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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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Chary A, Tohidi M, Hasheminia M, Golmohammadi M, Haji Hosseini R, Hedayati M, Azizi F, Hadaegh F. Association Between HDL2-C and HDL3-C with Cardiovascular Disease: A Nested Case-Control Study in an Iranian Population. Int J Endocrinol Metab 2024; 22:e141550. [PMID: 38665147 PMCID: PMC11041996 DOI: 10.5812/ijem-141550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/18/2023] [Accepted: 11/28/2023] [Indexed: 04/28/2024] Open
Abstract
Background The contribution of high-density lipoprotein cholesterol (HDL-C) subclasses to incident cardiovascular disease (CVD) and coronary heart disease (CHD) remains a subject of debate. Objectives The objective of this study was to investigate these associations in a population with a high prevalence of dyslipidemia and CVD. Methods In a nested case-control study, HDL-C and its subclasses (HDL2-C and HDL3-C) in 370 age and gender-matched case and control subjects were determined. This study employed multivariable-adjusted conditional logistic regression to calculate the odds ratios (ORs) for the associations between HDL-C, HDL2-C, HDL3-C, and HDL2-C/HDL3-C (both as continuous and categorical variables) with incident CVD and CHD. The present study models were adjusted for a comprehensive set of confounders, including body mass index, current smoking, hypertension, type 2 diabetes mellitus, use of lipid-lowering drugs, family history of premature CVD, non-HDL-C, and triglycerides. Results In multivariate analysis, when considering lipoprotein parameters as continuous variables, a 1-unit increase in HDL-C and HDL3-C was associated with a reduced risk of incident CVD and CHD. For CVD, the ORs (95% confidence intervals [CI]) were 0.95 (0.92 - 0.98) and 0.95 (0.93 - 0.98) for HDL-C and HDL3-C, respectively. The corresponding values for CHD were 0.94 (0.91 - 0.97) and 0.94 (0.91 - 0.97). In the categorical approach to lipoprotein parameters, higher quartiles of HDL-C and HDL3-C, compared to the first quartile, were significantly associated with a lower risk of incident CVD and CHD. The ORs (95% CI) for the fourth quartiles were 0.43 (0.25 - 0.74, P for trend = 0.003) and 0.46 (0.27 - 0.78, P for trend = 0.005) for HDL-C and HDL3-C regarding CVD and 0.32 (0.17 - 0.59) and 0.32 (0.18 - 0.59) (all P for trend = 0.001) regarding CHD, respectively. Paradoxically, across quartiles of HDL2-C/HDL3-C, this lipid ratio was associated with a higher risk of CHD (92% higher risk in the fourth quartile). Conclusions The results showed that HDL3-C, but not HDL2-C, was primarily responsible for the protective effect of HDL-C against CVD, particularly CHD, in Iranian adults.
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Affiliation(s)
- Abdolreza Chary
- Department of Biology, Payame Noor University, Tehran, Iran
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mitra Hasheminia
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Melika Golmohammadi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mehdi Hedayati
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, 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
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Kim J, Kim K. CT-based measurement of visceral adipose tissue volume as a reliable tool for assessing metabolic risk factors in prediabetes across subtypes. Sci Rep 2023; 13:17902. [PMID: 37864066 PMCID: PMC10589349 DOI: 10.1038/s41598-023-45100-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/16/2023] [Indexed: 10/22/2023] Open
Abstract
Visceral adipose tissue (VAT) is a well-established risk factor for the development of diabetes in individuals with prediabetes. We aimed to evaluate various adiposity and metabolic indices, including visceral adipose tissue (VAT) volume measured by CT, in individuals with prediabetes, based on their different subtypes. This retrospective study included 78 prediabetes individuals aged ≥ 20 years whose VAT volumes were evaluated by CT. Individuals were classified into prediabetes subtypes: impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and combined IFG and IGT (C-IFG/IGT). We conducted a comparison of the patients' adiposity indices and their associations with one other, as well as with insulin resistance, based on the different prediabetes subtypes. Individuals with C-IFG/IGT had higher levels of visceral obesity than those with IFG or IGT. VAT volume was more strongly associated with insulin resistance than other adiposity indices, regardless of prediabetes subtypes. Additionally, VAT volume and liver attenuation index showed a significant correlation with the other indices studied across the prediabetes subtypes. CT-based measurement of VAT volume may be a valuable tool for evaluating metabolic risk factors among individuals with prediabetes.
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Affiliation(s)
- Jihyun Kim
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok-Ro, Seo-Gu, Busan, Republic of Korea
| | - Keunyoung Kim
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok-Ro, Seo-Gu, Busan, Republic of Korea.
- Department of Nuclear Medicine, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea.
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Association of low-carbohydrate diet score and carbohydrate quality with visceral adiposity and lipid accumulation product. Br J Nutr 2023; 129:843-853. [PMID: 35570588 DOI: 10.1017/s000711452200143x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The present study examined the association between low-carbohydrate diet (LCD) score, glycemic index (GI), and glycemic load (GL) with visceral fat level (VFL) and lipid accumulation product (LAP). This cross-sectional study was conducted on 270 adults (118 men and 152 women) aged between 18-45 living in Tehran, Iran, between February 2017 and December 2018. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire (FFQ). Body composition were also assessed. We used analyses of covariance and binary logistic regression to explore associations after controlling for age, energy intake (model 1), education, smoking status, physical activity, occupation, marriage and metabolic diseases. There were no significant differences between tertiles of GI, GL and LCD for means of anthropometric measures, LAP and VFL index in men, while women in the highest tertile of GI and GL had significantly higher mean LAP in the crude model (P = 0·02) and model 1(P = 0·04), which disappeared after controlling for other confounders (P = 0·12). Moreover, the OR and CIs for having high LAP and VFL was not associated with dietary GI, GL and LCD in crude and adjusted models. However, chance of high VFL reduced by 65% and 57% among women with high adherence to LCD score (OR = 0·35, 95% CI = 0·16-0·78, P = 0·01) and model 1 (OR = 0·43, 95% CI = 0·18-1, P = 0·05), respectively. However, this significant association disappeared after controlling for other confounders (P = 0·07). Overall, we found carbohydrate quality and LCD score are not associated with LAP and VFL index. However, gender-specific relationship should not be neglect and warrants further investigation.
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Spain DR, Andrews AM, Crews SA, Khan JM. Males With Traumatic Lower Limb Loss Differ in Body Fat Distribution Compared to Those Without Limb Loss. Mil Med 2023; 188:e140-e144. [PMID: 34143209 DOI: 10.1093/milmed/usab237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/08/2021] [Accepted: 06/04/2021] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES The primary objective was to examine body fat composition in males with traumatic lower limb loss and a comparison group without limb loss. A secondary objective was to determine if there are differences in body fat composition by traumatic limb loss level. RESEARCH METHODS AND PROCEDURES Cross-sectional analyses of baseline in-person intake data was completed at a large military medical center. Data were collected from 2011 to 2020, and analysis was conducted in 2020. Participants (n = 89) included males who sustained traumatic lower limb loss (n = 50) and an age-matched comparison group without limb loss (n = 39). Mean age of participants was 36.0 ± 13.2 years. Main outcomes measured included age, height, body mass index, weight, body fat mass and percent, android fat mass and percent, gynoid fat mass and percent, and android/gynoid percent fat ratio. Differences between groups were assessed using t-tests or Mann-Whitney U tests. Differences between limb loss levels were assessed using one-way ANOVA or Wilcoxon signed-rank test. RESULTS Body fat percent (P = .001), gynoid fat percent (P = .010), android fat mass (P = .01), and percent (P = .02) were higher in the group with limb loss. There were no differences in body fat composition between limb loss levels (P > .05). CONCLUSION Males with traumatic lower limb loss had a higher body fat percent compared to those without limb loss. Given higher body fat composition in individuals with limb loss and the relationship between body fat composition and cardiovascular disease risk, including body composition analysis with clinical screening could identify changes and allow for early intervention.
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Affiliation(s)
- David R Spain
- Nutrition Services Department, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA.,U.S. Military-Baylor, Graduate Program of Nutrition, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA.,Nutrition Care Division, Tripler Army Medical Center, Honolulu, HI 96859, USA
| | - Anne M Andrews
- Research Protections Office, National Institute of Standards and Technology, Gaithersburg, MD 20889, USA.,Department of Orthopaedics and Rehabilitation, and US Military-Baylor Graduate Program in Nutrition, Nutrition Services Department, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
| | - Sara A Crews
- U.S. Military-Baylor, Graduate Program of Nutrition, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA.,Nutrition Services Department, Darnall Army Medical Center, Fort Hood, TX 76544, USA
| | - Joetta M Khan
- Nutrition Services Department, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
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Hypoxia as a Double-Edged Sword to Combat Obesity and Comorbidities. Cells 2022; 11:cells11233735. [PMID: 36496995 PMCID: PMC9736735 DOI: 10.3390/cells11233735] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/14/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022] Open
Abstract
The global epidemic of obesity is tightly associated with numerous comorbidities, such as type II diabetes, cardiovascular diseases and the metabolic syndrome. Among the key features of obesity, some studies have suggested the abnormal expansion of adipose-tissue-induced local endogenous hypoxic, while other studies indicated endogenous hyperoxia as the opposite trend. Endogenous hypoxic aggravates dysfunction in adipose tissue and stimulates secretion of inflammatory molecules, which contribute to obesity. In contrast, hypoxic exposure combined with training effectively generate exogenous hypoxic to reduce body weight and downregulate metabolic risks. The (patho)physiological effects in adipose tissue are distinct from those of endogenous hypoxic. We critically assess the latest advances on the molecular mediators of endogenous hypoxic that regulate the dysfunction in adipose tissue. Subsequently we propose potential therapeutic targets in adipose tissues and the small molecules that may reverse the detrimental effect of local endogenous hypoxic. More importantly, we discuss alterations of metabolic pathways in adipose tissue and the metabolic benefits brought by hypoxic exercise. In terms of therapeutic intervention, numerous approaches have been developed to treat obesity, nevertheless durability and safety remain the major concern. Thus, a combination of the therapies that suppress endogenous hypoxic with exercise plans that augment exogenous hypoxic may accelerate the development of more effective and durable medications to treat obesity and comorbidities.
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Barnett JB, Zeng W. Healthy Eating for Successful Living in Older Adults™ community education program—evaluation of lifestyle behaviors: A randomized controlled trial. FRONTIERS IN AGING 2022; 3:960986. [PMID: 36187849 PMCID: PMC9521496 DOI: 10.3389/fragi.2022.960986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022]
Abstract
Objective: Older adults face many chronic health issues including heart disease and osteoporosis, which are preventable through changes in lifestyle behaviors. The Healthy Eating for Successful Living in Older Adults™ (HESL) is a 6-week community education program designed specifically for persons aged ≥60 years, to promote behavioral changes toward a healthy lifestyle. Our objective is to evaluate the HESL. This is the first official evaluation of the HESL since its initiation in 2005.Study Design: A cluster randomized controlled trial.Method: Program implementation and evaluation took place between July 2018 and January 2020. Twenty-nine sites, with 292 participants aged ≥60 years from across five states (mostly from Massachusetts), were randomized into the intervention group (IG) (16 sites; n = 150 participants) and control group (CG) (13 sites; n = 142 participants). The HESL workshops followed a scripted curriculum including information from the USDA’s MyPlate™ and the USDA 2015–2020 dietary guidelines. Intervention elements included goal setting, self-assessment, group support, and problem solving through brainstorming. The CG received no intervention. Outcome measures were collected in both groups at baseline, 2 weeks postintervention (week 8), and 6 months postintervention. These included self-reported lifestyle behaviors, a composite healthy behavior index (HBI), body mass index [weight (kg)/height (m2)], and waist-to-hip circumference ratio (WHR). Mixed-effects regression models were used to examine the impact of the intervention.Results: The IG showed significantly improved responses to most healthy lifestyle behavior questions at week 8 compared to the CG. However, not all improved responses were sustained at month 6. Significant improvements detected at month 6 included responses to the question on making food choices that are healthy for the heart, using MyPlate™ tools for food choices, reading nutrition labels when shopping/planning meals, and confidence in managing own health (p < 0.001 in most cases). HBI was significantly improved at week 8 and month 6 (p < 0.001). WHR decreased significantly (p < 0.05) at month 6.Conclusion: Positive changes in lifestyle behaviors and WHR were observed in older adults due to the HESL intervention.Clinical Trial Registration:clinicaltrial.gov, Identifier: NCT04991844; https://clinicaltrials.gov/ct2/show/NCT04991844
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Affiliation(s)
- Junaidah B. Barnett
- Health and Healing Research Education and Service, Boston, MA, United States
- Department of Nutrition, Harvard School of Public Health, Harvard University, Boston, MA, United States
- Tufts University Sensory and Science Center, Medford, MA, United States
- *Correspondence: Junaidah B. Barnett,
| | - Wu Zeng
- Department of Global Health, School of Health, Georgetown University, Washington, DC, United States
- Schneider Institutes for Health Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States
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Association between visceral adipose tissue volume, measured using computed tomography, and cardio-metabolic risk factors. Sci Rep 2022; 12:387. [PMID: 35013484 PMCID: PMC8748432 DOI: 10.1038/s41598-021-04402-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/19/2021] [Indexed: 11/08/2022] Open
Abstract
We evaluated the associations between metabolic parameters with visceral adipose tissue (VAT) volume in women with prediabetes or type 2 diabetes (T2DM), and we compared the VAT volume with the VAT area. We enrolled women aged > 20 years with prediabetes or T2DM, who underwent oral glucose tolerance test and whose VAT was evaluated using computed tomography (CT) at our institution between 2017 and 2019. All participants underwent unenhanced spiral CT with a 3-mm slice thickness from the level of the diaphragm to the level of the mid-thigh. The two VAT areas were defined as the free drawn area on the levels of the umbilicus and L2 vertebra. The VAT areas were also manually drawn from the level of the diaphragm to the level of the pelvic floor and were used to calculate the VAT volumes by summing all areas with a slice thickness of 3 mm after setting the attenuation values from -45 to -195 Hounsfield Unit. All metabolic characteristics, except blood pressure, were significantly correlated with the VAT volume. The VAT areas measured at the level of the L2 vertebra and umbilicus were correlated with serum triglyceride, high-density lipoprotein cholesterol, and Framingham steatosis index alone. Multivariable regression analyses revealed that the VAT volume was significantly associated with several metabolic parameters. In conclusion, in women with prediabetes and T2DM, the VAT volume acquired from CT-based calculation has more significant correlations with metabolic risk factors compared with the VAT area.
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Chen YC, Wang YW, Ko CH, Chen JF, Hsu CY, Yu SF, Cheng TT. Hip BMD is associated with visceral fat change: a registry study of osteoporosis and sarcopenia. Ther Adv Chronic Dis 2022; 13:20406223221134051. [DOI: 10.1177/20406223221134051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 09/30/2022] [Indexed: 11/18/2022] Open
Abstract
Background: Osteoporosis increases the risk of fractures. Visceral fat is associated with cardiovascular disease (CVD). There is inadequate knowledge on the relationship between osteoporosis and visceral fat. The study aimed to evaluate the relationship between bone mineral density (BMD) and visceral fat mass in the elderly. Methods: This was a prospective cohort study. Subjects were enrolled from the Rheumatology Clinic. All subjects underwent baseline bone mineral density and body composition measurements using dual-energy X-ray absorptiometry. Results: A total of 321 patients including 288 females and 33 males were enrolled in this study. We followed up DEXA for 1 year for fat and muscle mass change and found that 162 (50.5%) had a decrease in fat mass, 129 (40.2%) had decreased visceral fat, and 138 (43%) had decreased muscle mass. Furthermore, we found that the baseline hip T score was correlated with visceral fat decrease. Using visceral fat decrease as the outcome, we found that hip T score could predict visceral fat loss: the higher the T score, the more visceral fat loss was found [ p < 0.001, OR: 1.6, CI: (1.3–2.1)]. Conclusion: A high hip T score was associated with a future decrease in visceral fat, which may decrease the risk of atherosclerosis and CV risk. Therefore, evaluation of visceral fat may be useful for assessing CVD risk in patients with osteoporosis. Effective management of the risk of atherosclerosis and CVD is important in improving the life expectancy of these patients.
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Affiliation(s)
- Ying-Chou Chen
- Department of Rheumatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung District, Kaohsiung 833
| | - Yu-Wei Wang
- Department of Rheumatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
| | - Chi-Hua Ko
- Department of Rheumatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
| | - Jia-Feng Chen
- Department of Rheumatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
| | - Chung-Yuan Hsu
- Department of Rheumatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
| | - Shan-Fu Yu
- Department of Rheumatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
| | - Tien-Tsai Cheng
- Department of Rheumatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
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Song SO, Hwang YC, Ryu HU, Kahn SE, Leonetti DL, Fujimoto WY, Boyko EJ. Lower High-Density Lipoprotein Cholesterol Concentration Is Independently Associated with Greater Future Accumulation of Intra-Abdominal Fat. Endocrinol Metab (Seoul) 2021; 36:835-844. [PMID: 34474518 PMCID: PMC8419607 DOI: 10.3803/enm.2021.1130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/15/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Both intra-abdominal fat (IAF) and high-density lipoprotein cholesterol (HDL-C) are known to be associated with cardiometabolic health. We evaluated whether the accumulation of computed tomography (CT)-measured IAF over 5 years was related to baseline HDL-C concentration in a prospective cohort study. METHODS All participants were Japanese-Americans between the ages of 34 and 74 years. Plasma HDL-C concentration and CT measurements of IAF, abdominal subcutaneous fat (SCF), and thigh SCF cross-sectional areas were assessed at baseline and at 5-year follow-up visits. RESULTS A total of 397 subjects without diabetes were included. The mean±standard deviation HDL-C concentration was 51.6±13.0 mg/dL in men and 66.0±17.0 mg/dL in women, and the IAF was 91.9±48.4 cm2 in men and 63.1±39.5 cm2 in women. The baseline plasma concentration of HDL-C was inversely associated with the change in IAF over 5 years using multivariable regression analysis with adjustment for age, sex, family history of diabetes, weight change over 5 years, and baseline measurements of body mass index, IAF, abdominal SCF, abdominal circumference, thigh SCF, and homeostatic model assessment for insulin resistance. CONCLUSION These results demonstrate that HDL-C concentration significantly predicts future accumulation of IAF over 5 years independent of age, sex, insulin sensitivity, and body composition in Japanese-American men and women without diabetes.
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Affiliation(s)
- Sun Ok Song
- Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA,
USA
- Department of Medicine, University of Washington School of Medicine, Seattle, WA,
USA
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang,
Korea
| | - You-Cheol Hwang
- Division of Endocrinology and Metabolism, Department of Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul,
Korea
| | - Han Uk Ryu
- Department of Neurology, Jeonbuk National University Medical School, Jeonju,
Korea
| | - Steven E. Kahn
- Hospital and Specialty Medicine Service, VA Puget Sound Health Care System, Seattle, WA,
USA
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA,
USA
| | - Donna L. Leonetti
- Department of Anthropology, University of Washington, Seattle, WA,
USA
| | - Wilfred Y. Fujimoto
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA,
USA
| | - Edward J. Boyko
- Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA,
USA
- Department of Medicine, University of Washington School of Medicine, Seattle, WA,
USA
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Son DH, Ha HS, Lee HS, Han D, Choi SY, Chun EJ, Han HW, Park SH, Sung J, Jung HO, Lee JW, Chang HJ. Association of the new visceral adiposity index with coronary artery calcification and arterial stiffness in Korean population. Nutr Metab Cardiovasc Dis 2021; 31:1774-1781. [PMID: 33975738 DOI: 10.1016/j.numecd.2021.02.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS The new visceral adiposity index (NVAI) is an indirect marker of visceral adipose tissue recently developed using a Korean population. Here we examined the association of NVAI with coronary artery calcification and arterial stiffness in asymptomatic Korean patients. METHODS AND RESULTS We analyzed data from 60,938 asymptomatic Korean adults. Odds ratios and 95% confidence intervals (CIs) for coronary artery calcification score (CACS) > 100 and brachial-ankle pulse wave velocity (baPWV) ≥14 m/s were calculated across NVAI tertiles using multiple logistic regression analysis. Receiver operating characteristic (ROC) and area under the curve (AUC) analyses were used to assess the ability of NVAI to predict moderate to high risk of cardiovascular disease. The prevalence of moderate and high risk of cardiovascular disease increased significantly as the NVAI tertile increased. The odds ratio (95% CI) of the highest NVAI tertile for CACS >100 was 5.840 (5.101-6.686) for men and 18.916 (11.232-31.855) for women, after adjusting for confounders. All NVAI AUC values were significantly higher than the AUC values for other visceral adiposity markers. CONCLUSIONS This study provides the evidence that NVAI is independently and positively associated with coronary calcification and arterial stiffness in asymptomatic Korean adults.
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Affiliation(s)
- Da-Hye Son
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Medicine, Graduate School, Yonsei University, Republic of Korea
| | - Hyun-Su Ha
- Department of Medicine, Graduate School, Yonsei University, Republic of Korea
| | - Hye S Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Donghee Han
- Department of Imaging and Medicine, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Su-Yeon Choi
- Division of Cardiology, Seoul National University Healthcare System Gangnam Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eun J Chun
- Department of Radiology, Seoul National University Bundang Hospital, Seoul, Republic of Korea
| | - Hae-Won Han
- Department of Internal Medicine, Gangnam Heartscan Clinic, Seoul, Republic of Korea
| | - Sung H Park
- Department of Radiology, Gangnam Heartscan Clinic, Seoul, Republic of Korea
| | - Jidong Sung
- Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine, Heart Stroke & Vascular Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Hae O Jung
- Division of Cardiology, Cardiovascular Center, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ji-Won Lee
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Hyuk-Jae Chang
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Ballin M, Nordström P, Niklasson J, Nordström A. Associations of Visceral Adipose Tissue and Skeletal Muscle Density With Incident Stroke, Myocardial Infarction, and All-Cause Mortality in Community-Dwelling 70-Year-Old Individuals: A Prospective Cohort Study. J Am Heart Assoc 2021; 10:e020065. [PMID: 33870709 PMCID: PMC8200751 DOI: 10.1161/jaha.120.020065] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/15/2021] [Indexed: 12/13/2022]
Abstract
Background Aging leads to increased visceral adipose tissue (VAT) and reduced skeletal muscle density. To which extent these are associated with the risk of stroke, myocardial infarction (MI), and all-cause mortality in older adults is unknown. Methods and Results A total of 3294 70-year-old individuals (49.6% women) underwent a health examination in Umeå, Sweden, during 2012 to 2018. VAT and muscle density were measured using dual-energy x-ray absorptiometry and peripheral quantitative computed tomography. Cases of stroke, MI, and all-cause mortality were collected through national registers. Cox regressions were used to calculate hazard ratios (HRs) and 95% CIs per SD greater VAT and per SD lower muscle density. During a mean follow-up of 3.6 years, there were 108 cases of stroke or MI, and 97 deaths. Greater VAT (adjusted HR [aHR], 1.56; 95% CI, 1.09-2.22), but not lower muscle density (aHR, 1.14; 95% CI, 0.97-1.34), was associated with increased risk of stroke or MI. Neither VAT (aHR, 0.95; 95% CI, 0.65-1.41) nor muscle density (aHR, 1.11; 95% CI, 0.92-1.34) was associated with all-cause mortality. The association of VAT with stroke or MI was only significant in men (aHR, 1.86; 95% CI, 1.19-2.91) but not women (aHR, 0.60; 95% CI, 0.25-1.42) (Pinteraction=0.038). Conclusions With the limitation of being an observational study, these findings suggest that VAT is an important obesity-related predictor of cardiovascular risk in 70-year-old men, and by implication, that decreasing VAT may potentially reduce their risk of cardiovascular disease.
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Affiliation(s)
- Marcel Ballin
- Unit of Geriatric MedicineDepartment of Community Medicine and RehabilitationUmeå UniversityUmeåSweden
- Section of Sustainable HealthDepartment of Public Health and Clinical MedicineUmeå UniversityUmeåSweden
| | - Peter Nordström
- Unit of Geriatric MedicineDepartment of Community Medicine and RehabilitationUmeå UniversityUmeåSweden
| | - Johan Niklasson
- Unit of Geriatric MedicineDepartment of Community Medicine and RehabilitationUmeå UniversityUmeåSweden
| | - Anna Nordström
- Section of Sustainable HealthDepartment of Public Health and Clinical MedicineUmeå UniversityUmeåSweden
- School of Sport SciencesUiT The Arctic University of NorwayTromsøNorway
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13
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Body Composition Change, Unhealthy Lifestyles and Steroid Treatment as Predictor of Metabolic Risk in Non-Hodgkin's Lymphoma Survivors. J Pers Med 2021; 11:jpm11030215. [PMID: 33802940 PMCID: PMC8002720 DOI: 10.3390/jpm11030215] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/26/2021] [Accepted: 03/10/2021] [Indexed: 12/30/2022] Open
Abstract
Unhealthy lifestyle, as sedentary, unbalanced diet, smoking, and body composition change are often observed in non-Hodgkin’s lymphoma (NHL) survivors, and could be determinant for the onset of cancer treatment-induced metabolic syndrome (CTIMetS), including abdominal obesity, sarcopenia, and insulin resistance. The aim of this study was to assess whether changes in body composition, unhealthy lifestyles and types of anti-cancer treatment could increase the risk of metabolic syndrome (MetSyn) and sarcopenia in long-term NHL survivors. We enrolled 60 consecutive NHL patients in continuous remission for at least 3 years. Nutritional status was assessed by anthropometry-plicometry, and a questionnaire concerning lifestyles and eating habits was administered. More than 60% of survivors exhibited weight gain and a change in body composition, with an increased risk of MetSyn. Univariate analysis showed a significantly higher risk of metabolic disorder in patients treated with steroids, and in patients with unhealthy lifestyles. These data suggest that a nutritional intervention, associated with adequate physical activity and a healthier lifestyle, should be indicated early during the follow-up of lymphoma patients, in order to decrease the risk of MetSyn’s onset and correlated diseases in the long term.
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14
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Lewandowski Ł, Urbanowicz I, Kepinska M, Milnerowicz H. Concentration/activity of superoxide dismutase isozymes and the pro-/antioxidative status, in context of type 2 diabetes and selected single nucleotide polymorphisms (genes: INS, SOD1, SOD2, SOD3) - Preliminary findings. Biomed Pharmacother 2021; 137:111396. [PMID: 33761612 DOI: 10.1016/j.biopha.2021.111396] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/04/2021] [Accepted: 02/10/2021] [Indexed: 11/29/2022] Open
Abstract
The alterations in concentration/activity of superoxide dismutase isozymes in the context of type 2 diabetes or obesity are well-described. Moreover, many hereditary factors, including single-nucleotide polymorphisms (SNPs) of genes for coding insulin, insulin receptors, or insulin receptor substrates (INS, INSR, IRS1, IRS2) or superoxide dismutase isozymes (SOD1, SOD2, SOD3), have been linked with the incidence of obesity and diabetes. However, the underlying changes in the plasma concentration/activity of superoxide dismutase isozymes and their potential connection with the said hereditary factors remain unexplored. Previously, we have observed that the plasma concentration/activity of superoxide dismutase isozymes differs in the context of obesity and/or rs2234694 (SOD1) and rs4880 (SOD2) and that the concentrations of SOD1, SOD2, SOD3 are correlated with each other. Intersexual variability of SOD1 concentration was detected regardless of obesity. In this study, the variability of concentration/activity of superoxide dismutase isozymes in plasma is considered in the context of type 2 diabetes and/or SNPs: rs2234694 (SOD1), rs5746105 (SOD2), rs4880 (SOD2), rs927450 (SOD2), rs8192287 (SOD3). Genotypic variability of SNP rs3842729 (INS), previously studied in the context of insulin-dependent diabetes, is investigated in terms of selected clinical parameters associated with type 2 diabetes. This study revealed higher SOD1 concentration in diabetic men compared to women, and extremely high SOD1 concentration, higher total superoxide dismutase, and copper-zinc superoxide dismutase activity, and lower superoxide dismutase and copper-zinc superoxide dismutase activity (when adjusted for the concentration of SODs) in the diabetic group regardless of sex. Multiple logistic regression, applied to explore possible links between the studied SNPs and other factors with the odds of type 2 diabetes or obesity, revealed that the genotypic variability of rs4880 (SOD2) could affect these odds, supporting the findings of several other studies.
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Affiliation(s)
- Łukasz Lewandowski
- Department of Biomedical and Environmental Analyses, Faculty of Pharmacy, Wroclaw Medical University, Borowska Street 211, 50-556 Wrocław, Poland.
| | - Iwona Urbanowicz
- Department of Clinical Chemistry and Laboratory Hematology, Faculty of Pharmacy, Wroclaw Medical University, Borowska Street 211A, 50-556 Wrocław, Poland
| | - Marta Kepinska
- Department of Biomedical and Environmental Analyses, Faculty of Pharmacy, Wroclaw Medical University, Borowska Street 211, 50-556 Wrocław, Poland
| | - Halina Milnerowicz
- Department of Biomedical and Environmental Analyses, Faculty of Pharmacy, Wroclaw Medical University, Borowska Street 211, 50-556 Wrocław, Poland
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15
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Yang X, Lin Y, Xu GD, Chen YS, Zhou Y, Sun J, Li L. Optimal Cut-Off Values of Visceral Fat Area for Predicting Metabolic Syndrome Among Type 2 Diabetes Patients in Ningbo, China. Diabetes Metab Syndr Obes 2021; 14:1375-1383. [PMID: 33790605 PMCID: PMC8006810 DOI: 10.2147/dmso.s304164] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/02/2021] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To examine the optimal cut-off values of visceral fat area (VFA) for predicting metabolic syndrome (MetS) among type 2 diabetes (T2D) patients in Ningbo China. METHODS A total of 1017 subjects were selected from T2D patients who accepted standardized management by the National Standardized Metabolic Disease Management Center at Ningbo First Hospital from March 2018 to January 2020. Demography and medical information were collected through questionnaires. Regional adiposity was examined by a visceral fat analyzer using the dual bioelectrical impedance method. RESULTS Overall, 769 (75.6%) T2D patients were defined to have MetS. Patients with MetS had higher anthropometric values and biomarkers, compared to those without MetS. VFA was significantly correlated with risk factors of MetS. Further logistic regression models showed that VFA was significantly associated with MetS in men (OR=1.02) and in women (OR=1.03) (P<0.001 for both genders) after controlling for related factors. Receiver-operating characteristic curve analysis demonstrated that the optimal cut-off values of VFA were 84.7 cm2 for men and 81.1 cm2 for women to predict MetS in T2D patients. CONCLUSION VFA was associated with MetS and could be an independent predictor of MetS in T2D patients. CLINICAL TRIAL REGISTRATION www.ClinicalTrials.gov, number: NCT03811470.
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Affiliation(s)
- Xi Yang
- Department of Nutrition, Ningbo First Hospital, Ningbo, Zhejiang Province, People’s Republic of China
| | - Yi Lin
- Center for Health Economics, School of Economics, Faculty of Humanities and Social Sciences, University of Nottingham, Ningbo, Zhejiang Province, People’s Republic of China
| | - Guo-dong Xu
- Department of Medical Records Statistics, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang Province, People’s Republic of China
| | - Yan-shu Chen
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, Zhejiang Province, People’s Republic of China
| | - Ye Zhou
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, Zhejiang Province, People’s Republic of China
| | - Jing Sun
- Menzies Health Institute Queensland and School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Li Li
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, Zhejiang Province, People’s Republic of China
- Correspondence: Li Li Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, Zhejiang Province, People’s Republic of China Tel +86 137 5742 6626 Email
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16
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Association of the Gut Microbiota with Weight-Loss Response within a Retail Weight-Management Program. Microorganisms 2020; 8:microorganisms8081246. [PMID: 32824364 PMCID: PMC7463616 DOI: 10.3390/microorganisms8081246] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/08/2020] [Accepted: 08/14/2020] [Indexed: 12/22/2022] Open
Abstract
Retail programs offer popular weight-loss options amid the ongoing obesity crisis. However, research on weight-loss outcomes within such programs is limited. This prospective-cohort observational study enrolled 58 men and women between ages 20 and 72 years from a retail program to assess the influence of client features on energy-restriction induced weight-loss response. DESeq2 in R-studio, a linear regression model adjusting for significantly correlating covariates, and Wilcoxon signed-rank and Kruskal–Wallis for within- and between-group differences, respectively, were used for data analyses. An average 10% (~10 kg) reduction in baseline-weight along with lower total-, android-, gynoid-, and android:gynoid-fat were observed at Week 12 (all, p < 0.05). Fifty percent of participants experienced a higher response, losing an average of 14.5 kg compared to 5.9 kg in the remaining low-response group (p < 0.0001). Hemoglobin-A1C (p = 0.005) and heart rate (p = 0.079) reduced in the high-response group only. Fat mass and A1C correlated when individuals had high android:gynoid fat (r = 0.55, p = 0.008). Gut-microbial β-diversity was associated with BMI, body fat%, and android-fat (all, p < 0.05). Microbiota of the high-response group had a higher baseline OTU-richness (p = 0.02) as well as differential abundance and/or associations with B. eggerthi, A. muciniphila, Turicibacter, Prevotella, and Christensenella (all, p/padj < 0.005). These results show that intestinal microbiota as well as sex and body composition differences may contribute to variable weight-loss response. This highlights the importance of various client features in the context of real-world weight control efforts.
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17
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Yi SY, Steffen LM, Terry JG, R Jacobs D, Duprez D, Steffen BT, Zhou X, Shikany JM, Harnack L, J Carr J. Added sugar intake is associated with pericardial adipose tissue volume. Eur J Prev Cardiol 2020; 27:2016-2023. [PMID: 32594762 DOI: 10.1177/2047487320931303] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AIM The purpose of this study was to determine the relationships of pericardial adipose tissue and visceral adipose tissue volume with added sugar and sugar-sweetened beverage intakes. We hypothesized that both added sugar and sugar-sweetened beverages were positively associated with pericardial adipose tissue and visceral adipose tissue volumes in black and white men and women enrolled in the prospective Coronary Artery Risk Development in Young Adults study. METHODS AND RESULTS Dietary intake was assessed by diet history at baseline, year 7 and year 20 examinations in 3070 participants aged 18-30 and generally healthy at baseline. After 25 years follow-up, participants underwent a computed tomography scan of chest and abdomen; the computed tomography scans were read, and pericardial adipose tissue, visceral adipose tissue, and subcutaneous adipose tissue volumes were calculated. Quintiles were created for the average of baseline, year 7 and year 20 added sugar and for the average of sugar-sweetened beverages. General linear regression analysis evaluated the associations of pericardial adipose tissue and visceral adipose tissue volumes across quintiles of added sugar and across quintiles of sugar-sweetened beverage intakes adjusted for potential confounding factors. In a multivariable model, pericardial adipose tissue volume was higher across increasing quintiles of added sugar and sugar-sweetened beverage intakes (ptrend = 0.001 and ptrend < 0.001, respectively). A similar relation was observed for visceral adipose tissue (ptrend < 0.001 for both added sugar and sugar-sweetened beverages). CONCLUSIONS Long-term intakes of added sugar and sugar-sweetened beverages were associated with higher pericardial adipose tissue, visceral adipose tissue, and subcutaneous adipose tissue volumes. Because these ectopic fat depots are associated with greater risk of disease incidence, these findings support limiting intakes of added sugar and sugar-sweetened beverages.
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Affiliation(s)
- So-Yun Yi
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, USA
| | - Lyn M Steffen
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, USA
| | - James G Terry
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, USA
| | - Daniel Duprez
- Department of Medicine, University of Minnesota Medical School, USA
| | - Brian T Steffen
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, USA
| | - Xia Zhou
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, USA
| | - James M Shikany
- Division of Preventive Medicine, University of Alabama at Birmingham, USA
| | - Lisa Harnack
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, USA
| | - John J Carr
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center USA
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18
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Abstract
This review addresses the interplay between obesity, type 2 diabetes mellitus, and cardiovascular diseases. It is proposed that obesity, generally defined by an excess of body fat causing prejudice to health, can no longer be evaluated solely by the body mass index (expressed in kg/m2) because it represents a heterogeneous entity. For instance, several cardiometabolic imaging studies have shown that some individuals who have a normal weight or who are overweight are at high risk if they have an excess of visceral adipose tissue-a condition often accompanied by accumulation of fat in normally lean tissues (ectopic fat deposition in liver, heart, skeletal muscle, etc). On the other hand, individuals who are overweight or obese can nevertheless be at much lower risk than expected when faced with excess energy intake if they have the ability to expand their subcutaneous adipose tissue mass, particularly in the gluteal-femoral area. Hence, excessive amounts of visceral adipose tissue and of ectopic fat largely define the cardiovascular disease risk of overweight and moderate obesity. There is also a rapidly expanding subgroup of patients characterized by a high accumulation of body fat (severe obesity). Severe obesity is characterized by specific additional cardiovascular health issues that should receive attention. Because of the difficulties of normalizing body fat content in patients with severe obesity, more aggressive treatments have been studied in this subgroup of individuals such as obesity surgery, also referred to as metabolic surgery. On the basis of the above, we propose that we should refer to obesities rather than obesity.
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Affiliation(s)
- Marie-Eve Piché
- From the Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval (M.-E.P., A.T., J.-P.D.), Université Laval, Québec, QC, Canada.,Department of Medicine, Faculty of Medicine (M.-E.P.), Université Laval, Québec, QC, Canada
| | - André Tchernof
- From the Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval (M.-E.P., A.T., J.-P.D.), Université Laval, Québec, QC, Canada.,School of Nutrition (A.T.), Université Laval, Québec, QC, Canada
| | - Jean-Pierre Després
- From the Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval (M.-E.P., A.T., J.-P.D.), Université Laval, Québec, QC, Canada.,Vitam - Centre de recherche en santé durable, CIUSSS - Capitale-Nationale (J.-P.D.), Université Laval, Québec, QC, Canada.,Department of Kinesiology, Faculty of Medicine (J.-P.D.), Université Laval, Québec, QC, Canada
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19
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Amini MR, Shahinfar H, Babaei N, Davarzani S, Ebaditabar M, Djafarian K, Clark CCT, Shab-Bidar S. Association of Dietary Patterns with Visceral Adiposity, Lipid Accumulation Product, and Triglyceride-Glucose Index in Iranian Adults. Clin Nutr Res 2020; 9:145-156. [PMID: 32395444 PMCID: PMC7192667 DOI: 10.7762/cnr.2020.9.2.145] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 04/14/2020] [Accepted: 04/21/2020] [Indexed: 12/14/2022] Open
Abstract
In the present study, we sought to examine the association between dietary patterns (DPs) and visceral adiposity, lipid accumulation product (LAP), and triglyceride-glucose index. This cross-sectional study was conducted on adults aged between 18–45 years old who lived in Tehran, Iran, between February 2017 and December 2018 (n = 270). DPs were derived using principal component analysis. We used analysis of variance to examine differences in continues variables across tertiles of major DPs. Subsequently, for the modeling of these relationships, and also considering the possible effect of the confounding factors, multivariate regression was used. Three DPs were identified: healthy pattern, mixed pattern, and western pattern, respectively. Compared with individuals in the lowest category of mixed pattern, those in the highest category had lower fasting blood sugar (96.26 ± 11.57 vs. 101 ± 28.66, p = 0.01). A significant association was found between healthy pattern, after adjustment for potential confounders, and odds of LAP; such that individuals in the top category of healthy pattern score were 71% less likely to have a high LAP compared with those in the lowest category (odds ratio, 0.29; 95% confidence interval, 0.10–0.81). We found that adherence to a healthy DP was associated with decreased LAP. To confirm the veracity of these findings, more studies should be conducted.
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Affiliation(s)
- Mohammad Reza Amini
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14167-53955, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
| | - Hossein Shahinfar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
| | - Nadia Babaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
| | - Samira Davarzani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
| | - Mojdeh Ebaditabar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
| | - Cain C T Clark
- Centre for Sport, Exercise, and Life Sciences, Coventry University, Coventry CV1 5FB, UK
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
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20
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Song SO, Hwang YC, Kahn SE, Leonetti DL, Fujimoto WY, Boyko EJ. Intra-Abdominal Fat and High Density Lipoprotein Cholesterol Are Associated in a Non-Linear Pattern in Japanese-Americans. Diabetes Metab J 2020; 44:277-285. [PMID: 32174061 PMCID: PMC7188973 DOI: 10.4093/dmj.2019.0008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 07/04/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND We describe the association between high density lipoprotein cholesterol (HDL-C) concentration and computed tomography (CT)-measured fat depots. METHODS We examined the cross-sectional associations between HDL-C concentration and intra-abdominal (IAF), abdominal subcutaneous (SCF), and thigh fat (TF) areas in 641 Japanese-American men and women. IAF, SCF, and TF were measured by CT at the level of the umbilicus and mid-thigh. The associations between fat area measurements and HDL-C were examined using multivariate linear regression analysis adjusting for age, sex, diabetes family history, homeostasis model assessment of insulin resistance (HOMA-IR), and body mass index (BMI). Non-linearity was assessed using fractional polynomials. RESULTS Mean±standard deviation of HDL-C concentration and IAF in men and women were 1.30±0.34 mg/dL, 105±55.3 cm², and 1.67±0.43 mg/dL, 74.4±46.6 cm² and differed significantly by gender for both comparisons (P<0.001). In univariate analysis, HDL-C concentration was significantly associated with CT-measured fat depots. In multivariate analysis, IAF was significantly and non-linearly associated with HDL-C concentration adjusted for age, sex, BMI, HOMA-IR, SCF, and TF (IAF: β=-0.1012, P<0.001; IAF²: β=0.0008, P<0.001). SCF was also negatively and linearly associated with HDL-C (β=-0.4919, P=0.001). CONCLUSION HDL-C does not linearly decline with increasing IAF in Japanese-Americans. A more complex pattern better fits this association.
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Affiliation(s)
- Sun Ok Song
- Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
| | - You Cheol Hwang
- Division of Endocrinology and Metabolism, Department of Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Steven E Kahn
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
- Hospital and Specialty Medicine Service, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Donna L Leonetti
- Department of Anthropology, University of Washington, Seattle, WA, USA
| | - Wilfred Y Fujimoto
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Edward J Boyko
- Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
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21
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Su W, Wang J, Mu Y. Association Between Hypertriglyceridemic Waist Phenotype and Increased Urinary Albumin-Creatinine Ratio in Chinese Adults: The REACTION Study. Diabetes Metab Syndr Obes 2020; 13:2965-2974. [PMID: 32904657 PMCID: PMC7457398 DOI: 10.2147/dmso.s257736] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 08/03/2020] [Indexed: 12/28/2022] Open
Abstract
PURPOSE The hypertriglyceridemic waist (HTGW) phenotype can predict cardiovascular disease (CVD) risk. Additionally, strong evidence indicates that elevated urinary albumin-creatinine ratio (UACR) is associated with increased prevalence of CVD. However, few studies have explored the association between the HTGW phenotype and UACR. PATIENTS AND METHODS In this cross-sectional descriptive study, a total of 40,674 subjects (28,562 women and 12,112 men older than 40 years) were recruited from seven different geographic regional centres. The HTGW phenotype was defined as increased triglyceride levels (triglyceride ≥ 1.5 mmol/L for female and ≥2.0 mmol/L for male) and waist circumference (WC; WC ≥ 85 for female and WC ≥ 90 cm for male). Logistic regression analyses were performed to assess the relationship between UACR and the HTGW phenotype. RESULTS Subjects with the HTGW phenotype showed a more significant trend towards increased excretion of UACR [among all subjects, odds ratio (OR) = 1.303, 95% CI: 1.132-1.499, P < 0.001; among men, OR = 1.406, 95% CI: 1.057-1.870, P = 0.019; among women, OR = 1.268, 95% CI: 1.074-1.496, P = 0.005]. Furthermore, the stratified analysis showed that the OR for high-risk significantly increased in individuals in the HTGW group aged below 65 years, with 5.6 ≤ fasting blood glucose < 7.0 or 7.8 ≤ post-load blood glucose <11.1 mmol/L, 120 ≤ systolic blood pressure < 140 or 80 ≤ diastolic blood pressure < 90, 24 ≤ body mass index < 28 kg/m2, and estimated globular filtration rate > 90 mL/min per 1.73 m2. CONCLUSION This study has advanced the understanding of visceral obesity and our results supported the fact that the HTGW phenotype is associated with elevated UACR excretion among general Chinese adults.
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Affiliation(s)
- Wanlu Su
- Medicine School of Nankai University, No. 94 Weijin Road, Tianjin300071, People’s Republic of China
- Department of Endocrinology, Chinese People’s Liberation Army General Hospital, Beijing100853, People’s Republic of China
| | - Jie Wang
- Medicine School of Nankai University, No. 94 Weijin Road, Tianjin300071, People’s Republic of China
- Department of Endocrinology, Chinese People’s Liberation Army General Hospital, Beijing100853, People’s Republic of China
| | - Yiming Mu
- Medicine School of Nankai University, No. 94 Weijin Road, Tianjin300071, People’s Republic of China
- Department of Endocrinology, Chinese People’s Liberation Army General Hospital, Beijing100853, People’s Republic of China
- Correspondence: Yiming Mu Department of Endocrinology, Chinese People’s Liberation Army General Hospital, No. 28 Fuxing Road, Beijing100853, People’s Republic of China Email
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22
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Sun W, Sun X, Chu W, Yu S, Dong F, Xu G. CircRNA expression profiles in human visceral preadipocytes and adipocytes. Mol Med Rep 2019; 21:815-821. [PMID: 31974620 PMCID: PMC6947878 DOI: 10.3892/mmr.2019.10886] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 11/08/2019] [Indexed: 12/27/2022] Open
Abstract
Circular RNAs (circRNAs) regulate several physiological and pathological processes, but their role in visceral lipid deposition has not been explored. In the present study, human preadipocytes from visceral fat tissue (HPA-v) were induced to form adipocytes, and the circRNA expression profiles in HPA-v and adipocytes were detected using circRNA microarrays. The microarray data revealed that 2,215 and 1,865 circRNAs were significantly up- and downregulated, respectively, in adipocytes compared with HPA-v. Moreover, the parental genes of differentially expressed circRNAs were associated with fatty acid metabolism based on Kyoto Encyclopedia of Genes and Genomes analysis. Three circRNAs (hsa_circ_0136134, hsa_circ_0017650, and hsa-circRNA9227-1) were selected for quantitative PCR (qPCR) validation, and the qPCR results were consistent with the microarray results. Furthermore, MiRanda software was used to predict the microRNAs (miRNAs) potentially targeting the top 10 up- and downregulated circRNAs, and 14 miRNAs with more than two miRNA response elements targeting these circRNAs. This is the first study of the expression profiles of circRNAs in HPA-v and adipocytes and may suggest potential therapeutic targets for the visceral obesity.
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Affiliation(s)
- Wenxing Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Nantong University, Nantong, Jiangsu 226019, P.R. China
| | - Xuecheng Sun
- Department of Trauma Surgery, Weifang People's Hospital, Weifang, Shandong 26100, P.R. China
| | - Weiwei Chu
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat‑sen University, Guangzhou, Guangdong 510275, P.R. China
| | - Shigang Yu
- Engineering Research Center of Sichuan Province Higher School of Local Chicken Breeds Industrialization in Southern Sichuan, College of Life Science, Leshan Normal University, Leshan, Sichuan 614000, P.R. China
| | - Fulu Dong
- Laboratory of Nuclear Receptors and Cancer Research, Center for Basic Medical Research, Medical College, Nantong University, Nantong, Jiangsu 226019, P.R. China
| | - Guangfei Xu
- Department of Nutrition and Food Hygiene, School of Public Health, Nantong University, Nantong, Jiangsu 226019, P.R. China
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Nakao K, Sasaki H, Nishimura T, Banno H, Otsuka K, Hirabuki S, Hoshiba T. Periaortic Abdominal Fat Area as a Predictor of Surgical Difficulties during Extraperitoneal Laparoscopic Para-aortic Lymphadenectomy. J Minim Invasive Gynecol 2019; 27:1377-1382. [PMID: 31676398 DOI: 10.1016/j.jmig.2019.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 10/17/2019] [Accepted: 10/20/2019] [Indexed: 11/29/2022]
Abstract
STUDY OBJECTIVE To evaluate whether obesity is a marker of surgical difficulty during extraperitoneal para-aortic lymphadenectomy. DESIGN Retrospective observational cohort study. SETTING Tertiary medical center in the Kanazawa area of Japan. PATIENTS Eighty-four patients with primary endometrial cancer who underwent extraperitoneal laparoscopic para-aortic lymphadenectomy (LPAND) between January 2005 and December 2017 were included. INTERVENTIONS We investigated the correlation between operative times and body mass indexes, visceral fat areas, and periabdominal artery fat areas (PAFAs). The number of lymph nodes harvested was used as an indicator of the degree of surgical completion. MEASUREMENTS AND MAIN RESULTS There was no correlation between the operative time and body mass index. Significant correlations were observed between operative time and visceral fat area (p = .026; r = 0.243) and between operative time and PAFA (p = .007; r = 0.293). A multivariate analysis showed that PAFA was a significant independent marker that could be used to predict prolonged operative times for extraperitoneal LPAND (p = .045; odds ratio, 3.05). The number of para-aortic lymph nodes harvested was not significant in the high- and low-PAFA groups (22 and 25, respectively; p = .525). CONCLUSION PAFA is an adequate marker of prolonged operative time for extraperitoneal LPAND among patients with endometrial cancer.
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Affiliation(s)
- Kohshiro Nakao
- Department of Obstetrics and Gynecology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan (all authors)..
| | - Hiromasa Sasaki
- Department of Obstetrics and Gynecology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan (all authors)
| | - Toshiya Nishimura
- Department of Obstetrics and Gynecology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan (all authors)
| | - Harumichi Banno
- Department of Obstetrics and Gynecology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan (all authors)
| | - Kaori Otsuka
- Department of Obstetrics and Gynecology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan (all authors)
| | - Shinya Hirabuki
- Department of Obstetrics and Gynecology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan (all authors)
| | - Tsutomu Hoshiba
- Department of Obstetrics and Gynecology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan (all authors)
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Arase Y, Shiraishi K, Anzai K, Sato H, Teramura E, Tsuruya K, Hirose S, Deguchi R, Toyoda M, Mine T, Kagawa T. Effect of Sodium Glucose Co-Transporter 2 Inhibitors on Liver Fat Mass and Body Composition in Patients with Nonalcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus. Clin Drug Investig 2019; 39:631-641. [PMID: 30993553 PMCID: PMC6593121 DOI: 10.1007/s40261-019-00785-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Background and Objective Sodium glucose co-transporter 2 inhibitors increase urinary glucose excretion and reduce visceral adiposity and body weight, but their efficacy on patients with nonalcoholic fatty liver disease has not been sufficiently investigated. The aim of this study was to assess the effect of sodium glucose co-transporter 2 inhibitors on liver fat mass and body composition in patients with nonalcoholic fatty liver disease and type 2 diabetes mellitus. Methods We retrospectively analyzed 17 patients with nonalcoholic fatty liver disease and type 2 diabetes who received sodium glucose co-transporter 2 inhibitors between November 2016 and July 2017. Changes in liver fat, subcutaneous and visceral fat, body composition, and liver function-related parameters were assessed after 24 weeks of sodium glucose co-transporter 2 inhibitor treatment and compared to baseline values. Results Ten patients received dapagliflozin at 5 mg/day and seven patients received canagliflozin at 100 mg/day for 24 weeks. All patients completed the study without any serious adverse effects and achieved body weight loss and improved glycated hemoglobin levels. Liver fat mass evaluated by proton magnetic resonance spectroscopy was significantly reduced (19.1% vs. 9.2%, p < 0.01), and so were both subcutaneous and visceral fat mass. The body fat/body weight ratio decreased, whereas the skeletal muscle mass/body weight ratio increased. Liver function (aspartate aminotransferase, alanine aminotransferase, and γ-glutamyl transpeptidase) improved significantly. Conclusions Sodium glucose co-transporter 2 inhibitor treatment not only improved glycemic control but also reduced liver fat mass in patients with nonalcoholic fatty liver disease and type 2 diabetes. Body weight loss was primarily attributable to a reduction in fat mass, especially visceral fat. Thus, sodium glucose co-transporter 2 inhibitors could potentially serve as a therapeutic agent for patients with nonalcoholic fatty liver disease and type 2 diabetes.
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Affiliation(s)
- Yoshitaka Arase
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
- Division of Gastroenterology and Hepatology, Tokai University Oiso Hospital, Nakagun, Kanagawa, Japan.
| | - Koichi Shiraishi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
- Division of Gastroenterology and Hepatology, Tokai University Tokyo Hospital, Tokyo, Japan
| | - Kazuya Anzai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
- Division of Gastroenterology and Hepatology, Tokai University Oiso Hospital, Nakagun, Kanagawa, Japan
| | - Hirohiko Sato
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
- Division of Gastroenterology and Hepatology, Tokai University Oiso Hospital, Nakagun, Kanagawa, Japan
| | - Erika Teramura
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
- Division of Gastroenterology and Hepatology, Tokai University Oiso Hospital, Nakagun, Kanagawa, Japan
| | - Kota Tsuruya
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Shunji Hirose
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Ryuzo Deguchi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
- Division of Gastroenterology and Hepatology, Tokai University Oiso Hospital, Nakagun, Kanagawa, Japan
| | - Masao Toyoda
- Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Tetsuya Mine
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Tatehiro Kagawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
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Cespedes Feliciano EM, Chen WY, Bradshaw PT, Prado CM, Alexeeff S, Albers KB, Castillo AL, Caan BJ. Adipose Tissue Distribution and Cardiovascular Disease Risk Among Breast Cancer Survivors. J Clin Oncol 2019; 37:2528-2536. [PMID: 31369302 DOI: 10.1200/jco.19.00286] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Cardiovascular disease (CVD) is a major source of morbidity and mortality among breast cancer survivors. Although body mass index (BMI) is associated with CVD risk, adipose tissue distribution may better identify patients with a high risk of CVD after breast cancer. METHODS Among 2,943 patients with nonmetastatic breast cancer without prior CVD, we used International Classification of Diseases (9th and 10th revisions) codes to identify incidence of nonfatal stroke, myocardial infarction, heart failure, or CVD death. From clinically acquired computed tomography scans obtained near diagnosis, we measured visceral adiposity (centimeters squared), subcutaneous adiposity (centimeters squared), and intramuscular adiposity (fatty infiltration into muscle [Hounsfield Units, scored inversely]). We estimated hazard ratios (HRs) and 95% CIs per SD increase in adiposity accounting for competing risks and adjusting for demographics, smoking, cancer treatment, and pre-existing CVD risk factors. RESULTS Mean (SD) age was 56 (12) years. Over a median follow-up of 6 years, 328 CVD events occurred. Each SD increase in visceral or intramuscular adiposity was associated with an increase in CVD risk (HR, 1.15 [95% CI, 1.03 to 1.29] and HR, 1.21 [95% CI, 1.06 to 1.37]), respectively). Excess visceral and intramuscular adiposity occurred across all BMI categories. Among normal-weight patients, each SD greater visceral adiposity increased CVD risk by 70% (HR, 1.70 [95% CI, 1.10 to 2.62]). CONCLUSION Visceral and intramuscular adiposity were associated with increased CVD incidence after breast cancer diagnosis, independent of pre-existing CVD risk factors and cancer treatments. The increased CVD incidence among normal-weight patients with greater visceral adiposity would go undetected with BMI alone. Measures of adipose tissue distribution may help identify high-risk patients and tailor CVD prevention strategies.
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Affiliation(s)
| | - Wendy Y Chen
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA.,Dana Farber Cancer Institute, Boston, MA
| | | | | | | | | | | | - Bette J Caan
- Kaiser Permanente Northern California, Oakland, CA
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26
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Altered body composition and increased visceral adipose tissue in premenopausal and late postmenopausal patients with SLE. Clin Rheumatol 2019; 38:3117-3127. [PMID: 31363873 DOI: 10.1007/s10067-019-04701-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 07/02/2019] [Accepted: 07/15/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Visceral adipose tissue (VAT) is becoming a recognized cardiovascular (CV) risk factor. This study aimed to evaluate body composition, especially VAT, in systemic lupus erythematosus (SLE) and to explore the association between VAT and SLE disease-related factors. METHOD Ninety-eight inpatients with SLE and 108 age- and body mass index (BMI)-matched healthy controls were included. Demographic and clinical parameters were recorded. The VAT was measured by dual-energy x-ray absorptiometry. RESULT The mean age and disease duration of patients were 46.4 ± 13.0 years and 8.0 ± 7.0 years, respectively. Patients with SLE had higher VAT volume (p = 0.0015) and mass (p = 0.0017) than controls, especially in premenopausal and postmenopausal groups. The subanalysis of subjects with BMI less than 25 kg/m2 indicated that patients had lower lean mass (p = 0.0005), fat-free mass (p = 0.0005), and fat-free mass index (p = 0.0001), but increased adiposity distribution than controls, including VAT volume and mass. However, overweight/obese patients had similar body composition with controls. The VAT volume correlated with BMI, age, menopausal status, hypertension, uric acid, creatinine, non-high-density lipoprotein cholesterol, and triglyceride in both groups. In the patient group, the VAT volume correlated with disease duration, Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR-DI), and low serum complement, but not with SLEDAI and glucocorticoid dose. CONCLUSION This study suggested that SLE patients had some traditional CV risk factors such as altered body composition and increased VAT. The higher VAT in patients with SLE was associated with traditional cardiometabolic risks, which may contribute to CV events in SLE populations. Key Points • Patients with SLE had increased VAT volume and mass than controls. • The VAT volume correlated with traditional cardiometabolic risk factors. • In SLE patient group, the VAT volume correlated with disease duration, SLICC/ACR-DI, and low serum complementC3/C4, but not with SLEDAI and glucocorticoid dose.
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Al-Sofiani ME, Ganji SS, Kalyani RR. Body composition changes in diabetes and aging. J Diabetes Complications 2019; 33:451-459. [PMID: 31003924 PMCID: PMC6690191 DOI: 10.1016/j.jdiacomp.2019.03.007] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 03/19/2019] [Accepted: 03/28/2019] [Indexed: 12/25/2022]
Abstract
Aging is associated with changes in body composition, including both fat gain and muscle loss beginning in middle age, and is associated with increased risk of type 2 diabetes. Moreover, changes in fat distribution take place in adults as they age and may contribute to the increased risk of type 2 diabetes. Recent literature has shown differences in the age-related changes in body composition by diabetes status suggesting that some of these changes might not only be a risk factor of the development of diabetes but could also be a consequence of the disease. In this article, we review the current evidence on body composition changes that take place in adults after the diagnosis of type 2 diabetes and compare them to those observed in adults without diabetes as they age. We also review the effect of various lifestyle, pharmacological, and surgical treatments that lower blood glucose on body composition in adults with type 2 diabetes.
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Affiliation(s)
- Mohammed E Al-Sofiani
- Division of Endocrinology, Diabetes & Metabolism, The Johns Hopkins University, Baltimore, MD, United States of America; Division of Endocrinology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Suneeta S Ganji
- Division of Endocrinology, Diabetes & Metabolism, The Johns Hopkins University, Baltimore, MD, United States of America
| | - Rita R Kalyani
- Division of Endocrinology, Diabetes & Metabolism, The Johns Hopkins University, Baltimore, MD, United States of America.
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Haberka M, Skilton M, Biedroń M, Szóstak-Janiak K, Partyka M, Matla M, Gąsior Z. Obesity, visceral adiposity and carotid atherosclerosis. J Diabetes Complications 2019; 33:302-306. [PMID: 30770289 DOI: 10.1016/j.jdiacomp.2019.01.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/11/2018] [Accepted: 01/12/2019] [Indexed: 12/30/2022]
Abstract
UNLABELLED Carotid artery atherosclerosis is a complex and multifactorial chronic disease. Our aim was to assess the associations between obesity, fat depots and carotid artery stenosis (CAS) in patients with high cardiovascular (CV) risk. METHODS The study group included 391 patients (F/M: 136/255 pts.; age: 61.8 ± 8 years) scheduled for elective coronary angiography. A comprehensive clinical assessment included a carotid artery and abdominal ultrasound involving the following fat depots: (1) carotid extra-media thickness (EMT) indexed to the body mass index (perivascular adipose tissue [PVAT]), and (2) abdominal visceral and subcutaneous fat. RESULTS Patients with a ≥50% stenosis of internal carotid artery (ICA) were older (65.9 ± 7 vs 60.3 ± 7 years, p < 0.0001) and had increased PVAT (836 ± 120 vs 779 ± 127 μm, p < 0.01) compared to individuals with <50% internal carotid artery stenosis. None of the CAS parameters were associated with any measures of obesity. Multivariable regression model showed that age (p < 0.0001), PVAT (p < 0.0001) and smoking (p = 0.04) were independently associated with the severity of ICA stenosis. CONCLUSIONS Our study showed that carotid extra-media thickness, an index measure of PVAT, is associated with CAS severity. It is a strong and independent predictor of significant ICA stenosis. None of the obesity measurements revealed associations with carotid atherosclerosis.
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Affiliation(s)
- Maciej Haberka
- Department of Cardiology, School of Health Sciences, Medical University of Silesia, Katowice, Poland.
| | - Michael Skilton
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Sydney Medical School, University of Sydney, Australia
| | - Małgorzata Biedroń
- Department of Cardiology, School of Health Sciences, Medical University of Silesia, Katowice, Poland
| | - Karolina Szóstak-Janiak
- Department of Cardiology, School of Health Sciences, Medical University of Silesia, Katowice, Poland
| | | | - Monika Matla
- Department of Cardiology, School of Health Sciences, Medical University of Silesia, Katowice, Poland
| | - Zbigniew Gąsior
- Department of Cardiology, School of Health Sciences, Medical University of Silesia, Katowice, Poland
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Lu Y, Hahn JK, Zhang X. 3D Shape-Based Body Composition Inference Model Using a Bayesian Network. IEEE J Biomed Health Inform 2019; 24:205-213. [PMID: 30843854 DOI: 10.1109/jbhi.2019.2903190] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Body composition can be assessed in many different ways. High-end medical equipment, such as Dual-energy X-ray Absorptiometry (DXA), Computed Tomography (CT), and Magnetic Resonance Imaging (MRI) offers high-fidelity pixel/voxel-level assessment, but is prohibitive in cost. In the case of DXA and CT, the approach exposes users to ionizing radiation. Whole-body air displacement plethysmography (BOD POD) can accurately estimate body density, but the assessment is limited to the whole-body fat percentage. Optical three-dimensional (3D) scan and reconstruction techniques, such as using depth cameras, have brought new opportunities for improving body composition assessment by intelligently analyzing body shape features. In this paper, we present a novel supervised inference model to predict pixel-level body composition and percentage of body fat using 3D geometry features and body density. First, we use body density to model a fat distribution base prediction. Then, we use a Bayesian network to infer the probability of the base prediction bias with 3D geometry features. Finally, we correct the bias using non-parametric regression. We use DXA assessment as the ground truth in model training and validation. We compare our method, in terms of pixel-level body composition assessment, with the current state-of-the-art prediction models. Our method outperforms those prediction models by 52.69% on average. We also compare our method, in terms of whole-body fat percentage assessment, with the medical-level equipment-BOD POD. Our method outperforms the BOD POD by 23.28%.
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Mizuno N, Seko Y, Kataoka S, Okuda K, Furuta M, Takemura M, Taketani H, Hara T, Umemura A, Nishikawa T, Yamaguchi K, Moriguchi M, Itoh Y. Increase in the skeletal muscle mass to body fat mass ratio predicts the decline in transaminase in patients with nonalcoholic fatty liver disease. J Gastroenterol 2019; 54:160-170. [PMID: 29948305 DOI: 10.1007/s00535-018-1485-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 06/11/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND The aim of this retrospective study was to determine the effect of skeletal muscle and body fat on liver function in patients with nonalcoholic fatty liver disease (NAFLD) diagnosed by liver biopsy. METHODS Among the 219 patients with NAFLD enrolled in this study was a cohort of 139 patients who had their body composition measured with Inbody720 at baseline and at ≥ 1 year postbaseline, to elucidate the relationship between liver function and changes in skeletal muscle and body fat mass. Multivariate analysis was used to identify factors influencing low skeletal muscle mass index (SMI, defined as 7 kg/m2 in men, and 5.7 kg/m2 in women) and the skeletal muscle mass to body fat mass ratio (SF ratio). RESULTS Of the 219 patients enrolled, 27 (12.3%) had a low SMI. Patient age (> 70 years) and female gender were identified as risk factors for low SMI. Hepatic fibrosis was not associated with SMI. In the cohort followed up at baseline and 12 months later, transaminase activity, body fat mass, and SMI significantly decreased over time. Changes in the SF ratio were significantly associated with changes in liver function. An increase in the SF ratio [hazard ratio (HR) 10.99 in men, 6.849 in women] was a predictor of reduced ALT, independent of age and other backgrounds. CONCLUSIONS In the patients with NAFLD, SMI was decreased, even in the early stages of NAFLD. Therapeutic strategies for NAFLD require a reduction in body fat mass and the maintenance of skeletal muscle is also needed.
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Affiliation(s)
- Naoki Mizuno
- Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yuya Seko
- Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
| | - Seita Kataoka
- Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Keiichiroh Okuda
- Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Mitsuhiro Furuta
- Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Masashi Takemura
- Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Hiroyoshi Taketani
- Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Tasuku Hara
- Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Atsushi Umemura
- Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Taichiro Nishikawa
- Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Kanji Yamaguchi
- Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Michihisa Moriguchi
- Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yoshito Itoh
- Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
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Panagiotou M, Deboer T. Chronic high-caloric diet accentuates age-induced sleep alterations in mice. Behav Brain Res 2019; 362:131-139. [PMID: 30639608 DOI: 10.1016/j.bbr.2019.01.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 11/15/2022]
Abstract
Obesity and sleep disturbances comprise major health problems which are likely interrelated. Diet-induced obesity in young mice has been demonstrated to lead towards an altered sleep homeostasis. In the current study, we investigated the effect of chronic (12 weeks) high-caloric diet (HCD, 45% fat) consumption on sleep and the sleep electroencephalogram (EEG) in young and older mice (6-month-old, n = 9; 18-month-old, n = 8 and 24-month-old, n = 4) and compared with age-matched controls on normal chow (n = 11, n = 9 and n = 9 respectively). Half of the 24-month-old mice did not cope well with HCD, therefore this group has a lower n and limited statistical power. We recorded EEG and the electromyogram for continuous 48-h and performed a 6-h sleep deprivation during the second day. In aged HCD fed mice (18 months old) compared to young, an aging effect was still evident, characterized by decreased waking and increased NREM sleep in the dark period, decreased REM sleep during the light period, as well as increased slow-wave-activity (SWA, EEG power in NREM sleep in 0.5-4.0 Hz). Additionally, aged HCD treated mice showed increased NREM sleep and decreased waking, compared to age-matched controls, denoting an enhanced aging phenotype in the sleep architecture. Notably, an overall increase was found in the slow component of SWA (0.5-2.5 Hz) in aged HCD fed mice compared to age-matched controls. Our data suggest that the effect of aging is the dominant variable irrespective of diet. However, a synergistic effect of aging and diet is noted indicating that chronic HCD consumption exacerbates age-associated sleep alterations.
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Affiliation(s)
- M Panagiotou
- Laboratory for Neurophysiology, Department of Cell and Chemical Biology, Leiden University Medical Centre, Leiden, the Netherlands
| | - T Deboer
- Laboratory for Neurophysiology, Department of Cell and Chemical Biology, Leiden University Medical Centre, Leiden, the Netherlands.
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Wander PL, Hayashi T, Sato KK, Uehara S, Hikita Y, Leonetti DL, Kahn SE, Fujimoto WY, Boyko EJ. Design and validation of a novel estimator of visceral adipose tissue area and comparison to existing adiposity surrogates. J Diabetes Complications 2018; 32:1062-1067. [PMID: 30236542 PMCID: PMC6174110 DOI: 10.1016/j.jdiacomp.2018.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 07/30/2018] [Accepted: 09/06/2018] [Indexed: 10/28/2022]
Abstract
AIMS Visceral adiposity measured by computed tomography (CT) as intra-abdominal fat area (IAFA) predicts metabolic diseases. Existing adiposity surrogates have not been systematically compared to a regression-based model derived in individuals of Japanese ancestry. We developed and validated a method to estimate IAFA in individuals of Japanese ancestry and compared it to existing adiposity surrogates. METHODS We assessed age, BMI, waist circumference (WC), fasting lipids, glucose, smoking status, grip strength, mid-thigh circumference (MTC), humeral length, leg length, and IAFA by single-slice CT at the umbilicus for 622 Japanese Americans. We used stepwise linear regression to predict IAFA and termed the predicted value the Estimate of Visceral Adipose Tissue Area (EVA). For men, the final model included age, BMI, WC, high-density lipoprotein cholesterol (HDLc), glucose, and MTC; for women, age, BMI, WC, HDLc, low-density lipoprotein cholesterol, glucose, and MTC. We compared goodness-of-fit (R2) from linear regression models and mean-squared errors (MSE) from k-fold cross-validation to compare the ability of EVA to estimate IAFA compared to an estimate by Després et al., waist-to-height ratio, WC, deep abdominal adipose tissue index, BMI, lipid accumulation product, and visceral adiposity index (VAI). We classified low/high IAFA using area under receiver-operating characteristic curves (AUROC) for IAFA dichotomized at the 75th percentile. RESULTS EVA gave the least MSE and greatest R2 (men: 1244, 0.61; women: 581, 0.72). VAI gave the greatest MSE and smallest R2 (mean 2888, 0.08; women 1734, 0.14). CONCLUSIONS EVA better predicts IAFA in Japanese-American men and women compared to existing surrogates for adiposity.
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Affiliation(s)
- Pandora L Wander
- Department of Medicine, University of Washington, Seattle, WA, United States of America; Veterans Affairs Puget Sound Health Care System, Seattle, WA, United States of America.
| | - Tomoshige Hayashi
- Department of Medicine, University of Washington, Seattle, WA, United States of America; Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kyoko Kogawa Sato
- Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Shinichiro Uehara
- Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan
| | | | - Donna L Leonetti
- Department of Anthropology, University of Washington, Seattle, WA, United States of America
| | - Steven E Kahn
- Department of Medicine, University of Washington, Seattle, WA, United States of America; Veterans Affairs Puget Sound Health Care System, Seattle, WA, United States of America
| | - Wilfred Y Fujimoto
- Department of Medicine, University of Washington, Seattle, WA, United States of America
| | - Edward J Boyko
- Department of Medicine, University of Washington, Seattle, WA, United States of America; Veterans Affairs Puget Sound Health Care System, Seattle, WA, United States of America
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Kabakambira JD, Baker RL, Briker SM, Courville AB, Mabundo LS, DuBose CW, Chung ST, Eckel RH, Sumner AE. Do current guidelines for waist circumference apply to black Africans? Prediction of insulin resistance by waist circumference among Africans living in America. BMJ Glob Health 2018; 3:e001057. [PMID: 30364383 PMCID: PMC6195140 DOI: 10.1136/bmjgh-2018-001057] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/19/2018] [Accepted: 08/20/2018] [Indexed: 02/06/2023] Open
Abstract
Background To lower the risk of diabetes and heart disease in Africa, identification of African-centred thresholds for inexpensive biomarkers of insulin resistance (IR) is essential. The waist circumference (WC) thresholds that predicts IR in African men and women have not been established, but investigations recently conducted in Africa using indirect measures of IR suggest IR is predicted by WC of 80–95 cm in men and 90–99 cm in women. These WC cannot be used for guidelines until validated by direct measurements of IR and visceral adipose tissue (VAT). Therefore, we determined in a group of African-born black people living in America (A) the WC, which predicts IR and (B) the influence of abdominal fat distribution on IR. Methods The 375 participants (age 38±10 years (mean±SD), 67% men) had IR determined by HOMA-IR and Matsuda index. VAT and subcutaneous adipose tissue (SAT) were measured by abdominal CT scans. Optimal WC for the prediction of IR was determined in sex-specific analyses by area under the receiver operating characteristic (AUC-ROC) and Youden index. Results Women had more SAT (203±114 vs 128±74 cm2) and less VAT than men (63±48 vs 117±72 cm2, p<0.001). Optimal WC for prediction of IR in men and women were: 91 cm (AUC-ROC: 0.80±0.03 (mean±SE)) and 96 cm (AUC-ROC: 0.81±0.08), respectively. Regression analyses revealed a significant sex–VAT interaction (p<0.001). Therefore, for every unit increase in VAT, women had a 0.94 higher unit increase in SAT and 0.07 higher unit increase in WC than men. Conclusion Working with a group of African-born black people living in America, we accessed technology, which validated observations made in Africa. Higher SAT at every level of VAT explained why the WC that predicted IR was higher in women (96 cm) than men (91 cm). For Africans to benefit from WC measurements, convening a panel of experts to develop evidence-based African-centred WC guidelines may be the way forward.
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Affiliation(s)
- J Damascene Kabakambira
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, Bethesda, Maryland, USA.,National Institute of Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Rafeal L Baker
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Sara M Briker
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Amber B Courville
- Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Lilian S Mabundo
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Christopher W DuBose
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Stephanie T Chung
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Robert H Eckel
- University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Anne E Sumner
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, Bethesda, Maryland, USA.,National Institute of Minority Health and Health Disparities, Bethesda, Maryland, USA
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Kinoshita M, Yokote K, Arai H, Iida M, Ishigaki Y, Ishibashi S, Umemoto S, Egusa G, Ohmura H, Okamura T, Kihara S, Koba S, Saito I, Shoji T, Daida H, Tsukamoto K, Deguchi J, Dohi S, Dobashi K, Hamaguchi H, Hara M, Hiro T, Biro S, Fujioka Y, Maruyama C, Miyamoto Y, Murakami Y, Yokode M, Yoshida H, Rakugi H, Wakatsuki A, Yamashita S. Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2017. J Atheroscler Thromb 2018; 25:846-984. [PMID: 30135334 PMCID: PMC6143773 DOI: 10.5551/jat.gl2017] [Citation(s) in RCA: 488] [Impact Index Per Article: 81.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 06/11/2018] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Koutaro Yokote
- Department of Diabetes, Metabolism and Endocrinology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Mami Iida
- Department of Internal Medicine and Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Yasushi Ishigaki
- Division of Diabetes and Metabolism, Department of Internal Medicine, Iwate Medical University, Iwate, Japan
| | - Shun Ishibashi
- Division of Endocrinology and Metabolism, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Seiji Umemoto
- Center for Integrated Medical Research, Hiroshima University Hospital, Hiroshima, Japan
| | | | - Hirotoshi Ohmura
- Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan
| | - Tomonori Okamura
- Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Shinji Kihara
- Biomedical Informatics, Osaka University, Osaka, Japan
| | - Shinji Koba
- Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Isao Saito
- Department of Community Health Systems Nursing, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Tetsuo Shoji
- Department of Vascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan
| | - Kazuhisa Tsukamoto
- Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Juno Deguchi
- Department of Vascular Surgery, Saitama Medical Center, Saitama, Japan
| | - Seitaro Dohi
- Chief Health Management Department, Mitsui Chemicals Inc., Tokyo, Japan
| | - Kazushige Dobashi
- Department of Pediatrics, Showa University School of Medicine, Tokyo, Japan
| | | | - Masumi Hara
- Department of Internal Medicine, Mizonokuchi Hospital, Teikyo University School of Medicine, Kanagawa, Japan
| | - Takafumi Hiro
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | | | - Yoshio Fujioka
- Faculty of Nutrition, Division of Clinical Nutrition, Kobe Gakuin University, Hyogo, Japan
| | - Chizuko Maruyama
- Department of Food and Nutrition, Faculty of Human Sciences and Design, Japan Women's University, Tokyo, Japan
| | - Yoshihiro Miyamoto
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | | | - Masayuki Yokode
- Department of Clinical Innovative Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroshi Yoshida
- Department of Laboratory Medicine, Jikei University Kashiwa Hospital, Chiba, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Akihiko Wakatsuki
- Department of Obstetrics and Gynecology, Aichi Medical University, Aichi, Japan
| | - Shizuya Yamashita
- Department of Community Medicine, Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Rinku General Medical Center, Osaka, Japan
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Ren Y, Liu Y, Sun X, Wang B, Zhao Y, Luo X, Wang C, Li L, Zhang L, Zhou J, Han C, Liu X, Zhang D, Zhao J, Zhang M, Hu D. Cohort study to determine the waist circumference cutoffs for predicting type 2 diabetes mellitus in rural China. Diabetes Metab Res Rev 2018; 34:e3007. [PMID: 29633484 DOI: 10.1002/dmrr.3007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 12/07/2017] [Accepted: 03/26/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Limited information is available on the cutoffs of waist circumference (WC) for predicting type 2 diabetes mellitus (T2DM). We aimed to define the optimal WC cutoffs for predicting T2DM among rural Chinese people. METHODS A cohort of 11 968 participants (732 new-onset T2DM) from a rural area in China with age 18 to 87 years was established at baseline during July to August of 2007 and 2008 and followed up during July to August of 2013 and 2014. Scatterplot, X-tile plot, and receiver operating characteristic (ROC) curve analyses were used to determine WC cutoffs for predicting T2DM. RESULTS The WC cutoffs for males and females were 84 and 86 cm (scatterplot), 83 and 88 cm (X-tile plot), and 87 and 88 cm (ROC curve). According to the highest risk score, the optimal WC cutoffs were 87 cm for males and 88 cm for females. With the optimal WC cutoffs, the sensitivity, specificity, positive likelihood ratio, area under the ROC curve, and population-attributable risk proportions were 67.9%, 67.0%, 2.06%, 0.70%, and 46%, respectively, for males and 52.5%, 75.0%, 2.10%, 0.69%, and 34%, respectively, for females; the corresponding adjusted hazard ratio for WC predicting T2DM was 3.66 (95% confidence interval 2.80-4.78) for males and 2.55 (2.08-3.12) for females. CONCLUSIONS The optimal WC cutoffs for predicting T2DM were similar between males and females. As well, the criteria of WC for central obesity are no longer practical for predicting T2DM.
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Affiliation(s)
- Yongcheng Ren
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yu Liu
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Xizhuo Sun
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Bingyuan Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Xinping Luo
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Chongjian Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Linlin Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Lu Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Junmei Zhou
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Chengyi Han
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xuejiao Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Dongdong Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Jingzhi Zhao
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, Henan, People's Republic of China
| | - Ming Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
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Piché ME, Vasan SK, Hodson L, Karpe F. Relevance of human fat distribution on lipid and lipoprotein metabolism and cardiovascular disease risk. Curr Opin Lipidol 2018; 29:285-292. [PMID: 29994839 DOI: 10.1097/mol.0000000000000522] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE OF REVIEW Upper body abdominal and lower body gluteofemoral fat depot masses display opposing associations with plasma lipid and lipoprotein and cardiovascular disease (CVD) risk profiles. We review developments on adipose tissue fatty acid metabolism in the context of body fat distribution and how that might be related to adverse lipid and lipoprotein profiles and CVD risk. RECENT FINDINGS Recent data have confirmed the paradoxical relationship of upper abdominal and lower body gluteofemoral adiposity and CVD risk. Mechanistically, this is likely to reflect the different ways fat depots handle lipid storage and release, which impacts directly and indirectly on lipid and lipoprotein metabolism. The upper body enhances immediate fat storage pathway with rapid uptake of dietary-derived fatty acids, whereas the lower body fat depot has a reduced lipid turnover accommodating a slower fat redistribution. Body fat distribution and the fat depots' ability to undergo appropriate expansion when fat storage is required, rather than overall body fatness, appear as the important determinant of metabolic health. SUMMARY A focus on fat distribution in overweight people, preferably using precise imaging methods, rather than quantifying total body fatness, is likely to provide the medical community with better tools to stratify and treat patients with obesity-related complications.
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Affiliation(s)
- Marie-Eve Piché
- Quebec Heart and Lung Institute, Laval University, Canada
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital
| | - Senthil K Vasan
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital
| | - Leanne Hodson
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital
| | - Fredrik Karpe
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital
- NIHR Oxford Biomedical Centre, Oxford University Hospital Trust and University of Oxford, Oxford, UK
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Yoshida T, Hashimoto M, Kawahara R, Yamamoto H, Tanaka M, Ito H, Masuda I, Hosoda K, Yamamoto W, Uozumi R, Morita S, Fujii Y, Mimori T, Nin K. Non-obese visceral adiposity is associated with the risk of atherosclerosis in Japanese patients with rheumatoid arthritis: a cross-sectional study. Rheumatol Int 2018; 38:1679-1689. [PMID: 29974186 PMCID: PMC6105136 DOI: 10.1007/s00296-018-4095-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 06/25/2018] [Indexed: 12/11/2022]
Abstract
Rheumatoid arthritis (RA) patients often have altered body composition including reduced muscle mass and increased fat mass. Some RA patients are likely to increase visceral fat without obesity [Body Mass Index (BMI) ≥ 25]. The objective of the study was to determine the association between obesity and/or visceral adiposity and the risk for atherosclerosis in Japanese RA patients. Obesity was evaluated using the BMI, with visceral adiposity evaluated using the visceral fat area (VFA) and the visceral/subcutaneous fat ratio (V/S ratio), quantified using the dual bioelectrical impedance method. Atherosclerosis was evaluated based on the intima–media thickness (IMT) and Plaque score (PS) of the carotid artery, measured using ultrasonography. Multivariate analysis was performed to determine the factors associated with IMT and PS. IMT and PS were compared among groups of patients sub-classified according to BMI and VFA levels. The V/S ratio was higher in RA patients than healthy controls, after adjustment for age, BMI, and waist circumference. On multivariate analysis, the V/S ratio, but not the BMI, was independently associated with the IMT and PS. Among the sub-classifications for BMI and VFA, non-obese patients with a high visceral adiposity (18.5 ≤ BMI < 25 kg/m2 and VFA ≥ 100 cm2) had the highest IMT (mean IMT, 0.93 ± 0.29 mm; maximum IMT, 1.44 ± 0.71 mm) and PS (1.43 ± 0.61), compared to all other BMI and VFA subgroups. RA patients have increased visceral adiposity, which is associated with a high prevalence of atherosclerotic of plaques. Non-obese RA patients who have visceral adiposity have a specifically higher risk for atherosclerosis.
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Affiliation(s)
- Tamami Yoshida
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Motomu Hashimoto
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Rie Kawahara
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroko Yamamoto
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masao Tanaka
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiromu Ito
- Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Izuru Masuda
- Medical Examination Center, Takeda Hospital, Kyoto, Japan
| | - Kiminori Hosoda
- Department of Lifestyle-Related Disease, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Wataru Yamamoto
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryuji Uozumi
- Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine Kyoto University, Kyoto, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine Kyoto University, Kyoto, Japan
| | - Yasutomo Fujii
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tsuneyo Mimori
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazuko Nin
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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Piché ME, Poirier P, Lemieux I, Després JP. Overview of Epidemiology and Contribution of Obesity and Body Fat Distribution to Cardiovascular Disease: An Update. Prog Cardiovasc Dis 2018; 61:103-113. [PMID: 29964067 DOI: 10.1016/j.pcad.2018.06.004] [Citation(s) in RCA: 278] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 06/21/2018] [Indexed: 01/14/2023]
Abstract
Obesity is recognized as a heterogeneous condition in which individuals with similar body mass index may have distinct metabolic and cardiovascular risk profiles. Susceptibility to obesity-related cardiometabolic complications is not solely mediated by overall body fat mass, but is largely dependent upon individual differences in regional body fat distribution and ability of subcutaneous adipose tissue to expand. The present review will discuss to what extent the individual variation in body fat distribution is one of the clinical key variables explaining the metabolic heterogeneity of obesity and its related cardiovascular risk. We will present the evidence for the complex nature of the relationship between obesity and cardiovascular disease, outline our current understanding of the mechanisms involved, and identify future direction of research pertinent to this interaction.
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Affiliation(s)
- Marie-Eve Piché
- Quebec Heart and Lung Institute, Québec, Canada; Faculty of Medicine, Université Laval, Québec, Canada.
| | - Paul Poirier
- Quebec Heart and Lung Institute, Québec, Canada; Faculty of Pharmacy, Université Laval, Québec, Canada
| | | | - Jean-Pierre Després
- Quebec Heart and Lung Institute, Québec, Canada; Faculty of Medicine, Université Laval, Québec, Canada
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Chen P, Hou X, Hu G, Wei L, Jiao L, Wang H, Chen S, Wu J, Bao Y, Jia W. Abdominal subcutaneous adipose tissue: a favorable adipose depot for diabetes? Cardiovasc Diabetol 2018; 17:93. [PMID: 29945626 PMCID: PMC6020307 DOI: 10.1186/s12933-018-0734-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 06/18/2018] [Indexed: 02/07/2023] Open
Abstract
Background Previous studies have documented that visceral adipose tissue is positively associated with the risk of diabetes. However, the association of subcutaneous adipose tissue with diabetes risk is still in dispute. We aimed to assess the associations between different adipose distributions and the risk of newly diagnosed diabetes in Chinese adults. Methods The Shanghai Nicheng Cohort Study was conducted among Chinese adults aged 45–70 years. The baseline data of 12,137 participants were analyzed. Subcutaneous and visceral fat area (SFA and VFA) were measured by magnetic resonance imaging. Diabetes was newly diagnosed using a 75 g oral glucose tolerance test. Results The multivariable-adjusted odds ratios (OR) and 95% confidence intervals (CI) of newly diagnosed diabetes per 1—standard deviation increase in SFA and VFA were 1.29 (1.19–1.39) and 1.61 (1.49–1.74) in men, and 1.10 (1.03–1.18) and 1.56 (1.45–1.67) in women, respectively. However, the association between SFA and newly diagnosed diabetes disappeared in men and was reversed in women (OR 0.86 [95% CI, 0.78–0.94]) after additional adjustment for body mass index (BMI) and VFA. The positive association between VFA and newly diagnosed diabetes remained significant in both sexes after further adjustment for BMI and SFA. Areas under the receiver operating characteristic curve of newly diagnosed diabetes predicted by VFA (0.679 [95% CI, 0.659–0.699] for men and 0.707 [95% CI, 0.690–0.723] for women) were significantly larger than by the other adiposity indicators. Conclusions SFA was beneficial for lower risk of newly diagnosed diabetes in women but was not associated with newly diagnosed diabetes in men after taking general obesity and visceral obesity into account. VFA, however, was associated with likelihood of newly diagnosed diabetes in both Chinese men and women. Electronic supplementary material The online version of this article (10.1186/s12933-018-0734-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Peizhu Chen
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.,Shanghai Diabetes Institute, Shanghai, China.,Shanghai Clinical Center for Diabetes, Shanghai, China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Xuhong Hou
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.,Shanghai Diabetes Institute, Shanghai, China.,Shanghai Clinical Center for Diabetes, Shanghai, China.,Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Gang Hu
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Li Wei
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.,Shanghai Diabetes Institute, Shanghai, China.,Shanghai Clinical Center for Diabetes, Shanghai, China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Lei Jiao
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Hongmei Wang
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Siyu Chen
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.,Shanghai Diabetes Institute, Shanghai, China.,Shanghai Clinical Center for Diabetes, Shanghai, China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Jingzhu Wu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.,Shanghai Diabetes Institute, Shanghai, China.,Shanghai Clinical Center for Diabetes, Shanghai, China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.,Shanghai Diabetes Institute, Shanghai, China.,Shanghai Clinical Center for Diabetes, Shanghai, China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Weiping Jia
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China. .,Shanghai Diabetes Institute, Shanghai, China. .,Shanghai Clinical Center for Diabetes, Shanghai, China. .,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
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Lee JJ, Pedley A, Hoffmann U, Massaro JM, Levy D, Long MT. Visceral and Intrahepatic Fat Are Associated with Cardiometabolic Risk Factors Above Other Ectopic Fat Depots: The Framingham Heart Study. Am J Med 2018; 131. [PMID: 29518370 PMCID: PMC5964004 DOI: 10.1016/j.amjmed.2018.02.002] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND We examined the associations among 8 different fat depots accumulated in various anatomic regions and the relationship between these fat depots and multiple cardiometabolic risk factors. METHODS Participants were from the Framingham Heart Study Offspring and Third Generation who also participated in the multidetector computed tomography substudy in 2002-2005. Exposures were multidetector computed tomography-derived fat depots, including abdominal subcutaneous adipose tissue, abdominal visceral adipose tissue, intramuscular fat, intrathoracic fat, pericardial fat, thoracic periaortic fat, intrahepatic fat, and renal sinus fat. Multivariable-adjusted regression analyses with a forward selection procedure were performed to identify the most predictive fat depots. RESULTS Of 2529 participants, 51.9% were women (mean age, 51.1 years). Visceral adipose tissue had the strongest correlations with each of the other fat measures (range, 0.26-0.77) and with various cardiometabolic risk factors (range, -0.34 to 0.39). As determined by the selection models, visceral adipose tissue was the only fat depot that was associated with all cardiometabolic risk factors evaluated in this study (all P<.05). Selection models also showed that subcutaneous adipose tissue and intrahepatic fat were associated with cardiometabolic risk factors related to the traits of dysglycemia, dyslipidemia, and hypertension (all P<.05). However, only associations with visceral adipose tissue and intrahepatic fat persisted after further adjustment for body mass index and waist circumference. CONCLUSIONS Visceral adipose tissue and intrahepatic fat were consistent correlates of cardiometabolic risk factors, above and beyond standard anthropometric indices. Our data provide important insights for understanding the associations between variations in fat distribution and cardiometabolic abnormalities.
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Affiliation(s)
- Jane J Lee
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, Md; Framingham Heart Study, Framingham, Mass
| | - Alison Pedley
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, Md; Framingham Heart Study, Framingham, Mass
| | - Udo Hoffmann
- Department of Radiology, Massachusetts General Hospital, Boston, Mass
| | | | - Daniel Levy
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, Md; Framingham Heart Study, Framingham, Mass; Boston University School of Medicine, Boston, Mass
| | - Michelle T Long
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, Md; Framingham Heart Study, Framingham, Mass; Department of Medicine, Division of Gastroenterology, Boston University School of Medicine, Boston, Mass.
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Shakiba M, Mansournia MA, Salari A, Soori H, Mansournia N, Kaufman JS. Accounting for Time-Varying Confounding in the Relationship Between Obesity and Coronary Heart Disease: Analysis With G-Estimation: The ARIC Study. Am J Epidemiol 2018; 187:1319-1326. [PMID: 29155924 DOI: 10.1093/aje/kwx360] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 11/13/2017] [Indexed: 12/23/2022] Open
Abstract
In longitudinal studies, standard analysis may yield biased estimates of exposure effect in the presence of time-varying confounders that are also intermediate variables. We aimed to quantify the relationship between obesity and coronary heart disease (CHD) by appropriately adjusting for time-varying confounders. This study was performed in a subset of participants from the Atherosclerosis Risk in Communities (ARIC) Study (1987-2010), a US study designed to investigate risk factors for atherosclerosis. General obesity was defined as body mass index (weight (kg)/height (m)2) ≥30, and abdominal obesity (AOB) was defined according to either waist circumference (≥102 cm in men and ≥88 cm in women) or waist:hip ratio (≥0.9 in men and ≥0.85 in women). The association of obesity with CHD was estimated by G-estimation and compared with results from accelerated failure-time models using 3 specifications. The first model, which adjusted for baseline covariates, excluding metabolic mediators of obesity, showed increased risk of CHD for all obesity measures. Further adjustment for metabolic mediators in the second model and time-varying variables in the third model produced negligible changes in the hazard ratios. The hazard ratios estimated by G-estimation were 1.15 (95% confidence interval (CI): 0.83, 1.47) for general obesity, 1.65 (95% CI: 1.35, 1.92) for AOB based on waist circumference, and 1.38 (95% CI: 1.13, 1.99) for AOB based on waist:hip ratio, suggesting that AOB increased the risk of CHD. The G-estimated hazard ratios for both measures were further from the null than those derived from standard models.
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Affiliation(s)
- Maryam Shakiba
- Cardiovascular Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
- School of Health, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Arsalan Salari
- Cardiovascular Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Hamid Soori
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Mansournia
- Department of Endocrinology, AJA University of Medical Sciences, Tehran, Iran
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
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Ei Ei Khaing N, Shyong TE, Lee J, Soekojo CY, Ng A, Van Dam RM. Epicardial and visceral adipose tissue in relation to subclinical atherosclerosis in a Chinese population. PLoS One 2018; 13:e0196328. [PMID: 29694442 PMCID: PMC5919010 DOI: 10.1371/journal.pone.0196328] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 04/11/2018] [Indexed: 01/24/2023] Open
Abstract
Background Body fatness is associated with risk of coronary heart disease and it has been postulated that epicardial adipose tissue (EAT) may have a particularly detrimental effect because of its localized toxic effects. We therefore aimed to examine the association between EAT and coronary artery calcification and compared this with associations for visceral adipose tissue (VAT) and other regional fat depots. Methods We conducted a cross-sectional study of 487 Chinese participants aged 50 years old and above, living in Singapore. Participants, free from known diabetes mellitus and coronary heart diseases, completed interviews, a health screening to evaluate obesity and cardiovascular disease risk factors, and computed tomography scans of the abdomen and coronary arteries. Associations between regional fat depots and subclinical atherosclerosis defined as CAC> = 100 were determined by multiple logistic regression analysis. Results Epicardial adipose tissue (EAT) was highly correlated with visceral adipose tissue (VAT) (Pearson r = 0.72) and trunk fat mass (r = 0.66). The age and sex-adjusted odd ratio (OR) (in 1-SD increase) of subclinical atherosclerosis was 1.28 (1.01–1.61) for EAT and 1.40 (1.04–1.88) for VAT. These associations were weaker and non-significant after adjusting for markers of dyslipidemia and hyperglycemia. Total body fat, subcutaneous abdominal fat, and leg, arm and trunk fat mass were not significantly associated with atherosclerosis. Conclusion VAT and EAT showed similar associations with coronary artery calcification and the associations could be mediated by traditional risk factors in this ethnic Chinese population.
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Affiliation(s)
- Nang Ei Ei Khaing
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
- * E-mail:
| | - Tai E. Shyong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
- Department of Medicine, National University Health System, Singapore, Republic of Singapore
| | - Jeannette Lee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
| | - Cinnie Yentia Soekojo
- Department of Medicine, National University Health System, Singapore, Republic of Singapore
| | - Alvin Ng
- Mount Elizabeth Medical Centre, Singapore, Republic of Singapore
- Department of Endocrinology, Singapore General Hospital, Singapore, Republic of Singapore
| | - Rob M. Van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
- Department of Medicine, National University Health System, Singapore, Republic of Singapore
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
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Wahab N, Chen R, Curb JD, Willcox BJ, Rodriguez BL. The Association of Fasting Glucose, Insulin, and C-Peptide, with 19-Year Incidence of Coronary Heart Disease in Older Japanese-American Men; the Honolulu Heart Program. Geriatrics (Basel) 2018; 3. [PMID: 30555835 PMCID: PMC6290673 DOI: 10.3390/geriatrics3020022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The role of fasting glucose, insulin levels, and C-peptide in coronary heart disease (CHD) in non-diabetic individuals remains uncertain. We examined the association between fasting glucose, insulin and C-peptide with the long-term incidence of CHD in Japanese-American men. In 1980–1982, from a random sample of the Honolulu Heart Program men (n = 1378), aged 61–81 years, data on several CHD and metabolic risk factors were obtained to examine the relation of fasting glucose, insulin and C-peptide to 19-year CHD incidence. Age-adjusted incidence of CHD increased with increasing quintiles of glucose, insulin and C-peptide. Age-adjusted CHD rates in the glucose quintiles were 11.9, 11.6, 14.4, 18.1 and 24.1 per 1000 person-years (trend p < 0.001). In individual Cox models (lowest quintiles of glucose, insulin and C-peptide as reference) the relative risks (95% confidence interval) of CHD incidence for the glucose quintiles adjusting for age, smoking, hypertension, cholesterol, physical activity, and body mass index, were 0.9 (0.6–1.4), 1.2 (0.8–1.8), 1.4 (0.9–2.2), and 1.7 (1.1–2.6), respectively (trend p = 0.004). Insulin and C-peptide were not significantly associated with CHD on multivariate analysis. Fasting glucose remained the only significant predictor of increased CHD risk (p = 0.003) in a model combining all 3 metabolic variables. In this cohort, only fasting glucose independently predicts long-term incidence of CHD. Age-adjusted insulin and C-peptide levels were associated with CHD incidence, but after adjustment for other risk factors, do not independently predict CHD.
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Affiliation(s)
- Nazneem Wahab
- CK Hui Heart Centre, Division of Cardiology, Royal Alexandra Hospital, University of Alberta, Rm 6S132A Robbins Pavillion, 10240 Kingsway Avenue, Edmonton, AB T5H 3V9, Canada
- Correspondence: ; Tel.: +1-780-428-3246
| | - Randi Chen
- Department of Research, Kuakini Medical Center, 347 N. Kuakini St, Honolulu, Hawaii, 96817, USA; (R.C.); (B.J.W.)
| | - Jess David Curb
- Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Hale Pulama Mau, 9th Floor, 347 N. Kuakini St, Honolulu, Hawaii, 96817, USA;
- Escuela deMedicina, Tecnologico deMonterrey, AvenidaMorones Prieto 3000, Monterrey, NL, 64710, Mexico
| | - Bradley J. Willcox
- CK Hui Heart Centre, Division of Cardiology, Royal Alexandra Hospital, University of Alberta, Rm 6S132A Robbins Pavillion, 10240 Kingsway Avenue, Edmonton, AB T5H 3V9, Canada
- Escuela deMedicina, Tecnologico deMonterrey, AvenidaMorones Prieto 3000, Monterrey, NL, 64710, Mexico
| | - Beatriz L. Rodriguez
- Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Hale Pulama Mau, 9th Floor, 347 N. Kuakini St, Honolulu, Hawaii, 96817, USA;
- Escuela deMedicina, Tecnologico deMonterrey, AvenidaMorones Prieto 3000, Monterrey, NL, 64710, Mexico
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Loh WJ, Johnston DG, Oliver N, Godsland IF. Skinfold thickness measurements and mortality in white males during 27.7 years of follow-up. Int J Obes (Lond) 2018; 42:1939-1945. [PMID: 29491491 DOI: 10.1038/s41366-018-0034-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 12/23/2017] [Accepted: 01/03/2018] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Obesity is a major risk factor for mortality from a range of causes. We investigated whether skinfold measurements were associated with mortality independently of variation in body mass index (BMI). METHODS A prospective analysis of mortality in 870 apparently healthy adult Caucasian men participating in an occupational health cohort was undertaken. At baseline, skinfold measurements were taken at biceps, triceps, iliac and subscapular sites. Derived measurements included the sum of all four skinfolds and subscapular to triceps, subscapular to iliac and BMI to iliac ratios. All-cause mortality was analysed by Cox proportional hazards modelling and death in specific mortality subcategories by competing risks analysis. RESULTS During a mean of 27.7 years follow up, there were 303 deaths (119 cancer, 101 arteriovascular, 40 infection, 43 other). In univariable analysis, BMI was associated with all-cause, cancer, arteriovascular and other mortality and subscapular skinfold with all-cause and arteriovascular mortality. On bivariable analysis, with inclusion of BMI, subscapular skinfold ceased to be a associated with mortality but iliac skinfold emerged as strongly, negatively associated with all-cause and arteriovascular mortality. In multivariable analysis, with inclusion of age, BMI, smoking, alcohol and exercise, iliac skinfold was negatively associated with all-cause (Hazard ratio HR 0.77, 95% confidence interval CI 0.66-0.90, p = 0.002), arteriovascular (HR 0.75, 95%CI 0.58,0.97, p = 0.02) and infection (HR 0.63, 95%CI 0.42,0.94, p = 0.02) death. Among obese participants (BMI ≥ 30 kg/m2), iliac skinfold of ≤9.7 mm was associated with a six-fold increase in all-cause mortality risk. CONCLUSION Low iliac skinfold thickness is an independent risk factor for all-cause mortality in adult white males with risk apparently concentrated among people who are obese.
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Affiliation(s)
- Wann Jia Loh
- Diabetes Endocrinology and Metabolic Medicine, Faculty of Medicine, Imperial College London, St. Mary's Campus, London, UK. .,Department of Endocrinology, Changi General Hospital, Singapore, Singapore.
| | - Desmond G Johnston
- Diabetes Endocrinology and Metabolic Medicine, Faculty of Medicine, Imperial College London, St. Mary's Campus, London, UK
| | - Nick Oliver
- Diabetes Endocrinology and Metabolic Medicine, Faculty of Medicine, Imperial College London, St. Mary's Campus, London, UK
| | - Ian F Godsland
- Diabetes Endocrinology and Metabolic Medicine, Faculty of Medicine, Imperial College London, St. Mary's Campus, London, UK
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Mongraw-Chaffin M, Gujral UP, Kanaya AM, Kandula NR, Carr JJ, Anderson CA. Relation of Ectopic Fat with Atherosclerotic Cardiovascular Disease Risk Score in South Asians Living in the United States (from the Mediators of Atherosclerosis in South Asians Living in America [MASALA] Study). Am J Cardiol 2018; 121:315-321. [PMID: 29241969 DOI: 10.1016/j.amjcard.2017.10.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/11/2017] [Accepted: 10/13/2017] [Indexed: 12/14/2022]
Abstract
Few studies have investigated the association between ectopic fat from different depots and cardiovascular risk scores and their components in the same population, and none have investigated these relations in South Asians. In a cross-sectional analysis of 796 participants in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study who had measurements of visceral, subcutaneous, pericardial, hepatic, and intermuscular fat from abdominal and cardiac computed tomography scans, we used linear regression to determine the associations of 1 standard deviation difference in each ectopic fat depot with pooled cohort risk score and its components. Pericardial and visceral fat were more strongly associated with the pooled cohort risk score (3.1%, 95% confidence interval [CI] 2.5 to 3.7, and 2.7%, 95% CI 2.1 to 3.3, respectively) and components than intermuscular fat (2.3%, 95% CI 1.7 to 3.0); subcutaneous fat was inversely associated with the pooled cohort risk score (-2.6%, 95% CI -3.2 to 1.9) and hepatic fat attenuation was not linearly associated with the pooled cohort risk score when mutually adjusted (-0.3%, 95% CI -0.9 to 0.4). Associations for risk factor components differed by fat depot. In conclusion, subcutaneous and hepatic fat may have different functions than fat stored in other depots in South Asians. Determining whether these relations are heterogeneous by race may help elucidate the mechanisms underlying CVD disparities.
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Han SJ, Kim SK, Fujimoto WY, Kahn SE, Leonetti DL, Boyko EJ. Effects of combination of change in visceral fat and thigh muscle mass on the development of type 2 diabetes. Diabetes Res Clin Pract 2017; 134:131-138. [PMID: 29032053 PMCID: PMC5723555 DOI: 10.1016/j.diabres.2017.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 09/20/2017] [Accepted: 10/02/2017] [Indexed: 12/25/2022]
Abstract
AIM We investigated the association between combined changes of visceral fat and thigh muscle over 5 years and incident type 2 diabetes in a prospective study of Japanese Americans. METHODS We followed 420 nondiabetic Japanese American subjects for 5 years and assessed visceral fat and thigh muscle by computed tomography (CT) at baseline and at 5 years. We categorized study subjects into 4 body composition change groups: visceral fat loss/thigh muscle gain (VF-loss/TM-gain), visceral fat loss/thigh muscle loss (VF-loss/TM-loss), visceral fat gain/thigh muscle gain (VF-gain/TM-gain), and visceral fat gain/thigh muscle loss (VF-gain/TM-loss) by combining changes from baseline in CT measured visceral fat and estimated thigh muscle areas. We fit a logistic regression model to examine the association between body composition categories and the development of incident type 2 diabetes at 5 years. RESULTS Cumulative incidence of type 2 diabetes was 9.8% at 5 years. VF-gain/TM-gain and VF-loss/TM-loss groups had higher risk for incident type 2 diabetes in a model adjusted for age, sex, family history of diabetes, and body mass index compared to VF-loss/TM-gain group as the reference category (OR=6.83 (1.85-25.17), 4.55 (1.06-19.48), respectively). However, the VF-gain/TM-loss group did not show a significant association with the odds of incident diabetes (3.24; 95% CI. 0.78-13.47). CONCLUSIONS Concordant gain or loss in visceral fat and thigh muscle was related to higher risk of incident type 2 diabetes compared to the reference combination of loss of visceral fat and gain of thigh muscle in Japanese Americans.
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Affiliation(s)
- Seung Jin Han
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea; Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Soo-Kyung Kim
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Wilfred Y Fujimoto
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Steven E Kahn
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA; Hospital and Specialty Medicine Service, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Donna L Leonetti
- Department of Anthropology, University of Washington, Seattle, WA, USA
| | - Edward J Boyko
- Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA; Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
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Mongraw-Chaffin M, Allison MA, Burke GL, Criqui MH, Matsushita K, Ouyang P, Shah RV, Shay CM, Anderson CAM. CT-Derived Body Fat Distribution and Incident Cardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis. J Clin Endocrinol Metab 2017; 102:4173-4183. [PMID: 28938406 PMCID: PMC5673276 DOI: 10.1210/jc.2017-01113] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 08/11/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Visceral fat has been shown to be associated with increased cardiometabolic risk, but the role of subcutaneous fat remains unclear, and evidence from diverse populations is lacking. We hypothesized that visceral fat, but not subcutaneous fat, would be independently associated with incident cardiovascular disease (CVD) and all-cause mortality. METHODS Among 1910 participants from the Multi-Ethnic Study of Atherosclerosis with abdominal fat measurements from computed tomography scans and followed for an average of 9.3 years, we used multivariable Cox proportional hazards models to investigate the relationship of both visceral and subcutaneous fat tertiles with CVD and all-cause mortality. We tested for interaction and performed sensitivity analysis for subgroups and missing values of visceral fat. RESULTS Participants had mean age of 65 years, visceral fat 150 cm2, subcutaneous fat 263 cm2, and 50% were female, 21% African American, 13% Asian, and 26% Hispanic. In models adjusted for age, sex, race/ethnicity, income, education, smoking, and subcutaneous fat, there was a statistically significant positive association between visceral fat and CVD, but not mortality. The association for combined CVD may be driven by incident coronary heart disease [tertile 2: hazard ratio, 2.43 (1.38 to 4.28); tertile 3: hazard ratio, 3.00 (1.66 to 5.43)]. Additionally, we found no substantial associations between subcutaneous fat and CVD or mortality. There were no statistically significant interactions by age, sex, or race/ethnicity. CONCLUSIONS Visceral fat, but not subcutaneous fat, is significantly associated with increased risk for CVD in a multiethnic cohort. These data support the need for effective strategies for lifestyle changes that prevent and reduce visceral fat.
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Affiliation(s)
- Morgana Mongraw-Chaffin
- Department of Epidemiology & Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
- Department of Medicine, School of Medicine, University of California San Diego, La Jolla, California 92093
| | - Matthew A. Allison
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California 92093
| | - Gregory L. Burke
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Michael H. Criqui
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California 92093
| | - Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205
| | - Pamela Ouyang
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
| | - Ravi V. Shah
- HMS Cardiovascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215
| | | | - Cheryl A. M. Anderson
- Department of Medicine, School of Medicine, University of California San Diego, La Jolla, California 92093
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California 92093
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205
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Kashiwagi R, Iwahashi H, Yamada Y, Sakaue T, Okita T, Kawachi Y, Iwamoto R, Saisho K, Tamba S, Yamamoto K, Watanabe T, Fujimoto T, Matsuzawa Y. Effective waist circumference reduction rate necessary to avoid the development of type 2 diabetes in Japanese men with abdominal obesity. Endocr J 2017; 64:881-894. [PMID: 28717063 DOI: 10.1507/endocrj.ej17-0113] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The aim of this study was to determine the effective waist circumference (WC) reduction rate in avoiding the development of type 2 diabetes mellitus (T2DM) in <55 years and ≥55 years Japanese men with abdominal obesity. The study subjects were 795 men with WC ≥85 cm, fasting plasma glucose <126 mg/dL, 2-hr plasma glucose on 75 g of oral glucose tolerance test <200 mg/dL, and HbA1c 5.6-6.4 % (38-40 mmol/mol) at baseline who underwent general health checkups more than twice between April 2007 and May 2015. They were divided into 5 groups based on the change in WC during the observation period (WC gain group, and four groups stratified according the rate of WC loss). The subjects were also divided into the <55 years and ≥55 years (at baseline) subgroups. The cumulative incidence rate of T2DM was analyzed and compared among the groups. The cumulative incidence rates of the largest WC loss quartile (≥5.45 %) in all age, of the largest WC loss quartile (≥5.60 %) and second largest WC loss quartile (3.44-5.59 %) in the <55 years subgroup, and of the largest WC loss quartile (≥5.37 %) in the ≥55 years subgroup were significantly lower than that of the gain group (p<0.001, p=0.009, 0.012, and 0.012, respectively). WC reduction rate of at least about 3 % in the younger (<55 years) and at least about 5 % in the older (≥55 years) non-diabetic Japanese men with abdominal obesity can effectively reduce the chance of development of T2DM.
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Affiliation(s)
- Risa Kashiwagi
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka, Japan
| | - Hiromi Iwahashi
- Department of Diabetes Care Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Yuya Yamada
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka, Japan
| | - Takaaki Sakaue
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka, Japan
| | - Tomonori Okita
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka, Japan
| | - Yusuke Kawachi
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka, Japan
| | - Ryuya Iwamoto
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka, Japan
| | - Kenji Saisho
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka, Japan
| | - Sachiko Tamba
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka, Japan
| | - Koji Yamamoto
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka, Japan
| | | | | | - Yuji Matsuzawa
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka, Japan
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Fujihara K, Matsubayashi Y, Yamamoto M, Osawa T, Ishizawa M, Kaneko M, Matsunaga S, Kato K, Seida H, Yamanaka N, Kodama S, Sone H. Impact of body mass index and metabolic phenotypes on coronary artery disease according to glucose tolerance status. DIABETES & METABOLISM 2017; 43:543-546. [PMID: 28918195 DOI: 10.1016/j.diabet.2017.08.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 07/27/2017] [Accepted: 08/13/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE This study aimed to examine the impact of obesity, as defined by body mass index (BMI), and a metabolically unhealthy phenotype on the development of coronary artery disease (CAD) according to glucose tolerance status. METHODS . Metabolically unhealthy individuals were defined as those with one or more of the following conditions: hypertension, hypertriglyceridaemia and/or low HDL cholesterol. A Cox proportional hazards regression model identified variables related to CAD incidence. RESULTS The prevalences of obese subjects with normal glucose tolerance, prediabetes and diabetes were 21%, 34% and 53%, whereas those for metabolically unhealthy people were 43%, 60% and 79%, respectively. Multivariate analysis showed that a metabolically unhealthy phenotype increases hazard ratios (HRs) for CAD compared with a metabolically healthy phenotype, regardless of glucose tolerance status (normal glucose tolerance: 1.98, 95% CI: 1.32-2.95; prediabetes: 2.91, 95% CI: 1.85-4.55; diabetes: 1.90, 95% CI: 1.18-3.06). HRs for CAD among metabolically unhealthy non-obese diabetes patients and obese diabetes patients with a metabolically unhealthy status were 6.14 (95% CI: 3.94-9.56) and 7.86 (95% CI: 5.21-11.9), respectively, compared with non-obese subjects with normal glucose tolerance and without a metabolically unhealthy status. CONCLUSION A metabolically unhealthy state can associate with CAD independently of obesity across all glucose tolerance stages. Clinicians may need to consider those with at least one or more conditions indicating a metabolically unhealthy state as being at high risk for CAD regardless of glucose tolerance status.
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Affiliation(s)
- K Fujihara
- Department of Internal Medicine, Niigata University Faculty of Medicine, 1-757, Asahimachi, 951-8510 Niigata, Japan
| | - Y Matsubayashi
- Department of Internal Medicine, Niigata University Faculty of Medicine, 1-757, Asahimachi, 951-8510 Niigata, Japan
| | - M Yamamoto
- Department of Internal Medicine, Niigata University Faculty of Medicine, 1-757, Asahimachi, 951-8510 Niigata, Japan
| | - T Osawa
- Department of Internal Medicine, Niigata University Faculty of Medicine, 1-757, Asahimachi, 951-8510 Niigata, Japan
| | - M Ishizawa
- Department of Internal Medicine, Niigata University Faculty of Medicine, 1-757, Asahimachi, 951-8510 Niigata, Japan
| | - M Kaneko
- Department of Internal Medicine, Niigata University Faculty of Medicine, 1-757, Asahimachi, 951-8510 Niigata, Japan
| | - S Matsunaga
- Department of Internal Medicine, Niigata University Faculty of Medicine, 1-757, Asahimachi, 951-8510 Niigata, Japan
| | - K Kato
- Department of Internal Medicine, Niigata University Faculty of Medicine, 1-757, Asahimachi, 951-8510 Niigata, Japan
| | - H Seida
- Japan Medical Data Center Co., Ltd., 2-5-5, Shibadaimon, 105-0012 Tokyo, Japan
| | - N Yamanaka
- Japan Medical Data Center Co., Ltd., 2-5-5, Shibadaimon, 105-0012 Tokyo, Japan
| | - S Kodama
- Department of Internal Medicine, Niigata University Faculty of Medicine, 1-757, Asahimachi, 951-8510 Niigata, Japan
| | - H Sone
- Department of Internal Medicine, Niigata University Faculty of Medicine, 1-757, Asahimachi, 951-8510 Niigata, Japan.
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