tehran, Iran
| | - Mohammad E Khamseh
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, No. 10, Firoozeh St., South Vali-asr Ave., Vali-Asr Sq., Tehran, Iran.
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Nuhu JM, Yakasai AM, Danazumi MS, Nazeef F, Zakari UU, Usman Z, Mohammed J. Effect of aerobic exercise and burst-modulated biphasic pulsed current on glycemic control, central obesity and body image in individuals with type 2 diabetes mellitus: study protocol for a randomized controlled trial. ADVANCES IN INTEGRATIVE MEDICINE 2022. [DOI: 10.1016/j.aimed.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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DI Giuseppe G, Ciccarelli G, Cefalo CM, Cinti F, Moffa S, Improta F, Capece U, Pontecorvi A, Giaccari A, Mezza T. Prediabetes: how pathophysiology drives potential intervention on a subclinical disease with feared clinical consequences. Minerva Endocrinol (Torino) 2021; 46:272-292. [PMID: 34218657 DOI: 10.23736/s2724-6507.21.03405-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder whose rising incidence suggests the epidemic proportions of the disease. Impaired Fasting Glucose (IFG) and Impaired Glucose Tolerance (IGT) - alone or combined - represent two intermediate metabolic condition between Normal Glucose Tolerance (NGT) and overt T2DM. Several studies have demonstrated that insulin resistance and beta-cell impairment can be identified even in normoglycemic prediabetic individuals. Worsening of these two conditions may lead to progression of IGT and/or IFG status to overt diabetes. Starting from these assumptions, it seems logical to suppose that interventions aimed at improving metabolic conditions, even in prediabetes, could represent an effective target to halt transition from IGT/IFG to manifest T2DM. Starting from pathophysiological knowledge, in this review we evaluate two possible interventions (lifestyle modifications and pharmacological agents) eligible as prediabetes therapy since they have been demonstrated to improve insulin resistance and beta-cell impairment. Detecting high-risk people and treating them could represent an effective strategy to slow down progression to overt diabetes, normalize glucose tolerance, and even prevent micro- and macrovascular complications.
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Affiliation(s)
- Gianfranco DI Giuseppe
- Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gea Ciccarelli
- Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Chiara M Cefalo
- Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesca Cinti
- Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Simona Moffa
- Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Flavia Improta
- Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Umberto Capece
- Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alfredo Pontecorvi
- Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Giaccari
- Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Teresa Mezza
- Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy - .,Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
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9
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Okamura T, Hashimoto Y, Hamaguchi M, Obora A, Kojima T, Fukui M. Clinical characteristics and longitudinal changes of patients with non-alcoholic fatty liver disease in 2 decades: the NAGALA study. BMC Gastroenterol 2021; 21:223. [PMID: 34001028 PMCID: PMC8130346 DOI: 10.1186/s12876-021-01809-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 04/01/2021] [Indexed: 11/29/2022] Open
Abstract
Background In this study, to clarify the evolving background of people with non-alcoholic fatty liver disease (NAFLD), we compared the current prevalence of NAFLD with that of 2 decades ago. Methods We included two cohorts. The past cohort was from 1994 to 1997 and included 4279 men and 2502 women. The current cohort was from 2014 to 2017 and included 8918 men and 7361 women. NAFLD was diagnosed by abdominal ultrasonography. Results The prevalence of NAFLD increased in both genders throughout these 2 decades (18.5% in the past cohort and 27.1% in the current cohort for men; and 8.0% in the past cohort and 9.4% in the current cohort for women). The prevalence of hyperglycemia increased, whereas the prevalence of low high-density lipoprotein cholesterol levels and hypertriglyceridemia significantly decreased. There was no significant difference in the mean body mass index. Multivariate analysis revealed that the prevalence of obesity and body mass index were significantly associated with the prevalence of NAFLD in both the past and current cohorts. Conclusions The incidence of NAFLD significantly increased throughout these 2 decades, and obesity is the most prevalent factor. Thus, body weight management is an essential treatment option for NAFLD. Supplementary Information The online version contains supplementary material available at 10.1186/s12876-021-01809-2.
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Affiliation(s)
- Takuro Okamura
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
| | - Akihiro Obora
- Department of Gastroenterology, Asahi University Hospital, Gifu, Japan
| | - Takao Kojima
- Department of Gastroenterology, Asahi University Hospital, Gifu, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
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Rajput R, Garg R, Rajput M, Rani M, Darshan An V. Body composition and handgrip strength in patients with prediabetes: A case-control study from Haryana, North India. Diabetes Metab Syndr 2021; 15:823-827. [PMID: 33865056 DOI: 10.1016/j.dsx.2021.03.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS Previous studies suggest that body composition and handgrip strength are significantly altered in individuals with type 2 diabetes mellitus. Only few studies are available in prediabetic individuals. The aim is to study the change in body composition in adult individuals with prediabetes and compare it with age and sex-matched normoglycemic individuals. METHODS 100 diagnosed cases of prediabetes and 100 age and sex-matched normoglycemic controls were recruited in the study. Body composition was assessed with Omron HBF 510w and Slim guide skinfold caliper. Handgrip strength was assessed with Camry digital dynamometer. RESULTS Out of 100 subjects with prediabetes; 53 were female and 47 were male. In this study, there was higher mean body fat percentage (29.37 ± 5.65 vs 25.46 ± 5.27) and visceral fat (11.21 ± 1.92 vs 7.27 ± 2.82) in individuals with prediabetes compared to normoglycemic individuals. Also, there was a lower mean of skeletal muscle percentage (27.21 ± 4.32 vs 31.19 ± 4.63) and handgrip strength (29.61 ± 6.38 vs 33.75 ± 6.8) in individuals with prediabetes compared to normoglycemic individuals. In this study, body fat percentage was positively correlated (r = 0.3385) with prediabetes. The skeletal muscle percentage (r = -0.40721) and handgrip strength (r = -0.301) were negatively correlated with prediabetes. CONCLUSIONS It can be concluded that there is a significant change in body composition and handgrip strength in the individuals with prediabetes, and changes in body composition and handgrip strength can be included as a primary care strategy to motivate lifestyle modifications.
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Affiliation(s)
- Rajesh Rajput
- Department of Endocrinology, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India.
| | - Rakesh Garg
- Department of Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India.
| | - Meena Rajput
- Department of Community Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India.
| | - Monu Rani
- Department of Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India.
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11
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Sneed NM, Morrison SA. Body Composition Methods in Adults with Type 2 Diabetes or at Risk for T2D: a Clinical Review. Curr Diab Rep 2021; 21:14. [PMID: 33730341 DOI: 10.1007/s11892-021-01381-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2021] [Indexed: 01/22/2023]
Abstract
PURPOSE OF REVIEW The aim of this study is to summarize anthropometric and advanced methods used to assess body composition in adults diagnosed with type 2 diabetes (T2D) or at risk for T2D that provide clinically relevant information about T2D disease-related complications or risk factors. RECENT FINDINGS Anthropometry is commonly used in clinical settings; however, provides unreliable estimates of fat mass, fat-free mass, and body fat distribution for metabolic health assessments compared to advanced techniques such as bioelectrical impedance analysis (BIA), dual-energy x-ray absorptiometry (DXA), computerized tomography (CT), and magnetic resonance imaging (MRI). Few studies report the clinical use of anthropometric and advanced body composition methods that identify T2D disease-related complications or T2D risk factors. Anthropometry, BIA, DXA, CT, and MRI were used to estimate body adiposity and distribution, visceral and subcutaneous adipose tissue depots, and skeletal muscle mass. Review findings indicate that these methods were capable of identifying clinically relevant T2D disease-related complications such as sarcopenia and T2D risk factors such as obesity or regional adiposity. However, estimates were often sex and race/ethnicity specific warranting cross-validation of these methods in broader populations with T2D or risk for T2D prior to clinical implementation.
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Affiliation(s)
- Nadia Markie Sneed
- School of Nursing, Office of Research and Scholarship, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Shannon A Morrison
- School of Nursing, Department of Family, Community Health, and Systems, University of Alabama at Birmingham, Birmingham, AL, USA
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12
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de Soysa AKH, Langaas M, Jakic A, Shojaee-Moradie F, Umpleby AM, Grill V, Mostad IL. The fat mass and obesity-associated (FTO) gene allele rs9939609 and glucose tolerance, hepatic and total insulin sensitivity, in adults with obesity. PLoS One 2021; 16:e0248247. [PMID: 33684170 PMCID: PMC7939351 DOI: 10.1371/journal.pone.0248247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 02/23/2021] [Indexed: 12/02/2022] Open
Abstract
The objective of the study was to assess associations of the rs9939609 FTO allele to glucose tolerance, hepatic and total insulin sensitivity (IS) in individuals with obesity. From a low-dose hyperinsulinemic euglycemic clamp with glucose-tracer, hepatic IS was assessed by rates of basal and suppressed glucose appearance (Ra), a measure of endogenous glucose production (EGP), and the hepatic insulin resistance index (HIR). Total IS was assessed by rates of glucose infusion (GIR), disappearance (Rd), and metabolic clearance (MCR). From a meal test we assessed IS by the Matsuda index and glucose tolerance by glucose and insulin measurements in the fasted state and postprandially for 2.5 h. The meal test was performed in 97 healthy individuals with BMI ≥35 in similar-sized risk-allele groups (n = 32 T/T, 31 A/T, and 34 A/A), and 79 of them performed the clamp. We analyzed outcomes separately for males and females, and adjusted glucose Ra, Rd, MCR, GIR, and HIR for fat mass. We did not find genotype effects on EGP. Among males, genotype A/A was associated with a significantly lower glucose Rd, MCR, and Matsuda index score relative to genotype T/T. Glucose tolerance was significantly lower in males with genotype A/T vs. T/T and A/A. For females, there were no genotype effects on hepatic or total IS, or on glucose tolerance. Independently of genotypes, females displayed a significantly better hepatic and total IS, and better glucose tolerance than males. We conclude that in subjects with similar obesity we did not register any FTO risk-allele effect on hepatic IS. A FTO risk-allele effect on total IS was registered in males only, findings which need to be reproduced in further studies. Results confirm marked differences in IS between the biological sexes and extend present knowledge by demonstrating a lower endogenous glucose production in females vs. males in uniformly obese individuals.
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Affiliation(s)
- Ann Kristin Hjelle de Soysa
- Department of Clinical Nutrition and Speech-Language Therapy, Clinic of Clinical Services, St. Olavs Hospital - Trondheim University Hospital, Trondheim, Norway
- Faculty of Medicine and Health Sciences, Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- * E-mail:
| | - Mette Langaas
- Faculty of Information Technology and Electrical Engineering, Department of Mathematical Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Anida Jakic
- Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - A. Margot Umpleby
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Valdemar Grill
- Faculty of Medicine and Health Sciences, Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ingrid Løvold Mostad
- Department of Clinical Nutrition and Speech-Language Therapy, Clinic of Clinical Services, St. Olavs Hospital - Trondheim University Hospital, Trondheim, Norway
- Faculty of Medicine and Health Sciences, Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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13
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Dubé JJ, Collyer ML, Trant S, Toledo FGS, Goodpaster BH, Kershaw EE, DeLany JP. Decreased Mitochondrial Dynamics Is Associated with Insulin Resistance, Metabolic Rate, and Fitness in African Americans. J Clin Endocrinol Metab 2020; 105:dgz272. [PMID: 31833547 PMCID: PMC7067552 DOI: 10.1210/clinem/dgz272] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 12/11/2019] [Indexed: 12/27/2022]
Abstract
CONTEXT African American women (AAW) have a higher incidence of insulin resistance and are at a greater risk for the development of obesity and type 2 diabetes than Caucasian women (CW). Although several factors have been proposed to mediate these racial disparities, the mechanisms remain poorly defined. We previously demonstrated that sedentary lean AAW have lower peripheral insulin sensitivity, reduced maximal aerobic fitness (VO2max), and lower resting metabolic rate (RMR) than CW. We have also demonstrated that skeletal muscle mitochondrial respiration is lower in AAW and appears to play a role in these racial differences. OBJECTIVE The goal of this study was to assess mitochondrial pathways and dynamics to examine the potential mechanisms of lower insulin sensitivity, RMR, VO2max, and mitochondrial capacity in AAW. DESIGN To achieve this goal, we assessed several mitochondrial pathways in skeletal muscle using gene array technology and semiquantitative protein analysis. RESULTS We report alterations in mitochondrial pathways associated with inner membrane small molecule transport genes, fusion-fission, and autophagy in lean AAW. These differences were associated with lower insulin sensitivity, RMR, and VO2max. CONCLUSIONS Together these data suggest that the metabolic racial disparity of insulin resistance, RMR, VO2max, and mitochondrial capacity may be mediated by perturbations in mitochondrial pathways associated with membrane transport, fission-fusion, and autophagy. The mechanisms contributing to these differences remain unknown.
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Affiliation(s)
- John J Dubé
- Division of Endocrinology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
- School of Arts, Business, and Science, Department of Biology, Chatham University, Pittsburgh, Pennsylvania
| | - Michael L Collyer
- School of Arts, Business, and Science, Department of Biology, Chatham University, Pittsburgh, Pennsylvania
| | - Sara Trant
- School of Arts, Business, and Science, Department of Biology, Chatham University, Pittsburgh, Pennsylvania
| | - Frederico G S Toledo
- Division of Endocrinology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Bret H Goodpaster
- Division of Endocrinology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Erin E Kershaw
- Division of Endocrinology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - James P DeLany
- Division of Endocrinology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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14
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Liu AW, Song SO, Hayashi T, Sato KK, Kahn SE, Leonetti DL, Fujimoto WY, Boyko EJ. Change in CT-measured abdominal subcutaneous and visceral but not thigh fat areas predict future insulin sensitivity. Diabetes Res Clin Pract 2019; 154:17-26. [PMID: 31228493 PMCID: PMC6698223 DOI: 10.1016/j.diabres.2019.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 05/31/2019] [Accepted: 06/14/2019] [Indexed: 01/07/2023]
Abstract
AIMS We examined the longitudinal association between change in body composition directly measured by computed tomography (CT) and future insulin sensitivity. METHODS This was a prospective study with 10 years of follow-up with 297 Japanese-American without diabetes. Intra-abdominal fat area (IAFA) and abdominal subcutaneous fat area (SCFA), and thigh SCFA were measured by CT. Insulin sensitivity was calculated by HOMA-IR and the Matsuda index. RESULTS Baseline and change in IAFA were significantly and independently associated with change in HOMA-IR and Matsuda index during follow-up. In multivariate analysis, IAFA and 10-year change in IAFA (Δ IAFA) was significantly and positively associated with 10-year HOMA-IR (p < 0.001) and significantly and negatively associated with 10-year Matsuda index (p < 0.001). The association with Matsuda index though was non-linear and best modeled as a quadratic function (Δ IAFA + Δ IAFA2). No significant associations in multivariate analyses were seen between thigh SCFA and insulin sensitivity or abdominal SCFA and HOMA-IR but an increase in abdominal SCFA was associated with diminished insulin sensitivity measured by the Matsuda index. CONCLUSIONS An increase in visceral adiposity predicts diminished insulin sensitivity over 10 years of follow-up independent of the size of this adipose depot at baseline.
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Affiliation(s)
- Amy W Liu
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Sun Ok Song
- Department of Medicine, University of Washington, Seattle, WA, USA; Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA; Division of Endocrinology and Metabolism, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
| | - Tomoshige Hayashi
- Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kyoko K Sato
- Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Steven E Kahn
- Hospital and Specialty Medicine Service, VA Puget Sound Health Care System, Seattle, WA, USA; Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Donna L Leonetti
- Department of Anthropology, University of Washington, Seattle, WA, USA
| | - Wilfred Y Fujimoto
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Edward J Boyko
- Department of Medicine, University of Washington, Seattle, WA, USA; Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA
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15
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Thomas DD, Corkey BE, Istfan NW, Apovian CM. Hyperinsulinemia: An Early Indicator of Metabolic Dysfunction. J Endocr Soc 2019; 3:1727-1747. [PMID: 31528832 PMCID: PMC6735759 DOI: 10.1210/js.2019-00065] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 07/18/2019] [Indexed: 02/06/2023] Open
Abstract
Hyperinsulinemia is strongly associated with type 2 diabetes. Racial and ethnic minority populations are disproportionately affected by diabetes and obesity-related complications. This mini-review provides an overview of the genetic and environmental factors associated with hyperinsulinemia with a focus on racial and ethnic differences and its metabolic consequences. The data used in this narrative review were collected through research in PubMed and reference review of relevant retrieved articles. Insulin secretion and clearance are regulated processes that influence the development and progression of hyperinsulinemia. Environmental, genetic, and dietary factors are associated with hyperinsulinemia. Certain pharmacotherapies for obesity and bariatric surgery are effective at mitigating hyperinsulinemia and are associated with improved metabolic health. Hyperinsulinemia is associated with many environmental and genetic factors that interact with a wide network of hormones. Recent studies have advanced our understanding of the factors affecting insulin secretion and clearance. Further basic and translational work on hyperinsulinemia may allow for earlier and more personalized treatments for obesity and metabolic diseases.
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Affiliation(s)
- Dylan D Thomas
- Department of Medicine, Section of Endocrinology, Diabetes, Nutrition and Weight Management, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
| | - Barbara E Corkey
- Department of Medicine, Section of Endocrinology, Diabetes, Nutrition and Weight Management, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
| | - Nawfal W Istfan
- Department of Medicine, Section of Endocrinology, Diabetes, Nutrition and Weight Management, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
| | - Caroline M Apovian
- Department of Medicine, Section of Endocrinology, Diabetes, Nutrition and Weight Management, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
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16
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Silva KR, Baptista LS. Adipose-derived stromal/stem cells from different adipose depots in obesity development. World J Stem Cells 2019; 11:147-166. [PMID: 30949294 PMCID: PMC6441940 DOI: 10.4252/wjsc.v11.i3.147] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 01/27/2019] [Accepted: 02/28/2019] [Indexed: 02/06/2023] Open
Abstract
The increasing prevalence of obesity is alarming because it is a risk factor for cardiovascular and metabolic diseases (such as type 2 diabetes). The occurrence of these comorbidities in obese patients can arise from white adipose tissue (WAT) dysfunctions, which affect metabolism, insulin sensitivity and promote local and systemic inflammation. In mammals, WAT depots at different anatomical locations (subcutaneous, preperitoneal and visceral) are highly heterogeneous in their morpho-phenotypic profiles and contribute differently to homeostasis and obesity development, depending on their ability to trigger and modulate WAT inflammation. This heterogeneity is likely due to the differential behavior of cells from each depot. Numerous studies suggest that adipose-derived stem/stromal cells (ASC; referred to as adipose progenitor cells, in vivo) with depot-specific gene expression profiles and adipogenic and immunomodulatory potentials are keys for the establishment of the morpho-functional heterogeneity between WAT depots, as well as for the development of depot-specific responses to metabolic challenges. In this review, we discuss depot-specific ASC properties and how they can contribute to the pathophysiology of obesity and metabolic disorders, to provide guidance for researchers and clinicians in the development of ASC-based therapeutic approaches.
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Affiliation(s)
- Karina Ribeiro Silva
- Laboratory of Tissue Bioengineering, Directory of Metrology Applied to Life Sciences, National Institute of Metrology, Quality and Technology, Duque de Caxias, RJ 25250-020, Brazil
- Post-Graduation Program of Biotechnology, National Institute of Metrology, Quality and Technology, Duque de Caxias, RJ 25250-020, Brazil
| | - Leandra Santos Baptista
- Laboratory of Tissue Bioengineering, Directory of Metrology Applied to Life Sciences, National Institute of Metrology, Quality and Technology, Duque de Caxias, RJ 25250-020, Brazil
- Post-Graduation Program of Biotechnology, National Institute of Metrology, Quality and Technology, Duque de Caxias, RJ 25250-020, Brazil
- Multidisciplinary Center for Biological Research (Numpex-Bio), Federal University of Rio de Janeiro Campus Duque de Caxias, Duque de Caxias, RJ 25245-390, Brazil
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17
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Lajeunesse-Trempe F, Dufour R, du Souich P, Paquette M, Kaduka LU, Christensen DL. Anthropometric measures and their association with risk factors for cardio-metabolic diseases in Kenyan adults. Ann Hum Biol 2019; 45:486-495. [PMID: 30608195 DOI: 10.1080/03014460.2018.1562568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND The prevalence of cardio-metabolic diseases (CMD) is drastically increasing worldwide. Anthropometric measures of fat accumulation are correlated with CMD and Metabolic Syndrome (MS), but few studies have addressed this association in sub-Saharan African populations. AIM To investigate the association between anthropometric features, MS and other CMD risk factors in a population from Kenya. SUBJECTS AND METHODS In this cross-sectional study including 1405 Kenyans, anthropometric measurements including visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue (SAT) were carried out. Fasting blood glucose and standard oral glucose tolerance test, fasting serum insulin and plasma lipids were analysed. Homeostatic model assessment of insulin resistance was calculated. Systolic and diastolic blood pressures were measured. RESULTS CMD risk factors and MS were associated with all anthropometric features, except for high-density lipoprotein cholesterol levels (p < 0.05). The strongest association between MS and anthropometrics was seen with SAT (β = 1.45 ± 0.32 in men and 0.88 ± 0.14 in women, both p < 0.05). CONCLUSIONS Anthropometric measures, especially features of central obesity such as VAT and SAT, are relevant indicators of cardio-metabolic health in Kenyan populations. SAT is the strongest predictor of MS. These results highlight the need for further research on the pathological implication of VAT and SAT, in order to understand patterns of fat distribution and cardio-metabolic health among different ethnic groups.
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Affiliation(s)
- F Lajeunesse-Trempe
- a Faculty of Medicine , University of Montreal , Montreal , Canada.,b Nutrition, Metabolism and Atherosclerosis Clinic , Montreal Clinical Research Institute, affiliated with University of Montreal , Montreal , Canada
| | - R Dufour
- b Nutrition, Metabolism and Atherosclerosis Clinic , Montreal Clinical Research Institute, affiliated with University of Montreal , Montreal , Canada.,c Department of Nutrition , University of Montreal , Montreal , Canada
| | - P du Souich
- b Nutrition, Metabolism and Atherosclerosis Clinic , Montreal Clinical Research Institute, affiliated with University of Montreal , Montreal , Canada.,d Department of Pharmacology and Physiology, Faculty of Medicine , University of Montreal , Montreal , Canada
| | - M Paquette
- b Nutrition, Metabolism and Atherosclerosis Clinic , Montreal Clinical Research Institute, affiliated with University of Montreal , Montreal , Canada
| | - L U Kaduka
- e Centre for Public Health Research , KEMRI , Nairobi , Kenya
| | - D L Christensen
- f Department of Public Health , University of Copenhagen , Copenhagen , Denmark
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18
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Elling D, Surkan PJ, Enayati S, El-Khatib Z. Sex differences and risk factors for diabetes mellitus - an international study from 193 countries. Global Health 2018; 14:118. [PMID: 30486848 PMCID: PMC6263066 DOI: 10.1186/s12992-018-0437-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 11/08/2018] [Indexed: 02/07/2023] Open
Abstract
Background Increases in overweight and obesity among youths have resulted in the diagnosis of Type 2 diabetes mellitus (T2DM) at earlier ages. The impact of lifestyle-related factors has been implicated; however, its relation to morbidity and mortality and sex differences remain unclear. We aimed to document the changes in risk factors and sex differences associated with T2DM-related morbidity and mortality during 1995–2015. Method We used mortality rates and morbidity estimates from the Global Burden of Diseases Study 2016 using Disability-Adjusted Life Years (DALY). Multiple linear regression analyses were used to determine associations between T2DM-related mortality and related risk factors. DALYs were grouped by country income level, and were stratified by sex. Results Increases in mortality were observed for both sexes, and females tended to have higher mortality rates per 100,000 persons. Body mass index (BMI) continued to be the leading risk factor for T2DM-related mortality, and increases in BMI were more common in low- and middle-income countries (LIC and MIC). Low physical activity was strongly associated with mortality rates, followed by dietary risks and smoking (2.4; 1.4; 0.8 per 100,000 persons, respectively). Similar patterns were observed after adjustments for income level, sex, and age. DALYs continued to show increasing trends across all income levels during 1995–2015 (high-income (HIC):16%; MIC: 36%; LIC: 12%). Stratification by sex showed similar results; males had fewer T2DM DALYs than females, though a greater increase was observed among males. Conclusion Overall, T2DM related mortality was higher among females. Compared to in HIC, there appeared to be a considerable increase in the burden of T2DM in MIC and LIC, where BMI is the leading risk factor for T2DM-related mortality. Prevention programs should emphasize related risk factors according to the existing standard of care.
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Affiliation(s)
- Devy Elling
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden. .,Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Sahba Enayati
- Kompetenzcenter Gesundheit, St. Stephan, Wels, Austria
| | - Ziad El-Khatib
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,World Health Programme, Université du Québec en Abitibi-Témiscamingue (UQAT), Québec, Canada
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19
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Umano GR, Shabanova V, Pierpont B, Mata M, Nouws J, Tricò D, Galderisi A, Santoro N, Caprio S. A low visceral fat proportion, independent of total body fat mass, protects obese adolescent girls against fatty liver and glucose dysregulation: a longitudinal study. Int J Obes (Lond) 2018; 43:673-682. [PMID: 30337653 DOI: 10.1038/s41366-018-0227-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 08/13/2018] [Accepted: 08/29/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND The relative proportion of visceral fat (VAT) to subcutaneous fat (SAT) has been described as a major determinant of insulin resistance (IR). Our study sought to evaluate the effect of body fat distribution on glucose metabolism and intrahepatic fat content over time in a multiethnic cohort of obese adolescents. SUBJECTS/METHODS We examined markers of glucose metabolism by oral glucose tolerance test, and body fat distribution by abdominal MRI at baseline and after 19.2 ± 11.4 months in a cohort of 151 obese adolescents (88 girls, 63 boys; mean age 13.3 ± 3.4 years; mean BMI z-score 2.15 ± 0.70). Hepatic fat content was assessed by fast-gradient MRI in a subset of 93 subjects. We used the median value of VAT/(VAT + SAT) ratio within each gender at baseline to stratify our sample into high and low ratio groups (median value 0.0972 in girls and 0.118 in boys). RESULTS Female subjects tended to remain in their VAT/(VAT + SAT) category over time (change over follow-up P = 0.14 among girls, and P = 0.04 among boys). Baseline VAT/(VAT + SAT) strongly predicted the hepatic fat content, fasting insulin, 2-h glucose, and whole-body insulin sensitivity index at follow-up among girls, but not in boys. CONCLUSIONS The VAT/(VAT + SAT) ratio is a major determinant of impaired glucose metabolism and hepatic fat accumulation over time, and its effects are more pronounced in girls than in boys.
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Affiliation(s)
- Giuseppina R Umano
- Department of Pediatrics, Division of Pediatric Endocrinology, Yale University School of Medicine, New Haven, CT, 06520, USA.,Department of the Woman, the Child, of General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Veronika Shabanova
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT, 06520, USA
| | - Bridget Pierpont
- Department of Pediatrics, Division of Pediatric Endocrinology, Yale University School of Medicine, New Haven, CT, 06520, USA
| | - Mariana Mata
- Department of Pediatrics, Division of Pediatric Endocrinology, Yale University School of Medicine, New Haven, CT, 06520, USA
| | - Jessica Nouws
- Department of Pediatrics, Division of Pediatric Endocrinology, Yale University School of Medicine, New Haven, CT, 06520, USA
| | - Domenico Tricò
- Department of Internal Medicine, Section of Endocrinology, Yale University School of Medicine, New Haven, CT, 06520, USA.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alfonso Galderisi
- Department of Pediatrics, Division of Pediatric Endocrinology, Yale University School of Medicine, New Haven, CT, 06520, USA.,Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Nicola Santoro
- Department of Pediatrics, Division of Pediatric Endocrinology, Yale University School of Medicine, New Haven, CT, 06520, USA
| | - Sonia Caprio
- Department of Pediatrics, Division of Pediatric Endocrinology, Yale University School of Medicine, New Haven, CT, 06520, USA.
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Clinical impact of abdominal fat distribution measured by 3-D computed tomography volumetry on post-transplant renal function in recipients after living kidney transplantation: a retrospective study. Clin Exp Nephrol 2018; 23:415-424. [DOI: 10.1007/s10157-018-1643-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/30/2018] [Indexed: 01/23/2023]
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21
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Dan Lantsman C, Herman A, Verlaan JJ, Stern M, Mader R, Eshed I. Abdominal fat distribution in diffuse idiopathic skeletal hyperostosis and ankylosing spondylitis patients compared to controls. Clin Radiol 2018; 73:910.e15-910.e20. [PMID: 30031587 DOI: 10.1016/j.crad.2018.06.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 06/04/2018] [Indexed: 12/31/2022]
Abstract
AIM To evaluate abdominal fat distribution (subcutaneous adipose tissue [SAT] and visceral adipose tissue [VAT]) in two enthesopathy-related diseases with known correlation to metabolic syndrome (MS): diffuse idiopathic skeletal hyperostosis (DISH) and ankylosing spondylitis (AS) compared with controls. MATERIALS AND METHODS Abdominal computed tomography (CT) examinations of 43 DISH (Resnick radiographic criteria) patients, 31 AS (Modified New York Criteria) patients and 42 age- and gender-matched (to DISH) controls (males: 29; 29; 27 and mean age: 71.7±7; 56.1±16; 72.7±8 years, respectively) were evaluated and compared for VAT and SAT surface areas on mid L3, L4, L5 levels. RESULTS AS patients were significantly younger compared to DISH patients and controls. No significant differences were observed between VAT and SAT of DISH and AS patients or between SAT values in all groups even after correction for age. VAT was higher in DISH and AS patients compared to controls on all three levels, but reached significance (p<0.05) only for DISH patients (L3: 24.34/23.6/18.43; L4: 23.85/22.21/18.05; L5: 19.09/18.94/14.24 mm2, respectively). This did not change after correction for age. The VAT/SAT ratio was significantly larger in DISH and AS patients on all levels compared to controls. CONCLUSION The higher VAT surface area, a known marker for MS, which by itself is associated with bone proliferation, in DISH and AS patients compared to controls substantiates its role as a potential surrogate marker for MS as well as suggests a potential shared pathogenic pathway for enthesopathic excessive bone production in DISH and AS.
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Affiliation(s)
- C Dan Lantsman
- Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Israel
| | - A Herman
- Department of Orthopedic Surgery, Assuta Ashdod Medical Center, Ashdod, Affiliated to Ben Gurion University, Beer Sheva, Israel
| | - J J Verlaan
- Department of Orthopaedic Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands
| | - M Stern
- Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Israel
| | - R Mader
- Rheumatic Diseases Unit, Ha'Emek Medical Center, Afula, Israel affiliated to the B. Rappaport Faculty of Medicine, The Technion Institute of Technology Haifa, Israel
| | - I Eshed
- Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Israel.
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22
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Hill JH, Solt C, Foster MT. Obesity associated disease risk: the role of inherent differences and location of adipose depots. Horm Mol Biol Clin Investig 2018; 33:/j/hmbci.ahead-of-print/hmbci-2018-0012/hmbci-2018-0012.xml. [PMID: 29547393 DOI: 10.1515/hmbci-2018-0012] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 02/09/2018] [Indexed: 02/07/2023]
Abstract
Obesity and associated metabolic co-morbidities are a worldwide public health problem. Negative health outcomes associated with obesity, however, do not arise from excessive adiposity alone. Rather, deleterious outcomes of adipose tissue accumulation are a result of how adipocytes are distributed to individual regions in the body. Due to our increased understanding of the dynamic relationship that exists between specific adipose depots and disease risk, an accurate characterization of total body adiposity as well as location is required to properly evaluate a population's disease risk. Specifically, distinctive tissue depots within the body include the lower body, upper body and abdominal (deep and superficial) subcutaneous regions, as well as visceral (mesenteric and omental) regions. Upper body and visceral adipose tissues are highly associated with metabolic dysfunction and chronic disease development, whereas lower body gluteofemoral subcutaneous adipose tissue imparts protection against diet-induced metabolic derangement. Each adipose depot functions distinctly as an endocrine organ hence it has a different level of impact on health outcomes. Effluent from adipose tissue can modulate the functions of other tissues, whilst receiving differential communication from the rest of the body via central nervous system innervation, metabolites and other signaling molecules. More so, adipose depots contain a diverse reservoir of tissue-resident immune cells that play an integral part in both maintaining tissue homeostasis, as well as propagating metabolically-induced inflammation. Overall, the conceptualization of obesity and associated risks needs updating to reflect the complexities of obesity. We review adipose tissue characteristics that are linked to deleterious or beneficial adipose tissue distributions.
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Affiliation(s)
- Jessica H Hill
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA
| | - Claudia Solt
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA
| | - Michelle T Foster
- Department of Food Science and Human Nutrition, Colorado State University, 1571 Campus Delivery, 500 West Lake Street, Fort Collins, CO 80523, USA, Phone: +(970) 491-6189, Fax: +(970) 491-3875
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23
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Chuang HC, Wang JS, Lee IT, Sheu WHH, Tan TH. Epigenetic regulation of HGK/MAP4K4 in T cells of type 2 diabetes patients. Oncotarget 2017; 7:10976-89. [PMID: 26918832 PMCID: PMC4905452 DOI: 10.18632/oncotarget.7686] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 02/05/2016] [Indexed: 12/16/2022] Open
Abstract
Type 2 diabetes (T2D) is a complex and heterogeneous disease. Obesity increases the risk of obese T2D; but in Asia non-obese T2D is prevalent. The cause of non-obese T2D has remained elusive. We studied the potential involvement of HGK/MAP4K4 in T2D using clinical samples from newly diagnosed, drug-naïve patients and healthy controls. HGK levels fell and IL-6 levels increased in T cells from T2D patients. Frequencies of IL-6-producing T cells were correlated with glucose levels after glucose-tolerance tests (but not body mass index and waist circumference) and inversely correlated with HGK expression levels. Moreover, methylation frequencies of the HGK promoter were increased in T2D patients and correlated with glucose levels after glucose-tolerance tests. The correlation was independent of body mass index. Demethylation treatment increased HGK expression levels and reduced IL-6 production in T2D T cells. This report identifies HGK methylation/downregulation in T cells as a potential biomarker for non-obese T2D.
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Affiliation(s)
- Huai-Chia Chuang
- Immunology Research Center, National Health Research Institutes, Zhunan, Taiwan
| | - Jun-Sing Wang
- Division of Endocrinology and Metabolism, Taichung Veterans General Hospital, Taichung, Taiwan
| | - I-Te Lee
- Division of Endocrinology and Metabolism, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Wayne H-H Sheu
- Division of Endocrinology and Metabolism, Taichung Veterans General Hospital, Taichung, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tse-Hua Tan
- Immunology Research Center, National Health Research Institutes, Zhunan, Taiwan.,Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas, USA
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24
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Alman AC, Smith SR, Eckel RH, Hokanson JE, Burkhardt BR, Sudini PR, Wu Y, Schauer IE, Pereira RI, Snell-Bergeon JK. The ratio of pericardial to subcutaneous adipose tissues is associated with insulin resistance. Obesity (Silver Spring) 2017; 25:1284-1291. [PMID: 28558132 PMCID: PMC5488713 DOI: 10.1002/oby.21875] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 03/17/2017] [Accepted: 04/10/2017] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To examine the association between pericardial adipose tissue (PAT) and the ratio of PAT to subcutaneous adipose tissue (SAT) with insulin resistance in adults with and without type 1 diabetes (T1D). METHODS Data for this report came from a substudy of the Coronary Artery Calcification in Type 1 Diabetes cohort (n = 83; 38 with T1D, 45 without T1D). Insulin resistance was measured by hyperinsulinemic-euglycemic clamp. Abdominal computed tomography (CT) was used to measure visceral adipose tissue (VAT) and SAT. PAT was measured from CT scans of the heart. RESULTS PAT and the ratio of PAT to SAT was higher in males compared to females. After adjustment for demographics, diabetes, blood pressure and lipid factors, BMI, VAT, and log PAT/SAT ratio, log PAT was positively associated with the glucose infusion rate (GIR) in females only (β = 3.36 ± 1.96, P = 0.097, P for sex interaction = 0.055). Conversely, the log PAT/SAT ratio was significantly associated with decreased GIR in both males and females (β = -2.08 ± 1.03, P = 0.047, P for sex interaction = 0.768). CONCLUSIONS A significant association between the PAT/SAT ratio and insulin resistance was found, independent of BMI, VAT, and PAT. These results highlight the importance of considering fat distribution independent of volume.
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Affiliation(s)
- Amy C. Alman
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL USA
| | - Steven R. Smith
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL USA
| | - Robert H. Eckel
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Denver, Aurora, CO USA
| | - John E. Hokanson
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO USA
| | - Brant R. Burkhardt
- Department of Cell Biology, Microbiology and Molecular Biology, College of Liberal Arts and Sciences, University of South Florida, Tampa, FL USA
| | - Preethi R. Sudini
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL USA
| | - Yougui Wu
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL USA
| | - Irene E. Schauer
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Denver, Aurora, CO USA
- Denver VA Medical Center, Denver, CO
| | - Rocio I. Pereira
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Denver, Aurora, CO USA
- Denver Health Medical Center, Denver, CO
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25
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Oz I, Bilici M, Serifoglu I, Karakaya Arpaci D, Buyukuysal M, Bayraktaroglu T. ASSOCIATION OF PANCREAS VOLUME AND INSULIN RESISTANCE WITH ABDOMINAL FAT DISTRIBUTION IN TYPE-2 DIABETES AS EVALUATED BY COMPUTED TOMOGRAPHY. ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2017; 13:168-173. [PMID: 31149169 PMCID: PMC6516451 DOI: 10.4183/aeb.2017.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE We aimed to assess the relationship between the regional body fat distribution and insulin resistance and pancreas volume (PV) in type-2 diabetes (DM) patients. METHODS Fifty-three consecutive type-2 diabetic and 51 non-diabetic patients matched by age, gender and body mass index (BMI) were enrolled. Subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), waist circumference, and PV were measured with computed tomography. Insulin resistance was assessed by the homeostasis model assessment of insulin resistance (HOMA-IR). RESULTS Patients with type-2 DM had significantly lower PV than non-diabetic individuals. HOMA-IR ranged from 0.74 to 6.24; and from 0.37 to 3.26, in type-2 DM patients and non-diabetics, respectively. VAT was positively correlated with HOMA-IR in two groups. There were inverse correlations between PV and VAT and VAT/SAT but only in diabetics. CONCLUSIONS The VAT/SAT ratio may reflect the possible role of VAT to better understand the pathogenesis of obesity-related disorders in patients with type-2 DM.
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Affiliation(s)
- I.I. Oz
- Bulent Ecevit University School of Medicine, Department of Radiology, Zonguldak, Turkey
| | - M. Bilici
- Bulent Ecevit University School of Medicine, Department of Internal Medicine, Zonguldak, Turkey
| | - I. Serifoglu
- Bulent Ecevit University School of Medicine, Department of Radiology, Zonguldak, Turkey
| | - D. Karakaya Arpaci
- Bulent Ecevit University School of Medicine, Department of Endocrinology, Zonguldak, Turkey
| | - M.C. Buyukuysal
- Bulent Ecevit University School of Medicine, Department of Biostatistics, Esenköy, Kozlu, Zonguldak, Turkey
| | - T. Bayraktaroglu
- Bulent Ecevit University School of Medicine, Department of Endocrinology, Zonguldak, Turkey
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26
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Lei H, Chen X, Liu S, Chen Z. Effect of Electroacupuncture on Visceral and Hepatic Fat in Women with Abdominal Obesity: A Randomized Controlled Study Based on Magnetic Resonance Imaging. J Altern Complement Med 2017; 23:285-294. [PMID: 28394670 DOI: 10.1089/acm.2016.0361] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Visceral adipose tissue (VAT) and hepatic fat deposition are the most important risk factors for women's health. Acupuncture, including electroacupuncture (EA), is used to treat obesity throughout the world. The effect of EA is evaluated mainly by body mass index (BMI) and waist circumference (WC). Few studies have assessed its effect in reducing VAT volume and hepatic fat fraction (HFF) based on an exact measurement method such as magnetic resonance imaging (MRI). This study aimed to resolve this issue. METHODS Thirty subjects were randomly divided into two groups. The control group (n = 15) did not receive any intervention and maintained a normal diet and their usual exercise habits. The treatment group (n = 15) received EA three times a week for 3 months. BMI and WC were measured using different devices. VAT and HFF were measured by MRI and calculated by related software before and after the intervention. RESULTS A marked difference was evident in group that received EA treatment in the following tests. The differences in BMI (U = 21.00, p < 0.001), WC (U = 40.50, p = 0.002), VAT volume (U = 13.00, p < 0.001), and mean HFF (U = 0.00, p < 0.001) before and after the intervention in the treatment group were distinct and significant compared with those of the control group. Three months later, the treatment group showed a lower BMI (W = 91.00, p = 0.001), WC (t = 4.755, p < 0.001), VAT volume (t = 5.164, p < 0.001), and mean HFF (W = 120.00, p = 0.001) compared with pretreatment levels. Compared with the control group, the treatment group showed a lower VAT volume (t = 60.00, p = 0.029) after 3 months of treatment. After 3 months, the control group showed higher mean HFF (t = -2.900, p = 0.012) and VAT volume (W = 11.50, p = 0.006) compared with their initial levels. CONCLUSION Based on MRI evaluation, this randomized controlled study proved that EA treatment reduces BMI and WC as well as VAT volume and HFF in women with abdominal obesity.
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Affiliation(s)
- Hong Lei
- 1 Department of Acupuncture, Puai Hospital , Wuhan, Hubei, People's Republic of China
| | - Xiao Chen
- 2 Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, Hubei, People's Republic of China
| | - Shuyun Liu
- 3 College of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, Hubei, People's Republic of China
| | - Zhenyan Chen
- 4 Department of Nutrition, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, Hubei, People's Republic of China
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27
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Mohammad A, De Lucia Rolfe E, Sleigh A, Kivisild T, Behbehani K, Wareham NJ, Brage S, Mohammad T. Validity of visceral adiposity estimates from DXA against MRI in Kuwaiti men and women. Nutr Diabetes 2017; 7:e238. [PMID: 28067890 PMCID: PMC5301039 DOI: 10.1038/nutd.2016.38] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 05/12/2016] [Accepted: 07/20/2016] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES The prevalence of obesity and diabetes in the Middle East is among the highest in the world. Valid measures of abdominal adiposity are essential to understanding the metabolic consequences of obesity. Dual-energy X-ray absorptiometry (DXA) is increasingly being utilised to assess body composition in population studies, and has recently been used to estimate visceral adipose tissue (VAT). The aim of this study was to determine the accuracy of DXA-derived VAT in a Middle Eastern population using magnetic resonance imaging (MRI) as the criterion measure. METHOD VAT was estimated from abdominal DXA measures in 237 adult men (n=130) and women (n=107), aged 18-65 years, participating in the Kuwait Wellbeing Study. These estimates were compared with MRI measures of the corresponding anatomical region. The agreement between methods was assessed using Bland-Altman as well as correlation analysis. RESULTS Median MRI VAT was 1148.5 cm3 (95% confidence interval: 594.2-1734.6) in men and 711.3 cm3 (95% confidence interval: 395.5-1042.8) in women. DXA estimates of VAT showed high correlations with corresponding MRI measures (r=0.94 (P<0.0001) in men; r=0.93 (P<0.0001) in women). DXA overestimated VAT with a mean bias (95% limits of agreement) of 79.7 cm3 (-767 to 963) in men and 46.8 cm3 (-482 to 866) in women. The imprecision of DXA increased with increasing VAT level in both men and women. CONCLUSION DXA estimates of VAT are valid for use in Middle Eastern populations, although accuracy decreases with increasing level of visceral adiposity.
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Affiliation(s)
- A Mohammad
- Department of Public Health Research, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - E De Lucia Rolfe
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - A Sleigh
- Wolfson Brain Imaging Centre, University of Cambridge School of Clinical Medicine, and NIHR/Wellcome Trust Clinical Research Facility, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - T Kivisild
- Department of Biological Anthropology, University of Cambridge, Cambridge, UK
| | - K Behbehani
- Department of Public Health Research, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - N J Wareham
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - S Brage
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - T Mohammad
- Department of Biological Anthropology, University of Cambridge, Cambridge, UK
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28
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Kouda K, Nakamura H, Ohara K, Fujita Y, Iki M. Increased Ratio of Trunk-to-Appendicular Fat and Decreased Adiponectin: A Population-Based Study of School Children in Hamamatsu, Japan. J Clin Densitom 2017; 20:66-72. [PMID: 26655234 DOI: 10.1016/j.jocd.2015.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 10/27/2015] [Accepted: 10/30/2015] [Indexed: 01/13/2023]
Abstract
Very few epidemiological studies have examined the relative impact of visceral fat and subcutaneous fat on serum adiponectin levels. Trunk-to-extremity fat ratio is reportedly a better surrogate for visceral fat than for subcutaneous fat. In the present study, we investigated the association between adiponectin and trunk-to-appendicular fat ratio (TAR) in a school population. The source population was all fifth graders (799 pupils) enrolled in the 2 elementary schools in Hamamatsu, Japan. Of the source population, we analyzed cross-sectional data from 609 children (mean age: 11.2 yr). TAR was evaluated by dual-energy X-ray absorptiometry and calculated as trunk fat mass divided by appendicular (arms and legs) fat mass. After stratification by tertiles of total body fat, multiple regression analysis was used to examine the relationships between adiponectin and TAR adjusted for potential confounding factors. In the highest tertile of total body fat, increasing TARs were significantly (p < 0.05) associated with decreasing serum adiponectin levels after stratification by total body fat (β = -0.32 in boys; β = -0.31 in girls). In the second tertile of total body fat, TAR in girls also showed significant inverse relationships with serum adiponectin levels (β = -0.27). Data from this population-based study demonstrated that an increased proportion of trunk fat is associated with decreased adiponectin in relatively overweight children, and also demonstrated that girls with a normal volume of body fat that follows a more centralized distribution show decreased adiponectin.
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Affiliation(s)
- Katsuyasu Kouda
- Department of Public Health, Kinki University Faculty of Medicine, Osaka-Sayama, Japan.
| | - Harunobu Nakamura
- Department of Health Promotion and Education, Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| | - Kumiko Ohara
- Department of Health Promotion and Education, Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| | - Yuki Fujita
- Department of Public Health, Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - Masayuki Iki
- Department of Public Health, Kinki University Faculty of Medicine, Osaka-Sayama, Japan
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29
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Pan Q, Chen MM, Zhang RN, Wang YQ, Zheng RD, Mi YQ, Liu WB, Shen F, Su Q, Fan JG. PNPLA3 rs1010023 Predisposes Chronic Hepatitis B to Hepatic Steatosis but Improves Insulin Resistance and Glucose Metabolism. J Diabetes Res 2017; 2017:4740124. [PMID: 28695131 PMCID: PMC5488317 DOI: 10.1155/2017/4740124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 05/07/2017] [Accepted: 05/16/2017] [Indexed: 02/07/2023] Open
Abstract
PNPLA3 polymorphisms serve as the genetic basis of hepatic steatosis in normal population and lead to dysregulated glucose metabolism. Whether it underlies the hepatic steatosis and glucose homeostasis in chronic hepatitis B patients remains uncertain. Here, we investigated the PNPLA3 polymorphisms in biopsy-proven chronic hepatitis B patients with (CHB+HS group, n = 52) or without hepatic steatosis (CHB group, n = 47) and non-CHB subjects with (HS group, n = 37) or without hepatic steatosis (normal group, n = 45). When compared to the TT genotype, C-allele at PNPLA3 rs1010023 (CC and TC genotypes) conferred higher risk to hepatic steatosis in chronic hepatitis B patients (odds ratio (OR) = 1.768, 95% confidence interval (CI): 1.027-3.105; P = 0.045) independent of age, gender, and body mass index. In contrast to their role in hepatic steatosis, CC and TC genotypes of PNPLA3 rs1010023 were correlated to significant improvement of homeostasis model assessment index (HOMA-IR) as compared to TT genotype in the CHB+HS group. Downregulated fasting blood glucose also characterized the CHB+HS patients with C-allele at PNPLA3 rs1010023 (CC/TC versus TT: 4.81 ± 0.92 mmol/L versus 5.86 ± 2.11 mmol/L, P = 0.02). These findings suggest that PNPLA3 rs1010023 may predispose chronic hepatitis B patients to hepatic steatosis but protects them from glucose dysregulation by attenuating insulin resistance.
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Affiliation(s)
- Qin Pan
- Department of Gastroenterology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
| | - Mei-Mei Chen
- Department of Gastroenterology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
| | - Rui-Nan Zhang
- Department of Gastroenterology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
| | - Yu-Qin Wang
- Department of Gastroenterology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
| | - Rui-Dan Zheng
- Diagnosis and Treatment Center for Liver Diseases, Zhengxing Hospital, Zhangzhou, Fujian Province 363000, China
| | - Yu-Qiang Mi
- Department of Infectious Diseases, Tianjin Infectious Disease Hospital, Tianjin 300192, China
| | - Wen-Bin Liu
- Wu-Jiao-Chang Community Health Center, Shanghai 200433, China
| | - Feng Shen
- Department of Gastroenterology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
| | - Qing Su
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
| | - Jian-Gao Fan
- Department of Gastroenterology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
- Shanghai Key Laboratory of Children's Digestion and Nutrition, Shanghai 200092, China
- *Jian-Gao Fan:
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30
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Littlejohn NK, Keen HL, Weidemann BJ, Claflin KE, Tobin KV, Markan KR, Park S, Naber MC, Gourronc FA, Pearson NA, Liu X, Morgan DA, Klingelhutz AJ, Potthoff MJ, Rahmouni K, Sigmund CD, Grobe JL. Suppression of Resting Metabolism by the Angiotensin AT2 Receptor. Cell Rep 2016; 16:1548-1560. [PMID: 27477281 DOI: 10.1016/j.celrep.2016.07.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 06/09/2016] [Accepted: 07/01/2016] [Indexed: 11/15/2022] Open
Abstract
Activation of the brain renin-angiotensin system (RAS) stimulates energy expenditure through increasing of the resting metabolic rate (RMR), and this effect requires simultaneous suppression of the circulating and/or adipose RAS. To identify the mechanism by which the peripheral RAS opposes RMR control by the brain RAS, we examined mice with transgenic activation of the brain RAS (sRA mice). sRA mice exhibit increased RMR through increased energy flux in the inguinal adipose tissue, and this effect is attenuated by angiotensin II type 2 receptor (AT2) activation. AT2 activation in inguinal adipocytes opposes norepinephrine-induced uncoupling protein-1 (UCP1) production and aspects of cellular respiration, but not lipolysis. AT2 activation also opposes inguinal adipocyte function and differentiation responses to epidermal growth factor (EGF). These results highlight a major, multifaceted role for AT2 within inguinal adipocytes in the control of RMR. The AT2 receptor may therefore contribute to body fat distribution and adipose depot-specific effects upon cardio-metabolic health.
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Affiliation(s)
| | - Henry L Keen
- Department of Pharmacology, University of Iowa, Iowa City, IA 52242, USA
| | | | - Kristin E Claflin
- Department of Pharmacology, University of Iowa, Iowa City, IA 52242, USA
| | - Kevin V Tobin
- Department of Pharmacology, University of Iowa, Iowa City, IA 52242, USA
| | - Kathleen R Markan
- Department of Pharmacology, University of Iowa, Iowa City, IA 52242, USA
| | - Sungmi Park
- Department of Pharmacology, University of Iowa, Iowa City, IA 52242, USA
| | - Meghan C Naber
- Department of Pharmacology, University of Iowa, Iowa City, IA 52242, USA
| | | | - Nicole A Pearson
- Department of Pharmacology, University of Iowa, Iowa City, IA 52242, USA
| | - Xuebo Liu
- Department of Pharmacology, University of Iowa, Iowa City, IA 52242, USA
| | - Donald A Morgan
- Department of Pharmacology, University of Iowa, Iowa City, IA 52242, USA
| | - Aloysius J Klingelhutz
- Department of Microbiology, University of Iowa, Iowa City, IA 52242, USA; Fraternal Order of Eagles' Diabetes Research Center, University of Iowa, Iowa City, IA 52242, USA
| | - Matthew J Potthoff
- Department of Pharmacology, University of Iowa, Iowa City, IA 52242, USA; Fraternal Order of Eagles' Diabetes Research Center, University of Iowa, Iowa City, IA 52242, USA; Obesity Research and Education Initiative, University of Iowa, Iowa City, IA 52242, USA
| | - Kamal Rahmouni
- Department of Pharmacology, University of Iowa, Iowa City, IA 52242, USA; Fraternal Order of Eagles' Diabetes Research Center, University of Iowa, Iowa City, IA 52242, USA; Obesity Research and Education Initiative, University of Iowa, Iowa City, IA 52242, USA; François M. Abboud Cardiovascular Research Center, University of Iowa, Iowa City, IA 52242, USA; Center for Hypertension Research, University of Iowa, Iowa City, IA 52242, USA
| | - Curt D Sigmund
- Department of Pharmacology, University of Iowa, Iowa City, IA 52242, USA; Fraternal Order of Eagles' Diabetes Research Center, University of Iowa, Iowa City, IA 52242, USA; Obesity Research and Education Initiative, University of Iowa, Iowa City, IA 52242, USA; François M. Abboud Cardiovascular Research Center, University of Iowa, Iowa City, IA 52242, USA; Center for Hypertension Research, University of Iowa, Iowa City, IA 52242, USA.
| | - Justin L Grobe
- Department of Pharmacology, University of Iowa, Iowa City, IA 52242, USA; Fraternal Order of Eagles' Diabetes Research Center, University of Iowa, Iowa City, IA 52242, USA; Obesity Research and Education Initiative, University of Iowa, Iowa City, IA 52242, USA; François M. Abboud Cardiovascular Research Center, University of Iowa, Iowa City, IA 52242, USA; Center for Hypertension Research, University of Iowa, Iowa City, IA 52242, USA.
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Akhlaghi M. Non-alcoholic Fatty Liver Disease: Beneficial Effects of Flavonoids. Phytother Res 2016; 30:1559-1571. [DOI: 10.1002/ptr.5667] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 05/23/2016] [Accepted: 05/24/2016] [Indexed: 12/31/2022]
Affiliation(s)
- Masoumeh Akhlaghi
- Nutrition Research Center, School of Nutrition and Food Sciences; Shiraz University of Medical Sciences; Shiraz Iran
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Newman D, Kelly-Morland C, Leinhard OD, Kasmai B, Greenwood R, Malcolm PN, Romu T, Borga M, Toms AP. Test-retest reliability of rapid whole body and compartmental fat volume quantification on a widebore 3T MR system in normal-weight, overweight, and obese subjects. J Magn Reson Imaging 2016; 44:1464-1473. [DOI: 10.1002/jmri.25326] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 05/16/2016] [Indexed: 12/22/2022] Open
Affiliation(s)
- David Newman
- Department of Radiology; Norfolk & Norwich University Hospital; UK
| | | | - Olof Dahlqvist Leinhard
- Center for Medical Image Science and Visualisation; Linköping University; Sweden
- Department of Medical and Health Sciences; Linköping University; Sweden
- Advanced MR Analytics AB; Linköping Sweden
| | - Bahman Kasmai
- Department of Radiology; Norfolk & Norwich University Hospital; UK
| | | | - Paul N. Malcolm
- Department of Radiology; Norfolk & Norwich University Hospital; UK
| | - Thobias Romu
- Center for Medical Image Science and Visualisation; Linköping University; Sweden
- Advanced MR Analytics AB; Linköping Sweden
- Department of Biomedical Engineering; Linköping University; Sweden
| | - Magnus Borga
- Center for Medical Image Science and Visualisation; Linköping University; Sweden
- Advanced MR Analytics AB; Linköping Sweden
- Department of Biomedical Engineering; Linköping University; Sweden
| | - Andoni P. Toms
- Department of Radiology; Norfolk & Norwich University Hospital; UK
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Feasibility of simultaneous 18F-FDG PET/MRI for the quantitative volumetric and metabolic measurements of abdominal fat tissues using fat segmentation. Nucl Med Commun 2016; 37:616-22. [PMID: 26836629 DOI: 10.1097/mnm.0000000000000488] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Quantification of volume and inflammatory activity in the fat tissue is important because these are closely related to type 2 diabetes mellitus and cardiovascular disease. Fluorine-18 fluorodeoxyglucose (F-FDG) PET/computed tomography (CT) has been utilized to measure the metabolic activity of fat tissue. In this study, we assessed the feasibility of simultaneous PET/magnetic resonance (MR) in metabolic and volumetric measurements of fat tissue and the potential advantage over PET/CT. METHODS Twenty-four healthy individuals were enrolled, who underwent simultaneous F-FDG PET/MRI. Twenty-five F-FDG PET/CT scans were selected. Isocontour volumes of interest (VOIs) were used to segment and separate visceral fat (VF) and abdominal subcutaneous fat (SF) in using the MR image (T1 DIXON VIBE sequence) of PET/MR and the CT image of PET/CT. Volume, mean standardized uptake value of VF, and SF VOIs were calculated. RESULTS Overlap between F-FDG PET and VF VOI was better in F-FDG PET/MR than PET/CT. The mean standardized uptake value of VF was associated with the degree of intestinal uptake on F-FDG PET/CT, but not on F-FDG PET/MR. Volumetric and metabolic measurements using F-FDG PET/MR showed an excellent reproducibility, with a high intraclass correlation coefficient between different observers (0.951-0.997). The measured metabolic activity was higher in VF than SF. CONCLUSION We established a method for the quantitative measurement of volume and metabolic status of abdominal VF and SF using simultaneous F-FDG PET/MR. F-FDG PET/MR has an advantage over F-FDG PET/CT in terms of being less confounded by intestinal uptake. This method could be used to assess the inflammatory activity of fat tissue, which is a major risk factor for type 2 diabetes mellitus and cardiovascular disease.
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Christ ER, Egger A, Allemann S, Buehler T, Kreis R, Boesch C. Effects of aerobic exercise on ectopic lipids in patients with growth hormone deficiency before and after growth hormone replacement therapy. Sci Rep 2016; 6:19310. [PMID: 26792091 PMCID: PMC4726290 DOI: 10.1038/srep19310] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 12/09/2015] [Indexed: 01/21/2023] Open
Abstract
Growth hormone replacement therapy (GHRT) increases exercise capacity and insulin resistance while it decreases fat mass in growth hormone-deficient patients (GHD). Ectopic lipids (intramyocellular (IMCL) and intrahepatocellular lipids (IHCL) are related to insulin resistance. The effect of GHRT on ectopic lipids is unknown. It is hypothesized that exercise-induced utilization of ectopic lipids is significantly decreased in GHD patients and normalized by GHRT. GHD (4 females, 6 males) and age/gender/waist-matched control subjects (CS) were studied. VO2max was assessed on a treadmill and insulin sensitivity determined by a two-step hyperinsulinaemic-euglycaemic clamp. Visceral (VAT) and subcutaneous (SAT) fat were quantified by MR-imaging. IHCL and IMCL were measured before and after a 2 h exercise at 50-60% of VO2max using MR-spectroscopy (∆IMCL, ∆IHCL). Identical investigations were performed after 6 months of GHRT. VO2max was similar in GHD and CS and significantly increased after GHRT; GHRT significantly decreased SAT and VAT. 2 h-exercise resulted in a decrease in IMCL (significant in CS and GHRT) and a significant increase in IHCL in CS and GHD pre and post GHRT. GHRT didn't significantly impact on ∆IMCL and ∆IHCL. We conclude that aerobic exercise affects ectopic lipids in patients and controls. GHRT increases exercise capacity without influencing ectopic lipids.
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Affiliation(s)
- Emanuel R Christ
- Division of Endocrinology, Diabetology and Clinical Nutrition, University Hospital of Bern, Inselspital, CH-3010 Bern, Switzerland
| | - Andrea Egger
- Division of Endocrinology, Diabetology and Clinical Nutrition, University Hospital of Bern, Inselspital, CH-3010 Bern, Switzerland.,Department of Internal Medicine, University Hospital of Basel, CH-4056 Basel, Switzerland
| | - Sabin Allemann
- Division of Endocrinology, Diabetology and Clinical Nutrition, University Hospital of Bern, Inselspital, CH-3010 Bern, Switzerland
| | - Tania Buehler
- Department of Clinical Research, Division of MR-Spectroscopy and Methodology, University of Bern, Inselspital, CH-3010 Bern, Switzerland
| | - Roland Kreis
- Department of Clinical Research, Division of MR-Spectroscopy and Methodology, University of Bern, Inselspital, CH-3010 Bern, Switzerland
| | - Chris Boesch
- Department of Clinical Research, Division of MR-Spectroscopy and Methodology, University of Bern, Inselspital, CH-3010 Bern, Switzerland
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Solanki JD, Makwana AH, Mehta HB, Gokhale PA, Shah CJ. Body Composition in Type 2 Diabetes: Change in Quality and not Just Quantity that Matters. Int J Prev Med 2015; 6:122. [PMID: 26900436 PMCID: PMC4736063 DOI: 10.4103/2008-7802.172376] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 05/14/2015] [Indexed: 12/21/2022] Open
Abstract
Background: Deranged body fat and muscle mass are aftermaths of uncontrolled diabetes. Anthropometric methods like body mass index (BMI) do not give qualitative inferences like total body fat (TBF), visceral fat (VF) or subcutaneous fat (SF) that can be given by bio-electrical impedance analysis (BIA). We studied body composition of type 2 diabetics in comparison to controls matched by age-sex, weight and BMI separately. Methods: Seventy-eight under-treatment type 2 diabetics of either sex with known glycemic and lipidemic control and equal number of controls with three patterns of matching were taken from our city. We derived parameters of body composition in both groups by Omron Karada Scan (Model HBF-510, China), using the principle of tetra poplar BIA and compared them for statistical significance. Results: We found significantly more SF (30.47% ± 7.73%), VF (11.94% ± 4.97%) and TBF (33.96% ± 6.07%) and significantly lesser skeletal muscle mass (23.39% ± 4.49%) in type 2 diabetics as compared to controls, persisting even after matching with weight or BMI. On assessing qualitatively, the risk of high VF, high TBF, low skeletal muscle mass was significantly high in type 2 diabetics, which were 10.41, 3.01, 9.21 respectively for comparable BMI and 6.78, 3.51, 11.93 respectively for comparable weight. Conclusions: BIA reveals that type 2 diabetics have more ectopic fat on the expense of skeletal muscle that persists even after matching by weight or BMI, both quantitatively and qualitatively. Measurement of body composition can be included as a primary care strategy to motivate lifestyle modifications while managing metabolic derangements of type 2 diabetes.
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Affiliation(s)
- Jayesh D Solanki
- Department of Physiology, Govt. Medical College, Bhavnagar, Gujarat, India
| | - Amit H Makwana
- Department of Physiology, Govt. Medical College, Bhavnagar, Gujarat, India
| | - Hemant B Mehta
- Department of Physiology, Govt. Medical College, Bhavnagar, Gujarat, India
| | - Pradnya A Gokhale
- Department of Physiology, Govt. Medical College, Bhavnagar, Gujarat, India
| | - Chinmay J Shah
- Department of Physiology, Govt. Medical College, Bhavnagar, Gujarat, India
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Distinct regulatory mechanisms governing embryonic versus adult adipocyte maturation. Nat Cell Biol 2015; 17:1099-111. [PMID: 26280538 PMCID: PMC4553131 DOI: 10.1038/ncb3217] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 07/02/2015] [Indexed: 12/15/2022]
Abstract
Pathological expansion of adipose tissue contributes to the metabolic syndrome. Distinct depots develop at various times under different physiological conditions. The transcriptional cascade mediating adipogenesis is established in vitro, and centers around a core program involving PPARγ and C/EBPα. We developed an inducible, adipocyte-specific knockout system to probe the requirement of key adipogenic transcription factors at various stages of adipogenesis in vivo. C/EBPα is essential for all white adipogenic conditions in the adult stage, such as adipose tissue regeneration, adipogenesis in muscle and unhealthy expansion of white adipose tissue during high fat feeding or due to leptin deficiency. Surprisingly, terminal embryonic adipogenesis is fully C/EBPα independent, does depend however on PPARγ; cold-induced beige adipogenesis is also C/EBPα independent. Moreover, C/EBPα is not vital for adipocyte survival in the adult stage. We reveal a surprising diversity of transcriptional signals required at different stages of adipogenesis in vivo.
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Yeoh AJ, Pedley A, Rosenquist KJ, Hoffmann U, Fox CS. The Association Between Subcutaneous Fat Density and the Propensity to Store Fat Viscerally. J Clin Endocrinol Metab 2015; 100:E1056-64. [PMID: 26062015 PMCID: PMC4525002 DOI: 10.1210/jc.2014-4032] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Alterations in the cellular characteristics of subcutaneous adipose tissue (SAT) may reduce its ability to expand in times of caloric excess, increasing the propensity to store excess calories viscerally (visceral adipose tissue [VAT]). We hypothesized (1) that increased SAT density, an indirect marker of fat quality, would be associated with an increased VAT/SAT ratio and increased cardiovascular disease (CVD) risk and (2) that these associations would be independent of the absolute volume of SAT. METHODS We investigated the association of SAT density with the VAT/SAT ratio and CVD risk in 3212 participants (48% women, mean age, 50.7 years) from the Framingham Heart Study. Adipose tissue depot density and volume were quantified by computed tomography; traditional CVD risk factors were quantified. RESULTS Higher SAT density was correlated with a higher VAT/SAT ratio in men (r = 0.17; P < .0001) but not in women (r = 0.04; P ≥ .05). More adverse levels of CVD risk factors were observed in the high SAT density/high VAT/SAT ratio group than in the referent group (low density/low ratio). For example, women had an increased risk of diabetes (odds ratio [OR], 6.7; 95% confidence interval [CI], 2.6-17.6; P = .0001) and hypertension (OR, 1.6; 95% CI, 1.1-2.4; P = .009). Additional adjustment for SAT volume generally strengthened these associations (diabetes OR, 10.8; 95% CI, 4.1-29.0; hypertension OR, 2.5; 95% CI, 1.7-3.7; all P < .0001). These trends were similar but generally weaker in men. CONCLUSION High fat density, an indirect marker of fat quality, is associated with the propensity to store fat viscerally vs subcutaneously and is jointly characterized by an increased burden of CVD risk factors.
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Affiliation(s)
- Aaron J Yeoh
- National Heart, Lung, and Blood Institute Framingham Heart Study (A.J.Y., A.P., K.J.R., C.S.F.), Framingham, Massachusetts 01702-5827; Division of Endocrinology and Metabolism (C.S.F.), Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115; and Department of Radiology (U.H.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114
| | - Alison Pedley
- National Heart, Lung, and Blood Institute Framingham Heart Study (A.J.Y., A.P., K.J.R., C.S.F.), Framingham, Massachusetts 01702-5827; Division of Endocrinology and Metabolism (C.S.F.), Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115; and Department of Radiology (U.H.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114
| | - Klara J Rosenquist
- National Heart, Lung, and Blood Institute Framingham Heart Study (A.J.Y., A.P., K.J.R., C.S.F.), Framingham, Massachusetts 01702-5827; Division of Endocrinology and Metabolism (C.S.F.), Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115; and Department of Radiology (U.H.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114
| | - Udo Hoffmann
- National Heart, Lung, and Blood Institute Framingham Heart Study (A.J.Y., A.P., K.J.R., C.S.F.), Framingham, Massachusetts 01702-5827; Division of Endocrinology and Metabolism (C.S.F.), Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115; and Department of Radiology (U.H.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114
| | - Caroline S Fox
- National Heart, Lung, and Blood Institute Framingham Heart Study (A.J.Y., A.P., K.J.R., C.S.F.), Framingham, Massachusetts 01702-5827; Division of Endocrinology and Metabolism (C.S.F.), Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115; and Department of Radiology (U.H.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114
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Schaudinn A, Linder N, Garnov N, Kerlikowsky F, Blüher M, Dietrich A, Schütz T, Karlas T, Kahn T, Busse H. Predictive accuracy of single- and multi-slice MRI for the estimation of total visceral adipose tissue in overweight to severely obese patients. NMR IN BIOMEDICINE 2015; 28:583-590. [PMID: 25808071 DOI: 10.1002/nbm.3286] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 02/16/2015] [Accepted: 02/17/2015] [Indexed: 06/04/2023]
Abstract
The quantification of visceral adipose tissue (VAT) is increasingly being considered for risk assessment and treatment monitoring in obese patients, but is generally time-consuming. The goals of this work were to semi-automatically segment and quantify VAT areas of MRI slices at previously proposed anatomical landmarks and to evaluate their predictive power for whole-abdominal VAT volumes on a relatively large number of patients. One-hundred and ninety-seven overweight to severely obese patients (65 males; body mass index, 33.3 ± 3.5 kg/m(2); 132 females; body mass index, 34.3 ± 3.2 kg/m(2)) underwent MRI examination. Total VAT volumes (VVAT-T ) of the abdominopelvic cavity were quantified by retrospective analysis of two-point Dixon MRI data (active-contour segmentation, visual correction and histogram analysis). VVAT-T was then compared with VAT areas determined on one or five slices defined at seven anatomical landmarks (lumbar intervertebral spaces, umbilicus and femoral heads) and corresponding conversion factors were determined. Statistical measures were the coefficients of variation and standard deviations σ1 and σ5 of the difference between predicted and measured VAT volumes (Bland-Altman analysis). VVAT-T was 6.0 ± 2.0 L (2.5-11.2 L) for males and 3.2 ± 1.4 L (0.9-7.7 L) for females. The analysis of five slices yielded a better agreement than the analysis of single slices, required only a little extra time (4 min versus 2 min) and was substantially faster than whole-abdominal assessment (24 min). Best agreements were found at intervertebral spaces L3-L4 for females (σ5/1 = 523/608 mL) and L2-L3 for males (σ5/1 = 613/706 mL). Five-slice VAT volume estimates at the level of lumbar disc L3-L4 for females and L2-L3 for males can be obtained within 4 min and were a reliable predictor for abdominopelvic VAT volume in overweight to severely adipose patients. One-slice estimates took only 2 min and were slightly less accurate. These findings may contribute to the implementation of analytical methods for fast and reliable (routine) estimation of VAT volumes in obese patients.
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Affiliation(s)
- Alexander Schaudinn
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Leipzig, Germany; Integrated Research and Treatment Center (IFB) AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany
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Burke SJ, May AL, Noland RC, Lu D, Brissova M, Powers AC, Sherrill EM, Karlstad MD, Campagna SR, Stephens JM, Collier JJ. Thiobenzothiazole-modified Hydrocortisones Display Anti-inflammatory Activity with Reduced Impact on Islet β-Cell Function. J Biol Chem 2015; 290:13401-16. [PMID: 25851902 DOI: 10.1074/jbc.m114.632190] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Indexed: 12/20/2022] Open
Abstract
Glucocorticoids signal through the glucocorticoid receptor (GR) and are administered clinically for a variety of situations, including inflammatory disorders, specific cancers, rheumatoid arthritis, and organ/tissue transplantation. However, glucocorticoid therapy is also associated with additional complications, including steroid-induced diabetes. We hypothesized that modification of the steroid backbone is one strategy to enhance the therapeutic potential of GR activation. Toward this goal, two commercially unavailable, thiobenzothiazole-containing derivatives of hydrocortisone (termed MS4 and MS6) were examined using 832/13 rat insulinoma cells as well as rodent and human islets. We found that MS4 had transrepression properties but lacked transactivation ability, whereas MS6 retained both transactivation and transrepression activities. In addition, MS4 and MS6 both displayed anti-inflammatory activity. Furthermore, MS4 displayed reduced impact on islet β-cell function in both rodent and human islets. Similar to dexamethasone, MS6 promoted adipocyte development in vitro, whereas MS4 did not. Moreover, neither MS4 nor MS6 activated the Pck1 (Pepck) gene in primary rat hepatocytes. We conclude that modification of the functional groups attached to the D-ring of the hydrocortisone steroid molecule produces compounds with altered structure-function GR agonist activity with decreased impact on insulin secretion and reduced adipogenic potential but with preservation of anti-inflammatory activity.
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Affiliation(s)
- Susan J Burke
- From the Laboratory of Islet Biology and Inflammation, the Departments of Nutrition and
| | - Amanda L May
- Chemistry, University of Tennessee, Knoxville, Tennessee 37996
| | | | - Danhong Lu
- the Sarah W. Stedman Nutrition and Metabolism Center, Duke University School of Medicine, Durham, North Carolina 27701
| | - Marcela Brissova
- the Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, and
| | - Alvin C Powers
- the Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, and the Department of Molecular Physiology and Biophysics, Vanderbilt University Medical Center, Nashville, Tennessee 37232, the Tennessee Valley Healthcare System, Department of Veterans Affairs, Nashville, Tennessee 37212
| | | | - Michael D Karlstad
- the Department of Surgery, Graduate School of Medicine, University of Tennessee Medical Center, Knoxville, Tennessee 37920, and
| | | | - Jacqueline M Stephens
- the Adipocyte Biology Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana 70808
| | - J Jason Collier
- From the Laboratory of Islet Biology and Inflammation, the Departments of Nutrition and the Department of Surgery, Graduate School of Medicine, University of Tennessee Medical Center, Knoxville, Tennessee 37920, and
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Vieira SA, Magalhães TCA, Ribeiro AQ, Priore SE, Franceschini SDCC, Sant'Ana LFDR. Influence of weight gain rate on early life nutritional status and body composition of children. ScientificWorldJournal 2014; 2014:616108. [PMID: 25538953 PMCID: PMC4236901 DOI: 10.1155/2014/616108] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 10/06/2014] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To evaluate the influence of the weight gain rate at 4-6 months on nutritional status and body composition in children between 4 and 7 years of age. METHODS Retrospective cohort study, sample of 257 children. Data collection was performed in two stages, with the first relating to retrospective data of weight gain from birth to the first 4-6 months of life in the patient records. Measurements of weight, height, waist circumference, and body composition in children between ages 4 and 7 years were obtained. Nutritional status was assessed by the BMI/age. Control variables, such as pregnancy, breastfeeding, lifestyle, and sociodemographics, were studied. Descriptive analysis and multiple linear regression were performed. RESULTS In the nutritional status assessment, the prevalence of overweight observed was 24.9%. After adjusting for control variables, it was found that the increase of the WGR at 4-6 months of age explained the occurrence of higher BMI/age, percentage of total body fat, body fat percentage in the android region, and waist circumference in children between 4 and 7 years of age. CONCLUSION The increase of the WGR in the first months of life can lead to the occurrence of higher values of parameters of nutritional status and body composition in later life.
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Affiliation(s)
- Sarah Aparecida Vieira
- Department of Nutrition and Health, Federal University of Viçosa, 36570-000 Viçosa, MG, Brazil
| | | | - Andréia Queiroz Ribeiro
- Department of Nutrition and Health, Federal University of Viçosa, 36570-000 Viçosa, MG, Brazil
| | - Silvia Eloiza Priore
- Department of Nutrition and Health, Federal University of Viçosa, 36570-000 Viçosa, MG, Brazil
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Daniele G, Abdul-Ghani M, DeFronzo RA. What are the pharmacotherapy options for treating prediabetes? Expert Opin Pharmacother 2014; 15:2003-18. [PMID: 25139488 DOI: 10.1517/14656566.2014.944160] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The incidence of type 2 diabetes mellitus (T2DM) has risen to epidemic proportions, and this is associated with enormous cost. T2DM is preceded by 'prediabetes', and the diagnosis of impaired glucose tolerance (IGT) and/or impaired fasting glucose (IFG) provides an opportunity for targeted intervention. Prediabetic subjects manifest both core defects characteristic of T2DM, that is, insulin resistance and β-cell dysfunction. Interventions which improve insulin sensitivity and/or preserve β-cell function are logical strategies to delay the conversion of IGT/IFG to T2DM or revert glucose tolerance to normal. AREAS COVERED The authors examine pharmacologic agents that have proven to decrease the conversion of IGT to T2DM and represent potential treatment options in prediabetes. EXPERT OPINION Weight loss improves whole body insulin sensitivity, preserves β-cell function and decreases progression of prediabetes to T2DM. In real life long-term weight loss is the exception and, even if successful, 40 - 50% of IGT individuals still progress to T2DM. Pharmacotherapy provides an alternative strategy to improve insulin sensitivity and preserve β-cell function. Thiazolidinediones (TZDs) are highly effective in T2DM prevention. Long-acting glucagon-like peptide-1 (GLP-1) analogs, because they augment β-cell function and promote weight loss, are effective in preventing IGT progression to T2DM. Metformin is considerably less effective than TZDs or GLP-1 analogs.
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Affiliation(s)
- Giuseppe Daniele
- University of Texas Health Science Center at San Antonio, Division of Diabetes , 7703 Floyd Curve Dr, San Antonio, TX, 78229 , USA +1 210 567 6691 ; +1 210 567 6554 ;
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Can the use of blood-based biomarkers in addition to anthropometric indices substantially improve the prediction of visceral fat volume as measured by magnetic resonance imaging? Eur J Nutr 2014; 54:701-8. [DOI: 10.1007/s00394-014-0748-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 07/24/2014] [Indexed: 12/12/2022]
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Dietrich P, Hellerbrand C. Non-alcoholic fatty liver disease, obesity and the metabolic syndrome. Best Pract Res Clin Gastroenterol 2014; 28:637-53. [PMID: 25194181 DOI: 10.1016/j.bpg.2014.07.008] [Citation(s) in RCA: 274] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 06/25/2014] [Accepted: 07/05/2014] [Indexed: 02/07/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is now recognized as the most common cause of chronic liver disease worldwide. Its prevalence has increased to more than 30% of adults in developed countries and its incidence is still rising. The majority of patients with NAFLD have simple steatosis but in up to one third of patients, NAFLD progresses to its more severe form nonalcoholic steatohepatitis (NASH). NASH is characterized by liver inflammation and injury thereby determining the risk to develop liver fibrosis and cancer. NAFLD is considered the hepatic manifestation of the metabolic syndrome. However, the liver is not only a passive target but affects the pathogenesis of the metabolic syndrome and its complications. Conversely, pathophysiological changes in other organs such as in the adipose tissue, the intestinal barrier or the immune system have been identified as triggers and promoters of NAFLD progression. This article details the pathogenesis of NAFLD along with the current state of its diagnosis and treatment.
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Affiliation(s)
- Peter Dietrich
- Institute of Pathology, University Regensburg, 93053 Regensburg, Germany
| | - Claus Hellerbrand
- Department of Internal Medicine I, University Hospital Regensburg, 93053 Regensburg, Germany.
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Effect of Aerobic Training on Glucose Control and Blood Pressure in T2DDM East African Males. ISRN ENDOCRINOLOGY 2014; 2014:864897. [PMID: 24729886 PMCID: PMC3960729 DOI: 10.1155/2014/864897] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 01/20/2014] [Indexed: 12/22/2022]
Abstract
Background. Exercise training intervention is underused in the management of type 2 diabetes mellitus in East Africa.
Methods. 41 physically-active males with type 2 diabetes mellitus living in Mozambique were recruited and randomly assigned to 12 weeks of supervised exercise of low intensity exercise (LEX), vigorous intensity exercise (VEX), or to a control group (CON). Since there were no differences for any outcome variables between the exercise groups, VEX and LEX were combined into one exercise group (EX). Results. Age and baseline body weight were similar between EX and CON. Plasma glucose at 120 min following glucose load (Glu 120) was significantly reduced in the EX group after training (Glu 120 : 17.3 mmol/L to 15.0 mmol/L, P < 0.05), whereas Glu 120 remained unchanged in the CON (Glu 120 : 16.6 mmol/L to 18.7 mmol/L). After controlling for baseline blood pressure (BP), posttraining systolic BP and diastolic BP were lower in the EX group than in the CON group (EX: 129/77 mm Hg, CON: 152/83 mm Hg, P < 0.05). Conclusion. Adding exercise to already active African men with type 2 diabetes improved glucose control and BP levels without concomitant changes in weight.
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Kim S, Kim JY, Lee DC, Lee HS, Lee JW, Jeon JY. Combined impact of cardiorespiratory fitness and visceral adiposity on metabolic syndrome in overweight and obese adults in Korea. PLoS One 2014; 9:e85742. [PMID: 24454926 PMCID: PMC3893257 DOI: 10.1371/journal.pone.0085742] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 12/01/2013] [Indexed: 01/10/2023] Open
Abstract
Background Obesity, especially visceral obesity, is known to be an important correlate for cardiovascular disease and increased mortality. On the other hand, high cardiorespiratory fitness is suggested to be an effective contributor for reducing this risk. This study was conducted to determine the combined impact of cardiorespiratory fitness and visceral adiposity, otherwise known as fitness and fatness, on metabolic syndrome in overweight and obese adults. Methods A total of 232 overweight and obese individuals were grouped into four subtypes according to their fitness level. This was measured by recovery heart rate from a step test in addition to visceral adiposity defined as the visceral adipose tissue area to subcutaneous adipose tissue area ratio (VAT/SAT ratio). Associations of fitness and visceral fatness were analyzed in comparison with the prevalence of metabolic syndrome. Results The high visceral fat and low fitness group had the highest prevalence of metabolic syndrome [Odds Ratio (OR) 5.02; 95% Confidence Interval (CI) 1.85–13.61] compared with the reference group, which was the low visceral adiposity and high fitness group, after adjustments for confounding factors. Viscerally lean but unfit subjects were associated with a higher prevalence of metabolic syndrome than more viscerally obese but fit subjects (OR 3.42; 95% CI 1.27–9.19, and OR 2.70; 95% CI 1.01–7.25, respectively). Conclusions Our study shows that visceral obesity and fitness levels are cumulatively associated with a higher prevalence of metabolic syndrome in healthy overweight and obese adults. This suggests that cardiorespiratory fitness is a significant modifier in the relation of visceral adiposity to adverse metabolic outcomes in overweight and obese individuals.
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Affiliation(s)
- Sue Kim
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ji-Young Kim
- Department of Sport and Leisure Studies, Yonsei University, Seoul, Korea
| | - Duk-Chul Lee
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hye-Sun Lee
- Biostatistics Collaboration Units, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Korea
| | - Ji-Won Lee
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- * E-mail: (JWL); (JYJ)
| | - Justin Y. Jeon
- Department of Sport and Leisure Studies, Yonsei University, Seoul, Korea
- * E-mail: (JWL); (JYJ)
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Wang QA, Tao C, Gupta RK, Scherer PE. Tracking adipogenesis during white adipose tissue development, expansion and regeneration. Nat Med 2013; 19:1338-44. [PMID: 23995282 DOI: 10.1038/nm.3324] [Citation(s) in RCA: 912] [Impact Index Per Article: 82.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 07/09/2013] [Indexed: 12/12/2022]
Abstract
White adipose tissue displays high plasticity. We developed a system for the inducible, permanent labeling of mature adipocytes that we called the AdipoChaser mouse. We monitored adipogenesis during development, high-fat diet (HFD) feeding and cold exposure. During cold-induced 'browning' of subcutaneous fat, most 'beige' adipocytes stem from de novo-differentiated adipocytes. During HFD feeding, epididymal fat initiates adipogenesis after 4 weeks, whereas subcutaneous fat undergoes hypertrophy for a period of up to 12 weeks. Gonadal fat develops postnatally, whereas subcutaneous fat develops between embryonic days 14 and 18. Our results highlight the extensive differences in adipogenic potential in various fat depots.
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Affiliation(s)
- Qiong A Wang
- Touchstone Diabetes Center, Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Egger A, Kreis R, Allemann S, Stettler C, Diem P, Buehler T, Boesch C, Christ ER. The effect of aerobic exercise on intrahepatocellular and intramyocellular lipids in healthy subjects. PLoS One 2013; 8:e70865. [PMID: 23967125 PMCID: PMC3743875 DOI: 10.1371/journal.pone.0070865] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 06/21/2013] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Intrahepatocellular (IHCL) and intramyocellular (IMCL) lipids are ectopic lipid stores. Aerobic exercise results in IMCL utilization in subjects over a broad range of exercise capacity. IMCL and IHCL have been related to impaired insulin action at the skeletal muscle and hepatic level, respectively. The acute effect of aerobic exercise on IHCL is unknown. Possible regulatory factors include exercise capacity, insulin sensitivity and fat availability subcutaneous and visceral fat mass). AIM To concomitantly investigate the effect of aerobic exercise on IHCL and IMCL in healthy subjects, using Magnetic Resonance spectroscopy. METHODS Normal weight, healthy subjects were included. Visit 1 consisted of a determination of VO2max on a treadmill. Visit 2 comprised the assessment of hepatic and peripheral insulin sensitivity by a two-step hyperinsulinaemic euglycaemic clamp. At Visit 3, subcutaneous and visceral fat mass were assessed by whole body MRI, IHCL and IMCL before and after a 2-hours aerobic exercise (50% of VO(2max)) using ¹H-MR-spectroscopy. RESULTS Eighteen volunteers (12M, 6F) were enrolled in the study (age, 37.6±3.2 years, mean±SEM; VO(2max), 53.4±2.9 mL/kg/min). Two hours aerobic exercise resulted in a significant decrease in IMCL (-22.6±3.3, % from baseline) and increase in IHCL (+34.9±7.6, % from baseline). There was no significant correlation between the exercise-induced changes in IMCL and IHCL and exercise capacity, subcutaneous and visceral fat mass and hepatic or peripheral insulin sensitivity. CONCLUSIONS IMCL and IHCL are flexible ectopic lipid stores that are acutely influenced by physical exercise, albeit in different directions. TRIAL REGISTRATION ClinicalTrial.gov NCT00491582.
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Affiliation(s)
- Andrea Egger
- Division of Endocrinology, Diabetology and Clinical Nutrition, University Hospital of Bern, Inselspital, Bern, Switzerland
| | - Roland Kreis
- Department of Clinical Research, Magnetic Resonance Spectroscopy and Methodology, University of Bern, Bern, Switzerland
| | - Sabin Allemann
- Division of Endocrinology, Diabetology and Clinical Nutrition, University Hospital of Bern, Inselspital, Bern, Switzerland
| | - Christoph Stettler
- Division of Endocrinology, Diabetology and Clinical Nutrition, University Hospital of Bern, Inselspital, Bern, Switzerland
| | - Peter Diem
- Division of Endocrinology, Diabetology and Clinical Nutrition, University Hospital of Bern, Inselspital, Bern, Switzerland
| | - Tania Buehler
- Department of Clinical Research, Magnetic Resonance Spectroscopy and Methodology, University of Bern, Bern, Switzerland
| | - Chris Boesch
- Department of Clinical Research, Magnetic Resonance Spectroscopy and Methodology, University of Bern, Bern, Switzerland
| | - Emanuel R. Christ
- Division of Endocrinology, Diabetology and Clinical Nutrition, University Hospital of Bern, Inselspital, Bern, Switzerland
- * E-mail:
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MUSIL F, ŠMAHELOVÁ A, BLÁHA V, HYŠPLER R, TICHÁ A, LESNÁ J, ZADÁK Z, SOBOTKA L. Effect of Low Calorie Diet and Controlled Fasting on Insulin Sensitivity and Glucose Metabolism in Obese Patients With Type 1 Diabetes Mellitus. Physiol Res 2013; 62:267-76. [DOI: 10.33549/physiolres.932381] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Obesity in T1DM patients is associated with the components of metabolic syndrome. The influence of controlled fasting and low calorie diet (LCD) on insulin sensitivity and glucose metabolism was studied in 14 obese patients with type 1 diabetes mellitus (T1DM) (42.6±9.4 years, BMI 32.4±2.1 kg m−2). Insulin sensitivity in obese T1DM patients was measured using a hyperinsulinemic-euglycemic clamp before fasting, immediately after 7 days of fasting, and after 21 days of LCD. Glucose oxidation and non-oxidative glucose disposal were measured before and during the clamp by indirect calorimetry. In the control group of 13 of non-obese T1DM patients (36.9±13.9 years, BMI 22.6±2.1 kg m−2), only one hyperinsulinemic-euglycemic clamp was performed. Obese T1DM patients lost 6.1±1.1 kg after fasting and maintained reduction in body weight after 21 days of LCD. Fasting transiently reduced insulin-mediated glucose disposal in the clamp (from 9.69±1.48 to 6.78±1.21 mg min−1 kg−1, P<0.001). This was caused by reduced glucose oxidation after the fasting period (from 2.81±0.52 to 0.88±0.98 mg min−1 kg−1, P<0.001). We conclude that one week of fasting transiently decreased insulin-mediated glucose disposal in T1DM patients. This was caused by reduced glucose oxidation.
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Affiliation(s)
- F. MUSIL
- Department of Metabolic Care and Gerontology, Faculty of Medicine, Charles University and University Hospital, Hradec Králové, Czech Republic
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Thörmer G, Bertram HH, Garnov N, Peter V, Schütz T, Shang E, Blüher M, Kahn T, Busse H. Software for automated MRI-based quantification of abdominal fat and preliminary evaluation in morbidly obese patients. J Magn Reson Imaging 2012; 37:1144-50. [PMID: 23124651 DOI: 10.1002/jmri.23890] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Accepted: 09/14/2012] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To present software for supervised automatic quantification of visceral and subcutaneous adipose tissue (VAT, SAT) and evaluates its performance in terms of reliability, interobserver variation, and processing time, since fully automatic segmentation of fat-fraction magnetic resonance imaging (MRI) is fast but susceptible to anatomical variations and artifacts, particularly for advanced stages of obesity. MATERIALS AND METHODS Twenty morbidly obese patients (average BMI 44 kg/m(2) ) underwent 1.5-T MRI using a double-echo gradient-echo sequence. Fully automatic analysis (FAA) required no user interaction, while supervised automatic analysis (SAA) involved review and manual correction of the FAA results by two observers. Standard of reference was provided by manual segmentation analysis (MSA). RESULTS Average processing times per patient were 6, 6+4, and 21 minutes for FAA, SAA, and MSA (P < 0.001), respectively. For VAT/SAT assessment, Pearson correlation coefficients, mean (bias), and standard deviations of the differences were R = 0.950, +0.003, and 0.043 between FAA and MSA and R = 0.981, +0.009, and 0.027 between SAA and MSA. Interobserver variation and intraclass correlation were 3.1% and 0.996 for SAA, and 6.6% and 0.986 for MSA, respectively. CONCLUSION The presented supervised automatic approach provides a reliable option for MRI-based fat quantification in morbidly obese patients and was much faster than manual analysis.
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Affiliation(s)
- Gregor Thörmer
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Leipzig, Germany
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Kaess BM, Pedley A, Massaro JM, Murabito J, Hoffmann U, Fox CS. The ratio of visceral to subcutaneous fat, a metric of body fat distribution, is a unique correlate of cardiometabolic risk. Diabetologia 2012; 55:2622-2630. [PMID: 22898763 PMCID: PMC3636065 DOI: 10.1007/s00125-012-2639-5] [Citation(s) in RCA: 223] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 06/05/2012] [Indexed: 02/07/2023]
Abstract
AIMS/HYPOTHESIS The anatomic location of excess body fat has an impact on associated cardiometabolic morbidity, and visceral adipose tissue (VAT) is more pathogenic than subcutaneous adipose tissue (SAT). However, VAT or SAT alone provides little information regarding the relative distribution of body fat. We hypothesised that the propensity to store energy in VAT relative to SAT depots may be a correlate of cardiometabolic risk, and tested this hypothesis using the VAT/SAT ratio as a metric of fat distribution. METHODS We investigated associations of the VAT/SAT ratio with cardiometabolic traits in 3,223 participants (48% women) from the Framingham Heart Study. Fat depots were quantified by multidetector computed tomography (CT) scanning. RESULTS In women and men, higher VAT/SAT ratio was associated (p < 0.05) with most assessed cardiovascular risk factors reflecting blood pressure, dyslipidaemia and insulin resistance. Additional adjustment for BMI did not materially change the findings in women, and generally strengthened associations in men. Further adjustment for VAT attenuated some associations in women, but those with lower HDL-cholesterol, higher triacylglycerol (both p < 0.0001) and higher prevalence of hypertension (p = 0.02), diabetes (p = 0.01) and the metabolic syndrome (p = 0.005) remained significant. Similarly, in men, associations with higher systolic (p = 0.006) and diastolic blood pressure (p = 0.03), higher fasting glucose (p = 0.0005), lower HDL-cholesterol and higher triacylglycerol (both p < 0.0001) and higher prevalence of diabetes (p = 0.006) remained significant. CONCLUSIONS/INTERPRETATION VAT/SAT ratio is a correlate of cardiometabolic risk, above and beyond BMI and VAT. The propensity to store fat viscerally versus subcutaneously may be a unique risk factor independent of absolute fat volumes.
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Affiliation(s)
- B M Kaess
- National Heart, Lung and Blood Institute's Framingham Heart Study, 73 Mt Wayte Ave Suite no. 2, Framingham, MA, 01702, USA
- Klinik und Poliklinik für Innere Medizin II, University of Regensburg, Regensburg, Germany
| | - A Pedley
- National Heart, Lung and Blood Institute's Framingham Heart Study, 73 Mt Wayte Ave Suite no. 2, Framingham, MA, 01702, USA
| | - J M Massaro
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - J Murabito
- Boston University School of Medicine, Boston, MA, USA
| | - U Hoffmann
- Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - C S Fox
- National Heart, Lung and Blood Institute's Framingham Heart Study, 73 Mt Wayte Ave Suite no. 2, Framingham, MA, 01702, USA.
- Brigham and Women's Division of Endocrinology, Hypertension, and Metabolism and Harvard Medical School, Boston, MA, USA.
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