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Zieff G, Cornwall J, Blue MN, Smith-Ryan AE, Stoner L. Ultrasound-based measurement of central adiposity: Key considerations and guidelines. Obes Rev 2024; 25:e13716. [PMID: 38418428 DOI: 10.1111/obr.13716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 12/05/2023] [Accepted: 01/12/2024] [Indexed: 03/01/2024]
Abstract
Central adiposity, which is visceral and subcutaneous adiposity in the abdominal region, is a known risk factor for developing chronic cardiometabolic diseases. Central adiposity can be measured relatively inexpensively using ultrasound. Ultrasound has been shown to be precise and reliable, with measurement accuracy comparable to computed tomography and magnetic resonance. Despite the advantages conferred by ultrasound, widespread adoption has been hindered by lack of reliable standard operating procedures. To consolidate the literature and bring clarity to the use of ultrasound-derived measures of central adiposity, this review outlines (i) the [patho]physiological importance of central adiposity to cardiometabolic disease risk; (ii) an overview of the history and main technical aspects of ultrasound methodology; (iii) key measurement considerations, including transducer selection, subject preparation, image acquisition, image analysis, and operator training; and (iv) guidelines for standardized ultrasound protocols for measuring central adiposity.
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Affiliation(s)
- Gabriel Zieff
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jon Cornwall
- Centre for Early Learning in Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Malia N Blue
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Abbie E Smith-Ryan
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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2
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Mirzababaei A, Mahmoodi M, Keshtkar A, Ashraf H, Abaj F, Khosravinia D, Radmehr M, Rasaei N, Mirzaei K. Association between dietary intakes of Nitrate and Nitrite with Angina and atherogenic index in adults: A cross-sectional study from Tehran University of Medical Sciences employees` cohort (TEC) study. Curr Probl Cardiol 2024; 49:102206. [PMID: 37967801 DOI: 10.1016/j.cpcardiol.2023.102206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 11/11/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Previous studies have shown that the intake of nitrate and nitrite may be associated with cardiovascular disease. Therefore, this study sought to investigate the association between dietary intakes of nitrate and nitrite with the odds of angina and atherogenic index in adults. METHODS The study analyzed 1182 adults aged 20+ in the Tehran University of Medical Sciences (TUMS) Employee's Cohort study (TEC), focusing on dietary intakes, angina, and atherogenic indexes, using a validated food frequency questionnaire (FFQ) and the Rose Angina Questionnaire (RAQ). RESULT The study found a significant inverse relationship between nitrate intake and odds of grade 2 angina. The highest dietary nitrate was associated with 29 % lower odds of grade 1 angina and also, 46 % lower odds of angina possible (P<0.05). Adults with the highest nitrate intake had 29 % lower odds of grade 1 angina and 46 % lower odds of angina possible. Adherence to nitrate reduced CRI, Atherogenic index of plasma, and TyG in participants, but no significant association was found with other factors. CONCLUSION The study suggests that high nitrate and nitrite intake can alter angina risk, and a reverse association was found between dietary nitrate intake and various atherogenic indices.
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Affiliation(s)
- Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Mahmoodi
- Department of Cellular and Molecular Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbasali Keshtkar
- Department of Disaster and Emergency Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Haleh Ashraf
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Faezeh Abaj
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Darya Khosravinia
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mina Radmehr
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Niloufar Rasaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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3
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Kokura Y, Nishioka S, Maeda K, Wakabayashi H. Ultrasound utilized by registered dietitians for body composition measurement, nutritional assessment, and nutritional management. Clin Nutr ESPEN 2023; 57:173-180. [PMID: 37739653 DOI: 10.1016/j.clnesp.2023.06.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/09/2023] [Accepted: 06/23/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND AND AIMS Ultrasound has been used primarily as a tool for body composition measurement in the field of clinical nutrition. Although many recent reports have demonstrated that ultrasound could be a useful tool for nutritional assessment, it is not well incorporated into registered dietitians' (RDs) practice. The aim of this review was to summarize the usefulness of ultrasound in assessing body composition and nutritional status and in nutritional management by RDs. METHODS Studies on ultrasonography, nutritionists, body composition, nutritional assessment, and diet therapy was searched using the MEDLINE databases. RESULTS After reviewing the articles, we categorized them into the following topics; 1) principles of muscle measurement using the ultrasound, types of muscle that can be measured, 2) indices of muscle and muscle mass and quality as assessed using ultrasound and its relationship to nutritional indicator, 3) diagnosis of the Global Leadership Initiative on Malnutrition (GLIM) criteria malnutrition using ultrasound, 4) practical nutritional management using ultrasound and 5) education and issues for ultrasound implementation. Ultrasound can evaluate low body mass index, unintentional loss of body weight, low skeletal muscle mass index, decreased food intake/assimilation, and disease burden/inflammation, all which are essential items of the phenotypic and etiologic criteria of the GLIM. CONCLUSION Ultrasound may be useful for RDs to perform body composition measurement, nutritional assessment, and nutritional management. It will be important to identify the cutoff values for ultrasound-based measurements of muscle mass. In order for RDs to perform a body composition measurement, nutritional assessment, and nutritional management using ultrasound, educational issues need to be addressed.
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Affiliation(s)
- Yoji Kokura
- Department of Nutritional Management, Keiju Hatogaoka Integrated Facility for Medical and Long-term Care, Anamizu, Japan.
| | - Shinta Nishioka
- Department of Clinical Nutrition and Food Services, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | - Keisuke Maeda
- Nutrition Therapy Support Center, Aichi Medical University Hospita, Nagakute, Japan; Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan
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Andersen MM, Laurberg T, Bjerregaard A, Sandbæk A, Brage S, Vistisen D, Quist JS, Bruun JM, Witte DR. The association between sleep duration and detailed measures of obesity: A cross sectional analysis in the ADDITION-PRO study. Obes Sci Pract 2023; 9:226-234. [PMID: 37287518 PMCID: PMC10242268 DOI: 10.1002/osp4.640] [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: 07/15/2022] [Revised: 09/07/2022] [Accepted: 09/13/2022] [Indexed: 03/21/2024] Open
Abstract
Background Sleep duration is associated with BMI and waist circumference. However, less is known about whether sleep duration affects different measurements of obesity differently. Objective To investigate the association between sleep duration and different measures of obesity. Methods In this cross-sectional analysis 1309, Danish, older adults (55% men) completed at least 3 days of wearing a combined accelerometer and heart rate-monitor for assessing sleep duration (hours/night) within self-reported usual bedtime. Participants underwent anthropometry and ultrasonography to assess BMI, waist circumference, visceral fat, subcutaneous fat, and fat percentage. Linear regression analyses examined the associations between sleep duration and obesity-related outcomes. Results Sleep duration was inversely associated with all obesity-related outcomes, except visceral-/subcutaneous-fat-ratio. After multivariate adjustment the magnitude of associations became stronger and statistically significant for all outcomes except visceral-/subcutaneous-fat-ratio, and subcutaneous fat in women. The associations with BMI and waist circumference demonstrated the strongest associations, when comparing standardized regression coefficients. Conclusions Shorter sleep duration were associated with higher obesity across all outcomes except visceral-/subcutaneous-fat-ratio. No specifically salient associations with local or central obesity were observed. Results suggest that poor sleep duration and obesity correlate, however, further research is needed to conclude on beneficial effects of sleep duration regarding health and weight loss.
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Affiliation(s)
- Mie M. Andersen
- Department of Public HealthAarhus UniversityAarhusDenmark
- Steno Diabetes Center AarhusAarhusDenmark
| | | | | | | | - Søren Brage
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - Dorte Vistisen
- Clinical ResearchCopenhagen University Hospital ‐ Steno Diabetes Center CopenhagenHerlevDenmark
- Department of Public HealthUniversity of CopenhagenCopenhagenDenmark
| | - Jonas S. Quist
- Clinical ResearchCopenhagen University Hospital ‐ Steno Diabetes Center CopenhagenHerlevDenmark
- Department of Biomedical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Jens M. Bruun
- Steno Diabetes Center AarhusAarhusDenmark
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Daniel R. Witte
- Department of Public HealthAarhus UniversityAarhusDenmark
- Steno Diabetes Center AarhusAarhusDenmark
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Russu OM, Pop TS, Feier AM, Iova A, Farcaș DM, Burta OL, Borodi PG, Sebestyen K. Evaluation of Kangoo Jumps rebound exercise program: A prospective study of a general population. BALNEO AND PRM RESEARCH JOURNAL 2022. [DOI: 10.12680/balneo.2022.511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction. The number of non-communicable diseases (NCDs) is in a constant rise, especially in the low and middle income countries. They could be highly prevented by implementing programs that will help in promoting health and changing harmful behaviors. The aim of this paper is to show that Rebound exercisesis a great example of such physical activity. Material and method. The study plan was designed to asses both physical and functional explorations, ultrasound scans, self-perception of body image and laboratory parameters for each patient. A total of 64 parameters were analyzed: 44 anthropometric parameters and 20 body composition parameters from 80 participants. The subjects were analyzed for a period of 6 months. Results and discussions. Parameters were analyzed at the beginning of the study (07.02.2019), after 3 months (25.05.2019) and at the end (26.09.2019). The results showed improvements in all utilized parameters. Conclusions. This study offers a novel perspective on Kangoo jumps practice. People with spine problems, diabetes, overweight levels, improved their health, got rid of back pain, lost weight and had a more toned body.
Keywords: physical activity, overweight, harmful behaviors, non-communicable diseases
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Affiliation(s)
- Octav Marius Russu
- “Department of Orthopaedics and Traumatology, Clinical County Hospital”, Târgu Mureș, Romania 2 “University of Medicine, Pharmacy, Sciences and Technology George Emil Palade”, Târgu Mureș, Ro-mania
| | - Tudor Sorin Pop
- “Department of Orthopaedics and Traumatology, Clinical County Hospital”, Târgu Mureș, Romania 2 “University of Medicine, Pharmacy, Sciences and Technology George Emil Palade”, Târgu Mureș, Romania
| | - Andrei Marian Feier
- “Department of Orthopaedics and Traumatology, Clinical County Hospital”, Târgu Mureș, Romania 2 “University of Medicine, Pharmacy, Sciences and Technology George Emil Palade”, Târgu Mureș, Romania
| | - Alin Iova
- “University of Oradea, Faculty of Medicine”, Oradea, Romania
| | | | | | - Paul-Gabriel Borodi
- “University of Medicine, Pharmacy, Sciences and Technology George Emil Palade”, Târgu Mureș, Ro-mania
| | - Kinga Sebestyen
- “University of Oradea, Faculty of Medicine”, Oradea, Romania
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Youn S, Jogiat U, Baracos VE, McCall M, Eurich DT, Sawyer MB. CT-based assessment of body composition and skeletal muscle in melanoma: A systematic review. Clin Nutr ESPEN 2021; 45:127-133. [PMID: 34620308 DOI: 10.1016/j.clnesp.2021.06.029] [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] [Received: 01/24/2021] [Revised: 05/28/2021] [Accepted: 06/29/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND/OBJECTIVES Sarcopenia (low skeletal muscle index) and myosteatosis (low skeletal radiodensity) have been associated with poor outcomes in melanoma. This systematic review was performed to summarize and critically evaluate current literature surrounding body composition in melanoma. METHODS MEDLINE and Embase databases were searched for studies of melanoma patients with computed tomography (CT) based body composition analysis from 2000 to 2020. Outcomes of interest were survival, including overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS), as well as treatment-related adverse events (AEs). RESULTS Nine studies of 914 patients were included in the final review. The majority of studies were of metastatic melanoma patients treated with immunotherapy. Studies demonstrated a variety of CT analysis techniques and cut-offs to define sarcopenia and myosteatosis. Associations of sarcopenia or myosteatosis with survival (OS, PFS, DFS) or risk of treatment-related AEs were conflicting. Multiple studies had low quality of evidence due to small sample sizes, use of non-validated CT measures, and lack of multivariable analyses. CONCLUSIONS Due to methodologic heterogeneity and low quality of evidence, impacts of CT-derived body composition parameters on outcomes in melanoma are unclear. Further research should be conducted to elucidate impacts of body composition in melanoma.
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Affiliation(s)
- Susie Youn
- Department of Surgery, University of Alberta, Edmonton, AB, Canada; School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Uzair Jogiat
- Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Vickie E Baracos
- Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada
| | - Michael McCall
- Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Dean T Eurich
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Michael B Sawyer
- Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada.
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Interaction between Autonomic Regulation, Adiposity Indexes and Metabolic Profile in Children and Adolescents with Overweight and Obesity. CHILDREN-BASEL 2021; 8:children8080686. [PMID: 34438577 PMCID: PMC8394084 DOI: 10.3390/children8080686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/31/2021] [Accepted: 08/04/2021] [Indexed: 01/22/2023]
Abstract
Early obesity predicts initial modifications in cardiac and vascular autonomic regulation. The aim of this study was to assess the possible interaction between non-invasive measures of autonomic cardiovascular control and peripheral endothelium regulation in children with overweight and obesity. We involved 114 young subjects (77M/37F, 12.7 ± 2.2 years) with normal weight (NW, n = 46) to overweight or obesity (OB, n = 68). Multivariate statistical techniques utilizing a collection of modern indices of autonomic regulation, adiposity indexes and metabolic profile were employed. Resting values show substantial equivalence of data. Conversely, blood pressure variance is greater in NW/OB groups. The correlation matrix between major autonomic and metabolic/hemodynamic variables shows a clustered significant correlation between homogeneous indices. A significant correlation between metabolic indices and endothelial and autonomic control, mostly in its vascular end, was recorded. Particularly, the alpha index is significantly correlated with triglycerides (r = −0.261) and endothelial indices (RHI, r = 0.276). Children with obesity show a link between indices of autonomic and endothelial function, fat distribution and metabolic profile. The optimization of autonomic control, for instance by exercise/nutrition interventions, could potentially prevent/delay the occurrence of structural vascular damage leading to reduced cardiovascular health.
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Cremona A, Hayes K, O’Gorman CS, Laighin CN, Ismail KI, Donnelly AE, Hamilton J, Cotter A. Inter and intra-reliability of ultrasonography for the measurement of abdominal subcutaneous & visceral adipose tissue thickness at 12 weeks gestation. BMC Med Imaging 2019; 19:95. [PMID: 31847832 PMCID: PMC6916062 DOI: 10.1186/s12880-019-0393-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 11/08/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Excess abdominal adiposity cause metabolic disturbances, particularly in pregnancy. Methods of accurate measurement are limited in pregnancy due to risks associated with these procedures. This study outlines a non-invasive methodology for the measurement of adipose tissue in pregnancy and determines the intra- and inter-observer reliability of ultrasound (US) measurements of the two components of adipose tissue (subcutaneous (SAT) and visceral adipose tissue (VAT)) within a pregnant population. METHODS Thirty pregnant women were recruited at the end of their first trimester, from routine antenatal clinic at the University Maternity Hospital Limerick, Ireland. Measurements of adipose tissue thickness were obtained using a GE Voluson E8 employing a 1-5 MHz curvilinear array transducer. Two observers, employing methodological rigour in US technique, measured thickness of adipose tissue three times, and segmented the US image systematically in order to define measurements of SAT and VAT using specifically pre-defined anatomical landmarks. RESULTS Intra-observer and inter-observer precision was assessed using Coefficient of Variation (CV). Measurements of SAT and total adipose for both observers were < 5% CV and < 10% CV for VAT in measures by both observers. Inter-observer reliability was assessed by Limits of Agreement (LoA). LoA were determined to be - 0.45 to 0.46 cm for SAT and - 0.34 to 0.53 cm for VAT values. Systematic bias of SAT measurement was 0.01 cm and 0.10 cm for VAT. Inter-observer precision was also assessed by coefficient of variation (CV: SAT, 3.1%; VAT, 7.2%; Total adipose, 3.0%). CONCLUSION Intra-observer precision was found to be acceptable for measures of SAT, VAT and total adipose according to anthropometric criterion, with higher precision reported in SAT values than in VAT. Inter-observer reliability assessed by Limits-Of-Agreement (LoA) confirm anthropometrically reliable to 0.5 cm. Systematic bias was minimal for both measures, falling within 95% confidence intervals. These results suggest that US can produce reliable, repeatable and accurate measures of SAT and VAT during pregnancy.
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Affiliation(s)
- Alexandra Cremona
- Graduate Entry Medical School (GEMS), University of Limerick, Limerick, Ireland
- School of Allied Health (SAH), University of Limerick, Limerick, Ireland
- Institute of Nutrition & Dietetics (INDI), Dublin, Ireland
- Health Research Institute (HRI), University of Limerick, Limerick, Ireland
- Physical Education and Sport Sciences (PESS), University of Limerick, Limerick, Ireland
| | - Kevin Hayes
- Department of Statistics, University College Cork (UCC), Cork, Ireland
| | - Clodagh S. O’Gorman
- Graduate Entry Medical School (GEMS), University of Limerick, Limerick, Ireland
- Health Research Institute (HRI), University of Limerick, Limerick, Ireland
| | - Ciara Ní Laighin
- Graduate Entry Medical School (GEMS), University of Limerick, Limerick, Ireland
- University Maternity Hospital Limerick (UMHL), Limerick, Ireland
| | - Khadijah I. Ismail
- Graduate Entry Medical School (GEMS), University of Limerick, Limerick, Ireland
- University Maternity Hospital Limerick (UMHL), Limerick, Ireland
| | - Alan E. Donnelly
- Health Research Institute (HRI), University of Limerick, Limerick, Ireland
- Physical Education and Sport Sciences (PESS), University of Limerick, Limerick, Ireland
| | | | - Amanda Cotter
- Graduate Entry Medical School (GEMS), University of Limerick, Limerick, Ireland
- University Maternity Hospital Limerick (UMHL), Limerick, Ireland
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9
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Epicardial Adipose Tissue: Clinical Biomarker of Cardio-Metabolic Risk. Int J Mol Sci 2019; 20:ijms20235989. [PMID: 31795098 PMCID: PMC6929015 DOI: 10.3390/ijms20235989] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 11/23/2019] [Accepted: 11/26/2019] [Indexed: 02/07/2023] Open
Abstract
Epicardial adipose tissue (EAT) is part of the visceral adipose tissue (VAT) that surrounds the heart and it is a quantifiable, modifiable, and multifaceted tissue that has both local and systemic effects. When EAT is enlarged, EAT contributes to atherosclerotic cardiovascular disease (ASCVD) risk and plays a role in the development of metabolic syndrome (MetS). In this review, we will discuss the role of EAT in various facets of MetS, including type 2 diabetes mellitus (T2DM) and insulin resistance. We examine the association between EAT and liver steatosis. We also address the correlations of EAT with HIV therapy and with psoriasis. We discuss racial differences in baseline EAT thickness. We conclude that EAT measurement serves as a powerful potential diagnostic tool in assessing cardiovascular and metabolic risk. Measurement of EAT is made less costly, more convenient, and yet accurate and reliable by transthoracic echocardiography. Furthermore, modification of EAT thickness has therapeutic implications for ASCVD, T2DM, and MetS.
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10
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Thaware PK, Patterson CC, Young IS, Casey C, McCance DR. Clinical utility of ultrasonography-measured visceral adipose tissue depth as a tool in early pregnancy screening for gestational diabetes: a proof-of-concept study. Diabet Med 2019; 36:898-901. [PMID: 30672019 DOI: 10.1111/dme.13906] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/21/2019] [Indexed: 01/20/2023]
Abstract
AIM To examine, in a proof-of-concept study, the ability of visceral adipose tissue depth and subcutaneous fat depth measured in early pregnancy to predict subsequent gestational diabetes, and to assess the performance of these measures as screening tests for gestational diabetes compared with use of the current UK criteria. METHODS A total of 100 women in early pregnancy were recruited from a maternity hospital in Belfast, UK. Visceral adipose tissue depth and subcutaneous fat depth were measured, and each participant underwent a 75-g oral glucose tolerance test at 28 weeks' gestation for the diagnosis of gestational diabetes using WHO 2013 criteria. RESULTS Eighty women completed the study, of whom 15 (19%) developed gestational diabetes. Increasing visceral adipose tissue depth, but not subcutaneous fat depth, was associated with greater gestational diabetes risk after adjusting for confounding factors (odds ratio for a 1-sd rise 2.09, 95% CI 1.06-4.12; P=0.03). Visceral adipose tissue depth ≥4.27 cm had greater sensitivity compared with current National Institute of Health and Care Excellence criteria (87% vs 40%, respectively; P=0.02) and similar specificity (62% vs 74%, respectively; P=0.15) for identifying gestational diabetes. CONCLUSIONS Ultrasonography-measured visceral adipose tissue in early pregnancy is a potential clinical tool for improving sensitivity of selective screening for gestational diabetes, which, compared with universal oral glucose tolerance testing, is likely to reduce by half the numbers requiring this test. Further larger studies are now required for confirmation, including investigation into impact on clinical outcomes.
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Affiliation(s)
- P K Thaware
- Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, UK
| | - C C Patterson
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - I S Young
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - C Casey
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - D R McCance
- Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, UK
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Sheean P, Gonzalez MC, Prado CM, McKeever L, Hall AM, Braunschweig CA. American Society for Parenteral and Enteral Nutrition Clinical Guidelines: The Validity of Body Composition Assessment in Clinical Populations. JPEN J Parenter Enteral Nutr 2019; 44:12-43. [DOI: 10.1002/jpen.1669] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 05/09/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Patricia Sheean
- Marcella Niehoff School of Nursing Department of Health Promotion Loyola University Chicago Maywood Illinois USA
| | - M. Cristina Gonzalez
- Postgraduate Program in Health and Behavior Catholic University of Pelotas Pelotas Rio Grande do Sul Brazil
| | - Carla M. Prado
- Human Nutrition Research Unit Department of Agricultural Food and Nutritional Science Division of Human Nutrition, University of Alberta Edmonton Alberta Canada
| | - Liam McKeever
- Department of Kinesiology and Nutrition University of Illinois Chicago Illinois USA
| | - Amber M. Hall
- University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Carol A. Braunschweig
- Department of Kinesiology and Nutrition and Division of Epidemiology and Biostatistics University of Illinois at Chicago Chicago Illinois USA
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12
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Association of pulse wave velocity with body fat measures at 30 y of age. Nutrition 2019; 61:38-42. [DOI: 10.1016/j.nut.2018.09.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 08/26/2018] [Accepted: 09/29/2018] [Indexed: 01/09/2023]
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13
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Hung CY, Chang CW, Chen CJ, Chang CW, Cheng HY, Chen MJ. Sonographic Measurement of Visceral Fat and Prediction of Metabolic Syndrome in the Elderly. INT J GERONTOL 2018. [DOI: 10.1016/j.ijge.2018.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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14
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Stamatelopoulos K, Papavagelis C, Augoulea A, Armeni E, Karagkouni I, Avgeraki E, Georgiopoulos G, Yannakoulia M, Lambrinoudaki I. Dietary patterns and cardiovascular risk in postmenopausal women: Protocol of a cross-sectional and prospective study. Maturitas 2018; 116:59-65. [DOI: 10.1016/j.maturitas.2018.07.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/16/2018] [Accepted: 07/18/2018] [Indexed: 11/25/2022]
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15
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Angoorani H, Karimi Z, Naderi F, Mazaherinezhad A. Is ultrasound-measured abdominal fat thickness a reliable method for predicting metabolic diseases in obese and overweight women? Med J Islam Repub Iran 2018; 32:78. [PMID: 30643753 PMCID: PMC6325283 DOI: 10.14196/mjiri.32.78] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Indexed: 11/18/2022] Open
Abstract
Background: Central fat deposition seems to be a risk factor for developing metabolic and cardiovascular diseases in overweight and obese individuals. Ultrasound is an accurate and non-invasive tool for measuring abdominal fat thickness and can precisely separate subcutaneous from visceral fat. This study was conducted to apply ultrasonography as a simple and reliable method to measure subcutaneous and visceral abdominal fat thickness and evaluate the relationship between this measured abdominal fat thickness and metabolic risk factors. Methods: A total of 80 overweight and obese women were included in this study. Anthropometric indices and abdominal fat thickness were measured using ultrasound. The association between abdominal fat thickness and metabolic risk factors with anthropometric indices was assessed using correlation coefficient. Results: The mean (± SD) of subcutaneous and visceral fat thickness was 2.71±0.92 and 5.46±1.88, respectively. There was a relationship between waist circumference and visceral and subcutaneous fat thickness. Also, there was a relationship between ultrasound- measured visceral fat thickness and fasting blood glucose and triglyceride. Conclusion: Ultrasonography is a simple and reliable method to measure abdominal fat thickness as an important predictor of metabolic diseases.
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Affiliation(s)
- Hooman Angoorani
- Department of Sports and Exercise Medicine, Hazrat Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Zeinab Karimi
- Department of Sports and Exercise Medicine, Hazrat Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farokh Naderi
- Department of Radiology, Hazrat Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Mazaherinezhad
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
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16
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Bi X, Loo YT, Henry CJ. Ultrasound measurement of intraabdominal fat thickness as a predictor of insulin resistance and low HDL cholesterol in Asians. Nutrition 2018; 55-56:99-103. [PMID: 29980094 DOI: 10.1016/j.nut.2018.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 03/06/2018] [Accepted: 04/08/2018] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Insulin resistance (IR) is important in the pathogenesis of diabetes, the prevalence of which has become a major public health threat in Asia. The aim of this study was to use ultrasound measurements of abdominal fat thickness to predict IR and low high-density lipoprotein cholesterol (HDL-C) levels among Singaporean adults. METHODS A total of 399 healthy Singaporeans (mean age 36.7 ± 14.3 y; 43.4% men) took part in this study. Preperitoneal fat thickness (PFT) and subcutaneous fat thickness (SFT) were determined by ultrasound. RESULT We found that both PFT and SFT had significant positive correlations (P < 0.05) with fasting insulin concentration, homeostasis model assessment of insulin resistance, triacylglycerol (TG), and blood pressure, and negatively correlated to serum HDL-C in all participants. Separating men and women, PFT was an independent determinant of IR and low HDL-C only in men. On receiver-operating characteristic curve analysis, PFT ≥1.2 cm was the optimal cutoff value to identify IR and low HDL-C in men. On the other hand, SFT was the determinant of IR, elevated TG, and low HDL-C only in women. An SFT of 1.1 cm was the optimal cutoff value to define IR, elevated TG, and low HDL-C in women. CONCLUSIONS Results of this study suggested that ultrasound measurements of PFT and SFT could provide simple and useful indices of IR and lipid disorders for healthy Singaporean men and women. They might have the diagnostic values for predicting cardiovascular risks in this population.
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Affiliation(s)
- Xinyan Bi
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research and National University Health System, Singapore
| | - Yi Ting Loo
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research and National University Health System, Singapore; Centre for Translational Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Christiani Jeyakumar Henry
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research and National University Health System, Singapore; Centre for Translational Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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17
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Woldemariam MM, Evans KD, Butwin AN, Pargeon RL, Volz KR, Spees C. Measuring Abdominal Visceral Fat Thickness With Sonography: A Methodologic Approach. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2018. [DOI: 10.1177/8756479317747210] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This methodological approach to assessing obesity is based on the prepilot work conducted on a small sample of men and women (25-58 years of age) in a laboratory setting. The use of skinfold calipers, body mass index, and sonographic imaging of adipose and visceral fat were obtained. In this pre-experimental work, the rigorous use of sonographic measures of visceral fat demonstrated better trend results than the other measurement tools. The sonographic methods employed were modeled after the work published by Hamagawa et al. All measurements were taken five times, and only the middle three were retained for mean data points. The data are compared and contrasted with a paucity of international studies using sonography to measure visceral adiposity. It is important to determine whether sonography could serve as a non-ionizing imaging technique for the assessment of body composition and a screening technique for cardiovascular disease prediction.
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Affiliation(s)
- Mulubrhan M. Woldemariam
- The College of Medicine, School of Health & Rehabilitation Sciences, Laboratory for Investigatory Imaging, The Ohio State University, Columbus, OH, USA
| | - Kevin D. Evans
- The College of Medicine, School of Health & Rehabilitation Sciences, Laboratory for Investigatory Imaging, The Ohio State University, Columbus, OH, USA
| | - Angela N. Butwin
- The College of Medicine, School of Health & Rehabilitation Sciences, Laboratory for Investigatory Imaging, The Ohio State University, Columbus, OH, USA
| | - Rachel L. Pargeon
- The College of Medicine, School of Health & Rehabilitation Sciences, Laboratory for Investigatory Imaging, The Ohio State University, Columbus, OH, USA
| | - Kevin R. Volz
- The College of Medicine, School of Health & Rehabilitation Sciences, Laboratory for Investigatory Imaging, The Ohio State University, Columbus, OH, USA
| | - Colleen Spees
- The College of Medicine, School of Health & Rehabilitation Sciences, Laboratory for Investigatory Imaging, The Ohio State University, Columbus, OH, USA
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18
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Tripathy P, Sahu A, Sahu M, Nagy A. Ultrasonographic evaluation of intra-abdominal fat distribution and study of its influence on subclinical atherosclerosis in women with polycystic ovarian syndrome. Eur J Obstet Gynecol Reprod Biol 2017; 217:18-22. [PMID: 28850821 DOI: 10.1016/j.ejogrb.2017.08.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/04/2017] [Accepted: 08/08/2017] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To evaluate abdominal fat distribution and cardiovascular disease (CVD) risk factors in women with polycystic ovarian syndrome (PCOS) and to determine the independent risk factors for subclinical atherosclerosis. STUDY DESIGN One hundred and twenty-four women with PCOS were compared with 118 age and BMI-matched controls. Abdominal obesity was assessed as the waist-to-hip ratio (WHR) and abdominal fat distribution was measured as subcutaneous fat thickness (SFT), pre-peritoneal fat thickness (PFT) and visceral fat thickness (VFT) using Ultrasound (US). Markers of subclinical atherosclerosis (carotid intima-media thickness (CIMT) and brachial artery flow-mediated dilation (FMD)) and other CVD risk factors such as fasting glucose, fasting insulin (FIN), insulin resistance (HOMA-IR), androgens and lipid levels were measured. RESULTS In comparison to controls, PCOS women had increased VFT and subclinical atherosclerosis. PCOS women also had higher FIN and lower levels of high-density lipoprotein cholesterol (HDL-C) and an elevated total cholesterol (TC) to HDL-C ratio. In PCOS women, VFT showed a strong association with CIMT and WHR showed a strong association with FIN and HOMA-IR; however these associations were weak in controls. Multiple regression analysis revealed VFT as the strongest independent predictor of CIMT in PCOS women whereas age was the only independent predictor of CIMT and FMD in controls. CONCLUSIONS While age can be an independent baseline risk factor for subclinical atherosclerosis in normal menstruating women, excess visceral fat accumulation is the most important predictor of atherosclerosis in PCOS patients.
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Affiliation(s)
| | - Asutosh Sahu
- Department of Radio-Diagnosis, S.C.B. Medical College, Cuttack, India
| | - Mahija Sahu
- Department of Obstetrics & Gynecology, S.C.B. Medical College, Cuttack, India
| | - Attila Nagy
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
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19
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Seven E, Thuesen BH, Linneberg A, Jeppesen JL. Abdominal Adiposity Distribution Quantified by Ultrasound Imaging and Incident Hypertension in a General Population. Hypertension 2016; 68:1115-1122. [DOI: 10.1161/hypertensionaha.116.07306] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 08/12/2016] [Indexed: 01/04/2023]
Abstract
Abdominal obesity is a major risk factor for hypertension. However, different distributions of abdominal adipose tissue may affect hypertension risk differently. The main purpose of this study was to explore the association of subcutaneous abdominal adipose tissue (SAT) and visceral adipose tissue (VAT) with incident hypertension in a population-based setting. We hypothesized that VAT, rather than SAT, would be associated with incident hypertension. VAT and SAT were determined by ultrasound imagining in 3363 randomly selected Danes (mean age 49 years, 56% women, mean body mass index 25.8 kg/m
2
). We constructed multiple logistic regression models to compute standardized odds ratios with 95% confidence intervals per SD increase in SAT and VAT. Of the 2119 normotensive participants at baseline, 1432, with mean SAT of 2.8 cm and mean VAT of 5.7 cm, returned 5 years later for a follow-up examination and among them 203 had developed hypertension. In models including both VAT and SAT, the Framingham Hypertension Risk Score variables (age, sex, smoking status, family history of hypertension, and baseline blood pressure) and glycated hemoglobin, odds ratio (95% confidence interval) for incident hypertension for 1 SD increase in VAT and SAT was 1.27 (1.08–1.50,
P
=0.004) and 0.97 (0.81–1.15,
P
=0.70), respectively. Adjusting for body mass index instead of SAT attenuated the association between VAT and incident hypertension, but it was still significant (odds ratio, 1.22 [1.01–1.48,
P
=0.041] for each SD increase in VAT). In conclusion, ultrasound-determined VAT, but not SAT, was associated with incident hypertension in a random sample of Danish adults.
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Affiliation(s)
- Ekim Seven
- From the Research Centre for Prevention and Health, The Capital Region of Denmark, Copenhagen (E.S., B.H.T., A.L.); Department of Internal Medicine, Hvidovre Hospital Glostrup, University of Copenhagen, Glostrup, Denmark (E.S., J.L.J.); Department of Clinical Experimental Research, Rigshospitalet, Denmark (A.L.); and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (A.L., J.L.J.)
| | - Betina H. Thuesen
- From the Research Centre for Prevention and Health, The Capital Region of Denmark, Copenhagen (E.S., B.H.T., A.L.); Department of Internal Medicine, Hvidovre Hospital Glostrup, University of Copenhagen, Glostrup, Denmark (E.S., J.L.J.); Department of Clinical Experimental Research, Rigshospitalet, Denmark (A.L.); and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (A.L., J.L.J.)
| | - Allan Linneberg
- From the Research Centre for Prevention and Health, The Capital Region of Denmark, Copenhagen (E.S., B.H.T., A.L.); Department of Internal Medicine, Hvidovre Hospital Glostrup, University of Copenhagen, Glostrup, Denmark (E.S., J.L.J.); Department of Clinical Experimental Research, Rigshospitalet, Denmark (A.L.); and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (A.L., J.L.J.)
| | - Jørgen L. Jeppesen
- From the Research Centre for Prevention and Health, The Capital Region of Denmark, Copenhagen (E.S., B.H.T., A.L.); Department of Internal Medicine, Hvidovre Hospital Glostrup, University of Copenhagen, Glostrup, Denmark (E.S., J.L.J.); Department of Clinical Experimental Research, Rigshospitalet, Denmark (A.L.); and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (A.L., J.L.J.)
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20
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Visceral Adiposity in the First Half of Pregnancy in Association with Glucose, Lipid and Insulin Profiles in Later Pregnancy: A Cohort Study. Matern Child Health J 2016; 20:1720-5. [DOI: 10.1007/s10995-016-1975-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Moss A, Sievert K, Siegfried W, Siegfried A, Brandt S, Koenig W, Wabitsch M. Sonographically Assessed Intra-Abdominal Fat And Cardiometabolic Risk Factors in Adolescents with Extreme Obesity. Obes Facts 2016; 9:121-37. [PMID: 27058884 PMCID: PMC5644824 DOI: 10.1159/000443690] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 07/12/2015] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The metabolic and cardiovascular risk of obesity is predominantly defined through the amount of intra-abdominal fat (IAF). Regarding this risk and the benefits of weight reduction gender-specific differences have been described. The aim of this study was to examine the gender-specific relationship between IAF assessed via ultrasound and the cardiometabolic risk profile in extremely obese adolescents before and after weight loss. METHODS In 107 consecutively admitted adolescents (n = 59 girls, mean age 15.4 ± 2.6 years boys and 15.1 ± 2.1 years girls, mean BMI z-score 3.2 ± 0.6 boys and 3.5 ± 0.6 girls) anthropometric and fasting laboratory chemical parameters were measured before and after an in-patient long-term therapy (mean durance 5.6 ± 2.3 months). IAF was determined by measuring the intra-abdominal depth (IAD) via ultrasound. RESULTS IAD was higher in boys as compared to girls (58.0 ± 22.4 mm vs. 51.3 ± 16.0 mm). IAD values were positively associated with BMI-z scores, waist circumferences, HOMA-IR and serum levels of x03B3;GT, hs-CRP and IL-6 in both genders. In boys, but not in girls, IAD was significantly correlated with systolic and diastolic blood pressure, serum levels of triglycerides, ALT as well as adiponectin and HDL-cholesterol. After a marked mean weight loss of -27.1 ± 16.2 kg (-20.1 ± 7.9%) in boys and of -20.5 ± 11.5 kg (-17.3 ± 7.1%) in girls, IAD decreased by -20.7 ± 16.2 mm (--32.4 ± 16.9%) in boys and by -18.4 ± 12,7 mm (-34.3 ± 18.4%) in girls, resulting in more pronounced ameliorations of cardiovascular risk factors in boys than in girls. CONCLUSIONS The present study indicates that IAF assessed by ultrasound is a good indicator for the cardiometabolic risk factor profile in extremely obese adolescents. Associations between IAF and risk factors are more pronounced in boys than in girls.
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Affiliation(s)
- Anja Moss
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Ulm University, Ulm, Germany
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22
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Kozakova M, Morizzo C, Bianchi V, Marchetti S, Federico G, Palombo C. Hemodynamic overload and intra-abdominal adiposity in obese children: Relationships with cardiovascular structure and function. Nutr Metab Cardiovasc Dis 2016; 26:60-66. [PMID: 26643211 DOI: 10.1016/j.numecd.2015.10.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 09/21/2015] [Accepted: 10/13/2015] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND AIMS Childhood obesity promotes adverse changes in cardiovascular structure and function. This study evaluated whether these changes are related to intra-abdominal adiposity and associated cardiometabolic risk or to body-size induced hemodynamic overload. METHODS AND RESULTS 55 obese children/adolescents and 35 healthy-weight controls underwent carotid, cardiac and abdominal ultrasound to assess carotid artery intima-media thickness (IMT), diameter, distension and stiffness, left ventricular (LV) dimension, mass and function and extent of intra-abdominal adiposity. As compared to controls with healthy BMI, obese children had higher systolic blood pressure (BP), stroke volume and lower total peripheral resistance (P < 0.001-0.0001), higher plasma triglycerides, glycated hemoglobin, insulin and HOMA-IR index (P = 0.01-<0.0001), higher carotid IMT, diameter and distension (P < 0.005-0.0005), higher LV diameter, wall thickness and mass (P < 0.001-0.0001), and impaired LV diastolic function assessed by myocardial longitudinal performance (P < 0.005). In entire population, independent determinants of carotid diameter, LV diameter, wall thickness and mass were fat-free mass (or stroke volume, respectively) and BP. Carotid distension was determined by carotid diameter and BP, and carotid IMT by carotid diameter, BP, HDL-cholesterol and glycated hemoglobin. LV diastolic performance was inversely related to preperitoneal fat thickness and plasma insulin levels. CONCLUSIONS Obese youths present signs of impaired lipid and glucose metabolism, hyperdynamic circulation and cardiovascular changes. Increase in LV dimensions and mass and in carotid diameter and distension seems to reflect adaptation to body-size induced increase in hemodynamic load, changes in LV diastolic performance a negative impact of intra-abdominal adiposity and associated metabolic risk, and increase in IMT both adaptive remodeling and metabolic risk.
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Affiliation(s)
- M Kozakova
- Department of Clinical and Experimental Medicine, University of Pisa, Italy.
| | - C Morizzo
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Italy
| | - V Bianchi
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - S Marchetti
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - G Federico
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - C Palombo
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Italy
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23
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Stoner L, Chinn V, Cornwall J, Meikle G, Page R, Lambrick D, Faulkner J. Reliability tests and guidelines for B-mode ultrasound assessment of central adiposity. Eur J Clin Invest 2015; 45:1200-8. [PMID: 26402259 DOI: 10.1111/eci.12540] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 09/20/2015] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Ultrasound represents a validated and relatively inexpensive diagnostic device for assessing central adiposity; however, widespread adoption has been impeded by the lack of reliable standard operating procedures. PURPOSE To examine the reliability of, and describe guidelines for, ultrasound-derived recording of intra-abdominal fat thickness (IAT) and maximal preperitoneal fat thickness (PFT). METHODS Ultrasound scans were obtained from 20 adults (50% female, 26 ± 7 years, 24·5 kg/m(2) ) on three different mornings. IAT was assessed 2 cm above the umbilicus (transverse plane) measuring from linea alba to: (i) anterior aorta, (ii) posterior aorta and (iii) anterior aspect of the vertebral column. PFT was measured from linea alba to visceral peritoneum in (i) sagittal and (ii) transverse planes, immediately over and inferior to the xiphi-sternum, respectively. RESULTS For IAT, the criterion intraclass correlation coefficient (ICC) of 0·75 was exceeded for measurements to anterior aorta (0·95), posterior aorta (0·94) and vertebra (0·96). The reliability coefficient expressed as a percentage of the mean (RC%) was lowest (better) for measurement to vertebrae (9·8%). For PFT, mean thickness was comparable for sagittal (1·74 cm) and transverse (1·76 cm) planes; ICC values were also comparable for both planes (0·98 vs. 0·98, respectively), as were RC% (7·5% vs. 7·1%, respectively). CONCLUSIONS IAT assessments to the vertebra were marginally more reliable than those to other structures. While PFT assessments were equally reliable for both measurements planes, precise probe placement was easier for the sagittal plane. Based on these findings, guidelines for the reliable measurement of central adiposity using ultrasound are presented.
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Affiliation(s)
- Lee Stoner
- School of Sport and Exercise, Massey University, Wellington, New Zealand
| | - Victoria Chinn
- Institute of Food, Nutrition and Human Health, Massey University, Wellington, New Zealand
| | - Jon Cornwall
- Department of Physiology, University of Otago, Dunedin, New Zealand
| | - Grant Meikle
- Department of Radiology, Dunedin Public Hospital, Southern District Health Board, Dunedin, New Zealand.,Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Rachel Page
- Institute of Food, Nutrition and Human Health, Massey University, Wellington, New Zealand
| | | | - James Faulkner
- Department of Sport & Exercise, University of Winchester, Winchester, UK
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24
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Koh KK, Oh PC, Sakuma I, Kim EY, Lee Y, Hayashi T, Han SH, Park YM, Shin EK. Vascular and metabolic effects of ezetimibe combined with simvastatin in patients with hypercholesterolemia. Int J Cardiol 2015; 199:126-31. [DOI: 10.1016/j.ijcard.2015.07.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 07/06/2015] [Indexed: 11/27/2022]
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25
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Roever L, Resende ES, Veloso FC, Diniz ALD, Penha-Silva N, Casella-Filho A, Dourado PMM, Chagas ACP. Perirenal Fat and Association With Metabolic Risk Factors: The Uberlândia Heart Study. Medicine (Baltimore) 2015; 94:e1105. [PMID: 26402796 PMCID: PMC4616820 DOI: 10.1097/md.0000000000001105] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Perirenal fat (PRF) is associated with cardiovascular risk factors. Gender differences in the correlations of cardiovascular disease risk factors and PRF in the Brazilian population are lacking.Cross-sectional study with 101 (50.49% men; mean age 56.5 ± 18, range 19-74 years) drawn from the Uberlândia Heart Study underwent ultrasonography assessment of abdominal adipose. For the PRF, a 3.5 MHz transducer was measured in the middle third of the right kidney, with the transducer positioned at the axillary midline. The examinations were always performed by the same examiner. The PRF thickness was examined in relation to waist circumference, blood pressure, and metabolic risk factors. The PRF was significantly associated with the levels of gamma-glutamyl transferase (P < 0.05, r = 0.08), fasting plasma glucose (P < 0.05, r = 0.07), waist circumference (P < 0.05, r = 0.10), and metabolic syndrome (P < 0.001, r = 0.38) in men, and with the levels of fasting plasma glucose (P < 0.05) in women.The PRF was correlated with most cardiovascular risk factors in men and only in glucose at the women.
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Affiliation(s)
- Leonardo Roever
- From the Federal University of Uberlândia (LR, ESR, FCV, ALDD, NPS); Heart Institute (InCor), HCFMUSP, University of São Paulo Medical School, São Paulo (ACF, PMMD, ACPC); and Faculty of Medicine ABC, Santo André, Brazil (ACPC)
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26
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Lambrinoudaki I, Armeni E, Rizos D, Georgiopoulos G, Athanasouli F, Triantafyllou N, Panoulis K, Augoulea A, Creatsa M, Alexandrou A, Alevizaki M, Stamatelopoulos K. Indices of adiposity and thyroid hormones in euthyroid postmenopausal women. Eur J Endocrinol 2015; 173:237-45. [PMID: 26142102 DOI: 10.1530/eje-15-0141] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE We aimed to evaluate the association between thyroid hormones and indices of obesity in a sample of euthyroid postmenopausal women. DESIGN Cross-sectional study. METHODS Serum levels of TSH, free triiodothyronine (FT3), and free thyroxine (FT4) as well as BMI and waist:hip ratio (WHR) were evaluated in 194 healthy euthyroid postmenopausal women. Ultrasonography was used to assess abdominal fat layers (subcutaneous fat (SF), preperitoneal fat (PF), and SF:PF ratio). Indices of adiposity were defined as high vs low depending on the median value of the assessed parameters. RESULTS After multivariate adjustment for traditional risk factors, lower FT4 levels and a higher FT3:FT4 ratio predicted higher SF mass (FT4, Exp(β)=0.035, P=0.020 and FT3:FT4, Exp(β)=2.374, P=0.018), whereas higher FT3 predicted higher PF mass (Exp(β)=2.815, P=0.032). Women with FT3:FT4 above the highest quartile had a significantly higher SF mass as compared to women in the lowest quartile (1.81 ± 0.62 cm vs 1.54 ± 0.46 cm, P=0.027). BMI had a positive independent association with TSH (Exp(β)=1.829, P=0.018). Finally, FT3 was significantly associated with SF mass among women with higher BMI (FT3, β=0.259, P=0.040) and women with higher WHR (β=0.309, P=0.020) but not among women with lower BMI or WHR values. CONCLUSION Thyroid hormone levels, and in particular FT3, were independently associated with SF and PF in euthyroid postmenopausal women, and this association was mainly evident in women with higher BMIs. On the other hand, among traditional indices of adiposity, only TSH was positively associated with BMI. Larger prospective studies are needed to evaluate the significance of the present findings.
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Affiliation(s)
- Irene Lambrinoudaki
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Eleni Armeni
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Demetrios Rizos
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Georgios Georgiopoulos
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Foteini Athanasouli
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Nikolaos Triantafyllou
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Konstantinos Panoulis
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Areti Augoulea
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Maria Creatsa
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Andreas Alexandrou
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Maria Alevizaki
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Kimon Stamatelopoulos
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
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Relation of skinfold thickness and visceral fat with the endothelial function in Mexican postmenopausal women. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2015; 14:90-6. [PMID: 26327895 PMCID: PMC4498024 DOI: 10.5114/pm.2015.52048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Revised: 01/09/2015] [Accepted: 05/15/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the relationship between skinfolds and visceral fat with vascular reactivity according to body weight, fat distribution and time since menopause in Mexican postmenopausal women. MATERIAL AND METHODS In postmenopausal women, tricipital, suprailiac and subscapular skinfolds as well as blood pressure were measured, and body mass index (BMI) and waist-hip ratio (WHR) were calculated. Brachial artery Doppler ultrasound at baseline and after the hyperemic stimulus was done and Doppler parameters were assessed. For statistical analysis, Pearson and Spearman correlation analysis, as well as Student t were used. RESULTS Sixty-six postmenopausal women were studied; age was 54.5 ± 7.4 years. Skinfold thickness was related with subcutaneous and visceral fat. In all groups, the arterial diameter increased after the hyperemic stimulus among 6.5% and 9% of women. The pulsatility index decreased in the whole group and in those with BMI ≤ 27, WHR ≤ 0.85 and time since menopause ≤ 10 years. Negative correlations were observed between the percentage of change in arterial dilatation and the subscapular skinfold and subcutaneous fat in the whole group and in the subgroups with BMI > 27 and WHR > 0.85. CONCLUSIONS Skinfolds are indirectly related with visceral fat, and skinfold thickness permit to conclude about impact in endothelial environment.
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Fukuda K, Seki Y, Ichihi M, Okada T, Hirata A, Kogita S, Sawai Y, Igura T, Tsugawa M, Imai Y. Usefulness of ultrasonographic estimation of preperitoneal and subcutaneous fat thickness in the diagnosis of nonalcoholic fatty liver disease in diabetic patients. J Med Ultrason (2001) 2015; 42:357-63. [PMID: 26576787 DOI: 10.1007/s10396-015-0615-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 01/14/2015] [Indexed: 12/23/2022]
Abstract
PURPOSE Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) have been regarded as the hepatic manifestation of metabolic syndrome. Abdominal wall fat index (AFI), defined as the ratio of preperitoneal and subcutaneous fat thickness in the abdomen estimated by ultrasonography (US), has been shown to be useful in screening for disorders related to metabolic syndrome. We investigated the relation between AFI and NAFLD/NASH in diabetic patients. METHODS The degree of fat accumulation in the liver and the thickness of preperitoneal and subcutaneous fat were determined by US in 340 diabetic patients. An NAFLD fibrosis score (NAFLD-FS) was used to assess the advancement of hepatic fibrosis in NAFLD patients. RESULTS Of all 340 subjects, 209 (61 %) were diagnosed with NAFLD by US. AFI of NAFLD subjects was significantly higher than that of non-NAFLD subjects. Of the 209 subjects with NAFLD, 31 (15 %) were shown to have advanced NASH fibrosis according to NAFLD-FS. Multivariate analysis identified AFI as a significant predictor of advanced fibrosis. CONCLUSION AFI easily obtained by US was significantly related to the presence of NAFLD and/or advanced hepatic fibrosis in diabetic patients.
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Affiliation(s)
- Kazuto Fukuda
- Department of Gastroenterology, Ikeda Municipal Hospital, 3-1-18 Jonan, Ikeda, Osaka, 563-8510, Japan.
| | - Yasushi Seki
- Department of Ultrasonography, Ikeda Municipal Hospital, Ikeda, Japan
| | - Masahiro Ichihi
- Department of Ultrasonography, Ikeda Municipal Hospital, Ikeda, Japan
| | - Takuya Okada
- Department of Endocrinology and Metabolism, Ikeda Municipal Hospital, Ikeda, Japan
| | - Ayumu Hirata
- Department of Endocrinology and Metabolism, Ikeda Municipal Hospital, Ikeda, Japan
| | - Sachiyo Kogita
- Department of Gastroenterology, Ikeda Municipal Hospital, 3-1-18 Jonan, Ikeda, Osaka, 563-8510, Japan
| | - Yoshiyuki Sawai
- Department of Gastroenterology, Ikeda Municipal Hospital, 3-1-18 Jonan, Ikeda, Osaka, 563-8510, Japan
| | - Takumi Igura
- Department of Gastroenterology, Ikeda Municipal Hospital, 3-1-18 Jonan, Ikeda, Osaka, 563-8510, Japan
| | - Mamiko Tsugawa
- Department of Endocrinology and Metabolism, Ikeda Municipal Hospital, Ikeda, Japan
| | - Yasuharu Imai
- Department of Gastroenterology, Ikeda Municipal Hospital, 3-1-18 Jonan, Ikeda, Osaka, 563-8510, Japan
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Mirmiran P, Bahadoran Z, Azizi F. Lipid accumulation product is associated with insulin resistance, lipid peroxidation, and systemic inflammation in type 2 diabetic patients. Endocrinol Metab (Seoul) 2014; 29:443-9. [PMID: 25325262 PMCID: PMC4285040 DOI: 10.3803/enm.2014.29.4.443] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 04/05/2014] [Accepted: 04/09/2014] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Lipid accumulation product (LAP) is a novel biomarker of central lipid accumulation related to risk of diabetes and cardiovascular disease. In this study, we assessed the association of LAP with glucose homeostasis, lipid and lipid peroxidation, and subclinical systemic inflammation in diabetic patients. METHODS Thirty-nine male and 47 female type 2 diabetic patients were assessed for anthropometrics and biochemical measurements. LAP was calculated as [waist circumference (cm)-65]×[triglycerides (mmol/L)] in men, and [waist circumference (cm)-58]×[triglycerides (mmol/L)] in women. Associations of LAP with fasting glucose, insulin, insulin resistance index, lipid and lipoprotein levels, malondialdehyde, and high-sensitive C-reactive protein (hs-CRP) were assessed. RESULTS Mean age and LAP index were 53.6±9.6 and 51.9±31.2 years, respectively. After adjustments for age, sex and body mass index status, a significant positive correlation was observed between LAP index and fasting glucose (r=0.39, P<0.001), and homeostasis model assessment of insulin resistance (r=0.31, P<0.05). After additional adjustment for fasting glucose levels, antidiabetic and antilipidemic drugs, the LAP index was also correlated to total cholesterol (r=0.45, P<0.001), high density lipoprotein cholesterol (HDL-C) levels (r=-0.29, P<0.05), triglycerides to HDL-C ratio (r=0.89, P<0.001), malondialdehyde (r=0.65, P<0.001), and hs-CRP levels (r=0.27, P<0.05). CONCLUSION Higher central lipid accumulation in diabetic patients was related to higher insulin resistance, oxidative stress and systemic inflammation.
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Affiliation(s)
- Parvin Mirmiran
- Nutrition and Endocrine Research Center, and Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Bahadoran
- Nutrition and Endocrine Research Center, and Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Borruel S, Moltó JF, Alpañés M, Fernández-Durán E, Álvarez-Blasco F, Luque-Ramírez M, Escobar-Morreale HF. Surrogate markers of visceral adiposity in young adults: waist circumference and body mass index are more accurate than waist hip ratio, model of adipose distribution and visceral adiposity index. PLoS One 2014; 9:e114112. [PMID: 25479351 PMCID: PMC4257592 DOI: 10.1371/journal.pone.0114112] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 11/03/2014] [Indexed: 01/06/2023] Open
Abstract
Surrogate indexes of visceral adiposity, a major risk factor for metabolic and cardiovascular disorders, are routinely used in clinical practice because objective measurements of visceral adiposity are expensive, may involve exposure to radiation, and their availability is limited. We compared several surrogate indexes of visceral adiposity with ultrasound assessment of subcutaneous and visceral adipose tissue depots in 99 young Caucasian adults, including 20 women without androgen excess, 53 women with polycystic ovary syndrome, and 26 men. Obesity was present in 7, 21, and 7 subjects, respectively. We obtained body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), model of adipose distribution (MOAD), visceral adiposity index (VAI), and ultrasound measurements of subcutaneous and visceral adipose tissue depots and hepatic steatosis. WC and BMI showed the strongest correlations with ultrasound measurements of visceral adiposity. Only WHR correlated with sex hormones. Linear stepwise regression models including VAI were only slightly stronger than models including BMI or WC in explaining the variability in the insulin sensitivity index (yet BMI and WC had higher individual standardized coefficients of regression), and these models were superior to those including WHR and MOAD. WC showed 0.94 (95% confidence interval 0.88-0.99) and BMI showed 0.91 (0.85-0.98) probability of identifying the presence of hepatic steatosis according to receiver operating characteristic curve analysis. In conclusion, WC and BMI not only the simplest to obtain, but are also the most accurate surrogate markers of visceral adiposity in young adults, and are good indicators of insulin resistance and powerful predictors of the presence of hepatic steatosis.
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Affiliation(s)
- Susana Borruel
- Department of Endocrinology & Nutrition, Universidad de Alcalá & Hospital Universitario Ramón y Cajal & Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain; Department of Radiology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - José F Moltó
- Department of Endocrinology & Nutrition, Universidad de Alcalá & Hospital Universitario Ramón y Cajal & Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain; Department of Radiology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Macarena Alpañés
- Department of Endocrinology & Nutrition, Universidad de Alcalá & Hospital Universitario Ramón y Cajal & Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Elena Fernández-Durán
- Department of Endocrinology & Nutrition, Universidad de Alcalá & Hospital Universitario Ramón y Cajal & Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Francisco Álvarez-Blasco
- Department of Endocrinology & Nutrition, Universidad de Alcalá & Hospital Universitario Ramón y Cajal & Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Manuel Luque-Ramírez
- Department of Endocrinology & Nutrition, Universidad de Alcalá & Hospital Universitario Ramón y Cajal & Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Héctor F Escobar-Morreale
- Department of Endocrinology & Nutrition, Universidad de Alcalá & Hospital Universitario Ramón y Cajal & Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
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Schlecht I, Wiggermann P, Behrens G, Fischer B, Koch M, Freese J, Rubin D, Nöthlings U, Stroszczynski C, Leitzmann MF. Reproducibility and validity of ultrasound for the measurement of visceral and subcutaneous adipose tissues. Metabolism 2014; 63:1512-9. [PMID: 25242434 DOI: 10.1016/j.metabol.2014.07.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 07/04/2014] [Accepted: 07/29/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Ultrasound represents a low-cost and widely available field method for assessing visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) but its measurement properties are uncertain. The aim of the current study was to examine the reproducibility and validity of ultrasound to quantify abdominal fat compartments. METHODS In two study centers, VAT and SAT thicknesses were quantified by ultrasound two times by two observers each among 127 adults aged 20-70 years. In a separate sample of 30 adults, the ultrasound method was validated by comparing VAT and SAT thicknesses with VAT and SAT areas at vertebrae L2/L3 as obtained by a single magnetic resonance imaging (MRI) slice. RESULTS For VAT, the intra-rater reproducibility values for observers 1 and 2 were r=0.996 (95% CI=0.994-0.997) and r=0.999 (95% CI=0.999-0.999), respectively. For SAT, the intra-rater reproducibility values were r=0.992 (95% CI=0.989-0.994) and r=0.993 (95% CI=0.990-0.995), respectively. The inter-rater reproducibility values for VAT and SAT were r=0.998 (95% CI=0.997-0.999) and r=0.990 (95% CI=0.986-0.993), respectively. For VAT and SAT, the correlation coefficients between ultrasound and MRI measurements were r=0.898 (P<0.001) and r=0.705 (P<0.001), respectively. CONCLUSION Ultrasound provides reproducible and valid estimates of VAT and SAT and represents a useful method to assess abdominal fat in large scale epidemiologic studies.
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Affiliation(s)
- Inga Schlecht
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany.
| | - Philipp Wiggermann
- Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
| | - Gundula Behrens
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
| | - Beate Fischer
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
| | - Manja Koch
- Department of Epidemiology, Christian-Albrechts University of Kiel, Niemannsweg 11, 24105 Kiel, Germany
| | - Johanna Freese
- Section of Nutritional Epidemiology, Department of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms-University Bonn, Endenicher Allee 11-13, 53115 Bonn, Germany
| | - Diana Rubin
- Charité - Universitätsmedizin Berlin, Interdisziplinäres Stoffwechsel-Centrum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Ute Nöthlings
- Section of Nutritional Epidemiology, Department of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms-University Bonn, Endenicher Allee 11-13, 53115 Bonn, Germany
| | - Christian Stroszczynski
- Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
| | - Michael F Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
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Premanath M, Basavanagowdappa H, Mahesh M, Suresh M. Correlation of abdominal adiposity with components of metabolic syndrome, anthropometric parameters and Insulin resistance, in obese and non obese, diabetics and non diabetics: A cross sectional observational study. (Mysore Visceral Adiposity in Diabetes Study). Indian J Endocrinol Metab 2014; 18:676-82. [PMID: 25285285 PMCID: PMC4171891 DOI: 10.4103/2230-8210.139231] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To measure Visceral Fat (VF) and Subcutaneous Fat (SCF) by ultrasound, in obese and non-obese diabetics and obese and non-obese non diabetics, in a South Indian (Asian Indian) Population and correlate them with Body Mass Index (BMI), Waist Circumference (WC), components of metabolic syndrome and Insulin Resistance (IR). RESEARCH DESIGN AND METHODS This was a prospective observational study, 80 diabetics (40 obese and 40 non obese) and 80 non diabetics (40 obese and 40 non obese) a total of 160 subjects were enrolled, out of whom 153 completed the study. The subjects were evaluated with respect to BMI, WC, Blood Pressure (BP); Fasting Blood Sugar (FBS) Fasting Insulin levels (FIL), HbA1C and Lipid profile. The SCF and VF were measured by Ultrasonography.The results were statistically analyzed. RESULTS WC correlated significantly with VF in all the groups. Diabetics had more VF compared to non-diabetics. Insulin resistance was significant in all the groups; however diabetics had greater levels of IR, BMI, WC, VF and SCF had no correlation with IR and had no significant correlation with metabolic parameters. CONCLUSIONS In this study population, WC was found to be a useful surrogate measure of VF conforming to its well established applicability in other populations. Contrary to other studies elsewhere, SCF and VF were found to be poor indicators of Insulin Resistance. BMI, WC, VF and SCF were not useful in the prediction of metabolic syndrome. Ultrasound was found to be an easier and economic method of measuring abdominal adiposity and actual measurement of abdominal fat was more informative than anthropometric measurements.
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Affiliation(s)
- M. Premanath
- Senior Consultant in Internal Medicine and Diabetes, Mysore, Karnataka, India
| | - H. Basavanagowdappa
- Department of Medicine, JSS Medical College, JSS University, Mysore, Karnataka, India
| | - M. Mahesh
- Department of Medicine, JSS Medical College, JSS University, Mysore, Karnataka, India
| | - M. Suresh
- Department of Medicine, JSS Medical College, JSS University, Mysore, Karnataka, India
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George JA, Micklesfield LK, Norris SA, Crowther NJ. The association between body composition, 25(OH)D, and PTH and bone mineral density in black African and Asian Indian population groups. J Clin Endocrinol Metab 2014; 99:2146-54. [PMID: 24617710 DOI: 10.1210/jc.2013-3968] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
CONTEXT AND OBJECTIVE There are few data on the contribution of body composition to bone mineral density (BMD) in non-Caucasian populations. We therefore studied the contribution of body composition, and possible confounding of 25-hydroxyvitamin D and PTH, to BMD at various skeletal sites in black African (BA) and Asian Indian (AI) subjects. DESIGN AND SETTING This was a cross-sectional study in Johannesburg, South Africa. PARTICIPANTS BMD, body fat, and lean mass were measured using dual x-ray absorptiometry and abdominal fat distribution by ultrasound in 714 healthy subjects, aged 18-65 years. RESULTS Whole-body (subtotal), hip, femoral neck, and lumbar spine (lumbar) BMD were significantly higher in BA than AI subjects (P < .001 for all). Whole-body lean mass positively associated with BMD at all sites in both ethnic groups (P < .001 for all) and partially explained the higher BMD in BA females compared with AI females. Whole-body fat mass correlated positively with lumbar BMD in BA (P = .001) and inversely with subtotal BMD in AI subjects (P < .0001). Visceral adiposity correlated inversely with subtotal BMD in the BA (P = .037) and with lumbar BMD in the AI group (P = .005). No association was found between serum 25-hydroxyvitamin D and BMD. PTH was inversely associated with hip BMD in the BA group (P = .01) and with subtotal (P = .002), hip (P = .001), and femoral BMD (P < .0001) in the AI group. CONCLUSIONS Significant differences in whole-body and site-specific BMD between the BA and AI groups were observed, with lean mass the major contributor to BMD at all sites in both groups. The contribution of other components of body composition differed by site and ethnic group.
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Affiliation(s)
- Jaya A George
- Department of Chemical Pathology (J.G., N.J.C.), National Health Laboratory Service and University of the Witwatersrand, and Medical Research Council/Wits Developmental Pathways for Health Research Unit (L.K.M., S.A.N.), Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2193, South Africa
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Aortomesenteric Fat Thickness With Ultrasound Predicts Metabolic Diseases in Obese Patients. Am J Med Sci 2014; 347:8-13. [DOI: 10.1097/maj.0b013e318288f795] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shabestari AA, Bahrami-Motlagh H, Hosseinpanah F, Heidari K. Abdominal fat sonographic measurement compared to anthropometric indices for predicting the presence of coronary artery disease. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2013; 32:1957-1965. [PMID: 24154900 DOI: 10.7863/ultra.32.11.1957] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVES Sonography for measuring intra-abdominal fat is more accurate than anthropometric measurements. Computed tomographic (CT) angiography has become an accurate noninvasive method for detection of coronary artery disease (CAD). We examined the associations between both sonographic and anthropometric measurements of abdominal adiposity and the presence of CAD on CT angiography. METHODS We evaluated 83 consecutive patients (70% men; mean age ± SD, 56 ± 10.8 years) who were referred for CT angiography. Clinical and laboratory variables were determined, and CT angiography was performed using a 64-slice scanner. The severity of CAD was defined by visual assessment of any plaque, either calcified or noncalcified. Preperitoneal fat, subcutaneous fat, and visceral fat thicknesses were determined on sonography, and the abdominal fat index was calculated as the preperitoneal fat thickness-to-subcutaneous fat thickness ratio. RESULTS Coronary artery disease was detected in 56 patients (67%). Patients with CAD had higher visceral fat thickness (9.3 ± 2.0 versus 8.2 ± 2.2 cm; P = .035) and a higher waist-to-hip ratio (0.97 ± 0.07 versus 0.92 ± 0.07; P = .018) than those without CAD. The preperitoneal fat thickness, subcutaneous fat thickness, and abdominal fat index were not correlated with the CAD status. After adjusting for traditional cardiovascular risk factors, however, only a waist-to-hip ratio higher than 0.95 remained significantly associated with the presence of CAD (odds ratio, 4.03; 95% confidence interval, 1.2-13.4). CONCLUSIONS This study shows that sonographically based obesity measurements are not superior to anthropometric indices in predicting the presence of CAD.
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Affiliation(s)
- Abbas Arjmand Shabestari
- Department of Radiology, Loghman Hospital, Shahid Beheshti University of Medical Science, Makhsus Avenue, Tehran 13336 31152, Iran.
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Lee MJ, Shin DH, Kim SJ, Yoo DE, Ko KI, Koo HM, Kim CH, Doh FM, Oh HJ, Park JT, Han SH, Yoo TH, Choi KH, Kang SW. Sagittal abdominal diameter is an independent predictor of all-cause and cardiovascular mortality in incident peritoneal dialysis patients. PLoS One 2013; 8:e77082. [PMID: 24167560 PMCID: PMC3805560 DOI: 10.1371/journal.pone.0077082] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 09/05/2013] [Indexed: 11/19/2022] Open
Abstract
Backgrounds and Aims Visceral fat has a crucial role in the development and progression of cardiovascular disease, the major cause of death in end-stage renal disease (ESRD). Although sagittal abdominal diameter (SAD), as an index of visceral fat, significantly correlated with mortality in the general population, the impact of SAD on clinical outcomes has never been explored in ESRD patients. Therefore, we sought to elucidate the prognostic value of SAD in incident peritoneal dialysis (PD) patients. Methods We prospectively determined SAD by lateral abdominal X-ray at PD initiation, and evaluated the association of SAD with all-cause and cardiovascular mortality in 418 incident PD patients. Results The mean SAD was 24.5±4.3 cm, and during a mean follow-up of 39.4 months, 97 patients (23.2%) died, and 49.4% of them died due to cardiovascular disease. SAD was a significant independent predictor of all-cause [3rd versus 1st tertile, HR (hazard ratio): 3.333, 95% CI (confidence interval): 1.514–7.388, P = 0.01; per 1 cm increase, HR: 1.071, 95% CI: 1.005–1.141, P = 0.03] and cardiovascular mortality (3rd versus 1st tertile, HR: 8.021, 95% CI: 1.994–32.273, P = 0.01; per 1 cm increase, HR: 1.106, 95% CI: 1.007–1.214, P = 0.03). Multivariate fractional polynomial analysis also showed that all-cause and cardiovascular mortality risk increased steadily with higher SAD values. In addition, SAD provided higher predictive value for all-cause (AUC: 0.691 vs. 0.547, P<0.001) and cardiovascular mortality (AUC: 0.644 vs. 0.483, P<0.001) than body mass index (BMI). Subgroup analysis revealed higher SAD (≥24.2 cm) was significantly associated with all-cause mortality in men, women, younger patients (<65 years), and patients with lower BMI (<22.3 kg/m2). Conclusions SAD determined by lateral abdominal X-ray at PD initiation was a significant independent predictor of all-cause and cardiovascular mortality in incident PD patients. Estimating visceral fat by SAD could be useful to stratify mortality risk in these patients.
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Affiliation(s)
- Mi Jung Lee
- Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Dong Ho Shin
- Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Seung Jun Kim
- Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Dong Eun Yoo
- Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Kwang Il Ko
- Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Hyang Mo Koo
- Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Chan Ho Kim
- Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Fa Mee Doh
- Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Hyung Jung Oh
- Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Jung Tak Park
- Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Seung Hyeok Han
- Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Tae-Hyun Yoo
- Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea
- Severance Biomedical Science Institute, Brain Korea 21, Yonsei University, Seoul, Korea
| | - Kyu Hun Choi
- Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Shin-Wook Kang
- Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea
- Severance Biomedical Science Institute, Brain Korea 21, Yonsei University, Seoul, Korea
- * E-mail:
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Bazzocchi A, Filonzi G, Ponti F, Amadori M, Sassi C, Salizzoni E, Albisinni U, Battista G. The role of ultrasonography in the evaluation of abdominal fat: analysis of technical and methodological issues. Acad Radiol 2013; 20:1278-85. [PMID: 24029060 DOI: 10.1016/j.acra.2013.07.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Revised: 07/23/2013] [Accepted: 07/24/2013] [Indexed: 12/13/2022]
Abstract
RATIONALE AND OBJECTIVES Ultrasonography (US) is becoming popular for the assessment of adiposity, but no one has studied this tool in the light of its potential limitations. Our purpose was to investigate the impact of technical conditions on the evaluation of abdominal fat by US. MATERIALS AND METHODS Forty-five healthy males and 45 healthy females were consecutively enrolled in the study, randomly assigned to three groups equally distributed by sex, and examined accordingly to three technical points: fasting state (before and after meal [A]), breathing (expiration and inspiration [B]), and US equipment from different generations: 2003 and 1998 (C). Two blinded radiologists performed US in the these opposite conditions, acquiring five parameters representative of subcutaneous and visceral adiposity in two times. Student's t-test and Lin's correlation coefficient were used for statistical analysis to assess differences in the measures as well as in inter- and intra-observer agreements. RESULTS The maximum and the only statistically significant changes were observed for intra-abdominal fat thickness regarding fasting state and breathing (Δ% = 24.1 ± 21.3 and Δ% = 9.2 ± 20.4, respectively; P < .0001). Reproducibility and repeatability, especially for visceral fat, were proved more stable in the following conditions: fasting state, expiration, and newer machine (2003). CONCLUSION This article provides essential information and "range of confidence" for variations that can be expected from using different conditions in the measurement of abdominal adiposity by US to be carefully addressed as well as considered by US users and by researchers involving this technique in the field of body composition.
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Shetty R, Vivek G, Naha K, Nayak K, Goyal A, Dias LS. Correlation of epicardial fat and anthropometric measurements in Asian-Indians: A community based study. Avicenna J Med 2013; 2:89-93. [PMID: 23826555 PMCID: PMC3696206 DOI: 10.4103/2231-0770.110739] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND: It is increasingly evident that visceral adipose tissue plays a leading role in the pathogenesis of the metabolic syndrome. Unfortunately, accurate quantification of intra-abdominal visceral fat is cumbersome and expensive. Epicardial fat represents the component of visceral fat distributed around the heart, and is readily and non-invasively assessed by echocardiography. AIMS: To determine the correlation of epicardial fat with anthropometric parameters in a healthy population of Asian-Indians. MATERIALS AND METHODS: A prospective, cross-sectional study was conducted as part of a community outreach program from December to March 2011. Individuals over 18 years of age were included in the study. Anthropometric data was collected for all patients. Epicardial fat was assessed in parasternal long and short axes. RESULTS: 350 healthy individuals were included in the study. Of them, 66.7% were males. Mean age was 42.7 ± 15.3 years (range 18-84). Mean body-mass index (BMI) and waist circumference were 23.3 ± 4.5 kg/m2 (range 15.2-34.3) and 80.2 ± 13.3 cm (range 43-115) respectively. Mean epicardial fat in both axes was 2.6 ± 1.3 mm (range 0.3-7.0). Epicardial fat measured in both axes correlated well with weight (r = 0.399, P < 0.001), waist circumference (r = 0.522, P < 0.001) and BMI (r = 0.471, P < 0.001). Epicardial fat also correlated with age (r = 0.559, P < 0.001). CONCLUSIONS: There is an excellent correlation between epicardial fat measured by echocardiography and anthropometric parameters of metabolic syndrome.
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Affiliation(s)
- Ranjan Shetty
- Department of Cardiology, Kasturba Medical College, Manipal, India
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Soresi M, Noto D, Cefalù AB, Martini S, Vigna GB, Fonda M, Manzato E, Cattin L, Fellin R, Averna MR, Notarbartolo A. Nonalcoholic fatty liver and metabolic syndrome in Italy: results from a multicentric study of the Italian Arteriosclerosis society. Acta Diabetol 2013; 50:241-9. [PMID: 22684314 DOI: 10.1007/s00592-012-0406-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 05/22/2012] [Indexed: 02/06/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is associated with all the components of metabolic syndrome (MS) and might to be considered an additional component of MS itself. The Italian Society for the Study of Atherosclerosis (SISA) in 2005 started a research project aimed to study the NAFLD, using ultrasound (US), in nondiabetic MS subjects matching at least one of the ATP III criteria for HDL-C or triglycerides [TG]. Prevalence of US-NAFLD and its associated risk factors and prevalence of hypertransaminasemia and its possible determinants were evaluated. NAFLD prevalence was 0.78. Men with steatosis compared to men without steatosis were younger (P < 0.05) with higher TG (P < 0.03), homeostasis model assessment insulin resistance (HOMA-R) (P < 0.003), and visceral fat thickness (VFT) (P < 0.0001). Women with steatosis showed higher TG (P < 0.05), HOMA-R (P < 0.04), VFT (P < 0.0001), and lower age (P < 0.05). At multivariate analyses, VFT (P < 0.0001), HOMA-R (P < 0.02), and TG/HDL (P < 0.05) were associated with severity of NAFLD. Age (P < 0.05), LogTG (P < 0.005), and VFT (P < 0.01) were associated with higher ALT. The US prevalence of steatosis in this study (0.78) is the highest reported in patients with MS. Considering the exclusion of severe obese and diabetic patients and the recruitment criteria, this finding highlights the prominent role played by the alterations of lipid metabolism in the pathogenesis of NAFLD.
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Affiliation(s)
- Maurizio Soresi
- Department of Internal Medicine and Medical Specialties (DIMIS), University of Palermo, Via del Vespro 141, 90127, Palermo, Italy
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Abdominal circumference measurement by ultrasound does not enhance estimating the association of visceral fat with cardiovascular risk. Nutrition 2013; 29:393-8. [DOI: 10.1016/j.nut.2012.06.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Revised: 06/19/2012] [Accepted: 06/22/2012] [Indexed: 11/22/2022]
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Ismail NA, Ragab S, Abd El Baky ANE, Hamed M, Ayoub DF. Relation between serum progranulin, inflammatory markers and visceral fat in childhood obesity. ADVANCES IN BIOSCIENCE AND BIOTECHNOLOGY 2013; 04:1030-1038. [DOI: 10.4236/abb.2013.412138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Lee MJ, Shin DH, Kim SJ, Oh HJ, Yoo DE, Kim JK, Park JT, Han SH, Kang SW, Choi KH, Yoo TH. Visceral fat thickness is associated with carotid atherosclerosis in peritoneal dialysis patients. Obesity (Silver Spring) 2012; 20:1301-7. [PMID: 21818151 DOI: 10.1038/oby.2011.245] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Visceral fat has been known to associate with atherosclerosis, inflammation, and insulin resistance. However, the influence of visceral fat on cardiovascular disease (CVD) in peritoneal dialysis (PD) patients has never been elucidated. We investigated whether visceral fat thickness (VFT) has a predictive role in carotid atherosclerosis determined by carotid intima-media thickness (cIMT) in PD patients. A cross-sectional study was undertaken in 88 prevalent PD patients. BMI and waist circumference (WC) were measured as anthropometric indexes of obesity. VFT and subcutaneous fat thickness (SFT) were determined by sonographic measurement of abdominal fat. Carotid atherosclerosis was defined as increased cIMT (>1.0 mm) or presence of plaque. Thirty-two (36.3%) patients had carotid atherosclerosis. Patients with carotid atherosclerosis showed significantly higher VFT, BMI, and WC. In univariate logistic analysis, BMI, WC, and VFT except SFT were significant risk factors of carotid atherosclerosis. However, multivariate analysis revealed VFT was an independent factor associated with carotid atherosclerosis after adjusting for demographic, biochemical parameters, and anthropometric indexes (per 1 mm increase, odds ratio (OR) = 2.294, 95% confidence interval: 1.048-5.021, P = 0.038). When the patients were divided into three groups according to VFT, log high sensitivity C-reactive protein (hs-CRP), and homeostasis model assessment-insulin resistance (HOMA(IR)) were both higher in the third tertile compared to other tertiles. In conclusion, VFT, not SFT, is independently associated with carotid atherosclerosis in PD patients. Therefore sonographic measurement of VFT could be useful to stratify the risk of cardiovascular disease in PD patients.
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Affiliation(s)
- Mi Jung Lee
- Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea
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Sandhu JS, Esht V, Shenoy S. Cardiovascular risk factors in middle age obese Indians: a cross-sectional study on association of per cent body fat and intra-abdominal fat mass. HEART ASIA 2012; 4:1-5. [PMID: 27326015 DOI: 10.1136/heartasia-2011-010006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/02/2011] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To determine the association of per cent total body fat (TBF), intra-abdominal fat (IAF) mass and subcutaneous abdominal fat with cardiovascular risk factors in middle age obese Indians. DESIGN Cross-sectional study. SETTING Hydrostatic Laboratory, Department of Sports Medicine and Physiotherapy, Guru Nanak Dev University, India. PARTICIPANTS 51 subjects aged 30-55 years with a body mass index value 23 and above. METHODOLOGY In all the participants, TBF was estimated by underwater weighing machine and IAF and subcutaneous fat were measured by ultrasonography. Lipid profile was determined by a semiautomated analyser. Main outcome measures were: IAF, per cent body fat to TBF ratio, lipid profile and risk of developing cardiovascular diseases. RESULTS IAF was found to be significantly associated with lipid variables (95% CI, p<0.01) and risk of developing cardiovascular diseases (95% CI, p≤0.05) in both male and female subjects. TBF and subcutaneous fat thickness showed no significant results (95% CI, p>0.05) with either lipid variables or risk of developing cardiovascular diseases (tables 1 and 2). IAF mass showed significant association with age (95% CI, p<0.01) and significant negative association with physical activity (95% CI, p<0.05) in male subjects (tables 3 and 4). CONCLUSION An ultrasonic measurement of IAF is a better predictor of the risk of developing cardiovascular diseases in middle aged Indian population. In male subjects, physical activity of 5 or more days a week showed lesser amount of IAF as compared with those with physical activity <5 days a week.
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Affiliation(s)
- Jaspal Singh Sandhu
- Department of Sports Medicine and Physiotherapy, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Vandana Esht
- Department of Sports Medicine and Physiotherapy, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Shweta Shenoy
- Department of Sports Medicine and Physiotherapy, Guru Nanak Dev University, Amritsar, Punjab, India
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Pereira AZ, Marchini JS, Carneiro G, Arasaki CH, Zanella MT. Lean and Fat Mass Loss in Obese Patients Before and After Roux-en-Y Gastric Bypass: A New Application for Ultrasound Technique. Obes Surg 2011; 22:597-601. [DOI: 10.1007/s11695-011-0538-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Carranza-Lira S, Bárcena-Jacobo TD, Sandoval-Barragán MP, Ramos-León JC. Visceral adiposity after tibolone use. Int J Gynaecol Obstet 2011; 115:191-3. [PMID: 21872859 DOI: 10.1016/j.ijgo.2011.05.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Revised: 05/20/2011] [Accepted: 07/28/2011] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To evaluate the differences in visceral fat between women using tibolone and those not using tibolone. METHODS Sixty-five healthy postmenopausal women were included in the study: 26 who were taking tibolone (2.5 mg/day); and 39 who were not receiving tibolone treatment. Anthropometric measurements were performed, with subcutaneous and visceral fat measured via ultrasound. Differences between the groups were determined via Student t test. RESULTS There were no significant differences in age (P=0.796), weight (P=0.256), height (P=0.456), body mass index (P=0.08), waist circumference (P=0.420), or waist-hip ratio (P=0.1) between the groups. Hip circumference was significantly lower in the study group than in the control group (97.7 ± 12.2 cm vs 103 ± 8.1cm; P<0.04). There were no significant differences between the groups in subcutaneous fat measurements (P=0.56). There were significantly lower visceral fat measurements (2.8 ± 1.1cm vs 3.9 ± 1.6 cm; P<0.004) and a significantly lower visceral fat-subcutaneous fat ratio (1.1 ± 0.3 vs 1.5 ± 0.7; P<0.005) in the study group than in the control group. CONCLUSION Postmenopausal women who use tibolone have lower visceral fat measurements than do woman of similar age who do not use tibolone.
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Affiliation(s)
- Sebastián Carranza-Lira
- Gynecology and Obstetrics Hospital Luis Castelazo Ayala, Social Security Mexican Institute, Mexico City, Mexico.
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Shuster A, Patlas M, Pinthus JH, Mourtzakis M. The clinical importance of visceral adiposity: a critical review of methods for visceral adipose tissue analysis. Br J Radiol 2011; 85:1-10. [PMID: 21937614 DOI: 10.1259/bjr/38447238] [Citation(s) in RCA: 518] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
As a result of the rising epidemic of obesity, understanding body fat distribution and its clinical implications is critical to timely treatment. Visceral adipose tissue is a hormonally active component of total body fat, which possesses unique biochemical characteristics that influence several normal and pathological processes in the human body. Abnormally high deposition of visceral adipose tissue is known as visceral obesity. This body composition phenotype is associated with medical disorders such as metabolic syndrome, cardiovascular disease and several malignancies including prostate, breast and colorectal cancers. Quantitative assessment of visceral obesity is important for evaluating the potential risk of development of these pathologies, as well as providing an accurate prognosis. This review aims to compare different methods of measuring visceral adiposity with emphasis on their advantages and drawbacks in clinical practice.
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Affiliation(s)
- A Shuster
- Department of Diagnostic Imaging, Hamilton General Hospital, Hamilton, ON, Canada.
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Bazzocchi A, Filonzi G, Ponti F, Sassi C, Salizzoni E, Battista G, Canini R. Accuracy, reproducibility and repeatability of ultrasonography in the assessment of abdominal adiposity. Acad Radiol 2011; 18:1133-43. [PMID: 21724427 DOI: 10.1016/j.acra.2011.04.014] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Revised: 03/30/2011] [Accepted: 04/09/2011] [Indexed: 12/20/2022]
Abstract
RATIONALE AND OBJECTIVES Despite improvements in the methods used in body composition analysis, some goals remain far from clinical practice. Among them, the most important is the quantification of intra-abdominal adipose tissue. Fat distribution is a key point in the assessment of cardiovascular and metabolic risk status. The aim of this study was to define the accuracy, reproducibility, and repeatability of ultrasonography in the evaluation of abdominal adiposity. MATERIALS AND METHODS Twenty-six nonobese patients (group A) who underwent computed tomographic (CT) abdominal imaging and 29 obese patients (group B) were enrolled. Patients from both groups were independently evaluated using ultrasound by three radiologists; computed tomography-like conditions were reproduced, and six main parameters of subcutaneous and internal adiposity were measured (as well as three derived indexes) with both linear and convex probes. In group A, the same measurements were also obtained on CT images. Time spent for every ultrasound session was recorded. Results were analyzed using Lin's concordance correlation (ρ), intraclass correlation, and linear regression analysis (and analysis of variance). RESULTS Three patients were excluded from group A after CT scans because of technical problems. Mesenteric fat thickness did not show significant correlations and reliability. Strong correlations between ultrasound and CT measurements were observed for all other visceral and subcutaneous parameters (ρ = 0.85-0.96). Intraobserver and interobserver agreement was excellent in both groups (repeatability: ρ = 0.83-0.99 for group A, ρ = 0.90-0.99 for group B; reproducibility: intraclass correlation coefficient = 0.90-0.99 for groups A and B). The mean time spent was 95 ± 21 seconds for group A (mean body mass index, 27.4 ± 2.4 kg/m(2)) and 129 ± 33 seconds for group B (mean body mass index, 37.3 ± 11.9 kg/m(2)). CONCLUSIONS Ultrasound is accurate, reproducible, and fast in the analysis of abdominal adiposity. It offers a regional, easy, and close-at-hand evaluation of subcutaneous and visceral fat compartments. This should be taken into consideration when clinical routine examinations are performed or to evaluate patients with specific metabolic diseases before and after treatment.
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Oh J, Kim SK, Shin DK, Park KS, Park SW, Cho YW. A simple ultrasound correlate of visceral fat. ULTRASOUND IN MEDICINE & BIOLOGY 2011; 37:1444-1451. [PMID: 21775047 DOI: 10.1016/j.ultrasmedbio.2011.05.844] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Revised: 05/09/2011] [Accepted: 05/26/2011] [Indexed: 05/31/2023]
Abstract
The roles of body fat and muscle masses for developing cardiometabolic disorders are opposed to each other. The aim of this study was to analyze whether abdominal visceral to thigh muscle thickness ratio (AVTMR) measured by ultrasonography can be a simple yet useful index assessing the disproportion between visceral fat and thigh muscle, and whether it is associated with carotid atherosclerosis. This was an observational study performed on 15 healthy men and 68 men with newly-diagnosed type 2 diabetes. Using ultrasonography, abdominal visceral thickness, mid-thigh muscle thickness and carotid artery intima-media thickness (CA-IMT) were determined. The visceral fat amount and lipid-rich muscle mass were increased and metabolic profile was poorer across AVTMR tertiles. The AVTMR was associated an increased CA-IMT independent of traditional risk factors. The AVTMR measure using ultrasonography might be a relevant index identifying individuals at an increased risk of cardiovascular disease.
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Affiliation(s)
- Jisu Oh
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, South Korea
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Emmons RR, Garber CE, Cirnigliaro CM, Kirshblum SC, Spungen AM, Bauman WA. Assessment of measures for abdominal adiposity in persons with spinal cord injury. ULTRASOUND IN MEDICINE & BIOLOGY 2011; 37:734-741. [PMID: 21439716 DOI: 10.1016/j.ultrasmedbio.2011.02.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Revised: 01/25/2011] [Accepted: 02/03/2011] [Indexed: 05/30/2023]
Abstract
Ultrasound may be a useful tool to assess abdominal adiposity, but it has not been validated in the spinal cord injury (SCI) population. This study evaluated associations between abdominal ultrasound and other methods to assess adiposity in 24 men with SCI and 20 able-bodied (AB) men. Waist (WC) and hip circumference (HC) and waist-to-hip ratio (WHR) were measured. Trunk (TRK%), android (A%) and waist fat (W%) were determined by dual energy x-ray absorptiometry (DXA); ultrasonography determined abdominal subcutaneous (SF) and visceral fat (VF). The SCI group had greater TRK% (40.0 ± 9.6 vs. 32.0 ± 10.3), W% (47.0 ± 9.7 vs. 40.6 ± 9.4), A% (43.0 ± 9.8 vs. 35.8 ± 10.6) and WHR (0.99 ± 0.1 vs. 0.92 ± 0.06) than the AB group. WC and WHR correlated with VF in the SCI group. These associations suggest that ultrasound may be a useful tool in clinical practice for the measurement of VF in weight loss programs and for the assessment of cardiometabolic disorders.
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Affiliation(s)
- Racine R Emmons
- Department of Veterans Affairs, Rehabilitation Research and Development Center of Excellence for the Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center, Bronx, NY 10468, USA.
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Battaglia C, Battaglia B, Mancini F, Paradisi R, Fabbri R, Venturoli S. Ultrasonographic extended-view technique for evaluation of abdominal fat distribution in lean women with polycystic ovary syndrome. Acta Obstet Gynecol Scand 2011; 90:600-8. [DOI: 10.1111/j.1600-0412.2011.01124.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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