Evaluation of ultrasonographic approaches aimed at determining distinct abdominal adipose tissue depots

Objective

To analyze different anatomical sites in the abdominal region, in order to determine the positional parameter that identifies a higher level of visceral adipose tissue (VAT) and confers a greater cardiometabolic risk.

Materials and methods

This is a methodological study in which VAT was evaluated by ultrasonography (USG) in three anatomical sites in the abdomen, while the abdominal circumference (AC) was measured using seven different protocols. Additionally, the glycemic and lipid profile, C-reactive protein, and the presence of systemic arterial hypertension were evaluated.

Results

One hundred and six individuals with an average age of 42 (36.8-46.2) years were included. The evaluation of the calibration of the ultrasound procedure for the analysis of VAT by intra- and inter-evaluators showed high reproducibility. The pattern of abdominal fat distribution differed between sexes, with higher mean VAT in males (p < 0.05) and higher mean SAT (subcutaneous adipose tissue) in females (p < 0.005). In the abdominal scan applied to women, higher levels of VAT and lower levels of SAT were observed in the narrower waist region, between the iliac crest and the last rib (p < 0.001). In males, the profile of adipose disposition along the abdomen was uniform (p > 0.05). Correlations between VAT measured by USG and cardiometabolic parameters were relatively stronger in the upper abdomen (p < 0.05).

Conclusion

Women accumulate more VAT in the narrower waist region, while men accumulate VAT uniformly across the abdomen. There was relative superiority in predicting cardiometabolic risk in the upper abdomen for both sexes.

The applicability of the Visceral Adiposity Index (VAI) for predicting visceral fat

Abstract As obesity has reached epidemic proportions and given the current recognition of central adiposity as an important cardiometabolic risk factor, several researchers have focused on developing and validating predictive indexes and equations to evaluate Visceral Adipose Tissue (VAT). This study evaluates the applicability of the Visceral Adiposity Index (VAI) for predicting cardiometabolic risk in individuals treated in a hospital In the northeast region of Brazil. The VAT was evaluated by computed tomography (CT) and the VAI was calculated through specific equations for each gender. The sample involved adult and elderly patients of both genders followed up in a cardiology outpatient clinic. The following cardiometabolic parameters were collected: fasting glycemia, glycated hemoglobin, lipid profile, C-reactive protein (CRP) and uric acid. The simple linear regression was used to evaluate the explanatory power of the VAI in relation to the volume of VAT determined by CT. The predictive capacity of VAI in relation to the volume of VAT determined by CT was 25.8% (p=0.004) for males and 19.9% (p<0.001) for females. VAI correlated strongly with the triglyceride (TG) (p<0.001) and TG/high-density lipoprotein (HDL) ratio (p<0.001) and inversely correlated with HDL (p<0.001). Moreover, VAI showed low correlation with the following variables: abdominal circumference, total cholesterol, low density lipoprotein, fasting glycemia, and glycated hemoglobin (p<0.05). VAI was associated with variables considered as cardiometabolic risk factors, but exhibited a low predictive capacity regarding the volume of VAT determined by CT. Thus, caution is recommended in its use in Brazilian individuals.

Sarcopenia and sarcopenic obesity as prognostic predictors in hospitalized elderly patients with acute myocardial infarction

OBJECTIVE

To investigate the potential value of sarcopenia and sarcopenic obesity as prognostic predictors in hospitalized elderly patients with acute myocardial infarction.

METHODS

A cross-sectional study based on data collected from elderly patients with acute myocardial infarction, admitted to a public hospital located in the Northeastern region of Brazil, from April to July 2015. The diagnosis of sarcopenia was based on muscle mass, muscle strength and physical performance measurements. Cardiovascular risk and prognostic markers, such as troponin and creatine kynase MB isoenzyme values, acute myocardial infarction classification according to ST segment elevation, and thrombolysis in myocardial infarction score were used.

RESULTS

The sample comprised 99 patients with mean age of 71.6 (±7.4) years. Prevalence of sarcopenia and sarcopenic obesity was 64.6% and 35.4%, respectively. Sarcopenia was more prevalent among males (p=0.017) aged >80 years (p=0.008). Thrombolysis in myocardial infarction was the only marker of cardiovascular risk significantly associated with sarcopenia (p=0.002).

CONCLUSION

Prevalence of sarcopenia was high and associated with thrombolysis in myocardial infarction risk score. Sarcopenic obesity affected approximately one-third of patients and was not associated with any of the prognostic predictors.