Abdominal Subcutaneous Fat Thickness Research Articles

Abdominal subcutaneous fat thickness combined with a 50-g glucose challenge test at 24-28 weeks of pregnancy in predicting gestational diabetes mellitus

Background This investigation aimed to analyse the efficacy of abdominal subcutaneous fat thickness (ASFT) value >18.1 mm combined with a 50-g glucose challenge test (GCT) between 24-28 weeks of gestation in predicting gestational diabetes mellitus (GDM) cases. Methods This cross-sectional study was carried out from February 2021 to December 2022. All pregnant women received a 50-g GCT at 24-28 weeks of pregnancy for the GDM screening. Pregnant women with a blood glucose value between 140-190 mg/dl experienced 100 g OGTT. Even if 50-g GCT was normal, 100-g OGTT was offered to patients with an ASFT value above 18.1 mm Results Among the 728 pregnant women we enrolled, 154 (21.2%) cases were screened as positive. The number of patients who first screened positive and determined to be GDM after the 100-g oral glucose tolerance test (OGTT) was 43 (5.9%). A total of 67 cases (9.2%) had an ASFT measurement above 18.1 mm. Two cases with a negative 50-g GCT and ASFT <18.1 mm were diagnosed as GDM in the later weeks of pregnancy. A 50-g GCT combined with ASFT measurement above 18.1 mm predicted GDM with a sensitivity of 87.9%, a specificity of 88.7%, a positive predictive value (PPV) of 36.0%, and a negative PV (NPV) of 99.7%. Conclusions A 50-g GCT combined with ASFT measurement that can be easily and accurately obtained during routine antenatal care in the second trimester might be a beneficial indicator for predicting GDM cases.

Abdominal Fat is a Reliable Indicator of Lumbar Intervertebral Disc Degeneration than Body Mass Index

To determine whether abdominal fat status correlates with low back pain (LBP) and lumbar intervertebral disc degeneration (IVDD), and to identify a new anthropometric index to predict the likelihood of developing LBP. Patients with chronic low back pain admitted to the Affiliated Hospital of Southwest Medical University from June 2022 to May 2023 were collected as the experimental group. Volunteers without LBP from June 2022 to May 2023 were also recruited as the control group. They underwent lumbar spine magnetic resonance imaging (MRI) and had their body mass index (BM) measured. Abdominal parameters were measured on T2-weighted median sagittal MRI at the L3/4 level: abdominal diameter (AD), sagittal abdominal diameter (SAD), and subcutaneous abdominal fat thickness (SAFT). Each lumbar IVDD was assessed using the Pfirrmann grading system. The differences in abdominal parameters and BMI between the experimental and control groups were compared, and the correlations between abdominal parameters, BMI, LBP, and IVDD were analyzed. AD, SAD, and SAFT had moderate-to-strong correlations with BMI. SAD was significantly associated with severe IVDD at L4-L5 and L5-S1 levels with ORs of 3.201 (95% CI: 1.850-5.539, p < 0.001) and 1.596 (95% CI: 1.072-2.378, p = 0.021), respectively. BMI had no significant association with severe IVDD. In females, SAFT and BMI were significantly correlated with LBP; in males, only SAFT was significantly correlated with LBP. Appropriate cutoff values for males and females were 1.52cm (AUC=0.702, 95% CI: 0.615-0.789,p<0.001) and 1.97cm (AUC=0.740, 95% CI: 0.662-0.818,p<0.001), respectively. Males and females with SAFT of >1.52cm and >1.97cm, respectively, had significantly higher rates of LBP. SAD could predict severe IVDD better than BMI. SAFT is a better predictor of LBP than BMI, especially in males, and reliably distinguished patients with LBP from asymptomatic subjects with reliable cutoff values for males and females.

Preoperative CT imaging as a tool to predict incisional hernia outcomes following abdominal wall reconstruction: A retrospective cohort analysis

Ventral wall hernia often causes significant morbidity and requires complex abdominal wall reconstruction (AWR). This study aims to determine whether subcutaneous abdominal fat thickness (AFT) measured with preoperative CT scans could predict postoperative outcomes in patients undergoing AWR. A retrospective cohort study was conducted on all patients who underwent AWR at our institution between 2009 and 2021, with a minimum follow-up of 12 months. Using preoperative CT scans, AFT was measured at the xiphoid process, umbilicus, and pubic tubercle, as well as the hernia dimensions. Demographic, operative, and surgical outcome data were also collected and analyzed using statistical tests. The results showed that 9 of 101 patients (8.9%) experienced hernia recurrence. Smoking was associated with an increased risk of hernia recurrence (p<0.001) with a predictive odds ratio (OR) of 18.27 (p=0.041). Increased AFT at the xiphoid (p=0.005), umbilicus (p<0.001), and pubic tubercle (p<0.001) were also associated with hernia recurrence and risk of infection. Only AFT at the pubic tubercle reached significance in the regression model predicting recurrence (OR=1.10; p=0.030) and infection (OR=1.04; p=0.021). A cut-off value of 67mm was associated with a positive predictive value of 42.14% (sensitivity of 67% and specificity of 91%). Hernia defect area was not associated with risk of recurrence or infection. Smoking and increased AFT at the pubic tubercle are significant predictive factors for recurrence and infection in patients undergoing AWR, and preoperative optimization should focus on reducing these factors.

The relationship between obesity-related H19DMR methylation and H19 and IGF2 gene expression on offspring growth and body composition.

Imprinted genes are important for the offspring development. To assess the relationship between obesity-related H19DMR methylation and H19 and IGF2 gene expression and offspring growth and body composition. Thirty-nine overweight/obese and 25 normal weight pregnant women were selected from the "Araraquara Cohort Study" according to their pre-pregnancy BMI. Fetal growth and body composition and newborn growth were assessed, respectively, by ultrasound and anthropometry. The methylation of H19DMR in maternal blood, cord blood, maternal decidua and placental villi tissues was evaluated by methylation-sensitive restriction endonuclease qPCR, and H19 and IGF2 expression by relative real-time PCR quantification. Multiple linear regression models explored the associations of DNA methylation and gene expression with maternal, fetal, and newborn parameters. H19DMR was less methylated in maternal blood of the overweight/obese group. There were associations of H19DMR methylation in cord blood with centiles of fetal biparietal diameter (BPD) and abdominal subcutaneous fat thickness and newborn head circumference (HC); H19DMR methylation in maternal decidua with fetal occipitofrontal diameter (OFD), HC, and length; H19DMR methylation in placental villi with fetal OFD, HC and abdominal subcutaneous fat thickness and with newborn HC. H19 expression in maternal decidua was associated with fetal BPD and femur length centiles and in placental villi with fetal OFD and subcutaneous arm fat. IGF2 expression in maternal decidua was associated with fetal BPD and in placental villi with fetal OFD. To our knowledge, this is the first study to demonstrate associations of imprinted genes variations at the maternal-fetal interface of the placenta and in cord blood with fetal body composition, supporting the involvement of epigenetic mechanisms in offspring growth and body composition.

Machine Learning-Based Prediction of Abdominal Subcutaneous Fat Thickness During Pregnancy.

Objective: Current evidence regarding the safety of abdominal subcutaneous injections in pregnant women is limited. In this study, we developed a predictive model for abdominal skin-subcutaneous fat thickness (S-ScFT) by gestational periods (GP) in pregnant women. Methods: A total of 354 cases were measured for S-ScFT. Three machine learning algorithms, namely deep learning, random forest, and support vector machine, were used for S-ScFT predictive modeling and factor analysis for each abdominal site. Data analysis was performed using SPSS and RapidMiner softwares. Results: The deep learning algorithm best predicted the abdominal S-ScFT. The common important variables in all three algorithms for the prediction of abdominal S-ScFT were menarcheal age, prepregnancy weight, prepregnancy body mass index (categorized), large fetus for gestational age, and alcohol consumption. Conclusion: Predicting the safety of subcutaneous injections during pregnancy could be beneficial for managing gestational diabetes mellitus in pregnant women.

313 Preoperative CT Imaging: A Tool to Predict Incisional Hernia Outcomes Following Abdominal Wall Reconstruction

Abstract Aim Abdominal wall reconstruction (AWR) is a surgical technique used to manage recurrent incisional hernias, which cause significant morbidity and are difficult to treat. In this study, we sought to determine whether subcutaneous abdominal fat thickness (AFT) measured at the xiphoid process, umbilicus, and pubic tubercle using preoperative CT scans could predict postoperative outcomes in patients undergoing AWR. Method A retrospective cohort study was conducted on all patients who underwent AWR at our institution between 2009 and 2021 with a minimum follow-up of 12 months. Using preoperative CT scans, AFT was measured at the xiphoid process, umbilicus, and pubic tubercle, as well as the hernia dimensions. Demographic, operative, and surgical outcome data were also collected and analysed using statistical tests. Results The results showed that 9 out of 101 patients (8.9%) experienced hernia recurrence. Smoking was significantly associated with an increased risk of hernia recurrence (p&amp;lt;0.001) and had a predictive odds ratio (OR) of 18.27 (p = 0.041). Increased AFT at the xiphoid (p = 0.005), umbilicus (p&amp;lt;0.001), and pubic tubercle (p&amp;lt;0.001) were also associated with hernia recurrence and additionally with risk of infection. However, only AFT at the pubic tubercle reached significance in the multivariate logistic regression model predicting recurrence (OR = 1.10; p = 0.030) and infection (OR = 1.04; p = 0.021). Conclusions In conclusion, smoking and increased subcutaneous abdominal fat thickness at the pubic tubercle are significant risk factors for recurrence and infection in patients undergoing abdominal wall reconstruction, and preoperative optimisation should focus on reducing these factors.

Assessment of Maternal Abdominal Subcutaneous Fat Thickness (Sft) Measured by Ultrasound as an Independent Predictor of Adverse Pregnancy Outcomes

Introduction: Obese pregnant women are at increased risk for a variety of maternal and perinatal complications. The maternal risks related to obesity include Gestational Diabetes mellitus, Preeclampsia, increased caesarean sections. The fetes is at risk of stillbirth, preterm birth and congenital anomalies. This study focuses on the use of Maternal abdominal subcutaneous fat thickness (SFT) as a surrogate measure for central obesity as measured by ultrasound, and determining its efficacy compared to BMI in predicting obesity related pregnancy complications. Objective: To measure mid-trimester SFT in antenatal women and establish SFT as an independent predictor of obesity related adverse pregnancy outcomes Methods: This was a prospective cohort study. 150 pregnant women between 20-40 years of age were recruited. Demographic data of each participant was collected from the OPD. USG for abdominal subcutaneous fat thickness (SFT) was done at 18-22 wks period of gestation. The participants were followed up to labour. Adverse pregnancy outcomes and their correlation with the SFT measured was studied. Results: There was significant positive correlation between BMI and SFT (r=0.591, p&lt;0.001) .A positive correlation was noticed between BMI and adverse pregnancy outcomes such as PIH, GDM , preterm birth , postdates and NICU admissions. SFT independently showed a positive correlation with the above parameters. The mean SFT among women without PIH was 11.45 mm, and with PIH was 16.48 mm[p &lt;0.001].Mean SFT were 11.68mm and 16.24 mm among the ladies without and with GDM respectively[p&lt;0.001]. The mean SFT for term pregnancies was 12.06 mm whereas the mean SFT for preterm births was 14.21 showing positive correlation between SFT and preterm birth. SFT also showed positive correlation with need for NICU admission for neonates [ SFT avg being 11.72mm and 14.94 mm in the 2 groups]. A comparative analysis was done between BMI and SFT regarding their correlation to the various outcomes. SFT showed higher correlation coefficients for these variables than BMI, with lower p values suggesting more statistical significance. Conclusion: BMI showed a positive correlation with adverse pregnancy outcomes in mother as well as fetes, SFT showed greater and more statistically significant correlation for adverse outcomes. Thus it was concluded that SFT is a better independent predictor of obesity related adverse pregnancy outcomes.

Predictive analysis of maternal subcutaneous fat thickness for the risk of postpartum haemorrhage

The incidence of postpartum haemorrhage has been increasing in several developed countries over the past two decades. Obese women are at increased risk of postpartum hemorrhage. Till date BMI has been used to define obesity. Maternal abdominal subcutaneous fat thickness (SCFT) can be used as a measure for central obesity and can be measured by ultrasound easily. The present study was done to find association between maternal BMI and SCFT with development of PPH and to find a cut-off value of BMI and SCFT for prediction of risk of PPH. Methods: 200 women with live singleton pregnancy of 16-18 weeks gestation were included in the study after obtaining written informed consent. Maternal abdominal subcutaneous thickness was measured by USG. All women were monitored till delivery and observed for PPH. All data were entered into MS excel sheet and analysed. Results: Mean BMI was significantly more in women who had PPH (25.85 ± 3.24 vs 22.63 ± 2.80 kg/m2, p - &lt;0.001). Mean SCFT was significantly more in women who had PPH than in women without PPH (16.12 ± 2.75 vs 12.22 ± 3.00 mm, p - &lt;0.001). On ROC curve analysis, SCFT above 15.7 mm (AUC=0.840) predicted PPH with a sensitivity of 85% and specificity of 86% and associated with approximately 34 times increased risk of PPH [OR 34.1; 95% CI ((7.1383 – 162.49290, p - &lt;0.0001]. Conclusion: Maternal abdominal subcutaneous fat thickness measured at 16 to 18 weeks of pregnancy by USG is a reliable marker to identify women at risk of PPH.

Site of left axillary vein crossing the clavicle: an analysis with computed tomography venography as a guide for vein puncture for device implantation.

Blind axillary venous access is a convenient but technically difficult approach for cardiac rhythm device lead implantation. We try to explore whether there are rules on the axillary vein course to facilitate blind venous cannulation. In a single-center, retrospective study, we included 155 patients who underwent computed tomography venography (CTV) examination of left axillary vein. All scans were reviewed for the relationship between left axillary vein and clavicle, vein steepness, and depth. Factors probably affecting above indicators were analyzed. The location of left axillary vein crossing the clavicle was mainly concentrated around the medial 1/3 of clavicle, with mean crossing location of the medial 1/3 of clavicle, which was not correlated with sex, age, abdominal subcutaneous fat thickness, upper thoracic kyphosis angle, or the angle between clavicle and anterior midline (P < 0.05). The average angle between axillary vein and horizontal line was 31.57 ± 11.72°, which was positively associated with age, whereas inversely associated with the angle between clavicle and anterior midline (P < 0.05). The proximal axillary vein ran more and more shallow until becoming the subclavian vein (P < 0.01); and it had a mean depth of 3cm, which was significantly associated with abdominal subcutaneous fat thickness (P < 0.05). The left axillary vein and clavicle had a relatively fixed relationship that axillary vein commonly crossed the medial 1/3 of clavicle. The average angle between axillary vein and horizontal line was 31.57 ± 11.72°, associated with age and the clavicle course. The mean depth of proximal axillary vein was 3cm, and patients with larger weight had a deeper position of axillary vein.

Cryolipolysis for abdominal subcutaneous fat reduction: A prospective, multicenter, single arm, clinical study.

Various treatment methods are used for noninvasive body contouring. To evaluate the efficacy and safety of a newly designed cryolipolysis device using a three-dimensional cooling method for abdominal fat reduction. Twenty-five participants with clinically apparent abdominal fat tissue participated in the study. The thickness of fat tissue below the umbilicus level was measured using a caliper at baseline and 12 weeks after the first treatment. The height of abdominal subcutaneous fat tissue on ultrasonography and participant satisfaction were assessed at every visit for 16 weeks. All adverse events (AEs) during the study period were recorded. p values <0.05 were considered statistically significant. Twenty-four participants completed this study; the mean BMI of participants was 29.34 ± 2.36 kg/m2 . The mean thickness of abdominal subcutaneous fat was significantly lower at 12 weeks (40.4 ± 6.8 mm, p < 0.001) than at baseline (49.3 ± 8.5 mm). Differences in the height of abdominal subcutaneous fat compared to that at baseline were 1.02 ± 0.41 cm (12 weeks, p < 0.001) and 1.13 ± 0.44 cm (16 weeks, p < 0.001). Rates of abdominal subcutaneous fat reduction at 12 and 16 weeks compared to that at baseline were 28.45% and 31.13%, respectively. The ratio of abdominal circumference to hip circumference at 12 and 16 weeks was significantly decreased compared to that at baseline. Most participants (95.8%) reported improvement in satisfaction scores at 16 weeks. There were no serious AEs during the entire study period. The study demonstrated the efficacy of a noninvasive cryolipolysis device using a three-dimensional cooling method for reducing abdominal subcutaneous fat.

Non-invasive cooling wear as an effective means of reducing subcutaneous adipose tissue mass: an in-vivo study.

ObjectiveThe increasing prevalence of obesity is a major health problem worldwide. Several non-surgical treatments are now available that reduce body and subcutaneous fat mass. We aimed to determine the efficacy of mild cold for body mass reduction.MethodsNovel cooling wear, which induces mild cooling via evaporation, was worn by 29 women with overweight for 4 weeks. Specifically, the participants wore a cooling waist belt and chaps for 1 hour per day. Non-invasive lipometry was used to determine their subcutaneous adipose tissue thicknesses, and the total weight loss, abdominal circumference, and body mass index (BMI) of the participants were measured.ResultsThe participants achieved a significant total weight loss of 0.7 kg (0.9%), and significant reductions in BMI (0.2 kg/m2) and abdominal circumference (1.9 cm, 1.7%). Furthermore, there was a trend towards a reduction in abdominal subcutaneous fat thickness and a significant reduction in thickness of the anterior thigh was noted. A questionnaire-based evaluation indicated high usability and comfort of the cooling wear.ConclusionThere is a high and growing demand for non-invasive treatment strategies for obesity. Cooling wear represents a novel and promising approach that may be of particular use for individuals who do not require bariatric surgery.

Predictive analysis of maternal subcutaneous fat thickness for the risk of foetal macrosomia

Introduction: Foetal macrosomia is defined as a birth weight above the 90th percentile for gestational age or a birth weight ≥4000 g. Maternal obesity is one of the risk factors for foetal macrosomia. Maternal abdominal subcutaneous fat thickness can be used as a marker for central obesity. This present study was done to find association of maternal BMI and abdominal SCFT with macrosomia and to find a cut-off value of BMI and SCFT for prediction of macrosomia. Methods: 200 women, with live singleton pregnancy of 16-18 weeks of gestation were included after written informed consent. Maternal abdominal subcutaneous thickness was measured by ultrasonography. Women were followed till delivery and birth weight was calculated and babies with birth weight &gt;4000 gm were diagnosed to be macrosomic. Data were analyses. Results: Spearman correlation between SCFT and neonatal weight shows a significant but weak positive linear relation (r= 0.4325, p- 0.000). Mean SCFT was significantly more in women with macrosomia (17.26 ± 2.6 vs. 12.35 ± 3.05 mm, p 0.0005 respectively) ROC curve analysis for ASCFT showed that ASCFT above 14.3 mm (AUC=0.970) predicted macrosomia with a sensitivity of 100% and specificity of 73%. Increased abdominal SCFT was significantly associated with increased risk of developing macrosomia. Using 14.3 mm cut -off value (by ROC curve) for ASCFT, the odd ratio of macrosomia was 30 (95% CI 1.6341-553.2106, p 0.02). Conclusion: Our study found that measurement of SCFT at 16-18 weeks is a significant predictor of macrosomia.

Performance of maternal abdominal subcutaneous fat thickness in predicting cesarean section

Introduction: Overweight and obesity during pregnancy is associated with increased risk for cesarean delivery. BMI is the most frequently used parameters to define and to assess risk of pregnancy related complications. Maternal abdominal subcutaneous fat thickness (SCFT) can be used as a measure of obesity. The present study was done to find association of maternal SCFT with risk of cesarean section. Methods: 200 women with singleton live pregnancy at 16-18 weeks were included in the study after obtaining written informed consent. Ultrasonography was done to assess foetal wellbeing and rule out congenital malformation. Maternal abdominal subcutaneous thickness was measured. All women were followed during labour till discharge. ROC curve analysis was done to predict the risk of cesarean section. Odd ratio for SCFT mediated risk of cesarean section was calculated. Results: 32.5% women had cesarean delivery. Mean SCFT was also significantly more in women delivered by cesarean than who delivered vaginally (p &lt;0.001). ROC curve analysis for SCFT showed that SCFT above 11.5 mm (AUC=0.735) predicted LSCS with a sensitivity of 86.2% and specificity of 47.4% and Youden index of 0.34. Increased abdominal SCFT was significantly associated with increased risk of LSCS. . Using 11.5 mm cut -off value (by ROC curve) for SCFT, the odd ratio of LSCS was 7.5 (95% CI 3.4056 – 16.5837, p &lt;0.0001). Stitch line infection was seen in 15.38% women. Conclusion: This study observed that measurement of SCFT by ultrasonography at 16-18 weeks pregnancy is a significant predictor of cesarean section.

MP52-15 ABDOMINAL SUBCUTANEOUS FAT THICKENING IS THE USEFUL MARKER TO PREDICT LOWER URINARY TRACT DYSFUNCTION AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY

You have accessJournal of UrologyCME1 May 2022MP52-15 ABDOMINAL SUBCUTANEOUS FAT THICKENING IS THE USEFUL MARKER TO PREDICT LOWER URINARY TRACT DYSFUNCTION AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY Shunta Makabe, Yusuke Kirihana, Tomoyuki Kumekawa, Hiroki Natsuya, Yusuke Hakozaki, Shunsuke Yoshioka, Yu Endo, Akihisa Hasegawa, Yuki Harigane, Kei Yaginuma, Hitomi Imai, Akifumi Onagi, Kanako Matsuoka, Tomoyuki Koguchi, Junya Hata, Yuichi Sato, Hidenori Akaihata, Masao Kataoka, and Yoshiyuki Kojima Shunta MakabeShunta Makabe More articles by this author , Yusuke KirihanaYusuke Kirihana More articles by this author , Tomoyuki KumekawaTomoyuki Kumekawa More articles by this author , Hiroki NatsuyaHiroki Natsuya More articles by this author , Yusuke HakozakiYusuke Hakozaki More articles by this author , Shunsuke YoshiokaShunsuke Yoshioka More articles by this author , Yu EndoYu Endo More articles by this author , Akihisa HasegawaAkihisa Hasegawa More articles by this author , Yuki HariganeYuki Harigane More articles by this author , Kei YaginumaKei Yaginuma More articles by this author , Hitomi ImaiHitomi Imai More articles by this author , Akifumi OnagiAkifumi Onagi More articles by this author , Kanako MatsuokaKanako Matsuoka More articles by this author , Tomoyuki KoguchiTomoyuki Koguchi More articles by this author , Junya HataJunya Hata More articles by this author , Yuichi SatoYuichi Sato More articles by this author , Hidenori AkaihataHidenori Akaihata More articles by this author , Masao KataokaMasao Kataoka More articles by this author , and Yoshiyuki KojimaYoshiyuki Kojima More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002627.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Obesity is known as an important patient factor to determine lower urinary tract dysfunction (LUTD) after robot-assisted radical prostatectomy (RARP). BMI is one of the makers of obesity, and usually used to evaluate the effect of obesity on lower urinary tract function. However, BMI does not differentiate between fat and nonfat tissue including muscle. We considered the possibility that total body or local fat might more accurately reflect obesity compared to BMI. This study aimed to investigate whether total body or local fat was useful predictors of LUTD associated with obesity after RARP. METHODS: A total of 536 patients (66.9±5.3 years) who underwent RARP at our institution were included in this study. We measured the thickness of abdominal subcutaneous fat (SCFT) and preprostatic fat (PPFT) in preoperative magnetic resonance imaging as evaluation items for total body and local fat. Uroflowmetry (UFM), post-void residual urine volume (PVR) and one-hour pad test were performed in all patients at 1,3,6 and 12 months after RARP. Bladder voiding efficiency (BVE, defined as the ratio between voided volume and total bladder capacity by UFM and PVR) and volume of incontinence at each month after RARP were used as postoperative objective parameters reflecting lower urinary tract function. The association between preoperative total body and local fat and the postoperative objective parameters were evaluated. RESULTS: BVE were significantly correlated with SCFT at 1,3,6 and 12 months after RARP (p<0.05). Volume of incontinence were significantly correlated with SCFT at 3,6 and 12 months after RARP (p<0.05). PPFT did not show a significant correlation with all postoperative objective parameters. In multivariate analysis, SCFT was significantly associated with BVE at 1,3,6 and 12 months after RARP (p<0.05) and volume of incontinence at 3,6 and 12 months (p<0.05). CONCLUSIONS: In our study, preoperative SCFT was associated with decreased BVE and increased urinary incontinence, although preoperative PPFT was not associated with LUTD after RARP. These results indicated that total body fat may have a greater effect on the onset of LUTD after RARP than local fat. SCFT might reflect metabolic disorders which were known to be associated with LUTD. Preoperative SCFT measurement may be useful predictor of the onset of LUTD after RARP. Source of Funding: nothing © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e892 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shunta Makabe More articles by this author Yusuke Kirihana More articles by this author Tomoyuki Kumekawa More articles by this author Hiroki Natsuya More articles by this author Yusuke Hakozaki More articles by this author Shunsuke Yoshioka More articles by this author Yu Endo More articles by this author Akihisa Hasegawa More articles by this author Yuki Harigane More articles by this author Kei Yaginuma More articles by this author Hitomi Imai More articles by this author Akifumi Onagi More articles by this author Kanako Matsuoka More articles by this author Tomoyuki Koguchi More articles by this author Junya Hata More articles by this author Yuichi Sato More articles by this author Hidenori Akaihata More articles by this author Masao Kataoka More articles by this author Yoshiyuki Kojima More articles by this author Expand All Advertisement PDF DownloadLoading ...

Short-term curative effect and safety on female abdominal obesity and defecation function treated with acupoint embedding therapy at different layers under B ultrasound

To investigate the short-term effect and safety on female abdominal obesity and defecation function in treatment with acupoint embedding therapy at different abdominal layers under B ultrasound. A total of 102 female patients with abdominal obesity were randomly divided into 3 groups, i.e. a deep embedding group (34 cases, 1 case dropped out), a shallow embedding group (34 cases, 3 cases dropped out) and a sham-embedding group (34 cases, 6 cases dropped out). Finally, 92 cases were included in the three groups. Under B ultrasound, in the deep embedding group, the absor-bable surgical suture were embedded in subcutaneous fat layer and muscle layer. In the shallow embedding group, the absorbable surgical suture was embedded in the fat layer and in the sham-embedding group, no suture was embedded. The acupoints for embedding therapy included Zhongwan (CV12), Guanyuan (CV4), bilateral Guanmen (ST22), bilateral Tianshu (ST25), bilateral Daimai (GB26) and bilateral Shuidao (ST28). The acupoint embedding therapy was exerted once every two weeks, for 4 times totally. Before and after treatment, the changes in abdominal obesity indicators (waist circumference ［WC］, body fat rate ［BFR］, body mass index ［BMI］, abdominal subcutaneous fat thickness ［ASFT］) and defecation function indicators (spontaneous bowel movement times ［SBMs］ and Bristol stool scale ［BSS］) were observed and the safety indicators were assessed. After treatment, WC, BFR, BMI and ASFT were lower than those before treatment in both the deep embedding group and the shallow embedding group (P<0.05), those values in the deep embedding group were reduced more obviously as compared with the shallow embedding group (P<0.05). SBMs and BSS after treatment were increased as compared with those before treatment in both the deep embedding group and the shallow embedding group (P<0.05) and the increase in the deep embedding group was more obvious than in the shallow embedding group (P<0.05). The abdominal obesity indicators and defecation function indicators after treatment were not different statistically as compared with those before treatment in the sham-embedding group (P>0.05). The pain score of acupuncture in either the deep embedding group or the shallow embedding group was higher than in the sham-embedding group (P<0.05). The acceptance was more than 2 points in all of the three groups and there was no statistical significance among groups (P>0.05). Acupoint embedding therapy in both the deep and the shallow subcutaneous layers under B ultrasound may regulate the indicators of female abdominal obesity safely. The acupoint embedding therapy in the deep layer is more effective on abdominal obesity and defecation improvement as compared with that exerted in the shallow layer.

Interplay of serum hepcidin with female sex hormones, metabolic syndrome, and abdominal fat distribution among premenopausal and postmenopausal women

Background and purposeHepcidin is the central regulatory molecule of systemic iron homeostasis. Serum ferritin, insulin resistance (IR) and metabolic syndrome (MetS), female sex hormones, and abdominal fat distribution are related to each other and all are linked to menopausal state. Our study was the first to assess the impact of these parameters on hepcidin level among premenopausal women (group I) during the early follicular phase (group I-F) and mid-luteal-phase (group I-L) of the same reproductive cycle and among postmenopausal women (group II). Serum iron parameters, estrogen, progesterone and hepcidin, and plasma insulin were assessed. Abdominal subcutaneous fat (SCF) and peritoneal visceral fat (PVF) thickness were measured by unenhanced- CT. Group I and group II were divided into MetS and non-MetS subgroups.ResultsThe entire group II and MetS-stratified subgroups had significant higher hepcidin level than corresponding group I-F and group I-L. Group I-L had significant higher hepcidin than group I-F. Among group I-F, group I-L, and group II, MetS subgroups had higher hepcidin but not hepcidin/ ferritin ratio (H/F) than corresponding non-MetS; and hepcidin had positive correlations with ferritin, insulin, IR, and SCF. In group I-F and group II, hepcidin had positive correlations with estrogen and progesterone; hepcidin levels increase significantly and linearly with increasing number of MetS features; and cut off values of hepcidin for prediction of MetS were 5.8 ≥ and ≥ 10.3 ng/ml respectively. Main contributors to hepcidin were iron and ferritin in all groups, SCF and progesterone in group I-F, and insulin, progesterone, and MetS in group II. H/F ratio was higher in group II.ConclusionPostmenopausal state (postMS), MetS, and luteal phase are independently associated with high hepcidin level. Serum iron parameters (iron and ferritin) as main regulators of hepcidin are preserved regardless of menopausal state. Its regulation differs based on menopausal state: IR, MetS, and progesterone in postMS meanwhile abdominal SCF and progesterone in premenopausal states. Despite positive associations of estrogen and progesterone with hepcidin, they do not explain its higher level in postMS. Hepcidin levels linearly increase with number of Mets feature and it had high sensitivity for diagnosis of MetS.

Risk factors for the development of a parastomal hernia in patients with enterostomy: a systematic review and meta-analysis.

Parastomal hernia (PSH) is a common and serious complication in patients with enterostomy, but there is no current consensus for the risk factors for PSH from previous studies. Therefore, this study systematically analyzed the risk factors for PSH to provide a reference for prevention and treatment of this condition. Seven databases and 3 registers were systematically searched from database inception to January, 2021. Study quality was assessed by Newcastle-Ottawa Scale. Review Manager 5.3 software was used for statistical analysis. The data that could not be combined quantitatively were only analyzed qualitatively. Sixteen studies with 2031 patients were included. Higher BMI (OR, 1.29; 95% CI,1.02-1.63), older age (OR, 1.04; 95% CI, 1.02-1.07), female (OR, 2.55; 95% CI,1.39-4.67), lager aperture size (OR, 2.8; 95%CI, 1.78-4.42), transperitoneal stoma creation (OR, 2.4; 95% CI, 1.33-4.35), and lager waist circumference (OR, 1.01; 95% CI,1.0-1.01) were significant risk factors for PSH. The laparoscopic approach was not a risk factor for PSH (OR, 2.09; 95% CI, 0.83-5.27). Other risk factors, including the thickness of abdominal subcutaneous fat, no mesh, a stoma not through the middle of the rectus abdominis, atrophy of left lower medial part of rectus abdominis, α1(III) procollagen expression level, emergency surgery, no preoperative stoma site marking, end colostomy, smoking, diabetes, peristomal infection, severe abdominal distention, severe cough, chronic obstructive pulmonary disease, operation time and hypertension, were significant on the multivariate analysis of each individual study. The current available evidence showed that higher BMI, older age, female, larger aperture size, the creation of a transperitoneal stoma, and a larger waist circumference were independent risk factors for PSH. For factors without exact cutoff value, further explorations are needed in the future. In addition, reference to the limited number of studies in the pooled analysis, these factors still need to be interpreted carefully.

Relevance of Subcutaneous Fat Thickness as a Risk Factor for Surgical Site Infections in Abdominal Surgeries.

IntroductionIncisional surgical site infection is an important cause of postoperative morbidity which results in extended hospital stay and may result in future incisional hernia. We intended to evaluate the thickness of subcutaneous fat with a cut-off value of 2.5cm as a risk factor in causing surgical site infection using a simple, cost-effective, and direct intraoperative method for measuring subcutaneous fat thickness.MethodsA total of 147 patients who underwent abdominal surgeries from September 2017 to April 2019 were included in this prospective study. A proforma was used to collect information of all patients regarding various variables. Abdominal subcutaneous fat thickness was measured in the supine position intraoperatively with a measuring scale from below dermis to rectus sheath at 1cm caudal to umbilicus level.ResultsThe study's overall incidence of incisional surgical site infection (SSI) in laparotomy surgeries was 10.8%. Subcutaneous fat thickness was independently associated with incisional SSI. Subcutaneous fat thickness association with SSI was more statistically significant than that of BMI. The other associated risk factors were found to be obesity, diabetes, and emergency surgery.ConclusionOur results suggest that the risk of incisional SSI increases with the increased subcutaneous fat thickness of more than 2.5cm. Placement of subcutaneous drain in patients undergoing laparotomy with increased subcutaneous fat thickness plays a significant role in reducing the incidence of surgical site infection. Risk of SSI increases in obesity, diabetes, increased age group, dirty surgery, and emergency surgeries. Subcutaneous fat thickness is an independent risk factor for surgical site infection and subcutaneous drain decreases the risk of SSI in thick subcutaneous fat.

ABDOMINAL SUBCUTANEOUS FAT THICKNESS MEASURED BY ULTRASOUND AS A PREDICTOR OF TOTAL FAT MASS IN YOUNG- AND MIDDLE-AGED ADULTS.

Predictive equations estimate total fat mass obtained from multiple-site ultrasound measurements; however, the predictive equation of total fat mass has not been investigated solely from abdominal subcutaneous fat thickness. To develop regression-based prediction equations using abdominal subcutaneous fat thickness for predicting fat mass, and to explore the validity of these predictive equations. Cross-sectional study. Twenty-seven males and eighteen females were randomly divided into two groups as the model prediction and the validation. Total body fat mass was determined by dual-energy X-ray absorptiometry. The linear regression analysis was used to predict equations for total body fat mass from abdominal subcutaneous fat thickness acquired by ultrasound. Then, these predictive equations were tested on the validation group. Lin's concordance correlation coefficient (CCC) was used as a further measure of agreement. When fat mass prediction equations were tested on the validation groups, measured- and estimated-total fat masses in males (p=0.9) and females (p=0.5) were found similar. A good level of agreement between measurements in males (CCC=0.84) and females (CCC=0.76) was attained. The abdominal subcutaneous fat thickness obtained from a single region by ultrasound might provide a non-invasive and quick evaluation.

Abdominal skin subcutaneous fat thickness over the gestational period in Korean pregnant women: a descriptive observational study.

PurposeAlthough insulin is usually injected into the abdominal subcutaneous fat, in pregnancy women tend to avoid abdominal injections due to concern about fetal damage. Prior studies have been limited to only measuring skin-subcutaneous fat thickness (S-ScFT) at one site at specific pregnancy points. This study aimed to measure S-ScFT across several abdominal sites and over the gestational period in Korean pregnant women. This can identify which site would be relatively safe for subcutaneous injection during pregnancy. MethodsHealthy women over 24 weeks of pregnancy in Korea were invited to voluntarily participate in this descriptive study. For the 142 women, S-ScFT of 12 sites in the abdomen were measured by ultrasound, several times over the pregnancy. Each incidence was treated as a case and a total of 262 cases were analyzed.ResultsThe mean S-ScFT during pregnancy was 1.14±0.47 cm (1.25±0.54 cm at 24+0–27+6 weeks; 1.17±0.48 cm at 28+0–31+6 weeks; 1.09+0.40 cm at 32+0–35+6 weeks; and 1.06±0.47 cm at 36+0–40 weeks of pregnancy). Most S-ScFT were thicker than 10 mm. But S-ScFTs in the lateral abdomen and some sites were suboptimal (<6 mm), especially in the pre-pregnancy underweight body mass index group, who had a high rate of suboptimal thickness (27.1% overall and 33.9% in the lateral side). ConclusionThe whole abdomen seems to be appropriate for subcutaneous injection in most Korean women during pregnancy, with a 4 to 5-mm short needle. However, for the lateral abdomen, making the skin fold might be needed for fetal safety.