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Kilonzo SB, Kamala E, Jaka H, Ngoya P. Non-alcoholic fatty liver disease in Tanzania: prevalence, determinants, and diagnostic performance of triglycerides-glucose index and triglycerides-glucose index -body mass index compared to the hepatic ultrasound in overweight and obese individuals. BMC Gastroenterol 2024; 24:96. [PMID: 38438930 PMCID: PMC10910753 DOI: 10.1186/s12876-024-03164-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 02/08/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD), which is closely associated with metabolic syndrome (MetS), is rarely reported in Tanzania, where MetS is prevalent. The purpose of this study was to determine the prevalence and associated factors of this condition in overweight and obese individuals and to correlate standard ultrasound diagnosis with triglyceride-glucose index (TyG) and TyG-body mass index (TyG-BMI). METHODS A cross-sectional analysis was performed in 181 adult outpatients attending a general medical clinic. The presence of fatty liver was detected by ultrasound. Demographic, clinical, and laboratory data were collected and analyzed using STATA 15. To compare categorical variables, a chi-square test was employed, while a Student's t-test was used to compare continuous variables. Additionally, a multivariate regression analysis was conducted to identify the determinants of NAFLD. A significance level was set at p < 0.05. The discriminatory power of TyG and TyG-BMI for diagnosing NAFLD was evaluated using Receiver Operating Characteristic (ROC) Curve analysis and the Area Under the ROC Curve (AUC) was reported. RESULTS The overall prevalence of NAFLD was 30.4% (55/181). The prevalence's of NAFLD in patients with class III obesity, class II obesity, class I obesity and overweight were 50.0% (12/24),, 38% (19/50), 23.7% (18/76), and 19.5% (6/31),respectively. NAFLD was strongly predicted by hyperuricemia (≥ 360 μmol/L) (p = 0.04) and TyG ≥ 8.99 (p = 0.003). The best cut-off values of TyG and TyG-BMI to predict NAFLD were 8.99 [AUC 0.735; sensitivity 70.9%, specificity 79.3%] and 312 [AUC 0.711; sensitivity 60% and specificity 75.4%] respectively. CONCLUSIONS The prevalence of NAFLD is high among people with overweight and obesity in Tanzania. We did not find sufficient evidence to recommend the use of TyG and TyG-BMI as surrogates for hepatic ultrasound in detecting NAFLD, and further evaluation is recommended.
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Affiliation(s)
- Semvua B Kilonzo
- Department of Internal Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania.
- Department of Internal Medicine, Bugando Medical Centre, P.O. Box 1370, Mwanza, Tanzania.
| | - Eliud Kamala
- Department of Internal Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Hyasinta Jaka
- Department of Internal Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
- Department of Internal Medicine, Bugando Medical Centre, P.O. Box 1370, Mwanza, Tanzania
| | - Patrick Ngoya
- Department of Radiology, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
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Pickhardt PJ. Invited Commentary: Metabolic Syndrome: The Urgent Need for an Imaging-based Definition. Radiographics 2024; 44:e230230. [PMID: 38329902 DOI: 10.1148/rg.230230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Affiliation(s)
- Perry J Pickhardt
- From the Department of Radiology, The University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Science Center, 600 Highland Ave, Madison, WI 53792-3252
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Kalisz K, Navin PJ, Itani M, Agarwal AK, Venkatesh SK, Rajiah PS. Multimodality Imaging in Metabolic Syndrome: State-of-the-Art Review. Radiographics 2024; 44:e230083. [PMID: 38329901 DOI: 10.1148/rg.230083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Metabolic syndrome comprises a set of risk factors that include abdominal obesity, impaired glucose tolerance, hypertriglyceridemia, low high-density lipoprotein levels, and high blood pressure, at least three of which must be fulfilled for diagnosis. Metabolic syndrome has been linked to an increased risk of cardiovascular disease and type 2 diabetes mellitus. Multimodality imaging plays an important role in metabolic syndrome, including diagnosis, risk stratification, and assessment of complications. CT and MRI are the primary tools for quantification of excess fat, including subcutaneous and visceral adipose tissue, as well as fat around organs, which are associated with increased cardiovascular risk. PET has been shown to detect signs of insulin resistance and may detect ectopic sites of brown fat. Cardiovascular disease is an important complication of metabolic syndrome, resulting in subclinical or symptomatic coronary artery disease, alterations in cardiac structure and function with potential progression to heart failure, and systemic vascular disease. CT angiography provides comprehensive evaluation of the coronary and systemic arteries, while cardiac MRI assesses cardiac structure, function, myocardial ischemia, and infarction. Liver damage results from a spectrum of nonalcoholic fatty liver disease ranging from steatosis to fibrosis and possible cirrhosis. US, CT, and MRI are useful in assessing steatosis and can be performed to detect and grade hepatic fibrosis, particularly using elastography techniques. Metabolic syndrome also has deleterious effects on the pancreas, kidney, gastrointestinal tract, and ovaries, including increased risk for several malignancies. Metabolic syndrome is associated with cerebral infarcts, best evaluated with MRI, and has been linked with cognitive decline. ©RSNA, 2024 Test Your Knowledge questions for this article are available in the supplemental material. See the invited commentary by Pickhardt in this issue.
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Affiliation(s)
- Kevin Kalisz
- From the Duke University School of Medicine, Durham, NC (K.K.); Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 559905 (P.J.N., S.K.V., P.S.R.); Mallinckrodt Institute of Radiology, Washington University, St. Louis, Mo (M.I.); and Mayo Clinic, Jacksonville, Fla (A.K.A.)
| | - Patrick J Navin
- From the Duke University School of Medicine, Durham, NC (K.K.); Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 559905 (P.J.N., S.K.V., P.S.R.); Mallinckrodt Institute of Radiology, Washington University, St. Louis, Mo (M.I.); and Mayo Clinic, Jacksonville, Fla (A.K.A.)
| | - Malak Itani
- From the Duke University School of Medicine, Durham, NC (K.K.); Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 559905 (P.J.N., S.K.V., P.S.R.); Mallinckrodt Institute of Radiology, Washington University, St. Louis, Mo (M.I.); and Mayo Clinic, Jacksonville, Fla (A.K.A.)
| | - Amit Kumar Agarwal
- From the Duke University School of Medicine, Durham, NC (K.K.); Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 559905 (P.J.N., S.K.V., P.S.R.); Mallinckrodt Institute of Radiology, Washington University, St. Louis, Mo (M.I.); and Mayo Clinic, Jacksonville, Fla (A.K.A.)
| | - Sudhakar K Venkatesh
- From the Duke University School of Medicine, Durham, NC (K.K.); Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 559905 (P.J.N., S.K.V., P.S.R.); Mallinckrodt Institute of Radiology, Washington University, St. Louis, Mo (M.I.); and Mayo Clinic, Jacksonville, Fla (A.K.A.)
| | - Prabhakar Shantha Rajiah
- From the Duke University School of Medicine, Durham, NC (K.K.); Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 559905 (P.J.N., S.K.V., P.S.R.); Mallinckrodt Institute of Radiology, Washington University, St. Louis, Mo (M.I.); and Mayo Clinic, Jacksonville, Fla (A.K.A.)
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Badawy M, Elsayes KM, Lubner MG, Shehata MA, Fowler K, Kaoud A, Pickhardt PJ. Metabolic syndrome: imaging features and clinical outcomes. Br J Radiol 2024; 97:292-305. [PMID: 38308038 DOI: 10.1093/bjr/tqad044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/19/2023] [Accepted: 11/27/2023] [Indexed: 02/04/2024] Open
Abstract
Metabolic syndrome, which affects around a quarter of adults worldwide, is a group of metabolic abnormalities characterized mainly by insulin resistance and central adiposity. It is strongly correlated with cardiovascular and all-cause mortality. Early identification of the changes induced by metabolic syndrome in target organs and timely intervention (eg, weight reduction) can decrease morbidity and mortality. Imaging can monitor the main components of metabolic syndrome and identify early the development and progression of its sequelae in various organs. In this review, we discuss the imaging features across different modalities that can be used to evaluate changes due to metabolic syndrome, including fatty deposition in different organs, arterial stiffening, liver fibrosis, and cardiac dysfunction. Radiologists can play a vital role in recognizing and following these target organ injuries, which in turn can motivate lifestyle modification and therapeutic intervention.
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Affiliation(s)
- Mohamed Badawy
- Department of Diagnostic Radiology, Wayne State University, Detroit, MI, 48202, United States
| | - Khaled M Elsayes
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, United States
| | - Meghan G Lubner
- Department of Diagnostic Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792, United States
| | - Mostafa A Shehata
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, United States
| | - Kathryn Fowler
- Department of Diagnostic Radiology, University of California San Diego, San Diego, CA, 92093, United States
| | - Arwa Kaoud
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, United States
| | - Perry J Pickhardt
- Department of Diagnostic Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792, United States
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Bunnell KM, Galdamez ME, Torriani M, Bredella MA. Breast adipose tissue attenuation as a novel imaging biomarker for cardiometabolic risk. Acta Radiol 2024; 65:167-172. [PMID: 36560894 DOI: 10.1177/02841851221146267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Certain adipose tissue depots infer higher cardiometabolic risk than body mass index (BMI). PURPOSE To assess breast adipose tissue (BrAT) attenuation as a novel imaging biomarker for cardiometabolic risk. MATERIAL AND METHODS We studied 151 women (mean age = 56 ± 1 years) across the weight spectrum. BrAT attenuation, abdominal adipose tissue cross-sectional areas (CSA), and attenuation were quantified using non-contrast computed tomography (CT) scans. Cardiometabolic risk factors were assessed from medical records. RESULTS BrAT attenuation was lower in obese women compared to lean women. BrAT attenuation was inversely associated with BMI, waist circumference, abdominal fat CSA, fasting glucose, and triglycerides (P ≤ 0.02), and positively associated with abdominal adipose tissue attenuation (P < 0.001). BrAT attenuation had a sensitivity of 90% but a specificity of only 35% in detecting the metabolic syndrome (area under the curve = 0.63). CONCLUSION BrAT attenuation is associated with cardiometabolic risk markers and could serve as an imaging biomarker for opportunistic risk assessment in patients undergoing CT examination of the chest.
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Affiliation(s)
- Katherine M Bunnell
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Marilyn E Galdamez
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Martin Torriani
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Miriam A Bredella
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Zhao X, Xiao C, Sun L, Zhang F. Assessment of left atrial function in patients with metabolic syndrome by four-dimensional automatic left atrial quantification. Diabetes Res Clin Pract 2024; 207:111080. [PMID: 38145827 DOI: 10.1016/j.diabres.2023.111080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 12/11/2023] [Accepted: 12/22/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE This study aimed at assessing the changes of left atrial (LA) volume and strain function in metabolic syndrome (MS) patients using four-dimensional automatic left atrial quantification (4D-LAQ) and exploring independent correlative factors for LA function. METHODS A total of 110 MS patients and 70 normal controls were selected and assigned into the MS group and the control group, respectively. Echocardiogram parameters were routinely examined and the thickness of epicardial adipose tissue (EAT) were measured with a parasternal long axis of left ventricle(LV). The LA volume and strain parameters were determined using 4D-LAQ. The independent correlation factors for LA strain parameters in MS patients were investigated through linear regression analysis. RESULTS Compared with the control group, LA volume parameters were increased in the MS group, LA strain parameters and LA emptying fraction (LAEF) were decreased (all P < 0.05). EAT thickness is associated with LA reservoir longitudinal strain (LASr), conduit longitudinal strain (LAScd), reservoir circumferential strain (LASr-c), and conduit circumferential strain (LAScd-c) (all P < 0.05). LA contraction longitudinal (LASct) and circumferential strain (LASct-c) were not statistically significant. Regression analysis results show that systolic blood pressure (SBP) and triglyceride (TG) are independent correlative factors. Intra-observer and inter-observer repeatability test showed that the LA parameters examined by 4D-LAQ had good agreement. CONCLUSIONS 4D-LAQ is capable of effectively assessing the LA function in MS patients and providing a useful reference for clinical diagnosis. SBP and TG serve as the independent correlative factors for LA function.
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Affiliation(s)
- Xuebing Zhao
- Hebei Medical University, Shijiazhuang, Hebei, China; Department of Ultrasound, First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China
| | - Chengwei Xiao
- Hebei Medical University, Shijiazhuang, Hebei, China; Department of Ultrasound, First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China
| | - Lijuan Sun
- Department of Ultrasound, First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China.
| | - Fang Zhang
- Department of Ultrasound, First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China
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Huang S, Shi K, Li Y, Wang J, Jiang L, Gao Y, Yan WF, Shen LT, Yang ZG. Effect of Metabolic Dysfunction-Associated Fatty Liver Disease on Left Ventricular Deformation and Atrioventricular Coupling in Patients With Metabolic Syndrome Assessed by MRI. J Magn Reson Imaging 2023; 58:1098-1107. [PMID: 36591962 DOI: 10.1002/jmri.28588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Metabolic dysfunction-associated fatty liver disease (MAFLD) was recently recognized as an important risk factor for cardiovascular diseases. PURPOSE To examine the effect of MAFLD on cardiac function in metabolic syndrome by MRI. STUDY TYPE Retrospective. POPULATION One hundred seventy-nine patients with metabolic syndrome (MetS), 101 with MAFLD (MAFLD [+]) and 78 without (MAFLD [-]). Eighty-one adults without any of the components of MetS or cardiac abnormalities were included as control group. FIELD STRENGTH/SEQUENCE 3.0 T; balanced steady-state free precession sequence. ASSESSMENT Left atrial (LA) strain was assessed during three phases: reservoir strain (LA-RS), conduit strain (LA-CS), and booster strain (LA-BS). Left ventricular (LV) global longitudinal (LV-GLS) strain was also derived. The left atrioventricular coupling index (LACI) was calculated as the ratio of LA end-diastolic volume (LA-EDV) and LV-EDV. STATISTICAL TESTS Student's t test or Mann-Whitney U test; One-way analysis of variance. A P value <0.05 was considered statistically significant. RESULTS Among MetS patients, individuals with MAFLD had significantly lower magnitude LV-GLS (-11.6% ± 3.3% vs. -13.8% ± 2.7%) than those without MAFLD. For LA strains, LA-RS (36.9% ± 13.7% vs. 42.9% ± 13.5%) and LA-CS (20.0% ± 10.6% vs. 24.1% ± 9.2%) were also significantly reduced in MAFLD (+) compared to MAFLD (-). The LACIs (17.2% [12.9-21.2] % vs. 15.8% [12.2-19.7] %) were significantly higher in patients with MAFLD compared to those without MAFLD. After adjustment for other clinical factors, MAFLD was found to be independently correlated with LV-GLS (β = -0.270) and LACI (β = 0.260). DATA CONCLUSION MAFLD had an unfavorable effect on LV myocardial strain in MetS. Moreover, LA strain and atrioventricular coupling were further impaired in patients with concomitant MAFLD compared to those without MAFLD. Last, MAFLD was independently associated with subclinical LV dysfunction and atrioventricular coupling after adjustment for other clinical factors. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: 3.
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Affiliation(s)
- Shan Huang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ke Shi
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuan Li
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jin Wang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li Jiang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yue Gao
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wei-Feng Yan
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li-Ting Shen
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhi-Gang Yang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Ma ZY, Duan H, Han D, He B, Xie XJ, Lu L, Jiang J, Li RH. Epicardial fat in patients with metabolic syndrome: A systematic review and meta-analysis. Eur J Radiol 2023; 167:111056. [PMID: 37666076 DOI: 10.1016/j.ejrad.2023.111056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE Abnormally increased epicardial fat appears to be associated with an additional risk of major adverse cardiovascular events (MACEs) in the context of metabolic syndrome (MetS). However, evidence on the relationship between epicardial fat volumes (EFVs), epicardial fat thickness (EFT) and MetS remains inconsistent. METHODS Specific searches of electronic databases from 1 January 2000 to 31 October 2022 were independently performed by two researchers. In this study, two quantification measures of epicardial fat were included: comparison of total computed tomography-based EFVs and EFT between two groups (individuals with and without MetS), estimating standardized mean difference (SMD) with corresponding 95 % confidence intervals (CIs) through a random-effects model analysis. The heterogeneity in the included studies was explored by meta-regression and subgroup analyses. RESULTS The EFVs were significantly increased in MetS subjects compared with non-MetS subjects (SMD: 1.07, 95 % CI: 0.69-1.45, p < 0.001), and the EFT was also significantly larger in MetS patients than in the Non-MetS (SMD: 1.12, 95 % CI: 0.84-1.41, p < 0.001). We compared the Caucasian and American subgroups with the Asian and African subgroups, and the EFT was greater in the former subgroups (SMD: 1.32, 95 % CI: 0.44-2.20, p < 0.001). When comparing the EFT among the age subgroups, there was a significant SMD between adolescents and adults or elderly individuals (SMD: 1.21, 95 % CI: 0.84-1.52, p < 0.001). CONCLUSIONS MetS patients tend to present greater EFT near the right ventricular free wall and greater total EFVs. Increased epicardial fat, an imaging biomarker, independently affects the onset of MetS.
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Affiliation(s)
- Zhong-Yan Ma
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Hui Duan
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China.
| | - Dan Han
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Bo He
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Xiao-Jie Xie
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Lin Lu
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Jie Jiang
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Rui-Hong Li
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
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Zheng W, Zhou X, Yin J, Liu H, Yin W, Zhang W, Zhu X, Sun Z. Metabolic syndrome-related cognitive impairment with white matter hyperintensities and functional network analysis. Obesity (Silver Spring) 2023; 31:2557-2567. [PMID: 37724054 DOI: 10.1002/oby.23873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 06/19/2023] [Accepted: 06/26/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVE This study aimed to explore the relationship between white matter hyperintensities (WMHs) and cognitive impairment related to metabolic syndrome (MetS) and the underlying neural network mechanisms. METHODS This cross-sectional study included 50 participants with MetS and WMHs (MetS-WMHs), 45 with MetS without WMHs, and 50 control participants. All participants underwent resting-state functional magnetic resonance imaging and a detailed cognitive evaluation. A graph theory analysis based on resting-state functional magnetic resonance imaging was conducted to calculate functional network properties. A mediation analysis was conducted to determine the relationship between WMHs and MetS-related cognitive impairment. RESULTS Compared with the control group, the participants in the MetS-WMHs group displayed lower global efficiency, local efficiency, and nodal efficiency, mainly located in the regions of the salience network. Furthermore, a significant correlation was observed between functional network efficiency and cognitive performance. Mediation analysis indicated that WMHs served as a mediating variable between MetS and cognitive decline, affecting attention/executive function, language, and global cognitive function. CONCLUSIONS WMHs mediated the association between MetS and cognitive function, with a decline in the efficiency of functional brain networks being a probable neural mechanism.
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Affiliation(s)
- Wenhui Zheng
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xia Zhou
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jiabin Yin
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Han Liu
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Neurology, Anhui Public Clinical Center, Hefei, China
| | - Wenwen Yin
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Wei Zhang
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaoqun Zhu
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zhongwu Sun
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
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Roifman I. Editorial for "Effect of Metabolic Dysfunction-Associated Fatty Liver Disease on Left Ventricular Deformation and Atrioventricular Coupling in Patients With Metabolic Syndrome Assessed by MRI". J Magn Reson Imaging 2023; 58:1108-1109. [PMID: 36621892 DOI: 10.1002/jmri.28594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 12/28/2022] [Indexed: 01/10/2023] Open
Affiliation(s)
- Idan Roifman
- Schulich Heart Program, Sunnybrook Health Science Center, University of Toronto, Toronto, Ontario, Canada
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11
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Sun LJ, Xiao CW, Zhao XB, Guo S, Zhang F. Association between epicardial adipose tissue and myocardial work by non-invasive left ventricular pressure-strain loop in people with suspected metabolic syndrome. Sci Rep 2023; 13:14415. [PMID: 37660205 PMCID: PMC10475131 DOI: 10.1038/s41598-023-41779-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 08/31/2023] [Indexed: 09/04/2023] Open
Abstract
Given the inconsistent results on the prognostic significance of epicardial adipose tissue (EAT), the purpose of the present study was to investigate the association of EAT thickness and myocardial work by non-invasive left ventricular pressure-strain loop in people with suspected metabolic syndrome (MS). A total of 194 participants imaged with echocardiography were evaluated. In accordance with the median EAT thickness, MS patients fell into thin EAT group and thick EAT group. Conventional echocardiographic parameters, global longitudinal strain (GLS) and the global myocardial work parameters obtained by pressure-strain loop analysis, comprising the global work index (GWI), global work efficiency (GWE), global constructive work (GCW) and global wasted work (GWW) were compared between the two groups. In comparison with the thin EAT group, thick EAT group achieved significantly higher values in interventricular septal thickness, end-diastolic left ventricular posterior wall thickness, left ventricular mass index and GWW (p < 0.05). while the absolute value of GLS, GWI, GCW, and GWE were notably lower in the thick EAT group (p < 0.001). EAT thickness showed a significant correlation with GWI and GCW (r = - 0.328, p = 0.001; r = - 0.253, p = 0.012), and also independently correlated with GWI and GCW in the multivariate regression analysis (β = - 0.310, p = 0.001; β = - 0.199, p = 0.049). EAT thickness is associated with left ventricular myocardial function in subjects with suspected metabolic syndrome, independently of other risk factors. Further studies are supposed to ensure the causal associations and related mechanisms.
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Affiliation(s)
- Li-Juan Sun
- Department of Ultrasound, First Hospital of Qinhuangdao, Qinhuangdao, 066000, Hebei, China
| | - Cheng-Wei Xiao
- Department of Ultrasound, First Hospital of Qinhuangdao, Qinhuangdao, 066000, Hebei, China
- Hebei Medical University, Shijiazhuang, China
| | - Xue-Bing Zhao
- Department of Ultrasound, First Hospital of Qinhuangdao, Qinhuangdao, 066000, Hebei, China
- Hebei Medical University, Shijiazhuang, China
| | - Shuai Guo
- Department of Ultrasound, First Hospital of Qinhuangdao, Qinhuangdao, 066000, Hebei, China
| | - Fang Zhang
- Department of Ultrasound, First Hospital of Qinhuangdao, Qinhuangdao, 066000, Hebei, China.
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Huang P, Tint MT, Lee M, Ngoh ZM, Gluckman P, Chong YS, Han W, Fu Y, Wee CL, Fortier MV, Ang KK, Lee YS, Yap F, Eriksson JG, Meaney MJ, Tan AP. Functional activity of the caudate mediates the relation between early childhood microstructural variations and elevated metabolic syndrome scores. Neuroimage 2023; 278:120273. [PMID: 37473977 DOI: 10.1016/j.neuroimage.2023.120273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/10/2023] [Accepted: 07/11/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Metabolic syndrome score in children assesses the risk of developing cardiovascular disease in future. We aim to probe the role of the caudate in relation to the metabolic syndrome score. Furthermore, using both functional and structural neuroimaging, we aim to examine the interplay between functional and structural measures. METHODS A longitudinal birth cohort study with functional and structural neuroimaging data obtained at 4.5, 6.0 and 7.5 years and metabolic syndrome scores at 8.0 years was used. Pearson correlation and linear regression was used to test for correlation fractional anisotropy (FA) and fractional amplitude of low frequency fluctuations (fALFF) of the caudate with metabolic syndrome scores. Mediation analysis was used to test if later brain measures mediated the relation between earlier brain measures and metabolic syndrome scores. Inhibitory control was also tested as a mediator of the relation between caudate brain measures and metabolic syndrome scores. RESULTS FA at 4.5 years and fALFF at 7.5 years of the left caudate was significantly correlated with metabolic syndrome scores. Post-hoc mediation analysis showed that fALFF at 7.5 years fully mediated the relation between FA at 4.5 years and metabolic syndrome scores. Inhibitory control was significantly correlated with fALFF at 7.5 years, but did not mediate the relation between fALFF at 7.5 years and metabolic syndrome scores. CONCLUSIONS We found that variations in caudate microstructure at 4.5 years predict later variation in functional activity at 7.5 years. This later variation in functional activity fully mediates the relation between microstructural changes in early childhood and metabolic syndrome scores at 8.0 years.
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Affiliation(s)
- Pei Huang
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Mya Thway Tint
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Marissa Lee
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Zhen Ming Ngoh
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Peter Gluckman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Centre for Human Evolution, Adaptation and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Department of Obstetrics & Gynaecology, National University Hospital Singapore, Singapore
| | - Weiping Han
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore; Center for Neuro-Metabolism and Regeneration Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China; School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yu Fu
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Caroline Lei Wee
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Marielle V Fortier
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Department of Diagnostic and Interventional Radiology, KK Women's and Children's Hospital, Singapore
| | - Kai Keng Ang
- Institute for Infocomm Research, Agency for Science, Technology and Research (A*STAR), Singapore; School of Computer Science and Engineering, Nanyang Technological University, Singapore
| | - Yung Seng Lee
- Department of Paedatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Fabian Yap
- Department of Paediatrics, Endocrinology Service, KK Women's and Children's Hospital, Singapore, Singapore
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Michael J Meaney
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; Brain - Body Initiative, Agency for Science and Technology (A*STAR), Singapore
| | - Ai Peng Tan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Department of Diagnostic Imaging, National University Hospital Singapore, Singapore.
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Sakthivadivel V, Chinnathambi C, Selvaraju D, Gaur A, Bakthavatchalam R, Srivijayan A, Sundaramurthy R, Tadi LJ, John NA. Metabolic syndrome - cardiac structure and functional analysis by echocardiography; a cross sectional comparative study. Horm Mol Biol Clin Investig 2023; 44:305-310. [PMID: 36855825 DOI: 10.1515/hmbci-2022-0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 02/08/2023] [Indexed: 03/02/2023]
Abstract
OBJECTIVES Metabolic syndrome (MS) is a collection of metabolic disorders including hyperglycemia, hypertension and dyslipidemia. The outcome of metabolic syndrome depends on structural changes in heart like increased left atrial size or increased left ventricular mass. This study was done to determine the echocardiography abnormalities in metabolic syndrome. METHODS After obtaining informed consent, 75 subjects with metabolic syndrome and 75 controls were included in the study. 2D echo/M mode examination was performed for all. Aortic root, left atrial size, left atrial volume, septal wall thickness during systole (SWs) and diastole (SWd), posterior wall thickness during systole (PWs) and diastole (PWd), left ventricle dimension during systole (LVDs) and diastole (LVDd), and ejection fraction were measured. The values were compared between the groups. RESULTS After adjustment for age, sex, smoking, alcohol and BMI; left ventricular diameter in systole and diastole was significantly more than controls (p<0.001); HR of 1.29 (95% CI 1.13-1.46), 1.29 (95% CI 1.15-1.45) respectively. Left ventricular mass and left atrial volume were increased significantly in subjects with metabolic syndrome (p<0.001); HR were 1.06 (95% CI 1.03-1.08), 1.13 (95% CI 1.06-1.19) respectively. Ejection fraction was low normal in subjects with metabolic syndrome compared to controls (p<0.05); HR 0.90 (95% CI 0.83-0.98). CONCLUSIONS Cardiac abnormalities were common in subjects with metabolic syndrome, predominantly affecting the left ventricular mass, diameter and left atrial volume. Early life style modifications are essential to prevent these complications.
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Affiliation(s)
- Varatharajan Sakthivadivel
- Department of General Medicine, All India Institute of Medical Sciences Bibinagar, Hyderabad, Telangana, India
| | - Chennappan Chinnathambi
- Department of Neurology, Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, Tamilnadu, India
| | - Divya Selvaraju
- Department of Obstetrics and Gynecology, K.A.P.Viswanatham Government Medical College, Tiruchirapalli, Tamilnadu, India
| | - Archana Gaur
- Department of Physiology, All India Institute of Medical Sciences-Bibinagar, Hyderabad, Telangana, India
| | | | - Appandraj Srivijayan
- Department of General Medicine, Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research, Melmaruvathur, Tamilnadu, India
| | - Raja Sundaramurthy
- Department of Microbiology, All India Institute of Medical Sciences-Bibinagar, Hyderabad, India
| | - Lakshmi Jyothi Tadi
- Department of Microbiology, All India Institute of Medical Sciences-Bibinagar, Hyderabad, India
| | - Nitin Ashok John
- Department of Physiology, All India Institute of Medical Sciences-Bibinagar, Hyderabad, India
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14
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Kang SH, Liu M, Park G, Kim SY, Lee H, Matloff W, Zhao L, Yoo H, Kim JP, Jang H, Kim HJ, Jahanshad N, Oh K, Koh SB, Na DL, Gallacher J, Gottesman RF, Seo SW, Kim H. Different effects of cardiometabolic syndrome on brain age in relation to gender and ethnicity. Alzheimers Res Ther 2023; 15:68. [PMID: 36998058 PMCID: PMC10061789 DOI: 10.1186/s13195-023-01215-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 03/20/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND A growing body of evidence shows differences in the prevalence of cardiometabolic syndrome (CMS) and dementia based on gender and ethnicity. However, there is a paucity of information about ethnic- and gender-specific CMS effects on brain age. We investigated the different effects of CMS on brain age by gender in Korean and British cognitively unimpaired (CU) populations. We also determined whether the gender-specific difference in the effects of CMS on brain age changes depending on ethnicity. METHODS These analyses used de-identified, cross-sectional data on CU populations from Korea and United Kingdom (UK) that underwent brain MRI. After propensity score matching to balance the age and gender between the Korean and UK populations, 5759 Korean individuals (3042 males and 2717 females) and 9903 individuals from the UK (4736 males and 5167 females) were included in this study. Brain age index (BAI), calculated by the difference between the predicted brain age by the algorithm and the chronological age, was considered as main outcome and presence of CMS, including type 2 diabetes mellitus (T2DM), hypertension, obesity, and underweight was considered as a predictor. Gender (males and females) and ethnicity (Korean and UK) were considered as effect modifiers. RESULTS The presence of T2DM and hypertension was associated with a higher BAI regardless of gender and ethnicity (p < 0.001), except for hypertension in Korean males (p = 0.309). Among Koreans, there were interaction effects of gender and the presence of T2DM (p for T2DM*gender = 0.035) and hypertension (p for hypertension*gender = 0.046) on BAI in Koreans, suggesting that T2DM and hypertension are each associated with a higher BAI in females than in males. In contrast, among individuals from the UK, there were no differences in the effects of T2DM (p for T2DM*gender = 0.098) and hypertension (p for hypertension*gender = 0.203) on BAI between males and females. CONCLUSIONS Our results highlight gender and ethnic differences as important factors in mediating the effects of CMS on brain age. Furthermore, these results suggest that ethnic- and gender-specific prevention strategies may be needed to protect against accelerated brain aging.
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Affiliation(s)
- Sung Hoon Kang
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Mengting Liu
- School of Biomedical Engineering, Sun Yat-Sen University, Shenzhen, China
- Keck School of Medicine of University of Southern California, USC Steven Neuroimaging and Informatics Institute, Los Angeles, CA, 90033, USA
| | - Gilsoon Park
- Keck School of Medicine of University of Southern California, USC Steven Neuroimaging and Informatics Institute, Los Angeles, CA, 90033, USA
| | - Sharon Y Kim
- Keck School of Medicine of University of Southern California, USC Steven Neuroimaging and Informatics Institute, Los Angeles, CA, 90033, USA
| | - Hyejoo Lee
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - William Matloff
- Keck School of Medicine of University of Southern California, USC Steven Neuroimaging and Informatics Institute, Los Angeles, CA, 90033, USA
| | - Lu Zhao
- Keck School of Medicine of University of Southern California, USC Steven Neuroimaging and Informatics Institute, Los Angeles, CA, 90033, USA
| | - Heejin Yoo
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jun Pyo Kim
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyemin Jang
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hee Jin Kim
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Neda Jahanshad
- Keck School of Medicine of University of Southern California, USC Steven Neuroimaging and Informatics Institute, Los Angeles, CA, 90033, USA
| | - Kyumgmi Oh
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Seong-Beom Koh
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Duk L Na
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - John Gallacher
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Rebecca F Gottesman
- National Institute of Neurological Disorders and Stroke Intramural Research Program, National Institutes of Health, Bethesda, MD, USA
| | - Sang Won Seo
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea.
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea.
- Alzheimer's Disease Convergence Research Center, Samsung Medical Center, Seoul, South Korea.
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, South Korea.
| | - Hosung Kim
- Keck School of Medicine of University of Southern California, USC Steven Neuroimaging and Informatics Institute, Los Angeles, CA, 90033, USA
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Andica C, Kamagata K, Takabayashi K, Kikuta J, Kaga H, Someya Y, Tamura Y, Kawamori R, Watada H, Taoka T, Naganawa S, Aoki S. Neuroimaging findings related to glymphatic system alterations in older adults with metabolic syndrome. Neurobiol Dis 2023; 177:105990. [PMID: 36621631 DOI: 10.1016/j.nbd.2023.105990] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 12/03/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE The glymphatic system is a glial-based perivascular network that promotes brain metabolic waste clearance. Reduced glymphatic flow has been observed in rat models of type 2 diabetes and hypertension, indicating the role of vascular risk factors in the glymphatic system. However, little is known about how vascular risk factors affect the human glymphatic system. The present study aims to assess the relationships between metabolic syndrome (MetS), a cluster of vascular risk factors, and the glymphatic system function using diffusion magnetic resonance imaging (MRI)-based measures of water diffusivity in the glymphatic compartments, including the brain interstitial space and perivascular spaces around the deep medullary vein. We hypothesized that vascular risk factors are associated with glymphatic dysfunction, leading to cognitive impairment in older adults. METHODS This cross-sectional study assessed 61 older adults (age range, 65-82 years) who had participated in the Bunkyo Health Study, including 15 healthy controls (mean age, 70.87 ± 4.90 years) and 46 individuals with MetS (mean age, 71.76 ± 4.61 years). Fractional volume of extracellular-free water (FW) and an index of diffusion tensor imaging along the perivascular space (DTI-ALPS) were used as indirect indicators of water diffusivity in the interstitial extracellular and perivenous spaces of white matter, respectively. RESULTS After adjusting for age, sex, years of education, total Fazekas scale, Pittsburgh sleep quality index (PSQI) score, and intracranial volume (ICV), a significantly (P = 0.030; Cohen's d = 1.01) higher FW was observed in individuals with MetS than in the healthy controls. Furthermore, individuals with MetS had a significantly (P = 0.031; Cohen's d = 0.86) lower ALPS index than the healthy controls, with age, sex, years of education, total Fazekas scale, PSQI score, ICV, fractional anisotropy, and mean diffusivity included as confounding factors. Higher FW was significantly associated with lower ALPS index (r = -0.37; P = 0.004). Multiple linear regression (MLR) with backward elimination analyses showed that higher diastolic blood pressure (BP; standardized β = 0.33, P = 0.005) was independently associated with higher FW, whereas higher fasting plasma glucose levels (standardized β = -0.63, P = 0.002) or higher Brinkman index of cigarette consumption cumulative amount (standardized β = -0.27, P = 0.022) were associated with lower ALPS index. The lower ALPS index (standardized β, 0.28; P = 0.040) was associated with poorer global cognitive performance, which was determined using the Japanese version of the Montreal Cognitive Assessment (MOCA-J) scores. Finally, partial correlation analyses showed a significant correlation between higher FW and lower MOCA-J scores (r = -0.35; P = 0.025) and between higher FW and higher diastolic BP (r = 0.32, P = 0.044). CONCLUSION The present study shows the changes in diffusion MRI-based measures reflected by the higher FW and lower ALPS index in older adults with MetS, possibly due to the adverse effect of vascular risk factors on the glymphatic system. Our findings also indicate the associations between the diffusion MRI-based measures and elevated diastolic BP, hyperglycemia, smoking habit, and poorer cognitive performance. However, owing to the limitations of this study, the results should be cautiously interpreted.
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Affiliation(s)
- Christina Andica
- Faculty of Health Data Science, Juntendo University, 6-8-1 Hinode, Urayasu, Chiba 279-0013, Japan; Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
| | - Koji Kamagata
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Kaito Takabayashi
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Junko Kikuta
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Hideyoshi Kaga
- Sportology Center, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0034, Japan; Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Yuki Someya
- Sportology Center, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0034, Japan
| | - Yoshifumi Tamura
- Sportology Center, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0034, Japan; Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Ryuzo Kawamori
- Sportology Center, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0034, Japan; Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Hirotaka Watada
- Sportology Center, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0034, Japan; Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Toshiaki Taoka
- Department of Innovative Biomedical Visualization, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Shigeki Aoki
- Faculty of Health Data Science, Juntendo University, 6-8-1 Hinode, Urayasu, Chiba 279-0013, Japan; Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
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Blaho M, Macháčková J, Dítě P, Holéczy P, Šedivý P, Psár R, Švagera Z, Vilímek D, Toman D, Urban O, Bužga M. Use of Magnetic Resonance Imaging to Quantify Fat and Steatosis in the Pancreas in Patients after Bariatric Surgery: a Retrospective Study. Obes Surg 2022; 32:3666-3674. [PMID: 36121606 DOI: 10.1007/s11695-022-06278-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Pancreatic steatosis (PS) has both metabolic consequences and local effects on the pancreas itself. Magnetic resonance imaging (MRI) is the most reliable non-invasive method for diagnosing PS. We investigated the impact of metabolic syndrome (MS) on the presence of PS, differences in individuals with and without PS, and the metabolic effects of bariatric procedures. METHODS Changes in anthropometric and basic biochemistry values and MS occurrence were evaluated in 34 patients with obesity who underwent a bariatric procedure. After the procedure, patients underwent MRI with manual 3D segmentation mask creation to determine the pancreatic fat content (PFC). We compared the differences in the PFC and the presence of PS in individuals with and without MS and compared patients with and without PS. RESULTS We found no significant difference in the PFC between the groups with and without MS or in the occurrence of PS. There were significant differences in patients with and without PS, especially in body mass index (BMI), fat mass, visceral adipose tissue (VAT), select adipocytokines, and lipid spectrum with no difference in glycemia levels. Significant metabolic effects of bariatric procedures were observed. CONCLUSIONS Bariatric procedures can be considered effective in the treatment of obesity, MS, and some of its components. Measuring PFC using MRI did not show any difference in relation to MS, but patients who lost weight to BMI < 30 did not suffer from PS and had lower overall fat mass and VAT. Glycemia levels did not have an impact on the presence of PS.
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Affiliation(s)
- Martin Blaho
- Department of Internal Medicine and Cardiology, Division of Gastroenterology, University Hospital Ostrava, Ostrava, Czech Republic
- Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
- Department of Internal Medicine II - Gastroenterology and Geriatrics, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital, Olomouc, Czech Republic
| | - Jitka Macháčková
- Department of Internal Medicine and Cardiology, Division of Gastroenterology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Petr Dítě
- Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
- Department of Gastroenterology and Internal Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Pavol Holéczy
- Department of Surgery, Vitkovice Hospital, Ostrava, Czech Republic
- Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Petr Šedivý
- MR Unit, Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Robert Psár
- Department of Radiology, Vitkovice Hospital, Ostrava, Czech Republic
- Department of Radiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital, Olomouc, Czech Republic
| | - Zdeněk Švagera
- Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
- Institute of Laboratory Medicine, University Hospital Ostrava, Ostrava, Czech Republic
| | - Dominik Vilímek
- Department of Cybernetics and Biomedical Engineering, VSB-Technical University of Ostrava, Ostrava, Czech Republic
| | - Daniel Toman
- Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
- Department of Surgery, University Hospital Ostrava, Ostrava, Czech Republic
| | - Ondřej Urban
- Department of Internal Medicine II - Gastroenterology and Geriatrics, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital, Olomouc, Czech Republic
| | - Marek Bužga
- Institute of Laboratory Medicine, University Hospital Ostrava, Ostrava, Czech Republic.
- Department of Physiology and Pathophysiology, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.
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Montemayor S, Mascaró CM, Ugarriza L, Casares M, Gómez C, Martínez JA, Tur JA, Bouzas C. Intrahepatic Fat Content and COVID-19 Lockdown in Adults with NAFLD and Metabolic Syndrome. Nutrients 2022; 14:nu14173462. [PMID: 36079720 PMCID: PMC9457922 DOI: 10.3390/nu14173462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
Background: COVID-19 lockdowns had a significant impact on people’s health, triggering levels of anxiety, perceived stress, and changes in food and nutritional status. Objectives: To assess the changes in dietary habits, metabolic syndrome (MetS) and liver parameters before and after the COVID-19 lockdown according to changes in intrahepatic fat content in adults with non-alcoholic fatty liver disease (NAFLD) and MetS. Design: Pre- and post-lockdown observation of the COVID-19 lockdown on fifty-nine 40–60-year-old participants with MetS and NAFLD, in a parallel group, randomised experiment intended to treat NAFLD. Methods: Anthropometrics, liver and MetS biochemical parameters, intrahepatic fat content by abdominal magnetic resonance imaging, and dietary assessment using a validated 148-item Food Frequency Questionnaire were collected pre-COVID-19 lockdown and post-lockdown. Results: COVID-19 lockdown led to negative changes in the liver of patients with NAFLD and MetS, with weight gain and increases in glycemia, ALT and intrahepatic fat content post lockdown. Participants with worsened liver status had low consumption of fibre, cheese, nuts and coffee, and high consumption of sweets and pastries. Participants who improved liver status ameliorated ALT values, waist circumference, and intrahepatic fat content, assessed by magnetic resonance imaging post-lockdown. Conclusions: The maintenance of healthy lifestyle habits is vital, especially for populations with NAFLD and MetS, to reduce unhealthy lifestyle patterns displayed during lockdown.
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Affiliation(s)
- Sofía Montemayor
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain
- Health Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain
| | - Catalina M. Mascaró
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain
- Health Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain
| | - Lucía Ugarriza
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain
- Health Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain
- Camp Redó Primary Health Care Center, 07010 Palma de Mallorca, Spain
| | - Miguel Casares
- Radiodiagnosis Service, Red Asistencial Juaneda, 07011 Palma de Mallorca, Spain
| | - Cristina Gómez
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain
- Health Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain
- Clinical Analysis Service, Universitary Hospital Son Espases, 07120 Palma de Mallorca, Spain
| | - J. Alfredo Martínez
- Center for Nutrition Research, Department of Nutrition, Food Sciences, and Physiology, University of Navarra, 31008 Pamplona, Spain
- Cardiometabolics Precision Nutrition Program, IMDEA Food, CEI UAM-CSIC, 28049 Madrid, Spain
| | - Josep A. Tur
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain
- Health Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Correspondence:
| | - Cristina Bouzas
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain
- Health Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
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18
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Li JQ, Wang X, Peng LT, Yan W, Liu QQ, Li XN. [The correlations of abdominal adipose tissue with anthropometric and metabolic parameters in obese children by magnetic resonance imaging]. Zhonghua Er Ke Za Zhi 2022; 60:798-803. [PMID: 35922191 DOI: 10.3760/cma.j.cn112140-20220129-00099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To explore abdominal fat mass distribution and contents among obese children via magnetic resonance imaging (MRI), and analyze the correlations of abdominal adipose tissue with anthropometric and metabolic parameters. Methods: Cross-sectional study. There were 60 obese children admitted to the Children's Health Care Department and Endocrinology Department at Children's Hospital of Nanjing Medical University from July 2016 to December 2018. Children's gender, age, height, weight, body composition, waist circumference and blood pressure were recorded. The levels of fasting blood glucose, lipids, insulin were measured, and liver ultrasound was performed, and the body mass index Z score (BMI-Z), waist-to-height ratio (WHtR) and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. In addition, contents of subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT) and total abdominal adipose tissue (TAAT) were calculated according to feedback of abdominal MRI scan images. The associations between the contents of abdominal adipose tissue, physical examination status and metabolic disorders among obese children were analyzed through correlation analysis and regression analysis. Receiver operating characteristic (ROC) curve was used to compare the accuracy of fat mass in different parts of the abdomen in predicting their metabolic disorders. Results: A total of 60 children were enrolled in the study, included 44 boys and 16 girls, with age of (9.2±1.4) years. The contents of SAT, VAT and TAAT among the 60 children were positively associated with BMI-Z (r=0.60, 0.46, 0.59), body fat percentage (r=0.64, 0.67, 0.68) and waist-to-height ratio (r=0.60, 0.57, 0.61) (all P<0.01). Meanwhile, contents of SAT and TAAT were also positively correlated with systolic blood pressure (r=0.47, 0.49), triglyceride (r=0.33, 0.35) and HOMA-IR (r=0.33, 0.28)(all P<0.05). In order to adjust the confounding effects among various variables, regression analysis was applied and the result showed that the body fat percentage (β=0.59, 0.66, 0.65) and waist-to-height ratio (β=0.53, 0.63, 0.59) were most related to abdominal fat contents (all P<0.01), including SAT, VAT and TAAT among obese children. According to ROC, SAT had outstanding evaluation performances for the diagnosis of insulin resistance and metabolic syndrome, while VAT had excellent evaluation performances for non-alcoholic fatty liver disease (area under curve=0.68, 0.69, 0.69, 95%CI 0.54-0.82, 0.55-0.84, 0.53-0.85, P=0.017, 0.014, 0.019). Conclusions: As one of the best indexes, body fat percentage and WHtR can be used to predict the contents of SAT, VAT and TAAT among obese children. With the increase of abdominal SAT or VAT, the risks for insulin resistance, metabolic syndrome and non-alcoholic fatty liver disease would increase. Assessment of abdominal fat and metabolic risks in obese children should combine BMI-Z with waist circumference and body composition analysis.
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Affiliation(s)
- J Q Li
- Department of Child Health Care, Children's Hospital of Nanjing Medical University,Nanjing 210008,China
| | - X Wang
- Department of Radiology, Children's Hospital of Nanjing Medical University,Nanjing 210008,China
| | - L T Peng
- Department of Child Health Care, Children's Hospital of Nanjing Medical University,Nanjing 210008,China
| | - W Yan
- Department of Child Health Care, Children's Hospital of Nanjing Medical University,Nanjing 210008,China
| | - Q Q Liu
- Department of Child Health Care, Children's Hospital of Nanjing Medical University,Nanjing 210008,China
| | - X N Li
- Department of Child Health Care, Children's Hospital of Nanjing Medical University,Nanjing 210008,China
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19
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Bennett JP, Liu YE, Quon BK, Kelly NN, Leong LT, Wong MC, Kennedy SF, Chow DC, Garber AK, Weiss EJ, Heymsfield SB, Shepherd JA. Three-dimensional optical body shape and features improve prediction of metabolic disease risk in a diverse sample of adults. Obesity (Silver Spring) 2022; 30:1589-1598. [PMID: 35894079 PMCID: PMC9333197 DOI: 10.1002/oby.23470] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/05/2022] [Accepted: 04/21/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This study examined whether body shape and composition obtained by three-dimensional optical (3DO) scanning improved the prediction of metabolic syndrome (MetS) prevalence compared with BMI and demographics. METHODS A diverse ambulatory adult population underwent whole-body 3DO scanning, blood tests, manual anthropometrics, and blood pressure assessment in the Shape Up! Adults study. MetS prevalence was evaluated based on 2005 National Cholesterol Education Program criteria, and prediction of MetS involved logistic regression to assess (1) BMI, (2) demographics-adjusted BMI, (3) 85 3DO anthropometry and body composition measures, and (4) BMI + 3DO + demographics models. Receiver operating characteristic area under the curve (AUC) values were generated for each predictive model. RESULTS A total of 501 participants (280 female) were recruited, with 87 meeting the criteria for MetS. Compared with the BMI model (AUC = 0.819), inclusion of age, sex, and race increased the AUC to 0.861, and inclusion of 3DO measures further increased the AUC to 0.917. The overall integrated discrimination improvement between the 3DO + demographics and the BMI model was 0.290 (p < 0.0001) with a net reclassification improvement of 0.214 (p < 0.0001). CONCLUSIONS Body shape measures from an accessible 3DO scan, adjusted for demographics, predicted MetS better than demographics and/or BMI alone. Risk classification in this population increased by 29% when using 3DO scanning.
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Affiliation(s)
- Jonathan P Bennett
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Honolulu, Hawaii, USA
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Yong En Liu
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Brandon K Quon
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Nisa N Kelly
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Lambert T Leong
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Michael C Wong
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Honolulu, Hawaii, USA
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Samantha F Kennedy
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Dominic C Chow
- John A. Burns School of Medicine, University of Hawai'i Manoa, Honolulu, Hawaii, USA
| | - Andrea K Garber
- Division of Adolescent & Young Adult Medicine, University of California, San Francisco, California, USA
| | - Ethan J Weiss
- Division of Cardiology, University of California School of Medicine, San Francisco, California, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - John A Shepherd
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Honolulu, Hawaii, USA
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
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20
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Klarenberg H, Dekkers IA, Peeters CFW, de Mutsert R, Jukema JW, Rosendaal FR, Leiner T, Gosselink M, Froeling M, Strijkers GJ, Boekholdt SM, Lamb HJ. Confirmatory factor analysis including MRI-derived adipose tissues quantification improves associations of metabolic dysregulation to diastolic dysfunction. J Diabetes Complications 2022; 36:108202. [PMID: 35491309 DOI: 10.1016/j.jdiacomp.2022.108202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/29/2022] [Accepted: 04/15/2022] [Indexed: 11/28/2022]
Abstract
AIMS To quantify metabolic impairment via a one-factor approach with confirmatory factor analysis (CFA) including MRI-derived visceral and subcutaneous adipose tissues and to associate it with diastolic dysfunction. METHODS In this cross-sectional analysis, 916 participants (53% female, mean age (SD): 56 (6)) underwent abdominal and cardiovascular MRI. With CFA a metabolic-load factor of metabolic-syndrome variables and visceral and subcutaneous adipose tissues was constructed. A piecewise structural equation model approach with adjustment for confounding factors was used to determine associations with left-ventricular diastolic function, cardiac morphology and hemodynamics. RESULTS Model fitting excluding blood pressure and waist circumference but including visceral and subcutaneous adipose tissues, fasting glucose, HDL-c and triglycerides was used to construct the metabolic-load factor. Evaluating measurement invariance demonstrated sex-specificity. Change in mitral early/late peak filling rate ratio was -0.12 for both males [-0.20; -0.05, p > 0.05] and females [-0.17; -0.07, p > 0.001] per SD of metabolic-load factor. Change in deceleration time of mitral early filling was -11.83 ms in females [-17.38; -6.27] per SD of metabolic-load factor. CONCLUSION A single latent metabolic-load factor via CFA including MRI-derived adipose tissues increased sensitivity for metabolic impairment obsoleting waist circumference and is associated with a decreased left-ventricular diastolic function, more apparent in females than in males.
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Affiliation(s)
- Hugo Klarenberg
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Centers, Amsterdam Cardiovascular Sciences, University of Amsterdam, the Netherlands.
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Carel F W Peeters
- Department of Epidemiology & Datascience, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands; Division of Mathematical & Statistical Methods - Biometris, Wageningen University & Research, Wageningen, the Netherlands
| | - R de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, the Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Tim Leiner
- Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Mark Gosselink
- Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Martijn Froeling
- Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Gustav J Strijkers
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Centers, Amsterdam Cardiovascular Sciences, University of Amsterdam, the Netherlands
| | - S Matthijs Boekholdt
- Department of Cardiology, Amsterdam University Medical Centers, Amsterdam Cardiovascular Sciences, University of Amsterdam, the Netherlands
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
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21
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Falsetti P, Conticini E, Baldi C, Bardelli M, Cantarini L, Frediani B. Diffuse Peripheral Enthesitis in Metabolic Syndrome: A Retrospective Clinical and Power Doppler Ultrasound Study. Reumatol Clin (Engl Ed) 2022; 18:273-278. [PMID: 35568441 DOI: 10.1016/j.reumae.2020.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/30/2020] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To investigate peripheral enthesitis with power Doppler ultrasound (PDUS) in patients presenting low back pain (LBP) and metabolic syndrome (MetS) in comparison with patients with only LBP, to correlate US scores with clinical-anthropometric characteristics, and to define any relationship between enthesitis and concurrent diffuse idiopathic hyperostosis syndrome (DISH). METHODS Sixty outpatients with LBP and MetS, evaluated with multi-site entheseal PDUS, scoring inflammatory and structural damage changes, were retrospectively analyzed. A group of 60 subjects with LBP, without MetS and evaluated with the same protocol, was analyzed as the control group. RESULTS Patients showed overweight (BMI 29.8) and low-grade inflammatory state (C-reactive protein [CRP] 0.58mg/dL, erythrosedimentation rate [ESR] 20.2mm/h). Enthesitis was demonstrated in 52 (86%) patients (17.6% entheses), and in 8 controls (13.3%) (p<.00001). PD signals (15% of patients) were associated with entheseal pain (p=.0138). US scores correlated with body mass index (BMI), pain, type 2 diabetes. In 28 (46%) patients a concurrent DISH was diagnosed, correlating with older age (p<.0001), CRP (p=.0428), ESR (p=.0069) and PDUS scores (p=.0312 inflammatory, p=.0071 structural). MetS had a strong association (OR 4.375, p=.0007) with concurrent DISH. CONCLUSIONS Diffuse peripheral enthesitis is very common in MetS. Almost half of MetS patients can have a concurrent diagnosis of DISH; they are older, with higher inflammation, and higher PDUS enthesitis scores.
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Affiliation(s)
- Paolo Falsetti
- Rheumatology Unit, University of Siena, Santa Maria alle Scotte Hospital, Siena, Italy.
| | - Edoardo Conticini
- Rheumatology Unit, University of Siena, Santa Maria alle Scotte Hospital, Siena, Italy
| | - Caterina Baldi
- Rheumatology Unit, University of Siena, Santa Maria alle Scotte Hospital, Siena, Italy
| | - Marco Bardelli
- Rheumatology Unit, University of Siena, Santa Maria alle Scotte Hospital, Siena, Italy
| | - Luca Cantarini
- Rheumatology Unit, University of Siena, Santa Maria alle Scotte Hospital, Siena, Italy
| | - Bruno Frediani
- Rheumatology Unit, University of Siena, Santa Maria alle Scotte Hospital, Siena, Italy
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22
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Karaman ZF, Hatipoğlu N, Kardaş F, Saraçoğlu S, Direk G, Kendirci M, Coşkun A. Identifying the effects of excess weight, metabolic syndrome and insulin resistance on liver stiffness using ultrasound elastography in children. Turk J Pediatr 2022; 64:671-682. [PMID: 36082641 DOI: 10.24953/turkjped.2021.1876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Metabolic syndrome (MetS) and insulin resistance (IR) are known predictors of nonalcoholic fatty liver disease (NAFLD) which is one of the significant comorbidities of obesity. Obese children with MetS and IR are reported to be more likely to have advanced liver fibrosis compared to those without MetS or IR. The aim of this study is to determine the effects of excess weight, MetS and IR on liver fibrosis assessing liver stiffness in children using ultrasound elastography and compare gray scale ultrasonographic findings of hepatic steatosis (HS) with liver fibrosis. METHODS The study group involved 131 overweight/obese children. The control group involved 50 healthy lean children. Groups were adjusted according to body mass index (BMI) and BMI-standard deviation scores (SDS). Liver stiffness measurements which are expressed by shear wave velocity (SWV) were performed for each individual. The study group was further subgrouped as children with MetS and without MetS, with IR and without IR. RESULTS The mean SWV of liver was 1,07 ± 0,12 m/s in the control group and 1,15 ± 0,51 m/s in the study group. The difference was significant (p=0,047). SWV of liver was weakly correlated with age, BMI, BMI-SDS, Homeostatic Model Assessment-Insulin Resistance and high-density lipoprotein cholesterol. The mean SWV of the liver in the study group for children without MetS was 1,1 ± 0,44 m/s, with MetS was 1,23 ± 0,70 m/s. The difference was not significant (p=0,719). The mean SWV of the liver in the study group for children without IR was 1,02 ± 0,29 m/s, with IR was 1,24 ± 0,61 m/s. The difference was not significant (p=0,101). In multivariate regression analysis, the only independent factor affecting liver stiffness was BMI-SDS (OR:2,584, 95% CI: 1,255- 5,318, p=0,010). CONCLUSIONS Obesity itself, regardless of MetS or IR seems to be the major problem affecting liver stiffness in this study. However, large scale longitudinal studies might clarify this issue.
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Affiliation(s)
- Zehra Filiz Karaman
- Departments of Pediatric Radiology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Nihal Hatipoğlu
- Departments of Pediatric Endocrinology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Fatih Kardaş
- Departments of Pediatric Nutrition and Metabolism, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Sibel Saraçoğlu
- Departments of Pediatric Radiology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Gül Direk
- Departments of Pediatric Endocrinology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Mustafa Kendirci
- Departments of Pediatric Endocrinology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Abdulhakim Coşkun
- Departments of Pediatric Radiology, Erciyes University Faculty of Medicine, Kayseri, Turkey
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Rashid B, Poole VN, Fortenbaugh FC, Esterman M, Milberg WP, McGlinchey RE, Salat DH, Leritz EC. Association between metabolic syndrome and resting-state functional brain connectivity. Neurobiol Aging 2021; 104:1-9. [PMID: 33951557 PMCID: PMC8225583 DOI: 10.1016/j.neurobiolaging.2021.03.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 03/18/2021] [Accepted: 03/24/2021] [Indexed: 01/01/2023]
Abstract
The objective of this study is to examine whether metabolic syndrome (MetS), the clustering of 3 or more cardiovascular risk factors, disrupts the resting-state functional connectivity (FC) of the large-scale cortical brain networks. Resting-state functional magnetic resonance imaging data were collected from seventy-eight middle-aged and older adults living with and without MetS (27 MetS; 51 non-MetS). FC maps were derived from the time series of intrinsic activity in the large-scale brain networks by correlating the spatially averaged time series with all brain voxels using a whole-brain seed-based FC approach. Participants with MetS showed hyperconnectivity across the core brain regions with evidence of loss of modularity when compared with non-MetS individuals. Furthermore, patterns of higher between-network MetS-related effects were observed across most of the seed regions in both right and left hemispheres. These findings indicate that MetS is associated with altered intrinsic communication across core neural networks and disrupted between-network connections across the brain due to the co-occurring vascular risk factors in MetS.
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Affiliation(s)
- Barnaly Rashid
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; The Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, USA.
| | - Victoria N Poole
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Francesca C Fortenbaugh
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Michael Esterman
- National Center for PTSD, VA Boston Healthcare System, Boston, MA; Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - William P Milberg
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Regina E McGlinchey
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - David H Salat
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; The Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, USA
| | - Elizabeth C Leritz
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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24
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Arana-Pazos KC, Narvaezrivera JL, Maceda-Serrano A, Benitez-Maldonado DR, Rubio-Guerra AF. Correlation between epicardial fat thickness with intima-media thickness and ankle-brachial index in patients with metabolic syndrome. Natl Med J India 2021; 34:151-153. [PMID: 34825540 DOI: 10.25259/nmji_182_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Background An increase in epicardial fat thickness (EFT) has been associated with increased cardiovascular risk and the development of atherosclerosis. Transthoracic echo-cardiography provides a reliable measurement of EFT. We evaluated the relationship of EFT with carotid intima-media thickness (CIMT) and ankle-brachial index (ABI), in patients with metabolic syndrome. Methods We assessed 80 patients with metabolic syndrome who underwent echocardiography; EFT was measured by two cardiologists. The CIMT (B-mode colour imaging of extracranial carotid arteries using high-resolution ultrasound) was also measured by a certified ultrasonographer, and ABI was measured by the main researcher. Results We did not find any correlation between ABI with EFT (r=0.0103, p=0.93) or with CIMT (r=-0.1625, p=0.15). However, we found a significant correlation between EFT and CIMT (r=0.2718, r2=0.074, p=0.015). When we evaluated the risk for a CIMT >0.9 mm in patients with an EFT >3 mm, we found a statistically significant association (p=0.039). Interestingly, only 1 patient with an EFT <3 mm had a CIMT >0.9 mm. Conclusion We found that the EFT correlates with CIMT in patients with metabolic syndrome, which explains, at least in part, the higher risk of atherosclerosis in them. Measurement of EFT should be part of the cardiovascular risk evaluation in patients with metabolic syndrome.
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Affiliation(s)
- Karla C Arana-Pazos
- Research Unit, Plan de San Luis S/N Esq Bandera, Col Ticomán, D.F. C.P. 07330, México
| | - Jorge L Narvaezrivera
- Echocardiography Department, Plan de San Luis S/N Esq Bandera, Col Ticomán, D.F. C.P. 07330, México
| | | | | | - Alberto Francisco Rubio-Guerra
- Ultrasound Department, Hospital General de Ticoman, SS CDMX, Plan de San Luis S/N Esq Bandera, Col Ticomán, D.F. C.P. 07330, México
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Maloberti A, Bombelli M, Vallerio P, Milani M, Cartella I, Tavecchia G, Tognola C, Grasso E, Sun J, De Chiara B, Riccobono S, Grassi G, Giannattasio C. Metabolic syndrome is related to vascular structural alterations but not to functional ones both in hypertensives and healthy subjects. Nutr Metab Cardiovasc Dis 2021; 31:1044-1052. [PMID: 33549437 DOI: 10.1016/j.numecd.2020.11.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/01/2020] [Accepted: 11/10/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Metabolic Syndrome (MS) has been related to an impairment in arterial structural and functional properties with heterogeneous results. In this paper we focused on the effects of MS on arterial carotid-femoral PWV and common carotid IMT in two different populations, one of hypertensive patients and one of healthy controls. METHODS AND RESULTS We enrolled 816 consecutive HT and 536 healthy controls. Vascular structural (IMT) and functional (PWV) properties were evaluated. NCEP-ATP-III criteria were used for diagnosis of MS. MS was diagnosed in 26.9% and 6.9% in hypertensive and control subjects, respectively. PWV was similar in controls with and without MS (7.7 ± 1.9 vs 7.6 ± 1.1 m/s, p = 0.69), while IMT was higher in controls with than those without MS (0.64 ± 0.18 vs 0.57 ± 0.13 mm, p = 0.02). Hypertensives with MS were older (57.9 ± 12.2 vs 52.7 ± 14.1 years, p < 0.001) and showed higher PWV (9.0 ± 2.3 vs 8.4 ± 2.1 m/s, p = 0.001) and IMT (0.72 ± 0.22 vs 0.65 ± 0.17 mm, p < 0.001) than those without MS, however at the age-adjusted analysis only the difference in IMT was confirmed (p = 0.007). Regression models showed that MS was an independent determinant of IMT in both controls (β = 0.08, p = 0.03) and hypertensives (β = 0.08, p = 0.01), but not of PWV either in controls (β = 0.006, p = 0.886 and β = 0.04, p = 0.19, respectively). CONCLUSIONS the main finding of our work is that MS is a significant determinant of IMT while this is not the case for PWV. This result have been confirmed both in hypertensive subjects and in healthy controls.
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Affiliation(s)
- Alessandro Maloberti
- Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy; Health Science Department, Milano-Bicocca University, Milan, Italy.
| | - Michele Bombelli
- Health Science Department, Milano-Bicocca University, Milan, Italy
| | - Paola Vallerio
- Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Martina Milani
- Health Science Department, Milano-Bicocca University, Milan, Italy
| | - Iside Cartella
- Health Science Department, Milano-Bicocca University, Milan, Italy
| | | | - Chiara Tognola
- Health Science Department, Milano-Bicocca University, Milan, Italy
| | - Enzo Grasso
- Health Science Department, Milano-Bicocca University, Milan, Italy
| | - Jinwei Sun
- Health Science Department, Milano-Bicocca University, Milan, Italy
| | - Benedetta De Chiara
- Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Salvatore Riccobono
- Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Guido Grassi
- Health Science Department, Milano-Bicocca University, Milan, Italy
| | - Cristina Giannattasio
- Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy; Health Science Department, Milano-Bicocca University, Milan, Italy
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26
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Xavier SA, Monteiro SO, Arieira CM, Castro FD, Magalhães JT, Leite SM, Marinho CM, Cotter JB. US-FLI score - Is it possible to predict the steatosis grade with an ultrasonographic score? Mol Genet Metab 2021; 132:204-209. [PMID: 33558081 DOI: 10.1016/j.ymgme.2021.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVES A recent ultrasonographic score (Ultrasonographic fatty liver indicator (US-FLI)) allows to grade steatosis severity on ultrasound (US).We aimed to evaluate the agreement of US-FLI with the controlled attenuation parameter (CAP) in patients with non-alcoholic fatty liver disease (NAFLD). METHODS Initially, inter-observer agreement for the score was assessed between 3 physicians using a sample of 31 patients.Later, 96 patients with NAFLD were included and several anthropometric/clinical/analytical parameters were assessed and US and transient elastography was performed. RESULTS Physicians showed an excellent absolute agreement regarding the total score, with an average Interclass Correlation Coefficient of 0.972(95% CI 0.949-0.986). Comparing US-FLI with CAP, considering the previously defined cut-off for steatosis >S1(268dB/m) and > S2(280dB/m), US-FLI had a good discriminative capacity for both grades, with areas under the curve (AUC) of 0.88(p < 0.001) and 0.90(p < 0.001), respectively.Also, US-FLI ≤ 3 points had a negative predictive value of 100% for steatosis >S2 and US-FLI ≥6 points had a positive predictive value (PPV) of 94.0% for steatosis >S2. When comparing the clinical score Fatty Liver Index (FLI) for the same CAP cut-offs, it showed a weak discriminative capacity for both grades, with AUC of 0.65(p = 0.030) and 0.66(p = 0.017). AUC for US-FLI and FLI were significantly different for both cut-offs (p < 0.001). CONCLUSION US-FLI has an excellent reproducibility and a good discriminative capacity for the different steatosis grades.Scores ≤3points exclude significant steatosis and scores ≥6 points have a PPV of 94,0% for steatosis >S2.US-FLI was significantly superior to the clinical score FLI in the discrimination between steatosis grades.
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Affiliation(s)
- Sofia A Xavier
- Hospital Senhora da Oliveira, Gastroenterology Department, Guimarães, Portugal; School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's Associate Laboratory, University of Minho, Braga, Portugal.
| | - Sara O Monteiro
- Hospital Senhora da Oliveira, Gastroenterology Department, Guimarães, Portugal; School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's Associate Laboratory, University of Minho, Braga, Portugal
| | - Cátia M Arieira
- Hospital Senhora da Oliveira, Gastroenterology Department, Guimarães, Portugal; School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's Associate Laboratory, University of Minho, Braga, Portugal
| | - Francisca D Castro
- Hospital Senhora da Oliveira, Gastroenterology Department, Guimarães, Portugal; School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's Associate Laboratory, University of Minho, Braga, Portugal
| | - Joana T Magalhães
- Hospital Senhora da Oliveira, Gastroenterology Department, Guimarães, Portugal; School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's Associate Laboratory, University of Minho, Braga, Portugal
| | - Sílvia M Leite
- Hospital Senhora da Oliveira, Gastroenterology Department, Guimarães, Portugal; School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's Associate Laboratory, University of Minho, Braga, Portugal
| | - Carla M Marinho
- Hospital Senhora da Oliveira, Gastroenterology Department, Guimarães, Portugal; School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's Associate Laboratory, University of Minho, Braga, Portugal
| | - José B Cotter
- Hospital Senhora da Oliveira, Gastroenterology Department, Guimarães, Portugal; School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's Associate Laboratory, University of Minho, Braga, Portugal
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Chiyanika C, Wong VWS, Wong GLH, Chan HLY, Hui SCN, Yeung DKW, Chu WCW. Implications of Abdominal Adipose Tissue Distribution on Nonalcoholic Fatty Liver Disease and Metabolic Syndrome: A Chinese General Population Study. Clin Transl Gastroenterol 2021; 12:e00300. [PMID: 33600104 PMCID: PMC7889374 DOI: 10.14309/ctg.0000000000000300] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/10/2020] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Visceral adipose tissue (VAT) has been found to play a critical role in the development of metabolic syndrome and nonalcoholic fatty liver disease (NAFLD) independent of generalized obesity. METHODS In this secondary study of prospectively acquired data, 625 participants underwent magnetic resonance spectroscopy and chemical shift fat-water separation MRI (2-point Dixon) of the liver and whole abdomen, respectively, in a 3 Tesla magnet. Whole abdominal VAT and subcutaneous adipose tissue (SAT) were extracted from the 2-point Dixon image series using an automated method. Clinical/anthropometric/blood biochemistry parameters were measured. Using region-specific body mass index, participants were classified into 3 paired subgroups (lean, overweight, and obese) and presence of NAFLD (liver fat content ≥ 5.5%). RESULTS All relevant clinical/anthropometric/blood biochemistry characteristics and liver enzymes were statistically significant between groups (P < 0.001). NAFLD was found in 12.1%, 43.8%, and 68.3% and metabolic syndrome in 51.1%, 61.9%, and 65% of the lean, overweight, and obese, respectively. Odds ratio for metabolic syndrome and NAFLD was increased by 2.73 (95% confidence interval [CI] 2.18-3.40) and 2.53 (95% CI 2.04-3.12), respectively, for 1SD increase in VAT volume while prevalence of metabolic syndrome was increased by 2.26 (95% CI 1.83-2.79) for 1SD increase in liver fat content (%). VAT/SAT ratio in the lean with fatty liver showed the highest ratio (0.54) among all the subgroups, without a significant difference between the lean and obese with NAFLD (P = 0.127). DISCUSSION Increased VAT volume/disproportional distribution of VAT/SAT may be vital drivers to the development of metabolic syndrome and NAFLD irrespective of body mass index category.
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Affiliation(s)
- Chileka Chiyanika
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
| | - Vincent Wai-Sun Wong
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Grace Lai-Hung Wong
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Henry Lik-Yuen Chan
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Steve C. N. Hui
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David K. W. Yeung
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
- Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong, China
| | - Winnie C. W. Chu
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
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Abstract
It is suggested that estrogen protects premenopausal women against non-alcoholic fatty liver disease. From another perspective, the relation between metabolic syndrome (MetS) and non-alcoholic fatty liver disease (NAFLD) is bidirectional. Role of insulin resistance (IR) in NAFLD continues to be a matter of debate. The present study aimed to assess the relation between IR and NAFLD in premenopausal women with MetS. The study included 51 premenopausal women with MetS. In addition, there were 40 age-matched healthy controls. All participants were subjected to careful history taking and thorough clinical examination. Performed laboratory investigations included fasting blood glucose, fasting insulin, lipid profile, and liver functions. Calculation of IR was achieved by the Homeostasis Model Assessment (HOMA-IR). NAFLD was graded into three grades according to findings of abdominal ultrasound. Patients had significantly higher BMI, SBP, DBP, FBG, fasting insulin, HOMA-IR, total cholesterol, triglycerides, and LDL levels when compared with controls. They also had significantly lower HDL levels in comparison to controls. Moreover, they have more advanced grades of NAFLD in contrast to controls. Comparison between patients with various grades of NAFLD regarding the clinical data revealed significant increase of fasting insulin and HOMA-IR levels with advancing NAFLD grade. Using multivariate regression analysis, HOMA-IR was an independent predictor of advanced NAFLD grade. In conclusion, the present study documented a combined inter-relation between MetS, IR, and NAFLD in premenopausal women with MetS. IR is correlated with NAFLD grade.
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Affiliation(s)
- Amr Ali El-Sehrawy
- Internal Medicine Department, Mansoura University Faculty of Medicine, Mansoura, Egypt
| | - Omnia State
- Internal Medicine Department, Mansoura University Faculty of Medicine, Mansoura, Egypt
| | - Rasha Rizk Elzehery
- Clinical Pathology Department, Mansoura University Faculty of Medicine, Mansoura, Egypt
| | - Ahmed Salem Mohamed
- Internal Medicine Department, Mansoura University Faculty of Medicine, Mansoura, Egypt
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Huang Z, Ng K, Chen H, Deng W, Li Y. Validation of Controlled Attenuation Parameter Measured by FibroScan as a Novel Surrogate Marker for the Evaluation of Metabolic Derangement. Front Endocrinol (Lausanne) 2021; 12:739875. [PMID: 35173677 PMCID: PMC8841525 DOI: 10.3389/fendo.2021.739875] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 12/16/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND/OBJECTIVES Renaming non-alcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated fatty liver disease (MAFLD) suggests a shift of emphasis to the accompanying metabolic disturbance. Controlled attenuation parameter (CAP) measured by FibroScan has been shown to be correlated with hepatic steatosis. We aim to validate its usefulness as a novel surrogate marker for evaluating metabolic derangement. SUBJECTS/METHODS Volunteers were recruited from medical staff at our hospital to undergo CAP measurements. Anthropometrics, CAP, and laboratory assessments for metabolic profiles and insulin resistance were collected. CAP < 238 dB/m denoted no hepatic steatosis, 238 ≤ CAP ≤ 259 dB/m denoted mild, 260 ≤ CAP ≤ 291 dB/m denoted moderate, and CAP > 291 dB/m denoted severe hepatic steatosis according to previous reports. RESULTS Data of 824 participants were included for analysis. The age was 53.2 ± 15.4 years, body mass index (BMI) was 23.6 ± 3.1 kg/m2, 24.4% were male subjects, and 22.0% met the criteria for metabolic syndrome (MetS). Taking the group with CAP < 238 dB/m as control, subjects with mild, moderate, and severe hepatic steatosis had increased odds of MetS by 3.51-, 3.32-, and 5.12-fold, respectively, after adjusting for multiple confounders (p = 0.020). Metabolic profiles, insulin resistance, and presence of MetS were similar between normal-weight subjects with CAP ≥ 238 dB/m and overweight subjects with CAP < 238 dB/m. Even in subjects with no MetS components, those with CAP ≥ 238 dB/m had higher BMI, waist circumferences, uric acid, triglyceride, white blood cell count, and insulin resistance, whereas lower adiponectin and estimated glomerular filtration rate. Waist circumference [OR 1.11 (1.04, 1.18), p = 0.001] and homeostatic model assessment of insulin resistance (HOMA-IR) [OR 2.39 (1.18, 4.83), p = 0.016] were predictive of hepatic steatosis according to CAP ≥ 238 dB/m. CONCLUSIONS CAP is a convenient, sensitive, and non-invasive indicator for metabolic derangement. Prospective studies are needed to further validate its usefulness as a surrogate marker for the transition of metabolic status over time.
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Affiliation(s)
- Zhimin Huang
- Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Kaka Ng
- Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Centro Hospitalar Conde de S Januário, Macau, Macau SAR, China
| | - Hongyan Chen
- Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Department of Endocrinology, Panyu District Traditional Chinese Medicine Hospital, Guangzhou, China
| | - Wanping Deng
- Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yanbing Li
- Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- *Correspondence: Yanbing Li,
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Pimanov S, Bondarenko V, Makarenko E. Visceral fat in different locations assessed by ultrasound: Correlation with computed tomography and cut-off values in patients with metabolic syndrome. Clin Obes 2020; 10:e12404. [PMID: 32857464 DOI: 10.1111/cob.12404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/23/2020] [Accepted: 08/03/2020] [Indexed: 12/23/2022]
Abstract
The aim of this study was to evaluate the correlation between ultrasound measurements of visceral adipose tissue (VAT) in different locations and visceral fat area parameters estimated by computed tomography (CT), as well as to determine the cut-off values of ultrasound measurements in patients with metabolic syndrome and in normal controls. Altogether, 304 patients aged 18 to 65 years were enrolled in the study. Ultrasound measurements of visceral fat volume were performed using a number of already described techniques. The correlations of ultrasound indices of VAT and СТ (104 patients) ranged from 0.420 to 0.726. For the most effective diagnostic VAT ultrasound indices, the cut-off values in metabolic syndrome were (200 patients): 21.12 cm2 for the inferior part of perirenal fat (AUC = 0.983); and 47.00, 61.3 and 72.7 mm for the distance between the internal surface of the rectus abdominis muscle and the anterior wall of the aorta, the posterior wall of the aorta and the lumbar vertebra (AUC = 0.960, 0.966, 0.968, respectively). Ultrasound VAT measurements highly correlated with CT results. Cut-off VAT values, determined by ultrasound for the patients with metabolic syndrome, yielded good diagnostic operational characteristics.
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Affiliation(s)
- Sergey Pimanov
- Therapy Department No. 2, Vitebsk State Medical University, Vitebsk, Belarus
| | | | - Elena Makarenko
- Therapy Department No. 2, Vitebsk State Medical University, Vitebsk, Belarus
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Li H, Wang Z, Liu JS, Zou BS, Chen HR, Xu Z, Li H, Tian S, Shi YL, Li S, Wu KN, Ran L, Kong LQ. Association Between Breast and Thyroid Lesions: A Cross-Sectional Study Based on Ultrasonography Screening in China. Thyroid 2020; 30:1150-1158. [PMID: 32148169 DOI: 10.1089/thy.2019.0184] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Introduction: Prior research has shown an association between breast and thyroid cancers, although their relationship is unclear. In China, asymptomatic women undergoing regular health checkups usually undergo breast and thyroid ultrasonography screening. The present cross-sectional ultrasound-based study estimated the prevalence of breast masses (BM) and thyroid nodules (TN) and their relationship among a population-based cohort of Chinese women. Methods: This study included 34,184 consecutive asymptomatic Chinese women who underwent both breast and thyroid ultrasound evaluation during one health care examination. Detected lesions were assigned into categories of different malignant risks according to the Breast and Thyroid Imaging Reporting and Data System (BI-/TI-RADS). Binomial logistic regression was used to determine the association between occurrence of BM and TN, and multinomial logistic regression was used to analyze the correlation of BM and TN in different BI-/TI-RADS categories. Associations between BM and TN, as well as anthropometric and biochemical markers, were also explored. Results: Of those enrolled, 6371 (18.6%) had BM, 12,153 (35.6%) had TN, and 2279 (6.7%) had both. After adjusting for age, body mass index (BMI), and height, females with TN had a higher risk of BM (odds ratio [OR] = 1.151, 95% confidence interval [CI 1.081-1.225], p < 0.0001) than those with normal thyroids, and females with BM had a higher risk of TN (OR = 1.165 [CI 1.096-1.238], p < 0.0001) than those without BM. Women with a TN >10 mm (OR = 1.249 [CI 1.104-1.413], p = 0.0004) and those with a TN ≤10 mm (OR = 1.134 [CI 1.062-1.211], p = 0.0002) were at higher risk of BM compared with those with normal thyroids. As RADS categories increased, so did the correlation between BM and TN. The increased risk of TN was associated with a higher BMI, height, systolic blood pressure, and a lower plasma albumin level. The increased risk of BM was associated with a lower BMI, plasma albumin levels, and higher height. Conclusions: A high prevalence of BM and TN was detected by ultrasonography screening in this cohort of Chinese women. These lesions occurred frequently and simultaneously, particularly in women with lesions in higher RADS categories.
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Affiliation(s)
- Hao Li
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ze Wang
- Department of Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jia-Shuo Liu
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Bao-Shan Zou
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hao-Ran Chen
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhou Xu
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hong Li
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shen Tian
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yan-Ling Shi
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shu Li
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Kai-Nan Wu
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Liang Ran
- Health Management Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ling-Quan Kong
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Hamasaki H, Furuta M, Yanai H. Validity of Visceral Fat Area Measurement by Bioelectrical Impedance Analysis in Japanese Obese Individuals. Curr Diabetes Rev 2020; 16:515-519. [PMID: 30686247 DOI: 10.2174/1573399815666190128113657] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/04/2019] [Accepted: 03/19/2019] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Obesity management is a critical global issue. It is essential to evaluate visceral adiposity which is associated with metabolic syndrome and cardiovascular disease. AIM This study aims at precisely evaluating the necessity of visceral adipose tissue in obesity management. METHODS We assessed the validity of visceral fat area (VFA) measurement using bioelectrical impedance analysis (BIA) with computed tomography (CT) as a reference in obese subjects. Although VFABIA exhibited significant correlation with VFACT, the difference between VFACT and VFABIA increased with an advancing degree of obesity. RESULT AND CONCLUSION The BIA device seemingly underestimated VFA in obese subjects compared with the normal-weight subjects.
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Affiliation(s)
- Hidetaka Hamasaki
- Hamasaki Clinic, Kagoshima, Japan
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Masashi Furuta
- Department of Nutrition, Toho University Omori Medical Center, Tokyo, Japan
| | - Hidekatsu Yanai
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
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Al-Saeed A. Comments on: Serum nesfatin-1 and galanin concentrations in the adult with metabolic syndrome. Relationships to insulin resistance and obesity. Saudi Med J 2019; 40:630-631. [PMID: 31219502 PMCID: PMC6778756 DOI: 10.15537/smj.2019.6.24181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Abdulghani Al-Saeed
- Department of Endocrinology and Diabetes, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Milovanovic T, Dragasevic S, Stojkovic Lalosevic M, Zgradic S, Milicic B, Dumic I, Kmezic S, Saponjski D, Antic A, Markovic V, Popovic D. Ultrasonographic Evaluation of Fatty Pancreas in Serbian Patients with Non Alcoholic Fatty Liver Disease-A Cross Sectional Study. ACTA ACUST UNITED AC 2019; 55:medicina55100697. [PMID: 31627351 PMCID: PMC6843527 DOI: 10.3390/medicina55100697] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 10/08/2019] [Accepted: 10/09/2019] [Indexed: 12/13/2022]
Abstract
Background and Objectives: The aim of the study was to determine the association between presences of fatty pancreas (FP) with the features of metabolic syndrome (MeS) in patients with non–alcoholic fatty liver disease (NAFLD) and to establish a new noninvasive scoring system for the prediction of FP in patients with NAFLD. Material and Methods: 143 patients with NAFLD were classified according to FP severity grade into the two groups and evaluated for diagnostic criteria of MeS. All patients underwent sonographic examination with adiposity measurements and the liver biopsy. Liver fibrosis was evaluated semi-quantitatively according to the METAVIR scoring system and using non-invasive markers of hepatic fibrosis. Results: Waist circumference (WC) was predictive for increased risk of FP in NAFLD patients. Elevated fasting plasma glucose, total cholesterol, serum amylase and lipase levels were associated with presence of severe FP (p value = 0.052, p value = 0.007, p value = 0.014; p value = 0.024, respectively). Presence of increased amounts of mesenteric fat was associated with severe FP (p value = 0.013). The results of this study demonstrated highly significant association between NAFLD and presence of FP. The model for predicting the presence of FP was designed with probability value above 6.5. Conclusion: Pancreatic fat accumulation leads to worsening of pancreatic function which in turns exacerbates severity of metabolic syndrome associated with both, NAFLD and NAFPD.
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Affiliation(s)
- Tamara Milovanovic
- School of Medicine, University of Belgrade, 11 000 Belgrade, Serbia.
- Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, 11 000 Belgrade, Serbia.
| | - Sanja Dragasevic
- Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, 11 000 Belgrade, Serbia.
| | - Milica Stojkovic Lalosevic
- School of Medicine, University of Belgrade, 11 000 Belgrade, Serbia.
- Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, 11 000 Belgrade, Serbia.
| | - Sanja Zgradic
- Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, 11 000 Belgrade, Serbia.
| | - Biljana Milicic
- Institute for Medical Informatics and Biostatistics, School of Dentistry, University of Belgrade, 11 000 Belgrade, Serbia.
| | - Igor Dumic
- Division of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA.
- Mayo Clinic College of Medicine and Sciences, Rochester, MN 55905, USA.
| | - Stefan Kmezic
- Clinic for Abdominal Surgery-First Surgical Clinic, Clinical Center of Serbia, 11 000 Belgrade, Serbia.
| | - Dusan Saponjski
- Center for Radiology and MRI, Clinical Center of Serbia, 11 000 Belgrade, Serbia.
| | - Andrija Antic
- School of Medicine, University of Belgrade, 11 000 Belgrade, Serbia.
- Clinic for Abdominal Surgery-First Surgical Clinic, Clinical Center of Serbia, 11 000 Belgrade, Serbia.
| | - Velimir Markovic
- School of Medicine, University of Belgrade, 11 000 Belgrade, Serbia.
- Clinic for Abdominal Surgery-First Surgical Clinic, Clinical Center of Serbia, 11 000 Belgrade, Serbia.
| | - Dragan Popovic
- School of Medicine, University of Belgrade, 11 000 Belgrade, Serbia.
- Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, 11 000 Belgrade, Serbia.
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Andersson C, Lyass A, Xanthakis V, Larson MG, Mitchell GF, Cheng S, Vasan RS. Risk factor-based subphenotyping of heart failure in the community. PLoS One 2019; 14:e0222886. [PMID: 31613888 PMCID: PMC6793865 DOI: 10.1371/journal.pone.0222886] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 09/09/2019] [Indexed: 12/28/2022] Open
Abstract
Background Heart failure (HF) is a heterogeneous clinical syndrome with varying prognosis. Subphenotyping of HF is a research priority to advance our understanding of the syndrome. We formulated a subphenotyping schema and compared long-term mortality risk among the HF subphenotypes in the community-based Framingham Study. Methods and results In hierarchical order, we grouped participants with new-onset HF (stratified by HF with reduced [HFrEF] vs. preserved ejection fraction [HFpEF]) according to the presence of: (1) coronary heart disease (CHD), (2) metabolic syndrome (MetS), (3) hypertension, and (4) ‘other’ causes. Age at HF onset was lowest in people with the MetS (mean 76 vs. 77 years for HFrEF and HFpEF, respectively) and highest in those with hypertension only (mean 82 and 85 years for HFrEF and HFpEF, respectively). For HFrEF, 10-year cumulative mortality and hazards ratios [HR] were 87% for CHD (n = 219; referent group), 88% for MetS (n = 105; HR 0.95 [95% CI 0.73–1.23]), 82% for hypertension (n = 104; HR 0.71 [0.55–0.91]), and 78% for other (n = 37; HR 0.81 [0.55–1.19]). Corresponding 10-year cumulative mortality and HR data for HFpEF were: 85% for CHD (n = 84; referent), 83% for MetS (n = 118; HR 0.98 [0.72–1.33]), 81% for hypertension (n = 127; HR 0.71 [0.52–0.95]), and 76% for other (n = 43; HR 0.76 [0.50–1.14]). In a sample without overt heart failure (n = 5536), several echocardiographic and vascular indices showed graded worsening of age- and sex adjusted-values among those having CHD, MetS, hypertension, or obesity, compared with individuals not having these risk factors. Conclusions HF subphenotypes characterized by the presence of CHD or metabolic syndrome present at a younger age and are marked by greater mortality risk. The clinical utility of the proposed subphenotyping schema warrants further research.
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Affiliation(s)
- Charlotte Andersson
- The Framingham Heart Study, Framingham, Massachusetts, United States of America
- Department of Cardiology, Herlev and Gentofte Hospital, Hellerup, Denmark
- Section of Cardiovascular Medicine, Boston University School of Medicine, Boston, Massachusetts, United States of America
- * E-mail:
| | - Asya Lyass
- The Framingham Heart Study, Framingham, Massachusetts, United States of America
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Vanessa Xanthakis
- The Framingham Heart Study, Framingham, Massachusetts, United States of America
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America
- Sections of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Martin G. Larson
- The Framingham Heart Study, Framingham, Massachusetts, United States of America
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Gary F. Mitchell
- Cardiovascular Engineering, Inc., Norwood, Massachusetts, United States of America
| | - Susan Cheng
- The Framingham Heart Study, Framingham, Massachusetts, United States of America
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Ramachandran S. Vasan
- The Framingham Heart Study, Framingham, Massachusetts, United States of America
- Section of Cardiovascular Medicine, Boston University School of Medicine, Boston, Massachusetts, United States of America
- Sections of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, Massachusetts, United States of America
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, United States of America
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36
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Neeland IJ, Ross R, Després JP, Matsuzawa Y, Yamashita S, Shai I, Seidell J, Magni P, Santos RD, Arsenault B, Cuevas A, Hu FB, Griffin B, Zambon A, Barter P, Fruchart JC, Eckel RH. Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: a position statement. Lancet Diabetes Endocrinol 2019; 7:715-725. [PMID: 31301983 DOI: 10.1016/s2213-8587(19)30084-1] [Citation(s) in RCA: 578] [Impact Index Per Article: 115.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 12/24/2018] [Accepted: 01/11/2019] [Indexed: 02/06/2023]
Abstract
Findings from epidemiological studies over the past 30 years have shown that visceral adipose tissue, accurately measured by CT or MRI, is an independent risk marker of cardiovascular and metabolic morbidity and mortality. Emerging evidence also suggests that ectopic fat deposition, including hepatic and epicardial fat, might contribute to increased atherosclerosis and cardiometabolic risk. This joint position statement from the International Atherosclerosis Society and the International Chair on Cardiometabolic Risk Working Group on Visceral Obesity summarises the evidence for visceral adiposity and ectopic fat as emerging risk factors for type 2 diabetes, atherosclerosis, and cardiovascular disease, with a focus on practical recommendations for health professionals and future directions for research and clinical practice. We discuss the measurement of visceral and ectopic fat, pathophysiology and contribution to adverse health outcomes, response to treatment, and lessons from a public health programme targeting visceral and ectopic fat. We identify knowledge gaps and note the need to develop simple, clinically applicable tools to be able to monitor changes in visceral and ectopic fat over time. Finally, we recognise the need for public health messaging to focus on visceral and ectopic fat in addition to excess bodyweight to better combat the growing epidemic of obesity worldwide.
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Affiliation(s)
- Ian J Neeland
- Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Robert Ross
- School of Medicine, Division of Endocrinology and Metabolism, Queen's University, Kingston, ON, Canada
| | - Jean-Pierre Després
- Quebec Heart and Lung Institute Research Centre, Quebec City, QC, Canada; Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec City, QC, Canada.
| | - Yuji Matsuzawa
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka, Japan
| | - Shizuya Yamashita
- Departments of Cardiovascular Medicine and Community Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Iris Shai
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Jaap Seidell
- Department of Health Sciences and the EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, Netherlands
| | - Paolo Magni
- Department of Pharmacological and Biomolecular Sciences, Universita' degli Studi di Milano, Milan, Italy
| | - Raul D Santos
- Lipid Clinic Heart Institute, University of São Paulo, Medical School Hospital and Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Benoit Arsenault
- Quebec Heart and Lung Institute Research Centre, Quebec City, QC, Canada; Department of Medicine, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Ada Cuevas
- Department of Clinical Nutrition and Metabolism, Clínica Las Condes, Santiago, Chile
| | - Frank B Hu
- Departments of Nutrition and Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Bruce Griffin
- Department of Nutritional Sciences, University of Surrey, Guildford, UK
| | - Alberto Zambon
- Department of Medicine, University of Padua, Padova, Italy
| | - Philip Barter
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | | | - Robert H Eckel
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado School of Medicine, Aurora, CO, USA
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Kotkowski E, Price LR, Franklin C, Salazar M, Woolsey M, DeFronzo RA, Blangero J, Glahn DC, Fox PT. A neural signature of metabolic syndrome. Hum Brain Mapp 2019; 40:3575-3588. [PMID: 31062906 PMCID: PMC6865471 DOI: 10.1002/hbm.24617] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 04/18/2019] [Accepted: 04/24/2019] [Indexed: 12/26/2022] Open
Abstract
That metabolic syndrome (MetS) is associated with age-related cognitive decline is well established. The neurobiological changes underlying these cognitive deficits, however, are not well understood. The goal of this study was to determine whether MetS is associated with regional differences in gray-matter volume (GMV) using a cross-sectional, between-group contrast design in a large, ethnically homogenous sample. T1-weighted MRIs were sampled from the genetics of brain structure (GOBS) data archive for 208 Mexican-American participants: 104 participants met or exceeded standard criteria for MetS and 104 participants were age- and sex-matched metabolically healthy controls. Participants ranged in age from 18 to 74 years (37.3 ± 13.2 years, 56.7% female). Images were analyzed in a whole-brain, voxel-wise manner using voxel-based morphometry (VBM). Three contrast analyses were performed, a whole sample analysis of all 208 participants, and two post hoc half-sample analyses split by age along the median (35.5 years). Significant associations between MetS and decreased GMV were observed in multiple, spatially discrete brain regions including the posterior cerebellum, brainstem, orbitofrontal cortex, bilateral caudate nuclei, right parahippocampus, right amygdala, right insula, lingual gyrus, and right superior temporal gyrus. Age, as shown in the post hoc analyses, was demonstrated to be a significant covariate. A further functional interpretation of the structures exhibiting lower GMV in MetS reflected a significant involvement in reward perception, emotional valence, and reasoning. Additional studies are needed to characterize the influence of MetS's individual clinical components on brain structure and to explore the bidirectional association between GMV and MetS.
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Affiliation(s)
- Eithan Kotkowski
- Research Imaging Institute, University of Texas Health Science Center at San AntonioSan AntonioTexas
- Department of RadiologyUniversity of Texas Health Science Center at San AntonioSan AntonioTX
| | - Larry R. Price
- Methodology, Measurement and Statistical Analysis CenterTexas State UniversitySan MarcosTexas
| | - Crystal Franklin
- Research Imaging Institute, University of Texas Health Science Center at San AntonioSan AntonioTexas
| | - Maximino Salazar
- Research Imaging Institute, University of Texas Health Science Center at San AntonioSan AntonioTexas
| | - Mary Woolsey
- Research Imaging Institute, University of Texas Health Science Center at San AntonioSan AntonioTexas
| | - Ralph A. DeFronzo
- Texas Diabetes InstituteSan AntonioTexas
- Diabetes Research Unit and Diabetes DivisionUniversity of Texas Health Science Center at San AntonioSan AntonioTexas
| | - John Blangero
- Genomics Computing Center, South Texas Diabetes and Obesity InstituteUniversity of Texas Rio Grande ValleyBrownsvilleTexas
| | - David C. Glahn
- Department of PsychiatryYale University School of MedicineNew HavenConnecticut
- Olin Neuropsychiatry Research CenterInstitute of Living, Hartford HospitalHartfordConnecticut
| | - Peter T. Fox
- Research Imaging Institute, University of Texas Health Science Center at San AntonioSan AntonioTexas
- Department of RadiologyUniversity of Texas Health Science Center at San AntonioSan AntonioTX
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38
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van Santen SS, Olsson DS, Hammarstrand C, Wijnen M, van den Heuvel-Eibrink MM, van der Lely AJ, Johannsson G, Janssen JAMJL, Neggers SJCMM. Diagnosing metabolic syndrome in craniopharyngioma patients: body composition versus BMI. Eur J Endocrinol 2019; 181:173-183. [PMID: 31167166 DOI: 10.1530/eje-19-0181] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 06/04/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Craniopharyngioma patients often have poor metabolic profiles due to hypothalamic-pituitary damage. Previously, using BMI as obesity marker, the occurrence of the metabolic syndrome in these patients was estimated at 46%. Our aim was to determine if dual X-ray absorptiometry (DXA) scan in evaluation of obesity and metabolic syndrome would be superior. DESIGN Retrospective study of craniopharyngioma patients for whom DXA scan results were available. METHODS BMI, fat percentage and fat mass index were used to evaluate obesity and as components for obesity in metabolic syndrome. RESULTS Ninety-five craniopharyngioma patients were included (51% female, 49% childhood-onset disease). Metabolic syndrome occurred in 34-53 (45-51%) subjects (depending on the definition of obesity, although all definitions occurred in higher frequency than in the general population). Metabolic syndrome frequency was higher if obesity was defined by fat percentage (52 vs 42%) or fat mass index (51 vs 43%) compared to BMI. Misclassification appeared in 9% (fat percentage vs BMI) and 7% (fat mass index vs BMI) for metabolic syndrome and 29 and 13% for obesity itself, respectively. For metabolic syndrome, almost perfect agreement was found for BMI compared with fat percentage or fat mass index. For obesity, agreement was fair to moderate (BMI vs fat percentage). CONCLUSION Using BMI to evaluate obesity underestimates the true prevalence of metabolic syndrome in patients with craniopharyngioma. Furthermore, fat percentage contributes to a better evaluation of obesity than BMI. The contribution of DXA scan might be limited for identification of the metabolic syndrome.
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Affiliation(s)
- Selvetta S van Santen
- Department of Internal Medicine, Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Daniel S Olsson
- Department of Internal Medicine, Endocrinology
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Casper Hammarstrand
- Department of Internal Medicine, Endocrinology
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Mark Wijnen
- Department of Internal Medicine, Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Marry M van den Heuvel-Eibrink
- Department of Internal Medicine, Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Aart J van der Lely
- Department of Internal Medicine, Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Gudmundur Johannsson
- Department of Internal Medicine, Endocrinology
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Joseph A M J L Janssen
- Department of Internal Medicine, Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Sebastian J C M M Neggers
- Department of Internal Medicine, Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Kole A, Cao Y, Hui J, Bolad IA, Alloosh M, Cheng JX, Sturek M. Comparative Quantification of Arterial Lipid by Intravascular Photoacoustic-Ultrasound Imaging and Near-Infrared Spectroscopy-Intravascular Ultrasound. J Cardiovasc Transl Res 2019; 12:211-220. [PMID: 30488332 PMCID: PMC6611754 DOI: 10.1007/s12265-018-9849-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/19/2018] [Indexed: 01/04/2023]
Abstract
Intravascular photoacoustic-ultrasound (IVPA-US) imaging and near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) are two hybrid modalities that detect arterial lipid, with comparison necessary to understand the relative advantages of each. We performed in vivo and ex vivo IVPA-US imaging of the iliac arteries of Ossabaw swine with metabolic syndrome (MetS) and lean swine to investigate sensitivity for early-stage atherosclerosis. We repeated imaging ex vivo with NIRS-IVUS for comparison to IVPA-US and histology. Both modalities showed significantly greater lipid in MetS vs. lean swine, but only IVPA-US localized the lipid as perivascular. To investigate late-stage atherosclerosis, we performed ex vivo IVPA-US imaging of a human coronary artery with comparison to NIRS-IVUS and histology. Two advanced fibroatheromas were identified, with agreement between IVPA-measured lipid area and NIRS-derived lipid content. As confirmed histologically, IVPA-US has sensitivity to detect lipid content similar to NIRS-IVUS and provides additional depth resolution, enabling quantification and localization of lipid cores within plaques.
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Affiliation(s)
- Ayeeshik Kole
- Department of Cellular & Integrative Physiology, Indiana University School of Medicine, 635 Barnhill Drive, MS 385, Indianapolis, IN, 46202, USA
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 47907, USA
| | - Yingchun Cao
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 47907, USA
| | - Jie Hui
- Department of Physics and Astronomy, Purdue University, West Lafayette, IN, 47907, USA
| | - Islam A Bolad
- Roudebush VA Medical Center and Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Mouhamad Alloosh
- Department of Cellular & Integrative Physiology, Indiana University School of Medicine, 635 Barnhill Drive, MS 385, Indianapolis, IN, 46202, USA
| | - Ji-Xin Cheng
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 47907, USA
- Department of Biomedical Engineering, Department of Electrical and Computer Engineering, Photonics Center, Boston University, Boston, MA, 02215, USA
| | - Michael Sturek
- Department of Cellular & Integrative Physiology, Indiana University School of Medicine, 635 Barnhill Drive, MS 385, Indianapolis, IN, 46202, USA.
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 47907, USA.
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40
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Liao YY, Yeh CK, Huang KC, Tsui PH, Yang KC. Metabolic Characteristics of a Novel Ultrasound Quantitative Diagnostic Index for Nonalcoholic Fatty Liver Disease. Sci Rep 2019; 9:7922. [PMID: 31138858 PMCID: PMC6538602 DOI: 10.1038/s41598-019-44453-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 05/14/2019] [Indexed: 02/06/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is an emerging epidemic worldwide and is regarded as a hepatic manifestation of metabolic syndrome (MetS). Only a few studies have discussed the biological features associated with quantitative assessment of ultrasound for characterizing NAFLD. Our aim was to delineate relevant metabolic characteristics using a new quantitative tool, the ultrasound quantitative diagnostic index (QDI). A total of 394 ultrasound data were analyzed to extract texture-feature parameters, the signal-to-noise ratio (SNR), and the slope of the center frequency downshift (CFDS) for determining the QDI. The texture index, SNR, and CFDS slope were all negatively correlated with high-density lipoprotein and positively correlated with other anthropometric indices and metabolic factors (all P < 0.05). The SNR had the greatest contribution to anthropometric and biochemical factors, followed by the texture index and CFDS slope. An increase in 1 unit of QDI score engendered a 9% higher risk of MetS, reflecting that the tool is feasible for use in identifying MetS (area under the receiver operating characteristic curve: 0.89). The QDI was correlated with metabolic factors and an independent predictor for MetS. Thus, this QDI might be a feasible method for use in clinical surveillance, epidemiology research, and metabolic function evaluations in patients with NAFLD.
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Affiliation(s)
- Yin-Yin Liao
- Department of Biomedical Engineering, Hungkuang University, Taichung, Taiwan
| | - Chih-Kuang Yeh
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan
| | - Kuo-Chin Huang
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, National Taiwan University Hospital, BeiHu Branch, Taipei, Taiwan
| | - Po-Hsiang Tsui
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University and Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Kuen-Cheh Yang
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
- Department of Family Medicine, National Taiwan University Hospital, BeiHu Branch, Taipei, Taiwan.
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Abstract
Metabolic syndrome (MetS) adversely affects the vasculature and cerebral white matter (CWM) integrity. Arterial stiffening has been associated with diminished CWM integrity. Physical activity (PA) can ameliorate components of MetS and subsequently affect arterial stiffening and CWM integrity. Our aim was to determine the role of PA on mitigating the adverse influence of MetS on arterial stiffness and CWM integrity. In a cross-sectional study design, sixty-six middle-aged adults (40-62 years) composed of 18 sedentary MetS (Sed MetS), 21 physically active MetS (Active MetS), and 27 healthy individuals absent of MetS risk factors were studied. Carotid artery stiffness was assessed via simultaneous ultrasound and tonometry. CWM integrity was measured using diffusion tensor imaging (DTI) through metrics of fractional anisotropy (FA) and mean diffusivity (MD). Carotid β-stiffness index in Active MetS was lower than Sed MetS but was not different from Healthy controls (6.6 ± 1.5, 7.7 ± 2.1, and 5.6 ± 1.6 au, p = 0.001). CWM integrity was significantly greater in Active MetS subjects compared to Sed MetS subjects but statistically equal to Healthy controls in the anterior limb of the internal capsule, and splenium of the corpus callosum, uncinate fasciculus, and superior corona radiata (all p < 0.05). Middle-aged individuals with MetS who habitually perform PA demonstrated lower arterial stiffness and more favorable CWM integrity than their sedentary peers, indicating that PA may be effective in mitigating the adverse effects of MetS on the vasculature and brain at midlife.
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Affiliation(s)
- Evan P Pasha
- Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd, D3700, Austin, TX, 78712, USA.
| | - Alex C Birdsill
- Department of Psychology, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Stephanie Oleson
- Department of Psychology, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Andreana P Haley
- Department of Psychology, The University of Texas at Austin, Austin, TX, 78712, USA
- Imaging Research Center, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Hirofumi Tanaka
- Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd, D3700, Austin, TX, 78712, USA
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Cho DH, Kim MN, Joo HJ, Shim WJ, Lim DS, Park SM. Visceral obesity, but not central obesity, is associated with cardiac remodeling in subjects with suspected metabolic syndrome. Nutr Metab Cardiovasc Dis 2019; 29:360-366. [PMID: 30782509 DOI: 10.1016/j.numecd.2019.01.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/14/2019] [Accepted: 01/19/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Metabolic syndrome (MetS) is a cluster of multiple risk factors including central obesity that may lead to cardiac damage and cardiovascular events. We investigated whether visceral obesity induces cardiac structural and functional remodeling independently from central obesity and other risk factors in subjects with suspected MetS. METHODS AND RESULTS We studied 229 participants with suspected MetS. Visceral fat area (VFA) was measured by bioelectrical impedance analysis. Left ventricular (LV) mass index, early diastolic velocity of mitral annulus (e'), and LV global longitudinal strain (GLS) were measured by echocardiography. Subjects were categorized into high and low VFA group (VFAh and VFAl). MetS was more prevalent in the VFAh than in the VFAl (p = 0.004). The VFAh had a higher waist circumference (WC) than the VFAl (p < 0.001). LV mass index was higher, but e' and GLS were lower in the VFAh than in VFAl (all p < 0.05). VFA was well correlated with blood pressure, fasting blood glucose, triglyceride, high-sensitivity C-reactive protein and adiponectin (all p < 0.05). VFA was correlated to LV mass index, e', and GLS (all p < 0.05) and was independently associated with GLS after adjustment for other risk factors, including WC (p = 0.005). CONCLUSIONS Visceral obesity assessed by VFA was well correlated with parameters of MetS. Visceral obesity, but not central obesity measured by WC, was independently associated with structural and functional cardiac remodeling in subjects with suspected MetS. It suggests that visceral obesity should be considered as an important risk factor for cardiac damage in dysmetabolic subjects. TRIAL REGISTRATION NCT02077530 (date of registration: November 1, 2013).
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Affiliation(s)
- D-H Cho
- Korea University Anam Hospital, Seoul, Republic of Korea
| | - M-N Kim
- Korea University Anam Hospital, Seoul, Republic of Korea
| | - H J Joo
- Korea University Anam Hospital, Seoul, Republic of Korea
| | - W J Shim
- Korea University Anam Hospital, Seoul, Republic of Korea
| | - D-S Lim
- Korea University Anam Hospital, Seoul, Republic of Korea.
| | - S-M Park
- Korea University Anam Hospital, Seoul, Republic of Korea.
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Kim HJ, Lee H, Lee B, Lee JW, Shin KE, Suh J, Park HW, Kim JA. Diagnostic value of using epicardial fat measurement on screening low-dose chest CT for the prediction of metabolic syndrome: A cross-validation study. Medicine (Baltimore) 2019; 98:e14601. [PMID: 30762814 PMCID: PMC6407965 DOI: 10.1097/md.0000000000014601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
There has been a marked increase in the use of low-dose computed tomography (LDCT) for lung cancer screening. However, the potential of LDCT to predict metabolic syndrome (MetS) has not been well-documented in this risk-sharing population. We assessed the reliability of epicardial fat volume (EFV) and epicardial fat area (EFA) measurements on chest LDCT for prediction of MetS.A total of 130 (mean age, 50.2 ± 10.77 years) asymptomatic male who underwent nonelectrocardiography (ECG)-gated LDCT were divided into 2 groups for the main analysis (n = 75) and validation (n = 55). Each group was further divided into subgroups with or without MetS. EFV and EFA were calculated semiautomatically using commercially available software with manual assistance. The area under the curve (AUC) on receiver operating characteristic (ROC) analysis and cutoff values to predict MetS on LDCT were then calculated and validated. Female data were not available for analysis due to small sample size in this self-referred lung cancer screening program.In the analysis group, the mean EFV was 123.12 ± 42.29 and 67.30 ± 20.68 cm for the MetS and non-MetS subgroups, respectively (P < .001), and the mean EFA was 7.95 ± 3.10 and 4.04 ± 1.73 cm, respectively (P < .001). Using 93.65 and 4.94 as the cutoffs for EFV and EFA, respectively, the sensitivity, specificity, positive and negative predictive values, and accuracy for predicting MetS were 84.2% and 84.2%, and 92.9% and 64.3% (P < .001); 80% and 44.4% (P = .01); 94.5% and 92.3%; and 90.7% and 69.3% (P < .001), respectively. The AUC for EFV and EFA for predicting MetS was 0.909 and 0.808 (95% confidence interval, 0.819-1.000 and 0.702-0.914, respectively) (P = .02). Using the same cutoff values in the analysis group, there was no significant difference in diagnostic performance using EFV and EFA between the analysis and validation sets.Although quantification of both EFA and EFV is feasible on non-ECG-gated LDCT, EFV may be used to reliably predict MetS with fairly high and better diagnostic performance in selected population.
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Affiliation(s)
| | - Heon Lee
- Department of Radiology, Wonmi-Gu, Bucheon
| | - Bora Lee
- Graduate School of Statistics, Chung-Ang University, Dongjak-gu, Seoul
| | | | | | - Jon Suh
- Cardiology Soonchunhyang University Hospital Bucheon, Wonmi-Gu, Bucheon
| | - Hyun Woo Park
- Cardiology Soonchunhyang University Hospital Bucheon, Wonmi-Gu, Bucheon
| | - Jeong A. Kim
- Department of Radiology, Ilsan Paik Hospital, Goyang, Republic of Korea
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Wong SK, Chin KY, Suhaimi FH, Ahmad F, Ima-Nirwana S. Exploring the potential of tocotrienol from Bixa orellana as a single agent targeting metabolic syndrome and bone loss. Bone 2018; 116:8-21. [PMID: 29990585 DOI: 10.1016/j.bone.2018.07.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 07/04/2018] [Accepted: 07/05/2018] [Indexed: 12/18/2022]
Abstract
Metabolic syndrome (MetS) is associated with osteoporosis due to the underlying inflammatory and hormonal changes. Annatto tocotrienol has been shown to improve medical complications associated with MetS or bone loss in animal studies. This study aimed to investigate the effects of annatto tocotrienol as a single treatment for MetS and osteoporosis in high-carbohydrate high-fat (HCHF) diet-induced MetS animals. Three-month-old male Wistar rats were randomly divided into five groups. The baseline group was euthanized at the onset of the study. The normal group received standard rat chow and tap water. The remaining groups received HCHF diet and treated with three different regimens orally daily: (a) tocopherol-stripped corn oil (the vehicle of tocotrienol), (b) 60 mg/kg annatto tocotrienol, and (c) 100 mg/kg annatto tocotrienol. At the end of the study, measurements of MetS parameters, body compositions, and bone mineral density were performed in animals before sacrifice. Upon euthanasia, blood and femur of the rats were harvested for the evaluations of bone microstructure, biomechanical strength, remodelling activities, hormonal changes, and inflammatory response. Treatment with annatto tocotrienol improved all MetS parameters (except abdominal obesity), trabecular bone microstructure, bone strength, increased osteoclast number, normalized hormonal changes and inflammatory response in the HCHF animals. In conclusion, annatto tocotrienol is a potential agent for managing MetS and osteoporosis concurrently. The beneficial effects of annatto tocotrienol may be attributed to its ability to prevent the hormonal changes and pro-inflammatory state in animals with MetS.
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Affiliation(s)
- Sok Kuan Wong
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaakob Latif, Bandar Tun Razak, 56000, Cheras, Kuala Lumpur, Malaysia
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaakob Latif, Bandar Tun Razak, 56000, Cheras, Kuala Lumpur, Malaysia
| | - Farihah Hj Suhaimi
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaakob Latif, Bandar Tun Razak, 56000, Cheras, Kuala Lumpur, Malaysia
| | - Fairus Ahmad
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaakob Latif, Bandar Tun Razak, 56000, Cheras, Kuala Lumpur, Malaysia
| | - Soelaiman Ima-Nirwana
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaakob Latif, Bandar Tun Razak, 56000, Cheras, Kuala Lumpur, Malaysia.
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45
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Cunha GM, Villela-Nogueira CA, Bergman A, Lobo Lopes FPP. Abbreviated mpMRI protocol for diffuse liver disease: a practical approach for evaluation and follow-up of NAFLD. Abdom Radiol (NY) 2018; 43:2340-2350. [PMID: 29450605 DOI: 10.1007/s00261-018-1504-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIM Multiparametric magnetic resonance imaging (mpMRI) may help determine the metabolic profile of patients with obesity and metabolic syndrome in addition to their clinical and laboratory biomarkers for diagnosis and monitoring. An abbreviated mpMRI protocol may be a faster, less-costly, and easier to perform alternative for the diagnosis, treatment, and follow-up of patients with NAFLD and for use in clinical trials. OBJECTIVE To evaluate an abbreviated mpMRI protocol tailored to analyze quantitative imaging features of patients with obesity and NAFLD and assess its use during treatment. METHODS This prospective study included patients with obesity and NAFLD to perform a quantitative analysis of liver fat and iron content, stiffness, as well as the visceral adipose tissue (VAT) during the course of a physical exercise-based treatment regimen. RESULTS Longitudinal improvements in imaging features were observed in patients with good response to treatment, in accordance with improvements in biochemical and anthropometric biomarkers. CONCLUSION An abbreviated mpMRI protocol consisting of liver fat and iron quantification, MR elastography, and VAT measurements is a feasible, less-costly, and accessible option for screening and monitoring of patients with obesity, NAFLD, and metabolic syndrome.
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Affiliation(s)
- Guilherme Moura Cunha
- Clínica de Diagnóstico por Imagem - CDPI/DASA, Av. Ataulfo de Paiva, 669, Leblon, Rio de Janeiro, 22440-032, Brazil.
| | - Cristiane A Villela-Nogueira
- Faculdade de Medicina, Departamento de Clínica Médica, Serviço de Hepatologia, Universidade Federal do Rio De Janeiro, UFRJ R. Prof. Rodolpho Paulo Rocco, 255 sala 9E16 - Cidade Universitária, Rio de Janeiro, 22440-032, Brazil
| | - Anke Bergman
- Instituto Nacional de Câncer (INCA), Rua André Cavalcanti, 37, Rio de Janeiro, 20231-050, Brazil
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Nyman K, Granér M, Pentikäinen MO, Lundbom J, Hakkarainen A, Sirén R, Nieminen MS, Taskinen MR, Lundbom N, Lauerma K. Metabolic syndrome associates with left atrial dysfunction. Nutr Metab Cardiovasc Dis 2018; 28:727-734. [PMID: 29764718 DOI: 10.1016/j.numecd.2018.02.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 02/05/2018] [Accepted: 02/13/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND AIMS Obesity and metabolic syndrome (MetS) are risk factors of atrial fibrillation (AF), but limited data exist on their effect on left atrial (LA) function. The aim of the study was to evaluate the effects of cardiac, hepatic and intra-abdominal ectopic fat depots and cardiometabolic risk factors on LA function in non-diabetic male subjects. METHODS AND RESULTS Myocardial and hepatic triglyceride contents were measured with 1.5T 1H-magnetic resonance spectroscopy and LA and left ventricular function, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), epicardial and pericardial fat by magnetic resonance imaging (MRI) in 33 men with MetS and 40 men without MetS. LA volumes were assessed using a novel three-chamber orientation based MRI approach. LA ejection fraction (EF) was lower in MetS patients than in the control group (44 ± 7.7% in MetS vs. 49 ± 8.6% in controls, p = 0.013) without LA enlargement, indicating LA dysfunction. LA EF correlated negatively with waist circumference, body mass index, SAT, VAT, fasting serum insulin, and homeostasis model assessment of insulin resistance index, and positively with fasting serum high-density lipoprotein cholesterol. VAT was the best predictor of reduced LA EF. CONCLUSIONS MetS associates with subclinical LA dysfunction. Multiple components of MetS are related to LA dysfunction, notably visceral obesity and insulin resistance. Further studies are needed to elucidate the role of mechanical atrial remodeling in the development of AF.
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Affiliation(s)
- K Nyman
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - M Granér
- Heart and Lung Center, Cardiology, Helsinki University Hospital, Helsinki, Finland; Diabetes and Obesity Research Program, Research Programs' Unit, University of Helsinki and Clinical Research Institute, HUCH Ltd, Helsinki, Finland
| | - M O Pentikäinen
- Heart and Lung Center, Cardiology, Helsinki University Hospital, Helsinki, Finland
| | - J Lundbom
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - A Hakkarainen
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - R Sirén
- Department of General Practice and Primary Health Care, Health Care Centre of City of Helsinki and University of Helsinki, Helsinki, Finland
| | - M S Nieminen
- Heart and Lung Center, Cardiology, Helsinki University Hospital, Helsinki, Finland
| | - M-R Taskinen
- Diabetes and Obesity Research Program, Research Programs' Unit, University of Helsinki and Clinical Research Institute, HUCH Ltd, Helsinki, Finland
| | - N Lundbom
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - K Lauerma
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Cho DH, Joo HJ, Kim MN, Lim DS, Shim WJ, Park SM. Association between epicardial adipose tissue, high-sensitivity C-reactive protein and myocardial dysfunction in middle-aged men with suspected metabolic syndrome. Cardiovasc Diabetol 2018; 17:95. [PMID: 29960588 PMCID: PMC6026337 DOI: 10.1186/s12933-018-0735-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 06/19/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND As body fat composition and metabolism differ between men and women, we evaluated sex-related differences in the association among epicardial adipose tissue (EAT), secretome profile, and myocardial function of subjects with suspected metabolic syndrome. METHODS We evaluated 277 participants (men, n = 140; 56.1 ± 4.7 years) who underwent conventional echocardiography and two-dimensional speckle tracking from the Seoul Metabolic Syndrome cohort. EAT was measured from the right ventricular free wall perpendicular to the aortic annulus at end systole. Global longitudinal strain (GLS) was obtained from 18 apical segments. Apolipoprotein A1, apolipoprotein B, adiponectin, and high-sensitivity C-reactive protein (hs-CRP) levels were measured using immunoturbidimetry assay. RESULTS Mean age, body mass index, and hs-CRP level did not differ by sex. Waist circumference, fasting blood glucose level, and triglyceride/high-density lipoprotein cholesterol ratio were higher, and apolipoprotein AI and adiponectin levels were lower in men. No significant difference in mean EAT thickness was found (7.02 ± 1.81 vs. 7.13 ± 1.70 mm, p = 0.613). Men had a higher left ventricular (LV) mass index and lower GLS. EAT thickness was associated with hs-CRP level in men alone (ß = 0.206, p = 0.015). LV mass index (ß = 2.311, p = 0.037) and function represented by e' (ß = - 0.279, p = 0.001) and GLS (ß = - 0.332, p < 0.001) were independently associated with EAT thickness in men alone. CONCLUSIONS In middle-aged subjects with suspected metabolic syndrome, EAT was associated with inflammation represented by hs-CRP level, LV mass, and subclinical myocardial dysfunction only in men, suggesting that the inflammatory activity of EAT induced myocardial remodeling and dysfunction in middle-aged subjects but was attenuated in women. Trial registration NCT02077530 (date of registration: November 1, 2013).
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Affiliation(s)
- Dong-Hyuk Cho
- Division of Cardiology, Korea University College of Medicine, Anam Hospital, Inchonro 73, Seongbukgu, Seoul, 136-705 Republic of Korea
| | - Hyung Joon Joo
- Division of Cardiology, Korea University College of Medicine, Anam Hospital, Inchonro 73, Seongbukgu, Seoul, 136-705 Republic of Korea
| | - Mi-Na Kim
- Division of Cardiology, Korea University College of Medicine, Anam Hospital, Inchonro 73, Seongbukgu, Seoul, 136-705 Republic of Korea
| | - Do-Sun Lim
- Division of Cardiology, Korea University College of Medicine, Anam Hospital, Inchonro 73, Seongbukgu, Seoul, 136-705 Republic of Korea
| | - Wan Joo Shim
- Division of Cardiology, Korea University College of Medicine, Anam Hospital, Inchonro 73, Seongbukgu, Seoul, 136-705 Republic of Korea
| | - Seong-Mi Park
- Division of Cardiology, Korea University College of Medicine, Anam Hospital, Inchonro 73, Seongbukgu, Seoul, 136-705 Republic of Korea
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Bellan M, Menegatti M, Ferrari C, Carnevale Schianca GP, Pirisi M. Ultrasound-assessed visceral fat and associations with glucose homeostasis and cardiovascular risk in clinical practice. Nutr Metab Cardiovasc Dis 2018; 28:610-617. [PMID: 29656956 DOI: 10.1016/j.numecd.2018.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 01/15/2018] [Accepted: 01/16/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS Despite the lack of evidence that assessing the global cardiovascular risk leads to a decreased incidence of cardiovascular events, accurate patient profiling is paramount in preventive medicine. An excess of visceral fat (VF) is associated with an enhanced cardiovascular risk; importantly, VF is quantifiable rapidly, cheaply and safely by ultrasound, which makes it suitable for use in clinical practice. In the present study, we aimed to evaluate if US-measured VF (USVF) could be a better predictor of glucose homeostasis and cardiovascular risk than simple anthropometric measures. METHODS AND RESULTS One-hundred sixty-two patients attending a Metabolic Disorders Clinic underwent a cross-sectional study for which USVF, anthropometric measures, a standard oral glucose tolerance test (OGTT), and calculation of cardiovascular Framingham score and vascular age were obtained. USVF was directly correlated with fasting and 2-h plasma glucose (respectively: r = 0.26, p < 0.001; r = 0.28, p < 0.0001), fasting and 2-h plasma insulin (for both: r = 0.41, p < 0.0001), homeostatic model assessment of insulin resistance (HOMA-IR; r = 0.42, p < 0.0001), cardiovascular Framingham score (r = 0.44 p < 0.0001) and vascular age (r = 0.30 p < 0.001). In receiver operator characteristic curves USVF had good diagnostic abilities for type 2 diabetes mellitus, fatty liver and metabolic syndrome, in both genders. At multivariate analysis, body mass index (BMI) outperformed USVF in the prediction of HOMA-IR; neverthless, USVF, not BMI, was an independent predictor of cardiovascular risk. Finally, models including USVF were the most parssimonious to predict Framingham score, vascular age and HOMA-IR. CONCLUSION In overweight and obese subjects, USVF could usefully complement other parameters for cardiovascular risk stratification.
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Affiliation(s)
- M Bellan
- Department of Translational Medicine, Università del Piemonte Orientale UPO, Novara, Italy; Division of Internal Medicine, "Sant'Andrea Hospital", Vercelli, Italy.
| | - M Menegatti
- Department of Translational Medicine, Università del Piemonte Orientale UPO, Novara, Italy; Emergency Medicine Department, "AOU Maggiore della Carità", Novara, Italy
| | - C Ferrari
- Department of Translational Medicine, Università del Piemonte Orientale UPO, Novara, Italy; Division of Internal Medicine, "AOU Maggiore della Carità, Novara, Italy
| | | | - M Pirisi
- Department of Translational Medicine, Università del Piemonte Orientale UPO, Novara, Italy; Division of Internal Medicine, "AOU Maggiore della Carità, Novara, Italy
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Ladeiras-Lopes R, Moreira HT, Bettencourt N, Fontes-Carvalho R, Sampaio F, Ambale-Venkatesh B, Wu C, Liu K, Bertoni AG, Ouyang P, Bluemke DA, Lima JA. Metabolic Syndrome Is Associated With Impaired Diastolic Function Independently of MRI-Derived Myocardial Extracellular Volume: The MESA Study. Diabetes 2018; 67:1007-1012. [PMID: 29444891 PMCID: PMC5910005 DOI: 10.2337/db17-1496] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 02/07/2018] [Indexed: 01/09/2023]
Abstract
The relationship of metabolic syndrome (MetS) and insulin resistance (one of its key pathophysiological mediators) with diastolic dysfunction and myocardial fibrosis is not well understood. This study aimed to evaluate the association of MetS with diastolic function and myocardial extracellular matrix (ECM) using cardiac MRI (CMRI) in a large community-based population. This cross-sectional analysis included 1,582 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) with left ventricular ejection fraction ≥50% and no history of cardiac events. Diastolic function was assessed using tagged CMRI parameters including end-diastolic strain rate (EDSR) and strain relaxation index (SRI). ECM was evaluated using extracellular volume (ECV) quantification. Participants' mean age was 67.4 ± 8.6 years, and 48.1% were males. MetS was present in 533 individuals (33.7%), and type 2 diabetes in 250 (15.8%). In the multivariable analyses, MetS (irrespective of the presence of type 2 diabetes) and higher insulin resistance were associated with impaired diastolic function (higher SRI and lower EDSR), independent of ECV. In conclusion, MetS, irrespective of the presence of type 2 diabetes, was independently associated with impaired diastole. These functional myocardial changes seem to result from intrinsic cardiomyocyte alterations, irrespective of the myocardial interstitium (including fibrosis).
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Affiliation(s)
- Ricardo Ladeiras-Lopes
- Cardiovascular Research and Development Center, Faculty of Medicine of the University of Porto, Porto, Portugal
- Cardiology Department, Gaia Hospital Centre, Vila Nova de Gaia, Portugal
| | - Henrique T Moreira
- The Johns Hopkins University, Baltimore, MD
- University of São Paulo, Ribeirão Preto, Brazil
| | - Nuno Bettencourt
- Cardiovascular Research and Development Center, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Ricardo Fontes-Carvalho
- Cardiovascular Research and Development Center, Faculty of Medicine of the University of Porto, Porto, Portugal
- Cardiology Department, Gaia Hospital Centre, Vila Nova de Gaia, Portugal
| | - Francisco Sampaio
- Cardiovascular Research and Development Center, Faculty of Medicine of the University of Porto, Porto, Portugal
- Cardiology Department, Gaia Hospital Centre, Vila Nova de Gaia, Portugal
| | | | - Colin Wu
- National Institutes of Health, Bethesda, MD
| | - Kiang Liu
- Northwestern University, Chicago, IL
| | - Alain G Bertoni
- Department of Epidemiology & Prevention, Wake Forest School of Medicine, Winston-Salem, NC
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Badhwar S, Chandran DS, Jaryal AK, Narang R, Deepak KK. Regional arterial stiffness in central and peripheral arteries is differentially related to endothelial dysfunction assessed by brachial flow-mediated dilation in metabolic syndrome. Diab Vasc Dis Res 2018; 15:106-113. [PMID: 29283006 DOI: 10.1177/1479164117748840] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The interrelationship between endothelial function and arterial stiffness may be different for central and peripheral arteries due to their structural and functional differences. The study aims to assess the interrelationship between central and peripheral vascular function and haemodynamics in metabolic syndrome. Thirty-seven patients [63.0 (57.5-66.0) years, 68.4% males] of metabolic syndrome (National Cholesterol Education Program - Adult Treatment Panel-III criteria) were studied. Carotid-femoral, carotid-radial pulse wave velocity and augmentation index (AIx@75) were assessed using applanation tonometry. Endothelial function was evaluated by brachial flow-mediated dilation using B-mode ultrasonography. Central and peripheral pressures were measured by radial tonometry and sphygmomanometer, respectively. Carotid-radial pulse wave velocity correlated significantly with peripheral diastolic blood pressure ( r = 0.33, p = 0.04) and inversely with flow-mediated dilation ( r = -0.61, p = 0.0001). AIx@75 correlated significantly with carotid-femoral pulse wave velocity ( r = 0.35, p = 0.03) and with aortic pulse pressure ( r = 0.43, p = 0.01). In principal component analysis, an inverse relationship was observed between flow-mediated dilation and carotid-radial pulse wave velocity but not with carotid-femoral pulse wave velocity. Regional arterial stiffness assessed by pulse wave velocity in central-elastic and peripheral-muscular arteries differentially relates to endothelial dysfunction. The central arteries might be predominantly influenced by endothelial dysfunction-induced structural changes, while the peripheral arteries are majorly affected by functional alterations.
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Affiliation(s)
- Smriti Badhwar
- 1 Autonomic and Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Dinu S Chandran
- 1 Autonomic and Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ashok Kumar Jaryal
- 1 Autonomic and Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajiv Narang
- 2 Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Kishore Kumar Deepak
- 1 Autonomic and Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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