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Bennett JP, Prado CM, Heymsfield SB, Shepherd JA. Evaluation of visceral adipose tissue thresholds for elevated metabolic syndrome risk across diverse populations: A systematic review. Obes Rev 2024; 25:e13767. [PMID: 38761009 DOI: 10.1111/obr.13767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 04/11/2024] [Accepted: 04/17/2024] [Indexed: 05/20/2024]
Abstract
Beyond obesity, excess levels of visceral adipose tissue (VAT) significantly contribute to the risk of developing metabolic syndrome (MetS), although thresholds for increased risk vary based on population, regions of interest, and units of measure employed. We sought to determine whether a common threshold exists that is indicative of heightened MetS risk across all populations, accounting for sex, age, BMI, and race/ethnicity. A systematic literature review was conducted in September 2023, presenting threshold values for elevated MetS risk. Standardization equations harmonized the results from DXA, CT, and MRI systems to facilitate a comparison of threshold variations across studies. A total of 52 papers were identified. No single threshold could accurately indicate elevated risk for both males and females across varying BMI, race/ethnicity, and age groups. Thresholds fluctuated from 70 to 165.9 cm2, with reported values consistently lower in females. Generally, premenopausal females and younger adults manifested elevated risks at lower VAT compared to their older counterparts. Notably, Asian populations exhibited elevated risks at lower VAT areas (70-136 cm2) compared to Caucasian populations (85.6-165.9 cm2). All considered studies reported associations of VAT without accommodating covariates. No single VAT area threshold for elevated MetS risk was discernible post-harmonization by technology, units of measure, and region of interest. This review summarizes available evidence for MetS risk assessment in clinical practice. Further exploration of demographic-specific interactions between VAT area and other risk factors is imperative to comprehensively delineate overarching MetS risk.
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Affiliation(s)
| | - Carla M Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
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Mazza E, Troiano E, Ferro Y, Lisso F, Tosi M, Turco E, Pujia R, Montalcini T. Obesity, Dietary Patterns, and Hormonal Balance Modulation: Gender-Specific Impacts. Nutrients 2024; 16:1629. [PMID: 38892561 PMCID: PMC11174431 DOI: 10.3390/nu16111629] [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: 05/07/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Understanding the intricate relationship between nutrition, hormonal balance, and gender-specific factors is crucial for developing targeted interventions to mitigate obesity-related endocrine disruptions and improve metabolic health. This narrative review examines the impact of various dietary patterns on hormonal regulation in both men and women, focusing on their effects on hormonal balance and metabolic health in the context of obesity. Calorie restriction, the Western diet, high-fat diets, low-CHO diets, plant-based diets, and the Mediterranean diet are analyzed in relation to their influence on obesity-related endocrine disruptions and metabolic health. Future research directions include investigating the specific mechanisms underlying dietary influences on hormonal regulation, addressing the gender-specific metabolic differences and body fat distribution, and exploring the dietary needs of individuals undergoing gender transition. Personalized dietary interventions tailored to individual metabolic and hormonal profiles are essential for optimizing health outcomes across the gender spectrum. By integrating gender-specific considerations into dietary recommendations, healthcare professionals can better support individuals in achieving optimal metabolic health and hormonal balance.
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Affiliation(s)
- Elisa Mazza
- Department of Clinical and Experimental Medicine, University Magna Græcia, 88100 Catanzaro, Italy; (E.M.); (T.M.)
- Technical Scientific Association of Food, Nutrition and Dietetics (ASAND), 95128 Catania, Italy; (E.T.); (F.L.)
| | - Ersilia Troiano
- Technical Scientific Association of Food, Nutrition and Dietetics (ASAND), 95128 Catania, Italy; (E.T.); (F.L.)
- Social Educational Directorate of Rome III Montesacro Municipality, 00139 Rome, Italy
| | - Yvelise Ferro
- Department of Medical and Surgical Science, University Magna Græcia, 88100 Catanzaro, Italy; (Y.F.); (R.P.)
| | - Fabrizia Lisso
- Technical Scientific Association of Food, Nutrition and Dietetics (ASAND), 95128 Catania, Italy; (E.T.); (F.L.)
- “Sant’Anna” Hospital, San Fermo della Battaglia, 22042 Como, Italy
| | - Martina Tosi
- Technical Scientific Association of Food, Nutrition and Dietetics (ASAND), 95128 Catania, Italy; (E.T.); (F.L.)
- Department of Health Sciences, University of Milan, 20146 Milan, Italy
| | - Ettore Turco
- Department of Public Health, University of Naples “Federico II”, 80131 Naples, Italy;
| | - Roberta Pujia
- Department of Medical and Surgical Science, University Magna Græcia, 88100 Catanzaro, Italy; (Y.F.); (R.P.)
| | - Tiziana Montalcini
- Department of Clinical and Experimental Medicine, University Magna Græcia, 88100 Catanzaro, Italy; (E.M.); (T.M.)
- Research Center for the Prevention and Treatment of Metabolic Diseases, University Magna Græcia, 88100 Catanzaro, Italy
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Li C, Zeng L, Li M, Deng K, Zhou D, Liang R, Zhang X, Hu Z, Luo A, Chen C, Chen Q, Wei W, Li W, Hu Z. New sagittal abdominal diameter and transverse abdominal diameter based equations to estimate visceral fat area in type 2 diabetes patients. BMC Public Health 2024; 24:1364. [PMID: 38773444 PMCID: PMC11106903 DOI: 10.1186/s12889-024-18659-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/18/2024] [Indexed: 05/23/2024] Open
Abstract
OBJECTIVE Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) are considered gold standards for measuring visceral fat area (VFA). However, their relatively high prices and potential radiation exposure limit their widespread use in clinical practice and everyday life. Therefore, our study aims to develop a VFA estimated equation based on sagittal abdominal diameter (SAD) and transverse abdominal diameter (TAD) using anthropometric indexes. To the best of our knowledge, there have been limited studies investigating this aspect thus far. METHODS This study was designed as a cross-sectional, retrospective cohort survey. A total of 288 patients (167 males and 121 females) aged 18-80 with type 2 diabetes (T2D) were consecutively collected from a multicenter hospital, and VFA was measured by CT. Subsequently, variables highly correlated with VFA were screened through general linear correlation analysis. A stepwise regression analysis was then conducted to develop a VFA estimated equation. Discrepancies between the estimated and actual VFA values were assessed using the Bland-Altman method to validate the accuracy of the equation. RESULTS In the female T2D population, triglyceride (TG), SAD, TAD were found to be independently correlated with VFA; in the male T2D population, BMI, TG, SAD and TAD showed independent correlations with VFA. Among these variables, SAD exhibited the strongest correlation with VFA (r = 0.83 for females, r = 0.88 for males), followed by TAD (r = 0.69 for females, r = 0.79 for males). Based on these findings, a VFA estimated equation was developed for the T2D population: VFA (male) =-364.16 + 15.36*SAD + 0.77*TG + 9.41*TAD - 5.00*BMI (R2 = 0.75, adjusted R2 = 0.74); VFA(female)=-170.87 + 9.72*SAD-24.29*(TG^-1) + 3.93*TAD (R2 = 0.69, adjusted R2 = 0.68). Both models demonstrated a good fit. The Bland-Altman plot indicated a strong agreement between the actual VFA values and the estimated values, the mean differences were close to 0, and the majority of differences fell within the 95% confidence interval. CONCLUSIONS In the T2D population, a VFA estimated equation is developed by incorporating SAD and TAD along with other measurement indices. This equation demonstrates a favorable estimated performance, suggesting to the development of novel and practical VFA estimation models in the future study.
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Affiliation(s)
- Chao Li
- Guangdong Medical University, Zhanjiang, 524001, China
| | - Liankun Zeng
- Department of Endocrinology, the Fourth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 511300, China
| | - Miaosheng Li
- Department of Joint surgery, Affiliated Southwest Hospital of Youjiang Medical University for Nationalities, Baise, 533099, China
- Baise People's Hospital, Baise, 533099, China
| | - Kang Deng
- Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524002, China
| | - Die Zhou
- Department of Clinical Laboratory, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510220, China
| | - Rutao Liang
- Guangdong Medical University, Zhanjiang, 524001, China
| | - Xiaoshu Zhang
- Department of Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510220, China
| | - Zhihui Hu
- Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524002, China
| | - Ai Luo
- Department of Endocrinology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510220, China
| | - Chunling Chen
- Guangdong Medical University, Zhanjiang, 524001, China
| | - Qi Chen
- Guangdong Medical University, Zhanjiang, 524001, China
| | - Wenlong Wei
- Guangzhou Red Cross Hospital(Guangzhou Red Cross Hospital of Jinan University), Guangzhou, 510240, China
| | - Wangen Li
- Department of Endocrinology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510220, China.
- Guangzhou Medical University, Guangzhou, 510220, China.
| | - Zhuoqing Hu
- Department of Endocrinology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510220, China.
- Guangzhou Medical University, Guangzhou, 510220, China.
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Leiby JS, Lee ME, Shivakumar M, Choe EK, Kim D. Deep learning imaging phenotype can classify metabolic syndrome and is predictive of cardiometabolic disorders. J Transl Med 2024; 22:434. [PMID: 38720370 PMCID: PMC11077781 DOI: 10.1186/s12967-024-05163-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/04/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Cardiometabolic disorders pose significant health risks globally. Metabolic syndrome, characterized by a cluster of potentially reversible metabolic abnormalities, is a known risk factor for these disorders. Early detection and intervention for individuals with metabolic abnormalities can help mitigate the risk of developing more serious cardiometabolic conditions. This study aimed to develop an image-derived phenotype (IDP) for metabolic abnormality from unenhanced abdominal computed tomography (CT) scans using deep learning. We used this IDP to classify individuals with metabolic syndrome and predict future occurrence of cardiometabolic disorders. METHODS A multi-stage deep learning approach was used to extract the IDP from the liver region of unenhanced abdominal CT scans. In a cohort of over 2,000 individuals the IDP was used to classify individuals with metabolic syndrome. In a subset of over 1,300 individuals, the IDP was used to predict future occurrence of hypertension, type II diabetes, and fatty liver disease. RESULTS For metabolic syndrome (MetS) classification, we compared the performance of the proposed IDP to liver attenuation and visceral adipose tissue area (VAT). The proposed IDP showed the strongest performance (AUC 0.82) compared to attenuation (AUC 0.70) and VAT (AUC 0.80). For disease prediction, we compared the performance of the IDP to baseline MetS diagnosis. The models including the IDP outperformed MetS for type II diabetes (AUCs 0.91 and 0.90) and fatty liver disease (AUCs 0.67 and 0.62) prediction and performed comparably for hypertension prediction (AUCs of 0.77). CONCLUSIONS This study demonstrated the superior performance of a deep learning IDP compared to traditional radiomic features to classify individuals with metabolic syndrome. Additionally, the IDP outperformed the clinical definition of metabolic syndrome in predicting future morbidities. Our findings underscore the utility of data-driven imaging phenotypes as valuable tools in the assessment and management of metabolic syndrome and cardiometabolic disorders.
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Affiliation(s)
- Jacob S Leiby
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, 19104, Philadelphia, PA, USA
| | - Matthew E Lee
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, 19104, Philadelphia, PA, USA
| | - Manu Shivakumar
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, 19104, Philadelphia, PA, USA
| | - Eun Kyung Choe
- Department of Surgery, Seoul National University Hospital Healthcare System Gangnam Center, 06236, Seoul, South Korea.
| | - Dokyoon Kim
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, 19104, Philadelphia, PA, USA.
- Institute for Biomedical Informatics, Perelman School of Medicine, University of Pennsylvania, 19104, Philadelphia, PA, USA.
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Bennett JP, Fan B, Liu E, Kazemi L, Wu XP, Zhou HD, Lu Y, Shepherd JA. Standardization of dual-energy x-ray visceral adipose tissue measures for comparison across clinical imaging systems. Obesity (Silver Spring) 2023; 31:2936-2946. [PMID: 37789584 DOI: 10.1002/oby.23885] [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: 04/12/2023] [Revised: 06/19/2023] [Accepted: 07/10/2023] [Indexed: 10/05/2023]
Abstract
OBJECTIVE Excess visceral adipose tissue (VAT) is a major risk factor for metabolic syndrome (MetS) and clinical guidelines have been proposed to define VAT levels associated with increased risk. The aim was to standardize VAT measures between two dual-energy x-ray absorptiometry (DXA) manufacturers who provide different VAT estimates to support standardization of measures across imaging modalities. METHODS Scans from 114 individuals (ages 18-81 years) on GE HealthCare (GEHC) and Hologic DXA systems were compared via Deming regression to standardize VAT between the two systems, validated in a separate sample (n = 15), with κ statistics to assess agreement of VAT measurements for classifying patients into risk categories. RESULTS The GEHC and Hologic VAT measures were highly correlated and validated in the separate data set (r2 = 0.97). VAT area measures substantially agreed for metabolic risk classification (weighted κ = 0.76) with no significant differences in the population mean values. CONCLUSIONS VAT measures can be estimated from GEHC and Hologic scans that classify individuals in a substantially similar way into metabolic risk categories, and systematic bias between the measures can be removed using simple regression equations. These findings allow for DXA VAT measures to be used in complement to other imaging modalities, regardless of whether scans used GEHC or Hologic systems.
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Affiliation(s)
| | - Bo Fan
- Department of Radiology and Bioimaging, University of California San Francisco, San Francisco, California, USA
| | - En Liu
- University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Leila Kazemi
- University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Xian-Ping Wu
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory for Metabolic Bone Diseases, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Chansha, Hunan, China
| | - Hou-De Zhou
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory for Metabolic Bone Diseases, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Chansha, Hunan, China
| | - Ying Lu
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, California, USA
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Kim HJ, Kim B, Kim S, Kwon H, Yun JM, Cho B, Park JH. Effects of the abdominal fat distribution on the relationship between exposure to air pollutants and thyroid hormones among Korean adult males. Eur J Med Res 2023; 28:423. [PMID: 37821991 PMCID: PMC10566041 DOI: 10.1186/s40001-023-01394-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 09/24/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Several significant associations between air pollution and thyroid function have been reported, but few studies have identified whether these associations differ by obesity, particularly its regional distribution. We assessed the relationship between ambient air pollution and thyroid hormone, and whether this relationship is modified by abdominal adiposity, as indicated by the waist circumference, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and visceral-to-subcutaneous fat ratio (VSR) in Korean men. METHODS We included 2440 male adults in the final analysis and used each person's annual average exposure to four air pollutants: particulate matter with an aerodynamic diameter ≤ 10 μm (PM10), nitrogen dioxide, sulfur dioxide (SO2), and carbon monoxide (CO). Abdominal fat deposition was quantified by computed tomography. Serum thyrotropin (TSH) and free thyroxine (FT4) concentrations were measured for thyroid hormone. To evaluate the relationship between air pollution and thyroid hormone according to adiposity, we performed multiple linear regression analysis on the two subgroups stratified by abdominal fat level. RESULTS Abdominal adiposity was significantly related to FT4 concentration. The exposures to air pollutants were associated with increased TSH and decreased FT4 concentrations. In stratified analysis using abdominal fat traits, ambient air pollution except for SO2 was significantly related to increased TSH and decreased FT4 concentrations in the high adiposity group (all p < 0.05), but not in the normal adiposity group. Among the air pollutants, PM10 showed an association with an increase of TSH concentration in all group with high adiposity, including high VAT, high SAT, and high VSR groups (all p < 0.05). In case of FT4, CO showed a similar pattern. Among the abdominal fat-related traits, the VSR in the high adiposity group had the largest effect on the relationship between exposure to air pollutants and thyroid hormone. CONCLUSIONS This study suggests the first clue that the relationship between air pollution exposure and thyroid hormone differs according to abdominal fat distribution among Korean adult males.
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Affiliation(s)
- Hyun-Jin Kim
- National Cancer Control Institute, National Cancer Center, Goyang, 10408, South Korea
| | - Byungmi Kim
- National Cancer Control Institute, National Cancer Center, Goyang, 10408, South Korea
| | - Seyoung Kim
- National Cancer Control Institute, National Cancer Center, Goyang, 10408, South Korea
| | - Hyuktae Kwon
- Department of Family Medicine, Seoul National University Hospital, 03 Daehakro, Yeongun-Dong, Jongno-Gu, Seoul, 03080, Korea
| | - Jae Moon Yun
- Department of Family Medicine, Seoul National University Hospital, 03 Daehakro, Yeongun-Dong, Jongno-Gu, Seoul, 03080, Korea
| | - Belong Cho
- Department of Family Medicine, Seoul National University Hospital, 03 Daehakro, Yeongun-Dong, Jongno-Gu, Seoul, 03080, Korea
- Department of Family Medicine, Seoul National University College of Medicine, 103 Daehakro, Yeongun-Dong, Jongno-Gu, Seoul, 03080, Korea
| | - Jin-Ho Park
- Department of Family Medicine, Seoul National University Hospital, 03 Daehakro, Yeongun-Dong, Jongno-Gu, Seoul, 03080, Korea.
- Department of Family Medicine, Seoul National University College of Medicine, 103 Daehakro, Yeongun-Dong, Jongno-Gu, Seoul, 03080, Korea.
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Baggerman MR, Dekker IM, Winkens B, Olde Damink SWM, Stapel SN, Weijs PJM, van de Poll MCG. Visceral obesity measured using computed tomography scans: No significant association with mortality in critically ill patients. J Crit Care 2023; 77:154316. [PMID: 37116438 DOI: 10.1016/j.jcrc.2023.154316] [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: 11/13/2022] [Revised: 04/14/2023] [Accepted: 04/17/2023] [Indexed: 04/30/2023]
Abstract
INTRODUCTION The association between obesity and outcome in critical illness is unclear. Since the amount of visceral adipose tissue(VAT) rather than BMI mediates the health effects of obesity we aimed to investigate the association between visceral obesity, BMI and 90-day mortality in critically ill patients. METHOD In 555 critically ill patients (68% male), the VAT Index(VATI) was measured using Computed Tomography scans on the level of vertebra L3. The association between visceral obesity, BMI and 90-day mortality was investigated using univariable and multivariable analyses, correcting for age, sex, APACHE II score, sarcopenia and muscle quality. RESULTS Visceral obesity was present in 48.1% of the patients and its prevalence was similar in males and females. Mortality was similar amongst patients with and without visceral obesity (27.7% vs 24.0%, p = 0.31). The corrected odds ratio of 90-day mortality for visceral obesity was 0.667 (95%CI 0.424-1.049, p = 0.080). Using normal BMI as reference, the corrected odds ratio for overweight was 0.721 (95%CI 0.447-1.164 p = 0.181) and for obesity 0.462 (95%CI 0.208-1.027, p = 0.058). CONCLUSION No significant association of visceral obesity and BMI with 90-day mortality was observed in critically ill patients, although obesity and visceral obesity tended to be associated with improved 90-day mortality.
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Affiliation(s)
- Michelle R Baggerman
- Maastricht University Medical Center+, Department of Intensive Care Medicine, P. Debyelaan 25, Maastricht, the Netherlands; Maastricht University, School for Nutrition and Translational Research in Metabolism (NUTRIM), Universiteitssingel 40, Maastricht, the Netherlands.; Erasmus University Medical Center, Department of Anesthesiology, Doctor Molewaterplein 40, Rotterdam, The Netherlands.
| | - Ingeborg M Dekker
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Nutrition and Dietetics, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Bjorn Winkens
- Maastricht University, Care and Public Health Research Institute (CAPHRI), Methodology and Statistics, P. Debeyeplein 1, Maastricht, the Netherlands
| | - Steven W M Olde Damink
- Maastricht University, School for Nutrition and Translational Research in Metabolism (NUTRIM), Universiteitssingel 40, Maastricht, the Netherlands.; Maastricht University Medical Center+, Department of Surgery, P. Debyelaan 25, Maastricht, the Netherlands; RWTH University Hospital Aachen, Department of General, Visceral and Transplantation Surgery, Pauwelsstraße 30, Aachen, Germany
| | - Sandra N Stapel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Intensive Care Medicine, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Peter J M Weijs
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Nutrition and Dietetics, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Intensive Care Medicine, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam University of Applied Sciences, Department of Nutrition and Dietetics, Dr. Meurerlaan 8, Amsterdam, the Netherlands
| | - Marcel C G van de Poll
- Maastricht University Medical Center+, Department of Intensive Care Medicine, P. Debyelaan 25, Maastricht, the Netherlands; Maastricht University, School for Nutrition and Translational Research in Metabolism (NUTRIM), Universiteitssingel 40, Maastricht, the Netherlands.; Maastricht University Medical Center+, Department of Surgery, P. Debyelaan 25, Maastricht, the Netherlands
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Yu X, Huang YH, Feng YZ, Cheng ZY, Wang CC, Cai XR. Association of body composition with postoperative complications after laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass. Eur J Radiol 2023; 162:110768. [PMID: 36913816 DOI: 10.1016/j.ejrad.2023.110768] [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: 08/01/2022] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 03/11/2023]
Abstract
OBJECTIVE To evaluate predictive values of body composition parameters measured from preoperative CT/MRIs for postoperative complications after laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (LRYGB) in patients with obesity. METHODS In this retrospective case-control study, patients performing abdominal CT/MRIs within one month before and developing 30-day complications after bariatric procedures were matched for age, sex, and type of surgery with patients without complications (1/3 ratio, respectively). Complications were determined by documentation in the medical record. Two readers blindly segmented the total abdominal muscle area (TAMA) and visceral fat area (VFA) using predetermined thresholds for the Hounsfield unit (HU) on unenhanced CT and the signal intensity (SI) on T1-weighted MRI at the L3 vertebral level. Visceral obesity (VO) was defined as VFA > 136 cm2 in males and > 95 cm2 in females. These measures, along with perioperative variables, were compared. Multivariate logistic regression analyses were performed. RESULTS Of 145 included patients, 36 had postoperative complications. No significant differences between LSG and LRYGB were present regarding complications and VO. Hypertension (p = 0.022), impaired lung function (p = 0.018), American Society of Anesthesiologists (ASA) grade (p = 0.046), VO (p = 0.021), and VFA/TAMA ratio (p < 0.0001) were associated with postoperative complications in the univariate logistic analysis; the VFA/TAMA ratio was the only independent predictor in multivariate analyses (OR 2.01, 95% CI 1.37-2.93, p < 0.001). CONCLUSION The VFA/TAMA ratio provides important perioperative information in predicting patients who are likely to develop postoperative complications undergoing bariatric surgery.
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Affiliation(s)
- Xin Yu
- Medical Imaging Centre, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yan-Hao Huang
- Medical Imaging Centre, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - You-Zhen Feng
- Medical Imaging Centre, First Affiliated Hospital of Jinan University, Guangzhou, China.
| | - Zhong-Yuan Cheng
- Medical Imaging Centre, First Affiliated Hospital of Jinan University, Guangzhou, China.
| | - Cun-Chuan Wang
- Department of General Surgery, First Affiliated Hospital of Jinan University, Guangzhou, China.
| | - Xiang-Ran Cai
- Medical Imaging Centre, First Affiliated Hospital of Jinan University, Guangzhou, China.
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Zhao Z, Zhou L, Han L, Zhou S, Tan Z, Dai R. The visceral pancreatic neck anterior distance may be an effective parameter to predict post-pancreaticoduodenectomy clinically relevant postoperative pancreatic fistula. Heliyon 2023; 9:e13660. [PMID: 36865459 PMCID: PMC9970899 DOI: 10.1016/j.heliyon.2023.e13660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 01/31/2023] [Accepted: 02/07/2023] [Indexed: 02/13/2023] Open
Abstract
Background The clinically relevant postoperative pancreatic fistula (CR-POPF) is significantly correlated with a high post-pancreaticoduodenectomy (PD) mortality rate. Several studies have reported an association between visceral obesity and CR-POPF. Nevertheless, there are many technical difficulties and controversies in the measurement of visceral fat. The aim of this research was to determine whether the visceral pancreatic neck anterior distance (V-PNAD) was a credible predictor for CR-POPF. Methods We retrospectively analyzed the data of 216 patients who underwent PD in our center between January 2016 and August 2021. The correlation of patients' demographic information, imaging variables, and intraoperative data with CR-POPF was assessed. Furthermore, areas under the receiver operating characteristic curves for six distances (abdominal thickness, visceral thickness, abdominal width, visceral width, abdominal PNAD, V-PNAD) were used to identify the best imaging distance to predict POPF. Results In the multivariate logistic analysis, V-PNAD (P < 0.01) was the most significant risk factor for CR-POPF after PD. Males with a V-PNAD >3.97 cm or females with a V-PNAD >3.66 cm were included into the high-risk group. The high-risk group had a higher prevalence of CR-POPF (6.5% vs. 45.1%, P < 0.001), intraperitoneal infection (1.9% vs. 23.9%, P < 0.001), pulmonary infection (3.7% vs. 14.1%, P = 0.012), pleural effusion (17.8% vs. 33.8%, P = 0.014), and ascites (22.4% vs. 40.8%, P = 0.009) than the low-risk group. Conclusion Of all imaging distances, V-PNAD may be the most effective predictor of CR-POPF. Moreover, high-risk patients (males, V-PNAD >3.97 cm; females, V-PNAD >3.66 cm) have a high incidence of CR-POPF and poor short-term post-PD prognosis. Therefore, surgeons should perform PD carefully and take adequate preventive measures to reduce the incidence of pancreatic fistula when the patient has a high V-PNAD.
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Affiliation(s)
- Zhirong Zhao
- College of Medicine, Southwest Jiaotong University, Chengdu, China,General Surgery Center, General Hospital of Western Theater Command, Chengdu, Sichuan Province, China
| | - Lichen Zhou
- General Surgery Center, General Hospital of Western Theater Command, Chengdu, Sichuan Province, China,College of Clinical Medicine Southwest Medical University, Luzhou, Sichuan Province, China
| | - Li Han
- College of Medicine, Southwest Jiaotong University, Chengdu, China,General Surgery Center, General Hospital of Western Theater Command, Chengdu, Sichuan Province, China
| | - Shibo Zhou
- General Surgery Center, General Hospital of Western Theater Command, Chengdu, Sichuan Province, China,College of Clinical Medicine Southwest Medical University, Luzhou, Sichuan Province, China
| | - Zhen Tan
- General Surgery Center, General Hospital of Western Theater Command, Chengdu, Sichuan Province, China
| | - Ruiwu Dai
- College of Medicine, Southwest Jiaotong University, Chengdu, China,General Surgery Center, General Hospital of Western Theater Command, Chengdu, Sichuan Province, China,College of Clinical Medicine Southwest Medical University, Luzhou, Sichuan Province, China,Pancreatic Injury and Repair Key Laboratory of Sichuan Province, General Hospital of Western Theater Command, Chengdu, Sichuan Province, China,Corresponding author. Affiliated Hospital of Southwest Jiaotong University, The General Hospital of Western Theater Command, Chengdu 610031, Sichuan, China.
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Anthropometric Cut-Off Values for Detecting the Presence of Metabolic Syndrome and Its Multiple Components among Adults in Vietnam: The Role of Novel Indices. Nutrients 2022; 14:nu14194024. [PMID: 36235677 PMCID: PMC9571833 DOI: 10.3390/nu14194024] [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: 08/20/2022] [Revised: 09/19/2022] [Accepted: 09/23/2022] [Indexed: 11/18/2022] Open
Abstract
Recent studies have shown that using international guidelines to diagnose metabolic syndrome (MetS) may underestimate its prevalence in different Asian populations. This study aims to determine the validity of anthropometric indicators and appropriate cut-off values to predict MetS for Vietnamese adults. We analyzed data on 4701 adults across four regions of Vietnam. Four conventional and five novel anthropometric indexes were calculated. The area under a receiver operating characteristic (ROC) curve (AUC) and Youden’s J statistic were applied to evaluate the diagnostic ability and optimal cut-off values. Regardless of diagnostic criteria and gender, Abdominal volume index (AVI), Body roundness index (BRI), and Waist-height ratio (WHtR) had the highest AUC values, followed by Body mass index (BMI) and Waist-hip ratio (WHR). However, it was seen that differences among the AUC values of most indices were minor. In men, using International Diabetes Federation (IDF) criteria, the threshold of indices was 3.86 for BRI, 16.20 for AVI, 0.53 for WHtR, 22.40 for BMI, and 0.90 for WHR. In women, the threshold for these figures were 3.60, 12.80, 0.51, 23.58, and 0.85, respectively. It is recommended that health personnel in Vietnam should apply appropriate thresholds of anthropometry, which are lower than current international guidelines, for MetS screening to avoid under-diagnosis.
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Lee S, Kim KW, Lee J. Sex-specific Cutoff Values of Visceral Fat Area for Lean vs. Overweight/Obese Nonalcoholic Fatty Liver Disease in Asians. J Clin Transl Hepatol 2022; 10:595-599. [PMID: 36062272 PMCID: PMC9396328 DOI: 10.14218/jcth.2021.00379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 10/17/2021] [Accepted: 10/30/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND AND AIMS Visceral obesity is a risk factor for nonalcoholic fatty liver disease (NAFLD). We investigated sex-specific optimal cutoff values for visceral fat area (VFA) associated with lean and overweight/obese NAFLD in an Asian population. METHODS This retrospective study included 678 potential living liver donors (mean age, 30.8±9.4 years; 434 men and 244 women) who had undergone abdominal computed tomography (CT) imaging and liver biopsy between November 2016 and October 2017. VFA was measured using single-slice abdominal CT. NAFLD was evaluated by liver biopsy (≥5% hepatic steatosis). Receiver operating characteristic curve analysis was used to determine cutoff values for VFA associated with lean (body mass index [BMI] <23 kg/m2) and overweight/obese (BMI ≥23 kg/m2) NAFLD. RESULTS Area under the curve (AUC) values with 95% confidence intervals (CI) for VFA were 0.82 (95% CI, 0.75-0.88) for lean and 0.74 (95% CI, 0.69-0.79) for overweight/obese men with NAFLD. The AUC values were 0.67 (95% CI, 0.58-0.75) for lean and 0.71 (95% CI, 0.62-0.80) for overweight/obese women with NAFLD. The cutoff values for VFA associated with lean NAFLD were 50.2 cm2 in men and 40.5 cm2 in women. The optimal cutoff values for VFA associated with overweight/obese NAFLD were 100.6 cm2 in men and 68.0 cm2 in women. CONCLUSIONS Sex-specific cutoff values for VFA may be useful for identifying subjects at risk of lean and overweight/obese NAFLD.
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Affiliation(s)
- Sunyoung Lee
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Correspondence to: Sunyoung Lee, Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea. Tel: +82-2-2228-7400, Fax: +82-2-2227-8337, E-mail:
| | - Kyoung Won Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jeongjin Lee
- School of Computer Science and Engineering, Soongsil University, Seoul, Republic of Korea
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12
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Kim EH, Kim HK, Lee MJ, Bae SJ, Choe J, Jung CH, Kim CH, Park JY, Lee WJ. Sex Differences of Visceral Fat Area and Visceral-to-Subcutaneous Fat Ratio for the Risk of Incident Type 2 Diabetes Mellitus. Diabetes Metab J 2022; 46:486-498. [PMID: 34911174 PMCID: PMC9171158 DOI: 10.4093/dmj.2021.0095] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/30/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND This study aimed to determine the optimal cut-off values of visceral fat area (VFA) and visceral-to-subcutaneous fat ratio (VSR) for predicting incident type 2 diabetes mellitus (T2DM). METHODS A total of 10,882 individuals (6,835 men; 4,047 women) free of T2DM at baseline aged between 30 and 79 years who underwent abdominal computed tomography scan between 2012 and 2013 as a part of routine health check-ups were included and followed. VFA, subcutaneous fat area, and VSR on L3 vertebral level were measured at baseline. RESULTS During a median follow-up of 4.8 years, 730 (8.1% for men; 4.3% for women) incident cases of T2DM were identified. Receiver operating characteristic curve analysis showed that the optimal cut-off values of VFA and VSR for predicting incident T2DM were 130.03 cm2 and 1.08 in men, respectively, and 85.7 cm2 and 0.48 in women, respectively. Regardless of sex, higher VFA and VSR were significantly associated with a higher risk of incident T2DM. Compared with the lowest quartiles of VFA and VSR, the highest quartiles had adjusted odds ratios of 2.62 (95% confidence interval [CI], 1.73 to 3.97) and 1.55 (95% CI, 1.14 to 2.11) in men, respectively, and 32.49 (95% CI, 7.42 to 142.02) and 11.07 (95% CI, 3.89 to 31.50) in women, respectively. CONCLUSION Higher VFA and VSR at baseline were independent risk factors for the development of T2DM. Sex-specific reference values for visceral fat obesity (VFA ≥130 cm2 or VSR ≥1.0 in men; VFA ≥85 cm2 or VSR ≥0.5 in women) are proposed for the prediction of incident T2DM.
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Affiliation(s)
- Eun Hee Kim
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hong-Kyu Kim
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Corresponding authors: Hong-Kyu Kim https://orcid.org/0000-0002-7606-3521 Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea E-mail:
| | - Min Jung Lee
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Jin Bae
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jaewon Choe
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang Hee Jung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea
- Asan Diabetes Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chul-Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Joong-Yeol Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea
- Asan Diabetes Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Je Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea
- Asan Diabetes Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Woo Je Lee https://orcid.org/0000-0002-9605-9693 Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea E-mail:
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13
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Computed tomography reference values for visceral obesity and increased metabolic risk in a Caucasian cohort. Clin Nutr ESPEN 2022; 48:408-413. [DOI: 10.1016/j.clnesp.2022.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/17/2021] [Accepted: 01/10/2022] [Indexed: 12/28/2022]
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14
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Kim YA, Kwak SG, Cho YJ. Optimal cutoff values for visceral fat volume to predict metabolic syndrome in a Korean population. Medicine (Baltimore) 2021; 100:e27114. [PMID: 34516502 PMCID: PMC8428730 DOI: 10.1097/md.0000000000027114] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/16/2021] [Indexed: 01/05/2023] Open
Abstract
Previous studies have reported the association between visceral fat and metabolic syndrome (MS); however, just few studies have been conducted to evaluate the relationship between actual visceral fat volume (VFV) and MS. This study aimed to obtain 3 dimensional VFV and subcutaneous fat volume (SFV) using abdominal computed tomography (CT) and determine MS-predictive cutoff values.A total of 250 individuals, aged 27 to 80 years, who underwent health screening with abdominal CT between November 2019 and May 2020 were included. The subcutaneous (SFA) and visceral (VFA) fat areas were quantified using axial images obtained at the level of the lowest to the highest part of the umbilicus. The SFV and VFV were quantified from the highest level of the liver dome to the pelvic floor on axial CT images. The Aquarius iNtuition software program (TeraRecon, Foster City, CA) was used to calculate the SFA, VFA, SFV, and VFV. Subcutaneous fat mass and visceral fat mass (VFM) were measured using an adipose tissue density of 0.9 g/mL. We used the modified criteria of MS proposed by the Third National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults and waist circumference of ≥90 cm in men and ≥85 cm in women to define MS. Multivariate analysis of covariance was used to compare the fat areas, volumes, and mass according to the presence of MS and sex. Additionally, a receiver operating characteristic curve analysis was performed to determine the cutoff values for VFV, SFV, VFM, subcutaneous fat mass, VFA, and SFA associated with MS.Of the assessed variables, VFV and VFM had the highest area under the receiver operating characteristic curve value for predicting MS in both men and women: 0.811 (95% confidence interval, 0.743-0.868) for men and 0.826 (95% confidence interval, 0.727-0.900) for women. The MS-predictive cutoff values were 4852 cm3 and 4366.8 g for men and 3101 cm3 and 2790.9 g for women, respectively. Further, large, population-based studies are needed to validate these cutoff values.
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Affiliation(s)
- Yun-A Kim
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Sang Gyu Kwak
- Department of Medical Statistics, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Yoon Jeong Cho
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
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15
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Kim GH, Choi KD, Ko Y, Park T, Kim KW, Park SY, Na HK, Ahn JY, Lee JH, Jung KW, Kim DH, Song HJ, Lee GH, Jung HY. Impact of Comorbidities, Sarcopenia, and Nutritional Status on the Long-Term Outcomes after Endoscopic Submucosal Dissection for Early Gastric Cancer in Elderly Patients Aged ≥ 80 Years. Cancers (Basel) 2021; 13:3598. [PMID: 34298811 PMCID: PMC8304160 DOI: 10.3390/cancers13143598] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/05/2021] [Accepted: 07/14/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND/AIM We investigated the oncologic outcomes in elderly patients who underwent endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) by focusing on the impact of comorbidities, sarcopenia, and nutritional status. METHODS Between 2005 and 2016, 280 patients aged ≥ 80 years with 289 EGCs underwent ESD at a tertiary care center. The short- and long-term survival outcomes were assessed. Cox regression analysis was used to identify factors associated with survival, including clinicopathologic factors and abdominal muscle area measured by computed tomography. RESULTS The rates of en bloc, R0, and, curative resection were 99.3%, 90.0%, and 69.2%, respectively. The rates of post-ESD bleeding and perforation rates were 2.1% and 3.1%, respectively, and no cases showed significant life-threatening adverse events. Over a median follow-up period of 70.5 months, the 3- and 5-year overall survival (OS) rates were 89.5% and 77.1%, respectively; of the114 patients who died, only four (3.5%) were due to gastric cancer. A total of 173 (61.8%) had sarcopenia, and they had lower rates of 3-year (88.4% vs. 91.4%) and 5-year (73.1% vs. 84.0%; p = 0.046) OS than did those without sarcopenia. In multivariable analyses, prognostic nutritional index (hazard ratio [HR], 0.93; 95% confidence interval [CI]: 0.90-0.98; p = 0.002) and Charlson comorbidity index (HR 1.19; 95% CI: 1.03-1.37; p = 0.018) were significant factors associated with overall survival. CONCLUSIONS ESD was a feasible and safe therapeutic method to use in elderly patients, whose long-term survival was significantly associated with nutritional status and comorbidities. These results suggest the need for a possible extension of the curative criteria for ESD in elderly patients with EGC.
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Affiliation(s)
- Ga Hee Kim
- Asan Medical Center, Department of Gastroenterology, University of Ulsan College of Medicine, Seoul 05505, Korea; (G.H.K.); (H.K.N.); (J.Y.A.); (J.H.L.); (K.W.J.); (D.H.K.); (H.J.S.); (G.H.L.); (H.-Y.J.)
| | - Kee Don Choi
- Asan Medical Center, Department of Gastroenterology, University of Ulsan College of Medicine, Seoul 05505, Korea; (G.H.K.); (H.K.N.); (J.Y.A.); (J.H.L.); (K.W.J.); (D.H.K.); (H.J.S.); (G.H.L.); (H.-Y.J.)
| | - Yousun Ko
- Biomedical Reseach Center, Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul 05505, Korea;
| | - Taeyong Park
- Asan Medical Center, Department of Radiology, University of Ulsan College of Medicine, Seoul 05505, Korea; (T.P.); (K.W.K.)
| | - Kyung Won Kim
- Asan Medical Center, Department of Radiology, University of Ulsan College of Medicine, Seoul 05505, Korea; (T.P.); (K.W.K.)
| | - Seo Young Park
- Department of Statistics and Data Science, Korea National Open University, Seoul 05505, Korea;
| | - Hee Kyong Na
- Asan Medical Center, Department of Gastroenterology, University of Ulsan College of Medicine, Seoul 05505, Korea; (G.H.K.); (H.K.N.); (J.Y.A.); (J.H.L.); (K.W.J.); (D.H.K.); (H.J.S.); (G.H.L.); (H.-Y.J.)
| | - Ji Yong Ahn
- Asan Medical Center, Department of Gastroenterology, University of Ulsan College of Medicine, Seoul 05505, Korea; (G.H.K.); (H.K.N.); (J.Y.A.); (J.H.L.); (K.W.J.); (D.H.K.); (H.J.S.); (G.H.L.); (H.-Y.J.)
| | - Jeong Hoon Lee
- Asan Medical Center, Department of Gastroenterology, University of Ulsan College of Medicine, Seoul 05505, Korea; (G.H.K.); (H.K.N.); (J.Y.A.); (J.H.L.); (K.W.J.); (D.H.K.); (H.J.S.); (G.H.L.); (H.-Y.J.)
| | - Kee Wook Jung
- Asan Medical Center, Department of Gastroenterology, University of Ulsan College of Medicine, Seoul 05505, Korea; (G.H.K.); (H.K.N.); (J.Y.A.); (J.H.L.); (K.W.J.); (D.H.K.); (H.J.S.); (G.H.L.); (H.-Y.J.)
| | - Do Hoon Kim
- Asan Medical Center, Department of Gastroenterology, University of Ulsan College of Medicine, Seoul 05505, Korea; (G.H.K.); (H.K.N.); (J.Y.A.); (J.H.L.); (K.W.J.); (D.H.K.); (H.J.S.); (G.H.L.); (H.-Y.J.)
| | - Ho June Song
- Asan Medical Center, Department of Gastroenterology, University of Ulsan College of Medicine, Seoul 05505, Korea; (G.H.K.); (H.K.N.); (J.Y.A.); (J.H.L.); (K.W.J.); (D.H.K.); (H.J.S.); (G.H.L.); (H.-Y.J.)
| | - Gin Hyug Lee
- Asan Medical Center, Department of Gastroenterology, University of Ulsan College of Medicine, Seoul 05505, Korea; (G.H.K.); (H.K.N.); (J.Y.A.); (J.H.L.); (K.W.J.); (D.H.K.); (H.J.S.); (G.H.L.); (H.-Y.J.)
| | - Hwoon-Yong Jung
- Asan Medical Center, Department of Gastroenterology, University of Ulsan College of Medicine, Seoul 05505, Korea; (G.H.K.); (H.K.N.); (J.Y.A.); (J.H.L.); (K.W.J.); (D.H.K.); (H.J.S.); (G.H.L.); (H.-Y.J.)
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16
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Villegas-Valle RC, Lim U, Maskarinec G, Franke AA, Ernst T, Fan B, Álvarez-Hernández G, Candia-Plata MDC, Díaz-Zavala RG, Wilkens LR, Monroe KR, Valencia ME, Le Marchand L, Shepherd JA. Metabolic syndrome screening using visceral adipose tissue (VAT) from opportunistic MRI locations in a multi-ethnic population. Obes Res Clin Pract 2021; 15:227-234. [PMID: 34024755 DOI: 10.1016/j.orcp.2021.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 03/06/2021] [Accepted: 03/09/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To determine if visceral adipose tissue (VAT) area measured through MRI can be used opportunistically to assess the presence of cardiometabolic risk factors and compare its performance to simpler adiposity measures. METHODS A cross-sectional analysis was carried out on a subset of 1683 participants (856 women) from the Adiposity Phenotype Study (mean age=69.2y; range 59.9-77.4). The association of total VAT area (sum of four cross sections, L1-L2, L2-L3, L3-L4, L4-L5) and each location, as well as BMI and body fat % (per SD) with the metabolic syndrome (MetSx) or its components was evaluated through logistic regression analysis. RESULTS Total VAT can be accurately predicted using all sites evaluated (R2 range=0.82-0.96). In men, VAT did not show a superior association to MetSx compared to BMI in men. However, in women, VAT was consistently superior to BMI and body fat % in its association to MetSx, independent of ethnicity [odds ratio for BMI, body fat %and total VAT area=2.25 (95% CI: 1.93-2.62); 1.66 (95% CI: 1.36-2.03); 6.20 (95% CI: 4.69-8.21) respectively in all women]. Ethnic-specific odds ratios to MetSx in women ranged from 5.38 to 8.63 for total VAT area and 2.12-4.08 for BMI. CONCLUSION Total VAT area can be accurately predicted from individual VAT regions in men and women and offers superior association to BMI for MetSx in women but not in men for five ethnicities. Therefore, opportunistic screening for elevated VAT area in women may be warranted across multiple ethnic groups.
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Affiliation(s)
- Rosa C Villegas-Valle
- Graduate Program on Chemical and Biological Sciences, University of Sonora, Blvd. Luis Encinas y Rosales S/N, Col. Centro, Hermosillo, Sonora, 83000, Mexico.
| | - Unhee Lim
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA.
| | - Gertraud Maskarinec
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA.
| | - Adrian A Franke
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA.
| | - Thomas Ernst
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii, 1356 Lusitana Street, University Tower, 7th Floor, Honolulu, HI, 96813, USA.
| | - Bo Fan
- Department of Epidemiology & Biostatistics, University of California-San Francisco, 550 16th Street, 2nd Floor, San Francisco, CA, 94158-2549, USA.
| | - Gerardo Álvarez-Hernández
- Department of Medicine and Health Sciences, University of Sonora, Avenida Luis Donaldo Colosio y Calle de la Reforma, Hermosillo, Sonora, 83000, Mexico.
| | - Maria Del Carmen Candia-Plata
- Department of Medicine and Health Sciences, University of Sonora, Avenida Luis Donaldo Colosio y Calle de la Reforma, Hermosillo, Sonora, 83000, Mexico.
| | - Rolando Giovanni Díaz-Zavala
- Department of Chemical and Biological Sciences, University of Sonora, Blvd. Luis Encinas y Rosales S/N, Hermosillo, Sonora, 83000, Mexico.
| | - Lynne R Wilkens
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA.
| | - Kristine R Monroe
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 North Soto Street, Los Angeles, CA, 90033, USA.
| | - Mauro E Valencia
- Department of Chemical and Biological Sciences, University of Sonora, Blvd. Luis Encinas y Rosales S/N, Hermosillo, Sonora, 83000, Mexico.
| | - Loïc Le Marchand
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA.
| | - John A Shepherd
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA.
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17
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Visceral fat area and cardiometabolic risk: The Kardiovize study. Obes Res Clin Pract 2021; 15:368-374. [PMID: 33744224 DOI: 10.1016/j.orcp.2021.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/09/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND Visceral fat is associated with adiposity-based complications. Bioimpedance measurement allows estimation of visceral fat area (VFA) in an easy manner. However, a validated cut-off value for VFA by bioimpedance associated with cardiometabolic risk is lacking in European population. AIM To determine cut-off values of VFA measured via bioimpedance associated with cardiometabolic risk. METHODS Random cross-sectional Czech population-based sample of 25-64 years old subjects. Receiver Operating Characteristic (ROC) curves were used and the area under the curve (AUC), sensitivity, and specificity were calculated. The Cardiometabolic Disease Staging System (CMDS) was used to classify cardiometabolic risk: Stage 1 - 1 or 2 metabolic syndrome (MetS) components, without impaired fasting glucose (IFG); Stage 2 - MetS or IFG; Stage 3 - MetS with IFG; Stage 4 - type 2 diabetes and/or cardiovascular disease. RESULTS 2052 participants (54.5% females, median age 49 years) were included. Median VFA (inter-quartile range) were 82.2 cm2 (54.8) in men and 89.8 cm2 (55.6) in women. The best VFA cut-offs associated with Stage 1 in men and women were 71 cm2 (sensitivity = 0.654; specificity = 0.427) and 83 cm2 (sensitivity = 0.705; specificity = 0.556) ; Stage 2: 84 cm2 (sensitivity = 0.673; specificity = 0.551) and 98 cm2 (sensitivity = 0.702; specificity = 0.628) ; Stage 3: 90 cm2 (sensitivity = 0.886; specificity = 0.605) and 109 cm2 (sensitivity = 0.755; specificity = 0.704); Stage 4: 91 cm2 (sensitivity = 0.625; specificity = 0.611) and 81 cm2 (sensitivity = 0.695; specificity = 0.448), respectively. CONCLUSION A cut-off value of VFA of 71 cm2 in men and 83 cm2 in women exhibited the earliest stage of cardiometabolic risk, and 90 cm2 in men and 109 cm2 in women showed the best performance to detect risk.
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18
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Muilwijk M, Callender N, Goorden S, Vaz FM, van Valkengoed IGM. Sex differences in the association of sphingolipids with age in Dutch and South-Asian Surinamese living in Amsterdam, the Netherlands. Biol Sex Differ 2021; 12:13. [PMID: 33436072 PMCID: PMC7805203 DOI: 10.1186/s13293-020-00353-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/26/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Men have a higher risk for cardiovascular disease (CVD) early in life, while women have a higher risk later in life. The sex-related differences in CVD risk, especially by age, could be related to sphingolipid metabolism. We compared plasma sphingolipid concentrations and its increase by age in men and women. METHODS Plasma concentrations of 13 types of sphingolipids were measured by liquid chromatography-tandem mass spectrometry in a random subsample of 328 men and 372 women of Dutch and South-Asian Surinamese ethnic origin, participating in the HELIUS study. Sphingolipid concentrations were compared between men and women by age group (18-39, 40-55, and 56-70 years). Multiple linear regression was used to determine sex differences in age trends in sphingolipids stratified by ethnicity. Analyses were performed without adjustment and adjusted for body mass index (BMI) and waist circumference. RESULTS At age 18-39 years, sphingolipid concentrations were lower in women than those in men, but at age 56-70 years this was reversed. At higher age, women showed higher concentrations than men. In line, we observed a more rapid increase of sphingolipid concentrations by age in women than in men. The observed sex differences were not explained by BMI or waist circumference. Patterns of sex differences were similar across ethnic groups, although the strength of associations differed. CONCLUSIONS Mean sphingolipid concentrations increase more rapidly with age in women than in men. Therefore, plasma lipid concentrations of sphingolipids, although lower in women than in men at younger age, are higher in women than in men at older age.
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Affiliation(s)
- Mirthe Muilwijk
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, The Netherlands.
| | - Nardie Callender
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, The Netherlands
| | - Susan Goorden
- Amsterdam UMC, University of Amsterdam, Laboratory Genetic Metabolic Diseases, Meibergdreef 9, Amsterdam, The Netherlands
| | - Frédéric M Vaz
- Amsterdam UMC, University of Amsterdam, Laboratory Genetic Metabolic Diseases, Meibergdreef 9, Amsterdam, The Netherlands
| | - Irene G M van Valkengoed
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, The Netherlands
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Usefulness of Different Imaging Modalities in Evaluation of Patients with Non-Alcoholic Fatty Liver Disease. Biomedicines 2020; 8:biomedicines8090298. [PMID: 32839409 PMCID: PMC7556032 DOI: 10.3390/biomedicines8090298] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/13/2020] [Accepted: 08/19/2020] [Indexed: 12/14/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are becoming some of the major health problems in well-developed countries, together with the increasing prevalence of obesity, metabolic syndrome, and all of their systemic complications. As the future prognoses are even more disturbing and point toward further increase in population affected with NAFLD/NASH, there is an urgent need for widely available and reliable diagnostic methods. Consensus on a non-invasive, accurate diagnostic modality for the use in ongoing clinical trials is also required, particularly considering a current lack of any registered drug for the treatment of NAFLD/NASH. The aim of this narrative review was to present current information on methods used to assess liver steatosis and fibrosis. There are several imaging modalities for the assessment of hepatic steatosis ranging from simple density analysis by computed tomography or conventional B-mode ultrasound to magnetic resonance spectroscopy (MRS), magnetic resonance imaging proton density fat fraction (MRI-PDFF) or controlled attenuation parameter (CAP). Fibrosis stage can be assessed by magnetic resonance elastography (MRE) or different ultrasound-based techniques: transient elastography (TE), shear-wave elastography (SWE) and acoustic radiation force impulse (ARFI). Although all of these methods have been validated against liver biopsy as the reference standard and provided good accuracy, the MRS and MRI-PDFF currently outperform other methods in terms of diagnosis of steatosis, and MRE in terms of evaluation of fibrosis.
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20
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Lee YH, Park J, Min S, Kang O, Kwon H, Oh SW. Impact of Visceral Obesity on the Risk of Incident Metabolic Syndrome in Metabolically Healthy Normal Weight and Overweight Groups: A Longitudinal Cohort Study in Korea. Korean J Fam Med 2020; 41:229-236. [PMID: 32344994 PMCID: PMC7385301 DOI: 10.4082/kjfm.18.0122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 10/23/2018] [Indexed: 01/10/2023] Open
Abstract
Background Although both obesity, measured by body mass index, and visceral obesity are known to be major risk factors of metabolic syndrome and its components, there have been debates on the relative contribution of general obesity and visceral obesity to the development of metabolic syndrome. Methods We performed a large longitudinal cohort study of 3,093 subjects (age range, 18–65 years) who were metabolically healthy and had a normal weight who received health screenings over a 3-year follow-up period. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for incident metabolic syndrome and its components per sex-specific 1-standard deviation (SD) increase in visceral adipose tissue (VAT) and body mass index. Results Both obesity and visceral obesity increased the risk of incident metabolic syndrome, but when HR was compared per sex-specific 1-SD, visceral obesity appeared to confer more risk than simple obesity. The HR for 1-SD of body mass index was 1.19 (95% CI, 1.07–1.32; P=0.001) in men and 1.29 (95% CI, 1.10–1.52; P=0.002) in women, while the HR for 1-SD of VAT was 1.29 (95% CI, 1.15–1.44; P<0.001) in men and 1.50 (95% CI, 1.28–1.75; P<0.001) in women. Conclusion Visceral obesity and obesity were longitudinally associated with an increased risk of incident metabolic syndrome among metabolically healthy adults, and visceral fat accumulation appears to be better predictor of metabolic syndrome.
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Affiliation(s)
- Yoon Hye Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jiyong Park
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Seran Min
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Oklim Kang
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hyuktae Kwon
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Seung-Won Oh
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
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21
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Effects of abdominal obesity on the association between air pollution and kidney function. Int J Obes (Lond) 2020; 44:1568-1576. [PMID: 31992841 DOI: 10.1038/s41366-020-0540-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/08/2020] [Accepted: 01/16/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES This study aimed to evaluate the associations between ambient air pollutants, obesity, and kidney function. SUBJECTS/METHODS We enrolled 3345 people who had undergone health checkups at Seoul National University Hospital. We recorded the annual average concentrations of ambient air pollutants, including particulate matter with an aerodynamic diameter of ≤10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO), in each subject's residential area. Various obesity traits, such as body mass index, waist circumference, and visceral and subcutaneous adipose tissue areas, were measured by quantified computerized tomography (CT), and kidney function was assessed in relation to estimated glomerular filtration rate as an indicator of kidney function. RESULTS High PM10, NO2, SO2, and CO concentrations were significantly associated with decreased kidney function (β = -2.39 and standard error = 0.32, -1.00 and 0.31, -1.23 and 0.28, and -1.32 and 0.29, respectively), and with the prevalence of chronic kidney disease (CKD). The association between air pollutant concentrations and decreased kidney function, including CKD, was stronger among those with high abdominal adiposity, as defined by CT measurement. For example, the association between increased concentrations of air pollutants and the prevalence of CKD was stronger in the group with greater visceral adiposity than in the group with less visceral adiposity (aORs = 1.29 vs 1.16 for PM10, 1.42 vs 1.21 for SO2, and 1.27 vs 1.11 for CO). CONCLUSIONS Long-term exposure to higher concentrations of air pollutants was unfavorably associated with kidney function and CKD prevalence, especially in people with abdominal obesity. This may indicate a high susceptibility to air pollutants in obese people.
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Jang M, Park HW, Huh J, Lee JH, Jeong YK, Nah YW, Park J, Kim KW. Predictive value of sarcopenia and visceral obesity for postoperative pancreatic fistula after pancreaticoduodenectomy analyzed on clinically acquired CT and MRI. Eur Radiol 2019; 29:2417-2425. [PMID: 30406311 DOI: 10.1007/s00330-018-5790-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 09/06/2018] [Accepted: 09/21/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To evaluate predictive values of sarcopenia and visceral obesity measured from preoperative CT/MRIs for postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy in patients with periampullary malignancies. METHODS From the prospectively constructed surgical registry, we included adult patients treated with pancreaticoduodenectomy. Based on CT/MRIs, body morphometric analysis was performed to evaluate the visceral obesity and sarcopenia, based on the areas of visceral fat and skeletal muscle measured at the L3 vertebrae level. We retrieved various perioperative factors from registry. As outcomes of postoperative complications, we evaluated POPF and major complications based on the Clavien-Dindo classification. Multivariate logistic regression analyses were performed. RESULTS From a total of 284 patients (163 males, 121 females) who met the inclusion/exclusion criteria, POPF, major complications, and 60-day mortality occurred in 52 (18.3%), 34 (12.0%), and 6 (2.1%), respectively. Sarcopenia and visceral obesity were noted in 123 (75.5%) and 66 (40.5%) of men and 68 (56.2%) and 53 (43.8%) of women, respectively. Combination of sarcopenia and obesity (sarcopenic obesity) was noted in 31.9% (52/163) of men and in 26.4% (32/121) of women. In multivariate logistic regression analyses, sarcopenic obesity was the only independent predictor for POPF (OR 2.65, 95% CI 1.43-4.93), and the vascular resection during pancreaticoduodenectomy was the only independent predictor for severe complications (OR 3.75, 95% CI 1.61-8.70). CONCLUSION Sarcopenic obesity might be highly predictive for POPF. Body morphometric analysis in preoperative CT/MRI combined with assessment of perioperative clinical features may help to identify high-risk patients and determine perioperative management strategies. KEY POINTS • Sarcopenic obesity might be predictive for postoperative pancreatic fistula after pancreaticoduodenectomy. • The vascular resection during pancreaticoduodenectomy might be predictive of major complications. • Body morphometric analysis might be helpful for identifying high-risk patients.
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Affiliation(s)
- Minji Jang
- Department of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, South Korea
| | - Hyung Woo Park
- Department of Surgery, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, South Korea
| | - Jimi Huh
- Department of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, South Korea.
- Department of Radiology, Ajou University School of Medicine & Graduate School of Medicine, Ajou University Medical Center, 164 World cup-ro, Yeongtong-gu, Suwon, 16499, South Korea.
| | - Jong Hwa Lee
- Department of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, South Korea
| | - Yoong Ki Jeong
- Department of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, South Korea
| | - Yang Won Nah
- Department of Surgery, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, South Korea
| | - Jisuk Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Kyung Won Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
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Wang Q, Zheng D, Liu J, Fang L, Li Q. Skeletal muscle mass to visceral fat area ratio is an important determinant associated with type 2 diabetes and metabolic syndrome. Diabetes Metab Syndr Obes 2019; 12:1399-1407. [PMID: 31616170 PMCID: PMC6698596 DOI: 10.2147/dmso.s211529] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 07/25/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Skeletal muscle mass to visceral fat area ratio (SVR) were shown to be related to some chronic diseases, such as non-alcoholic fatty liver diseases. The aim of this study is to determine whether the SVR is associated with metabolic syndrome (MS) and type 2 diabetes (T2DM). METHODS A total of 798 subjects were included in this cross-sectional study. Lipid profiles, plasma glucose, blood pressure, waist circumference (WC) and body mass index (BMI) were grouped by the SVR. The associations between the SVR and T2DM and MS were examined using logistic regression to determine whether the SVR was associated with T2DM and MS. RESULTS Lipid profiles, glucose levels, blood pressure, WC and BMI showed significant differences when stratified based on the extent of SVR. The SVR levels were also significantly higher in subjects without MS or T2DM than in those with MS or T2DM. The SVR was inversely correlated with lipid profiles and WC and was especially correlated with BMI, with an r>0.5. The SVR was identified as a risk factor for T2DM and MS after adjusting age and sex. SVR can predict T2DM [area under the curve =0.726, 95% CI (0.669-0.782), p<0.001] and MS [area under the curve =0.730, 95% CI (0.694-0.766), p<0.001]. The suitable cut-off value is 0.230 for T2DM (sensitivity 0.696, specificity 0.694) and 0.278 for the onset of MS (sensitivity 0.518, specificity 0.862). CONCLUSION The SVR is closely associated with an increased risk for exacerbating T2DM and MS and can be used as a diagnostic indicator for T2DM and MS.
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Affiliation(s)
- Qian Wang
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, People’s Republic of China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Jinan, Shandong, People’s Republic of China
- Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong, People’s Republic of China
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, People’s Republic of China
| | - Dongmei Zheng
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, People’s Republic of China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Jinan, Shandong, People’s Republic of China
- Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong, People’s Republic of China
| | - Jia Liu
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, People’s Republic of China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Jinan, Shandong, People’s Republic of China
- Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong, People’s Republic of China
| | - Li Fang
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, People’s Republic of China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Jinan, Shandong, People’s Republic of China
- Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong, People’s Republic of China
| | - Qiu Li
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, People’s Republic of China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Jinan, Shandong, People’s Republic of China
- Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong, People’s Republic of China
- Correspondence: Qiu LiDepartment of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jing 5 Road, Jinan, Shandong Province250021, People’s Republic of ChinaEmail
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Kim EH, Kim HK, Bae SJ, Lee MJ, Hwang JY, Choe J, Jung CH, Lee WJ, Park JY. Gender differences of visceral fat area for predicting incident type 2 diabetes in Koreans. Diabetes Res Clin Pract 2018; 146:93-100. [PMID: 30321564 DOI: 10.1016/j.diabres.2018.09.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 09/17/2018] [Accepted: 09/28/2018] [Indexed: 10/28/2022]
Abstract
AIMS Visceral fat accumulation is known to be an independent risk factor for type 2 diabetes. We aimed to determine the optimal cutoff values of visceral fat area (VFA) for predicting incident type 2 diabetes in Koreans. METHODS Our study population consisted of 13,004 individuals initially free of type 2 diabetes the ages between 20 and 69 years, who underwent routine health examinations between January 2012 and December 2012 and returned for follow-up examinations between January 2016 and December 2016. VFA values were derived from bioelectrical impedance analysis (BIA) at baseline. RESULTS During a median follow-up of 4.02 years, a total of 481 (4.6% for men and 2.3% for women) incident cases of type 2 diabetes were identified. According to the receiver operating characteristic (ROC) curve, the optimal VFA cutoff values for predicting incident type 2 diabetes were 118.8 cm2 in men and 82.6 cm2 in women, respectively. In a multivariable-adjusted model including obesity and glycemic status, the odds ratios (ORs) of VFA over 120 cm2 in men and 80 cm2 in women were 1.72 and 3.56, respectively. CONCLUSIONS Higher VFA at baseline was an independent risk factor for developing type 2 diabetes and the optimal VFA cutoff values were markedly different between men and women. Therefore, sex-specific reference values for visceral fat obesity such that men with a VFA ≥120 cm2 and women with a VFA ≥80 cm2 should be considered to predict incident type 2 diabetes.
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Affiliation(s)
- Eun Hee Kim
- Department of Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hong-Kyu Kim
- Department of Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Sung-Jin Bae
- Department of Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Min Jung Lee
- Department of Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jenie Yoonoo Hwang
- Department of International Healthcare Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jaewon Choe
- Department of Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Chang Hee Jung
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Woo Je Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Joong-Yeol Park
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Xia MF, Lin HD, Chen LY, Wu L, Ma H, Li Q, Aleteng Q, Chen Y, Sun YX, Hu Y, Pan BS, Li XY, Gao X. Association of visceral adiposity and its longitudinal increase with the risk of diabetes in Chinese adults: A prospective cohort study. Diabetes Metab Res Rev 2018; 34:e3048. [PMID: 30035847 DOI: 10.1002/dmrr.3048] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 07/04/2018] [Accepted: 07/15/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVE A Chinese visceral adiposity index (CVAI) was recently established to estimate the visceral fat area in Chinese adults. This study aimed to investigate the risk of incident prediabetes and diabetes in relation to visceral adiposity calculated by CVAI. METHODS A total of 2558 subjects with normal plasma glucose levels from the Shanghai Changfeng Study were enrolled in a prospective cohort study. The independent associations of basal visceral fat area by CVAI and its longitudinal change with incident prediabetes and diabetes were identified using Cox regression analyses. RESULTS During an average of 4.4 years of follow-up, 546 (21.3%) and 99 (3.9%) of 2558 nondiabetic subjects developed prediabetes and diabetes, respectively. Visceral fat area by CVAI and its longitudinal increase were independently associated with incident prediabetes and diabetes in Chinese adults. In a multivariable-adjusted regression model, CVAI, as well as its annual change, was the strongest independent predictor of incident prediabetes (HR, 1.383 [1.162-1.647]) and diabetes (HR, 1.607 [1.092-2.364]) compared with other estimates of obesity (BMI and waist circumference). Receiver operating characteristic curve analyses showed that CVAI had better performance than BMI and waist circumference for the prediction of prediabetes and diabetes in Chinese adults. CONCLUSIONS Visceral adiposity plays a pivotal role in the pathogenesis of diabetes, and the visceral adiposity estimated by CVAI is superior to the traditional estimates of obesity for the prediction of incident prediabetes and diabetes in Chinese adults.
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Affiliation(s)
- Ming-Feng Xia
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
- Fudan Institute for Metabolic Diseases, Fudan University, Shanghai, China
| | - Huan-Dong Lin
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
- Fudan Institute for Metabolic Diseases, Fudan University, Shanghai, China
| | - Ling-Yan Chen
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Li Wu
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
- Fudan Institute for Metabolic Diseases, Fudan University, Shanghai, China
| | - Hui Ma
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qian Li
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
- Fudan Institute for Metabolic Diseases, Fudan University, Shanghai, China
| | - Qiqige Aleteng
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
- Fudan Institute for Metabolic Diseases, Fudan University, Shanghai, China
| | - Ying Chen
- Department of Endocrinology and Metabolism, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Yi-Xuan Sun
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
- Fudan Institute for Metabolic Diseases, Fudan University, Shanghai, China
| | - Yu Hu
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Bai-Shen Pan
- Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiao-Ying Li
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
- Fudan Institute for Metabolic Diseases, Fudan University, Shanghai, China
| | - Xin Gao
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
- Fudan Institute for Metabolic Diseases, Fudan University, Shanghai, China
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Ping Z, Pei X, Xia P, Chen Y, Guo R, Hu C, Imam MU, Chen Y, Sun P, Liu L. Anthropometric indices as surrogates for estimating abdominal visceral and subcutaneous adipose tissue: A meta-analysis with 16,129 participants. Diabetes Res Clin Pract 2018; 143:310-319. [PMID: 30086371 DOI: 10.1016/j.diabres.2018.08.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 07/19/2018] [Accepted: 08/01/2018] [Indexed: 01/01/2023]
Abstract
AIM To seek anthropometric indices that estimate visceral and subcutaneous adipose tissue (VAT and SAT) by meta-analysis and comparing the predictive efficacy based on different characteristics of participants. METHODS PubMed, PubMed Central, Web of Science, China National Knowledge Infrastructure and Wanfang databases were searched for publications containing correlation coefficients of VAT and/or SAT with waist circumference (WC) and/or body mass index (BMI). The overall or subgroup pooled results were analyzed by meta and metafor packages of R with random effects model. MedCalc software was used to compare the correlation coefficients between groups. RESULTS Twenty-nine publications were included in this meta-analysis. The correlation coefficients of VAT-WC, VAT-BMI, SAT-WC and SAT-BMI for total studies were between 0.640 and 0.785. The correlation of VAT with WC was larger than that with BMI (Z = 11.664, P < 0.001). Meanwhile, the correlation coefficients of VAT-WC were statistically different among different age groups, areas, ethnicities, body shapes, scanning levels, units and instruments of measuring VAT (P < 0.05). The overall correlation of SAT with BMI was larger than that with WC (Z = 3.805, P < 0.001). The subgroups' correlation coefficients of SAT-BMI showed statistical differences between genders, age groups, areas, ethnicities, body shapes, scanning levels, units (cm2 and cm3) and instruments of measuring SAT (P < 0.05). CONCLUSIONS WC may be a common and simple surrogate for estimating VAT, and BMI for SAT, especially in Europeans, but not in the aged people.
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Affiliation(s)
- Zhiguang Ping
- College of Public Health, Zhengzhou University, Zhengzhou 450001, China.
| | - Xiaoting Pei
- College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Peige Xia
- Department of Clinical Medicine, Zhengzhou University, Zhengzhou 450001, China
| | - Yuansi Chen
- Department of Clinical Medicine, Zhengzhou University, Zhengzhou 450001, China
| | - Rui Guo
- The Nursing College of Zhengzhou University, Zhengzhou 450001, China
| | - Chenxi Hu
- School of Basic Medical Sciences, Zhengzhou University, Zhengzhou 450001, China
| | - Mustapha Umar Imam
- Department of Medical Biochemistry, Faculty of Basic Medical Sciences, College of Health Sciences, Usmanu Danfodio University, Sokoto, Nigeria
| | - Yanzi Chen
- College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Panpan Sun
- College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Li Liu
- School of Basic Medical Sciences, Zhengzhou University, Zhengzhou 450001, China.
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Lee A, Kim YJ, Oh SW, Lee CM, Choi HC, Joh HK, Oh B, Hwang SS, Kim SJ, Kwon OD. Cut-Off Values for Visceral Fat Area Identifying Korean Adults at Risk for Metabolic Syndrome. Korean J Fam Med 2018; 39:239-246. [PMID: 29972898 PMCID: PMC6056408 DOI: 10.4082/kjfm.17.0099] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 10/21/2017] [Indexed: 12/16/2022] Open
Abstract
Background Cut-off values for visceral fat area (VFA) measured by computed tomography (CT) for identifying individuals at risk of metabolic syndrome (MetS) have not been clearly established in Korean adults, particularly for large populations. We aimed to identify optimal VFA and waist circumference (WC) cut-off values and compare the ability of VFA and WC to predict the presence of ≥2 metabolic risk factors. Methods We included 36,783 subjects aged 19–79 years undergoing abdominal fat CT during regular health checkups between January 2007 and February 2015 in Seoul. The risk factors for MetS except WC were based on the International Diabetes Federation criteria. Receiver operating characteristic curve analyses were used to determine the appropriate VFA and WC cut-off values for MetS. Results VFA was a more significant predictor of metabolic risk factors than WC and body mass index (BMI). The optimal cut-off values for VFA and WC were 134.6 cm2 and 88 cm for men and 91.1 cm2 and 81 cm for women, respectively. We estimated age-specific cut-off values for VFA, WC, and BMI. VFA cut-off values increased with age, particularly among women. Conclusion This large population study proposed the cut-off values for VFA and WC for identifying subjects at risk of MetS among Korean adults. For more accurate diagnosis, different age-specific cut-off values for VFA and WC may be considered.
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Affiliation(s)
- Arang Lee
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Ye Ji Kim
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Seung-Won Oh
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - Cheol Min Lee
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - Ho Chun Choi
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - Hee-Kyung Joh
- Seoul National University Health Service Center, Seoul, Korea
| | - Bumjo Oh
- Department of Family Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Seung-Sik Hwang
- Department of Public Health Science, Seoul National University Graduate School of Public Health, Seoul, Korea
| | - Seung Jae Kim
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Oh Deog Kwon
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
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Bi X, Loo YT, Henry CJ. Ultrasound measurement of intraabdominal fat thickness as a predictor of insulin resistance and low HDL cholesterol in Asians. Nutrition 2018; 55-56:99-103. [PMID: 29980094 DOI: 10.1016/j.nut.2018.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 03/06/2018] [Accepted: 04/08/2018] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Insulin resistance (IR) is important in the pathogenesis of diabetes, the prevalence of which has become a major public health threat in Asia. The aim of this study was to use ultrasound measurements of abdominal fat thickness to predict IR and low high-density lipoprotein cholesterol (HDL-C) levels among Singaporean adults. METHODS A total of 399 healthy Singaporeans (mean age 36.7 ± 14.3 y; 43.4% men) took part in this study. Preperitoneal fat thickness (PFT) and subcutaneous fat thickness (SFT) were determined by ultrasound. RESULT We found that both PFT and SFT had significant positive correlations (P < 0.05) with fasting insulin concentration, homeostasis model assessment of insulin resistance, triacylglycerol (TG), and blood pressure, and negatively correlated to serum HDL-C in all participants. Separating men and women, PFT was an independent determinant of IR and low HDL-C only in men. On receiver-operating characteristic curve analysis, PFT ≥1.2 cm was the optimal cutoff value to identify IR and low HDL-C in men. On the other hand, SFT was the determinant of IR, elevated TG, and low HDL-C only in women. An SFT of 1.1 cm was the optimal cutoff value to define IR, elevated TG, and low HDL-C in women. CONCLUSIONS Results of this study suggested that ultrasound measurements of PFT and SFT could provide simple and useful indices of IR and lipid disorders for healthy Singaporean men and women. They might have the diagnostic values for predicting cardiovascular risks in this population.
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Affiliation(s)
- Xinyan Bi
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research and National University Health System, Singapore
| | - Yi Ting Loo
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research and National University Health System, Singapore; Centre for Translational Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Christiani Jeyakumar Henry
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research and National University Health System, Singapore; Centre for Translational Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Three novel obese indicators perform better in monitoring management of metabolic syndrome in type 2 diabetes. Sci Rep 2017; 7:9843. [PMID: 28852155 PMCID: PMC5574991 DOI: 10.1038/s41598-017-10446-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 08/09/2017] [Indexed: 12/13/2022] Open
Abstract
The present study evaluated the performance of three novel obese indicators, visceral adiposity index (VAI), lipid accumulation product (LAP) and waist circumference-triglyceride index (WTI), for identifying metabolic syndrome(MetS) in type 2 diabetes. A cross-sectional study was conducted on 711 type 2 diabetes in Qinhuangdao. The MetS was defined as the definition of Chinese Diabetes Society. Receiver operating characteristic curve analyses were performed to assess the accuracy of three obese indicators as diagnostic tests for MetS. The prevalence of MetS was 71.3%. In men, among all three obese indicators, the LAP had the highest area under curve (AUC) value (AUC = 0.894), followed by VAI (AUC = 0.860) and WTI (AUC = 0.855). In women, among all three obese indicators, the LAP had the highest AUC value (AUC = 0.906), followed by WTI (AUC = 0.887) and VAI (AUC = 0.881). However. there was no significant difference between the three obese indicators(P > 0.05). Three obese indicators were effective indicators for the screening of MetS, LAP and WTI are more simple.
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Zając-Gawlak I, Kłapcińska B, Kroemeke A, Pośpiech D, Pelclová J, Přidalová M. Associations of visceral fat area and physical activity levels with the risk of metabolic syndrome in postmenopausal women. Biogerontology 2017; 18:357-366. [PMID: 28316012 PMCID: PMC5434155 DOI: 10.1007/s10522-017-9693-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 03/14/2017] [Indexed: 01/07/2023]
Abstract
This study was aimed at the evaluation of relationship between visceral fat area (VFA) and physical activity (PA) with the metabolic syndrome (MetS) risk in the physically active postmenopausal women. A total of 85 attendants of the University of the Third Age (U3A) aged 62.8 ± 5.9 years (median time since menopause 11.8 y), participated in this study. VFA was assessed by bioimpedance method using InBody 720 analyzer. PA was assessed using the ActiGraph GT1 M accelerometer. Fasting levels of serum lipids (TG, HDL), serum glucose, waist circumference (WC) and blood pressure were measured to diagnose MetS according to NCEP-ATP III criteria. In 73 out of 85 participants the VFA exceeded the upper normal level of 100 cm2, however, in almost a half of this group (n = 36) with elevated VFA (139.5 ± 26.1 cm2 on average), only 2 out of 5 criteria for MetS diagnosis were met. Participants were physically active, making on average 10,919 ± 3435 steps/day. The risk of MetS occurrence in women with VFA > 100 cm2 was twelve times higher (OR 12.33; CI 95% [1.5; 99.8]) than in the group with VFA < 100 cm2. The participants from the group with the highest PA level (≥12,500 steps/day) were at almost 4 times lower risk for MetS, than their less active counterparts (OR 3.84; CI 95% [1.27;11.64]). Increased level of VFA is a strong risk factor for the MetS in postmenopausal women, however high level of regular PA above the threshold of 12,500 steps/day may substantially reduce it.
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Affiliation(s)
- Izabela Zając-Gawlak
- The Jerzy Kukuczka Academy of Physical Education, Mikołowska 72a, 40 065, Katowice, Poland
| | - Barbara Kłapcińska
- The Jerzy Kukuczka Academy of Physical Education, Mikołowska 72a, 40 065, Katowice, Poland.
| | - Aleksandra Kroemeke
- Department of Psychology, SWPS University of Social Sciences and Humanities, Chodakowska 19/31, 03-815, Warsaw, Poland
| | - Dariusz Pośpiech
- The Jerzy Kukuczka Academy of Physical Education, Mikołowska 72a, 40 065, Katowice, Poland
| | - Jana Pelclová
- Center for Kinanthropology Research, Faculty of Physical Culture, Palacký University Olomouc, Tř. Míru 115, 771 11, Olomouc, Czech Republic
| | - Miroslava Přidalová
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, Tř. Míru 115, 771 11, Olomouc, Czech Republic
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Oh YH, Moon JH, Kim HJ, Kong MH. Visceral-to-subcutaneous fat ratio as a predictor of the multiple metabolic risk factors for subjects with normal waist circumference in Korea. Diabetes Metab Syndr Obes 2017; 10:505-511. [PMID: 29270027 PMCID: PMC5729827 DOI: 10.2147/dmso.s150914] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
PURPOSE Visceral obesity has been recognized as a predictor of metabolic risk factors. However, few studies have evaluated the metabolic risks in subjects with normal waist circumference (WC). We aimed to examine if the visceral-to-subcutaneous fat ratio (VSR) has diagnostic value to identify multiple metabolic risk factors in subjects with normal WC, compared with visceral fat area (VFA) and subcutaneous fat area (SFA). METHODS This is a cross-sectional study in which we have compared mean VFA, SFA, and VSR according to each metabolic risk factor. We performed a receiver operating characteristic (ROC) curve analysis for VFA, SFA, and VSR to assess their accuracy in picking out two or more non-adipose factors for metabolic syndrome. RESULTS For each metabolic risk factor, mean VSRs were significantly different between groups (risk-absent group vs risk-present group) in men and women, except for men with low high-density lipoprotein. However, mean VFAs and SFAs showed no significant differences between groups. VSR showed superior diagnostic values in predicting at least two non-adipose metabolic risk factors in men and similar diagnostic value in women. Areas under ROC curves for VSR and VFA were 0.705 and 0.649 in men (P=0.028) and 0.798 and 0.785 in women (P=0.321). CONCLUSION For men with a normal WC, VSR appeared to effectively predict the presence of multiple metabolic risk factors. Thus, VSR may serve as an indicator for identifying men who have a normal WC and multiple metabolic risk factors.
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Affiliation(s)
- Yun Hwan Oh
- Department of Family Medicine, Jeju National University Hospital
- Department of Medicine, Graduate School of Jeju National University
| | - Ji Hyun Moon
- Department of Family Medicine, Jeju National University Hospital
- Department of Medicine, Graduate School of Jeju National University
| | - Hyeon Ju Kim
- Department of Family Medicine, Jeju National University Hospital
- Department of Family Medicine, School of Medicine, Jeju National University, Jeju, Republic of Korea
| | - Mi Hee Kong
- Department of Family Medicine, Jeju National University Hospital
- Department of Family Medicine, School of Medicine, Jeju National University, Jeju, Republic of Korea
- Correspondence: Mi Hee Kong, Department of Family Medicine, Jeju National University Hospital, 15, Aran 13-gil, Jeju-si, Jeju-do, 63241, Republic of Korea, Tel +82 64 717 1550, Fax +82 64 717 1581, Email
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Ramezankhani A, Kabir A, Pournik O, Azizi F, Hadaegh F. Classification-based data mining for identification of risk patterns associated with hypertension in Middle Eastern population: A 12-year longitudinal study. Medicine (Baltimore) 2016; 95:e4143. [PMID: 27583845 PMCID: PMC5008529 DOI: 10.1097/md.0000000000004143] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Hypertension is a critical public health concern worldwide. Identification of risk factors using traditional multivariable models has been a field of active research. The present study was undertaken to identify risk patterns associated with hypertension incidence using data mining methods in a cohort of Iranian adult population.Data on 6205 participants (44% men) age > 20 years, free from hypertension at baseline with no history of cardiovascular disease, were used to develop a series of prediction models by 3 types of decision tree (DT) algorithms. The performances of all classifiers were evaluated on the testing data set.The Quick Unbiased Efficient Statistical Tree algorithm among men and women and Classification and Regression Tree among the total population had the best performance. The C-statistic and sensitivity for the prediction models were (0.70 and 71%) in men, (0.79 and 71%) in women, and (0.78 and 72%) in total population, respectively. In DT models, systolic blood pressure (SBP), diastolic blood pressure, age, and waist circumference significantly contributed to the risk of incident hypertension in both genders and total population, wrist circumference and 2-h postchallenge plasma glucose among women and fasting plasma glucose among men. In men, the highest hypertension risk was seen in those with SBP > 115 mm Hg and age > 30 years. In women those with SBP > 114 mm Hg and age > 33 years had the highest risk for hypertension. For the total population, higher risk was observed in those with SBP > 114 mm Hg and age > 38 years.Our study emphasizes the utility of DTs for prediction of hypertension and exploring interaction between predictors. DT models used the easily available variables to identify homogeneous subgroups with different risk pattern for the hypertension.
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Affiliation(s)
- Azra Ramezankhani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences
| | - Ali Kabir
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences
| | - Omid Pournik
- Department of Community Medicine, School of Medicine, Iran University of Medical Sciences
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences
- Correspondence: Farzad Hadaegh, Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763 Tehran, Iran (e-mail: )
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Donner DG, Elliott GE, Beck BR, Forwood MR, Du Toit EF. The effects of visceral obesity and androgens on bone: trenbolone protects against loss of femoral bone mineral density and structural strength in viscerally obese and testosterone-deficient male rats. Osteoporos Int 2016; 27:1073-1082. [PMID: 26438310 DOI: 10.1007/s00198-015-3345-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 09/25/2015] [Indexed: 12/21/2022]
Abstract
SUMMARY In males, visceral obesity and androgen deficiency often present together and result in harmful effects on bone. Our findings show that both factors are independently associated with adverse effects on femoral bone structure and strength, and trenbolone protects rats from diet-induced visceral obesity and consequently normalises femoral bone structural strength. INTRODUCTION In light of the rapidly increasing incidence of obesity and osteoporosis globally, and recent conjecture regarding the effects of visceral adiposity and testosterone deficiency on bone health, we investigated the effects of increased visceral adipose tissue (VAT) mass on femoral bone mineral density (BMD), structure and strength in normal weight rats with testosterone deficiency. METHODS Male Wistar rats (n = 50) were fed either standard rat chow (CTRL, n = 10) or a high-fat/high-sugar diet (HF/HS, n = 40). Following 8 weeks of feeding, rats underwent sham surgery (CTRL, n = 10; HF/HS, n = 10) or orchiectomy (HF/HS + ORX, n = 30). Following a 4-week recovery period, mini-osmotic pumps containing either vehicle (CTRL, n = 10; HF/HS, n = 10; HF/HS + ORX, n = 10), 2.0 mg kg day(-1), testosterone (HF/HS + ORX + TEST, n = 10) or 2.0 mg kg day(-1) trenbolone (HF/HS + ORX + TREN, n = 10) were implanted for 8 weeks of treatment. Dual-energy X-ray absorptiometry and three-point bending tests were used to assess bone mass, structure and strength of femora. RESULTS Diet-induced visceral obesity resulted in decreased bone mineral area (BMA) and content (BMC) and impaired femoral stiffness and strength. Orchiectomy further impaired BMA, BMC and BMD and reduced energy to failure in viscerally obese animals. Both TEST and TREN treatment restored BMA, BMC, BMD and energy to failure. Only TREN reduced visceral adiposity and improved femoral stiffness and strength. CONCLUSIONS Findings support a role for both visceral adiposity and testosterone deficiency as independent risk factors for femoral osteoporosis, adverse bone geometry and impaired bone strength in male rats. Trenbolone may be a more effective candidate for androgen replacement therapy than testosterone in viscerally obese testosterone-deficient males.
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Affiliation(s)
- D G Donner
- Heart Foundation Research Centre, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.
| | - G E Elliott
- Heart Foundation Research Centre, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - B R Beck
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - M R Forwood
- School of Medical Science and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - E F Du Toit
- Heart Foundation Research Centre, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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Kim HJ, Park JH, Lee S, Son HY, Hwang J, Chae J, Yun JM, Kwon H, Kim JI, Cho B. A Common Variant of NGEF Is Associated with Abdominal Visceral Fat in Korean Men. PLoS One 2015; 10:e0137564. [PMID: 26340433 PMCID: PMC4560439 DOI: 10.1371/journal.pone.0137564] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 08/17/2015] [Indexed: 12/28/2022] Open
Abstract
Central adiposity, rather than body mass index (BMI), is a key pathophysiological feature of the development of obesity-related diseases. Although genetic studies by anthropometric measures such as waist circumference have been widely conducted, genetic studies for abdominal fat deposition measured by computed tomography (CT) have been rarely performed. A total of 1,243 participants who were recruited from two health check-up centers were included in this study. We selected four and three single-nucleotide polymorphisms (SNPs) in NGEF and RGS6, respectively, and analyzed the associations between the seven SNPs and central adiposity measured by CT using an additive, dominant, or recessive model. The participants were generally healthy middle-aged men (50.7 ± 5.3 years). In the additive model, the rs11678490 A allele of NGEF was significantly associated with total adipose tissue, visceral adipose tissue (VAT), and subcutaneous adipose tissue (all P < 0.05). The AA genotype of this SNP in the recessive model showed a more significant association with all adiposity traits, and its association with VAT remained significant even after adjustment for BMI (P = 0.005). In the overall or visceral obesity group analysis, the AA genotype of rs11678490 showed no association with overall obesity (P = 0.148), whereas it was significantly associated with visceral obesity both before (P = 0.010) and after (P = 0.029) adjustment for BMI. In particular, an AA genotype effect was conspicuous between lower and upper groups with 5% extreme VAT phenotypes (OR = 9.59, 95% CI = 1.50-61.31). However, we found no significant association between SNPs of RGS6 and central adiposity. We identified a visceral-fat-associated SNP, rs11678490 of NGEF, in Korean men. This study suggests that the genetic background of central adiposity and BMI is different, and that additional efforts should be made to find the unique genetic architecture of intra-abdominal fat accumulation.
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Affiliation(s)
- Hyun-Jin Kim
- Institute of Health and Environment, School of Public Health, Seoul National University, Seoul, South Korea
| | - Jin-Ho Park
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Seungbok Lee
- Genomic Medicine Institute (GMI), Medical Research Center, Seoul National University, Seoul, South Korea
| | - Ho-Young Son
- Department of Biochemistry, Seoul National University College of Medicine, Seoul, South Korea
| | - Jinha Hwang
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea
| | - Jeesoo Chae
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea
| | - Jae Moon Yun
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Hyuktae Kwon
- Department of Family Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
| | - Jong-Il Kim
- Genomic Medicine Institute (GMI), Medical Research Center, Seoul National University, Seoul, South Korea
- Department of Biochemistry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea
- * E-mail: (JK); (BC)
| | - Belong Cho
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
- * E-mail: (JK); (BC)
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Lim JS, Choi YJ, Kim SK, Huh BW, Lee EJ, Huh KB. Optimal Waist Circumference Cutoff Value Based on Insulin Resistance and Visceral Obesity in Koreans with Type 2 Diabetes. Diabetes Metab J 2015; 39:253-63. [PMID: 26124996 PMCID: PMC4483611 DOI: 10.4093/dmj.2015.39.3.253] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 09/15/2014] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Visceral obesity is the most powerful contributor to the development of metabolic syndrome (MetS) and cardiovascular diseases. In light of visceral obesity, however, there is a paucity of data on the appropriate cutoff point of waist circumference (WC) in subjects with type 2 diabetes. The aim of this study was to investigate the optimal cutoff value for WC that signals insulin resistance (IR) and visceral obesity in Koreans with type 2 diabetes. METHODS We evaluated 4,252 patients with type 2 diabetes (male 2,220, female 2,032, mean age 57.24 years) who visited our clinic between January 2003 and June 2009. WC was measured at the midpoint between the lower rib and the iliac crest, and insulin sensitivity was assessed by the rate constant of plasma glucose disappearance (Kitt %/min) using an insulin tolerance test. Visceral fat thickness was measured using ultrasonography. Statistical analysis was performed using receiver operating characteristic curve. RESULTS The optimal cutoff points for WC for identifying the presence of IR and visceral obesity, as well as two or more metabolic components, were 87 cm for men and 81 cm for women. Moreover, these cutoff points had the highest predictive powers for the presence of visceral obesity. The MetS defined by new criteria correlated with the increased carotid intima-media thickness in female subjects. CONCLUSION Our results suggest that the optimal cutoff values for WC in Koreans with type 2 diabetes should be reestablished based on IR and visceral obesity.
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Affiliation(s)
- Jung Soo Lim
- Division of Endocrinology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Young Ju Choi
- Huh's Diabetes Center and the 21C Diabetes and Vascular Research Institute, Seoul, Korea
| | - Soo-Kyung Kim
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Byoung Wook Huh
- Huh's Diabetes Center and the 21C Diabetes and Vascular Research Institute, Seoul, Korea
| | - Eun Jig Lee
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kap Bum Huh
- Huh's Diabetes Center and the 21C Diabetes and Vascular Research Institute, Seoul, Korea
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Febriana K, Nurani N, Julia M. Body mass index and waist-to-height ratio cut-offs as predictors of high blood pressure in adolescents. MEDICAL JOURNAL OF INDONESIA 2015. [DOI: 10.13181/mji.v24i1.1200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Background: Obesity is associated with increased risk for high blood pressure (BP). Although a routine BP measurement is indicated for all children visiting pediatric practice, recognition of children particularly at risk may save times. The aim of this study was to assess the cut-off point for body mass index (BMI) and waist-to-height ratio (WHtR) to predict high BP in adolescents. Methods: We conducted a cross-sectional study on 928 children aged 11 to 16 years in Yogyakarta. BP were measured using standard technique described by The Fourth Report on The Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. BMI was adjusted for age and sex using the WHO 2007 growth reference. WHtR was ratio of waist circumference related to height in centimeters. Receiver operating characteristic (ROC) curves were used to estimate the best cut-offs. Results: The best cut-off point for BMI-for-age Z-score (BMIZ) to predict high BP was 0.51 with sensitivity and specificity of 82% (95% CI = 78-86) and 76% (95% CI = 67-78) for systolic BP and sensitivity and specificity of 82% (95% CI = 78-86) and 72% (95% CI = 68-76) for diastolic BP. The best cut-off point for WHtR was 0.45, with sensitivity of 76% (95% CI = 67-78) and specificity of 74% (95% CI = 71-79) for systolic BP and sensitivity of 76% (95% CI = 72-80) and specificity of 70% (95% CI = 61-75) for diastolic BP.Conclusion: BMIZ of 0.51 and WHtR of 0.45 are the best cut-off point to predict high BP in adolescents.
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Bioelectrical impedance outperforms waist circumference for predicting cardiometabolic risk in Congolese hypertensive subjects: a cross-sectional study. BMC Cardiovasc Disord 2015; 15:17. [PMID: 25887798 PMCID: PMC4357142 DOI: 10.1186/s12872-015-0011-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 02/19/2015] [Indexed: 01/07/2023] Open
Abstract
Background Waist circumference threshold values used in sub-Saharan Africa correspond to those of European populations and are therefore inappropriate. Thus, they may over predict insulin resistance, especially in hypertensive Africans, in whom there is often no association between blood pressure and insulin resistance. Using bioelectrical impedance measurement in sub-Saharan Africa could possibly be advantageous to overcome the shortcomings of waist circumference measurement. The aim of this study was to evaluate the contribution of body composition estimation by bioelectrical impedance to predict cardiometabolic risk in Congolese hypertensive subjects. Methods Cardiovascular profiling and body composition analysis by bioelectrical impedance was measured in 400 patients (men = 40%; age = 51.1 ± 12.6 years). Patients were diagnosed with a metabolic syndrome (MS) according to the IDF Criteria with and without the “blood pressure” criterion to remove any confounding autocorrelation bias, a visceral fat-MS (with and without the “blood pressure” criterion) being defined by the presence of ≥ 2 criteria with the precondition of excess visceral fat defined by a bio impedance measurement score >10/30. Total cardiovascular risk was assessed using the criteria of Framingham-2008. Results The frequencies of enlarged waist circumference (71.9% vs 68.9%, p = 0.52) and IDF-MS without blood pressure criterion (24.9% vs 21.9%, p = 0.48) were similar among hypertensive vs. non hypertensive however excess visceral fat (57.6% vs 33.8%, p <0.0001) as well as visceral fat-MS without blood pressure criterion (18.9% vs 11.3%, p = 0.04) were more prevalent among hypertensive. Finally, total cardiovascular risk as well as arterial hypertension risk were associated with visceral fat, but not with waist circumference (p > 0.05). Conclusions Pending the determination of thresholds values for pathological waist circumference adapted to sub-Saharan populations, using bioelectrical impedance measurement may contribute to better characterize the cardiometabolic risk and the insulin resistant phenotype of hypertensive sub-Saharan Africans.
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Ornstrup MJ, Kjær TN, Harsløf T, Stødkilde-Jørgensen H, Hougaard DM, Cohen A, Pedersen SB, Langdahl BL. Adipose tissue, estradiol levels, and bone health in obese men with metabolic syndrome. Eur J Endocrinol 2015; 172:205-16. [PMID: 25416724 DOI: 10.1530/eje-14-0792] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Visceral adipose tissue (VAT) is associated with an increased risk of metabolic syndrome (MetS). Recent studies have suggested that VAT negatively affects bone. However, MetS has also been associated with higher estradiol (E2) levels, which is bone protective. We therefore investigated the impact of VAT and E2 levels on bone density, structural parameters, and strength estimates. DESIGN A cross-sectional study was conducted in 72 obese men with MetS to investigate the impact of VAT and E2 levels on bone. METHODS Bone parameters were assessed by dual-energy X-ray absorptiometry (DXA), quantitative computed tomography (QCT), and high-resolution peripheral QCT (HRpQCT) at lumbar spine, proximal femur, radius, and tibia. VAT volume was measured by magnetic resonance imaging (MRI) and sexual hormones were measured in blood samples. RESULTS Men with high VAT had a lower bone density at the hip (P<0.05), lower cortical thickness, and higher buckling ratio at femoral neck (FN) (P=0.008 and P=0.02), compared with men with low VAT, despite a similar body weight and BMI. Generally, E2 levels were low (median 43 pmol/l), and men with E2 levels below median had reduced bone density at lumbar spine (P=0.04), and impaired structural parameters at radius and tibia, compared with men with E2 levels above median. At the hip, VAT volume and E2 levels affected bone density independently and additively, and 50% of men with high VAT and low E2 levels had osteopenia with significantly lower T-score at FN (P=0.004). CONCLUSIONS High VAT and low E2 negatively affect bone in obese men with MetS. VAT and E2 affect bone density at the hip independently and additively, revealing an unexpected high prevalence of osteopenia in middle-aged men with MetS.
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Affiliation(s)
- Marie Juul Ornstrup
- Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
| | - Thomas Nordstrøm Kjær
- Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
| | - Torben Harsløf
- Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
| | - Hans Stødkilde-Jørgensen
- Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
| | - David Michael Hougaard
- Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
| | - Arieh Cohen
- Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
| | - Steen Bønløkke Pedersen
- Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
| | - Bente Lomholt Langdahl
- Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
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Kim W, Chung SG, Kim K, Seo HG, Oh BM, Yi Y, Kim MJ. The relationship between body fat and bone mineral density in Korean men and women. J Bone Miner Metab 2014; 32:709-17. [PMID: 24374493 DOI: 10.1007/s00774-013-0545-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Accepted: 11/07/2013] [Indexed: 10/25/2022]
Abstract
Previous studies of the effects of body fat on bone mineral density (BMD) have shown conflicting results depending on the age, sex, and menopausal status of the subjects. The purpose of the present study was to investigate the effects of body fat on BMD using data from the Fifth Korea National Health and Nutrition Examination Survey, which was conducted in 2010. Our data were drawn from a relevant population within the survey's range of participants, yielding a total of 4,138 subjects aged 20-93 years (1,133 men <50 years, 946 men ≥ 50 years, 1,332 premenopausal women, and 727 postmenopausal women). Percent body fat, fat mass (FM), lean mass (LM), and BMD of the total hip, lumbar spine, and arm were measured in the original survey using dual-energy X-ray absorptiometry. Relationships between FM and BMD were evaluated using multiple linear regression analyses. LM was the strongest determinant of BMD. Although FM also showed a significant positive correlation, even after adjusting for LM, with total hip and lumbar spine BMD in men ≥ 50 years and pre- and postmenopausal women, this positive correlation was not observed in the arm. In an analysis of obese and non-obese subgroups, the positive correlation between FM and BMD disappeared in obese subjects. Furthermore, FM and BMD exhibited a negative correlation in premenopausal obese women. These results suggest that FM contributes to BMD primarily through mechanical loading. FM, then, is not beneficial and may be detrimental to bone health in obese people.
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Affiliation(s)
- Won Kim
- Department of Rehabilitation Medicine, Asan Medical Center, 388-1 Pungnap-2 dong, Songpa-gu, Seoul, 138-736, South Korea
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Kim C. Gestational diabetes mellitus in korean women: similarities and differences from other racial/ethnic groups. Diabetes Metab J 2014; 38:1-12. [PMID: 24627822 PMCID: PMC3950189 DOI: 10.4093/dmj.2014.38.1.1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Gestational diabetes mellitus (GDM) reflects defects in insulin secretion in response to the metabolic demands of pregnancy. While GDM is increasingly common worldwide due in large part to the obesity epidemic, its frequency is relatively low in Korean women. In this report, the prevalence and risk factors for GDM, perinatal outcomes, and postpartum course are compared in non-Korean and Korean women. While Koreans and non-Koreans with GDM share pathophysiology and complications, there may be differences in the role of obesity and thus the effectiveness of interventions targeting obesity in GDM women. Further investigations of the effectiveness of weight loss interventions and pharmacotherapy specifically among Korean women are needed. Dietary and other lifestyle data from Korean populations could inform prevention and treatment strategies in other countries which suffer from significantly higher prevalences of GDM.
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Affiliation(s)
- Catherine Kim
- Department of Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA
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Lee OG, Hur YI, Kang JH, Park HA, Kim KW, Cho YG, Choi WY, Park H, Lee HA. The cutoff value of waist circumference for predicting metabolic risks in pre- and post-menopausal korean women: analysis of 2010 korean national health and nutrition examination survey data. Korean J Fam Med 2013; 34:307-18. [PMID: 24106583 PMCID: PMC3791338 DOI: 10.4082/kjfm.2013.34.5.307] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Accepted: 08/27/2013] [Indexed: 11/23/2022] Open
Abstract
Background With metabolic syndrome (MS) being a major risk factor for cardiovascular disease, and central obesity being a major predisposing factor for MS, intensive research is currently being performed on cutoff values according to race and sex. Menopause is an especially significant factor in designating cutoff values for female central obesity, as menopause brings sudden bodily changes that induce central obesity and increased prevalence of MS. Therefore this study aimed to investigate the cutoff values for the obesity index and its validity in predicting the criteria for MS in Korean women according to menstrual status. Methods The study focused on 3,103 women 20 years of age or older participating in the 2007 Korea National Health and Nutrition Examination Survey. Definitions of non-adipose components of MS were defined by the International Diabetes Federation, and menstrual status was judged on the basis of survey results. The sensitivity, specificity, and positive and negative predictive values of the central obesity index (body mass index [BMI], waist circumference [WC], waist-to-height ratio [WHtR]) according to menstrual status for two or more non-adipose components of MS were calculated based on the Youden index. Results Area under the curve (AUC) values predicting the presence of two or more metabolic risk factors were higher in pre-menopausal women, with AUC values for BMI, WC, and WHtR being, in pre- and post-menopausal women, 23.1 kg/m2 vs. 23.9 kg/m2, 76.1 cm vs. 82.5 cm, and 0.49 vs. 0.53, respectively. The WC cut off (76 cm) for pre-menopausal women was found to be more sensitive and more effective at screening for MS risks than the cutoff value given by the Korea Society for the Study of Obesity. Conclusion The central obesity index showed better predictability for MS risk in pre-menopausal women. Because the central obesity index cutoff values are lower in pre-menopausal women, the possibility of metabolic risk can be considered for pre-menopausal women with WC lower than 85 cm. Assessment and control of other risks are needed accordingly for preventing the development of MS.
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Affiliation(s)
- Ok-Gyu Lee
- Department of Family Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Kim K, Yun SH, Jang MJ, Oh KW. Body fat percentile curves for Korean children and adolescents: a data from the Korea National Health and Nutrition Examination Survey 2009-2010. J Korean Med Sci 2013; 28:443-9. [PMID: 23487528 PMCID: PMC3594610 DOI: 10.3346/jkms.2013.28.3.443] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Accepted: 12/20/2012] [Indexed: 12/25/2022] Open
Abstract
A valid assessment of obesity in children and adolescents is important due to significant change in body composition during growth. This study aimed to develop percentile curves of body fat and fat free mass using the Lambda, Mu, and Sigma method, and to examine the relationship among body mass index (BMI), fat mass and fat free mass in Korean children and adolescents, using the Korea National Health and Nutrition Examination Survey (KNHANES) 2009-2010. The study subjects were 834 for boys and 745 for girls aged between 10 and 18 yr. Fat mass and fat free mass were measured by dual-energy x-ray absorptiometry. The patterns of development in body fat percentage, fat mass and fat free mass differed for boys and girls, showing a decreased fat mass with an increased fat free mass in boys but gradual increases with age in girls. The considerable proportion of boys and girls with relatively normal fat mass appeared to be misclassified to be at risk of overweight based on the BMI criteria. Therefore, the information on the percentiles of body fat and fat free mass with their patterns would be helpful to complement assessment of overweight and obesity based on BMI for Korean children and adolescents.
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Affiliation(s)
- Kirang Kim
- Department of Food Science and Nutrition, Dankook University, Yongin, Korea
| | - Sung Ha Yun
- Division of Health and Nutrition Survey, Korea Centers for Disease Control and Prevention, Cheongwon, Korea
| | - Myoung Jin Jang
- Division of Health and Nutrition Survey, Korea Centers for Disease Control and Prevention, Cheongwon, Korea
| | - Kyung Won Oh
- Division of Health and Nutrition Survey, Korea Centers for Disease Control and Prevention, Cheongwon, Korea
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Harrington MG, McGeorge AP, Ballantyne JP, Beastall G. A prospective survey for insulinomas in a neurology department. Sleep Breath 1983; 22:673-681. [PMID: 29197986 PMCID: PMC6133118 DOI: 10.1007/s11325-017-1599-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 11/07/2017] [Accepted: 11/23/2017] [Indexed: 12/28/2022]
Abstract
Purpose Obesity is associated with both obstructive sleep apnea (OSA) and obesity hypoventilation. Differences in adipose tissue distribution are thought to underlie the development of both OSA and hypoventilation. We explored the relationships between the distribution of upper airway, neck, chest, abdominal and muscle fat in very obese individuals. Methods We conducted a cross-sectional cohort study of individuals presenting to a tertiary sleep clinic or for assessment for bariatric surgery. Individuals underwent magnetic resonance (MR) imaging of their upper airway, neck, chest, abdomen and thighs; respiratory polygraphy; 1 week of autotitrating CPAP; and morning arterial blood gas to determine carbon dioxide partial pressure and base excess. Results Fifty-three individuals were included, with mean age of 51.6 ± 8.4 years and mean BMI of 44.3 ± 7.9 kg/m2; there were 27 males (51%). Soft palate, tongue and lateral wall volumes were significantly associated with the AHI in univariable analyses (p < 0.001). Gender was a significant confounder in these associations. No significant associations were found between MRI measures of adiposity and hypoventilation. Conclusions In very obese individuals, our results indicate that increased volumes of upper airway structures are associated with increased severity of OSA, as previously reported in less obese individuals. Increasingly large upper airway structures that reduce pharyngeal lumen size are likely to lead to OSA by increasing the collapsibility of the upper airway. However, we did not show any significant association between regional fat distribution and propensity for hypoventilation, in this population. Electronic supplementary material The online version of this article (10.1007/s11325-017-1599-x) contains supplementary material, which is available to authorized users.
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