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Rabinowich A, Avisdris N, Zilberman A, Link-Sourani D, Lazar S, Herzlich J, Specktor-Fadida B, Joskowicz L, Malinger G, Ben-Sira L, Hiersch L, Ben Bashat D. Reduced adipose tissue in growth-restricted fetuses using quantitative analysis of magnetic resonance images. Eur Radiol 2023; 33:9194-9202. [PMID: 37389606 DOI: 10.1007/s00330-023-09855-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 04/18/2023] [Accepted: 04/21/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVES Fat-water MRI can be used to quantify tissues' lipid content. We aimed to quantify fetal third trimester normal whole-body subcutaneous lipid deposition and explore differences between appropriate for gestational age (AGA), fetal growth restriction (FGR), and small for gestational age fetuses (SGAs). METHODS We prospectively recruited women with FGR and SGA-complicated pregnancies and retrospectively recruited the AGA cohort (sonographic estimated fetal weight [EFW] ≥ 10th centile). FGR was defined using the accepted Delphi criteria, and fetuses with an EFW < 10th centile that did not meet the Delphi criteria were defined as SGA. Fat-water and anatomical images were acquired in 3 T MRI scanners. The entire fetal subcutaneous fat was semi-automatically segmented. Three adiposity parameters were calculated: fat signal fraction (FSF) and two novel parameters, i.e., fat-to-body volume ratio (FBVR) and estimated total lipid content (ETLC = FSF*FBVR). Normal lipid deposition with gestation and differences between groups were assessed. RESULTS Thirty-seven AGA, 18 FGR, and 9 SGA pregnancies were included. All three adiposity parameters increased between 30 and 39 weeks (p < 0.001). All three adiposity parameters were significantly lower in FGR compared with AGA (p ≤ 0.001). Only ETLC and FSF were significantly lower in SGA compared with AGA using regression analysis (p = 0.018-0.036, respectively). Compared with SGA, FGR had a significantly lower FBVR (p = 0.011) with no significant differences in FSF and ETLC (p ≥ 0.053). CONCLUSIONS Whole-body subcutaneous lipid accretion increased throughout the third trimester. Reduced lipid deposition is predominant in FGR and may be used to differentiate FGR from SGA, assess FGR severity, and study other malnourishment pathologies. CLINICAL RELEVANCE STATEMENT Fetuses with growth restriction have reduced lipid deposition than appropriately developing fetuses measured using MRI. Reduced fat accretion is linked with worse outcomes and may be used for growth restriction risk stratification. KEY POINTS • Fat-water MRI can be used to assess the fetal nutritional status quantitatively. • Lipid deposition increased throughout the third trimester in AGA fetuses. • FGR and SGA have reduced lipid deposition compared with AGA fetuses, more predominant in FGR.
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Affiliation(s)
- Aviad Rabinowich
- Sagol Brain Institute, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
- Department of Radiology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Netanell Avisdris
- Sagol Brain Institute, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- School of Computer Science and Engineering, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ayala Zilberman
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Department of Obstetrics and Gynecology, Lis Hospital for Women, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | | | - Sapir Lazar
- Department of Radiology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Jacky Herzlich
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Neonatal Intensive Care Unit, Dana Dwek Children's Hospital, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Bella Specktor-Fadida
- School of Computer Science and Engineering, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Leo Joskowicz
- School of Computer Science and Engineering, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Gustavo Malinger
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Department of Obstetrics and Gynecology, Lis Hospital for Women, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Liat Ben-Sira
- Department of Radiology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Liran Hiersch
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Department of Obstetrics and Gynecology, Lis Hospital for Women, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Dafna Ben Bashat
- Sagol Brain Institute, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
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Samim A, Spijkers S, Moeskops P, Littooij AS, de Jong PA, Veldhuis WB, de Vos BD, van Santen HM, Nievelstein RAJ. Pediatric body composition based on automatic segmentation of computed tomography scans: a pilot study. Pediatr Radiol 2023; 53:2492-2501. [PMID: 37640800 PMCID: PMC10635977 DOI: 10.1007/s00247-023-05739-x] [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: 04/24/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Body composition during childhood may predispose to negative health outcomes later in life. Automatic segmentation may assist in quantifying pediatric body composition in children. OBJECTIVE To evaluate automatic segmentation for body composition on pediatric computed tomography (CT) scans and to provide normative data on muscle and fat areas throughout childhood using automatic segmentation. MATERIALS AND METHODS In this pilot study, 537 children (ages 1-17 years) who underwent abdominal CT after high-energy trauma at a Dutch tertiary center (2002-2019) were retrospectively identified. Of these, the CT images of 493 children (66% boys) were used to establish normative data. Muscle (psoas, paraspinal and abdominal wall) and fat (subcutaneous and visceral) areas were measured at the third lumbar vertebral (L3) level by automatic segmentation. A representative subset of 52 scans was also manually segmented to evaluate the performance of automatic segmentation. RESULTS For manually-segmented versus automatically-segmented areas (52 scans), mean Dice coefficients were high for muscle (0.87-0.90) and subcutaneous fat (0.88), but lower for visceral fat (0.60). In the control group, muscle area was comparable for both sexes until the age of 13 years, whereafter, boys developed relatively more muscle. From a young age, boys were more prone to visceral fat storage than girls. Overall, boys had significantly higher visceral-to-subcutaneous fat ratios (median 1.1 vs. 0.6, P<0.01) and girls higher fat-to-muscle ratios (median 1.0 vs. 0.7, P<0.01). CONCLUSION Automatic segmentation of L3-level muscle and fat areas allows for accurate quantification of pediatric body composition. Using automatic segmentation, the development in muscle and fat distribution during childhood (in otherwise healthy) Dutch children was demonstrated.
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Affiliation(s)
- Atia Samim
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht and Wilhelmina Children's Hospital, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
| | - Suzanne Spijkers
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht and Wilhelmina Children's Hospital, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Pim Moeskops
- Quantib-U, Utrecht, The Netherlands
- Image Sciences Institute, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Annemieke S Littooij
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht and Wilhelmina Children's Hospital, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Pim A de Jong
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht and Wilhelmina Children's Hospital, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Wouter B Veldhuis
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht and Wilhelmina Children's Hospital, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Quantib-U, Utrecht, The Netherlands
| | - Bob D de Vos
- Quantib-U, Utrecht, The Netherlands
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Centers - location AMC, Amsterdam, The Netherlands
| | - Hanneke M van Santen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Rutger A J Nievelstein
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht and Wilhelmina Children's Hospital, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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3
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Van Ginneken C, Ayuso M, Van Bockstal L, Van Cruchten S. Preweaning performance in intrauterine growth-restricted piglets: Characteristics and interventions. Mol Reprod Dev 2023; 90:697-707. [PMID: 35652465 DOI: 10.1002/mrd.23614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 05/06/2022] [Accepted: 05/23/2022] [Indexed: 11/06/2022]
Abstract
Intrauterine growth restriction (IUGR) is frequently observed in pig production, especially when using highly prolific sows. IUGR piglets are born with low body weight and shape indicative of differences in organ growth. Insufficient uteroplacental nutrient transfer to the fetuses is the leading cause of growth restriction in the pig. Supplementing the sow's gestation diet with arginine and/or glutamine improves placenta growth and functionality and consequently is able to reduce IUGR incidence. IUGR piglets are at higher risk of dying preweaning and face higher morbidity than their normal-weight littermates. A high level of surveillance during farrowing and individual nutrient supplementation can reduce the mortality rates. Still, these do not reverse the long-term consequences of IUGR, which are induced by persistent structural deficits in different organs. Dietary interventions peri-weaning can optimize performance but these are less effective in combating the metabolic changes that occurred in IUGR, which affect reproductive performance later in life. IUGR piglets share many similarities with IUGR infants, such as a poorer outcome of males. Using the IUGR piglet as an animal model to further explore the structural and molecular basis of the long-term consequences of IUGR and the potential sex bias could aid in fully understanding the impact of prenatal undernutrition and finding solutions for both species and sexes.
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Affiliation(s)
- Chris Van Ginneken
- Comparative Perinatal Development (CoPeD), Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Antwerp, Belgium
| | - Miriam Ayuso
- Comparative Perinatal Development (CoPeD), Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Antwerp, Belgium
| | - Lieselotte Van Bockstal
- Comparative Perinatal Development (CoPeD), Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Antwerp, Belgium
| | - Steven Van Cruchten
- Comparative Perinatal Development (CoPeD), Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Antwerp, Belgium
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Röszer T. Metabolic impact of adipose tissue macrophages in the early postnatal life. J Leukoc Biol 2022; 112:1515-1524. [PMID: 35899927 PMCID: PMC9796690 DOI: 10.1002/jlb.3mr0722-201r] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 07/02/2022] [Indexed: 01/07/2023] Open
Abstract
Adipose tissue macrophages (ATMs) play key roles in metabolic inflammation, insulin resistance, adipose tissue fibrosis, and immune disorders associated with obesity. Research on ATM biology has mostly been conducted in the setting of adult obesity, since adipocyte hypertrophy is associated with a significant increase in ATM number. Signals that control ATM activation toward a proinflammatory or a proresolving phenotype also determine the developmental program and lipid metabolism of adipocytes after birth. ATMs are present at birth and actively participate in the synthesis of mediators, which induce lipolysis, mitobiogenesis, and mitochondrial uncoupling in adipocytes. ATMs in the newborn and the infant promote a lipolytic and fatty acid oxidizing adipocyte phenotype, which is essential to support the lipid-fueled metabolism, to maintain nonshivering thermogenesis and counteract an excessive adipose tissue expansion. Since adipose tissue metabolism in the early postnatal life determines obesity status in adulthood, early-life ATM functions may have a life-long impact.
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Affiliation(s)
- Tamás Röszer
- Division of Pediatric Obesity, Children's Hospital and Institute of PediatricsUniversity of DebrecenDebrecenHungary,Institute of NeurobiologyUlm UniversityUlmGermany
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5
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Adipose Tissue Development Relies on Coordinated Extracellular Matrix Remodeling, Angiogenesis, and Adipogenesis. Biomedicines 2022; 10:biomedicines10092227. [PMID: 36140327 PMCID: PMC9496222 DOI: 10.3390/biomedicines10092227] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 11/24/2022] Open
Abstract
Despite developing prenatally, the adipose tissue is unique in its ability to undergo drastic growth even after reaching its mature size. This development and subsequent maintenance rely on the proper coordination between the vascular niche and the adipose compartment. In this review, the process of adipose tissue development is broken down to explain (1) the ultrastructural matrix remodeling that is undertaken during simultaneous adipogenesis and angiogenesis, (2) the paracrine crosstalk involved during adipose development, (3) the mechanical regulators involved in adipose growth, and (4) the proteolytic and paracrine oversight for matrix remodeling during adipose development. It is crucial to gain a better understanding of the complex relationships that exist between adipose tissue and the vasculature during tissue development to provide insights into the pathological tissue expansion of obesity and to develop improved soft-tissue reconstruction techniques.
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Ong YY, Tint MT, Aris IM, Yuan WL, Chen LW, Fortier MV, Choo J, Ling LH, Shek L, Tan KH, Gluckman PD, Yap F, Chong YS, Godfrey KM, Chong MFF, Chan SY, Eriksson JG, Wlodek ME, De Lucia Rolfe E, Ong KK, Michael N, Lee YS. Newborn body composition and child cardiovascular risk markers: a prospective multi-ethnic Asian cohort study. Int J Epidemiol 2022; 51:1835-1846. [PMID: 35906917 PMCID: PMC9749728 DOI: 10.1093/ije/dyac154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 07/21/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Early epidemiological studies have associated low birthweight with increased cardiovascular risk. We aimed to examine whether the fat and fat-free components of birthweight have differing relationships with childhood cardiovascular risk markers. METHODS In the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort, air displacement plethysmography was conducted within 24 h after delivery in 290 naturally conceived singletons. We investigated associations of newborn cohort-specific standardized z-score of fat mass, fat-free mass, body fat percentage and birthweight on child (at 6 years of age) carotid intima-media thickness, pulse wave velocity, blood pressure, prehypertension/hypertension (>110/70 mmHg) and standardized systolic and diastolic blood pressure (SBP and DBP) trajectories (at 3-6 years of age), taking account of maternal education, height, tobacco exposure, parity, ethnicity, child's sex, gestational age, age at follow-up, and other maternal factors. RESULTS Clear inverse associations were seen for blood pressure with z-score of fat mass [SBP, β (95% CI): -1.31 mmHg (-2.57, -0.06); DBP: -0.79 mmHg (-1.74, 0.15)] and body fat percentage [SBP: -1.46 mmHg (-2.73, -0.19); DBP: -0.80 mmHg (-1.75, 0.16)], but not with fat-free mass [SBP: 0.27 mmHg (-1.29, 1.83)]; DBP: -0.14 mmHg (-1.30, 1.03)]. Being in the lowest tertile of fat mass or body fat percentage was associated with higher blood pressure trajectories and prehypertension/hypertension risk [OR (95% CI), fat mass: 4.23 (1.41, 12.68); body fat percentage: 3.22 (1.09, 9.53)] without concomitantly higher overweight/obesity risk. CONCLUSIONS At birth, low adiposity was associated with increased childhood blood pressure. Low newborn adiposity might serve as a marker of poor fetal growth or suboptimal intrauterine conditions associated with hypertension risk later in life.
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Affiliation(s)
- Yi Ying Ong
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mya-Thway Tint
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
| | - Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Wen Lun Yuan
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ling-Wei Chen
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Marielle V Fortier
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore,Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore
| | - Jonathan Choo
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | - Lieng Hsi Ling
- Department of Cardiology, National University Heart Centre, Singapore
| | - Lynette Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore,Department of Paediatrics, Khoo Teck Puat-National University Children’s Medical Institute, Singapore
| | - Kok Hian Tan
- Academic Medicine Department, Duke-NUS Medical School, Singapore,Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Fabian Yap
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore,Academic Medicine Department, Duke-NUS Medical School, Singapore
| | - Yap-Seng Chong
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Mary F-F Chong
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Shiao-Yng Chan
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
| | - Johan G Eriksson
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore,Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland,Public Health Research Program, Folkhälsan Research Center, Helsinki, Finland
| | - Mary E Wlodek
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
| | - Emanuella De Lucia Rolfe
- Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Ken K Ong
- Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | | | - Yung Seng Lee
- Corresponding author. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 12, Singapore 119228, Singapore. E-mail:
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Petry CJ, Hughes IA, Ong KK. Increased basal insulin sensitivity in late pregnancy in women carrying a male fetus: a cohort study. Biol Sex Differ 2022; 13:20. [PMID: 35509032 PMCID: PMC9069709 DOI: 10.1186/s13293-022-00429-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It has been suggested that fetal sex may be able to modify maternal metabolism and physiology during pregnancy. Recently pregnant women carrying a male fetus were reported to be more insulin sensitive than those carrying females, although related evidence is inconsistent. METHODS In this study we administered a 75 g oral glucose tolerance test at around week 28 of pregnancy in 813 pregnant women from a contemporary birth cohort (the Cambridge Baby Growth Study), derived surrogate indices of insulin secretion and sensitivity, and related them to the fetal sex. RESULTS Carrying a male fetus was associated with lower fasting glucose (difference in mean concentrations ≈ 0.1 mmol/L; β' = 0.063; p = 0.02) and insulin (≈ 1.1 pmol/L; β' = 0.075; p = 0.01) concentrations but not with post-load glucose or insulin concentrations. Male fetal sex was also associated with lower HOMA IR (≈ 1.08 units; β' = 0.071; p = 0.02) and higher QUICKI (≈ 1.06 units; β' = 0.080; p = 0.007) values suggesting increased basal insulin sensitivity. There were no differences in indices of insulin secretion, except for the insulin disposition index which was higher in women carrying a male fetus (≈ 1.15 units; β' = 0.090; p = 0.007). Birth weights were higher in male offspring. CONCLUSIONS Women carrying a male fetus were relatively more insulin sensitive in the fasting state and secreted more insulin relative to this degree of insulin sensitivity. These results are consistent with the idea that the fetal sex may be able to modify the maternal glucose-insulin axis.
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Affiliation(s)
- Clive J. Petry
- Department of Paediatrics, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Box 116, Cambridge, CB2 0QQ UK
| | - Ieuan A. Hughes
- Department of Paediatrics, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Box 116, Cambridge, CB2 0QQ UK
| | - Ken K. Ong
- Department of Paediatrics, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Box 116, Cambridge, CB2 0QQ UK
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Institute of Metabolic Science, University of Cambridge, Cambridge, UK
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8
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The mysterious values of adipose tissue density and fat content in infants: MRI-measured body composition studies. Pediatr Res 2021; 90:963-965. [PMID: 33504969 DOI: 10.1038/s41390-021-01376-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/25/2020] [Accepted: 12/29/2020] [Indexed: 11/08/2022]
Abstract
Adipose tissue is a type of connective tissue composed of closely packed adipocytes with collagenous and elastic fibers. These adipocytes store triglycerides at a high percentage and the estimate of this amount is important for the calculation of body fat mass. For example, magnetic resonance imaging (MRI) measures adipose tissue volume, but adipose tissue density (fat content percentage and density) is required to calculate fat mass. However, in previously published studies, the conversion factor for white adipose tissue density varies from study to study. This paper aimed to investigate the different adipose tissue densities used as conversion factors to clarify differences between studies. Furthermore, we include a new proposal for adipose tissue density and fat content of infants based on the results of recent water-fat MRI studies. IMPACT: Magnetic resonance imaging (MRI) is one of the methods used to measure body composition in infants and the inherent density of tissue/organs is needed in order to calculate the mass of target organs and tissues. The conversion factor used for white adipose tissue density currently varies from study to study. This article includes a new recommendation for the adipose tissue density and fat content of infants based on the results of recent water-fat MRI studies.
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9
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Flanagan EW, Altazan AD, Carmichael OT, Hu HH, Redman LM. Practical application of in vivo MRI-based brown adipose tissue measurements in infants. Obesity (Silver Spring) 2021; 29:1676-1683. [PMID: 34553508 PMCID: PMC9115839 DOI: 10.1002/oby.23237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The role of brown adipose tissue (BAT) in infant metabolism remains poorly understood, primarily because of the inherent limitation of positron emission tomography/computed tomography imaging to measure BAT, which is not suitable for infants. The aims of this method development study were to assess the feasibility, intra-rater reliability, interscan repeatability, and physiological relevance of measuring BAT in infants using magnetic resonance imaging (MRI). METHODS A total of 10 nonsedated infants (mean age, 22.6 [1.3] days old) completed two 3-T MRI exams using chemical-shift-encoded water-fat scans 6.2 (2.8) days apart. Candidate BAT voxels in the supraclavicular region were identified based on fat signal fraction (FSF). The volumes of BAT depots were manually traced, and FSF was calculated. Whole-body fat mass was determined using dual-energy x-ray absorptiometry. RESULTS Images were successfully obtained from 19 of 20 (95%) attempted scans. The mean BAT volume was 5.41 (SD 1.1) cm3 , and the mean FSF was 16.41% (SD 3.3%). Intra-rater analysis showed good reliability with no systemic bias (proportional bias for volume: p = 0.19; FSF: p = 0.30). Test-retest for interscan repeatability was good (intraclass correlation coefficients for volume: 0.92, p = 0.001 and intraclass correlation coefficients for FSF: 0.93, p < 0.001). FSF was inversely related to fat-free mass (r = -0.69, p = 0.03). CONCLUSIONS This method development study supports the use of MRI to obtain reliable and quantitative measurements of BAT volume in infants.
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Affiliation(s)
- Emily W Flanagan
- Pennington Biomedical Research Center, Baton Rouge, Louisana, USA
| | - Abby D Altazan
- Pennington Biomedical Research Center, Baton Rouge, Louisana, USA
| | | | - Houchun H Hu
- Hyperfine Research, Inc., Guilford, Connecticut, USA
| | - Leanne M Redman
- Pennington Biomedical Research Center, Baton Rouge, Louisana, USA
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10
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The association of low body mass index with neonatal morbidities in preterm infants. Sci Rep 2021; 11:18841. [PMID: 34552171 PMCID: PMC8458459 DOI: 10.1038/s41598-021-98338-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 09/07/2021] [Indexed: 11/08/2022] Open
Abstract
Little is known about the association between body proportionality at birth and neonatal outcomes in preterm infants. Body mass index (BMI) is one of the weigh-for-length ratios that represent body proportionality. The objective of this study was to examine whether BMI at birth affects neonatal outcomes in preterm infants. We assessed 3115 preterm (< 30 weeks), very low birth weight (< 1500 g) infants born between January 2013 and December 2016 and registered in the Korean Neonatal Network database. Using gender-specific BMI for gestational age curves, z-scores of BMI at birth were calculated. Low-, normal-, and high-BMI were defined as BMI z-scores of less than - 1, from - 1 to 1, and greater than 1, respectively. Neonatal morbidities and mortality in low- and high-BMI groups were compared to those in normal-BMI group. The low-BMI group had an increased risk of bronchopulmonary dysplasia, bronchopulmonary dysplasia or death, and necrotizing enterocolitis after adjusting for baseline characteristics and the birth weight z-score. High-BMI group had comparable neonatal outcomes to those of normal-BMI group. Low BMI at birth was associated with an increased risk of bronchopulmonary dysplasia and necrotizing enterocolitis, whereas High BMI at birth was not associated with adverse neonatal outcomes.
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Gallagher D, Andres A, Fields DA, Evans WJ, Kuczmarski R, Lowe WL, Lumeng JC, Oken E, Shepherd JA, Sun S, Heymsfield SB. Body Composition Measurements from Birth through 5 Years: Challenges, Gaps, and Existing & Emerging Technologies-A National Institutes of Health workshop. Obes Rev 2020; 21:e13033. [PMID: 32314544 PMCID: PMC7875319 DOI: 10.1111/obr.13033] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/22/2020] [Accepted: 03/24/2020] [Indexed: 12/14/2022]
Abstract
Body composition estimates are widely used in clinical research and field studies as measures of energy-nutrient balance, functionality and health. Despite their broad relevance and multiple applications, important gaps remain in techniques available for accurately and precisely quantifying body composition in infants and children from birth through 5 years. Identifying these gaps and highlighting research needs in this age group were the topics of a National Institutes of Health workshop held in Bethesda, MD, USA, 30-31 May 2019. Experts reviewed available methods (multicompartment models, air-displacement plethysmography, dual-energy X-ray absorptiometry, weight-length and height indices, bioimpedance analysis, anthropometry-skinfold techniques, quantitative magnetic resonance, optical imaging, omics and D3-creatine dilution), their limitations in this age range and high priority research needs. A summary of their individual and collective workshop deliberations is provided in this report.
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Affiliation(s)
- Dympna Gallagher
- New York Obesity Research Center, Division of Endocrinology, Dept. of Medicine, Columbia University Irving Medical Center, New York, New York, USA.,Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Aline Andres
- Arkansas Children's Nutrition Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - David A Fields
- Department of Pediatrics, Division of Endocrinology and Diabetes, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - William J Evans
- Nutritional Sciences and Toxicology, University of California, Berkeley, California, USA
| | - Robert Kuczmarski
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - William L Lowe
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Julie C Lumeng
- Department of Pediatrics, Medical School, Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - John A Shepherd
- Department of Epidemiology and Population Sciences, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Shumei Sun
- Department of Pediatrics, Medical School, Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.,Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, LSU System, Baton Rouge, Louisiana, USA
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Clinical and molecular evidence of accelerated ageing following very preterm birth. Pediatr Res 2020; 87:1005-1010. [PMID: 31812156 DOI: 10.1038/s41390-019-0709-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 10/14/2019] [Accepted: 10/16/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND The mechanisms responsible for the associations between very preterm birth and a higher risk of poor cardiovascular and metabolic health in adult life are unknown. METHODS Here, we compare the clinical and molecular phenotypes of healthy, normal-weight young adults (18-27 years), born very preterm (<33 weeks gestational age (GA)) and at full-term (37-42 weeks GA). Outcomes included whole-body MRI, hepatic and muscle 1H MRS, blood pressure measurements and telomere length. RESULTS We recruited 156 volunteers, 69 preterm (45 women; 24 men) and 87 born at full-term (45 women; 42 men). Preterm individuals had a significantly altered blood pressure profile, including higher systolic blood pressure (SBP mmHg: preterm men 133.4 ± 10.1, term men 23.0 ± 6.9; preterm women 124.3 ± 7.1, term women 118.4 ± 8.0, p < 0.01 for all). Furthermore, preterm men had fewer long telomeres (145-48.5 kb: preterm men 14.1 ± 0.9%, term men 17.8 ± 1.1%, p < 0.05; 48.5-8.6 kb: preterm men 28.2 ± 2.6, term men 37.0 ± 2.4%, p < 0.001) and a higher proportion of shorter telomeres (4.2-1.3 kb: preterm men 40.4 ± 3.5%, term men 29.9 ± 3.2%, p < 0.01). CONCLUSION Our data indicate that healthy young adults born very preterm manifest clinical and molecular evidence of accelerated ageing.
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Longitudinal body composition assessment in healthy term-born infants until 2 years of age using ADP and DXA with vacuum cushion. Eur J Clin Nutr 2020; 74:642-650. [PMID: 32055012 DOI: 10.1038/s41430-020-0578-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 01/29/2020] [Accepted: 01/29/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Accelerated gain in fat mass (FM) in early life increases the risk for adult diseases. Longitudinal data on infant body composition are crucial for clinical and research use, but very difficult to obtain due to limited measurement tools and unsuccessful measurements between age 6-24 months. We compared FM% by dual-energy X-ray absorptiometry (DXA), with cushion to reduce movement artifacts, with FM% by air-displacement plethysmography (ADP) and evaluated the reliability of this cushion during DXA by comparing FM% with and without cushion. Subsequently, we constructed sex-specific longitudinal body composition charts from 1-24 months. METHODS In 692 healthy, term-born infants (Sophia Pluto Cohort), FM% was measured by ADP from 1-6 months and DXA with cushion from 6-24 months. At 6 months, FM% was measured in triplicate by ADP and DXA with and without cushion(n = 278), later on in smaller numbers. RESULTS At 6 months, mean FM% by DXA with cushion was 24.1 and by ADP 25.0, mean difference of 0.9% (Bland-Altman p = 0.321, no proportional bias). Mean FM% by DXA without cushion was 12.5% higher compared to ADP (Bland-Altman p < 0.001). DXA without cushion showed higher mean FM% compared to DXA with cushion (+11.6%, p < 0.001) at 6 months. Longitudinally, FM% increased between 1-6 months and decreased from 6-24 months(both p < 0.001). CONCLUSIONS In infants, DXA scan with cushion limits movement artifacts and shows reliable FM%, comparable to ADP. This allowed us to construct longitudinal body composition charts until 24 months. Our study shows that FM% increases from 1-6 months and gradually declines until 24 months.
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Bruckner M, Khan Z, Binder C, Morris N, Windisch B, Holasek S, Urlesberger B. Extremely Preterm Infants Have a Higher Fat Mass Percentage in Comparison to Very Preterm Infants at Term-Equivalent Age. Front Pediatr 2020; 8:61. [PMID: 32219084 PMCID: PMC7078645 DOI: 10.3389/fped.2020.00061] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/10/2020] [Indexed: 02/05/2023] Open
Abstract
Background: Early nutritional support of preterm infants is important because it influences long-term health and development. Body composition has an influence on cardiovascular disease, metabolic syndrome, and neurocognitive outcome in the long term. Objective: To assess body composition in preterm infants <32 weeks of gestation at term-equivalent age and to analyze the influence of an optimized nutritional approach. Methods: This is a prespecified secondary outcome analysis of a prospective observational study comparing the body composition in regard to gestational age. The preterm infants were classified according to gestational age as extremely preterm infants (<28 weeks gestation at birth) and very preterm infants (≥28 weeks gestation at birth) and according to weight percentile as appropriate for gestational age and small for gestational age. Body composition was determined by air displacement plethysmography using the PEA POD. The preterm infants obtained nutrition according to the ESPGHAN 2010 Guidelines. Results: Seventy-four preterm infants were analyzed. The mean (SD) gestational age was 28.7 (2.4) weeks, and birth weight was 1,162 (372) g. Fat mass percentage was significantly higher in extremely preterm infants in comparison to very preterm infants [17.0, 95% confidence interval (CI) 15.9-18.1 vs. 15.5, 95% CI 14.7-16.2]. There was no significant difference of fat mass percentage according to weight percentiles. Conclusions: Extremely preterm infants had a significantly higher fat mass percentage compared to very preterm infants at term-equivalent age. There was no significant difference of fat mass percentage according to weight percentiles.
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Affiliation(s)
- Marlies Bruckner
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Zahra Khan
- Department of Food Science and Human Nutrition, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Christoph Binder
- Division of Neonatology, Pediatric Intensive Care Medicine and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Nicholas Morris
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Bernadette Windisch
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Sandra Holasek
- Division of Immunology and Pathophysiology, Otto Loewi Research Centre, Medical University Graz, Graz, Austria
| | - Berndt Urlesberger
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
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Chycki J, Zajac A, Michalczyk M, Maszczyk A, Langfort J. Hormonal and metabolic substrate status in response to exercise in men of different phenotype. Endocr Connect 2019; 8:814-821. [PMID: 31137013 PMCID: PMC6590201 DOI: 10.1530/ec-19-0216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 05/28/2019] [Indexed: 01/23/2023]
Abstract
OBJECTIVES The present study verified the effect of moderate-to-high-intensity aerobic exercise on the endocrine response profile and adipose tissue in young healthy men with different phenotype characteristics. DESIGN Eighteen men were divided into three experimental groups with defined body components and specific physical fitness: Endurance phenotype - EP (n = 6; low body mass; low fat content; aerobic endurance trained), Athletic phenotype - AP (n = 6; high body mass; low fat content, resistance trained), Obesity phenotype - OP (n = 6; high body mass; high fat content, untrained). METHODS The participants performed an progressive exercise protocol on a treadmill (30% VO2max, 50% VO2max, 70% VO2max), separated by 45 s of passive rest for blood collection. RESULTS Plasma glucose oxidation increased in relation to exercise intensity, but to a greater extent in the AP group. The free fatty acids' plasma level decreased with a rise in exercise intensity, but with different kinetics in particular phenotypes. Plasma growth hormone increased after the cessation of exercise and was significantly higher in all groups 45 min into recovery compared to resting values. Plasma insulin decreased during exercise in all groups, but in the OP, the decrease was blunted. CONCLUSIONS The results indicate that the rate of lipolysis, hormonal and metabolic response to aerobic exercise depends on the individuals' phenotype. Thus, exercise type, duration and intensity have to be strictly individualized in relation to phenotype in order to reach optimal metabolic benefits.
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Affiliation(s)
- J Chycki
- Department of Sports Training, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
- Correspondence should be addressed to J Chycki:
| | - A Zajac
- Department of Sports Training, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - M Michalczyk
- Department of Sports Nutrition, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - A Maszczyk
- Department of Methodology and Statistics, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - J Langfort
- Department of Sports Nutrition, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
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Armstrong T, Ly KV, Ghahremani S, Calkins KL, Wu HH. Free-breathing 3-D quantification of infant body composition and hepatic fat using a stack-of-radial magnetic resonance imaging technique. Pediatr Radiol 2019; 49:876-888. [PMID: 31001664 DOI: 10.1007/s00247-019-04384-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 02/12/2019] [Accepted: 03/08/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Body composition and hepatic fat correlate with future risk for metabolic syndrome. In children, many conventional techniques for quantifying body composition and hepatic fat have limitations. MRI is a noninvasive research tool to study body composition and hepatic fat in infants; however, conventional Cartesian MRI is sensitive to motion, particularly in the abdomen because of respiration. Therefore we developed a free-breathing MRI technique to quantify body composition and hepatic fat in infants. OBJECTIVE In infants, we aimed to (1) compare the image quality between free-breathing 3-D stack-of-radial MRI (free-breathing radial) and 3-D Cartesian MRI in the liver and (2) determine the feasibility of using free-breathing radial MRI to quantify body composition and hepatic proton-density fat fraction (PDFF). MATERIALS AND METHODS Ten infants ages 2-7 months were scanned with free-breathing radial (two abdominal; one head and chest) and Cartesian (one abdominal) MRI sequences. The median preparation and scan times were reported. To assess feasibility for hepatic PDFF quantification, a radiologist masked to the MRI technique scored abdominal scans for motion artifacts in the liver using a 3-point scale (1, or non-diagnostic, to 3, or no artifacts). Median visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and brown adipose tissue (BAT) volume and PDFF, and hepatic PDFF were measured using free-breathing radial MRI. We assessed repeatability of free-breathing radial hepatic PDFF (coefficient of repeatability) between back-to-back scans. We determined differences in the distribution of image-quality scores using McNemar-Bowker tests. P<0.05 was considered significant. RESULTS Nine infants completed the entire study (90% completion). For ten infants, the median preparation time was 32 min and scan time was 24 min. Free-breathing radial MRI demonstrated significantly higher image-quality scores compared to Cartesian MRI in the liver (radial scan 1 median = 2 and radial scan 2 median = 3 vs. Cartesian median = 1; P=0.01). Median measurements using free-breathing radial were VAT=52.0 cm3, VAT-PDFF=42.2%, SAT=267.7 cm3, SAT-PDFF=87.1%, BAT=1.4 cm3, BAT-PDFF=26.1% and hepatic PDFF=3.4% (coefficient of repeatability <2.0%). CONCLUSION In this study, free-breathing radial MRI in infants achieved significantly improved liver image quality compared to Cartesian MRI. It is feasible to use free-breathing radial MRI to quantify body composition and hepatic fat in infants.
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Affiliation(s)
- Tess Armstrong
- Department of Radiological Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, Ste. B119, Los Angeles, CA, 90095, USA.,Physics and Biology in Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Karrie V Ly
- Department of Pediatrics, Division of Neonatology, David Geffen School of Medicine, University of California Los Angeles, Mattel Children's Hospital, Los Angeles, CA, USA.,Physician Assistant Program, Midwestern University, Glendale, AZ, USA
| | - Shahnaz Ghahremani
- Department of Radiological Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, Ste. B119, Los Angeles, CA, 90095, USA
| | - Kara L Calkins
- Department of Pediatrics, Division of Neonatology, David Geffen School of Medicine, University of California Los Angeles, Mattel Children's Hospital, Los Angeles, CA, USA
| | - Holden H Wu
- Department of Radiological Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, Ste. B119, Los Angeles, CA, 90095, USA. .,Physics and Biology in Medicine, University of California Los Angeles, Los Angeles, CA, USA.
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17
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Alur P. Sex Differences in Nutrition, Growth, and Metabolism in Preterm Infants. Front Pediatr 2019; 7:22. [PMID: 30792973 PMCID: PMC6374621 DOI: 10.3389/fped.2019.00022] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 01/18/2019] [Indexed: 01/07/2023] Open
Abstract
Biological differences between the sexes are apparent even from the early part of the pregnancy. The crown-rump length is larger in male fetuses compared to females in the first trimester. Placentae of male and female fetuses have different protein and gene expressions, especially in adverse conditions. Even within the intrauterine milieu, the same extracellular micro RNA may show upregulation in females and downregulation in male fetuses. There appears to be a natural survival advantage for females. Maternal glucocorticoids (GC) play an important role in fetal growth and organ maturation. However, excess glucocorticoids can not only affect growth but the response may be sex-specific and probably mediated through glucocorticoid receptors (GR) in the placenta. Mild pre-eclampsia and asthma are associated with normal growth pattern in males, but in female fetuses, they are associated with a slowing of growth rate without causing IUGR probably as an adaptive response for future adverse events. Thus, female fetuses survive while male fetuses exhibit IUGR, preterm delivery and even death in the face of another adverse event. It is thought that the maternal diet may not influence growth but may influence the programming for adult disease. There is growing evidence that maternal pre-pregnancy overweight or obesity status is directly associated with a higher risk of obesity in a male child, but not in a female child, at 1 year of age. It is observed that exposure to gestational diabetes is a risk factor for childhood overweight in boys but not in girls. It is fascinating that male and female fetuses respond differently to the same intrauterine environment, and this suggests a fundamental biological variation most likely at the cellular and molecular level.
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Affiliation(s)
- Pradeep Alur
- Division of Neonatology, Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS, United States
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18
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Nutrition, the visceral immune system, and the evolutionary origins of pathogenic obesity. Proc Natl Acad Sci U S A 2018; 116:723-731. [PMID: 30598443 PMCID: PMC6338860 DOI: 10.1073/pnas.1809046116] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The global obesity epidemic is the subject of an immense, diversely specialized research effort. An evolutionary analysis reveals connections among disparate findings, starting with two well-documented facts: Obesity-associated illnesses (e.g., type-2 diabetes and cardiovascular disease), are especially common in: (i) adults with abdominal obesity, especially enlargement of visceral adipose tissue (VAT), a tissue with important immune functions; and (ii) individuals with poor fetal nutrition whose nutritional input increases later in life. I hypothesize that selection favored the evolution of increased lifelong investment in VAT in individuals likely to suffer lifelong malnutrition because of its importance in fighting intraabdominal infections. Then, when increased nutrition violates the adaptive fetal prediction of lifelong nutritional deficit, preferential VAT investment could contribute to abdominal obesity and chronic inflammatory disease. VAT prioritization may help explain several patterns of nutrition-related disease: the paradoxical increase of chronic disease with increased food availability in recently urbanized and migrant populations; correlations between poor fetal nutrition, improved childhood (catch-up) growth, and adult metabolic syndrome; and survival differences between children with marasmus and kwashiorkor malnutrition. Fats and sugars can aggravate chronic inflammation via effects on intestinal bacteria regulating gut permeability to visceral pathogens. The extremes in a nutrition-sensitive trade-off between visceral (immune-function) vs. subcutaneous (body shape) adiposity may have been favored by selection in highly stratified premedicine societies. Altered adipose allocation in populations with long histories of social stratification and malnutrition may be the result of genetic accommodation of developmental responses to poor maternal/fetal conditions, increasing their vulnerability to inflammatory disease.
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Hong YH, Chung S. Small for gestational age and obesity related comorbidities. Ann Pediatr Endocrinol Metab 2018; 23:4-8. [PMID: 29609443 PMCID: PMC5894558 DOI: 10.6065/apem.2018.23.1.4] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 03/15/2018] [Indexed: 12/19/2022] Open
Abstract
Infant born small for gestational age (SGA) are at increased risk of perinatal morbidity, persistent short stature and metabolic alterations in later life. The result of SGA followed by rapid weight gain during early postnatal life has been associated with increased long-term risks for central obesity, insulin resistance, impaired glucose tolerance, type 2 diabetes, hypertension, increased fat mass, and cardiovascular disease. We should carefully monitor their weight during infancy and childhood to prevent excessive rates of weight gain. 'Healthy catch up growth' may decreased the risk of obesity-related comorbidities in SGA. Establishing the optimal growth patterns in SGA to minimize short- and long-term risks is important, and further studies will be needed. This review discusses recent studies concentrating on obesity-related morbidities in SGA infants that may provide insight into growth monitoring.
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Affiliation(s)
- Yong Hee Hong
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University School of Medicine, Bucheon, Korea
| | - Sochung Chung
- Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
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20
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High-resolution rapid neonatal whole-body composition using 3.0 Tesla chemical shift magnetic resonance imaging. Pediatr Res 2018; 83:638-644. [PMID: 29168981 DOI: 10.1038/pr.2017.294] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 10/17/2017] [Indexed: 11/08/2022]
Abstract
BackgroundTo evaluate a whole-body rapid imaging technique to calculate neonatal lean body mass and percentage adiposity using 3.0 Tesla chemical shift magnetic resonance imaging (MRI).MethodsA 2-Point Dixon MRI technique was used to calculate whole-body fat and water images in term (n=10) and preterm (n=15) infants.ResultsChemical shift images were obtained in 42 s. MRI calculated whole-body mass correlated closely with measured body weight (R2=0.87; P<0.001). Scan-rescan analysis demonstrated a 95% limit of agreement of 1.3% adiposity. Preterm infants were born at a median of 25.7 weeks' gestation with birth weight 840 g. At term-corrected age, former preterm infants were lighter than term-born controls, 2,519 vs. 3,094 g regressing out age and group as covariates (P=0.005). However, this was not because of reduced percentage adiposity 26% vs. 24% (P=0.28). At term-corrected age, former preterm infants had significantly reduced lean body mass compared with that of term-born controls 1,935 vs. 2,416 g (P=0.002).ConclusionRapid whole-body imaging for assessment of lean body mass and adiposity in term and preterm infants is feasible, accurate, and repeatable. Deficits in whole-body mass in former preterm infants at term-corrected age are due to reductions in lean body mass not due to differences in adiposity.
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21
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Abstract
Skin fold thickness (SFT) measurement is a reliable, cheap, simple, noninvasive method of body fat estimation at all ages including the neonatal period. Objective. To determine reference values of biceps, triceps, subscapular, and suprailiac skinfold thickness measurements in term Nigerian newborns. Method. A prospective cross-sectional study over a six-month period (Dec 2010-May 2011) was carried out on term and healthy neonates delivered between 37 and 41 weeks. The anthropometric measurements were taken within the first 48 hours of life including the skinfold thickness. The skinfold thickness measurements were taken at four sites, namely, triceps, biceps, subscapular, and suprailiac, using Harpenden skinfold calipers. The mean of two readings was recorded. Result. A total of one thousand one hundred and sixty-eight neonates were studied. The birth weight ranged between 2000 g and 5000 g with a mean birth weight of the neonates at 3259 ± 470 g. The mean birth weight of the males (3339 ± 0.45) was significantly higher than that of females (3200 ± 0.44) (p < 0.0001). Female neonates had higher mean values of triceps, subscapular, and suprailiac skinfold thickness (p < 0.001, resp.) while male neonates had higher mean value of biceps skinfold thickness (p = 0.008). Females also had higher mean values of the sum of skinfold thicknesses at all four sites and the sum at the two truncal sites at every stratified gestational age. Conclusions. The sex specific percentile chart developed for skinfold thickness measurements can be used to detect deviation from the reference population such that infants who are at risk of nutritional or health problems are identified early, and intervention is instituted promptly.
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Body composition at birth and its relationship with neonatal anthropometric ratios: the newborn body composition study of the INTERGROWTH-21 st project. Pediatr Res 2017; 82:305-316. [PMID: 28445454 PMCID: PMC5605677 DOI: 10.1038/pr.2017.52] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 02/17/2017] [Indexed: 12/12/2022]
Abstract
BackgroundWe aimed to describe newborn body composition and identify which anthropometric ratio (weight/length; BMI; or ponderal index, PI) best predicts fat mass (FM) and fat-free mass (FFM).MethodsAir-displacement plethysmography (PEA POD) was used to estimate FM, FFM, and body fat percentage (BF%). Associations between FFM, FM, and BF% and weight/length, BMI, and PI were evaluated in 1,019 newborns using multivariate regression analysis. Charts for FM, FFM, and BF% were generated using a prescriptive subsample (n=247). Standards for the best-predicting anthropometric ratio were calculated utilizing the same population used for the INTERGROWTH-21st Newborn Size Standards (n=20,479).ResultsFFM and FM increased consistently during late pregnancy. Differential FM, BF%, and FFM patterns were observed for those born preterm (34+0-36+6 weeks' gestation) and with impaired intrauterine growth. Weight/length by gestational age (GA) was a better predictor of FFM and FM (adjusted R2=0.92 and 0.71, respectively) than BMI or PI, independent of sex, GA, and timing of measurement. Results were almost identical when only preterm newborns were studied. We present sex-specific centiles for weight/length ratio for GA.ConclusionsWeight/length best predicts newborn FFM and FM. There are differential FM, FFM, and BF% patterns by sex, GA, and size at birth.
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Ojha S, Symonds ME, Budge H. Suboptimal maternal nutrition during early-to-mid gestation in the sheep enhances pericardial adiposity in the near-term fetus. Reprod Fertil Dev 2017; 27:1205-12. [PMID: 24952585 DOI: 10.1071/rd14007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 04/29/2014] [Indexed: 01/30/2023] Open
Abstract
Manipulation of the maternal diet at defined stages of gestation influences long-term health by inducing changes in fetal adipose tissue development, characterised as possessing brown and white adipocytes. We determined whether suboptimal maternal nutrition in early-to-mid gestation, followed by ad libitum feeding until term, increases adiposity in the pericardial depot of the sheep fetus. Pericardial adipose tissue was sampled from near-term (140 days) fetuses delivered to mothers fed either 100% (C) or 60% (i.e. nutrient restricted (NR)) of their total metabolisable requirements from 28 to 80 days gestation and then fed ad libitum. Adipose tissue mass, uncoupling protein (UCP) 1 and gene expression of brown and white adipogenic genes was measured. Total visceral and pericardial adiposity was increased in offspring born to NR mothers. The abundance of UCP1 was increased, together with those genes involved in brown (e.g. BMP7 and C/EBPβ) and white (e.g. BMP4 and C/EBPα) adipogenesis, whereas insulin receptor gene expression was downregulated. In conclusion, suboptimal maternal nutrition between early-to-mid gestation followed by ad libitum feeding enhances pericardial adiposity near to term. A combination of raised UCP1 and adipose tissue mass could improve survival following cold exposure at birth. In the longer term, this enhanced adipogenic potential could predispose to greater pericardial adiposity.
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Affiliation(s)
- Shalini Ojha
- Division of Child Health, Obstetrics and Gynaecology, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Michael E Symonds
- Division of Child Health, Obstetrics and Gynaecology, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Helen Budge
- Division of Child Health, Obstetrics and Gynaecology, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
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Logan KM, Emsley RJ, Jeffries S, Andrzejewska I, Hyde MJ, Gale C, Chappell K, Mandalia S, Santhakumaran S, Parkinson JRC, Mills L, Modi N. Development of Early Adiposity in Infants of Mothers With Gestational Diabetes Mellitus. Diabetes Care 2016; 39:1045-51. [PMID: 27208326 DOI: 10.2337/dc16-0030] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 03/23/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Infants born to mothers with gestational diabetes mellitus (GDM) are at greater risk of later adverse metabolic health. We examined plausible candidate mediators, adipose tissue (AT) quantity and distribution and intrahepatocellular lipid (IHCL) content, comparing infants of mothers with GDM and without GDM (control group) over the first 3 postnatal months. RESEARCH DESIGN AND METHODS We conducted a prospective longitudinal study using MRI and spectroscopy to quantify whole-body and regional AT volumes, and IHCL content, within 2 weeks and 8-12 weeks after birth. We adjusted for infant size and sex and maternal prepregnancy BMI. Values are reported as the mean difference (95% CI). RESULTS We recruited 86 infants (GDM group 42 infants; control group 44 infants). Mothers with GDM had good pregnancy glycemic control. Infants were predominantly breast-fed up to the time of the second assessment (GDM group 71%; control group 74%). Total AT volumes were similar in the GDM group compared with the control group at a median age of 11 days (-28 cm(3) [95% CI -121, 65], P = 0.55), but were greater in the GDM group at a median age of 10 weeks (247 cm(3) [56, 439], P = 0.01). After adjustment for size, the GDM group had significantly greater total AT volume at 10 weeks than control group infants (16.0% [6.0, 27.1], P = 0.002). AT distribution and IHCL content were not significantly different at either time point. CONCLUSIONS Adiposity in GDM infants is amplified in early infancy, despite good maternal glycemic control and predominant breast-feeding, suggesting a potential causal pathway to later adverse metabolic health. Reduction in postnatal adiposity may be a therapeutic target to reduce later health risks.
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Affiliation(s)
- Karen M Logan
- Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K.
| | - Robby J Emsley
- Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K
| | - Suzan Jeffries
- Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K
| | - Izabela Andrzejewska
- Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K
| | - Matthew J Hyde
- Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K
| | - Chris Gale
- Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K
| | - Karyn Chappell
- Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K
| | - Sundhiya Mandalia
- Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K
| | - Shalini Santhakumaran
- Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K
| | - James R C Parkinson
- Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K
| | - Luke Mills
- Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K
| | - Neena Modi
- Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K
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Baum T, Cordes C, Dieckmeyer M, Ruschke S, Franz D, Hauner H, Kirschke JS, Karampinos DC. MR-based assessment of body fat distribution and characteristics. Eur J Radiol 2016; 85:1512-8. [PMID: 26905521 DOI: 10.1016/j.ejrad.2016.02.013] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 02/03/2016] [Accepted: 02/09/2016] [Indexed: 12/14/2022]
Abstract
The assessment of body fat distribution and characteristics using magnetic resonance (MR) methods has recently gained significant attention as it further extends our pathophysiological understanding of diseases including obesity, metabolic syndrome, or type 2 diabetes mellitus, and allows more detailed insights into treatment response and effects of lifestyle interventions. Therefore, the purpose of this study was to review the current literature on MR-based assessment of body fat distribution and characteristics. PubMed search was performed to identify relevant studies on the assessment of body fat distribution and characteristics using MR methods. T1-, T2-weighted MR Imaging (MRI), Magnetic Resonance Spectroscopy (MRS), and chemical shift-encoding based water-fat MRI have been successfully used for the assessment of body fat distribution and characteristics. The relationship of insulin resistance and serum lipids with abdominal adipose tissue (i.e. subcutaneous and visceral adipose tissue), liver, muscle, and bone marrow fat content have been extensively investigated and may help to understand the underlying pathophysiological mechanisms and the multifaceted obese phenotype. MR methods have also been used to monitor changes of body fat distribution and characteristics after interventions (e.g. diet or physical activity) and revealed distinct, adipose tissue-specific properties. Lastly, chemical shift-encoding based water-fat MRI can detect brown adipose tissue which is currently the focus of intense research as a potential treatment target for obesity. In conclusion, MR methods reliably allow the assessment of body fat distribution and characteristics. Irrespective of the promising findings based on these MR methods the clinical usefulness remains to be established.
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Affiliation(s)
- Thomas Baum
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - Christian Cordes
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Michael Dieckmeyer
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Stefan Ruschke
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Daniela Franz
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Hans Hauner
- Else Kröner Fresenius Center for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; ZIEL Research Center for Nutrition and Food Sciences, Technische Universität München, Germany
| | - Jan S Kirschke
- Section of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
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Toro-Ramos T, Paley C, Pi-Sunyer FX, Gallagher D. Body composition during fetal development and infancy through the age of 5 years. Eur J Clin Nutr 2015; 69:1279-89. [PMID: 26242725 PMCID: PMC4680980 DOI: 10.1038/ejcn.2015.117] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 06/08/2015] [Accepted: 06/11/2015] [Indexed: 02/07/2023]
Abstract
Fetal body composition is an important determinant of body composition at birth, and it is likely to be an important determinant at later stages in life. The purpose of this work is to provide a comprehensive overview by presenting data from previously published studies that report on body composition during fetal development in newborns and the infant/child through 5 years of age. Understanding the changes in body composition that occur both in utero and during infancy and childhood, and how they may be related, may help inform evidence-based practice during pregnancy and childhood. We describe body composition measurement techniques from the in utero period to 5 years of age, and identify gaps in knowledge to direct future research efforts. Available literature on chemical and cadaver analyses of fetal studies during gestation is presented to show the timing and accretion rates of adipose and lean tissues. Quantitative and qualitative aspects of fetal lean and fat mass accretion could be especially useful in the clinical setting for diagnostic purposes. The practicality of different pediatric body composition measurement methods in the clinical setting is discussed by presenting the assumptions and limitations associated with each method that may assist the clinician in characterizing the health and nutritional status of the fetus, infant and child. It is our hope that this review will help guide future research efforts directed at increasing the understanding of how body composition in early development may be associated with chronic diseases in later life.
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Affiliation(s)
- T Toro-Ramos
- Department of Medicine, New York Obesity Nutrition Research Center, St Luke’s-Roosevelt Hospital, New York, NY, USA
- Department of Medicine, Institute of Human Nutrition, Columbia University, New York, NY, USA
| | - C Paley
- Department of Medicine, New York Obesity Nutrition Research Center, St Luke’s-Roosevelt Hospital, New York, NY, USA
- Department of Pediatrics, St Luke’s-Roosevelt Hospital, New York, NY, USA
| | - FX Pi-Sunyer
- Department of Medicine, New York Obesity Nutrition Research Center, St Luke’s-Roosevelt Hospital, New York, NY, USA
- Department of Medicine, Institute of Human Nutrition, Columbia University, New York, NY, USA
| | - D Gallagher
- Department of Medicine, New York Obesity Nutrition Research Center, St Luke’s-Roosevelt Hospital, New York, NY, USA
- Department of Medicine, Institute of Human Nutrition, Columbia University, New York, NY, USA
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An Evolutionary Perspective of Nutrition and Inflammation as Mechanisms of Cardiovascular Disease. INTERNATIONAL JOURNAL OF EVOLUTIONARY BIOLOGY 2015; 2015:179791. [PMID: 26693381 PMCID: PMC4677015 DOI: 10.1155/2015/179791] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 11/12/2015] [Indexed: 01/11/2023]
Abstract
When cardiovascular diseases are viewed from an evolutionary biology perspective, a heightened thrifty and an inflammatory design could be their mechanisms. Human ancestors confronted a greater infectious load and were subjected to the selection for proinflammatory genes and a strong inflammatory function. Ancestors also faced starvation periods that pressed for a thrifty genotype which caused fat accumulation. The pressure of sustaining gluconeogenesis during periods of poor nourishment selected individuals with insulin resistance. Obesity induces a proinflammatory state due to the secretion of adipokines which underlie cardiometabolic diseases. Our actual lifestyle needs no more of such proinflammatory and thrifty genotypes and these ancestral genes might increase predisposition to diseases. Risk factors for atherosclerosis and diabetes are based on inflammatory and genetic foundations that can be accounted for by excess fat. Longevity has also increased in recent times and is related to a proinflammatory response with cardiovascular consequences. If human ancestral lifestyle could be recovered by increasing exercise and adapting a calorie restriction diet, obesity would decrease and the effects on chronic low-grade inflammation would be limited. Thereby, the rates of both atherosclerosis and diabetes could be reduced.
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Diedrich J, Gusky HC, Podgorski I. Adipose tissue dysfunction and its effects on tumor metabolism. Horm Mol Biol Clin Investig 2015; 21:17-41. [PMID: 25781550 DOI: 10.1515/hmbci-2014-0045] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 01/14/2015] [Indexed: 12/12/2022]
Abstract
Growing by an alarming rate in the Western world, obesity has become a condition associated with a multitude of diseases such as diabetes, metabolic syndrome and various cancers. Generally viewed as an abnormal accumulation of hypertrophied adipocytes, obesity is also a poor prognostic factor for recurrence and chemoresistance in cancer patients. With more than two-thirds of the adult population in the United States considered clinically overweight or obese, it is critical that the relationship between obesity and cancer is further emphasized and elucidated. Adipocytes are highly metabolically active cells, which, through release of adipokines and cytokines and activation of endocrine and paracrine pathways, affect processes in neighboring and distant cells, altering their normal homeostasis. This work will examine specifically how adipocyte-derived factors regulate the cellular metabolism of malignant cells within the tumor niche. Briefly, tumor cells undergo metabolic pressure towards a more glycolytic and hypoxic state through a variety of metabolic regulators and signaling pathways, i.e., phosphoinositol-3 kinase (PI3K), hypoxia-inducible factor-1 alpha (HIF-1α), and c-MYC signaling. Enhanced glycolysis and high lactate production are hallmarks of tumor progression largely because of a process known as the Warburg effect. Herein, we review the latest literature pertaining to the body of work on the interactions between adipose and tumor cells, and underlining the changes in cancer cell metabolism that have been targeted by the currently available treatments.
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Joung KE, Park KH, Filippaios A, Dincer F, Christou H, Mantzoros CS. Cord blood irisin levels are positively correlated with birth weight in newborn infants. Metabolism 2015; 64:1507-14. [PMID: 26303870 PMCID: PMC5348079 DOI: 10.1016/j.metabol.2015.07.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Revised: 07/20/2015] [Accepted: 07/23/2015] [Indexed: 01/03/2023]
Abstract
BACKGROUND Irisin is a novel myokine, secreted from skeletal muscle after exercise. Irisin mediates exercise-related energy expenditure by turning white adipose tissue (WAT) into brown adipose tissue (BAT). Thus, irisin is considered as a potential biomarker for obesity and metabolic syndrome. Infants born small for gestational age (SGA) have increased risk for metabolic syndrome. However, the physiologic role of irisin in neonates remains to be studied. OBJECTIVE To evaluate the association of umbilical cord blood irisin levels with gestational age and birth weight categories in neonates. METHODS A cross-sectional study of 341 newborns, from 26 to 41weeks' gestation. We collected umbilical cord blood and analyzed plasma for irisin by ELISA. RESULTS Plasma irisin levels were positively correlated with gestational age (r=0.21, p<0.001), and birth weight Z-score (r=0.18, p<0.001). SGA infants had significantly lower irisin (median [interquartile range] 55.38 [46.56-65.72]ng/mL) compared to appropriate for gestational age infants (64.41 [53.87-76.76]ng/mL) and large for gestational age infants (68.70 [54.78-79.09]ng/mL, p<0.01). The association between SGA and lower irisin remained significant in multivariate analysis independent of gestational age, maternal age, maternal BMI, and gestational diabetes (p=0.03). In singleton infants, irisin was also significantly negatively associated with maternal preeclampsia (p=0.01). CONCLUSIONS Our results support the notion that irisin may have a physiologic role in neonates. We speculate that decreased levels of irisin in SGA infants may contribute to the development of catch-up growth and metabolic syndrome later in life.
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Affiliation(s)
- Kyoung Eun Joung
- Division of Newborn Medicine, Boston Children's Hospital, 300 Brookline Ave, Boston, MA, 02115, USA; Department of Pediatrics, Division of Neonatology, Goryeb Children's Hospital, 100 Madison Ave, Morristown, NJ, 07960, USA; Division of Endocrinology and Metabolism, Beth Israel Deaconess Medical Center, 300 Brookline Ave, Boston, MA, 02215, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
| | - Kyung-Hee Park
- Division of Endocrinology and Metabolism, Beth Israel Deaconess Medical Center, 300 Brookline Ave, Boston, MA, 02215, USA; Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University, Gyeonggi-do, 431-070, Republic of Korea
| | - Andreas Filippaios
- Division of Endocrinology and Metabolism, Beth Israel Deaconess Medical Center, 300 Brookline Ave, Boston, MA, 02215, USA
| | - Fadime Dincer
- Division of Endocrinology and Metabolism, Beth Israel Deaconess Medical Center, 300 Brookline Ave, Boston, MA, 02215, USA
| | - Helen Christou
- Division of Newborn Medicine, Boston Children's Hospital, 300 Brookline Ave, Boston, MA, 02115, USA; Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
| | - Christos S Mantzoros
- Division of Endocrinology and Metabolism, Beth Israel Deaconess Medical Center, 300 Brookline Ave, Boston, MA, 02215, USA; Section of Endocrinology, Division of Endocrinology, Boston VA Healthcare System, Jamaica Plain, MA, 02130, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
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Roelants JA, de Jonge RCJ, Steegers-Theunissen RPM, Reiss IKM, Joosten KFM, Vermeulen MJ. Prenatal markers of neonatal fat mass: A systematic review. Clin Nutr 2015; 35:995-1007. [PMID: 26499032 DOI: 10.1016/j.clnu.2015.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 09/01/2015] [Accepted: 09/10/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Environmental influences during pregnancy are able to affect off spring phenotype with lifelong effects. Clinical applicable markers are needed to identify foetuses at risk for neonatal adiposity. This systematic review aims to 1) review the current literature on prenatal markers of neonatal fat mass, and 2) appraise the clinical applicability of the assessed markers. METHODS A systematic literature search was conducted to identify studies meeting the following inclusion criteria: 1) original research papers in English; 2) research on dynamic and measurable prenatal markers of neonatal fat mass; 3) neonatal fat mass measurement within one month after birth, using the four-compartment model, magnetic resonance imaging, dual-energy X-ray absorptiometry or air displacement plethysmography. Two reviewers independently performed study selection, assessment of methodological (QUADAS-II) and statistical quality and appraisal of clinical applicability. RESULTS Of 2333 studies primarily identified by the search strategy, 16 studies were included. Four of these were both methodologically and statistically of moderate or high quality. Prenatal markers investigated were ultrasound parameters, maternal biochemical markers and maternal characteristics. Markers of predefined interest were maternal pre-pregnancy body mass index, fasting glucose and HbA1c, showing varying results. A meta-analysis was not possible due to substantial methodological heterogeneity. Clinically applicability of all markers was rated poor. CONCLUSIONS Although associations were found, no useful marker was identified, due to lack of methodological and statistical quality, inconsistent results and poor clinical applicability. No markers were investigated in the periconceptional and embryonic period.
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Affiliation(s)
- Jorine A Roelants
- Department of Pediatrics, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Rogier C J de Jonge
- Department of Pediatrics, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | | | - Irwin K M Reiss
- Department of Pediatrics, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Koen F M Joosten
- Department of Pediatrics, Pediatric Intensive Care Unit, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Marijn J Vermeulen
- Department of Pediatrics, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands.
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Jain V, Kurpad AV, Kumar B, Devi S, Sreenivas V, Paul VK. Body composition of term healthy Indian newborns. Eur J Clin Nutr 2015; 70:488-93. [PMID: 26373958 DOI: 10.1038/ejcn.2015.152] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 07/30/2015] [Accepted: 08/05/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Previous anthropometry-based studies have suggested that in Indian newborns fat mass is conserved at the expense of lean tissue. This study was undertaken to assess the body composition of Indian newborns and to evaluate its relation with parents' anthropometry, birth weight and early postnatal weight gain. SUBJECTS/METHODS Body composition of healthy term singleton newborns was assessed by the deuterium dilution method in the second week of life. Anthropometry was carried out at birth and on the day of study. RESULTS Data from 127 babies were analyzed. Birth weight was 2969±383 g. Body composition was assessed at a mean age of 12.7±3.1 days. Fat and fat-free mass were 354±246 and 2764±402 g, respectively, and fat mass percentage (FM%) was 11.3±7.3%. Birth weight and fat-free mass were higher among boys, but no gender difference was noted in FM%. Birth weight was positively correlated with fat as well as fat-free mass but not FM%. FM% showed positive correlation with gain in weight from birth to the day of assessment. CONCLUSIONS This is the first study from India to report body composition in newborns using deuterium dilution. FM% was comparable to that reported for Western populations for babies of similar age. Our results suggest that the percentage of fat and fat-free mass is relatively constant over the range of birth weights included in this study, and greater weight gain during early postnatal period results in greater increase in FM%.
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Affiliation(s)
- V Jain
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - A V Kurpad
- Department of Physiology and Nutrition, St. John's National Academy of Health Sciences, Bengaluru, India
| | - B Kumar
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - S Devi
- Department of Physiology and Nutrition, St. John's National Academy of Health Sciences, Bengaluru, India
| | - V Sreenivas
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - V K Paul
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
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Hu HH, Chen J, Shen W. Segmentation and quantification of adipose tissue by magnetic resonance imaging. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2015; 29:259-76. [PMID: 26336839 DOI: 10.1007/s10334-015-0498-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 08/11/2015] [Accepted: 08/12/2015] [Indexed: 12/13/2022]
Abstract
In this brief review, introductory concepts in animal and human adipose tissue segmentation using proton magnetic resonance imaging (MRI) and computed tomography are summarized in the context of obesity research. Adipose tissue segmentation and quantification using spin relaxation-based (e.g., T1-weighted, T2-weighted), relaxometry-based (e.g., T1-, T2-, T2*-mapping), chemical-shift selective, and chemical-shift encoded water-fat MRI pulse sequences are briefly discussed. The continuing interest to classify subcutaneous and visceral adipose tissue depots into smaller sub-depot compartments is mentioned. The use of a single slice, a stack of slices across a limited anatomical region, or a whole body protocol is considered. Common image post-processing steps and emerging atlas-based automated segmentation techniques are noted. Finally, the article identifies some directions of future research, including a discussion on the growing topic of brown adipose tissue and related segmentation considerations.
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Affiliation(s)
- Houchun Harry Hu
- Department of Radiology, Phoenix Children's Hospital, 1919 East Thomas Road, Phoenix, AZ, 85016, USA.
| | - Jun Chen
- Obesity Research Center, Department of Medicine, Columbia University Medical Center, 1150 Saint Nicholas Avenue, New York, NY, 10032, USA
| | - Wei Shen
- Obesity Research Center, Department of Medicine and Institute of Human Nutrition, Columbia University Medical Center, 1150 Saint Nicholas Avenue, New York, NY, 10032, USA
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Walker GE, Marzullo P, Ricotti R, Bona G, Prodam F. The pathophysiology of abdominal adipose tissue depots in health and disease. Horm Mol Biol Clin Investig 2015; 19:57-74. [PMID: 25390016 DOI: 10.1515/hmbci-2014-0023] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 08/11/2014] [Indexed: 12/22/2022]
Abstract
Obesity is currently the most important contributor to ill health and expenditure worldwide. More alarming is the fact that the pediatric population parallels adults, with obesity closely associated to type 2 diabetes mellitus (T2D), cardiovascular disease, hypertension, non-alcoholic fatty liver disease, vitamin D deficiency (VDD) and certain types of cancer. The observation in the early 1950s that android or truncal adipose tissue (AT) distribution compared to gynoid had a greater association with metabolic dysfunction, in particular T2D and cardiovascular disease risk, led to the hypothesis that obesity-associated complications are not associated with fat mass per se, but the pattern of fat distribution. This concept was further supported by groups of individuals with metabolic dysfunction despite a lean phenotype, and healthy obese people protected from metabolic dysfunction. It is now well recognized that an increase in visceral AT is an independent risk factor for the development of obesity-associated comorbidities with AT depot distribution, their anatomic, cellular and molecular features defining their role. The differences and the plasticity of subcutaneous, visceral and ectopic ATs to store and release fatty acids and to synthesize and secrete adipokines, defines the metabolic outcomes. The present review will examine the phenotypic and pathophysiological differences between the different AT depots, with a particular focus on the abdominal depots and their link to metabolic complications.
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Bauer JS, Noël PB, Vollhardt C, Much D, Degirmenci S, Brunner S, Rummeny EJ, Hauner H. Accuracy and reproducibility of adipose tissue measurements in young infants by whole body magnetic resonance imaging. PLoS One 2015; 10:e0117127. [PMID: 25706876 PMCID: PMC4338239 DOI: 10.1371/journal.pone.0117127] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 12/19/2014] [Indexed: 11/18/2022] Open
Abstract
PURPOSE MR might be well suited to obtain reproducible and accurate measures of fat tissues in infants. This study evaluates MR-measurements of adipose tissue in young infants in vitro and in vivo. MATERIAL AND METHODS MR images of ten phantoms simulating subcutaneous fat of an infant's torso were obtained using a 1.5T MR scanner with and without simulated breathing. Scans consisted of a cartesian water-suppression turbo spin echo (wsTSE) sequence, and a PROPELLER wsTSE sequence. Fat volume was quantified directly and by MR imaging using k-means clustering and threshold-based segmentation procedures to calculate accuracy in vitro. Whole body MR was obtained in sleeping young infants (average age 67±30 days). This study was approved by the local review board. All parents gave written informed consent. To obtain reproducibility in vivo, cartesian and PROPELLER wsTSE sequences were repeated in seven and four young infants, respectively. Overall, 21 repetitions were performed for the cartesian sequence and 13 repetitions for the PROPELLER sequence. RESULTS In vitro accuracy errors depended on the chosen segmentation procedure, ranging from 5.4% to 76%, while the sequence showed no significant influence. Artificial breathing increased the minimal accuracy error to 9.1%. In vivo reproducibility errors for total fat volume of the sleeping infants ranged from 2.6% to 3.4%. Neither segmentation nor sequence significantly influenced reproducibility. CONCLUSION With both cartesian and PROPELLER sequences an accurate and reproducible measure of body fat was achieved. Adequate segmentation was mandatory for high accuracy.
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Affiliation(s)
- Jan Stefan Bauer
- Department of Neuroradiology, Technische Universität München, Munich, Germany
- * E-mail:
| | | | - Christiane Vollhardt
- Else Kröner-Fresenius-Center for Nutritional Medicine, Technische Universität München, Munich, Germany
| | - Daniela Much
- Else Kröner-Fresenius-Center for Nutritional Medicine, Technische Universität München, Munich, Germany
| | - Saliha Degirmenci
- Department of Radiology, Technische Universität München, Munich, Germany
| | - Stefanie Brunner
- Else Kröner-Fresenius-Center for Nutritional Medicine, Technische Universität München, Munich, Germany
| | | | - Hans Hauner
- Else Kröner-Fresenius-Center for Nutritional Medicine, Technische Universität München, Munich, Germany
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Morhard R, Jeffery H, McEwan A. Simulation-based optimization of a near-infrared spectroscopic subcutaneous fat thickness measuring device. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2014:510-3. [PMID: 25570008 DOI: 10.1109/embc.2014.6943640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Using Monte Carlo simulations we optimized the wavelength and source-detector distance (SDD) of a reflectance-based spectroscopic device used for measuring subcutaneous fat thickness. As the optical properties of muscle, fat and dermis are wavelength dependent, it is necessary to choose a wavelength that is highly sensitive to fat but insensitive to water and melanin. The SDD is important since it determines average photon penetration depth. With a tissue optics plug-in for the GEANT4/GAMOS system and published ex vivo tissue optical properties we were able to predict the behavior of different device configurations when used with varying thicknesses of fat, melanin concentrations or hydration levels. Our results indicate that the ideal wavelengths for fat measurement are 630-650 nm with an SDD of 2.6-29 cm. We also examined the potential of using near infrared (NIR) spectroscopy to determine tissue hydration levels, but concluded that this wavelength range was not ideal.
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Roggero P, Giannì ML, Forzenigo L, Tondolo T, Taroni F, Liotto N, Piemontese P, Biondetti P, Mosca F. No relative increase in intra-abdominal adipose tissue in healthy unstressed preterm infants at term. Neonatology 2015; 107:14-9. [PMID: 25301293 DOI: 10.1159/000364855] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 05/26/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Preterm infants may be at risk for altered adiposity, a known risk factor for unfavorable metabolic and cardiovascular outcomes. OBJECTIVES The aim was to compare body composition (total body fat mass (FM), subcutaneous and intra-abdominal adipose tissue (AT)) between infants born preterm and at term. METHODS We conducted an observational, cross-sectional study that involved 50 infants born preterm free from major co-morbidities and 34 term healthy breastfed infants. Anthropometric measurements, body composition (total body FM, subcutaneous and intra-abdominal AT) were assessed at 40-42 weeks postconceptional age for preterm infants and within 15 days of birth for term infants. Total body FM was assessed by an air displacement plethysmography system and subcutaneous abdominal and intra-abdominal AT were assessed by magnetic resonance imaging using a commercially available software program. RESULTS Compared to term infants, mean (SD) total body FM (g) (636.7 (247) vs. 418.4 (253), p < 0.0001) and mean (SD) subcutaneous abdominal AT (g) (123 (36) vs. 98.9 (22), p < 0.001) were significantly higher in preterm infants but mean (SD) fat-free mass (g) (2,530 (420) vs. 2,965 (389), p < 0.0001) and mean (SD) intra-abdominal AT (10.9 (5.2) vs. 18.2 (13.2), p = 0.001) were significantly lower. CONCLUSIONS In the absence of severe illness during the hospital stay, prematurity, although associated with increased total body FM, does not appear to be associated with a relative increase in intra-abdominal AT compared to term infants.
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Affiliation(s)
- Paola Roggero
- Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
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Okada T, Takahashi S, Nagano N, Yoshikawa K, Usukura Y, Hosono S. Early postnatal alteration of body composition in preterm and small-for-gestational-age infants: implications of catch-up fat. Pediatr Res 2015; 77:136-42. [PMID: 25310764 DOI: 10.1038/pr.2014.164] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Accepted: 09/09/2014] [Indexed: 12/12/2022]
Abstract
The concept of the developmental origins of health and disease is based on studies by Barker et al. They proposed a hypothesis that undernutrition in utero permanently changes the body's structure, function, and metabolism in ways that lead to atherosclerosis and insulin resistance in later life. In addition, profound effects on the extent of body fatness and insulin sensitivity are demonstrated, if there is a "mismatch" between prenatal and postnatal environments. In previous studies, undernutrition in utero has been evaluated simply by birth weight itself or birth weight for gestational age, and the degree of mismatch has been estimated by postnatal rapid weight gain. Recently, we investigated subcutaneous fat accumulation in small-for-gestational-age infants and found that a rapid catch-up in skinfold thickness developed prior to the body weight catch-up. Furthermore, insulin-like growth factor-I and lipoprotein lipase mass concentrations also demonstrate rapid increase during the neonatal period with fat accumulation. Investigating the precise mechanisms of developmental origins of health and disease including mediating metabolic and hormonal factors may provide a new approach to prevent atherosclerosis and insulin resistance. Better management of undernutrition during gestation and neonatal growth during the early postnatal period is an important theme for future health.
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Affiliation(s)
- Tomoo Okada
- 1] Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan [2] Department of Nutrition and Life Science, Kanagawa Institute of Technology, Kanagawa, Japan
| | - Shigeru Takahashi
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | - Nobuhiko Nagano
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | - Kayo Yoshikawa
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | - Yukihiro Usukura
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | - Shigeharu Hosono
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
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Multigenerational impact of maternal overnutrition/obesity in the sheep on the neonatal leptin surge in granddaughters. Int J Obes (Lond) 2014; 39:695-701. [PMID: 25354845 PMCID: PMC4390411 DOI: 10.1038/ijo.2014.190] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 09/17/2014] [Accepted: 09/18/2014] [Indexed: 01/21/2023]
Abstract
BACKGROUND/OBJECTIVES We have reported that maternal overnutrition/obesity (OB) in sheep resulting from feeding 150% of National Research Council (NRC) requirements throughout gestation leads to maternal hyperglycemia and hyperinsulinemia. Further, newborn lambs born to OB vs control-fed (CON, 100% of NRC) ewes exhibited greater adiposity, increased blood cortisol, insulin and glucose and the elimination of the postnatal leptin spike seen in lambs born to CON ewes. This early postnatal leptin peak is necessary for the development of hypothalamic circuits, which program appetite in later life. This study evaluated the multigenerational impact of OB on insulin:glucose dynamics of mature female F1 offspring fed only to requirements throughout gestation and on their lambs (F2 generation). DESIGN AND METHODS Adult F1 female offspring born to OB (n=10) or CON (n=7) ewes were utilized. All F1 ewes were subjected to a glucose tolerance test at midgestation and late gestation. Jugular blood was obtained from F2 lambs at birth (day 1) through postnatal day 11, and plasma glucose, insulin, cortisol and leptin concentrations were determined. Dual-energy X-ray absorptiometry was utilized to determine bone mineral density, bone mineral content, lean tissue mass and fat tissue mass. RESULTS Fasted blood glucose and insulin concentrations were greater (P<0.05) in OBF1 than CONF1 ewes at midgestation and late gestation. Further, after glucose infusion, both glucose and insulin concentrations remained higher in OBF1 ewes (P<0.05) than CONF1 ewes, demonstrating greater insulin resistance. Blood concentrations of glucose, insulin and cortisol and adiposity were higher (P<0.01) in OBF2 lambs than CONF2 lambs at birth. Importantly, OBF2 lambs failed to exhibit the early postnatal leptin peak exhibited by CONF2 lambs. CONCLUSIONS These data suggest that these OBF2 lambs are predisposed to exhibit the same metabolic alterations as their mothers, suggesting a multigenerational programming effect.
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Gale C, Thomas EL, Jeffries S, Durighel G, Logan KM, Parkinson JRC, Uthaya S, Santhakumaran S, Bell JD, Modi N. Adiposity and hepatic lipid in healthy full-term, breastfed, and formula-fed human infants: a prospective short-term longitudinal cohort study. Am J Clin Nutr 2014; 99:1034-40. [PMID: 24572562 DOI: 10.3945/ajcn.113.080200] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The effect of mode of infant feeding on adiposity deposition is not fully understood. OBJECTIVE The objective was to test the hypothesis that differences in total and regional adipose tissue content and intrahepatocellular lipid (IHCL) arise in early infancy between breast- and formula-fed infants and to describe longitudinal changes. DESIGN This prospective longitudinal cohort study was performed in 2 hospitals in the United Kingdom. Healthy, full-term, appropriate weight-for-gestational age infants were recruited; adipose tissue volume and distribution were directly quantified by using whole-body magnetic resonance imaging; IHCL was assessed by in vivo proton magnetic resonance spectroscopy. Measurements were performed after birth (median age: 13 d) and at 6-12 wk of age. Method of infant feeding was recorded prospectively by using maternally completed feeding diaries. Breastfed was defined as >80% of feeds consisting of breast milk at both points; formula-fed was defined as >80% of feeds consisting of formula milk at both points. RESULTS Longitudinal results were obtained from 70 infants (36 breastfed, 9 mixed-fed, and 25 formula-fed). No differences were found in total or regional adipose tissue or IHCL between breastfed and formula-fed infants. In pooled analyses including all feeding groups, IHCL and total adipose tissue approximately doubled between birth and 6-12 wk: IHCL after birth (median: 0.949; IQR: 0.521-1.711) and at 6-12 wk (1.828; 1.376-2.697; P < 0.001) and total adipose tissue after birth (0.749 L; 0.620-0.928 L) and at 6-12 wk (1.547 L; 1.332-1.790 L; P < 0.001). Increasing adiposity was characterized by greater relative increases in subcutaneous than in internal adipose tissue depots. CONCLUSIONS No differences were detectable in adipose tissue or IHCL accretion between breastfed and formula-fed infants up to 2 mo. The substantial increase in IHCL seen over this period in both breastfed and formula-fed infants is a novel observation, which suggests that hepatic storage of lipids may be physiologic up to 2 mo. This trial was registered at www.clinicaltrials.gov as NCT02033005.
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Affiliation(s)
- Christopher Gale
- Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, United Kingdom (CG, SJ, KML, JRCP, SU, SS, and NM); the Metabolic and Molecular Imaging Group, Medical Research Council Clinical Sciences Centre, Hammersmith Campus, Imperial College London, London, United Kingdom (ELT and JDB); and the Robert Steiner MRI Unit, Hammersmith Campus, Imperial College London, London, United Kingdom (GD)
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DEMERATH ELLENW, FIELDS DAVIDA. Body composition assessment in the infant. Am J Hum Biol 2014; 26:291-304. [PMID: 24424686 PMCID: PMC5761669 DOI: 10.1002/ajhb.22500] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 12/04/2013] [Accepted: 12/09/2013] [Indexed: 01/22/2023] Open
Abstract
Body composition assessment provides a sharper picture of the human biological response to genetic and environmental influences than measures of body size and weight. Infant body composition is particularly important as a marker of fetal adaptation and developmental programming of subsequent health and disease, but until recently, the range of options for measuring infant body composition was relatively narrow. The purpose of this Toolkit: Methods in Human Biology review is to provide a comprehensive overview of methods of body composition methods currently used in infants 0 to 2 years of age, including anthropometric prediction equations, air displacement plethysmography (ADP), dual energy X-ray absorptiometry (DXA), bioelectrical impedance analysis (BIA), isotope dilution, and magnetic resonance imaging (MRI). Information on the reliability, validity, and accuracy of the methods is provided. Unique aspects of infant physiology and behavior create challenges for body composition assessment, but this review provides guidance on suitable testing approaches and environments that may aid researchers in this important area of investigation.
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Affiliation(s)
- ELLEN W. DEMERATH
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota 55454
| | - DAVID A. FIELDS
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104
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Adjustment of directly measured adipose tissue volume in infants. Int J Obes (Lond) 2014; 38:995-9. [PMID: 24662695 PMCID: PMC4088334 DOI: 10.1038/ijo.2014.48] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 03/09/2014] [Accepted: 03/17/2014] [Indexed: 01/26/2023]
Abstract
Background: Direct measurement of adipose tissue (AT) using magnetic resonance imaging is increasingly used to characterise infant body composition. Optimal techniques for adjusting direct measures of infant AT remain to be determined. Objectives: To explore the relationships between body size and direct measures of total and regional AT, the relationship between AT depots representing the metabolic load of adiposity and to determine optimal methods of adjusting adiposity in early life. Design: Analysis of regional AT volume (ATV) measured using magnetic resonance imaging in longitudinal and cross-sectional studies. Subjects: Healthy term infants; 244 in the first month (1–31 days), 72 in early infancy (42–91 days). Methods: The statistical validity of commonly used indices adjusting adiposity for body size was examined. Valid indices, defined as mathematical independence of the index from its denominator, to adjust ATV for body size and metabolic load of adiposity were determined using log-log regression analysis. Results: Indices commonly used to adjust ATV are significantly correlated with body size. Most regional AT depots are optimally adjusted using the index ATV/(height)3 in the first month and ATV/(height)2 in early infancy. Using these indices, height accounts for<2% of the variation in the index for almost all AT depots. Internal abdominal (IA) ATV was optimally adjusted for subcutaneous abdominal (SCA) ATV by calculating IA/SCA0.6. Conclusions: Statistically optimal indices for adjusting directly measured ATV for body size are ATV/height3 in the neonatal period and ATV/height2 in early infancy. The ratio IA/SCA ATV remains significantly correlated with SCA in both the neonatal period and early infancy; the index IA/SCA0.6 is statistically optimal at both of these ages.
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Ojha S, Robinson L, Symonds ME, Budge H. Suboptimal maternal nutrition affects offspring health in adult life. Early Hum Dev 2013; 89:909-13. [PMID: 24080391 DOI: 10.1016/j.earlhumdev.2013.08.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/26/2013] [Indexed: 01/24/2023]
Abstract
Suboptimal maternal nutrition during pregnancy is prevalent and compromises fetal development. Physiological and metabolic adaptations made by the fetus to an inadequate, or excess, maternal nutritional environment, may promote immediate survival but are lasting, conferring significantly increased risks of ill health in childhood and adulthood. In addition, such fetal adaptations are particularly detrimental when nutrient supply is no longer constrained in contemporary nutrient rich environments. Given the prevalence of suboptimal maternal nutritional environments during fetal development, effective prevention, early detection and therapeutic interventions to reduce the increased risks on population health must be a health priority. Therefore, the mechanisms of these lasting in utero adaptations are highly relevant to establishing how exposure to a suboptimal nutritional environment impacts on the health of current generations living in an environment challenged by excess nutrition.
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Affiliation(s)
- Shalini Ojha
- The Early Life Research Unit, Academic Child Health, School of Medicine, The University of Nottingham, Nottingham, NG7 2UH, UK.
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Novel noninvasive anthropometric measure in preterm and full-term infants: normative values for waist circumference:length ratio at birth. Pediatr Res 2013; 74:299-306. [PMID: 23797534 DOI: 10.1038/pr.2013.109] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Accepted: 01/31/2013] [Indexed: 11/08/2022]
Abstract
BACKGROUND Waist circumference:length ratio (WLR) and ponderal index (PI) appear to be useful markers of visceral and total adiposity, respectively. However, there are no normative birth data across the full range of gestational ages. METHODS In this retrospective cohort study of 500 preterm and 1,426 full-term infants, born in 1998 and 2008 at three military hospitals, the percentile growth curves for WLR and PI were calculated. There were no sex differences, and results were combined to obtain values from 26 to 42 wk gestation. RESULTS Between 26 and 42 wk gestation, median birth WLR increased from 0.55 to 0.62, and median PI increased from 21.1 to 25.6. The adjusted mean WLR at birth among infants born <34 wk increased from 0.55 in 1998 to 0.58 in 2008 (P = 0.048), suggesting that early-preterm infants born in 2008 had greater abdominal adiposity than those born in 1998. CONCLUSION We report normative birth data for WLR and PI in preterm and full-term infants by gestational age and sex. WLR and PI may be useful as clinical markers of visceral and overall adiposity. In conjunction with other anthropometric measures, WLR and PI may be useful to monitor postnatal nutrition and growth and assess risk for later obesity and cardiometabolic disorders.
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Ethnic differences in neonatal body composition in a multi-ethnic population and the impact of parental factors: a population-based cohort study. PLoS One 2013; 8:e73058. [PMID: 24009731 PMCID: PMC3756946 DOI: 10.1371/journal.pone.0073058] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 07/17/2013] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Neonates from low and middle income countries (LAMIC) tend to have lower birth weight compared with Western European (WE) neonates. Parental height, BMI and maternal parity, age and educational level often differ according to ethnic background, and are associated with offspring birth weight. Less is known about how these factors affect ethnic differences in neonatal body composition. OBJECTIVES To explore differences in neonatal body composition in a multi-ethnic population, and the impact of key parental factors on these differences. METHODS A population-based cohort study of pregnant mothers, fathers and their offspring, living in Oslo, Norway. Gender- and gestational-specific z-scores were calculated for several anthropometric measurements, with the neonates of WE ethnic origin as reference. Mean z-scores for neonates with LAMIC origin, and their parents, are presented as outcome variables. RESULTS 537 singleton, term neonates and their parents were included. All anthropometric measurements were smaller in neonates with LAMIC origin. Abdominal circumference and ponderal index differed the most from WE (mean z-score: -0.57 (95% CI:-0.69 to -0.44) and -0.54 (-0.66 to -0.44), and remained so after adjusting for parental size. Head circumference and skin folds differed less, and length the least (-0.21 (-0.35 to -0.07)). These measures became comparable to WEs when adjusted for parental factors. CONCLUSIONS LAMIC origin neonates were relatively "thin-fat", as indicated by reduced AC and ponderal index and relatively preserved length and skin folds, compared with neonates with WE origin. This phenotype may predispose to type 2 diabetes.
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Telles MM, da Silva TG, Watanabe RLH, de Andrade IS, Estadella D, Nascimento CMO, Oyama LM, Ribeiro EB. Lateral hypothalamic serotonin is not stimulated during central leptin hypophagia. REGULATORY PEPTIDES 2013; 184:75-80. [PMID: 23518461 DOI: 10.1016/j.regpep.2013.03.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 09/12/2012] [Accepted: 03/03/2013] [Indexed: 10/27/2022]
Abstract
Whether leptin targets the hypothalamic serotonergic system to inhibit food intake is not established. We examined the effect of a short-term i.c.v. leptin treatment on serotonin microdialysate levels in rat lateral hypothalamus. Adipose tissue gene expression was also evaluated. Male rats received four daily injections of leptin (5 μg) or vehicle (with pair-feeding to leptin-induced intake) and a fifth injection during collection of LH microdialysates. We found that serotonin and 5-HIAA levels were not affected by the leptin pre-treatment, as basal levels were similar between the leptin and the pair-fed group. These levels remained unaltered after the acute leptin injection. For gene expression studies, rats were pre-treated with five daily injections of either leptin (5 μg) or vehicle (with either pair-feeding or ad libitum intake). mRNA levels of resistin, adiponectin, lipoprotein lipase, and PPAR-gamma were unaltered by either leptin or pair-feeding. Leptin gene expression was significantly reduced by leptin but not by pair-feeding, in both the retroperitoneal (-74%) and the epididymal (-99%) depots while no differences were observed in the subcutaneous depot. The observations confirmed the absence of an acute stimulatory effect of central leptin on serotonin release in the lateral hypothalamus and showed that the pre-treatment with leptin failed to modify this pattern. This indicates that components of the serotonergic system are probably not directly affected by leptin. Additionally, the central effect of leptin was able to downregulate its own adipose tissue gene expression in a depot-specific manner while other adipokine genes were not affected.
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Affiliation(s)
- Mônica Marques Telles
- Departamento de Fisiologia, Disciplina de Fisiologia da Nutrição, Universidade Federal de São Paulo (UNIFESP), São Paulo/SP, Brazil
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Lee YH, Mottillo EP, Granneman JG. Adipose tissue plasticity from WAT to BAT and in between. Biochim Biophys Acta Mol Basis Dis 2013; 1842:358-69. [PMID: 23688783 DOI: 10.1016/j.bbadis.2013.05.011] [Citation(s) in RCA: 149] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 04/21/2013] [Accepted: 05/06/2013] [Indexed: 01/09/2023]
Abstract
Adipose tissue plays an essential role in regulating energy balance through its metabolic, cellular and endocrine functions. Adipose tissue has been historically classified into anabolic white adipose tissue and catabolic brown adipose tissue. An explosion of new data, however, points to the remarkable heterogeneity among the cells types that can become adipocytes, as well as the inherent metabolic plasticity of mature cells. These data indicate that targeting cellular and metabolic plasticity of adipose tissue might provide new avenues for treatment of obesity-related diseases. This review will discuss the developmental origins of adipose tissue, the cellular complexity of adipose tissues, and the identification of progenitors that contribute to adipogenesis throughout development. We will touch upon the pathological remodeling of adipose tissue and discuss how our understanding of adipose tissue remodeling can uncover new therapeutic targets. This article is part of a Special Issue entitled: Modulation of Adipose Tissue in Health and Disease.
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Affiliation(s)
- Yun-Hee Lee
- Center for Integrative Metabolic and Endocrine Research, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Emilio P Mottillo
- Center for Integrative Metabolic and Endocrine Research, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - James G Granneman
- Center for Integrative Metabolic and Endocrine Research, Wayne State University School of Medicine, Detroit, MI 48201, USA.
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Brumbaugh DE, Tearse P, Cree-Green M, Fenton LZ, Brown M, Scherzinger A, Reynolds R, Alston M, Hoffman C, Pan Z, Friedman JE, Barbour LA. Intrahepatic fat is increased in the neonatal offspring of obese women with gestational diabetes. J Pediatr 2013; 162:930-6.e1. [PMID: 23260099 PMCID: PMC3610780 DOI: 10.1016/j.jpeds.2012.11.017] [Citation(s) in RCA: 130] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 10/11/2012] [Accepted: 11/02/2012] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To assess precision magnetic resonance imaging in the neonate and determine whether there is an early maternal influence on the pattern of neonatal fat deposition in the offspring of mothers with gestational diabetes mellitus (GDM) and obesity compared with the offspring of normal-weight women. STUDY DESIGN A total of 25 neonates born to normal weight mothers (n = 13) and to obese mothers with GDM (n = 12) underwent magnetic resonance imaging for the measurement of subcutaneous and intra-abdominal fat and magnetic resonance spectroscopy for the measurement of intrahepatocellular lipid (IHCL) fat at 1-3 weeks of age. RESULTS Infants born to obese/GDM mothers had a mean 68% increase in IHCL compared with infants born to normal-weight mothers. For all infants, IHCL correlated with maternal prepregnancy body mass index but not with subcutaneous adiposity. CONCLUSION Deposition of liver fat in the neonate correlates highly with maternal body mass index. This finding may have implications for understanding the developmental origins of childhood nonalcoholic fatty liver disease.
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Affiliation(s)
- David E Brumbaugh
- Department of Pediatrics, School of Medicine, University of Colorado Denver, Denver, CO, USA.
| | - Phillip Tearse
- Department of Radiology, University of Colorado Denver School of Medicine
| | - Melanie Cree-Green
- Department of Pediatrics, University of Colorado Denver School of Medicine
| | - Laura Z Fenton
- Department of Radiology, University of Colorado Denver School of Medicine
| | - Mark Brown
- Department of Radiology, University of Colorado Denver School of Medicine
| | - Ann Scherzinger
- Department of Radiology, University of Colorado Denver School of Medicine
| | - Regina Reynolds
- Department of Pediatrics, University of Colorado Denver School of Medicine
| | - Meredith Alston
- Department of Obstetrics/Gynecology, University of Colorado Denver School of Medicine, Denver Health and Hospitals
| | - Camille Hoffman
- Department of Obstetrics/Gynecology, University of Colorado Denver School of Medicine, Denver Health and Hospitals
| | - Zhaoxing Pan
- Department of Pediatrics, University of Colorado Denver School of Medicine
| | - Jacob E Friedman
- Department of Pediatrics, University of Colorado Denver School of Medicine,Jacob E. Friedman and Linda A. Barbour are co-senior authors
| | - Linda A Barbour
- Department of Medicine, University of Colorado Denver School of Medicine,Department of Obstetrics/Gynecology, University of Colorado Denver School of Medicine, Denver Health and Hospitals,Jacob E. Friedman and Linda A. Barbour are co-senior authors
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De Lucia Rolfe E, Modi N, Uthaya S, Hughes IA, Dunger DB, Acerini C, Stolk RP, Ong KK. Ultrasound estimates of visceral and subcutaneous-abdominal adipose tissues in infancy. J Obes 2013; 2013:951954. [PMID: 23710350 PMCID: PMC3654330 DOI: 10.1155/2013/951954] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 03/22/2013] [Accepted: 03/27/2013] [Indexed: 12/02/2022] Open
Abstract
Other imaging techniques to quantify internal-abdominal adiposity (IA-AT) and subcutaneous-abdominal adiposity (SCA-AT) are frequently impractical in infants. The aim of this study was twofold: (a) to validate ultrasound (US) visceral and subcutaneous-abdominal depths in assessing IA-AT and SCA-AT from MRI as the reference method in infants and (b) to analyze the association between US abdominal adiposity and anthropometric measures at ages 3 months and 12 months. Twenty-two infants underwent MRI and US measures of abdominal adiposity. Abdominal US parameters and anthropometric variables were assessed in the Cambridge Baby Growth Study (CBGS), n = 487 infants (23 girls) at age 3 months and n = 495 infants (237 girls) at 12 months. US visceral and subcutaneous-abdominal depths correlated with MRI quantified IA-AT (r = 0.48, P < 0.05) and SCA-AT (r = 0.71, P < 0.001) volumes, respectively. In CBGS, mean US-visceral depths increased by ~20 % between ages 3 and 12 months (P < 0.0001) and at both ages were lower in infants breast-fed at 3 months than in other infants. US-visceral depths at both 3 and 12 months were inversely related to skinfold thickness at birth (P = 0.03 and P = 0.009 at 3 and 12 months, resp.; adjusted for current skinfold thickness). In contrast, US-subcutaneous-abdominal depth at 3 months was positively related to skinfold thickness at birth (P = 0.004). US measures can rank infants with higher or lower IA-AT and SCA-AT. Contrasting patterns of association with visceral and subcutaneous-abdominal adiposities indicate that they may be differentially regulated in infancy.
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Affiliation(s)
- Emanuella De Lucia Rolfe
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, P.O. Box 285, Cambridge CB2 0QQ, UK.
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Akcay A, Akar M, Demirel G, Canpolat FE, Erdeve O, Dilmen U. Umbilical cord and fifth-day serum vaspin concentrations in small-, appropriate-, and large-for-gestational age neonates. J Pediatr Endocrinol Metab 2013; 26:635-8. [PMID: 23585177 DOI: 10.1515/jpem-2012-0111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2012] [Accepted: 05/06/2012] [Indexed: 11/15/2022]
Abstract
BACKGROUND Vaspin is a visceral adipose tissue-derived serine protease inhibitor that has an insulin-sensitizing effect. It is correlated with insulin resistance and glucose metabolism, and it improves glucose tolerance. AIM The aim of this study was to determine and compare serum vaspin and insulin concentrations in small-for- gestational age (SGA), appropriate-for-gestational age (AGA), and large-for-gestational age (LGA) infants at birth and fifth postnatal day. PATIENTS AND METHODS Eighty-two neonates were divided into three groups: SGA (n=22), AGA (n=30), and LGA (n=30). Mothers' age, gestational week, mode of delivery, and maternal diseases, such as diabetes, pre-eclampsia, and eclampsia were recorded. Blood for vaspin, insulin, and glucose was collected from the cord at birth and from a peripheral vein on the fifth postnatal day. RESULTS At birth, there were no statistically significant difference in serum insulin concentrations among the three groups, whereas cord serum vaspin concentrations were significantly higher in the SGA group (χ2=8.158, p<0.05). Serum glucose and vaspin levels on the fifth postnatal day had no significant difference among three groups (p<0.05). Circulating vaspin concentrations were not associated with the sex of the infant and delivery route. CONCLUSION Cord vaspin levels are significantly higher in SGA neonates than in AGA or LGA neonates. The fetal programming hypothesis proposes that many adulthood diseases originate from the adaptation that the fetus makes when it is undernourished. High cord-vaspin levels in SGA infants may be one of the adaptations for increased risk for adult metabolic diseases.
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Moura-Dos-Santos M, Wellington-Barros J, Brito-Almeida M, Manhães-de-Castro R, Maia J, Góis Leandro C. Permanent deficits in handgrip strength and running speed performance in low birth weight children. Am J Hum Biol 2012; 25:58-62. [DOI: 10.1002/ajhb.22341] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 10/04/2012] [Accepted: 10/10/2012] [Indexed: 11/10/2022] Open
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