Association between sagittal abdominal diameter-to-height ratio and arteriosclerotic cardiovascular disease among the United States adults: A cross-sectional study

Objectives

Abdominal obesity is recognized as a significant determinant of Arteriosclerotic cardiovascular disease (ASCVD), with sagittal abdominal diameter (SAD) being considered a more precise indicator of visceral fat. Nevertheless, the association between SAD and ASCVD remains unexplored in large-scale general-population studies.

Methods

The study included 11,211 participants aged 20 to 80 from the National Health and Nutrition Examination Survey. Logistic regression models were utilized to evaluate the association between the SAD-to-height ratio (SADHtR) and ASCVD. Subgroup analyses based on age categories, sex, diabetes, and hypertension were conducted to assess result robustness.

Results

The median SADHtR value was 0.13 (0.12-0.15), and 1,006 cases (7.46 %) of ASCVD were recorded. Multivariable models showed that each standard deviation increase in SADHtR was positively associated with higher odds of ASCVD (OR 1.48, 95 % CI 1.36-1.62 in model 1; OR 1.41, 95 % CI 1.28-1.54 in model 2; OR 1.18, 95 % CI 1.08-1.30 in model 3). Comparing the first quartile of SADHtR to the second to fourth quartiles, positive associations with ASCVD were observed in models 1 and 2. However, in model 3, only the fourth quartile of SADHtR remained statistically significant (OR 1.58, 95 % CI 1.17-2.15), with all p-values for the trend being less than 0.05. No interactions were found in the subgroup analyses.

Conclusion

This study demonstrates a positive association between SADHtR and ASCVD in the general adult population of the United States. Our findings indicate that SADHtR, especially when ≥ 0.155, could be a valuable metric for assessing the risk of ASCVD.

Association of visceral adipose tissue with albuminuria and interaction between visceral adiposity and diabetes on albuminuria

AIMS

To explore the correlation between visceral adipose tissue and albuminuria, and whether there is interaction between visceral adipose tissue and diabetes on albuminuria.

METHODS

The study subjects were adult subjects (age ≥ 18 years) from the National Health and Nutrition Examination Surveys (NHANES) database of the USA in 2017-2018. Visceral fat area (VFA) was measured by dual-energy X-ray absorptiometry (DXA). Subjects were divided into three groups according to VFA: low (VFA 0-60cm2), medium (VFA 60-120 cm2) and high (VFA ≥ 120 cm2). Albuminuria was defined as urinary albumin-to-creatinine ratio (UACR) ≥ 30 mg/g. The statistical analysis software used is STATA 17.0.

RESULTS

Data pertaining to 2965 participants (2706 without albuminuria) were included in the analysis. High VFA is an independent risk factor for albuminuria (OR 1.367, 95% CI 1.023-1.827). In the low-VFA group, there is no significant association between diabetes and albuminuria (OR 1.415, 95% CI 0.145-13.849). In the medium-VFA group, diabetes is an independent risk factor for albuminuria (OR 2.217, 95% CI 1.095-4.488). In the high-VFA group, diabetes is also an independent risk factor for albuminuria (OR 5.150, 95% CI 3.150-8.421). There is an additive interaction between high VFA (VFA ≥ 120 cm2) and diabetes on the effect of albuminuria (RERI 3.757, 95% CI 0.927-6.587, p = 0.009), while no multiplication interaction (OR 1.881, 95% CI 0.997-1.023, p = 0.141).

CONCLUSIONS

High VFA may represent an independent risk factor for albuminuria. The amount of visceral fat may affect the effect of diabetes on albuminuria. The higher the visceral fat, the stronger the correlation between diabetes and albuminuria should be present. We suppose an additive interaction between VFA and diabetes on the effect of albuminuria.

Renal sinus fat is associated with intrarenal hemodynamic abnormalities independent of visceral fat in patients with chronic kidney disease

OBJECTIVE

Obesity is a risk factor of chronic kidney disease (CKD), contributing to the rising incidence of cardiometabolic diseases. Renal sinus fat (RSF) is an ectopic fat depot located at the renal cavity that could impair renal function and hemodynamic through compression of renal structures. The major purpose of this study was to explore the relationship between RSF accumulation and renal dysfunction in CKD patients.

METHODS

We evaluated the associations between computed tomography measured RSF volume and key clinical and histologic parameters involved in renal function and hemodynamics in 132 well-characterized CKD patients who underwent renal biopsy (median age: 62 years; 63.6% men).

RESULTS

RSF volume normalized by renal volume (RSF%) positively correlated with obesity-related traits such body mass index and visceral fat volume (VFV) (all P < 0.001) whereas it negatively correlated with estimated glomerular filtration rate (eGFR) (ρ = -0.42, P < 0.001) and 24-h urinary creatinine clearance (CCr) (ρ = -0.34, P < 0.001). Notably, we found robust positive correlations between RSF% and renal resistive index (RRI) measured by the Doppler ultrasound (ρ = 0.40, P < 0.001), and the histological severity of global glomerular sclerosis (ρ = 0.48, P < 0.001) and interstitial fibrosis and tubular atrophy (IFTA) (ρ = 0.35, P < 0.001). In the multivariate linear regression models, after accounting for potential confounders including VFV, RSF% remained significantly associated with CCr (β = -0.26, P < 0.001), RRI (β = 0.17, P = 0.022), global glomerular sclerosis (β = 0.21, P = 0.002), and IFTA (β = 0.17, P = 0.012).

CONCLUSION

RSF accumulation is associated with renal dysfunction and hemodynamic abnormalities independent of visceral adiposity. Our results suggest that RSF may have a potential unique role in the pathogenesis of CKD.

Influence of abdominal fat distribution and inflammatory status on post-operative prognosis in non-small cell lung cancer patients: a retrospective cohort study

PURPOSE

To evaluate the influence of visceral fat area (VFA), subcutaneous fat area (SFA), the systemic immune-inflammation index (SII) and total inflammation-based systemic index (AISI) on the postoperative prognosis of non-small cell lung cancers (NSCLC) patients.

METHODS

266 NSCLC patients received surgery from two academic medical centers were included. To assess the effect of abdominal fat measured by computed tomography (CT) imaging and inflammatory indicators on patients' overall survival (OS) and progression-free survival (PFS), Kaplan-Meier survival analysis and Cox proportional hazards models were used.

RESULTS

Kaplan-Meier analysis showed the OS and PFS of patients in high-VFA group was better than low-VFA group (p < 0.05). AISI and SII were shown to be risk factors for OS and PFS (p < 0.05) after additional adjustment for BMI (Cox regression model II). After further adjustment for VFA (Cox regression model III), low-SFA group had longer OS (p < 0.05). Among the four subgroups based on VFA (high/low) and SFA (high/low) (p < 0.05), the high-VFA & low-SFA group had the longest median OS (108 months; 95% CI 74-117 months) and PFS (85 months; 95% CI 65-117 months), as well as the lowest SII and AISI (p < 0.05). Low-SFA was a protective factor for OS with different VFA stratification (p < 0.05).

CONCLUSION

VFA, SFA, SII and AISI may be employed as significant prognostic markers of postoperative survival in NSCLC patients. Moreover, excessive SFA levels may encourage systemic inflammation decreasing the protective impact of VFA, which may help to provide targeted nutritional support and interventions for postoperative NSCLC patients with poor prognosis.

Epicardial fat thickness in type 2 diabetes outpatient care

BACKGROUND AND AIM

Visceral fat is an independent predictor of the cardiovascular risk in subjects with type 2 diabetes (T2DM), but it is rarely assessed during an outpatient visit. Epicardial fat (EAT), the visceral fat of the heart, plays a role in coronary artery disease (CAD). EAT thickness can be clinically assessed with standard ultrasound. In this study we sought to evaluate the association of ambulatory ultrasound measured EAT thickness with CAD in asymptomatic well controlled T2DM subjects on metformin monotherapy during outpatient visits.

METHODS AND RESULTS

This was single center, pragmatic study in 142 T2DM patients. Each subject underwent baseline ultrasound EAT thickness measurement, anthropometric and biomarkers. The incidence of CAD was detected after 1 year. At baseline, HbA1c was 6.7 % and BMI 34.9 kg/m2, EAT thickness was 8.3 ± 2.3 in women and 9.4 ± 2.4 mm in men, higher than threshold values for high cardiovascular risk. In multivariate models, EAT was the only statistically significant correlate of CAD at 1-year f/u (p = 0.04).

CONCLUSIONS

Point of care ultrasound measured EAT thickness is a good correlate of CAD in well controlled and asymptomatic T2DM subjects on metformin monotherapy. EAT thickness predicted CAD better than traditional risk factors, such as BMI, HbA1c, age, blood pressure or duration of diabetes.

Chronic melatonin treatment improves obesity by inducing uncoupling of skeletal muscle SERCA-SLN mediated by CaMKII/AMPK/PGC1α pathway and mitochondrial biogenesis in female and male Zücker diabetic fatty rats

Melatonin acute treatment limits obesity of young Zücker diabetic fatty (ZDF) rats by non-shivering thermogenesis (NST). We recently showed melatonin chronically increases the oxidative status of vastus lateralis (VL) in both obese and lean adult male animals. The identification of VL skeletal muscle-based NST by uncoupling of sarcoendoplasmic reticulum Ca2+-ATPase (SERCA)- sarcolipin (SLN) prompted us to investigate whether melatonin is a SERCA-SLN calcium futile cycle uncoupling and mitochondrial biogenesis enhancer. Obese ZDF rats and lean littermates (ZL) of both sexes were subdivided into two subgroups: control (C) and 12 weeks orally melatonin treated (M) (10 mg/kg/day). Compared to the control groups, melatonin decreased the body weight gain and visceral fat in ZDF rats of both sexes. Melatonin treatment in both sex obese rats restored the VL muscle skin temperature and sensitized the thermogenic effect of acute cold exposure. Moreover, melatonin not only raised SLN protein levels in the VL of obese and lean rats of both sexes; also, the SERCA activity. Melatonin treatment increased the SERCA2 expression in obese and lean rats (both sexes), with no effects on SERCA1 expression. Melatonin increased the expression of thermogenic genes and proteins (PGC1-α, PPARγ, and NRF1). Furthermore, melatonin treatment enhanced the expression ratio of P-CaMKII/CaMKII and P-AMPK/AMPK. In addition, it rose mitochondrial biogenesis. These results provided the initial evidence that chronic oral melatonin treatment triggers the CaMKII/AMPK/PGC1α axis by upregulating SERCA2-SLN-mediated NST in ZDF diabetic rats of both sexes. This may further contribute to the body weight control and metabolic benefits of melatonin.

Association between abdominal adiposity and cognitive decline in older adults: a 10-year community-based study

OBJECTIVES

This study aimed to investigate the association between abdominal adiposity and change in cognitive function in community-dwelling older adults.

DESIGN, SETTING, AND PARTICIPANTS

This longitudinal study included older adults aged ≥60 years without cognitive impairment who participated in the National Institute for Longevity Sciences - Longitudinal Study of Aging.

MEASUREMENTS

Cognitive function was evaluated biennially using the Mini-Mental State Examination (MMSE) over 10 years. Waist circumference (WC) was measured at the naval level, and subcutaneous fat area (SFA) and visceral fat area (VFA) were assessed using baseline computed tomography scans. WC, SFA, and VFA areas were stratified into sex-adjusted tertiles. A linear mixed model was applied separately for men and women.

RESULTS

This study included 873 older adults. In men, the groups with the highest levels of WC, SFA, and VFA exhibited a greater decline in MMSE score than the groups with the lowest levels (β [95% confidence interval]: WC, -0.12 [-0.23 to -0.01]; SFA, -0.13 [-0.24 to -0.02]; VFA, -0.11 [-0.22 to -0.01]). In women, the group with the highest level of WC and SFA showed a greater decline in MMSE score than the group with the lowest level (WC, -0.12 [-0.25 to -0.01]; SFA, -0.18 [-0.30 to -0.06]), but VFA was not associated with cognitive decline.

CONCLUSION

Higher WC, SFA, and VFA in men and higher WC and SFA in women were identified as risk factors for cognitive decline in later life, suggesting that abdominal adiposity involved in cognitive decline may differ according to sex.

Predictors of visceral and subcutaneous adipose tissue and muscle density: The ShapeUp! Kids study

BACKGROUND AND AIMS

Body fat distribution, i.e., visceral (VAT), subcutaneous adipose tissue (SAT) and intramuscular fat, is important for disease prevention, but sex and ethnic differences are not well understood. Our aim was to identify anthropometric, demographic, and lifestyle predictors for these outcomes.

METHODS AND RESULTS

The cross-sectional ShapeUp!Kids study was conducted among five ethnic groups aged 5-18 years. All participants completed questionnaires, anthropometric measurements, and abdominal MRI scans. VAT and SAT areas at four lumbar levels and muscle density were assessed manually. General linear models were applied to estimate coefficients of determination (R2) and to compare the fit of VAT and SAT prediction models. After exclusions, the study population had 133 male and 170 female participants. Girls had higher BMI-z scores, waist circumference (WC), and SAT than boys but lower VAT/SAT and muscle density. SAT, VAT, and VAT/SAT but not muscle density differed significantly by ethnicity. R2 values were higher for SAT than VAT across groups and improved slightly after adding WC. For SAT, R2 increased from 0.85 to 0.88 (girls) and 0.62 to 0.71 (boys) when WC was added while VAT models improved from 0.62 to 0.65 (girls) and 0.57 to 0.62 (boys). VAT values were significantly lower among Blacks than Whites with little difference for the other groups.

CONCLUSION

This analysis in a multiethnic population identified BMI-z scores and WC as the major predictors of MRI-derived SAT and VAT and highlights the important ethnic differences that need to be considered in diverse populations.

Role of visceral fat on postoperative complications and relapse in patients with Crohn's disease after ileocecal resection: Is it overrated?

INTRODUCTION

The role of visceral fat in disease development, particularly in Crohn´s disease (CD), is significant. However, its preoperative prognostic value for postoperative complications and CD relapse after ileocecal resection (ICR) remains unknown. This study aims to assess the predictive potential of preoperatively measured visceral and subcutaneous fat in postoperative complications and CD recurrence using magnetic resonance imaging (MRI). The primary endpoint was postoperative anastomotic leakage of the ileocolonic anastomosis, with secondary endpoints evaluating postoperative complications according to the Clavien Dindo classification and CD recurrence at the anastomosis.

METHODS

We conducted a retrospective analysis of 347 CD patients who underwent ICR at our tertiary referral center between 2010 and 2020. We included 223 patients with high-quality preoperative MRI scans, recording demographics, postoperative outcomes, and CD recurrence rates at the anastomosis. To assess adipose tissue distribution, we measured total fat area (TFA), visceral fat area (VFA), subcutaneous fat area (SFA), and abdominal circumference (AC) at the lumbar 3 (L3) level using MRI cross-sectional images. Ratios of these values were calculated.

RESULTS

None of the radiological variables showed an association with anastomotic leakage (TFA p = 0.932, VFA p = 0.982, SFA p = 0.951, SFA/TFA p = 0.422, VFA/TFA p = 0.422), postoperative complications, or CD recurrence (TFA p = 0.264, VFA p = 0.916, SFA p = 0.103, SFA/TFA p = 0.059, VFA/TFA p = 0.059).

CONCLUSIONS

Radiological visceral obesity variables were associated with postoperative outcomes or clinical recurrence in CD patients undergoing ICR. Preoperative measurement of visceral fat measurement is not specific for predicting postoperative complications or CD relapse.

Association between weight-adjusted-waist index and gallstones: an analysis of the National Health and Nutrition Examination Survey

BACKGROUND

The weight-adjusted-waist index (WWI) is a novel obesity index, and gallstones are associated with obesity. This study aimed to investigate the possible relationship between WWI and gallstones.

METHODS

The datasets from the National Health and Nutrition Examination Survey (NHANES) 2017-2020 were used in a cross-sectional investigation. Multivariate linear regression models were used to examine the linear connection between WWI and gallstones incidence. Fitted smoothing curves and threshold effect analysis were used to describe the nonlinear relationship.

RESULTS

The study comprised 8004 participants over the age of 20, including 833 reported with gallstones. Participants in the higher WWI tertile tended to have a higher gallstones prevalence. In the final adjusted model, a positive association between WWI and gallstones prevalence was observed (OR = 1.34, 95% CI: 1.20‒1.49). Participants in the highest WWI tertile had a significantly 71% higher risk of gallstones than those in the lowest WWI tertile (OR = 1.71, 95% CI: 1.35‒2.17). A nonlinear correlation was found between the WWI and gallstones prevalence, with an inflection point of 12.7.

CONCLUSIONS

Our study found that higher WWI levels connected with increased prevalence of gallstones. However, more prospective studies are needed to validate our findings.

Implication of Bone Mineral Density and Body Composition Parameters for Length of Hospital Stay in Patients with COVID-19

BACKGROUND

Multisystem information, including musculoskeletal information, can be captured from chest CT scans of patients with COVID-19 without further examination.

AIMS

This study aims to assess the relationship between chest CT-extracted baseline bone mineral density (BMD) and body composition parameters and the length of hospital stay in these patients.

METHODS

A retrospective analysis was performed in a cohort of 88 patients with COVID-19. Correlation analysis and a generalized linear model (GLM) were used to assess the associations between the length of hospital stay and covariates, including age, sex, body mass index (BMI), BMD and body composition variables.

RESULTS

The mean length of hospital stay was 27.4±8.7 days. The length of hospital stay was significantly positively associated with age (r=0.202, p=0.046) and the paraspinal muscle fat ratio (r=0.246, p=0.021). The GLM involving age, sex, BMD, paraspinal muscle fat ratio, subcutaneous adipose tissue (SAT) area, visceral adipose tissue (VAT) area, and liver fat fraction (LFF) showed that the length of hospital stay was positively correlated with VAT area (β coefficients, 95% CI: 9.304, 1.141-17.478, p=0.025).

CONCLUSION

The musculoskeletal features extracted from chest CT correlated with the prognosis of COVID-19 patients. Factors including old age, a higher paraspinal muscle fat ratio and a larger VAT area in patients with COVID-19 were associated with longer hospital stays.

Body composition and metabolic syndrome in patients with type 1 diabetes

BACKGROUND

In recent years, the prevalence of obesity and metabolic syndrome in type 1 diabetes (T1DM) patients has gradually increased. Insulin resistance in T1DM deserves attention. It is necessary to clarify the relationship between body composition, metabolic syndrome and insulin resistance in T1DM to guide clinical treatment and intervention.

AIM

To assess body composition (BC) in T1DM patients and evaluate the relationship between BC, metabolic syndrome (MS), and insulin resistance in these indi-viduals.

METHODS

A total of 101 subjects with T1DM, aged 10 years or older, and with a disease duration of over 1 year were included. Bioelectrical impedance analysis using the Tsinghua-Tongfang BC Analyzer BCA-1B was employed to measure various BC parameters. Clinical and laboratory data were collected, and insulin resistance was calculated using the estimated glucose disposal rate (eGDR).

RESULTS

MS was diagnosed in 16/101 patients (15.84%), overweight in 16/101 patients (15.84%), obesity in 4/101 (3.96%), hypertension in 34/101 (33.66%%) and dyslipidemia in 16/101 patients (15.84%). Visceral fat index (VFI) and trunk fat mass were significantly and negatively correlated with eGDR (both P < 0.001). Female patients exhibited higher body fat percentage and visceral fat ratio compared to male patients. Binary logistic regression analysis revealed that significant factors for MS included eGDR [P = 0.017, odds ratio (OR) = 0.109], VFI (P = 0.030, OR = 3.529), and a family history of diabetes (P = 0.004, OR = 0.228). Significant factors for hypertension included eGDR (P < 0.001, OR = 0.488) and skeletal muscle mass (P = 0.003, OR = 1.111). Significant factors for dyslipidemia included trunk fat mass (P = 0.033, OR = 1.202) and eGDR (P = 0.037, OR = 0.708).

CONCLUSION

Visceral fat was found to be a superior predictor of MS compared to conventional measures such as body mass index and waist-to-hip ratio in Chinese individuals with T1DM. BC analysis, specifically identifying visceral fat (trunk fat), may play an important role in identifying the increased risk of MS in non-obese patients with T1DM.

Association between a body shape index and prostate cancer: a cross-sectional study of NHANES 2001-2018

OBJECTIVE

Abdominal obesity, especially visceral fat, may have negative effects on the development and progression of prostate cancer (PCa). A body shape index (ABSI) can more accurately measure visceral fat accumulation. This study aimed to investigate the association between ABSI and PCa in US adults.

METHODS

11,013 participants were enrolled in the National Health and Nutrition Examination Survey from 2001 to 2018. Weighted multivariate logistic regression analyses were employed to explore the independent relationship between ABSI and PCa. Moreover, restricted cubic spline (RCS) analysis, subgroup analysis, and interaction tests were performed.

RESULTS

ABSI was positively associated with the presence of PCa. When comparing the second, third, and fourth ABSI quartile to the lowest quartile, the adjusted odds ratios (95% confidence intervals) for PCa risk were 1.34 (0.77, 2.31), 1.75 (1.03, 3.00), and 1.91 (1.12, 3.27), respectively (p for trend = 0.011). The restricted cubic spline regression analysis did not reveal a non-linear correlation between ABSI and PCa (p for non-linearity = 0.076). Subgroup analysis showed a significant interaction effect in subgroups of different BMI (p for interaction = 0.01).

CONCLUSIONS

Elevated ABSI is significantly associated with an increased risk of PCa, particularly among individuals who are under/normal weighted or obese.

Positive correlation of ANGPTL8 expression in human visceral adipose tissue with body mass index

BACKGROUND

Angiopoietin-like protein 8 (ANGPTL8) is an important regulator of lipid metabolism. We aimed to investigate the difference of ANGPTL8 expression in different depots of adipose tissues between individuals with and without obesity, and its correlation with various metabolic parameters.

METHODS

Subcutaneous (SAT) and visceral adipose tissue (VAT) samples were collected from patients who underwent bariatric or intra-abdominal surgery. Expression levels of ANGPTL8, monoglyceride lipase (MGL), monocyte chemoattractant protein-1 (MCP-1), leptin and adiponectin (APM1) were determined using real-time quantitative polymerase chain reaction. The correlation of ANGPTL8 expression with various metabolic parameters and other gene expression levels was analyzed using Person's correlation analysis. Logistic regression was used to establish a prediction model of obesity.

RESULTS

Totally 330 subjects (obese: 281, non-obese: 49) were recruited. ANGPTL8 expression in VAT was significantly higher in the obesity group than in the non-obesity group (P = 0.0096). ANGPTL8 expression in VAT was positively correlated with body mass index (BMI) (r = 0.1169, P < 0.05) and was independently associated with obesity (O.R., 1.246; 95 % C.I. 1.013-21.533, P = 0.038). We also found the gene expression of ANGPTL8 in SAT and VAT was negatively correlated with APM1 expression in respective SAT and VAT.

CONCLUSIONS

ANGPTL8 expression levels in VAT were higher in subjects with obesity, and positively correlated with BMI. This suggests a role of ANGPTL8 in the pathophysiology of obesity and may pave the way for novel treatment target of obesity.

Sex differences in abdominal visceral fat composition and metabolism as predictors of DLBCL prognosis: A retrospective cohort study

PURPOSE

We aimed to determine if sex differences in abdominal visceral fat composition and metabolism can help predict the prognosis of diffuse large B-cell lymphoma (DLBCL) patients.

METHODS

This retrospective cohort study included 117 DLBCL patients. The area and metabolic activity of subcutaneous adipose tissue and visceral adipose tissue were measured using CT and PET imaging. Kaplan-Meier survival analysis was employed to evaluate the effect of these parameters on progression-free survival. Multivariate Cox proportional hazard regression models were used to determine the effects of relative visceral fat area (rVFA) on sex-specific survival.

RESULTS

Females with an rVFA greater than the optimal threshold of 35 % and a visceral-to-subcutaneous adipose tissue ratio (V/S) >3.24 had worse progression-free survival (p = 0.01, 0.001, respectively). No rVFA or V/S were identified in significantly stratified males with DLBCL (p = 0.249 and 0.895, respectively). Combining the changes in rVFA and V/S identified a subgroup of females with high rVFA and V/S values and exceptionally poor outcomes. The rVFA was a significant predictor of DLBCL progression in females alone.

CONCLUSION

Once female DLBCL patients accumulate fat over the tolerable range in the visceral area, they might be at an increased risk of progression (hazard ratio, 3.87; 95 % CI, 1.81-12.69, p = 0.02). Sex differences in visceral fat composition and metabolism may provide a new risk stratification system for patients with DLBCL.

Dietary flaxseed oil induces production of adiponectin in visceral fat and prevents obesity in mice

Induction of obesity by dietary fats and oils differs according to the type of fat. Adiponectin is believed to be related to obesity prevention. We hypothesized that flaxseed oil is important for preventing obesity and producing adiponectin. To clarify this hypothesis, we investigated the relationship between obesity and different fat sources in mice fed diets with 6 types of fat and oils. C57BL/6J mice were given a control diet containing 5% corn oil or a high-fat diet containing 20% of either lard, palm oil, rapeseed oil, oleate-rich safflower oil, corn oil, or flaxseed oil for 14 weeks. In another experiment, mice were given a control diet and rosiglitazone (10 mg/kg body weight) by oral gavage for 1 week. At the end of study, plasma adiponectin and expression of fatty acid metabolism-related factors in white and brown adipose tissue and the liver were measured. Dietary flaxseed oil, which is rich in α-linolenic acid, did not induce obesity. Flaxseed oil resulted in increased β-oxidation-related factors in epididymal white adipose tissue, decreased fatty acid synthesis-related factors in the liver, and thermogenesis-related factor in brown adipose tissue following increase of plasma adiponectin. The results suggested that increase in plasma adiponectin after intake of flaxseed oil may be due to altered expression of AdipoQ and peroxisome proliferator-activated receptor γ in epididymal white adipose tissue. Flaxseed oil increased expression of adiponectin in visceral fat and regulated obesity-controlling fatty acid metabolism-related factors in white adipose tissue and liver, and thermogenesis-related factor in brown adipose tissue.

Laser Diode - GaAlAs Acupuncture in the Treatment of Central Obesity: a Randomized Clinical Trial

Background

: Obesity is a global health challenge. Traditional approaches, including increased physical activity, dietary interventions, and medical therapy, often yield limited success, propelling some patients toward costly and invasive procedures like bariatric surgery. Laser acupuncture has been suggested as a complementary therapeutic approach to overcome this challenge. The present study investigated the effectiveness of laser acupuncture treatment in weight loss and abdominal subcutaneous fat reduction.

Methods

: A randomized, blinded, sham-controlled clinical trial was conducted, with 30 subjects each in the intervention and control groups. Patients in the intervention group underwent 12 sessions of laser acupuncture treatment within a month (three sessions/week), whereas those in the control group received sham laser treatment on identical acupoints. The patients were instructed not to alter their physical activity levels or dietary regimens. All parameters were evaluated before and after the treatment.

Results

: Significant reductions in weight, body mass index, and waist circumference were noted in both intervention and control groups. Further analysis revealed a more significant decrease in the laser acupuncture group. Abdominal sonography revealed a marked decrease in periumbilical fat thickness in the intervention group. Conversely, laboratory evaluations showed no significant difference between the two groups.

Conclusion

: Laser acupuncture is an effective method for weight loss in patients with periumbilical abdominal fat. The observed impact on subcutaneous fat suggests its potential as a non-invasive intervention for individuals seeking weight management alternatives. Further research is warranted to validate these findings and explore the underlying mechanisms of laser acupuncture in adipose tissue modulation.

Female-specific pancreatic cancer survival from CT imaging of visceral fat implicates glutathione metabolism in solid tumors

RATIONALE AND OBJECTIVES

To identify if body composition, assessed with preoperative CT-based visceral fat ratio quantification as well as tumor metabolic gene expression, predicts sex-dependent overall survival (OS) in patients with pancreatic ductal adenocarcinoma (PDAC).

MATERIALS AND METHODS

This was a retrospective analysis of preoperative CT in 98 male and 107 female patients with PDAC. Relative visceral fat (rVFA; visceral fat normalized to total fat) was measured automatically using software and corrected manually. Median and optimized rVFA thresholds were determined according to published methods. Kaplan Meier and log-rank tests were used to estimate OS. Multivariate models were developed to identify interactions between sex, rVFA, and OS. Unsupervised gene expression analysis of PDAC tumors from The Cancer Genome Atlas (TCGA) was performed to identify metabolic pathways with similar survival patterns to rVFA.

RESULTS

Optimized preoperative rVFA threshold of 38.9% predicted significantly different OS in females with a median OS of 15 months (above threshold) vs 24 months (below threshold; p = 0.004). No significant threshold was identified in males. This female-specific significance was independent of age, stage, and presence of chronic pancreatitis (p = 0.02). Tumor gene expression analysis identified female-specific stratification from a five-gene signature of glutathione S-transferases. This was observed for PDAC as well as clear cell renal carcinoma and glioblastoma.

CONCLUSION

CT-based assessments of visceral fat can predict pancreatic cancer OS in females. Glutathione S-transferase expression in tumors predicts female-specific OS in a similar fashion.

Impact of surgical treatment on lipid metabolism in patients with lumbar spinal disorders: Prospective observational study

PURPOSE

It is still unclear how lumbar spinal surgery affects the lipid metabolism of patients with lumbar spinal disorders (LSDs) such as lumbar spinal canal stenosis and lumbar disk herniation. The present study aimed to assess the impact of lumbar spinal surgery on lipid metabolism in patients with LSDs and clarify the factors associated with changes in visceral fat (VF) accumulation before and after lumbar spinal surgery.

METHODS

Consecutive patients with lumbar spinal surgery for LSDs were prospectively included. Abdominal computed tomography images and blood examination of the participants were evaluated before surgery and at 6 months and 1 year after surgery. The cross-sectional VF area (VFA) was measured at the level of the navel using computed tomography images. Blood examination items included triglycerides and high-density lipoprotein (HDL).

RESULTS

The study enrolled a total of 138 patients. Female patients with LSDs had significantly increased VFA and serum triglyceride levels after lumbar spinal surgery. On multivariable analysis, the group with > 100 cm2 of preoperative VFA and a postoperative decrease in VFA had a significantly worse preoperative walking ability based on the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (relative risk 2.1; 95% confidence intervals 1.1-4.1).

CONCLUSIONS

The present study demonstrated that patients with LSDs did not necessarily improve their lipid metabolism after lumbar spinal surgery. Instead, female patients with LSDs had significantly deteriorated lipid metabolism after lumbar spinal surgery. Finally, a worse preoperative walking ability was associated with the improvement in excess VF accumulation after lumbar spinal surgery.

Associations between visceral adipose index and stress urinary incontinence among US adult women: a cross-sectional study

OBJECTIVE

Visceral adipose index (VAI) is a novel parameter for the evaluation of visceral obesity. The present study aimed to investigate the association between VAI levels and stress urinary incontinence (SUI) in a nationally representative population.

MATERIALS AND METHODS

The National Health and Nutrition Examination Survey (NHANES) women population aged > 20 years were analyzed from 2001 to 2018. SUI was determined by self-reported questions. VAI was calculated using physical examination data and laboratory tests. Survey-weighted logistic regression models were used to analyze the correlation between SUI and VAI.

RESULTS

The final analysis included 9709 women. Among them, 4032 (41.53%) were any SUI, 1130 (11.64%) were at least weekly SUI, and 506 (5.21%) were at least daily SUI. In multivariate analysis, the odds ratio (OR) for overall SUI increased slightly after full adjustment (OR 1.06, 95% CI 1.03-1.10, P = 0.001). Similar results were observed in weekly (OR 1.04, 95% CI 1.00-1.08, P = 0.0327) and daily (OR 1.04, 95% CI 1.00-1.09, P = 0.0702) SUI. The analysis of VAI categorized showed an increased OR of any, weekly, and daily SUI in the highest compared to the lowest tertile (OR 1.44, 95% CI 1.26-1.65, P < 0.0001 for trend, OR 1.38, 95% CI 1.07-1.78, P = 0.0153 for trend, OR 1.33, 95% CI 0.94-1.87, P = 0.094 for trend).

CONCLUSION

This study revealed a significant association between SUI and VAI among US adult women. VAI is an easily applicable index for the evaluation of visceral fat dysfunction, which might be useful for the calculation of SUI risk.

The effect of regular running on body weight and fat tissue of individuals aged 18 to 65

BACKGROUND

Age and reduction in performed physical activity cause physiological changes that include an increase in body fat (BF) and visceral fat (VF) during aging. These parameters, together with increased body mass (BM), are some of the risk factors of several noninfectious diseases. However, changes in body composition can be influenced by regular physical activity. Running is a suitable, accessible, and the most effective physical activity cultivating people. The objective of this study is to investigate the effects of long-term, regular PA, specifically recreational running, on changes in body composition among recreational adult runners covering a weekly distance of at least 10 km, compared with inactive adult individuals within the same age bracket.

METHODS

The study included 1296 runners and inactive individuals (691 male and 605 female), divided into 5 age groups: 18-25, 26-35, 36-45, 46-55, and 56-65 years. Runners are as follows: ran ≥ 10 km/week, and inactive is as follows: did not follow the WHO 2020 physical activity recommendations. The measured parameters included BM, BF, and VF. To check statistical significance, the Mann-Whitney U-test was used. Practical significance was assessed using the effect of size.

RESULTS

All age groups of runners were selected to include individuals who run at least 10 km per week. In fact, they ran, on average, from 21.6 to 31.4 km per week in relation to age and showed significantly lower values of BM, BMI, BF, and VF (p < 0.05) than inactive individuals. Exceptions included insignificant differences (p > 0.05) in BM and BMI in males in the age category of 18-25 and in females in the age category of 18-25 and 26-35.

CONCLUSION

The selected runners had to run at least 10 km per week. Their actual average volume was significantly higher (from 21.6 to 31.4 km/week), and the results showed that it could lead to significantly better body composition values. It may lead to significant changes in body mass, body fat, and visceral fat. It may meet the contemporary societal expectations for physical activities that are both achievable and effective at the lowest possible volume.

Associations of serum carotenoids with visceral adiposity index and lipid accumulation product: a cross-sectional study based on NHANES 2001-2006

BACKGROUND

Visceral adiposity index (VAI) and lipid accumulation product (LAP) are comprehensive indicators to evaluate visceral fat and determine the metabolic health of individuals. Carotenoids are a group of naturally occurring antioxidants associated with several diseases. The purpose of this investigation was to explore the association between serum carotenoid concentration and VAI or LAP.

METHODS

The data were obtained from the National Health and Nutrition Examination Survey between 2001 and 2006. The levels of serum carotenoids were evaluated using high-performance liquid chromatography. Multivariate linear regression models were employed to investigate the relationship between levels of serum carotenoids and VAI or LAP. The potential non-linear relationship was determined using threshold effect analysis and fitted smoothing curves. Stratification analysis was performed to investigate the potential modifying factors.

RESULTS

In total, 5,084 participants were included in this population-based investigation. In the multivariate linear regressions, compared to the lowest quartiles of serum carotenoids, the highest quartiles were significantly associated with VAI, and the effect size (β) and 95% CI was - 0.98 (- 1.34, - 0.62) for α-carotene, - 1.39 (- 1.77, - 1.00) for β-carotene, - 0.79 (- 1.18, - 0.41) for β-cryptoxanthin, - 0.68 (- 0.96, - 0.39) for lutein/zeaxanthin, and - 0.88 (- 1.50, - 0.27) for trans-lycopene. Using piece-wise linear regression models, non-linear relationships were found between β-carotene and trans-lycopene and VAI with an inflection point of 2.44 (log2-transformed, ug/dL) and 3.80 (log2-transformed, ug/dL), respectively. The results indicated that α-carotene, β-cryptoxanthin, and lutein/zeaxanthin were linearly associated with VAI. An inverse association was also found between serum carotenoids and LAP after complete adjustments.

CONCLUSION

This study revealed that several serum carotenoids were associated with VAI or LAP among the general American population. Further large prospective investigations are warranted to support this finding.

Association of central sensitization, visceral fat, and surgical outcomes in lumbar spinal stenosis

BACKGROUND

Controversy remains regarding predictors of surgical outcomes for patients with lumbar spinal stenosis (LSS). Pain sensitization may be an underlying mechanism contributing to LSS surgical outcomes. Further, obesity is associated with dissatisfaction and poorer outcomes after surgery for LSS. Therefore, this study aimed to examine the relationship between central sensitization (CS), visceral fat, and surgical outcomes in LSS.

METHODS

Patients with LSS were categorized based on their central sensitization inventory (CSI) scores into low- (CSI < 40) and high- (CSI ≥ 40) CSI subgroups. The participants completed clinical outcome assessments preoperatively and 12 months postoperatively.

RESULTS

Overall, 60 patients were enrolled in the study (28 men, 32 women; mean age: 62.1 ± 2.8 years). The high-CSI group had significantly higher mean low back pain (LBP), leg pain, and leg numbness visual analogue scale (VAS) scores than the low-CSI group (p < 0.01). The high-CSI group had a significantly higher mean visceral fat area than the low-CSI group (p < 0.01). Postoperatively, LBP VAS score was significantly worse in the high-CSI group. Relative to preoperatively, postoperative leg pain and leg numbness improved significantly in both groups.

CONCLUSIONS

We believe that neuro decompression can be effective for LSS surgical outcomes in patients with CS; nonetheless, it should be approached with caution owing to the potential for worsening LBP. Additionally, visceral fat is an important indicator suggesting the involvement of CS.

Alterations of cardiometabolic risk profile in polycystic ovary syndrome: 13 years follow-up in an unselected population

PURPOSE

Cardiometabolic risk factors are common in women with polycystic ovary syndrome (PCOS) during reproductive years. The aim of this study was to determine the impact of aging on cardiometabolic risk of the syndrome by examining women who had previously been diagnosed to have PCOS or to be healthy in an unselected population in 2009.

PARTICIPANTS

Forty-one women with PCOS who were diagnosed and phenotyped according to the Rotterdam criteria and 43 age- and body mass index (BMI)-matched healthy women from the same unselected cohort.

METHODS

All participants were evaluated by structured interview, physical examination, anthropometric, hormonal and biochemical measurements. Additionally, body composition analyses and echocardiographic assessments of 30 women with PCOS and 30 control women were conducted at 13 years of follow-up.

RESULTS

There was no difference between the patient and the control groups in terms of anthropometric and body composition measures and metabolic parameters. Echocardiographic assessment showed similar systolic functions, strain measurements and epicardial fat measurements between the groups. PCOS patients still had higher levels of total testosterone, free androgen index (FAI) and dehydroepiandrosterone sulfate (DHEAS) levels compared to controls. Epicardial fat thickness showed positive correlations with BMI, total and truncal body fat, homeostatic model assessment for insulin resistance (HOMA-IR) and free androgen index (FAI).

CONCLUSIONS

Aging women with PCOS in the population have higher androgen levels and similar cardiometabolic risk profile compared to age- and BMI-matched healthy women. Epicardial fat thickness, a marker of cardiometabolic risk, appear to be associated with hyperandrogenism. Further research is needed on larger community-based cohorts where older patients are assessed with a longer follow-up.

Pediatric body composition based on automatic segmentation of computed tomography scans: a pilot study

BACKGROUND

Body composition during childhood may predispose to negative health outcomes later in life. Automatic segmentation may assist in quantifying pediatric body composition in children.

OBJECTIVE

To evaluate automatic segmentation for body composition on pediatric computed tomography (CT) scans and to provide normative data on muscle and fat areas throughout childhood using automatic segmentation.

MATERIALS AND METHODS

In this pilot study, 537 children (ages 1-17 years) who underwent abdominal CT after high-energy trauma at a Dutch tertiary center (2002-2019) were retrospectively identified. Of these, the CT images of 493 children (66% boys) were used to establish normative data. Muscle (psoas, paraspinal and abdominal wall) and fat (subcutaneous and visceral) areas were measured at the third lumbar vertebral (L3) level by automatic segmentation. A representative subset of 52 scans was also manually segmented to evaluate the performance of automatic segmentation.

RESULTS

For manually-segmented versus automatically-segmented areas (52 scans), mean Dice coefficients were high for muscle (0.87-0.90) and subcutaneous fat (0.88), but lower for visceral fat (0.60). In the control group, muscle area was comparable for both sexes until the age of 13 years, whereafter, boys developed relatively more muscle. From a young age, boys were more prone to visceral fat storage than girls. Overall, boys had significantly higher visceral-to-subcutaneous fat ratios (median 1.1 vs. 0.6, P<0.01) and girls higher fat-to-muscle ratios (median 1.0 vs. 0.7, P<0.01).

CONCLUSION

Automatic segmentation of L3-level muscle and fat areas allows for accurate quantification of pediatric body composition. Using automatic segmentation, the development in muscle and fat distribution during childhood (in otherwise healthy) Dutch children was demonstrated.

Prognostic utility of body composition parameters based on computed tomography analysis of advanced non-small cell lung cancer treated with immune checkpoint inhibitors

OBJECTIVE

The purpose of this study was to evaluate the prognostic impact of body composition parameters based on computed tomography (CT) in patients with non-small cell lung cancer (NSCLC) who received ICI treatment.

METHODS

This retrospective study analyzed the data from advanced NSCLC patients treated with ICI therapy between 2013 and 2019. We included patients with NSCLC who underwent baseline CT scans. The exclusion criteria included patients who received three or more lines of chemotherapy, those with insufficient clinical information, or those without treatment response evaluation.

RESULTS

A total of 136 patients were enrolled. Among the volumetric body composition parameters, patients in the highest quartiles (Q2-4) of the visceral fat index (VFI) exhibited a higher response rate to ICI therapy than those in the lowest quartile (Q1) of VFI (Q1 vs. Q2-4: 18.2% vs. 43.1%, p = 0.012). Patients with a VFI in Q2-4 had significantly prolonged progression-free survival (PFS) and overall survival (OS) (PFS, Q1 vs. Q2-4: 3.0 months vs. 6.4 months, p = 0.043; OS, Q1 vs. Q2-4: 5.6 months vs. 16.3 months, p = 0.004). Kaplan-Meier analysis based on the VFI and visceral fat Hounsfield unit (HU) revealed that patients with VFI in Q1 and HU in Q2-4 had the worst prognosis.

CONCLUSIONS

Visceral fat volume is significantly associated with treatment outcomes in ICI-treated patients with NSCLC. Moreover, fat quality may impact the treatment outcomes. This finding underscores the potential significance of both fat compartments and fat quality as prognostic indicators.

CRITICAL RELEVANCE STATEMENT

Visceral fat volume is significantly associated with treatment outcomes in ICI-treated patients with non-small cell lung cancer. Moreover, fat quality may impact the treatment outcomes. This finding underscores the potential significance of both fat compartments and fat quality as prognostic indicators.

KEY POINTS

• We found that visceral fat volume positively correlated with treatment response and survival in patients with non-small cell lung cancer receiving immune checkpoint inhibitors. • Additionally, a trend toward a negative correlation between visceral fat attenuation and survival was observed. • The findings highlight the prognostic utility of fat compartments and fat quality.

Anti-obesity effect of Neoagaro-oligosaccharides with overweight and obese subjects: a 16-week, randomized, double-blind, placebo-controlled clinical trial

BACKGROUND

This trial aimed to evaluate the anti-obesity effects and safety of Neoagaro-oligosaccharides (NAOs) in humans in a 16 week, randomized, double-blind, placebo-controlled clinical trial.

METHODS

One hundred overweight or obese subjects with a body mass index of 23 to 34.9 kg/m2 and a percent body fat of > 25% for males or > 30% for females were enrolled. NAOs or placebo products were administered at 3 g (twice a day, four capsules once) each for 16 weeks. Efficacy and safety biomarkers were measured before and after intervention.

RESULTS

After 16 weeks of intervention, the group administered with NAOs had statistically significant decreases in visceral fat area and visceral-subcutaneous fat area ratio compared to the placebo group. The NAOs group suppressed the increase in weight and BMI compared to the placebo group, which was significant between groups. High-density lipoprotein- cholesterol was increased in the group administered with NAOs, which showed a significant trend compared to the placebo group. Clinical changes were not observed for any safety biomarkers.

CONCLUSIONS

These results suggest that NAOs have a beneficial effect on obesity. Thus, NAOs could be used as an anti-obesity supplement without side effects.

TRIAL REGISTRATION

cris.nih.go.kr: (KCT0006640, 07/10/2021).

A nomogram for predicting postoperative complications based on tumor spectral CT parameters and visceral fat area in gastric cancer patients

PURPOSE

To construct a nomogram combining tumor spectral CT parameters and visceral fat area (VFA) to predict postoperative complications (POCs) in patients with gastric cancer (GC).

METHOD

This retrospective study included 101 GC patients who underwent preoperative abdominal spectral CT scan and were divided into two groups (37 with POCs and 64 without POCs) according to the Clavien-Dindo classification standard. Logistic regression was used to establish spectral, VFA, and combined models for predicting POCs. The combined prediction model was presented as a nomogram, and the diagnostic performance of each model was evaluated using receiver operating characteristic (ROC) curve analysis.

RESULTS

The AUCs of the VFA and spectral model were 0.71 (95% CI: 0.62-0.80) and 0.81 (95% CI: 0.72-0.88), respectively. VFA, the slope of spectral curve (λ) in venous phase (λ-VP) and tumor Hounsfield units on monoenergetic images 40 keV in VP (MonoE40keV-VP) were independent predictors of POCs in GC. The nomogram yielded an AUC of 0.89 (95% CI: 0.81-0.94). The combined model was superior to the VFA or spectral models by comparing their AUCs (P = 0.000 and 0.022).

CONCLUSIONS

The nomogram based on two tumor spectral parameters (λ-VP, MonoE40keV-VP) and VFA could serve as a convenient tool for predicting the POCs of GC patients.

Associations between alcohol consumption and body fat distribution in type 1 diabetes

AIM

To evaluate the associations between alcohol consumption and body fat distribution in type 1 diabetes (T1D).

METHODS

DXA assessed the body composition of 548 adults with T1D from the Finnish Diabetic Nephropathy Study. Visceral fat mass (VFM) ≥ 0.7% of body weight for women and ≥ 1.1% for men defined central obesity (CO), whereas body fat mass (BFM) ≥ 40.4% for women and ≥ 31.8% for men defined general obesity (GO). Alcohol consumption data were collected via questionnaires. One standard dose = 12 g of pure alcohol. Participants were classified as abstainers, low-risk, moderate-risk and high-risk alcohol consumers. We used linear and logistic regression models for analyses.

RESULTS

The higher the alcohol consumption the higher the VFM% (r2 = 0.23, β = 0.083, p = 0.04) in both sexes. BFM% presented a similar pattern in men (r2 = 0.12, β = 0.160, p = 0.01), but not in women. One weekly dose increase of alcohol consumption increases the odds of CO by 3% (OR 1.03, p = 0.037), but not GO. The odds of CO (OR 7.3, p = 0.003) and GO (OR 5.3, p = 0.007) increase with high-risk, but not with low- and moderate-risk consumptions.

CONCLUSIONS

In adults with T1D, alcohol consumption is linearly associated with VFM% regardless of sex, whereas the association with BFM% is sex-dependent.

The role of cognitive function in the relationship between surrogate markers of visceral fat and depressive symptoms in general middle-aged and elderly population: A nationwide population-based study

BACKGROUND

The relationship between obesity and depressive symptoms is well documented, but not visceral fat, especially among Chinese adults are scarce. We aimed to investigate the association between visceral fat and depressive symptoms and the mediation of cognitive function.

METHODS

A total of 19,919 and 5555 participants from the China Health and Retirement Longitudinal Study were enrolled in the cross-sectional and follow-up analyses. Depressive symptoms were measured by the Center of Epidemiological studies depression scale (CES-D). Visceral fat measured by the waist circumference triglyceride (WT) index [calculated as waist circumference (cm)* triglyceride (mmol/L)]. The relationship between the WT index and depressive symptoms was analyzed by binary logistics and Poisson regression. The mediated role of cognitive ability was examined by intermediary analysis.

RESULTS

In the cross-sectional study, higher visceral fat was associated with a lower risk of depressive symptoms. But in the follow-up study, individuals in quintile 2 to quintile 4 of the WT index have a reduced risk of depressive symptoms after four years. Compared with the lower index, quintile 2 of the WT index protected from difficulty concentrating (RR [95%CI]: 0.90 [0.82,0.98], p = 0.023), feeling scared (RR [95%CI]: 0.86 [0.73,0.98], p = 0.030) and feeling that life could not go on (RR [95%CI]: 0.85 [0.74,0.98], p = 0.023). Moreover, cognitive ability explained 11.52 % of the association between visceral fat and depressive symptoms.

CONCLUSIONS

Our findings show that moderate visceral fat was associated with a lower risk of depressive symptoms in middle-aged and older Chinese, partly mediated by cognitive function.

Correlation between serum uric acid and body fat distribution in patients with MAFLD

BACKGROUND

Metabolic dysfunction associated with fatty liver disease (MAFLD) is often correlated with obesity and hyperuricemia. The present study aimed to determine the association between serum uric acid (SUA) and central fat distribution in patients with MAFLD.

METHODS

A total of 485 patients were classified into the following groups: (1) controls without MAFLD and hyperuricemia (HUA), (2) MAFLD with normal SUA, and (3) MAFLD with HUA. DUALSCAN HDS-2000 was used to measure visceral fat (VAT) and subcutaneous fat (SAT). Dual-energy X-ray absorptiometry (DEXA) was used to measure body fat distribution.

RESULTS

MAFLD patients with HUA had remarkably higher BMI, fasting insulin, OGIRT AUC, ALT, AST, TG, VAT, SAT, Adipo-IR, trunk fat mass, android fat, and total body fat than MAFLD patients with normal SUA (all p < 0.05). The increase in VAT, SAT, CAP, Adipo-IR, upper limbs fat mass, trunk fat mass, and android fat, as well as the percentage of MAFLD, were significantly correlated with the increase in SUA. The percentage of MAFLD patients with HUA increased significantly with increasing VAT or SAT, as determined by the Cochran-Armitage trend test (all p < 0.05). Furthermore, VAT (OR = 1.01 CI: 1.00, 1.03; p < 0.05) and adipo-IR (OR = 1.09 CI: 1.00, 1.19; p < 0.05) were associated with circling SUA in MAFLD after adjusting for sex, age, TG, TC, HOMA-IR, and BMI.

CONCLUSION

Abdominal fat promotes the co-existence of HUA and MAFLD, while weight loss, especially, decreasing VAT, is of great importance to decrease SUA levels and manage MAFLD.

Association between body fat distribution and B-lymphocyte subsets in peripheral blood

BACKGROUND

Obesity is associated with chronic low-grade inflammation, which is underpinned by the presence of elevated levels of circulating proinflammatory cytokines in obese individuals. Due to the close relationship between adipose tissue and the immune system, it can be speculated that the accumulation of fat may influence the frequency and phenotype of lymphocyte populations. The aim of our study was to investigate whether body fat distribution is associated with B lymphocyte composition in peripheral blood. We examined the association between visceral (VAT) and total body fat (TBF) and the frequencies of B-cell subsets in 238 subjects over a period of up to one year using random intercept models. B lymphocyte subsets were determined by fluorescence-based flow cytometry.

RESULTS

Inverse associations were found between body fat measurements and plasma blasts, memory B cells, and IgM-IgD- cells. VAT, but not TBF, was positively associated with naive CD19 cells. In our analyses, both VAT and TBF showed positive associations with IgD only B cells.

CONCLUSIONS

In conclusion, body fat accumulation seems to be associated with a lower proportion of antibody-secreting plasma blasts and memory cells and an increasing amount of partially anergic, naive CD19 cells.

Associations between anthropometric parameters and immune-phenotypical characteristics of circulating Tregs and serum cytokines

OBJECTIVE

To investigate the associations between several anthropometric parameters and regulatory T cells (Tregs) and circulating cytokines in a population-based cohort.

METHODS

Between 2018 and 2021, a total of 238 participants were examined up to three times within the scope of the MEGA study in Augsburg, Germany. Tregs were analyzed using flow cytometry and the serum concentrations of 52 cytokines were determined. Anthropometric parameters were measured, using also bioelectrical impedance analysis: body mass index (BMI), relative total body fat, relative visceral adipose tissue (rVAT), waist circumference (WC), waist-to-hip ratio (WHR) and body fat distribution. Associations were analyzed using linear mixed models with random intercept (Tregs) and conventional linear regression models (cytokines).

RESULTS

WC and WHR were inversely associated with the general Treg subset. Four parameters (BMI, rVAT, WC, and WHR) were inversely associated with the conventional Treg population. Three cytokines showed a particularly strong association with several anthropometric parameters: the cutaneous T-cell attracting chemokine was inversely associated with anthropometric parameters, while hepatocyte growth factor and interleukine-18 showed positive associations.

CONCLUSIONS

Anthropometric measures are associated with Tregs and serum cytokine concentrations revealing new important interconnections between obesity and the adaptive immune system.

Dyslipidemia as a novel risk for the development of symptomatic ossification of the posterior longitudinal ligament

BACKGROUND CONTEXT

Obesity and visceral fat have been implicated as potential factors in the pathogenesis of the ossification of the posterior longitudinal ligament (OPLL); the details of the factors involved in OPLL remain unclear.

PURPOSE

We aimed to determine the association between dyslipidemia and symptomatic OPLL.

STUDY DESIGN

Single institution cross-sectional study.

PATIENT SAMPLE

Data were collected from Japanese patients with OPLL (n=92) who underwent whole-spine computed tomography scanning. Control data (n=246) without any spinal ligament ossification were collected from 627 Japanese participants who underwent physical examination.

OUTCOME MEASURES

Baseline information and lipid parameters, including triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) from fasting blood samples were collected to assess the comorbidity of dyslipidemia.

METHODS

Patient data were collected from 2020 to 2022. Patients with dyslipidemia were defined as those who were taking medication for dyslipidemia and who met one of the following criteria: TG ≥150 mg/dL, LDL-C ≥140 mg/dL, and/or HDL-C <40 mg/dL. The factors associated with OPLL development were evaluated using multivariate logistic regression analysis.

RESULTS

The comorbidity of dyslipidemia in the OPLL group was more than twice that in the control group (71.7% and 35.4%, respectively). The mean body mass index (BMI) of the OPLL group was significantly higher than that of the control group (27.2 kg/m2 and 23.0 kg/m2). Multivariate logistic regression analysis revealed that dyslipidemia was associated with the development of OPLL (regression coefficient, 0.80; 95% confidence interval, 0.11-1.50). Additional risk factors included age, BMI, and diabetes mellitus.

CONCLUSIONS

We demonstrated a novel association between dyslipidemia and symptomatic OPLL development using serum data. This suggests that visceral fat obesity or abnormal lipid metabolism are associated with the mechanisms of onset and exacerbation of OPLL as well as focal mechanical irritation due to being overweight.

[Visceral adiposity index (VAI) and dysfunctional adiposity index (DAI). Relationship with obesity parameters]

INTRODUCTION

Obesity is a global pandemic with a growing impact on morbidity and mortality. We assessed the associative strength of the Visceral Adiposity Index (VAI) and Dysfunctional Adiposity Index (DAI) in obesity and associated risk using different methods.

MATERIAL AND METHODS

Cross-sectional study in 418 343 workers from different autonomous communities in Spain, estimating prevalence of obesity with: waist circumference, waist/height index, BMI, CUN-BAE, ECORE-BF, RFM, PALAFOLLS, IMG, METS-VF calculated according to their specific formulas. Descriptive analysis of categorical variables and associative strength of VAI and DAI for obesity was performed with ROC curves considering high risk when the AUC value.0.8 and moderate with AUC.0.7 and.0.8. SPSS 27.0 was used, considering statistical significance p.0.05.

RESULTS

The prevalence of obesity varied according to the method used, being high with Palafolls (72.92% in women and 86.98% in men) and low with METS-VF (1.31% in women and 8.54% in men). The mean values of VAI and DAI are always higher in men. The AUC of the ROC curve for VAI was high with METS-VF: in women 0.836 (95%CI 0.829-0.843), in men 0.848 (95%CI 0.845-0.850) and with waist circumference in men: 0.819 (95%CI 0.816-0.822). DAI was high for METS-FV in women: 0.809 (95%CI 0.801-0.817).

CONCLUSIONS

The prevalence of obesity and related risk differs according to the assessment method used. VAI shows high strength of association with obesity and fat mass for METS-VF in both sexes and with waist circumference in men; DAI for METS-VF in women.

Pancreatic β-Cell Apoptosis in Normoglycemic Rats is Due to Mitochondrial Translocation of p53-Induced by the Consumption of Sugar-Sweetened Beverages

Overstimulation of pancreatic β-cells can lead to dysfunction and death, prior to the clinical manifestations of type 2 diabetes (T2D). The excessive consumption of carbohydrates induces metabolic alterations that can affect the functions of the β-cells and cause their death. We analyzed the role of p53 in pancreatic β cell death in carbohydrate-supplemented Sprague Dawley rats. For four months, the animals received drinking water containing either 40% sucrose or 40% fructose. The glucose tolerance test was performed at week 15. Apoptosis was assessed with the TUNEL assay (TdT-mediated dUTP-nick end-labeling). Bax, p53, and insulin were assessed by Western blotting, immunofluorescence, and real-time quantitative PCR. Insulin, triacylglycerol, and serum glucose and fatty acids in pancreatic tissue were measured. Carbohydrate consumption promotes apoptosis and mobilization of p53 from the cytosol to rat pancreatic β-cell mitochondria before blood glucose rises. An increase in p53, miR-34a, and Bax mRNA was also detected (P < 0.001) in the sucrose group. As well as hypertriglyceridemia, hyperinsulinemia, glucose intolerance, insulin resistance, visceral fat accumulation, and increased pancreatic fatty acids in the sucrose group. Carbohydrate consumption increases p53 and its mobilization into β-cell mitochondria and coincides with the increased rate of apoptosis, which occurs before serum glucose levels rise.

Iliopsoas muscle to visceral fat ratio on CT predicts Cushing's syndrome in elderly females with adrenal tumors

There is no computed tomography (CT)-based numerical index for predicting Cushing's syndrome (CS) in patients with adrenal incidentalomas. We tested the hypothesis that the iliopsoas muscle (Ip-M) to visceral fat (V-fat) ratio (IVR) on CT may predict CS in elderly female patients with adrenal tumors. We examined the V-fat area, subcutaneous fat (S-fat) area, Ip-M area, V-fat/S-fat ratio, and IVR at the third lumbar vertebra (L3) level using abdominal CT in female patients aged ≥50 years with cortisol-producing adrenal tumor diagnosed with CS or non-functioning adrenal tumor (NFT) in the derivation cohort. We performed receiver operating characteristic (ROC) analysis to evaluate the diagnostic value of the V-fat/S-fat ratio and IVR for predicting CS. We assessed the usefulness of the IVR in a separate validation cohort. In the derivation cohort, the IVR was significantly lower in the 9 patients with CS than in the 15 patients with NFT (p < 0.001). In ROC analysis with a cut-off value of 0.067, the IVR showed a sensitivity of 100%, specificity of 80.0%, positive likelihood ratio (PLR) of 5.000, and negative likelihood ratio (NLR) of 0.000. The area under the curve was significantly higher for the IVR than for the V-fat/S-fat ratio (0.933 vs. 0.704, respectively, p = 0.036). In 23 patients in the validation cohort, the IVR demonstrated a PLR of 5.714 and an NLR of 0.327. The novel IVR index, based on single-slice CT at the L3 level, predicted CS in elderly female patients with adrenal tumors.

Which obesity index is the most useful marker for predicting hepatic steatosis in children and adolescents with obesity? A cross-sectional study using quantitative magnetic resonance imaging

INTRODUCTION

We aimed to evaluate the relationships between hepatic steatosis and various indices of obesity, and to identify the most useful index for the prediction of hepatic steatosis in children and adolescents with obesity.

METHODS

A total of 226 children and adolescents with a mean body mass index (BMI) z-score of 2.65 and a mean age of 11.4 years were subjected to anthropometric and body composition measurements, laboratory testing, abdominal fat mass assessment, and hepatic fat accumulation by magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF). The participants were divided into quartiles according to the severity of their hepatic steatosis, and the presence of hepatic steatosis was defined using an MRI-PDFF ≥ 5%.

RESULTS

The multivariate ordinal regression analysis showed that the severity of hepatic steatosis was positively associated with BMI, waist circumference, waist-to-hip ratio, waist-to-height ratio, fat mass, fat-free mass, visceral adiposity, and abdominal subcutaneous adiposity. Higher activities of liver enzymes and higher concentrations of triglyceride, C-reactive protein, fasting insulin, and leptin were associated with more severe hepatic steatosis, whereas high-density lipoprotein-cholesterol and adiponectin were negatively associated with hepatic steatosis. The indices of obesity with areas under the receiver operating characteristic curves (AUCs) > 0.8 for the prediction of hepatic steatosis were liver enzymes, visceral adipose tissue area, waist-to-hip ratio, and waist-to-height ratio.

CONCLUSION

The severity of hepatic steatosis significantly correlated with various indices of obesity and cardiometabolic markers in children and adolescents with obesity. The indices of abdominal obesity would be the most useful for the prediction of hepatic steatosis.

Association of the time course of Chinese visceral adiposity index accumulation with cardiovascular events in patients with hypertension

BACKGROUND

The Chinese visceral adiposity index (CVAI), a simple surrogate measure of visceral fat, is significantly associated with cardiovascular disease (CVD) risk in the general population. This study aimed to evaluate the association of cumulative CVAI (cumCVAI) exposure and its accumulation time course with CVD risk among patients with hypertension.

METHODS

This prospective study involved 15,350 patients with hypertension from the Kailuan Study who were evaluated at least three times in the observation period of 2006 to 2014 (2006-2007, 2010-2011, and 2014-2015) and who were free of myocardial infarction and stroke before 2014. The cumCVAI was calculated as the weighted sum of the mean CVAI for each time interval (value × time). The time course of CVAI accumulation was categorized by splitting the overall accumulation into early (cumCVAI_06 - 10) and late (cumCVAI_10 - 14) accumulation, or the slope of CVAI versus time from 2006 to 2014 into positive and negative.

RESULTS

During the 6.59-year follow-up period, 1,184 new-onset CVD events were recorded. After adjusting for confounding variables, the hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD were 1.35 (1.13-1.61) in the highest quartile of cumCVAI, 1.35 (1.14-1.61) in the highest quartile of the time-weighted average CVAI, 1.26 (1.12-1.43) in those with a cumulative burden > 0, and 1.43 (1.14-1.78) for the group with a 10-year exposure duration. When considering the time course of CVAI accumulation, the HR (95% CI) for CVD was 1.33 (1.11-1.59) for early cumCVAI. When considering the combined effect of cumCVAI accumulation and its time course, the HR (95% CI) for CVD was 1.22 (1.03-1.46) for cumCVAI ≥ median with a positive slope.

CONCLUSIONS

In this study, incident CVD risk depended on both long-term high cumCVAI exposure and the duration of high CVAI exposure among patients with hypertension. Early CVAI accumulation resulted in a greater risk increase than later CVAI accumulation, emphasizing the importance of optimal CVAI control in early life.

Sarcopenia and visceral fat in patients with incisional hernia after urgent laparotomy

PURPOSE

Various risk factors have been associated with the development of incisional hernia (IH). Some recent papers underlined that visceral fat could be a reliable indicator. Another risk factor which is of increasing clinical interest is sarcopenia. Recent studies have identified it as an independent predictor of poor postoperative outcomes following abdominal surgery. We aimed to investigate the role of visceral fat and skeletal muscle as emerging risk factors for IH after urgent laparotomy.

METHODS

Patients aged 18 years or older who underwent urgent median laparotomy and with continuous direct suturing of the laparotomy were included. They were categorized into two groups: those with a median IH and those without IH at 12-month follow-up. Demographic data were prospectively collected while CT scans were retrospectively reviewed. The data were compared among two groups.

RESULTS

From January 2018 to May 2021, 364 patients underwent urgent surgery in our Department, of whom 222 were aged >18 years old and underwent median laparotomy. Forty-four patients had diagnosis of median IH, while 41 patients without IH were identified as the control group. Statistically significant differences emerged for BMI and for the area of visceral fat. The association with the presence/absence of sarcopenia was not significant.

CONCLUSION

Even when surgery is performed in urgent settings, it could be important to identify patients at risk, especially as CT scans are generally available for all patients with urgent abdominal disease.

Magnetic resonance study of visceral, subcutaneous, liver and pancreas fat changes after 12 weeks intermittent fasting in obese participants with prediabetes

BACKGROUND

It is not clear whether there are differences in proportions of fat loss from visceral:subcutaneous depots by probiotic supplementation, ethnicity or sex during weight loss; or whether visceral/pancreatic fat depot changes are related to changes in HbA1c. Our objective is to investigate whether weight loss from different fat depots is related to these factors during weight loss achieved by intermittent fasting.

METHOD

Prediabetes participants on 5:2 intermittent fasting were randomized 1:1 to either daily probiotic or placebo for 12 weeks. Twenty-four patients had magnetic resonance imaging data at baseline and 12 weeks.

RESULTS

After 12 weeks of intermittent fasting, subcutaneous fat (%) changed from 35.9 ± 3.1 to 34.4 ± 3.2, visceral fat (%) from 15.8 ± 1.3 to 14.8 ± 1.2, liver fat (%) from 8.7 ± 0.8 to 7.5 ± 0.7 and pancreatic fat (%) from 7.7 ± 0.5 to 6.5 ± 0.5 (all p< 0.001). Changes in weight, HbA1c, SAT, VAT, LF and PF did not differ significantly between probiotic and placebo groups.

CONCLUSION

Overall weight loss was correlated with fat loss from subcutaneous depots. Losses from different fat depots did not correlate with changes in HbA1c or differ by probiotic supplementation, ethnicity or sex.

Imaging-based assessment of body composition in patients with Crohn's disease: a systematic review

BACKGROUND AND AIMS

Body composition changes in patients with Crohn's disease (CD) have received increasing attention in recent years. This review aims to describe the changes in body composition in patients with CD on imaging and to analyze and summarize the prognostic value of body composition.

METHODS

We systematically searched Web of Science, PubMed, Embase, Cochrane Library, and Medline via OVID for literature published before November 2022, and two researchers independently evaluated the quality of the retrieved literature.

RESULTS

A total of 39 publications (32 cohort studies and 7 cross-sectional studies) involving 4219 patients with CD were retrieved. Imaging methods for body composition assessment, including dual-energy X-ray absorptiometry (DXA), computed tomography (CT) and magnetic resonance imaging (MRI), were included in this review. The study found that patients with CD typically have more visceral adipose tissue and less skeletal muscle mass, and the prevalence of sarcopenia and visceral obesity was significantly different in different studies (sarcopenia: 16-100%; visceral obesity: 5.3-30.5%). Available studies suggest that changes in the body composition of CD patients are significantly related to inflammatory status, disease behavior, poor outcomes, and drug efficacy.

CONCLUSION

Altered body composition can be a significant predictor of poor outcomes for CD patients. Therefore, the body composition of CD patients may serve as a potential therapeutic target to help optimize disease management strategies in clinical practice.

Shorter sleep duration is associated with greater visceral fat mass in US adults: Findings from NHANES, 2011-2014

Habitual declines in sleep duration and increased rates of obesity are public health concerns worldwide. Accumulating evidence suggests a prominent link between reduced sleep duration and weight gain. Our cross-sectional study investigated the relationship between sleep duration and body fat distribution in US adults. We extracted data for 5151 participants (2575 men and 2576 women) aged 18-59 years from the US National Health and Nutrition Examination Survey 2011-2012 and 2013-2014. Weekday or workday night-time sleep duration was estimated using an in-home interview questionnaire. Dual-energy x-ray absorptiometry scans were used to determine regional body fat mass (arms, legs, trunk [android and gynoid], and abdominal [subcutaneous and visceral]). Multiple linear regression and restricted cubic spline analyses were performed after adjusting for several demographic, anthropometric, and nutritional covariates. There was a significant negative association between sleep duration and visceral fat mass overall (β: -12.139, P < 0.001) and by sex (men: β: -10.096, P < 0.001; women: β: -11.545, P = 0.038), after adjusting for age, ethnicity, body mass index, total body fat mass, daily energy and alcohol intake, sleep quality and sleep disorder status. Sleep duration and visceral fat appeared to plateau at ≥ 8 h of daily sleep. Sleep duration is negatively associated with visceral fat mass accumulation during adulthood with possibly no benefits beyond 8 h of sleep per day. Mechanistic and prospective studies are required to confirm the effect of sleep duration on visceral adiposity and determine its causes.

CT analysis of thoracolumbar body composition for estimating whole-body composition

BACKGROUND

To evaluate the correlation between single- and multi-slice cross-sectional thoracolumbar and whole-body compositions.

METHODS

We retrospectively included patients who underwent whole-body PET-CT scans from January 2016 to December 2019 at multiple institutions. A priori-developed, deep learning-based commercially available 3D U-Net segmentation provided whole-body 3D reference volumes and 2D areas of muscle, visceral fat, and subcutaneous fat at the upper, middle, and lower endplate of the individual T1-L5 vertebrae. In the derivation set, we analyzed the Pearson correlation coefficients of single-slice and multi-slice averaged 2D areas (waist and T12-L1) with the reference values. We then built prediction models using the top three correlated levels and tested the models in the validation set.

RESULTS

The derivation and validation datasets included 203 (mean age 58.2 years; 101 men) and 239 patients (mean age 57.8 years; 80 men). The coefficients were distributed bimodally, with the first peak at T4 (coefficient, 0.78) and the second peak at L2-3 (coefficient 0.90). The top three correlations in the abdominal scan range were found for multi-slice waist averaging (0.92) and single-slice L3 and L2 (0.90, each), while those in the chest scan range were multi-slice T12-L1 averaging (0.89), single-slice L1 (0.89), and T12 (0.86). The model performance at the top three levels for estimating whole-body composition was similar in the derivation and validation datasets.

CONCLUSIONS

Single-slice L2-3 (abdominal CT range) and L1 (chest CT range) analysis best correlated with whole-body composition around 0.90 (coefficient). Multi-slice waist averaging provided a slightly higher correlation of 0.92.

Can visceral fat parameters based on computed tomography be used to predict occult peritoneal metastasis in gastric cancer?

BACKGROUND

The preoperative prediction of peritoneal metastasis (PM) in gastric cancer would prevent unnecessary surgery and promptly indicate an appropriate treatment plan.

AIM

To explore the predictive value of visceral fat (VF) parameters obtained from preoperative computed tomography (CT) images for occult PM and to develop an individualized model for predicting occult PM in patients with gastric carcinoma (GC).

METHODS

A total of 128 confirmed GC cases (84 male and 44 female patients) that underwent CT scans were analyzed and categorized into PM-positive (n = 43) and PM-negative (n = 85) groups. The clinical characteristics and VF parameters of two regions of interest (ROIs) were collected. Univariate and stratified analyses based on VF volume were performed to screen for predictive characteristics for occult PM. Prediction models with and without VF parameters were established by multivariable logistic regression analysis.

RESULTS

The mean attenuations of VF_{ROI 1} and VF_{ROI 2} varied significantly between the PM-positive and PM-negative groups (P = 0.044 and 0.001, respectively). The areas under the receiver operating characteristic curves (AUCs) of VF_{ROI 1} and VF_{ROI 2} were 0.599 and 0.657, respectively. The mean attenuation of VF_{ROI 2} was included in the final prediction combined model, but not an independent risk factor of PM (P = 0.068). No significant difference was observed between the models with and without mean attenuation of VF (AUC: 0.749 vs 0.730, P = 0.339).

CONCLUSION

The mean attenuation of VF is a potential auxiliary parameter for predicting occult PM in patients with GC.

The association between the body roundness index and the risk of colorectal cancer: a cross-sectional study

BACKGROUND

Colorectal cancer (CRC), has a link between obesity, especially visceral fat. The body roundness index (BRI) can more accurately assess body fat and visceral fat levels. It is, however, unknown whether BRI is associated with CRC risk.

METHODS

53,766 participants were enrolled from the National Health and Nutrition Examination Survey (NHANES). Analysing the corelation between BRI and CRC risk was performed using logistic regression. Stratified analyses revealed the association based on the population type. Receiver operating characteristic curve (ROC) was performed for predicting CRC risk using different anthropometric indices.

RESULTS

The risk of CRC mounting apparently with elevated BRI for participants with CRC compared to normal participants (P-trend < 0.001). The association persisted even after adjusting for all covariates (P-trend = 0.017). In stratified analyses, CRC risk increased with increasing BRI, especially among those who were inactive (OR (95% CI): Q3 3.761 (2.139, 6.610), P < 0.05, Q4 5.972 (3.347, 8.470), P < 0.01), overweight (OR (95% CI): Q3 2.573 (1.012, 7.431), P < 0.05, Q4 3.318 (1.221, 9.020), P < 0.05) or obese (OR (95% CI): Q3 3.889 (1.829, 8.266), P < 0.001, Q4 4.920 (2.349, 10.308), P < 0.001). ROC curve showed that BRI had a better ability in forecasting the risk of CRC than other anthropometric indices such as body weight etc. (all P < 0.05).

CONCLUSIONS

CRC risk and BRI have a positive and significant relationship, particularly in inactive participants with BMI ≥ 25 kg/m². It is hoped that these results will raise awareness of the importance of reducing visceral fat deposition.

The relationship between FGF23 and body composition according to albuminuria stage in type 1 diabetes

AIMS

Fibroblast growth factor 23 (FGF23) and obesity are linked to kidney disease. However, the relationship between FGF23 and body composition is unclear. Associations between FGF23 and body composition were investigated in type 1 diabetes from the Finnish Diabetic Nephropathy Study according to albuminuria stages.

METHODS

Data were available from 306 adults with type 1 diabetes (229 normal albumin excretion rate, T1D^normo; 38 microalbuminuria, T1D^micro; 39 macroalbuminuria, T1D^macro), and 36 controls. Serum FGF23 was measured by ELISA. Body composition was assessed with dual-energy X-ray absorptiometry. Associations between body composition and serum FGF23 were investigated using linear regression models.

RESULTS

Compared with T1D^normo, individuals with more advanced kidney disease were older, had longer diabetes duration, higher serum hsCRP, and higher FGF23 concentration. However, FGF23 concentration was comparable between T1D^normo and controls. Adjusted for potential confounders, in T1D^micro, FGF23 was positively associated with the percentages of total fat, visceral fat, and android fat tissues, while negative associations between FGF23 and lean tissue were observed. FGF23 was not associated with body composition in T1D^normo, T1D^macro, and controls.

CONCLUSIONS

In type 1 diabetes, the relationship between FGF23 and body composition is dependent on albuminuria stages.

Increase from low to moderate, but not high, caffeinated coffee consumption is associated with favorable changes in body fat

BACKGROUND & AIMS

Higher consumption of coffee and caffeine has been linked to less weight gain and lower body mass index in prospective cohort studies. The aim of the study was to longitudinally assess the association of changes in coffee and caffeine intake with changes in fat tissue, in particular, visceral adipose tissue (VAT) using dual x-ray absorptiometry (DXA).

METHODS

In the setting of a large, randomized trial of Mediterranean diet and physical activity intervention, we evaluated 1483 participants with metabolic syndrome (MetS). Repeated measurements of coffee consumption from validated food frequency questionnaires (FFQ) and DXA measurements of adipose tissue were collected at baseline, 6 months, 12 months and 3 years of follow-up. DXA-derived measurements of total and regional adipose tissue expressed as % of total body weight were transformed into sex-specific z-scores. Linear multilevel mixed-effect models were used to investigate the relationship between changes in coffee consumption and corresponding concurrent changes in fat tissue during a 3-year follow-up.

RESULTS

After adjustment for intervention group, and other potential confounders, an increase in caffeinated coffee consumption from no or infrequent consumption (≤3 cups/month) to moderate consumption (1-7 cups/week) was associated with reductions in total body fat (Δ z-score: -0.06; 95% CI: -0.11 to -0.02), trunk fat (Δ z-score: -0.07; 95% CI: -0.12 to -0.02), and VAT (Δ z-score: -0.07; 95% CI: -0.13 to -0.01). Neither changes from no or infrequent consumption to high levels of caffeinated coffee consumption (>1 cup/day) nor any changes in decaffeinated coffee consumption showed significant associations with changes in DXA measures.

CONCLUSIONS

Moderate changes in the consumption of caffeinated coffee, but not changes to high consumption, were associated with reductions in total body fat, trunk fat and VAT in a Mediterranean cohort with MetS. Decaffeinated coffee was not linked to adiposity indicators. Moderate consumption of caffeinated coffee may be part of a weight management strategy.

TRIAL REGISTRATION

The trial was registered at the International Standard Randomized Controlled Trial (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.