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Ahmed BA, Varah N, Ong FJ, Blondin DP, Gunn E, Konyer NB, Singh NP, Noseworthy MD, Haman F, Carpentier AC, Punthakee Z, Steinberg GR, Morrison KM. Impaired Cold-Stimulated Supraclavicular Brown Adipose Tissue Activity in Young Boys With Obesity. Diabetes 2022; 71:1193-1204. [PMID: 35293989 DOI: 10.2337/db21-0799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 02/28/2022] [Indexed: 11/13/2022]
Abstract
Childhood obesity is a growing worldwide problem. In adults, lower cold-induced brown adipose tissue (BAT) activity is linked to obesity and metabolic dysfunction; this relationship remains uncertain in children. In this cross-sectional study, we compared cold-induced supraclavicular (SCV) BAT activity (percent change in proton density fat fraction [PDFF]) within the SCV region after 1 h of whole-body cold exposure (18°C), using MRI in 26 boys aged 8-10 years: 13 with normal BMI and 13 with overweight/obesity. Anthropometry, body composition, hepatic fat, visceral adipose tissue (VAT), and pre- and postcold PDFF of the subcutaneous adipose tissue (SAT) in the posterior neck region and the abdomen were measured. Boys with overweight/obesity had lower cold-induced percent decline in SCV PDFF compared with those with normal BMI (1.6 ± 0.8 vs. 4.7 ± 1.2%, P = 0.044). SCV PDFF declined significantly in boys with normal BMI (2.7 ± 0.7%, P = 0.003) but not in boys with overweight/obesity (1.1 ± 0.5%, P = 0.053). No cold-induced changes in the PDFF of either neck SAT (-0.89 ± 0.7%, P = 0.250, vs. 0.37 ± 0.3%, P = 0.230) or abdominal SAT (-0.39 ± 0.5%, P = 0.409, and 0.25 ± 0.2%, P = 0.139, for normal BMI and overweight/obesity groups, respectively) were seen. The cold-induced percent decline in SCV PDFF was inversely related to BMI (r = -0.39, P = 0.047), waist circumference (r = -0.48, P = 0.014), and VAT (r = -0.47, P = 0.014). Thus, in young boys, as in adults, BAT activity is lower in those with overweight/obesity, suggesting that restoring activity may be important for improving metabolic health.
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Affiliation(s)
- Basma A Ahmed
- Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Nina Varah
- Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Frank J Ong
- Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Denis P Blondin
- Division of Neurology, Department of Medicine, Faculty of Medicine and Health Sciences, Centre de recherche du CHUS, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Elizabeth Gunn
- Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Norman B Konyer
- Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Nina P Singh
- Department of Radiology, McMaster University, Hamilton, Ontario, Canada
| | - Michael D Noseworthy
- Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
- Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Radiology, McMaster University, Hamilton, Ontario, Canada
- Department of Electrical and Computer Engineering, McMaster University, Hamilton, Ontario, Canada
- School of Biomedical Engineering, McMaster University, Hamilton, Ontario, Canada
| | - Francois Haman
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Andre C Carpentier
- Division of Endocrinology, Department of Medicine, Faculty of Medicine and Health Sciences, Centre de recherche du CHUS, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Zubin Punthakee
- Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Gregory R Steinberg
- Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Katherine M Morrison
- Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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Gu P, Chhabra A, Chittajallu P, Chang C, Mendez D, Gilman A, Fudman DI, Xi Y, Feagins LA. Visceral Adipose Tissue Volumetrics Inform Odds of Treatment Response and Risk of Subsequent Surgery in IBD Patients Starting Antitumor Necrosis Factor Therapy. Inflamm Bowel Dis 2022; 28:657-666. [PMID: 34291800 DOI: 10.1093/ibd/izab167] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Data describing the effect of obesity on antitumor necrosis factor (anti-TNF) treatment response are inconsistent. Visceral adipose tissue (VAT) is a superior marker of adiposity to body mass index. However, its effect on treatment response is unclear. We aimed to evaluate the effect of VAT on anti-TNF treatment response. METHODS Inflammatory bowel disease (IBD) patients starting anti-TNF agents between January 1, 2009, and July 31, 2019, were included. 3-dimensional measurements of VAT volume and visceral fat index (visceral:subcutaneous adipose tissue ratio; VFI) were obtained from computed tomography (CT) scans. Subjects were categorized by predefined volume cutoffs (<1500cm3, 1500-2999cm3, ≥3000cm3) and VFI (<0.33, 0.33-0.66, ≥0.67). Primary outcomes included a composite treatment response end point at 6 and 12 months. Secondary outcomes were surgery at 6 and 12 months. Multivariable logistic regression was used to calculate adjusted odds ratio (aOR) and 95% confidence interval (CI). RESULTS The final cohort included 176 patients. No significant differences in treatment response at 6 months was observed. At 12 months, compared with volume <1500cm3, patients with volume 1500-2999cm3 had higher odds of response (aOR, 3.52; 95% CI, 1.16-10.71; P = .023), whereas volume ≥3000cm3 did not. Compared with VFI<0.33, VFI ≥0.67 had higher odds of surgery at 6 (aOR, 48.22; 95% CI, 4.73-491.57; P = .023) and 12 months (aOR, 20.94; 95% CI, 3.14-139.67; P = .004). Post hoc analysis suggested VAT may affect drug pharmacokinetics. CONCLUSIONS We found VAT volume is associated with anti-TNF treatment response in a nondose dependent manner, and VFI may inform risk of surgery after anti-TNF initiation. If confirmed by prospective studies, VAT volumetrics are potentially useful biomarkers to inform IBD treatment decisions.
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Affiliation(s)
- Phillip Gu
- Division of Digestive and Liver Diseases, UT Southwestern, Dallas,TX, USA.,Department of Internal Medicine, UT Southwestern, Dallas,TX, USA
| | - Avneesh Chhabra
- Division of Musculoskeletal Radiology, Department of Radiology, UT Southwestern, Dallas,TX, USA
| | | | | | - Denisse Mendez
- Department of Internal Medicine, UT Southwestern, Dallas,TX, USA
| | - Andrew Gilman
- Division of Digestive and Liver Diseases, UT Southwestern, Dallas,TX, USA.,Department of Internal Medicine, UT Southwestern, Dallas,TX, USA
| | - David I Fudman
- Division of Digestive and Liver Diseases, UT Southwestern, Dallas,TX, USA.,Department of Internal Medicine, UT Southwestern, Dallas,TX, USA
| | - Yin Xi
- Division of Musculoskeletal Radiology, Department of Radiology, UT Southwestern, Dallas,TX, USA.,Department of Population and Data Sciences, UT Southwestern, Dallas,TX, USA
| | - Linda A Feagins
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Texas at Austin Dell Medical School, Austin,TX, USA
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Kurowski JA, Achkar JP, Gupta R, Barbur I, Bonfield TL, Worley S, Remer EM, Fiocchi C, Viswanath SE, Kay MH. Adipokine Resistin Levels at Time of Pediatric Crohn Disease Diagnosis Predict Escalation to Biologic Therapy. Inflamm Bowel Dis 2020; 27:1088-1095. [PMID: 32978938 PMCID: PMC8355503 DOI: 10.1093/ibd/izaa250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Indexed: 12/09/2022]
Abstract
BACKGROUND Hypertrophy of visceral adipose tissue (VAT) is a hallmark of Crohn disease (CD). The VAT produces a wide range of adipokines, biologically active factors that contribute to metabolic disorders in addition to CD pathogenesis. The study aim was to concomitantly evaluate serum adipokine profiles and VAT volumes as predictors of disease outcomes and treatment course in newly diagnosed pediatric patients with CD. METHODS Pediatric patients ages 6 to 20 years were enrolled, and their clinical data and anthropometric measurements were obtained. Adipokine levels were measured at 0, 6, and 12 months after CD diagnosis and baseline in control patients (CP). The VAT volumes were measured by magnetic resonance imaging or computed tomography imaging within 3 months of diagnosis. RESULTS One hundred four patients undergoing colonoscopy were prospectively enrolled: 36 diagnosed with CD and 68 CP. The serum adipokine resistin and plasminogen activator inhibitor (PAI)-1 levels were significantly higher in patients with CD at diagnosis than in CP. The VAT volume was similar between CD and CP. Baseline resistin levels at the time of diagnosis in patients with CD who were escalated to biologics was significantly higher than in those not treated using biologic therapy by 12 months (29.8 ng/mL vs 13.8 ng/mL; P = 0.004). A resistin level of ≥29.8 ng/mL at the time of diagnosis predicted escalation to biologic therapy in the first year after diagnosis with a specificity of 95% (sensitivity = 53%; area under the curve = 0.82; P = 0.015 for model with log-scale). There was a significantly greater reduction in resistin (P = 0.002) and PAI-1 (P = 0.010) at the 12-month follow-up in patients on biologics compared with patients who were not treated using biologics. CONCLUSIONS Serum resistin levels at diagnosis of pediatric CD predict the escalation to biologic therapy at 12 months, independent of VAT volumes. Resistin and PAI-1 levels significantly improved in patients with CD after treatment using biologics compared with those not on biologics. These results suggest the utility of resistin as a predictive biomarker in pediatric CD.
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Affiliation(s)
- Jacob A Kurowski
- Pediatric Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic, Cleveland, Ohio, United States,Address correspondence to: Jacob A. Kurowski, MD, Cleveland Clinic, Pediatric Gastroenterology, Hepatology, and Nutrition, 9500 Euclid Avenue, Desk R3, Cleveland, OH 44195 ()
| | - Jean-Paul Achkar
- Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic, Cleveland, Ohio, United States
| | - Rishi Gupta
- Pediatric Gastroenterology, University of Rochester, Rochester, New York, United States
| | - Iulia Barbur
- Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, United States
| | - Tracey L Bonfield
- Pediatrics, Case Western Reserve University, Cleveland, Ohio, United States
| | - Sarah Worley
- Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | - Erick M Remer
- Imaging Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | - Claudio Fiocchi
- Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | - Satish E Viswanath
- Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, United States
| | - Marsha H Kay
- Pediatric Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic, Cleveland, Ohio, United States
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Lee LW, Hsieh CJ, Wu YH, Liao YS. Added values of DXA-derived visceral adipose tissue to discriminate cardiometabolic risks in pre-pubertal children. PLoS One 2020; 15:e0233053. [PMID: 32401808 PMCID: PMC7219764 DOI: 10.1371/journal.pone.0233053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 04/27/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The new generation of dual energy X-ray absorptiometry (DXA) scanners provide visceral adipose tissue (VAT) estimates by applying different algorithms to the conventional DXA-derived fat parameters such as total fat, trunk fat and android fat for the same image data. OBJECTIVE This cross-sectional study aimed to investigate whether VAT estimates from Hologic scanners are better predictors of VAT than conventional DXA parameters in pre-pubertal children, and to explore the discrimination ability of these VAT methods for cardiometabolic risks. METHODS Healthy pre-pubertal children aged 7-10 years were recruited for basic anthropometric, DXA and magnetic resonance imaging (MRI) measurements. Laboratory tests included lipid profile, glycaemic tests and blood pressure. RESULTS All VAT methods had acceptable to excellent performance for the diagnosis of dyslipidaemia (area under the curve [AUC] = 0.753-0.837) and hypertensive risk (AUC = 0.710-0.821) in boys, but suboptimal performance for these risks in girls, except for VAT by MRI in the diagnosis of dyslipidaemia. In both sexes, all VAT methods had no or poor discrimination ability for diabetes risk. CONCLUSIONS DXA-derived VAT estimates are very highly correlated with standard methods but has equivalent discrimination abilities compared to the existing DXA-derived fat estimates.
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Affiliation(s)
- Li-Wen Lee
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Puzi City, Chiayi, Taiwan
- Department of Nursing, Chang Gung University of Science and Technology, Puzi City, Chiayi, Taiwan
| | - Chu-Jung Hsieh
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Puzi City, Chiayi, Taiwan
| | - Yun-Hsuan Wu
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Puzi City, Chiayi, Taiwan
| | - Yu-San Liao
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Puzi City, Chiayi, Taiwan
- Department of Nursing, Chang Gung University of Science and Technology, Puzi City, Chiayi, Taiwan
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Yunlin, Taiwan
- * E-mail:
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5
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Zhao L, Rao S, Zhu X, Liu S, Tao Q, Yang X, Zhu Y, Hu J. Coicis Semen formula treating monosodium glutamate-induced obesity in mice by alleviating hypothalamic injury. FOOD AGR IMMUNOL 2019. [DOI: 10.1080/09540105.2019.1703911] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Lijun Zhao
- College of Life Science and Technology, National Engineering Research Center for Nanomedicine, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Shiyu Rao
- College of Life Science and Technology, National Engineering Research Center for Nanomedicine, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Xiaoqiang Zhu
- College of Life Science and Technology, National Engineering Research Center for Nanomedicine, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Shuo Liu
- Joint Laboratory for the Research of Pharmaceutics, Huazhong University of Science and Technology and Infinitus, Wuhan, People’s Republic of China
| | - Qian Tao
- Joint Laboratory for the Research of Pharmaceutics, Huazhong University of Science and Technology and Infinitus, Wuhan, People’s Republic of China
| | - Xiangliang Yang
- College of Life Science and Technology, National Engineering Research Center for Nanomedicine, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Yanhong Zhu
- College of Life Science and Technology, National Engineering Research Center for Nanomedicine, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Jun Hu
- College of Life Science and Technology, National Engineering Research Center for Nanomedicine, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
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Simon TG, Van Der Sloot KWJ, Chin SB, Joshi AD, Lochhead P, Ananthakrishnan AN, Xavier R, Chung RT, Khalili H. IRGM Gene Variants Modify the Relationship Between Visceral Adipose Tissue and NAFLD in Patients With Crohn's Disease. Inflamm Bowel Dis 2018; 24:2247-2257. [PMID: 29788077 PMCID: PMC6230523 DOI: 10.1093/ibd/izy128] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is an increasingly recognized comorbidity in Crohn's disease (CD), but the mechanisms are poorly understood. Autophagy is a highly conserved process regulating innate immunity that contributes to CD susceptibility. Emerging data suggest that variants in the autophagy-governing IRGM gene may contribute to the accumulation of visceral adipose tissue (VAT) and hepatic fat. Our objective was to characterize the relationship between VAT, IRGM gene variants, and NAFLD risk in patients with CD. METHODS We included all CD patients in the Prospective Registry in Inflammatory Bowel Disease Study at Massachusetts General Hospital (PRISM) without history of alcohol abuse or liver disease. Hepatic fat was quantified by liver attenuation (LA) on computed tomography, with NAFLD defined by the validated liver:spleen (L:S) ratio. NAFLD severity was estimated by the FIB-4 Index and alanine aminotransferase (ALT). Using logistic regression modeling, we examined the relationship between VAT, autophagy gene variants, and NAFLD risk. RESULTS Among 462 patients, 52% had NAFLD. Increasing VAT quartile was associated with reduced LA (mean change, -7.43; 95% confidence interval [CI], -10.05 to -4.81; Ptrend < 0.0001). In the fully adjusted model, patients in the highest VAT quartile had a 2.2-fold increased NAFLD risk (95% CI, 1.21 to 4.14; Ptrend = 0.032) and a 4.2-fold increased risk of ALT>upper limit of normal (ULN) (95% CI, 1.19 to 14.76; Ptrend = 0.017). The relationship between VAT and NAFLD was modified by IRGM variants rs4958847 and rs13361189 (Pinteraction = 0.005 and Pinteraction < 0.001, respectively). CONCLUSIONS In a large CD cohort, VAT was directly associated with prevalent NAFLD, and this relationship was augmented by functionally annotated IRGM variants associated with impaired autophagy.
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Affiliation(s)
- Tracey G Simon
- Liver Center, Massachusetts General Hospital, Boston, Massachusetts,Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts,Harvard Medical School, Boston, Massachusetts
| | - Kimberley W J Van Der Sloot
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts,Department of Epidemiology, University Medical Center Groningen, Groningen, the Netherlands
| | - Samantha B Chin
- Liver Center, Massachusetts General Hospital, Boston, Massachusetts,Harvard Medical School, Boston, Massachusetts
| | - Amit D Joshi
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts,Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts,Harvard Medical School, Boston, Massachusetts
| | - Paul Lochhead
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts,Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts,Harvard Medical School, Boston, Massachusetts
| | - Ashwin N Ananthakrishnan
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts,Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts,Harvard Medical School, Boston, Massachusetts
| | - Ramnik Xavier
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts,Center for Computational and Integrative Biology, Massachusetts General Hospital, Boston, Massachusetts,Harvard Medical School, Boston, Massachusetts
| | - Raymond T Chung
- Liver Center, Massachusetts General Hospital, Boston, Massachusetts,Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts,Harvard Medical School, Boston, Massachusetts
| | - Hamed Khalili
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts,Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts,Harvard Medical School, Boston, Massachusetts,Clinical Epidemiology Unit, Karolinska Institutet, Stockholm Sweden,Address correspondence to: Hamed Khalili, MD, MPH, Massachusetts General Hospital, Crohn’s and Colitis Center, 165 Cambridge Street, 9th Floor, Boston, MA 02114 ()
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Abstract
BACKGROUND AND OBJECTIVE Recent evidence points toward an active immunological role of intra-abdominal adipose tissue in Crohn disease (CD). We quantified the abdominal adipose tissue compartments using magnetic resonance imaging (MRI) in 27 pediatric patients with CD compared with 14 controls undergoing MRI examination for other reasons. METHODS Total (TAAT), subcutaneous (SCAT) and intra-abdominal (IAAT) adipose tissue areas were measured by semiautomatic segmentation on a transverse slice centered on the umbilicus (mean ± standard deviation in square centimeter) using standard T1-weighted sequences. IAAT/TAAT and IAAT/height ratios were calculated and analyzed for associations with disease duration, phenotype, or therapy. RESULTS Patients with CD (median age 15.0 years, range 7.7-17.9, 18/27 boys, median disease duration 29 months, range 0-136) compared to controls (median age 13.9 years, range 3.3-17.8, 4/14 boys) had higher IAAT area (42.3 ± 21.0 vs 28.7 ± 11.6, P = 0.0494) but similar SCAT and TAAT areas (104.6 ± 72.8 vs 96.5 ± 50.8, P = 0.8170 and 146.9 ± 87.3 vs 125.3 ± 61.5, P = 0.7417, respectively). IAAT/TAAT ratio was higher in patients with CD compared to controls (0.32 ± 0.10 vs 0.24 ± 0.04, P = 0.0081). Patients with disease duration >2 years (n = 14) had higher IAAT/TAAT ratio than those with shorter disease and controls (0.35 ± 0.10 vs 0.28 ± 0.08, P = 0.0288 and 0.24 ± 0.04, P = 0.0009, respectively). In these patients, increased IAAT/height ratio was associated with complicated disease (P = 0.043, r = 0.573). No association was found between IAAT/TAAT ratio and actual disease activity or therapy. CONCLUSIONS IAAT is increased in pediatric CD and correlates with disease duration. Assessment of IAAT accumulation may be considered in future MRI scores for inflammation and bowel damage in CD and during follow-up of different therapeutic interventions.
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Pazin DC, Rosaneli CF, Olandoski M, Oliveira ERND, Baena CP, Figueredo AS, Baraniuk AO, Kaestner TLDL, Guarita-Souza LC, Faria-Neto JR. Waist Circumference is Associated with Blood Pressure in Children with Normal Body Mass Index: A Cross-Sectional Analysis of 3,417 School Children. Arq Bras Cardiol 2017; 109:509-515. [PMID: 29185613 PMCID: PMC5783431 DOI: 10.5935/abc.20170162] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 07/31/2017] [Indexed: 11/23/2022] Open
Abstract
Background The prevalence of childhood obesity and associated conditions, such as
hypertension, has become a major problem of public health. Although waist
circumference (WC) is a marker of cardiovascular risk in adults, it is
unclear whether this index is associated with cardiovascular risk factors in
children. Objective Our aim was to evaluate the association between increased WC and elevated
blood pressure (BP) in children with normal body mass index (BMI)
ranges. Methods Cross-sectional evaluation of students between 6 and 11 years with normal
BMI. WC was categorized by quartile for each age group. Normal BP was
defined as values < 90th percentile, and levels above this range were
considered elevated. Values of p < 0.05 were considered statistically
significant. Results Of the 5,037 children initially assessed, 404 (8%) were excluded for being
underweight and 1,216 (24.1%) were excluded for being overweight or obese. A
final sample of 3,417 children was evaluated. The prevalence of elevated BP
was 10.7%. In children with WC in the lowest quartile, the prevalence of
elevated BP was 8.1%. This prevalence increased in upper quartiles: 10.6% in
the second, 12.4% in third and 12.1% in the upper quartile. So, in this
group, being in the highest WC quartile was associated with a 57% higher
likelihood to present elevated BP when compared to those in the lowest
quartile (Q4 vs Q1; OR 1.57 - 95%CI 1.14 - 2.17). Conclusion In children aged 6 to 11 years, increased waist circumference is associated
with elevated BP even when BMI is normal.
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Affiliation(s)
| | | | - Márcia Olandoski
- Pontifícia Universidade Católica do Paraná, Curitiba, PR- Brazil
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9
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Abstract
INTRODUCTION Adipose tissue in mesenteric fat plays a key role in systemic and luminal inflammation. However, little is known about the role of visceral adipose tissue (VAT) and its interaction with genetic predisposition in Crohn's disease (CD) progression. METHODS Our study population included patients with CD enrolled in Prospective Registry in Inflammatory Bowel Disease Study at Massachusetts General Hospital (PRISM). VAT volume was measured from computed tomography using Aquarius 3D. We used logistic regression models to estimate the multivariable-adjusted odds ratio and 95% CI. We tested for effect modification by genetic predisposition using the log likelihood ratio test. RESULTS Among 482 patients with CD with available data on VAT, 174 developed penetrating disease, 132 developed stricturing disease, 147 developed perianal disease, and 252 required surgery. Compared with individuals in the lowest quartile of VAT volume, the multivariable-adjusted odds ratio of surgery among individuals in the highest quartile was 2.02 (95% CI, 1.09-3.76; Ptrend = 0.006). Similarly, the risk of penetrating disease seemed to increase with greater VAT volume (Ptrend = 0.022) but not stricturing or perianal disease (all Ptrend > 0.23). The associations between VAT volume and CD complications were not modified by genetic predisposition (all Pinteraction > 0.12). CONCLUSIONS Visceral adiposity as measured by VAT volume may be associated with a significant increase in the risk of penetrating disease and surgery in CD. Our data suggest that visceral adiposity as measured by VAT may negatively impact long-term progression of CD regardless of genetic predisposition.
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10
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O'Connor M, Ryan J, Foley S. Best single-slice location to measure visceral adipose tissue on paediatric CT scans and the relationship between anthropometric measurements, gender and VAT volume in children. Br J Radiol 2015; 88:20140711. [PMID: 26317895 DOI: 10.1259/bjr.20140711] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Visceral adipose tissue (VAT) is a significant risk factor for obesity-related metabolic diseases. This study investigates (1) the best single CT slice location for predicting total abdominal VAT volume in paediatrics and (2) the relationship between waist circumference (WC), sagittal diameter (SD), gender and VAT volume. METHODS A random sample of 130 paediatric abdomen CT scans, stratified according to age and gender, was collected. Three readers measured VAT area at each intervertebral level between T12 and S1 using ImageJ analysis (National Institute of Health, Bethesda, MD) software by thresholding -190 to -30 HU and manually segmenting VAT. Single-slice VAT measurements were correlated with total VAT volume to identify the most representative slice. WC and SD were measured at L3-L4 and L4-L5 slices, respectively. Regression analysis was used to evaluate WC, SD and gender as VAT volume predictors. RESULTS Interviewer and intraviewer reliability were excellent (intraclass correlation coefficient = 0.99). Although VAT measured at multiple slices correlated strongly with abdominal VAT, only one slice in females at L2-L3 and two slices in males at L1-L2 and L5-S1 were strongly correlated across all age groups. Linear regression analysis showed that WC was strongly correlated with VAT volume (beta = 0.970, p < 0.001). CONCLUSION Single-slice VAT measurements are highly reproducible. Measurements performed at L2-L3 in females and L1-L2 or L5-S1 in males were most representative of VAT. WC is indicative of VAT. ADVANCES IN KNOWLEDGE VAT should be measured at L2-L3 in female children and at either L1-L2 or L5-S1 in males. WC is a strong indicator of VAT in children.
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Affiliation(s)
- Michelle O'Connor
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - John Ryan
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Shane Foley
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
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CT Dose Reduction for Visceral Adipose Tissue Measurement: Effects of Model-Based and Adaptive Statistical Iterative Reconstructions and Filtered Back Projection. AJR Am J Roentgenol 2015; 204:W677-83. [PMID: 26001256 DOI: 10.2214/ajr.14.13411] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The objective of our study was to evaluate the effects of radiation dose reduction and the reconstruction algorithm used--filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR), or model-based iterative reconstruction (MBIR)--on the measurement of abdominal visceral fat using CT. SUBJECTS AND METHODS Standard-dose and low-dose abdominal CT examinations were performed simultaneously with automatic exposure control in 59 patients; the noise index for a 5-mm slice thickness was 12 for routine-dose CT and 24 for low-dose CT. The routine-dose CT images were reconstructed using FBP (reference standard), and the low-dose CT images were reconstructed using FBP, ASIR (so-called hybrid iterative reconstruction [IR]), and MBIR (so-called pure IR). In the 236 image series obtained, the visceral fat area was measured. Data were analyzed by the Pearson correlation coefficient test and a Bland-Altman difference analysis. RESULTS The radiation dose of the low-dose abdominal CT examinations was 73.0% (mean) lower than that of routine-dose CT examinations. Excellent correlations were observed between the visceral fat areas measured on the routine-dose FBP images and those measured on the low-dose FBP, low-dose ASIR, and low-dose MBIR images (r = 0.998, 0.998, and 0.998, respectively; p < 0.001). A Bland-Altman difference analysis revealed excellent agreements, with mean biases of -0.47, -0.41, and 0.18 cm(2) for the visceral fat area between the routine-dose FBP images and the low-dose FBP, low-dose ASIR, and low-dose MBIR images, respectively. CONCLUSION A 73.0% reduction of the radiation dose would be possible in CT for the measurement of the abdominal visceral fat regardless of which reconstruction algorithm is used (i.e., FBP, hybrid IR, or pure IR).
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Value of Focused Appendicitis Ultrasound and Alvarado Score in Predicting Appendicitis in Children: Can We Reduce the Use of CT? AJR Am J Roentgenol 2015; 204:W707-12. [DOI: 10.2214/ajr.14.13212] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Abstract
BACKGROUND Increased abdominal visceral adipose tissue (VAT) is associated with systemic inflammation. The influence of VAT on pediatric inflammatory bowel disease (IBD) has not been studied. The objective of this study was to investigate the differences in VAT between pediatric patients with IBD and age-matched controls and identify associations between VAT and Crohn's disease (CD) outcomes. METHODS Single-center retrospective cohort study of 114 pediatric patients with IBD (101 CD and 13 ulcerative colitis) who had abdominal computed tomography at diagnosis. VAT volumes were measured from computed tomography images. A control group of 78 age-matched patients without IBD who had abdominal computed tomography was selected for comparison. RESULTS Median VAT was 634 cm (interquartile range, 411-1041) in the IBD group and 659 cm (interquartile range, 394-1015) in the controls. IBD group had 33% higher VAT than controls (95% confidence interval [CI], 11-58) P = 0.002 after adjusting for body mass index and age. In patients with CD, higher VAT was associated with fistulizing or fibrostenotic disease (odds ratio [OR], 1.7; 95% CI, 1.1-2.9; P = 0.03), CD hospitalizations (OR, 1.9; 95% CI, 1.2-3.4; P = 0.01), moderate or severe disease activity scores (OR, 1.8; 95% CI, 1.1-3.1; P = 0.02), and shorter intervals from diagnosis to surgery (hazard ratio, 1.4; 95% CI, 1.0-2.0; P = 0.05) after adjusting for body mass index and age. CONCLUSIONS At diagnosis, pediatric patients with IBD have higher adjusted VAT volumes than age- and body mass index-matched controls. Higher VAT volumes in pediatric patients with CD predicted more hospitalizations, increased likelihood of complicated disease, shorter interval from diagnosis to surgery, and higher disease activity scores at diagnosis.
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Oike M, Yokokawa H, Fukuda H, Haniu T, Oka F, Hisaoka T, Isonuma H. Association between abdominal fat distribution and atherosclerotic changes in the carotid artery. Obes Res Clin Pract 2013; 8:e448-58. [PMID: 25263834 DOI: 10.1016/j.orcp.2013.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 08/26/2013] [Accepted: 09/05/2013] [Indexed: 12/16/2022]
Abstract
AIM We aimed to evaluate the association between abdominal fat distribution (e.g., abdominal visceral fat area [VFA], subcutaneous fat area [SFA], and total fat area [TFA]), waist circumference (WC), or body mass index (BMI) and atherosclerotic changes in the carotid artery after adjusting for common risk factors. METHODS The present study is a hospital-based, cross-sectional study. Study participants included 223 Japanese individuals who underwent a medical health checkup at Juntendo University Hospital, Tokyo, between December 2005 and August 2011. Multivariate logistic regression analysis was used to examine the association between abdominal VFA, SFA, TFA, the VFA/SFA ratio, WC, or BMI and intima-media thickness [IMT] (mean IMT≥1.1mm or maximum IMT≥1.2mm) as atherosclerotic changes in the carotid artery. RESULTS Multivariate logistic regression analysis showed that VFA (OR for ≥150cm(2) versus <100cm(2), 3.88; 95% CI, 1.39-10.85), BMI (OR for ≥27.6kg/m(2) versus <25kg/m(2), 5.22; 95% CI, 1.69-16.16), and TFA (OR for 200-285cm(2) versus <200cm(2), 4.15; 95% CI, 1.34-12.86: OR for ≥285cm(2) versus <200cm(2), 5.53; 95% CI, 1.76-17.35) were significantly associated with atherosclerotic changes in men. After adjustment for BMI, only TFA (OR for ≥285cm(2) versus <200cm(2), 3.76; 95%CI, 1.03-13.79) in men was significantly associated with atherosclerotic changes in the carotid artery. CONCLUSIONS Our results indicate that VFA, TFA, and BMI are independently associated with atherosclerotic changes in Japanese men. TFA may be considered as a valuable measure of atherosclerotic changes.
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Affiliation(s)
- Miki Oike
- Department of General Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Hirohide Yokokawa
- Department of General Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan.
| | - Hiroshi Fukuda
- Department of General Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Tomomi Haniu
- Department of General Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Fukuko Oka
- Department of General Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Teruhiko Hisaoka
- Department of General Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Hiroshi Isonuma
- Department of General Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan
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