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Ramessur V, Hunma S, Joonas N, Ramessur BN, Schutz Y, Montani JP, Dulloo AG. Visceral-to-peripheral adiposity ratio: a critical determinant of sex and ethnic differences in cardiovascular risks among Asian Indians and African Creoles in Mauritius. Int J Obes (Lond) 2024:10.1038/s41366-024-01517-3. [PMID: 38615158 DOI: 10.1038/s41366-024-01517-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND/AIMS Coronary heart disease morbidity and mortality are higher in people of South Asian origin than in those of African origin. We investigated whether as young adults without diabetes, people in Mauritius of South Asian descent (Indians) would show a more adverse cardiovascular risk profile that those of predominantly African descent (Creoles), and whether this could be explained by ethnic differences in visceral adiposity or other fat distribution patterns. METHODS The study was conducted in 189 young non-physically active adults, with the following measurements conducted after an overnight fast: anthropometry (weight, height, waist circumference), whole-body and regional body composition by dual-energy x-ray absorptiometry, blood pressure, and blood assays for glycemic (glucose and HbA1c) and lipid profile (triglycerides and cholesterols). RESULTS The results indicate higher serum triglycerides and lower HDL cholesterol in men than in women, and in Indians than in Creoles (p < 0.001). No significant differences due to sex or ethnicity are observed in body mass index and waist circumference, but indices of visceral adiposity (visceral/android, visceral/subcutaneous) and visceral-to-peripheral adiposity ratio (visceral/gynoid, visceral/limb) were significantly higher in men than in women, and in Indians than in Creoles. The significant effects of sex and ethnicity on blood lipid profile were either completely abolished or reduced to a greater extent after adjusting for the ratio of visceral-to-peripheral adiposity than for visceral adiposity per se. CONCLUSIONS In young adults in Mauritius, Indians show a more adverse pattern of body fat distribution and blood lipid risk profile than Creoles. Differences in their fat distribution patterns, however, only partially explain their differential atherogenic lipid risk profile, amid a greater impact of visceral-to-peripheral adiposity ratio than that of visceral adiposity per se on sex and ethnic differences in cardiovascular risks; the former possibly reflecting the ratio of hazardous (visceral) adiposity and protective (peripheral) superficial subcutaneous adiposity.
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Affiliation(s)
- Vinaysing Ramessur
- Obesity Research Unit, Biochemistry Dept., Central Health Laboratory, Victoria Hospital, Ministry of Health & Wellness, Plaines Wilhems, Mauritius
- Department of Endocrinology, Metabolism & Cardiovascular System, Faculty of Science & Medicine, University of Fribourg, Fribourg, Switzerland
| | - Sadhna Hunma
- Obesity Research Unit, Biochemistry Dept., Central Health Laboratory, Victoria Hospital, Ministry of Health & Wellness, Plaines Wilhems, Mauritius
| | - Noorjehan Joonas
- Obesity Research Unit, Biochemistry Dept., Central Health Laboratory, Victoria Hospital, Ministry of Health & Wellness, Plaines Wilhems, Mauritius
| | - Bibi Nasreen Ramessur
- Obesity Research Unit, Biochemistry Dept., Central Health Laboratory, Victoria Hospital, Ministry of Health & Wellness, Plaines Wilhems, Mauritius
| | - Yves Schutz
- Department of Endocrinology, Metabolism & Cardiovascular System, Faculty of Science & Medicine, University of Fribourg, Fribourg, Switzerland
| | - Jean-Pierre Montani
- Department of Endocrinology, Metabolism & Cardiovascular System, Faculty of Science & Medicine, University of Fribourg, Fribourg, Switzerland
| | - Abdul G Dulloo
- Department of Endocrinology, Metabolism & Cardiovascular System, Faculty of Science & Medicine, University of Fribourg, Fribourg, Switzerland.
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Assis MGC, Barbosa Junior JGG, Seffrin A, Ribeiro dos Anjos Souza V, Vivan L, Matos Rodrigues MA, de Lira CAB, Vancini RL, Knechtle B, Weiss K, Andrade MS. Maximal Oxygen Uptake, Muscular Oxidative Capacity, and Ventilatory Threshold in Amateur Triathletes: Eight-Month Training Follow-Up. Open Access J Sports Med 2024; 15:9-17. [PMID: 38505703 PMCID: PMC10950087 DOI: 10.2147/oajsm.s453875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 03/11/2024] [Indexed: 03/21/2024] Open
Abstract
Purpose Endurance sports performance is influenced by several factors, including maximal oxygen uptake (⩒O2max), the percentage of ⩒O2max that can be sustained in endurance events, running economy, and body composition. Traditionally, ⩒O2max can be measured as an absolute value, adjusted for body mass, reflecting the athlete's central capacity (maximal cardiac output), or adjusted for lean mass (LM), reflecting the athlete's peripheral capacity (muscular oxidative capacity). The present study aims to evaluate absolute, total body mass, and lower limb LM-adjusted ⩒O2max, ventilatory thresholds (VT), respiratory compensation points (RCP), and body composition during two training periods separated by 8 months. Patients and Methods Thirteen competitive amateur triathletes [seven men (40.7±13.7 years old, 76.3±8.3kg, and 173.9±4.8cm) and six women (43.5±6.9 years old, 55.0±2.7kg, 164.9±5.2cm)] were evaluated for body composition with dual-energy X-ray absorptiometry and ⩒O2max, VT, RPC, and maximal aerobic speed (MAS) with a cardiorespiratory maximal treadmill test. Results The absolute ⩒O2max (p = 0.003, d = 1.05), body mass-adjusted ⩒O2max (p < 0.001, d = 1.2859), and MAS (p = 0.047, d = 0.6139) values differed significantly across evaluation periods. Lower limb LM-adjusted ⩒O2max (p = 0.083, d = -0.0418), %⩒O2max at VT (p = 0.541, d = -0.1746), speed at VT (p = 0.337, d = -0.2774), % ⩒O2max at RCP (p = 0.776, d = 0.0806), and speed at RCP (p = 0.436, d = 0.2234) showed no difference. Conclusion The sensitivities of ⩒O2max adjusted for body mass and ⩒O2max adjusted for LM to detect changes in physical training state differ. Furthermore, decreases in physical fitness level, as evaluated by ⩒O2max values, are not accompanied by changes in VT.
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Affiliation(s)
| | | | - Aldo Seffrin
- Postgraduate Program in Translation Medicine, Federal University of São Paulo, São Paulo, Brazil
| | | | - Lavínia Vivan
- Postgraduate Program in Translation Medicine, Federal University of São Paulo, São Paulo, Brazil
| | | | | | - Rodrigo Luiz Vancini
- Center for Physical Education and Sports, Federal University of Espírito Santo, Espírito Santo, Brazil
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Katja Weiss
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
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Chan B, Yu Y, Huang F, Vardhanabhuti V. Towards visceral fat estimation at population scale: correlation of visceral adipose tissue assessment using three-dimensional cross-sectional imaging with BIA, DXA, and single-slice CT. Front Endocrinol (Lausanne) 2023; 14:1211696. [PMID: 37497346 PMCID: PMC10368369 DOI: 10.3389/fendo.2023.1211696] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/19/2023] [Indexed: 07/28/2023] Open
Abstract
Background In terms of assessing obesity-associated risk, quantification of visceral adipose tissue (VAT) has become increasingly important in risk assessment for cardiovascular and metabolic diseases. However, differences exist in the accuracy of various modalities, with a lack of up-to-date comparison with three-dimensional whole volume assessment. Aims Using CT or MRI three-dimensional whole volume VAT as a reference, we evaluated the correlation of various commonly used modalities and techniques namely body impedance analysis (BIA), dual-energy x-ray absorptiometry (DXA) as well as single slice CT to establish how these methods compare. Methods We designed the study in two parts. First, we performed an intra-individual comparison of the 4558 participants from the UK Biobank cohorts with matching data of MRI abdominal body composition, DXA with VAT estimation, and BIA. Second, we evaluated 174 CT scans from the publicly available dataset to assess the correlation of the commonly used single-slice technique compared to three-dimensional VAT volume. Results Across the UK Biobank cohort, the DXA-derived VAT measurement correlated better (R2 0.94, p<0.0001) than BIA (R2 0.49, p<0.0001) with reference three-dimensional volume on MRI. However, DXA-derived VAT correlation was worse for participants with a BMI of < 20 (R2 = 0.62, p=0.0013). A commonly used single slice method on CT demonstrated a modest correlation (R2 between 0.51 - 0.64), with best values at L3- and L4 (R2 L3 = 0.63, p<0.0001; L4 = 0.64, p<0.0001) compared to reference three-dimensional volume. Combining multiple slices yielded a better correlation, with a strong correlation when L2-L3 levels were combined (R2 = 0.92, p<0.0001). Conclusion When deployed at scale, DXA-derived VAT volume measurement shows excellent correlation with three-dimensional volume on MRI based on the UK Biobank cohort. Whereas a single slice CT technique demonstrated moderate correlation with three-dimensional volume on CT, with a stronger correlation achieved when multiple levels were combined.
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Affiliation(s)
- Benjamin Chan
- St. Catherine’s College, University of Oxford, Oxford, United Kingdom
| | - Yan Yu
- Snowhill Science Limited, Hong Kong, Hong Kong SAR, China
| | - Fan Huang
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Varut Vardhanabhuti
- Snowhill Science Limited, Hong Kong, Hong Kong SAR, China
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Barbosa JG, de Lira CAB, Vancini RL, dos Anjos VR, Vivan L, Seffrin A, Forte P, Weiss K, Knechtle B, Andrade MS. Physiological Features of Olympic-Distance Amateur Triathletes, as Well as Their Associations with Performance in Women and Men: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:healthcare11040622. [PMID: 36833156 PMCID: PMC9956327 DOI: 10.3390/healthcare11040622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/16/2023] [Accepted: 02/18/2023] [Indexed: 02/22/2023] Open
Abstract
The purpose of this study was to verify the physiological and anthropometric determinants of triathlon performance in female and male athletes. This study included 40 triathletes (20 male and 20 female). Dual-energy X-ray absorptiometry (DEXA) was used to assess body composition, and an incremental cardiopulmonary test was used to assess physiological variables. A questionnaire about physical training habits was also completed by the athletes. Athletes competed in the Olympic-distance triathlon race. For the female group, the total race time can be predicted by V̇O2max (β = -131, t = -6.61, p < 0.001), lean mass (β = -61.4, t = -2.66, p = 0.018), and triathlon experience (β = -886.1, t = -3.01, p = 0.009) (r2 = 0.825, p < 0.05). For the male group, the total race time can be predicted by maximal aerobic speed (β = -294.1, t = -2.89, p = 0.010) and percentage of body fat (β = 53.6, t = 2.20, p = 0.042) (r2 = 0.578, p < 0.05). The variables that can predict the performance of men are not the same as those that can predict the triathlon performance of women. These data can help athletes and coaches develop performance-enhancing strategies.
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Affiliation(s)
- José Geraldo Barbosa
- Department of Physiology, Federal University of São Paulo, São Paulo 04021-001, Brazil
| | - Claudio Andre Barbosa de Lira
- Human and Exercise Physiology Division, Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia 74690-900, Brazil
| | - Rodrigo Luiz Vancini
- Center for Physical Education and Sports, Federal University of Espírito Santo, Vitória 29075-210, Brazil
| | | | - Lavínia Vivan
- Department of Physiology, Federal University of São Paulo, São Paulo 04021-001, Brazil
| | - Aldo Seffrin
- Department of Physiology, Federal University of São Paulo, São Paulo 04021-001, Brazil
| | - Pedro Forte
- Department of Sports, Higher Institute of Educational Sciences of the Douro, 4560-547 Porto, Portugal
- Department of Sports Sciences, Instituto Politécnico de Bragança, 5300-253 Bragança, Portugal
- Research Center in Sports, Health and Human Development, 7000-671 Covilhã, Portugal
| | - Katja Weiss
- Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland
- Medbase St. Gallen Am Vadianplatz, 9000 St. Gallen, Switzerland
- Correspondence:
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Gradidge PJL, Jaff NG, Norris SA, Toman M, Crowther NJ. The negative association of lower body fat mass with cardiometabolic disease risk factors is partially mediated by adiponectin. Endocr Connect 2022; 11:e220156. [PMID: 36169024 PMCID: PMC9641776 DOI: 10.1530/ec-22-0156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 09/28/2022] [Indexed: 11/08/2022]
Abstract
Gluteofemoral fat correlates negatively with a number of cardiometabolic disease risk factors, but the mechanisms involved in these relationships are unknown. The aim of this study was to test the hypothesis that gluteofemoral fat attenuates the risk of cardiometabolic disease by increasing blood adiponectin levels. This was a cross-sectional study in which arm, leg, gluteofemoral, abdominal s.c. and visceral fat levels were measured by dual-energy X-ray absorptiometry in 648 African females. Fasting serum adiponectin, lipid, insulin and plasma glucose levels and blood pressure were measured. Relationships between variables were analysed using multivariable linear regression and structural equation modelling. Adiponectin correlated positively (β = 0.45, P < 0.0001) with gluteofemoral fat in a multivariable regression model that included age, height, and arm, s.c. and visceral fat levels. In further regression models, there was a negative correlation of gluteofemoral fat with fasting glucose (β = -0.28; P < 0.0001) and triglyceride levels (β = -0.29; P < 0.0001) and insulin resistance (HOMA; β = -0.26; P < 0.0001). Structural equation modelling demonstrated that adiponectin mediated 20.7% (P < 0.01) of the association of gluteofemoral fat with insulin resistance and 16.1% (P < 0.01) of the association with triglyceride levels but only 6.67% (P = 0.31) of the association with glucose levels. These results demonstrate that gluteofemoral and leg fat are positively associated with adiponectin levels and that the negative association of lower body fat with insulin resistance and triglyceride levels may partially be mediated by this adipokine. Further studies are required to determine other factors that mediate the effect of lower body fat on cardiometabolic disease risk factors.
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Affiliation(s)
- Philippe Jean-Luc Gradidge
- Centre for Exercise Science and Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicole G Jaff
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Global Health Research Institute, School of Human Development and Health, University of Southampton, Southampton, UK
| | - Marketa Toman
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nigel J Crowther
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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The Performance, Physiology and Morphology of Female and Male Olympic-Distance Triathletes. Healthcare (Basel) 2022; 10:healthcare10050797. [PMID: 35627934 PMCID: PMC9140916 DOI: 10.3390/healthcare10050797] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/12/2022] [Accepted: 04/21/2022] [Indexed: 11/25/2022] Open
Abstract
Sex differences in triathlon performance have been decreasing in recent decades and little information is available to explain it. Thirty-nine male and eighteen female amateur triathletes were evaluated for fat mass, lean mass, maximal oxygen uptake (VO2 max), ventilatory threshold (VT), respiratory compensation point (RCP), and performance in a national Olympic triathlon race. Female athletes presented higher fat mass (p = 0.02, d = 0.84, power = 0.78) and lower lean mass (p < 0.01, d = 3.11, power = 0.99). VO2 max (p < 0.01, d = 1.46, power = 0.99), maximal aerobic velocity (MAV) (p < 0.01, d = 2.05, power = 0.99), velocities in VT (p < 0.01, d = 1.26, power = 0.97), and RCP (p < 0.01, d = 1.53, power = 0.99) were significantly worse in the female group. VT (%VO2 max) (p = 0.012, d = 0.73, power = 0.58) and RCP (%VO2 max) (p = 0.005, d = 0.85, power = 0.89) were higher in the female group. Female athletes presented lower VO2 max value, lower lean mass, and higher fat mass. However, females presented higher values of aerobic endurance (%VO2 max), which can attenuate sex differences in triathlon performance. Coaches and athletes should consider that female athletes can maintain a higher percentage of MAV values than males during the running split to prescribe individual training.
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Bea JW, Chen Z, Blew RM, Nicholas JS, Follis S, Bland VL, Cheng TYD, Ochs-Balcom HM, Wactawski-Wende J, Banack HR, Neuhouser ML, Laddu D, Stefanick ML, Cauley JA, Caan B, LeBoff MS, Chlebowski RT, Odegaard AO. MRI Based Validation of Abdominal Adipose Tissue Measurements From DXA in Postmenopausal Women. J Clin Densitom 2022; 25:189-197. [PMID: 34404568 PMCID: PMC8799761 DOI: 10.1016/j.jocd.2021.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Visceral adipose tissue (VAT) is a hypothesized driver of chronic disease. Dual-energy X-ray absorptiometry (DXA) potentially offers a lower cost and more available alternative compared to gold-standard magnetic resonance imaging (MRI) for quantification of abdominal fat sub-compartments, VAT and subcutaneous adipose tissue (SAT). We sought to validate VAT and SAT area (cm2) from historical DXA scans against MRI. METHODOLOGY Participants (n = 69) from the Women's Health Initiative (WHI) completed a 3 T MRI scan and a whole body DXA scan (Hologic QDR2000 or QDR4500; 2004-2005). A subset of 43 participants were scanned on both DXA devices. DXA-derived VAT and SAT at the 4th lumbar vertebrae (5 cm wide) were analyzed using APEX software (v4.0, Hologic, Inc., Marlborough, MA). MRI VAT and SAT areas for the corresponding DXA region of interest were quantified using sliceOmatic software (v5.0, Tomovision, Magog, Canada). Pearson correlations between MRI and DXA-derived VAT and SAT were computed, and a Bland-Altman analysis was performed. RESULTS Participants were primarily non-Hispanic white (86%) with a mean age of 70.51 ± 5.79 years and a mean BMI of 27.33 ± 5.40 kg/m2. Correlations between MRI and DXA measured VAT and SAT were 0.90 and 0.92, respectively (p ≤ 0.001). Bland-Altman plots showed that DXA-VAT slightly overestimated VAT on the QDR4500 (-3.31 cm2); this bias was greater in the smaller subset measured on the older DXA model (QDR2000; -30.71 cm2). The overestimation of DXA-SAT was large (-85.16 to -118.66 cm2), but differences were relatively uniform for the QDR4500. CONCLUSIONS New software applied to historic Hologic DXA scans provide estimates of VAT and SAT that are well-correlated with criterion MRI among postmenopausal women.
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Affiliation(s)
- Jennifer W Bea
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA; Department of Medicine, University of Arizona, Tucson, AZ, USA; University of Arizona Cancer Center, Tucson, AZ, USA.
| | - Zhao Chen
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, USA
| | - Robert M Blew
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
| | | | - Shawna Follis
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Victoria L Bland
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
| | | | - Heather M Ochs-Balcom
- Department of Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, NY, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, NY, USA
| | - Hailey R Banack
- Department of Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, NY, USA
| | - Marian L Neuhouser
- Cancer Prevention Program. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Deepika Laddu
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - Marcia L Stefanick
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bette Caan
- Division of Research, Kaiser Permanente, Oakland, CA, USA
| | - Meryl S LeBoff
- Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Rowan T Chlebowski
- The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Andrew O Odegaard
- Department of Epidemiology and Biostatistics, University of California, Irvine, CA, USA
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URO-GAN: An untrustworthy region optimization approach for adipose tissue segmentation based on adversarial learning. APPL INTELL 2022. [DOI: 10.1007/s10489-021-02976-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Abstract
Aim: Cushing's syndrome (CS) is associated with weight gain and extreme central, visceral, abdominal obesity which is confirmed with dual-energy X-rays absorptiometric (DXA) diagnostic cut-off point (CP) values of central obesity indexes (COI), determined as an android to gynoid tissue and fat mass ratios. These best differentiate CS from non-CS obese women matched with CS according to their age and BMI. The aim of this study was to determine the CP values of new DXA indexes of central, abdominal obesity as a ratio of android and trunk to legs as well as trunk and legs to total tissue and fat mass that best differentiate CS and matched non-CS obese women in order to confirm central abdominal obesity, and to determine their normal CP values that best differentiate healthy non-obese women from CS and non-CS obese women, and to exclude abdominal obesity completely. Material and Methods: DXA indexes of abdominal obesity, calculated as а ratio of regional body fat and tissue mass compartments android to legs (A/L), trunk to legs (Tr/L), trunk to total (Tr/To) and legs to total (L/To) values were determined among 4 groups. Each group consisted of 18 women: 1st group of CS, 2nd group of obese women (O1) not different according to their age and BMI from CS, 3rd group of obese women (O2) with higher BMI of 35 ± 1.2 kg and a 4th group of non-obese, healthy women (C) with a normal BMI. Diagnostic accuracy (DG) of CP values of DXA indexes of abdominal obesity and indexes of normal body fat distribution (BFD) were determined. Results: A/L, Tr/L, Tr/To, and L/To DXA indexes were significantly different between CS and O1 as well as between non-CS women O2 compared to O1 and C. These indexes had a highly significant correlation among each other and also in relation to their BMI (p < 0.0001). A/L-Tm CP value of 0.3 best differentiated the CS from group O1, with the highest DG of 100 % and an A/L-Fm CP value of 0.26 differentiated them with a DG of 94.44% and sensitivity of 100 %. An A/L-Tn CP value of 0.23 and an A/L-Fn CP value of 0.25 best differentiated CS and C as well as O2 and C for the highest DG of 100 %. Conclusions: DXA indexes A/L, Tr/L, Tr/To and L/To values were significantly different among the four groups. These values correlated significantly among them and with their BMI in non-CS groups, thus confirming a BMI increase association with a more pronounced abdominal BFD. An A/L-Tm CP value of 0.3 and an A/L-Fm CP value of 0.26 were discovered as the best DXA diagnostic indexes of extreme abdominal obesity in CS and these could also be used in discovering abdominal BFD in non-CS obese women with metabolic syndrome (MS). An A/L-Tn CP value of 0.23 and an A/L-Fn CP value of 0.25 were discovered as the best DXA diagnostic indexes of normal BFD which completely excluded abdominal obesity.
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Alavi DH, Henriksen HB, Lauritzen PM, Kværner AS, Sakinis T, Langleite TM, Henriksen C, Bøhn SK, Paur I, Wiedswang G, Smeland S, Blomhoff R. Quantification of adipose tissues by Dual-Energy X-Ray Absorptiometry and Computed Tomography in colorectal cancer patients. Clin Nutr ESPEN 2021; 43:360-368. [PMID: 34024541 DOI: 10.1016/j.clnesp.2021.03.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/23/2021] [Accepted: 03/30/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND & AIMS Excess adipose tissue may affect colorectal cancer (CRC) patients' disease progression and treatment. In contrast to the commonly used anthropometric measurements, Dual-Energy X-Ray Absorptiometry (DXA) and Computed Tomography (CT) can differentiate adipose tissues. However, these modalities are rarely used in the clinic despite providing high-quality estimates. This study aimed to compare DXA's measurement of abdominal visceral adipose tissue (VAT) and fat mass (FM) against a corresponding volume by CT in a CRC population. Secondly, we aimed to identify the best single lumbar CT slice for abdominal VAT. Lastly, we investigated the associations between anthropometric measurements and VAT estimated by DXA and CT. METHODS Non-metastatic CRC patients between 50-80 years from the ongoing randomized controlled trial CRC-NORDIET were included in this cross-sectional study. Corresponding abdominal volumes were acquired by Lunar iDXA and from clinically acquired CT examinations. Also, single CT slices at L2-, L3-and L4-level were obtained. Agreement between the methods was investigated using univariate linear regression and Bland-Altman plots. RESULTS Sixty-six CRC patients were included. Abdominal volumetric VAT and FM measured by DXA explained up to 91% and 96% of the variance in VAT and FM by CT, respectively. Bland-Altman plots demonstrated an overestimation of VAT by DXA compared to CT (mean difference of 76 cm3) concurrent with an underestimation of FM (mean difference of -319 cm3). A higher overestimation of VAT (p = 0.015) and underestimation of FM (p = 0.036) were observed in obese relative to normal weight subjects. VAT in a single slice at L3-level showed the highest explained variance against CT volume (R2 = 0.97), but a combination of three slices (L2, L3, L4) explained a significantly higher variance than L3 alone (R2 = 0.98, p < 0.006). The anthropometric measurements explained between 31-65% of the variance of volumetric VAT measured by DXA and CT. CONCLUSIONS DXA and the combined use of three CT slices (L2-L4) are valid to predict abdominal volumetric VAT and FM in CRC patients when using volumetric CT as a reference method. Due to the poor performance of anthropometric measurements we recommend exploring the added value of advanced body composition by DXA and CT integrated into CRC care.
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Affiliation(s)
- Dena Helene Alavi
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
| | - Hege Berg Henriksen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | | | - Ane Sørlie Kværner
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway; Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway
| | - Tomas Sakinis
- Medical Division, Radiology & Nuclear Medicine, Neuroimaging Research Group, Oslo University Hospital, Oslo, Norway
| | - Torgrim Mikal Langleite
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Christine Henriksen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Siv Kjølsrud Bøhn
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Ingvild Paur
- Norwegian National Advisory Unit on Disease-Related Malnutrition, Oslo University Hospital, Oslo, Norway
| | - Gro Wiedswang
- Department of Gastrointestinal Surgery, Oslo University Hospital, Ullevål, Norway
| | - Sigbjørn Smeland
- Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Rune Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway; Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
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11
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Puccinelli P, DE Lira CA, Vancini RL, Nikolaidis PT, Knechtle B, Andrade MS. Distribution of body fat is associated with physical performance of male amateur triathlon athletes. J Sports Med Phys Fitness 2021; 62:215-221. [PMID: 33666075 DOI: 10.23736/s0022-4707.21.12075-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Endurance sports are strongly associated with maximum oxygen uptake, anaerobic threshold, running economy and body fat percentage. Despite the importance for performance of the low-fat mass being a consensus in the literature, there are no data about the importance of the pattern of fat distribution. Therefore, the aim of the present study was to investigate the association between fat mass distribution with triathlon performance and physiological determinants of performance: maximal oxygen consumption (VO2max), ventilatory threshold (AT) and running economy (RE), and to verify the predictive value for performance of gynoid or android fat mass distribution. METHODS Thirty-nine triathletes (38.8±6.9 years, 174.8±6.5cm and 74.3±8.8kg) were evaluated for anthropometric (total body mass, fat mass, lean mass, android and gynoid fat mass) and physiological (VO2max, AT and RE) parameters. Split and overall race times were registered. RESULTS Overall race time relationship with gynoid fat mass (r=.529, p<.05) was classified as moderate higher than and with android fat mass (r=.416, p<.05) was classified as low. All split times and overall race time presented significant positive correlation with only total fat mass (%) (r =.329 to .574, p<.05) and with gynoid fat mass (%) (r=.359 to .529, p<.05). Overall race time can be better predicted by gynoid fat mass (ß=0.529, t=4.093, p<0.001, r2=0.28) than by android fat mass (ß =0.416, t=2.997, p=0.005, r2=0.17). CONCLUSIONS Fat mass distribution is associated with triathlon performance, and the gynoid fat pattern is worse for triathlon performance than the android pattern.
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Affiliation(s)
- Paulo Puccinelli
- Department of Physiology, Federal University of São Paulo, São Paulo, Brazil
| | - Claudio A DE Lira
- Human and Exercise Physiology Division, Faculty of Physical Education and Dance, Federal University of Goiás, Goiás, Brazil
| | - Rodrigo L Vancini
- Center of Physical Education and Sports, Federal University of Espírito Santo, Espírito Santo, Brazil
| | | | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland - .,Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland
| | - Marilia S Andrade
- Department of Physiology, Federal University of São Paulo, São Paulo, Brazil
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Diagnostic Central Obesity Indexes Cut - Off Point Values Determined with Dual-Energy X-Ray Absorptiometry in Cushing's and Obese Women. ACTA ACUST UNITED AC 2020; 41:13-21. [PMID: 33500372 DOI: 10.2478/prilozi-2020-0041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM The aim of this study was to develop quantiative criteria for defining visceral obesity and to establish dual-energy X-ray absorptiometric (DXA) diagnostic cut-off points (CP) for normal and abnormal values of the central obesity indexes (COI) that best differentiate extreme visceral obesity in Cushing's syndrome (CS) from non CS obese and non obese women. MATERIAL AND METHODS COI1-4 values calculated as a ratio of android to gynoid tissue mass, fat mass and their % were determined in 4 groups, each consisting of 18 women: 1st group of CS, 2nd group of obese women (O1) not different according to their age and BMI from CS, 3rd group of obese women (O2) with BMI of 35 ± 1.2 kg and 4th group of non obese healthy women (C) with normal BMI. Diagnostic accuracy (DG) of CP values of COI1m-4m indexes of abdominal obesity and CP values of COI1n-4n indexes of normal body fat distribution (BFD) was determined. RESULTS COI1-4 indexes values were highly significantly different among the 4 examined groups and were significantly highest in CS patients and lowest in group C (p < 0.0001). COI1m-4m CP values differentiated extreme visceral, abdominal obesity in CS with highest DG as well as COI1n-4n CP values differentiated normal BFD in group C. COI1m CP of 0.55 best differentiated CS from O1 for DG of 100%. COI2n of 0.38 best differentiated C from CS and O2 for highest DG of 100% compared to O1 because of the significantly higher BMI and COI1n-4n values in O2 that were associated with more pronounced abdominal obesity and highly significantly positive correlation with BMI. CONCLUSIONS DXA cut-off point values of indexes COI1m-4m and COI1n-4n were established as diagnostic indexes and criteria useful in discovering extreme abdominal and normal BFD. COI1m CP value of 0.55 was discovered as a diagnostic criterion of extreme abdominal obesity and COI2n of 0.38 as a diagnostic criterion of normal BFD that excluded abdominal obesity. The other indexes COI1m-4m and COI1n-4n CP values had also high DG in discovering abdominal and normal body fat distribution.
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13
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Puccinelli PJ, Lima GHO, Pesquero JB, de Lira CAB, Vancini RL, Nikolaids PT, Knechtle B, Andrade MS. Previous experience, aerobic capacity and body composition are the best predictors for Olympic distance triathlon performance: Predictors in amateur triathlon. Physiol Behav 2020; 225:113110. [PMID: 32738318 DOI: 10.1016/j.physbeh.2020.113110] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Present study examines predictors of the overall race time and disciplines in the Olympic distance triathlon. METHODS Thirty-nine male and six female triathletes were evaluated for anthropometric, physiological, genetic, training, clinical and circadian characteristics. Body composition, maximum capacity for oxygen uptake (V˙O2max), maximum aerobic velocity (MAV), anaerobic threshold (AT), triathlon experience (TE) and XX genotype for α-actinin 3 affected total race time (p<0.05). RESULTS Total race time can be predicted by MAV (ß = -0.430, t = -3.225, p = 0.003), TE (ß = -0.378, t = -3.605, p = 0.001), and percentage of lean mass (%LM) (ß = -0.332, t = -2.503, p = 0.017). Swimming can be predicted by MAV (ß = -0.403, t = -3.239, p = 0.002), TE (ß = -0.339, t = -2.876, p = 0.007), and AT%V˙O2max (ß = 0.281, t = 2.278, p = 0.028). Cycling can be predicted by MAV (ß = -0.341, t = -2.333, p = 0.025), TE (ß = -0.363, t = -3.172, p = 0.003), and %LM (ß = -0.326, t = -2.265, p = 0.029). In running split, MAV (ß = -0.768, t = -6.222, p < 0.001) was the only parameter present in the best multiple linear regression model. CONCLUSION The most important variables in multiple regression models for estimating performance were MAV, TE, AT and %LM.
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Affiliation(s)
| | - Giscard H O Lima
- Departament of Biophysics, Federal University of São Paulo, Brazil
| | - João B Pesquero
- Departament of Biophysics, Federal University of São Paulo, Brazil
| | - Claudio A B de Lira
- Human and Exercise Physiology Division, Faculty of Physical Education and Dance, Federal University of Goiás, Brazil
| | - Rodrigo L Vancini
- Center of Physical Education and Sports, Federal University of Espírito Santo, Brazil
| | | | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Switzerland; Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland
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Moon HU, Lee N, Chung YS, Choi YJ. Reduction of visceral fat could be related to the improvement of TBS in diabetes mellitus. J Bone Miner Metab 2020; 38:702-709. [PMID: 32399674 DOI: 10.1007/s00774-020-01107-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 04/01/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Diabetes has been proposed as a risk factor for increased skeletal fragility. Visceral fat is known to yield adverse effects on bone metabolism in people with diabetes. We investigated the relationship between the change in visceral fat mass over time and TBS or BMD. MATERIALS AND METHODS This retrospective study enrolled 690 (male: 367; female: 323) subjects with type 2 diabetes mellitus. Visceral fat mass, lumbar and femoral neck BMD, and lumbar spine TBS were measured via dual-energy X-ray absorptiometry (DXA), including the follow-up data within a 3-year period. RESULTS TBS significantly increased as visceral fat mass decreased in both sexes (p < 0.001), whereas lumbar BMD and femoral neck BMD showed meaningful changes only in men. The multiple regression model with adjustment for age, weight, creatinine level, lipid profile, HbA1C, and status of osteoporosis medication use revealed that TBS and femoral neck BMD were correlated with visceral fat mass. However, regarding longitudinal changes, only the change in visceral fat mass had a significant relationship with TBS (males: β = - 0.298, p < 0.001; females: β = - 0.216, p < 0.001). CONCLUSIONS The results of this study may suggest the beneficial effect of controlling visceral fat mass on bone health in type 2 diabetes patients. Besides, DXA-derived TBS could be a useful diagnostic tool for evaluating the bone changes according to metabolic changes in type 2 diabetes, which are not entirely achieved with BMD.
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Affiliation(s)
- Hyun Uk Moon
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, South Korea
| | - Nami Lee
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, South Korea
| | - Yoon-Sok Chung
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, South Korea
| | - Yong Jun Choi
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, South Korea.
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15
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Turner RBS, Tyrrell D, Hepworth G, Dunshea FR, Mansfield CS. Compartmental fat distribution in the abdomen of dogs relative to overall body fat composition. BMC Vet Res 2020; 16:104. [PMID: 32228685 PMCID: PMC7106746 DOI: 10.1186/s12917-020-02327-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 03/23/2020] [Indexed: 12/04/2022] Open
Abstract
Background Adipose tissue may have different metabolic and endocrine functions depending on the region of the body in which it is located. While visceral or intra-abdominal fat has been found to contribute to leptin concentrations, insulin resistance and obesity-related diseases, there are only a few imaging studies documenting the preferential distribution of body fat to either the intra-abdominal or subcutaneous compartments in dogs. This study aimed to determine if CT-measured abdominal fat distributed preferentially to the visceral space (V) relative to the subcutaneous space (SQ), with increasing DXA-determined total body fat percentage; and if ultrasound measurements of the ventral midline subcutaneous (SAT) and visceral adipose thickness (VAT) can be used to estimate the distribution of fat to the subcutaneous and visceral abdominal spaces, in a sample of 22 dogs with variable body condition. Results Multivariate analysis showed no statistically significant correlation between visceral to subcutaneous fat ratio (V/SQ) and increasing total body fat percentage (β = − 0.07, p = 0.733), but strong correlation with age (β = 0.71 p = 0.002). A substantial amount of variation for the ultrasound visceral adipose thickness to subcutaneous fat thickness (VAT/SAT) could be explained by both CT V/SQ and sex (R2Adjusted = 0.477, p = 0.001), with female dogs having significant lower VAT/SAT ratios compared to the male dogs (p = 0.047). The ultrasound fat measurements appeared moderately reliable, but a larger sample number is required to confirm this. Conclusions The findings suggest that dogs with a relatively healthy to slightly overweight body condition score, distribute fat relatively similarly between their peritoneal (visceral) and subcutaneous abdominal compartments with increasing total body fat percentage. However, there was increased fat distribution to the peritoneal space relative to the subcutaneous space with increasing age. Further, abdominal ultrasound may be useful in estimating the ratio of fat distribution to both the abdominal visceral and subcutaneous spaces.
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Affiliation(s)
- R B S Turner
- U-Vet Animal Hospital, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, 250 Princes Highway, Werribee, Victoria, 3030, Australia.
| | - D Tyrrell
- U-Vet Animal Hospital, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, 250 Princes Highway, Werribee, Victoria, 3030, Australia
| | - G Hepworth
- Statistical Consulting Centre, University of Melbourne, 139 Barry Street, Carlton, Melbourne, Victoria, 3053, Australia
| | - F R Dunshea
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, Victoria, 3052, Australia
| | - C S Mansfield
- U-Vet Animal Hospital, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, 250 Princes Highway, Werribee, Victoria, 3030, Australia
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Murphy J, Bacon SL, Morais JA, Tsoukas MA, Santosa S. Intra-Abdominal Adipose Tissue Quantification by Alternative Versus Reference Methods: A Systematic Review and Meta-Analysis. Obesity (Silver Spring) 2019; 27:1115-1122. [PMID: 31131996 DOI: 10.1002/oby.22494] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 02/28/2019] [Indexed: 01/11/2023]
Abstract
OBJECTIVE This meta-analysis aimed to assess the agreement between intra-abdominal adipose tissue (IAAT) quantified by alternative methods and the reference standards, computed tomography (CT) and magnetic resonance imaging (MRI). METHODS MEDLINE and EMBASE electronic databases were systematically searched to identify studies that quantified IAAT thickness, area, or volume by a comparator method and CT or MRI. Using an inverse variance weighted approach (random-effects model), the mean differences and 95% limits of agreement (LoA) were pooled between methods. RESULTS The meta-analysis included 24 studies using four comparator methods. The pooled mean differences were -0.3 cm (95% LoA: -3.4 to 3.2 cm; P = 0.400) for ultrasound and -11.6 cm2 (95% LoA: -43.1 to 19.9 cm2 ; P = 0.004) for bioelectrical impedance analysis. Dual-energy x-ray absorptiometry (DXA) quantified both IAAT area and volume with mean differences of 8.1 cm2 (95% LoA: -98.9 to 115.1 cm2 ; P = 0.061) and 10 cm3 (95% LoA: -280 to 300 cm3 ; P = 0.808), respectively. CONCLUSIONS Ultrasound and DXA measure IAAT with minimal bias from CT or MRI, while bioelectrical impedance analysis systematically underestimates IAAT. However, with the exception of DXA for IAAT volume, the wide LoA caution against clinical or research use of the comparator methods and emphasize the need to optimize alternatives to the reference standards.
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Affiliation(s)
- Jessica Murphy
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Quebec, Canada
- Metabolism, Obesity and Nutrition Laboratory, PERFORM Centre, Concordia University, Montreal, Quebec, Canada
- Centre de recherche - Axe maladies chroniques, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Ile-de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
| | - Simon L Bacon
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Quebec, Canada
- Centre de recherche - Axe maladies chroniques, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Ile-de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
- Montreal Behavioural Medicine Centre, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Ile-de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
| | - José A Morais
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Quebec, Canada
- Division of Geriatric Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
- Division of Endocrinology and Metabolism, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Michael A Tsoukas
- Division of Endocrinology and Metabolism, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Sylvia Santosa
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Quebec, Canada
- Metabolism, Obesity and Nutrition Laboratory, PERFORM Centre, Concordia University, Montreal, Quebec, Canada
- Centre de recherche - Axe maladies chroniques, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Ile-de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
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The effect of resistance exercise upon age-related systemic and local skeletal muscle inflammation. Exp Gerontol 2019; 121:19-32. [PMID: 30905721 DOI: 10.1016/j.exger.2019.03.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 02/16/2019] [Accepted: 03/18/2019] [Indexed: 12/16/2022]
Abstract
AIM Chronic inflammation increases with age and is correlated positively to visceral fat mass, but inversely to muscle mass. We investigated the hypothesis that resistance training would increase muscle mass and strength together with a concomitant drop in local and systemic inflammation level independent of any changes in visceral fat tissue in elderly. METHODS 25 subjects (mean 67, range 62-70 years) were randomized to 1 year of heavy resistance training (HRT) or control (CON), and tested at 0, 4 and 12 months for physical performance, body composition (DXA), vastus lateralis muscle area (MRI) local and systemic inflammation (blood and muscle). In addition, systemic and local muscle immunological responses to acute exercise was determined before and after the training period. RESULTS Increases in muscle mass (≈2%, p < 0.05), vastus lateralis area (≈9%. P < 0.05), isometric (≈15%) and dynamic (≈15%) muscle strength (p < 0.05) were found in the HRT group after 12 months training. HRT did not alter overall or visceral fat mass (p > 0.05). Blood C-Reactive Protein declined over time in both groups (p < 0.05), whereas muscle inflammation markers were unchanged to 1 year of HRT. Acute exercise increased plasma IL-6 and FGF-19 (p < 0.05), decreased FGF-21 (p < 0.05) and CCL-20 (p < 0.05), and increased GDNF in muscle (p < 0.001) similarly before and after 1 year in both groups. CONCLUSION Long term resistance training increased muscle strength and improved muscle mass, but did not alter visceral fat mass and did not show any specific effect upon resting or exercise induced markers of inflammation.
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Rayes ABR, de Lira CAB, Viana RB, Benedito-Silva AA, Vancini RL, Mascarin N, Andrade MS. The effects of Pilates vs. aerobic training on cardiorespiratory fitness, isokinetic muscular strength, body composition, and functional tasks outcomes for individuals who are overweight/obese: a clinical trial. PeerJ 2019; 7:e6022. [PMID: 30842893 PMCID: PMC6397755 DOI: 10.7717/peerj.6022] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/29/2018] [Indexed: 11/20/2022] Open
Abstract
Background Some studies have been conducted to verify the effects of Pilates for individuals who are obese, but conclusive results are not yet available due to methodological concerns. The present study aims to verify and compare the effects of Pilates and aerobic training on cardiorespiratory fitness, isokinetic muscular strength, body composition, and functional task outcomes for individuals who are overweight/obese. Methods Of the sixty participants, seventeen were allocated to the control group, since the intervention protocol (Pilates or walking sessions) was during their working hours. The remaining 44 participants were randomly allocated to one of two experimental groups (Pilates (n = 22)) or aerobic groups (n = 21).The Pilates and aerobic groups attended 60-min exercise sessions, three times per week for 8 weeks. The aerobic group performed walking training at a heart rate corresponding to the ventilatory threshold. The Pilates group performed exercises on the floor, resistance apparatus, and 1-kg dumbbells. The control group received no intervention. All volunteers were evaluated at the beginning and end of the intervention. The following assessments were conducted: food intake, cardiorespiratory maximal treadmill test, isokinetic strength testing, body composition and anthropometry, abdominal endurance test, trunk extensor endurance test, flexibility test and functional (stair and chair) tests. Results There was no significant difference pre- and post-intervention in calorie intake [F(2, 57) = 0.02744, p = 0.97)]. A significant improvement in oxygen uptake at ventilatory threshold (p = 0.001; d = 0.60), respiratory compensation point (p = 0.01; d = 0.48), and maximum effort (p = 0.01; d = 0.33) was observed only in the Pilates group. Isokinetic peak torque for knee flexor and extensor muscles did not change for any groups. Lean mass (p = 0.0005; d = 0.19) and fat mass (p = 0.0001; d = 0.19) improved only in the Pilates group. Waist and hip circumference measurements decreased similarly in both experimental groups. Abdominal test performance improved more in the Pilates group (p = 0.0001; d = 1.69) than in the aerobic group (p = 0.003; d = 0.95). Trunk extensor endurance and flexibility improved only in the Pilates group (p = 0.0003; d = 0.80 and p = 0.0001; d = 0.41, respectively). The Pilates group showed greater improvement on the chair and stair tests (p = 0.0001; d = 1.48 and p = 0.003; d = 0.78, respectively) than the aerobic group (p = 0.005; d = 0.75 and p = 0.05; d = 0.41, respectively). Conclusion Pilates can be used as an alternative physical training method for individuals who are overweight or obese since it promotes significant effects in cardiorespiratory fitness, body composition, and performance on functional tests.
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Affiliation(s)
| | | | - Ricardo B Viana
- Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Ana A Benedito-Silva
- Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, Brazil
| | - Rodrigo L Vancini
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Naryana Mascarin
- Departamento de Fisiologia, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | - Marilia S Andrade
- Departamento de Fisiologia, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
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Comparison of visceral fat measurement by dual-energy X-ray absorptiometry to computed tomography in HIV and non-HIV. Nutr Diabetes 2019; 9:6. [PMID: 30804324 PMCID: PMC6389911 DOI: 10.1038/s41387-019-0073-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 12/07/2018] [Accepted: 01/31/2019] [Indexed: 01/18/2023] Open
Abstract
Background/Objectives Individuals with HIV are susceptible to visceral fat accumulation, which confers an increased risk of cardiometabolic disease. Advanced software to ascertain visceral fat content from dual-energy X-ray absorptiometry (DXA) has not been validated among this population. We sought to compare DXA with computed tomography (CT) in the measurement of visceral fat cross-sectional area (VAT) in HIV and non-HIV using Bland–Altman analyses. Subjects/Methods Data were combined from five previously conducted studies of individuals with HIV (n = 313) and controls without HIV (n = 144) in which paired DXA and CT scans were available. In cross-sectional analyses, DXA-VAT was compared with CT-VAT among participants with and without HIV. In longitudinal analyses, changes in VAT over time were compared between DXA and CT among participants with and without HIV receiving no intervention over 12 months and among individuals with HIV receiving tesamorelin—a medication known to reduce VAT—over 6 months. Results In HIV, DXA underestimated VAT compared with CT among individuals with increased visceral adiposity. The measurement bias was −9 ± 47 cm2 overall, but became progressively larger with greater VAT (P < 0.0001), e.g., −61 ± 58 cm2 among those with VAT ≥ 200 cm2. Sex-stratified analyses revealed that the relationship between VAT and measurement bias was especially pronounced in men (P < 0.0001). Longitudinally, DXA underestimated changes in VAT, particularly among those at the extremes of VAT gain or loss (P < 0.0001). In contrast to the cross-sectional findings, the tendency for DXA to underestimate longitudinal changes in VAT was evident in both men and women. Analogous findings were seen among controls in cross-sectional and longitudinal analyses. Conclusions DXA underestimated VAT relative to CT in men with and without HIV, who had increased visceral adiposity. DXA also underestimated changes in VAT over time in men and women, irrespective of HIV status. DXA-VAT should be used with caution among both HIV and non-HIV-infected populations.
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Association of Endothelial Function with Parental Hypertension in Normotensive-Obese African-American Women: A Pilot Study. Adv Prev Med 2019; 2019:5854219. [PMID: 30863643 PMCID: PMC6378072 DOI: 10.1155/2019/5854219] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 12/21/2018] [Accepted: 01/14/2019] [Indexed: 12/31/2022] Open
Abstract
Obese African-American (AA) women are at high risk of hypertension (HT) and cardiovascular disease (CVD). Flow-mediated dilation (FMD) and arterial augmentation index (AI) are measures of endothelial function and arterial stiffness. Whether endothelial function and arterial stiffness predict risk of HT or CVD in obese African-American women with, versus without, parental histories of HT and whether aerobic exercise is an effective countermeasure remain unclear. The capacity for FMD is partly heritable. Therefore, we tested the hypotheses that less FMD and greater AI may be found in normotensive-obese, young-adult (18-26 year-old) AA women with hypertensive parents (n=10) than in a matched control group with normotensive parents (n=10) and that a single bout of aerobic exercise improves both endothelial function and arterial stiffness, with less improvement in the women with hypertensive parents. We studied each subject while at rest, 20 min before and 20 min after, 30 min of aerobic exercise. The exercise-induced changes and parental hypertension-related differences in AI were not significant. The exercise increased FMD in both of the groups with no significant difference in magnitude between the women with hypertensive and normotensive parents. FMD was significantly less in the women with hypertensive parents than in the women with normotensive parents after, but not before, the exercise (mean ±95% confidence interval of 11.3 ± 4.9% vs. 15.6 ± 4.9%, P=0.05). These findings suggest that a 30-min bout of aerobic exercise may improve FMD and unmask endothelial dysfunction in normotensive-obese, young-adult AA women with parental histories of HT. Future studies should determine whether regular aerobic exercise protects obese AA women from the endothelial dysfunction associated with diabetes and prevents CVD in this high-risk population.
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Park SJ, Lim HS, Sheen SS, Yang HM, Seo KW, Choi SY, Choi BJ, Yoon MH, Tahk SJ. Impact of body fat distribution on long-term clinical outcomes after drug-eluting stent implantation. PLoS One 2018; 13:e0197991. [PMID: 29799868 PMCID: PMC5969753 DOI: 10.1371/journal.pone.0197991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 05/11/2018] [Indexed: 12/15/2022] Open
Abstract
Background and objective The distribution of body fat is closely related to cardiovascular disease and outcomes, although its impact on patient prognosis after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) has not been evaluated. We investigated the impact of truncal fat distribution on long-term clinical outcomes after DES treatment. Methods In 441 DES-treated patients, dual energy X-ray absorptiometry was performed to assess total and regional body fat distribution after index PCI. The ratio of truncal fat to total body fat mass (%FMtrunk/FMtotal) was calculated as a representative parameter for truncal fat distribution. The primary endpoint was major adverse cardiac events (MACE), a composite of ischemia-driven target vessel revascularization (TVR), non-procedural myocardial infarction, cardiac death at 5 years. Results During the median follow-up duration of 1780 days, MACE occurred in 22.0% of patients, with the highest-quartile group of %FMtrunk/FMtotal having a higher rate than the lowest quartile group (27.8% vs. 15.3%; log rank p = 0.026). The difference was driven by a higher rate of ischemia-driven TVR (25.9% vs. 9.9%; log rank p = 0.008). In multivariable Cox regression analyses, %FMtrunk/FMtotal was independently associated with MACE (hazard ratio: 1.075; 95% CI: 1.022–1.131; p = 0.005), but body mass index (BMI) was not. Conclusions In DES-treated patients, truncal fat distribution is associated with unfavorable clinical outcomes and is more clinically relevant than BMI.
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Affiliation(s)
- Se-Jun Park
- Division of Cardiology, Cardiovascular Center, Chun-Cheon Sacred Heart Hospital, Hallym University College of Medicine, Chun-Cheon, Republic of Korea
| | - Hong-Seok Lim
- Department of Cardiology, Ajou University School of Medicine, Suwon, Republic of Korea
- * E-mail:
| | - Seung-Soo Sheen
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Hyoung-Mo Yang
- Department of Cardiology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Kyoung-Woo Seo
- Department of Cardiology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - So-Yeon Choi
- Department of Cardiology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Byoung-Joo Choi
- Department of Cardiology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Myeong-Ho Yoon
- Department of Cardiology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Seung-Jea Tahk
- Department of Cardiology, Ajou University School of Medicine, Suwon, Republic of Korea
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22
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Kim SR, Lerman LO. Diagnostic imaging in the management of patients with metabolic syndrome. Transl Res 2018; 194:1-18. [PMID: 29175480 PMCID: PMC5839955 DOI: 10.1016/j.trsl.2017.10.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 10/18/2017] [Accepted: 10/26/2017] [Indexed: 02/07/2023]
Abstract
Metabolic syndrome (MetS) is the constellation of metabolic risk factors that might foster development of type 2 diabetes and cardiovascular disease. Abdominal obesity and insulin resistance play a prominent role among all metabolic traits of MetS. Because intervention including weight loss can reduce these morbidity and mortality in MetS, early detection of the severity and complications of MetS could be useful. Recent advances in imaging modalities have provided significant insight into the development and progression of abdominal obesity and insulin resistance, as well as target organ injuries. The purpose of this review is to summarize advances in diagnostic imaging modalities in MetS that can be applied for evaluating each components and target organs. This may help in early detection, monitoring target organ injury, and in turn developing novel therapeutic target to alleviate and avert them.
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Affiliation(s)
- Seo Rin Kim
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minn
| | - Lilach O Lerman
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minn.
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23
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Seimon RV, Wild-Taylor AL, Gibson AA, Harper C, McClintock S, Fernando HA, Hsu MSH, da Luz FQ, Keating SE, Johnson NA, Grieve SM, Markovic TP, Caterson ID, Byrne NM, Sainsbury A. Less Waste on Waist Measurements: Determination of Optimal Waist Circumference Measurement Site to Predict Visceral Adipose Tissue in Postmenopausal Women with Obesity. Nutrients 2018; 10:nu10020239. [PMID: 29461494 PMCID: PMC5852815 DOI: 10.3390/nu10020239] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/01/2018] [Accepted: 02/14/2018] [Indexed: 11/16/2022] Open
Abstract
With obesity being a leading cause of preventable death, it is vital to understand how best to identify individuals with greater risk of metabolic disease, especially those with high visceral adipose tissue (VAT). This study aimed to determine whether three commonly used waist circumference (WC) measurement sites could provide accurate estimations of VAT, as determined by magnetic resonance imaging (MRI), which is a gold standard for measuring VAT, in postmenopausal women with obesity. VAT volume was measured by MRI of the total abdomen in 97 women aged 57.7 ± 0.4 years (mean ± SEM), mean body mass index 34.5 ± 0.2 kg/m2. WC was measured at the midpoint between the lowest rib and the iliac crest (WCmid), the narrowest point of the torso (WCnarrow), and at the level of the umbilicus (WCumbilicus). WC differed significantly according to measurement site, with WCnarrow (102.1 ± 0.7 cm) < WCmid (108.3 ± 0.7 cm) < WCumbilicus (115.7 ± 0.8 cm) (p < 0.001). WCmid, WCnarrow and WCumbilicus were all significantly correlated with VAT, as measured by MRI (r = 0.581, 0.563 and 0.390, respectively; p < 0.001 for all), but the relationships between WCmid or WCnarrow and VAT determined by MRI were stronger than for WCumbilicus. Measurement of either WCmid or WCnarrow provides valid estimates of VAT in postmenopausal women with obesity, with WCnarrow being favoured in light of its greater ease and speed of measurement in this population.
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Affiliation(s)
- Radhika V. Seimon
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
- Correspondence: ; Tel.: +61-2-8627-1918; Fax: +61-2-8627-0141
| | - Anthony L. Wild-Taylor
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Alice A. Gibson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Claudia Harper
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Sally McClintock
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Hamish A. Fernando
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Michelle S. H. Hsu
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Felipe Q. da Luz
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
- School of Psychology, Faculty of Science, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Shelley E. Keating
- School of Human Movement and Nutrition Sciences, Centre for Research on Exercise, Physical Activity and Health, The University of Queensland, Brisbane, QLD 4072, Australia;
| | - Nathan A. Johnson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW 2050, Australia
| | - Stuart M. Grieve
- Sydney Translational Imaging Laboratory, Heart Research Institute, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia;
- Department of Radiology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Tania P. Markovic
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Ian D. Caterson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Nuala M. Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia;
| | - Amanda Sainsbury
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
- School of Psychology, Faculty of Science, The University of Sydney, Camperdown, NSW 2050, Australia
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24
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Seyed-Sadjadi N, Berg J, Bilgin AA, Grant R. Visceral fat mass: is it the link between uric acid and diabetes risk? Lipids Health Dis 2017; 16:142. [PMID: 28738905 PMCID: PMC5525310 DOI: 10.1186/s12944-017-0532-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 07/03/2017] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Uric acid (UA) has been suggested as a novel risk factor for diabetes. However, its definite role in this prevalent disease is still the subject of much discussion because it is always accompanied with other major risk factors such as obesity and high visceral adiposity. In order to clarify the role of UA in diabetes, this study aimed to investigate the associations between plasma UA and fasting plasma glucose, HbA1c, lipid profile and inflammatory markers after accounting for the contribution of other diabetes risk factors such as BMI and VAT fat mass. METHODS In the present cross-sectional study, 100 non-diabetic middle-aged males (n = 48) and females (n = 52) were recruited. Central fat distribution measures including android to gynoid fat ratio, VAT and subcutaneous adipose tissue (SAT) fat mass were determined using dual-energy X-ray absorptiometry (DXA). Biochemical analysis was done using methods well established for clinical and research laboratories. Multiple linear regression analysis was performed to analyse the association between plasma UA and the biochemical and central fat distribution measures. RESULTS UA was positivly associated with body mass index (BMI) (r (98) = 0.42, P ≤ 0.001), android to gynoid fat ratio (r (98) = 0.62, P ≤ 0.001) and VAT fat mass (r (96) = 0.55, P ≤ 0.001). UA was also positively associated with plasma glucose (r (98) = 0.33, P ≤ 0.001), hemoglobin A1c (r (93) = 0.25, P = 0.014), plasma triglyceride (r s (95) = 0.40, P ≤ 0.001), HDL cholesterol (r (98) = - 0.61, P ≤ 0.001) and CRP (r s (98) = 0.23, P = 0.026). However, these associations were no longer significant after accounting for BMI or/and VAT fat mass. No significant association was observed between UA and SAT fat mass (r (97) = 0.02, P ≥ 0.05), Total cholesterol (r (98) = 0.03, P ≥ 0.05), LDL cholesterol (r (98) = 0.13, P ≥ 0.05), TNF-α (r (97) = 0.12, P ≥ 0.05) and IL-6 (r (96) = -0.02, P ≥ 0.05). CONCLUSION Results from this study suggest, for the first time, that the association between plasma UA and glucose in a non-diabetic population is not direct but rather dependent on VAT fat mass.
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Affiliation(s)
- Neda Seyed-Sadjadi
- School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Jade Berg
- Australasian Research Institute, Sydney Adventist Hospital, 185 Fox Valley Road, Wahroonga, Sydney, NSW, 2076, Australia
| | - Ayse A Bilgin
- Department of Statistics, Macquarie University, Sydney, NSW, Australia
| | - Ross Grant
- School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia. .,Australasian Research Institute, Sydney Adventist Hospital, 185 Fox Valley Road, Wahroonga, Sydney, NSW, 2076, Australia. .,Sydney Adventist Hospital Clinical School, University of Sydney, Sydney, NSW, Australia.
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25
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Reinhardt M, Piaggi P, DeMers B, Trinidad C, Krakoff J. Cross calibration of two dual-energy X-ray densitometers and comparison of visceral adipose tissue measurements by iDXA and MRI. Obesity (Silver Spring) 2017; 25:332-337. [PMID: 28000375 PMCID: PMC5269467 DOI: 10.1002/oby.21722] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 10/04/2016] [Accepted: 10/19/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Compare total percentage body fat (pfat) measurements between two densitometers and visceral adipose tissue (VAT) estimates between iDXA and magnetic resonance imaging (MRI) from the same defined abdominal region. METHODS Participants [N = 93 (50 men, 43 women), BMI: 19.1-57.6 kg/m2 ] underwent dual-energy X-ray absorptiometry (DXA) scans on two DXA systems (GE Healthcare Lunar iDXA and Lunar Prodigy), and a subgroup underwent abdominal MRI imaging for quantification of VAT. RESULTS Pfat correlated strongly between both machines (r2 = 0.98, P < 1.0E-14). Bland-Altman plots showed a bias with higher measured pfat on iDXA versus Prodigy in leaner subjects and the opposite in more overweight subjects. The R2 for regression of MRI on iDXA VAT values was 0.948. Bland-Altman bias was +104.1 cm3 with 95% limits of agreement of -681.9 to 890.0 cm3 . For both DXA methods, and iDXA versus MRI determined VAT, comparison using rank regression demonstrated no order bias. CONCLUSIONS The total pfat measured by both machines was strongly and linearly associated, allowing for conversion (equations are provided) of iDXA for assessment of longitudinal body fat changes. Despite a bias of abdominal VAT measures of iDXA versus MRI, the high rank correlation makes iDXA a good alternative to the more complicated and time-consuming MRI for use in larger cross-sectional and longitudinal studies.
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Affiliation(s)
- Martin Reinhardt
- Obesity and Diabetes Clinical Research Section, Phoenix
Epidemiology and Clinical Research Branch National Institute of Diabetes and
Digestive and Kidney Diseases, National Institutes of Health, Department of Health
and Human Services, 4212 N. 16 Street, Phoenix, Arizona 85016
- Department of Diagnostic and Interventional Radiology,
University of Leipzig, Germany
| | - Paolo Piaggi
- Obesity and Diabetes Clinical Research Section, Phoenix
Epidemiology and Clinical Research Branch National Institute of Diabetes and
Digestive and Kidney Diseases, National Institutes of Health, Department of Health
and Human Services, 4212 N. 16 Street, Phoenix, Arizona 85016
| | - Barbara DeMers
- Obesity and Diabetes Clinical Research Section, Phoenix
Epidemiology and Clinical Research Branch National Institute of Diabetes and
Digestive and Kidney Diseases, National Institutes of Health, Department of Health
and Human Services, 4212 N. 16 Street, Phoenix, Arizona 85016
| | - Cathy Trinidad
- Obesity and Diabetes Clinical Research Section, Phoenix
Epidemiology and Clinical Research Branch National Institute of Diabetes and
Digestive and Kidney Diseases, National Institutes of Health, Department of Health
and Human Services, 4212 N. 16 Street, Phoenix, Arizona 85016
| | - Jonathan Krakoff
- Obesity and Diabetes Clinical Research Section, Phoenix
Epidemiology and Clinical Research Branch National Institute of Diabetes and
Digestive and Kidney Diseases, National Institutes of Health, Department of Health
and Human Services, 4212 N. 16 Street, Phoenix, Arizona 85016
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26
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Dexa Body Composition Assessment in 10-11 Year Healthy Children. PLoS One 2016; 11:e0165275. [PMID: 27788168 PMCID: PMC5082851 DOI: 10.1371/journal.pone.0165275] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 10/10/2016] [Indexed: 11/19/2022] Open
Abstract
Introduction Obesity is a growing health problem associated with metabolic derangements and cardiovascular disease. Accumulating evidence links the accumulation of visceral adipose tissue (VAT) to these obesity related health risks in adults. Childhood obesity is associated with a lifetime risk of cardiovascular disease and poses a serious challenge to future health care. In children, there is much less data on the prevalence and gender differences of visceral obesity than in adults. This study aims to provide reference values for VAT in children 10–11 years of age. Methods In a cross-sectional study performed in the north western part of theNetherlands, healthy children of 10–11 years of age, were recruited from primary schools. Anthropometric data consisting of height, weight, waist circumference (WC) and BMI were measured. Body composition was measured using DXA, providing measures for bone mineral content, total fat mass (TFM), lean body mass (LBM) and VAT. Results 217 children were eligible for this study. Girls appeared to have a greater TFM (31.4% vs 27.5% of total body weight (TBW); P < .01) but lower VAT (0.3% vs 0.5% of TBW;P < .01) than boys, whereas boys had higher LBM (65.4% vs 69.3% TBW;P < .01). Median VAT area (cm2) was 41.1 for boys and 22.4 for girls (P < .01). Moderate to strong correlations were found for WC and BMI with VAT (boys: r = .664 and r = .630; Girls r = .699 and r = .546 respectively all P < .001). Discussion This study shows gender specific differences in VAT percentiles in healthy non-obese 10–11 year old children as measured by DXA that may serve as reference values in children. Independent of BMI and WC, girls tend to have more TFM but less VAT and LBM than boys.
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27
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Yamada A, Sato KK, Kinuhata S, Uehara S, Endo G, Hikita Y, Fujimoto WY, Boyko EJ, Hayashi T. Association of Visceral Fat and Liver Fat With Hyperuricemia. Arthritis Care Res (Hoboken) 2016; 68:553-61. [PMID: 26414410 DOI: 10.1002/acr.22729] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 08/18/2015] [Accepted: 09/08/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine cross-sectionally whether intraabdominal fat area (IAFA), i.e., visceral fat, and liver fat assessed by computed tomography (CT) are independently associated with hyperuricemia. METHODS Subjects were 801 Japanese men not taking antidiabetic, antihypertensive, or urate-lowering medications, without any history of renal disease, cardiovascular disease, or cancer, and with serum creatinine <1.5 mg/dl. Abdominal, thoracic, and thigh fat areas were measured by CT. Total fat area (TFA) was the sum of these fat areas. Total subcutaneous fat area (TSFA) was TFA minus IAFA. Liver fat was assessed by liver-to-spleen (L/S) ratio measured by CT. Hyperuricemia was defined as serum uric acid level >7.0 mg/dl. Its association with adiposity was tested using logistic regression. RESULTS The prevalence of hyperuricemia was 19.6% (157 men). Both greater IAFA and lower L/S ratio were independently associated with hyperuricemia in models that simultaneously included IAFA and L/S ratio: multiple-adjusted odds ratios of hyperuricemia for quintiles 3, 4, and 5 of IAFA were 2.16 (95% confidence interval [95% CI] 1.02-4.59), 2.41 (95% CI 1.13-5.16), and 4.00 (95% CI 1.81-8.85), respectively, compared to quintile 1, and the L/S ratios for quintiles 3, 2, and 1 were 2.34 (95% CI 1.16-4.75), 2.15 (95% CI 1.06-4.34), and 2.79 (95% CI 1.35-5.76), respectively, compared to quintile 5. Both IAFA and L/S ratio remained significant even after adjusting for abdominal subcutaneous fat area, TFA, TSFA, body mass index, or waist circumference. Of all fat measurements, IAFA had the strongest association with hyperuricemia by Akaike's information criteria. CONCLUSION Greater amounts of both visceral fat and liver fat were independently associated with hyperuricemia.
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Affiliation(s)
- Akiko Yamada
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kyoko K Sato
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | | | | | - Ginji Endo
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | | | | | - Edward J Boyko
- Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, and University of Washington, Seattle
| | - Tomoshige Hayashi
- Osaka City University Graduate School of Medicine, Osaka, Japan, and University of Washington, Seattle
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28
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Neeland IJ, Grundy SM, Li X, Adams-Huet B, Vega GL. Comparison of visceral fat mass measurement by dual-X-ray absorptiometry and magnetic resonance imaging in a multiethnic cohort: the Dallas Heart Study. Nutr Diabetes 2016; 6:e221. [PMID: 27428873 PMCID: PMC4973141 DOI: 10.1038/nutd.2016.28] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 06/02/2016] [Accepted: 06/19/2016] [Indexed: 11/28/2022] Open
Abstract
Background/Objectives: Visceral adipose tissue (VAT) mass, a risk factor for cardiometabolic complications of obesity, is usually measured by magnetic resonance imaging (MRI) but this method is not practical in a clinical setting. In contrast, measurement of VAT by dual-x-ray absorptiometry (DXA) appears to circumvent the limitations of MRI. In this study, we compared measurements of VAT mass by MRI and DXA in the large, multiethnic cohort of the Dallas Heart Study (DHS). Subjects/Methods: About 2689 DHS participants underwent paired measurement of VAT by MRI and DXA. Sex-stratified analyses were performed to evaluate the correlation and agreement between DXA and MRI. Model validation was performed using bootstrapping and inter-reader variability was assessed. Results: Mean age of the cohort was 44 years, with 55% female, 48% Black and 75% overweight/obese participants. Regression analysis showed a linear relationship between DXA and MRI with R2=0.82 (95% confidence interval (CI) 0.81–0.84) for females and R2=0.86 (95% CI 0.85–0.88) for males. Mean difference between methods was 0.01 kg for females and 0.09 kg for males. Bland–Altman analysis showed that DXA tended to modestly underestimate VAT compared with MRI at lower VAT levels and overestimate it compared with MRI at higher VAT levels. Results were consistent in analyses stratified by race, body mass index status, waist girth and body fat. Inter-individual reader correlation among 50 randomly selected scans was excellent (inter-class correlation coefficient=0.997). Conclusions: VAT mass quantification by DXA was both accurate and valid among a large, multiethnic cohort within a wide range of body fatness. Further studies including repeat assessments over time will help determine its long-term applicability.
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Affiliation(s)
- I J Neeland
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - S M Grundy
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Dallas VA North Texas Health Care System, Dallas, TX, USA.,Center for Human Nutrition, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - X Li
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - B Adams-Huet
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - G L Vega
- Dallas VA North Texas Health Care System, Dallas, TX, USA.,Center for Human Nutrition, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Clinical Nutrition, University of Texas Southwestern Medical Center, Dallas, TX, USA
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29
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Jung SH, Ha KH, Kim DJ. Visceral Fat Mass Has Stronger Associations with Diabetes and Prediabetes than Other Anthropometric Obesity Indicators among Korean Adults. Yonsei Med J 2016; 57:674-80. [PMID: 26996568 PMCID: PMC4800358 DOI: 10.3349/ymj.2016.57.3.674] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 12/21/2015] [Accepted: 01/04/2016] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study determined which obesity measurement correlates the best with diabetes and prediabetes. MATERIALS AND METHODS This cross-sectional study enrolled 1603 subjects (611 men, 992 women; age 30-64 years) at the Cardiovascular and Metabolic Diseases Etiology Research Center. Body mass index, waist circumference, waist-height ratio, waist-hip ratio, waist-thigh ratio, and visceral fat were used as measures of obesity. Visceral fat was acquired using dual-energy X-ray absorptiometry (DXA). The prevalences of diabetes and prediabetes were defined using the criteria in the American Diabetes Association 2015 guidelines. RESULTS After adjusting for age and other potential confounding factors, participants with a visceral fat mass in the upper 10th percentile had a higher odds ratio (OR) for diabetes and prediabetes than the upper 10th percentile of other adiposity indices [men, OR=15.9, 95% confidence interval (CI)=6.4-39.2; women, OR=6.9, 95% CI=3.5-13.7]. Visceral fat mass also had the highest area under the curve with diabetes and prediabetes in both men (0.69, 95% CI=0.64-0.73) and women (0.70, 95% CI=0.67-0.74) compared to other anthropometric measurements of obesity. CONCLUSION Visceral fat mass measured using DXA is an indicator of diabetes or prediabetes, due to its ability to differentiate between abdominal visceral and subcutaneous fat.
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Affiliation(s)
- Suk Hwa Jung
- Ajou University School of Medicine, Suwon, Korea
| | - Kyoung Hwa Ha
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
- Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of Medicine, Suwon, Korea
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
- Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of Medicine, Suwon, Korea.
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Park SJ, Yang HM, Seo KW, Choi SY, Choi BJ, Yoon MH, Hwang GS, Tahk SJ, Sheen SS, Choi BIW, Lim HS. The relationship between coronary atherosclerosis and body fat distribution measured using dual energy X-ray absorptiometry. Atherosclerosis 2016; 248:190-5. [PMID: 27018543 DOI: 10.1016/j.atherosclerosis.2016.03.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 02/24/2016] [Accepted: 03/10/2016] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Body fat distribution is closely related to cardiovascular diseases. We aimed to evaluate the relationship between truncal fat distribution and the extent of coronary atherosclerosis. METHODS Total body fat and regional body fat distributions were measured using dual-energy X-ray absorptiometry (DXA) in 746 Korean patients who underwent coronary angiography. The ratios of truncal fat mass to total body fat mass (FMtrunk/FMtotal), truncal fat mass to fat mass in both legs (FMtrunk/FMleg) and truncal fat mass to fat mass in both arms (FMtrunk/FMarm) were calculated as representative parameters for truncal fat accumulation. The extent of coronary atherosclerosis was assessed using the Gensini score. RESULTS The mean Gensini score of the patients was 21.3 ± 24.4. FMtrunk/FMtotal, FMtrunk/FMleg and FMtrunk/FMarm revealed positive correlations with the Gensini score (r = 0.242, p < 0.001; r = 0.219, p < 0.001; r = 0.133, p < 0.001, respectively). In contrast, body mass index (BMI) and total body fat mass did not correlate with the Gensini score. On multiple regression analysis, FMtrunk/FMtotal was associated with the Gensini score independently of age, gender, BMI and major risk factors of coronary heart disease (B = 0.039, p < 0.001). CONCLUSION Truncal fat distribution is associated with the extent of coronary atherosclerosis and more clinically relevant to that compared with total body fat or BMI in Korean patients.
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Affiliation(s)
- Se-Jun Park
- Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-Ro, Suwon 16499, Republic of Korea; Division of Cardiology, Cardiovascular Center, Chun-Cheon Sacred Heart Hospital, Hallym University College of Medicine, 77 Sakju-Ro, Chun-Cheon 24253, Republic of Korea
| | - Hyoung-Mo Yang
- Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-Ro, Suwon 16499, Republic of Korea
| | - Kyoung-Woo Seo
- Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-Ro, Suwon 16499, Republic of Korea
| | - So-Yeon Choi
- Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-Ro, Suwon 16499, Republic of Korea
| | - Byoung-Joo Choi
- Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-Ro, Suwon 16499, Republic of Korea
| | - Myeong-Ho Yoon
- Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-Ro, Suwon 16499, Republic of Korea
| | - Gyo-Seung Hwang
- Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-Ro, Suwon 16499, Republic of Korea
| | - Seung-Jea Tahk
- Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-Ro, Suwon 16499, Republic of Korea
| | - Seung-Soo Sheen
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, 164 Worldcup-Ro, Suwon 16499, Republic of Korea
| | - Byung-Il W Choi
- Department of Cardiology, Medical College of Wisconsin, Milwaukee, WI 53266, USA
| | - Hong-Seok Lim
- Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-Ro, Suwon 16499, Republic of Korea.
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Park KS, Lee DH, Lee J, Kim YJ, Jung KY, Kim KM, Kwak SH, Choi SH, Park KS, Jang HC, Lim S. Comparison between two methods of bioelectrical impedance analyses for accuracy in measuring abdominal visceral fat area. J Diabetes Complications 2016; 30:343-9. [PMID: 26620129 DOI: 10.1016/j.jdiacomp.2015.10.014] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 10/19/2015] [Accepted: 10/20/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare the accuracy of abdominal visceral fat area (VFA) measurements between abdominal dual bioelectrical impedance analysis (BIA) and whole-body BIA referenced to computed tomography (CT) measures. METHODS Abdominal VFAs were measured in 102 individuals: 59 men and 43 women with a mean age of 44.2 ± 16.3 years (range 21 - 76), body mass index 23.9 ± 7.8 kg/m(2) (range 18 - 35) using a DUALSCAN HDS-2000 machine (dual abdominal BIA) and an InBody720 machine (whole-body BIA). The VFA values from each machine were compared with those from CT under various conditions. RESULTS Mean abdominal VFAs were 116 ± 69 cm(2) by CT, 89 ± 47 cm(2) by dual abdominal BIA, and 84 ± 33 cm(2) by whole-body BIA. The former measure showed a higher correlation with the CT measure than the latter (r=0.89 vs. r=0.64, P<0.001). Both BIA methods tended to underestimate abdominal VFAs compared with CT scans when CT VFA was not small. The dual abdominal BIA had less bias than the whole-body BIA in the assessment of VFAs. The whole-body BIA was affected by subcutaneous fat area. CONCLUSIONS Dual BIA was more accurate in assessing abdominal VFA than whole-body BIA.
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Affiliation(s)
- Kyeong Seon Park
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Dong-Hwa Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - JieEun Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Yoon Ji Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Kyong Yeun Jung
- Department of Internal Medicine, College of Medicine Eulji University, Seoul, South Korea
| | - Kyoung Min Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Soo Heon Kwak
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Sung Hee Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Kyong Soo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Hak Chul Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Soo Lim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
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Choi YJ. Dual-Energy X-Ray Absorptiometry: Beyond Bone Mineral Density Determination. Endocrinol Metab (Seoul) 2016; 31:25-30. [PMID: 26996419 PMCID: PMC4803557 DOI: 10.3803/enm.2016.31.1.25] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 01/15/2016] [Accepted: 01/21/2016] [Indexed: 01/06/2023] Open
Abstract
Significant improvements in dual-energy X-ray absorptiometry (DXA) concerning quality, image resolution and image acquisition time have allowed the development of various functions. DXA can evaluate bone quality by indirect analysis of micro- and macro-architecture of the bone, which and improve the prediction of fracture risk. DXA can also detect existing fractures, such as vertebral fractures or atypical femur fractures, without additional radiologic imaging and radiation exposure. Moreover, it can assess the metabolic status by the measurement of body composition parameters like muscle mass and visceral fat. Although more studies are required to validate and clinically use these parameters, it is clear that DXA is not just for bone mineral densitometry.
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Affiliation(s)
- Yong Jun Choi
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea.
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