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Jubayar AM, Khan S, Sadi J, Uddin N, Goni O, Khatun M, Siddique AE, Kabir E, Rimi RK, Beauty SA, Rossi KN, Abedin F, Sarder SJ, Islam MS, Sarker MK, Hossain S, Sumi D, Saud ZA, Barchowsky A, Wahed AS, Himeno S, Hossain K. Novel evidence of arsenic-related excess adiposity and its implication in the risk of cardiometabolic diseases. ENVIRONMENTAL RESEARCH 2025; 271:121059. [PMID: 39922254 PMCID: PMC11991875 DOI: 10.1016/j.envres.2025.121059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2024] [Revised: 02/04/2025] [Accepted: 02/05/2025] [Indexed: 02/10/2025]
Abstract
Arsenic exposure is associated with obesity- or excess adiposity-related disorders, including cardiometabolic diseases. Previously, many human studies attempted to establish the association of arsenic exposure with obesity, mainly through body mass index (BMI) but failed to provide any concrete evidence. Our study aimed to investigate the arsenic-related adiposity and its relationship with cardiometabolic diseases. Of the 524 participants, 126 and 398, respectively, were chosen from low- and high-arsenic exposure areas in Bangladesh. Obesity or body fat (adiposity) of the participants was measured by anthropometric measures [BMI, waist circumference (WC), and triceps skinfold thickness (TSFT)] and a serum biomarker, leptin. Sarcopenic characteristics were assessed by lean body mass (LBM) and serum creatinine levels. Insulin resistance, as measured by Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), hypertension, and hyperglycemia, were considered as the risk factors for cardiometabolic diseases. There were significant positive associations between drinking water, hair, and nail arsenic concentrations and the levels of WC and TSFT after adjusting for potential confounders. However, there were no significant associations with BMI. Increased arsenic exposure levels were associated with increased leptin levels [(Regression coefficient (β) = 1.00, 95% confidence interval (CI): 0.53, 1.46) for water, (β = 1.44, 95% CI: 0.42, 2.46) for hair, and (β = 1.47, 95% CI: 0.32, 2.61) for nail arsenic]. Notably, leptin levels had inverse associations with LBM (β = -7.87, 95% CI: -13.30, -2.45) and creatinine levels (β = -15.65, 95% CI: -21.50, -9.81). Furthermore, the elevated leptin levels associated with arsenic exposure were connected to higher HOMA-IR levels (β = 0.19, 95% CI: 0.14, 0.24), higher odds of hypertension [Odds ratio (OR) = 1.31, 95% CI: 1.12, 1.53], and hyperglycemia (OR = 1.30, 95% CI: 1.13, 1.47). Taken together, the results of this study demonstrated a unique association between arsenic exposure and adiposity, which could promote arsenic-induced cardiometabolic disorders by mirroring the distinctive characteristics of age-associated sarcopenic obesity.
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Affiliation(s)
- Ahsanul Mahbub Jubayar
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Shuchismita Khan
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Junayed Sadi
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Nesar Uddin
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Osman Goni
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Moriom Khatun
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Abu Eabrahim Siddique
- Interdisciplinary Graduate Program in Human Toxicology, University of Iowa, Iowa City, 52242, Iowa, USA
| | - Ehsanul Kabir
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Rajoana Karim Rimi
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Sharmin Akter Beauty
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Kamrun Nahar Rossi
- Department of Pharmacy, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Faysal Abedin
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Sharon Jahan Sarder
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Md Shofikul Islam
- Department of Applied Nutrition and Food Technology, Islamic University, Kushtia, 7003, Bangladesh
| | | | - Shakhawoat Hossain
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Daigo Sumi
- Laboratory of Molecular Toxicology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Tokushima, 770-8514, Japan
| | - Zahangir Alam Saud
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Aaron Barchowsky
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, PA, 15219, USA
| | - Abdus S Wahed
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, 14627, USA
| | - Seiichiro Himeno
- Laboratory of Molecular Toxicology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Tokushima, 770-8514, Japan; Division of Health Chemistry, School of Pharmacy, Showa University, Tokyo, 142-8555, Japan
| | - Khaled Hossain
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, 6205, Bangladesh.
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Wang X, Cheng H, Xiong J, Liu J, Dong H, Fu L, Xie X, Shan X, Zhao X, Yan Y, Xiao P, Mi J. Exploring Visceral Fat as a Screening Marker for Cardiometabolic Risk in Children and Adolescents. CHILDREN (BASEL, SWITZERLAND) 2025; 12:308. [PMID: 40150591 PMCID: PMC11941014 DOI: 10.3390/children12030308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2025] [Revised: 02/19/2025] [Accepted: 02/22/2025] [Indexed: 03/29/2025]
Abstract
Objective: To establish and validate age- and sex-specific visceral fat area (VFA) cutoff values for the effective identification of cardiometabolic risk (CMR) in children and adolescents. Methods: A cross-sectional study involving 8133 participants was conducted to derive age- and sex-specific VFA cutoffs, which were validated in a longitudinal cohort comprising 10,805 individuals. The predictive performance of the derived VFA cutoffs for CMR was evaluated using the area under the receiver operating characteristic curve (AUC). Additionally, logistic regression models were utilized to calculate the relative risk (RR) of CMR associated with elevated VFA levels. Results: The 75th percentile of the VFA was identified as the optimal cutoff for screening for hypertension, hyperglycemia, dyslipidemia, and CMR clustering in boys. In girls, the 75th percentile was optimal for screening hypertension, dyslipidemia, and CMR clustering, while the 80th percentile proved best for hyperglycemia. No significant difference in predicative performance was observed between the optimal and simplified VFA cutoffs. Longitudinal validation demonstrated that individuals exceeding the VFA cutoff had a significantly higher risk for CMR, with RRs ranging from 1.33 to 3.89 (all p < 0.001) for boys and from 1.63 to 3.16 (all p < 0.001) for girls. Notably, normal-weight boys with VFA above the cutoff had a significantly higher CMR risk compared to their peers in other weight status categories. Conclusions: Both the optimal and simplified VFA cutoffs are robust tools for screening CMR in Chinese children and adolescents, with significant implications for early intervention strategies.
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Affiliation(s)
- Xia Wang
- Center for Non-Communicable Disease Management, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100035, China; (X.W.); (H.D.); (L.F.); (X.X.); (Y.Y.)
| | - Hong Cheng
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100035, China; (H.C.); (J.L.); (X.S.); (X.Z.)
| | - Jingfan Xiong
- Department of Child and Adolescent Chronic Disease Prevention and Control, Shenzhen Center for Chronic Disease Control, Shenzhen 518000, China;
| | - Junting Liu
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100035, China; (H.C.); (J.L.); (X.S.); (X.Z.)
| | - Hongbo Dong
- Center for Non-Communicable Disease Management, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100035, China; (X.W.); (H.D.); (L.F.); (X.X.); (Y.Y.)
| | - Liwan Fu
- Center for Non-Communicable Disease Management, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100035, China; (X.W.); (H.D.); (L.F.); (X.X.); (Y.Y.)
| | - Xiangjun Xie
- Center for Non-Communicable Disease Management, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100035, China; (X.W.); (H.D.); (L.F.); (X.X.); (Y.Y.)
| | - Xinying Shan
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100035, China; (H.C.); (J.L.); (X.S.); (X.Z.)
| | - Xiaoyuan Zhao
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100035, China; (H.C.); (J.L.); (X.S.); (X.Z.)
| | - Yinkun Yan
- Center for Non-Communicable Disease Management, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100035, China; (X.W.); (H.D.); (L.F.); (X.X.); (Y.Y.)
| | - Pei Xiao
- Center for Non-Communicable Disease Management, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100035, China; (X.W.); (H.D.); (L.F.); (X.X.); (Y.Y.)
| | - Jie Mi
- Center for Non-Communicable Disease Management, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100035, China; (X.W.); (H.D.); (L.F.); (X.X.); (Y.Y.)
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Jin X, Jin X, Guan W, Tang M. Dietary Calcium-to-Phosphorous Ratio, Metabolic Risk Factors and Lipid Accumulation Product, Skeletal Muscle Mass, and Visceral Fat Area Among Healthy Young Individuals. Int J Sport Nutr Exerc Metab 2025; 35:43-50. [PMID: 39326862 DOI: 10.1123/ijsnem.2024-0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 07/26/2024] [Accepted: 07/27/2024] [Indexed: 09/28/2024]
Abstract
BACKGROUND Numerous studies have revealed the role of low dietary calcium-to-phosphorous ratio and low bone health. However, its possible role in visceral adiposity, skeletal muscle mass (SMM), and metabolic parameters has not been investigated before. Therefore, the aim of the current cross-sectional study was to evaluate the relation between dietary calcium-to-phosphorous ratio, metabolic risk factors, SMM, and visceral fat area (VFA) among physically active young individuals. METHODS In the current study, the sample was composed of 391 healthy young individuals (e.g., 205 men and 186 women), aged between 20 and 35 years old, who were engaged in moderate physical activity for at least 4 hr per week and were recruited thorough cluster sampling from seven sport clubs. Anthropometric measurements were performed, and VFA and SMM index (SMI) were calculated. Biochemical assays were also performed by standard kits. Data were analyzed by one-way analysis of variance, analysis of co-variance, and multinomial logistic regression analysis using SPSS software. RESULTS Those in the fourth quartile of dietary calcium-to-phosphorous ratio were more likely to have lower VFA (odds ratio [OR] = 0.98; 95% confidence interval [CI] [0.97, 0.99]; p = .023) and a nonsignificantly higher SMI (OR = 1.15; 95% CI [0.99, 1.34]; p = .058) after adjustment for the effects of confounders (e.g., age, gender, body mass index, physical activity level, dietary energy intake). Also, being in the third quartile of dietary calcium-to-phosphorous ratio made the subjects more susceptible to have lower insulin concentration (OR = 0.99; 95% CI [0.88, 0.93]; p = .026) in the adjusted model. CONCLUSION The findings of the current study revealed that a higher dietary calcium-to-phosphorous ratio in the habitual diet was negatively associated with visceral adiposity and insulin concentrations and higher SMM among physically active young individuals. Further interventional studies are required to confer causality that was not inferable in the current study because of cross-sectional design.
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Affiliation(s)
| | | | - Wen Guan
- National University of Korea, Seoul, Korea
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Abutaima R, Barakat M, Sawan HM, Al Omari SM, Mhaidat NM. Knowledge, attitudes, and practices towards the use of GLP-1 receptor agonists for weight loss among the general population in Jordan; A cross-sectional study. PLoS One 2024; 19:e0314407. [PMID: 39636914 PMCID: PMC11620468 DOI: 10.1371/journal.pone.0314407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Accepted: 11/09/2024] [Indexed: 12/07/2024] Open
Abstract
INTRODUCTION Obesity has emerged as a global pandemic, with its prevalence notably increasing during the COVID-19 lockdown of 2019. In response, many individuals have turned to pharmacological interventions, including antidiabetic medications, as means of achieving weight loss with minimal effort. This study aims to assess the knowledge, attitudes, and practices of the Jordanian population regarding the use of antidiabetic agents, specifically glucagon-like peptide-1 receptor agonists and biguanides, for weight management. METHOD A self-administered validated online questionnaire was developed and disseminated to public utilizing a cross-sectional design. Data were extracted to examine descriptive statistics. Linear regression was performed to evaluate associations with knowledge and attitude. A p-value ≤0.05 was chosen to indicate statistical significance. RESULTS Total of 389 responses were analyzed, 65.6% females, 54.2% married, 78.1% living in the center of Jordan, 35.5% overweight and 26.5% have >1000 Jordanian Dinars monthly income. Fifty seven percent of the study participants think that antidiabetics could be used for weight loss. 47.27%, 44.55%, 68.18% recognized glucagon-like peptide-1receptor agonists; (Ozempic®), (Saxenda®), (Mounjaro®) as well as (Glucophage®) use for weight loss, respectively and 12.3% of participants used medications to lose weight. Neutral attitude was observed. Gender and body mass index were significantly affecting the participants knowledge (p<0.001, p = 0.002, respectively). CONCLUSION Use of (Ozempic®), (Saxenda®) and other antidiabetics to lose weight become a common practice. The results of this study suggests supervising prescription and dispensing to avoid misuse, especially, in people who are contraindicated to use them.
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Affiliation(s)
- Rana Abutaima
- Faculty of Pharmacy, Zarqa University, Zarqa, Jordan
| | - Muna Barakat
- Faculty of Pharmacy, Applied Sciences Private University, Amman, Jordan
| | - Hana M. Sawan
- Faculty of Pharmacy, Zarqa University, Zarqa, Jordan
| | | | - Nizar M. Mhaidat
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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Zong M, Zhao A, Han W, Chen Y, Weng T, Li S, Tang L, Wu J. Sarcopenia, sarcopenic obesity and the clinical outcome of the older inpatients with COVID-19 infection: a prospective observational study. BMC Geriatr 2024; 24:578. [PMID: 38965468 PMCID: PMC11223396 DOI: 10.1186/s12877-024-05177-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 06/25/2024] [Indexed: 07/06/2024] Open
Abstract
OBJECTIVE We aimed to investigate the impact of sarcopenia and sarcopenic obesity (SO) on the clinical outcome in older patients with COVID-19 infection and chronic disease. METHODS We prospectively collected data from patients admitted to Huadong Hospital for COVID-19 infection between November 1, 2022, and January 31, 2023. These patients were included from a previously established comprehensive geriatric assessment (CGA) cohort. We collected information on their pre-admission condition regarding sarcopenia, SO, and malnutrition, as well as their medical treatment. The primary endpoint was the incidence of intubation, while secondary endpoints included in-hospital mortality rates. We then utilized Kaplan-Meier (K-M) survival curves and the log-rank tests to compare the clinical outcomes related to intubation or death, assessing the impact of sarcopenia and SO on patient clinical outcomes. RESULTS A total of 113 patients (age 89.6 ± 7.0 years) were included in the study. Among them, 51 patients had sarcopenia and 39 had SO prior to hospitalization. Intubation was required for 6 patients without sarcopenia (9.7%) and for 18 sarcopenia patients (35.3%), with 16 of these being SO patients (41%). Mortality occurred in 2 patients without sarcopenia (3.3%) and in 13 sarcopenia patients (25.5%), of which 11 were SO patients (28%). Upon further analysis, patients with SO exhibited significantly elevated risks for both intubation (Hazard Ratio [HR] 7.43, 95% Confidence Interval [CI] 1.26-43.90, P < 0.001) and mortality (HR 6.54, 95% CI 1.09-39.38, P < 0.001) after adjusting for confounding factors. CONCLUSIONS The prevalence of sarcopenia or SO was high among senior inpatients, and both conditions were found to have a significant negative impact on the clinical outcomes of COVID-19 infection. Therefore, it is essential to regularly assess and intervene in these conditions at the earliest stage possible.
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Affiliation(s)
- Min Zong
- Department of Clinical nutrition, Huadong Hospital affiliated to Fudan University, Shanghai, China
| | - Anda Zhao
- Department of Clinical nutrition, Huadong Hospital affiliated to Fudan University, Shanghai, China
| | - Weijia Han
- Department of Clinical nutrition, Huadong Hospital affiliated to Fudan University, Shanghai, China
| | - Yanqiu Chen
- Department of Clinical nutrition, Huadong Hospital affiliated to Fudan University, Shanghai, China
| | - Tingwen Weng
- Department of Geriatrics, Huadong Hospital affiliated to Fudan University, Shanghai, China
| | - Shijie Li
- Department of Clinical nutrition, Huadong Hospital affiliated to Fudan University, Shanghai, China
| | - Lixin Tang
- Department of Clinical nutrition, Huadong Hospital affiliated to Fudan University, Shanghai, China
| | - Jiang Wu
- Department of Clinical nutrition, Huadong Hospital affiliated to Fudan University, Shanghai, China.
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Wang MN, Zhai MX, Wang YT, Dai QF, Liu L, Zhao LP, Xia QY, Li S, Li B. Mechanism of Acupuncture in Treating Obesity: Advances and Prospects. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2024; 52:1-33. [PMID: 38351701 DOI: 10.1142/s0192415x24500010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Obesity is a common metabolic syndrome that causes a significant burden on individuals and society. Conventional therapies include lifestyle interventions, bariatric surgery, and pharmacological therapies, which are not effective and have a high risk of adverse events. Acupuncture is an effective alternative for obesity, it modulates the hypothalamus, sympathetic activity and parasympathetic activity, obesity-related hormones (leptin, ghrelin, insulin, and CCK), the brain-gut axis, inflammatory status, adipose tissue browning, muscle blood flow, hypoxia, and reactive oxygen species (ROS) to influence metabolism, eating behavior, motivation, cognition, and the reward system. However, hypothalamic regulation by acupuncture should be further demonstrated in human studies using novel techniques, such as functional MRI (fMRI), positron emission tomography (PET), electroencephalogram (EEG), and magnetoencephalography (MEG). Moreover, a longer follow-up phase of clinical trials is required to detect the long-term effects of acupuncture. Also, future studies should investigate the optimal acupuncture therapeutic option for obesity. This review aims to consolidate the recent improvements in the mechanism of acupuncture for obesity as well as discuss the future research prospects and potential of acupuncture for obesity.
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Affiliation(s)
- Mi-Na Wang
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, P. R. China
- School of Traditional Chinese Medicine, School of Life Science, Beijing University of Chinese Medicine, Beijing 100029, P. R. China
| | - Miao-Xin Zhai
- Yinghai Hospital, Daxing District, Beijing 100163, P. R. China
| | - Yi-Tong Wang
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, P. R. China
- School of Traditional Chinese Medicine, School of Life Science, Beijing University of Chinese Medicine, Beijing 100029, P. R. China
| | - Qiu-Fu Dai
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, P. R. China
| | - Lu Liu
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, P. R. China
| | - Luo-Peng Zhao
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, P. R. China
| | - Qiu-Yu Xia
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, P. R. China
| | - Shen Li
- Department of Emergency, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, P. R. China
| | - Bin Li
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, P. R. China
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He Y, Liao WJ, Hu AQ, Li XY, Wang JG, Qian D. A nomogram based on clinical characteristics and nutritional indicators for relative and absolute weight loss during radiotherapy in initially inoperable patients with locally advanced esophageal squamous cell carcinoma. Nutrition 2024; 117:112227. [PMID: 38486479 DOI: 10.1016/j.nut.2023.112227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/11/2023] [Accepted: 09/16/2023] [Indexed: 03/19/2024]
Abstract
OBJECTIVE Radiation for locally advanced esophageal squamous cell carcinoma often is accompanied by radiation esophagitis, which interferes with oral intake. We aimed to develop a nomogram model to identify initially inoperable patients with relative and absolute weight loss who need prophylactic nutritional supplementation. METHODS A total of 365 initially inoperable patients with locally advanced esophageal squamous cell carcinoma receiving radiotherapy between January 2018 and December 2022 were included in the study, which was divided into discovery and validation cohorts. Receiver operating characteristic and Kaplan-Meier curve analyses were performed to compare the areas under the curve and survival benefits. RESULTS A total of 42.2% (154 of 365) of the patients had been diagnosed with cancer cachexia. The malnourished group had a higher interruption rate of radiotherapy and number of complication diseases (P < 0.05). Meanwhile, patients with malnutrition had lower lymphocytes and prognostic nutritional index (P < 0.05). The combined index showed a higher area under the curve value (0.67; P < 0.001) than number of complication diseases (area under the curve = 0.52) and prognostic nutritional index (area under the curve = 0.49) for relative weight loss (≥ 5%). Similarly, the combined index had a higher area under the curve value (0.79; P < 0.001) than number of complication diseases (area under the curve = 0.56), treatment regimens (area under the curve = 0.56), subcutaneous fat thickness (area under the curve = 0.60), pretreatment body weight (area under the curve = 0.61), neutrophils (area under the curve = 0.56), and prognostic nutritional index (area under the curve = 0.50) for absolute weight loss (≥ 5 kg). Absolute and relative weight loss remained independent prognostic factors, with short overall survival rates compared with the normal group (P < 0.05). Patients with high nomogram scores supported by nutritional intervention had less weight loss, better nutrition scores, and increased plasma CD8+ T cells, and interferon gamma. CONCLUSIONS We developed a nomogram model that was intended to estimate relative and absolute weight loss in initially inoperable patients with locally advanced esophageal squamous cell carcinoma during radiotherapy, which might help facilitate an objective decision on prophylactic nutritional supplementation.
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Affiliation(s)
- Yuan He
- Department of Radiation Oncology, The First Affiliated Hospital of the University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Wen-Jun Liao
- Department of Radiation Oncology, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - An-Qi Hu
- Department of Radiation Oncology, The First Affiliated Hospital of the University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Xiao-Yang Li
- Department of Radiation Oncology, The First Affiliated Hospital of the University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Jian-Guo Wang
- Department of Radiation Oncology, The First Affiliated Hospital of the University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Dong Qian
- Department of Radiation Oncology, The First Affiliated Hospital of the University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
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Li X, Huang X, Lei L, Tong S. Impact of sarcopenia and sarcopenic obesity on survival in patients with primary liver cancer: a systematic review and meta-analysis. Front Nutr 2023; 10:1233973. [PMID: 37927508 PMCID: PMC10620805 DOI: 10.3389/fnut.2023.1233973] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 09/28/2023] [Indexed: 11/07/2023] Open
Abstract
Background Sarcopenia and sarcopenic obesity are associated with an increased possibility of adverse clinical outcomes; however, the effects of sarcopenia and sarcopenic obesity on patients with primary liver cancer remain controversial. Therefore, the present study aimed to determine the impact of sarcopenia and sarcopenic obesity on survival in patients with primary liver cancer. Methods We searched studies published in English in PubMed, Embase, Web of Science, and Cochrane Library databases up to 13 November 2022. Cohort studies that reported the association among sarcopenia, sarcopenic obesity, and patient survival were included. Results A total of 64 cohort studies with data on 11,970 patients with primary liver cancer were included in the meta-analysis. Sarcopenia was associated with poor overall survival in patients with primary liver cancer [adjusted hazard ratio (HR) 2.11, 95% confidence interval (CI): 1.89-2.36, P < 0.0001], with similar findings for sarcopenic obesity (adjusted HR: 2.87, 95% CI: 2.23-3.70, P < 0.0001). Sarcopenia was also associated with poor overall survival across the subgroups analyzed by ethnicity, type of liver cancer, treatment modalities, method used to define sarcopenia, and etiology of liver cancer. We also found a negative correlation among sarcopenia, sarcopenic obesity, and recurrence-free/disease-free survival (adjusted HR: 1.73, 95% CI: 1.50-1.99, P < 0.001; adjusted HR: 2.28, 95% CI: 1.54-3.35, P < 0.001, respectively). Conclusion Sarcopenia and sarcopenic obesity were significantly associated with poor overall survival and recurrence-free/disease-free survival in patients with primary liver cancer. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=378433, PROSPERO [42022378433].
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Affiliation(s)
- Xuanmei Li
- Department of Infectious Diseases, Department of Clinical Nutrition, Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Xue Huang
- Department of Ultrasound, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Lifu Lei
- Department of Clinical Nutrition, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Shiwen Tong
- Department of Clinical Nutrition, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
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Lyu J, Yang N, Guan W, Xiao L, Nie X, Liang L, Bai H, Li C, Kuang H, Wang X, Li T. Post-treatment serum triglyceride: An effective biomarker for body fat mass and overall survival in esophageal squamous cell cancer patients treated with chemoradiotherapy. Front Nutr 2022; 9:1050643. [PMID: 36532533 PMCID: PMC9755343 DOI: 10.3389/fnut.2022.1050643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/16/2022] [Indexed: 08/01/2023] Open
Abstract
OBJECTIVES Although lipids have been assessed for their possible roles in cancer survival prediction, studies on the association between serum triglyceride (TG) levels and the prognosis of esophageal squamous cell carcinoma (ESCC) patients are limited. This study aimed to evaluate whether serum TG is associated with outcomes in patients with ESCC and investigate any interaction between serum TG and clinical parameters, especially body fat mass. MATERIALS AND METHODS We conducted a prospective case study on patients diagnosed with ESCC between March 2012 and November 2018. We measured patients' serum TG levels before and after treatment. The association between serum TG and overall survival (OS) was evaluated using hazard ratios. We sought to determine a threshold point using optimal stratification. Survival analysis was performed using Kaplan-Meier curves and a Cox proportional hazards model. RESULTS Of the 257 participants diagnosed with ESCC, 200 (77.8%) were men. Median follow-up time was 22.4 months (range 3.3-92.4 months). Using univariate Cox proportional hazard analysis and subsequent multivariate analysis, post-TG levels, Karnofsky performance scores, T stages, and chemotherapy cycles were shown to be independent prognostic factors for OS (p < 0.05). The post-TG cut-off point to best classify patients with respect to time to mortality was 1.47 mmol/L. A post-TG level of ≥ 1.47 mmol/L could independently predict a better OS (hazard ratio: 0.55, 95% confidence interval: 0.37-0.79). The associations were consistent across the subtypes of clinical parameters. Furthermore, the post-body mass index, post-subcutaneous adipose tissue area, post-visceral adipose tissue area, post-total adiposity tissue area, and post-total adipose density exhibited a strong positive association with post-TG levels. CONCLUSION Post-TG levels were found to be a significant positive prognostic biomarker for body fat mass and OS in ESCC patients.
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Affiliation(s)
- Jiahua Lyu
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Ningjing Yang
- Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Wang Guan
- Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Ling Xiao
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xinyu Nie
- Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Long Liang
- Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Hansong Bai
- Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Churong Li
- Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Hao Kuang
- Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiao Wang
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Tao Li
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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Guan L, Li T, Wang X, Yu K, Xiao R, Xi Y. Predictive Roles of Basal Metabolic Rate and Body Water Distribution in Sarcopenia and Sarcopenic Obesity: The link to Carbohydrates. Nutrients 2022; 14:nu14193911. [PMID: 36235562 PMCID: PMC9571591 DOI: 10.3390/nu14193911] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/13/2022] [Accepted: 09/18/2022] [Indexed: 11/23/2022] Open
Abstract
Sarcopenic obesity is a new category of obesity and is a specific condition of sarcopenia. This study aimed to find the relationship of the basal metabolic rate (BMR) and body water distribution with muscle health and their prospective roles in screening for sarcopenic obesity and sarcopenia. The role of nutrients such as carbohydrates in the relationship was further detected. A total of 402 elderly subjects were recruited. Body composition was estimated by bioelectrical impedance analysis. Sarcopenia was defined by the Asian Working Group for Sarcopenia 2019. The cutoff values were determined by the receiver operating characteristic curve. Mediation analyses were performed using SPSS PROCESS. Higher BMR and BMR/body surface area (BSA) were protective factors against sarcopenic obesity (OR = 0.047, p = 0.004; OR = 0.035, p = 0.002) and sarcopenia (OR = 0.085, p = 0.001; OR = 0.100, p = 0.003) in elderly people. Low extracellular water (ECW)/intracellular water (ICW) and ECW/total body water (TBW) were negatively correlated with the skeletal muscle index (SMI). The intake of dietary carbohydrates in people with sarcopenic obesity was the lowest, but in subjects with obesity, it was the highest (p = 0.023). The results of the moderated mediation model showed that BMR fully mediated the positive relationship between carbohydrates and SMI, which was more obvious in the population with an abnormal body water distribution. BMR or BMR/BSA had the potential role of predicting a higher risk of sarcopenic obesity and sarcopenia. Higher BMR and lower ECW/ICW and ECW/TBW may benefit muscle health. The overconsumption of carbohydrates (especially > AMDR) might be a risk factor for obesity. Moderate dietary carbohydrate intake might promote SMI by regulating BMR and body water distribution in the elderly.
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Affiliation(s)
- Lizheng Guan
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Tiantian Li
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Xuan Wang
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Kang Yu
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Beijing 100730, China
| | - Rong Xiao
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Yuandi Xi
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing 100069, China
- Correspondence:
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Ji W, Liu X, Zhang Y, Zhao Y, He Y, Cui J, Li W. Development of Formulas for Calculating L3 Skeletal Muscle Mass Index and Visceral Fat Area Based on Anthropometric Parameters. Front Nutr 2022; 9:910771. [PMID: 35782936 PMCID: PMC9249379 DOI: 10.3389/fnut.2022.910771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/24/2022] [Indexed: 11/29/2022] Open
Abstract
Background The anthropometric index is not accurate but shows a great advantage in accessibility. Simple body composition formulas should be investigated before proceeding with the universal nutrition screening. Materials and Methods Clinical data of patients with a malignant tumor of the digestive system were collected. SliceOmatic 5.0 software (TOMOVISION, Canada) was used to analyze abdominal CT images and taken as references. A linear regression analysis was adopted to establish the formula for calculating skeletal muscle index (SMI) and visceral fat area (VFA). In addition, the relweights function was adopted to measure the contribution of each variable. Results In total, 344 patients were divided into the training set and 134 patients into the validation set. The selected formulas were SMI.pre = 0.540 × weight (kg) – 0.559 × height (cm) – 13.877 × sex (male = 1, female = 2) + 123.583, and VFA.pre = 5.146 × weight (kg) – 2.666 × height (cm) + 1.436 × age (year) + 134.096, of which the adjusted R2 were 0.597 and 0.581, respectively. The “weight” explained more than 80% of R2 in the prediction of VFA. In addition, “sex” occupied approximately 40% of R2 in the prediction of SMI. The paired t-test showed no significant difference between the real measured indices and the predicting ones (p = 0.123 for SMI and p = 0.299 for VFA). The logistic regression analysis exhibited similar diagnostic efficacy of the real measured parameters and formulas. Conclusion The SMI and VFA formulas were developed through basic indices, such as weight, height, sex, and age. According to the contribution of each variable, weight should always be focused on preserving appropriate muscle and adipose tissue.
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