Adipose Tissue Area Research Articles

One‐Year Comparison of Body Composition in a Cohort of Patients with Multiple Myeloma

ObjectiveTo examine whether there are changes in body fat composition and skeletal muscle density over a one‐year period in a cohort of patients with multiple myeloma.HypothesisWe hypothesized that there are differences in specific body fat composition and skeletal muscle indices in a one‐year follow‐up for patients with multiple myeloma. These changes may predict the progression of disease more accurately and offer opportunities to improve outcomes with clinical intervention.MethodsThis is a retrospective cohort study examining preexisting CT scans of multiple myeloma (MM) patients from a midwestern healthcare system. Demographic information including age, sex, race, and BMI was gathered (Table 1). The body fat and skeletal muscle measurements were performed by one investigator using Aquarius iNtuition software version 4.4.12. To standardize the CT scan measurements, slices were taken at the third lumbar vertebra where both transverse processes were visible. Measurements were confirmed using tissue‐specific Hounsfield unit (HU) ranges of ‐190 to ‐30 for adipose tissue and ‐20 to 150 for skeletal muscle. All scans were measured in a light‐controlled radiological reading room and investigator training was performed under the supervision of a board‐certified radiologist who specializes in abdominal imaging.ResultsA total of 22 unique patients (14 women and 8 men) with MM were identified as having had two whole body low‐dose CT scans one year apart during the study period. In women, the mean visceral adipose tissue (VAT) area (cm2) and the subcutaneous adipose tissue (SQAT) area (cm2) decreased slightly from baseline to the one‐year follow‐up (Figure 1). The mean skeletal muscle density showed a small increase from baseline to follow‐up. Men also showed a small decrease visceral adipose tissue (VAT) area (cm2) and the subcutaneous adipose tissue (SQAT) area (cm2) from baseline to one‐year follow‐up. In contrast to women, they showed a small decrease from baseline to follow‐up. All changes were non‐significant.ConclusionsWe performed a retrospective analysis of changes in body fat composition and skeletal muscle density in multiple myeloma patients over a one‐year period. Previous studies have shown that higher SQAT is associated with worse overall survival. However, we found no changes in any of our parameters over the course of one year that would indicate a trend towards disease progression. Further follow‐up may be needed over a longer time period. Additionally, a larger sample with more complete imaging records is needed to make stronger conclusions. More reliable prognostic biomarkers would help determine current disease burden.1. Gomez‐Perez SL, Haus JM, Sheean P, et al. Measuring abdominal circumference and skeletal muscle from a single cross‐sectional computed tomography image: A step‐by‐step guide for clinicians using National Institutes of Health ImageJ. J Parenter Enter Nutr. 2016;40(3):308‐318. doi:10.1177/01486071156041492. Da Cunha, Ademar Dantas, et al. “Adipose Tissue Radiodensity: A New Prognostic Biomarker in People with Multiple Myeloma.” Nutrition, vol. 86, 2021, p. 111141., https://doi.org/10.1016/j.nut.2021.111141.

Analysis of Risk Factors of Soft Tissue Bleeding in COVID-19 Patients: A Point of View After Two Years of Pandemic.

BackgroundThe aim of the study was to analyze the relationship between patient characteristics, including anagraphic and laboratoristic data and amount of adipose tissue measured in computed tomography (CT) scans in coronavirus disease 2019 (COVID-19) patients, and incidence of soft tissue bleeding requiring medical and/or interventional radiology management.MethodsA total of 132 patients hospitalized for COVID-19 pathology from October 2020 to May 2021 were included in the study and divided into two groups: a bleeding group of 70 cases with soft tissue bleeding occurring during hospitalization, and a control group of 62 hospitalized COVID-19 patients without bleeding events. In the bleeding group, two subgroups were considered: an embolization group including soft tissue bleeding cases requiring interventional radiology with transarterial embolization (TAE) (16/70; 22.9%) and a non-embolization group, clinically managed without TAE (54/70; 77.1%). Demographics and clinical data, visceral adipose tissue (VAT) area and subcutaneous adipose tissue (SAT) area measured on CT images and VAT/SAT ratio were compared between bleeding and control groups and between embolization and non-embolization subgroups.ResultsBleeding and control groups did not significantly differ for sex distribution, COVID-19, platelet (PLT) count, international normalized ratio (INR), SAT area, VAT area, and VAT/SAT ratio. Embolization and non-embolization groups did not significantly differ for age, COVID-19, PLT count, INR, SAT area, and VAT/SAT ratio. Bleeding group had lower body mass index (BMI) than control group as well as embolization group compared to non-embolization group. A statistically significant difference was observed between embolization and non-embolization groups for VAT area, with smaller values in embolization group (mean difference: 64.2 cm2, 95% confidence interval: 8.3 - 120.1; P < 0.05).ConclusionSoft tissue bleeding in COVID-19 is more frequent and severe in patients with low amount of VAT, demonstrating that fat mass may have a containing function on bleeding, limiting its progression in surrounding structures. There are some other factors that influence the risk of bleeding, such as age, thromboprophylaxis therapy and BMI.

Assessing Visceral Obesity and Abdominal Adipose Tissue Distribution in Healthy Populations Based on Computed Tomography: A Large Multicenter Cross-Sectional Study

ObjectiveAbdominal adipose is closely related to many endocrine and metabolic diseases. The aim of this study was to analyze the distribution of abdominal adipose tissue in a healthy population in northern China determined by abdominal computed tomography (CT).MethodsData for this study were obtained from a multicenter, retrospective, cross-sectional study that collected abdominal CT scans of 1787 healthy individuals from 4 representative cities in northern China. Areas of visceral adipose tissue (VATA) and subcutaneous adipose tissue (SATA) were obtained by measuring CT images at the level of the 3rd lumbar vertebra. Visceral adipose tissue index (VATI) and subcutaneous adipose index (SATI) were obtained by normalizing the square of height to analyze the distribution of the above indexes and visceral obesity among different body mass index (BMI), gender and age.ResultsThe mean age of this healthy population was 45.3 ± 15.2 years and the mean BMI was 23.5 ± 3.2 kg/m2, with 902 men and 885 women. Compared with women, men had a significantly higher median VATA (120.9 vs. 67.2 cm2), VATI (39.1 vs. 25.6 cm2/m2) and a significantly higher percentage of visceral adiposity (VATA ≥ 100 cm2) (60.8 vs. 30.4%), while women had significantly higher SATA (116.9 vs. 146.7 cm2) and SATI (38.8 vs. 55.8 cm2/m2) than men. Whether men or women, VATI was positively correlated with age. Interestingly, SATI was weakly positively correlated with age in women, while SATI was weakly negatively correlated with age in men. In persons with a normal BMI, the proportion of visceral adiposity increases with age, whereas in men with a normal BMI, the proportion of visceral adiposity decreases after the age of 60 years but remains >50%.ConclusionsThe distribution of abdominal visceral and subcutaneous adipose tissue parameters measured by CT differed among gender, age, and BMI. Even men and women with normal BMI have a high proportion of visceral obesity.

Associations of Computed Tomography Image-Assessed Adiposity and Skeletal Muscles with Triple-Negative Breast Cancer.

Simple SummaryDespite BMI’s wide use as a measure of body size and its clinical and epidemiological utility, it measures weight and height without differentiating between adipose tissue and skeletal muscle. To overcome these limitations, we analyzed the third lumbar (L3) computed tomography (CT) images of 350 breast cancer patients to measure the areas of adipose tissue and five-level skeletal muscle components and assessed their relationships with triple-negative breast cancer (TNBC), an aggressive subtype leading to higher mortality. We found that higher areas of adipose tissues were associated with an increased likelihood of TNBC subtype, especially in premenopausal women. Since the risk factors associated with adiposity and skeletal muscles are modifiable, such as healthy diets, resistance training, and adequate protein intake, it is expected that a better understanding of this body composition component will lead to novel prevention and management strategies for TNBC.Obesity measured by anthropometrics is associated with increased risk of triple-negative breast cancer (TNBC). It is unclear to what extent specific adipose tissue components, aside from muscle, are associated with TNBC. This retrospective study included 350 breast cancer patients who received treatment between October 2011 and April 2020 with archived abdominal or pelvic computed tomography (CT) images. We measured the areas of adipose tissue and five-density levels of skeletal muscle on patients’ third lumbar vertebra (L3) image. Logistic regression was performed to examine the associations of specific adiposity and skeletal muscles components and a four-category body composition phenotype with the TNBC subtype. Results showed that higher vs. lower areas (3rd vs. 1st tertiles) of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were associated with increased odds of TNBC vs. non-TNBC after adjusting for age, race, stage, tumor grade, tumor size, and skeletal muscle areas (adjusted odds ratio [AOR], 11.25 [95% CI = 3.46–36.52]) and (AOR, 10.34 [95% CI = 2.90–36.90]) respectively. Higher areas of low density muscle was also associated with increased odds of TNBC (AOR, 3.15 [95% CI = 1.05–10.98]). Compared to normal body composition (low adipose tissue/high muscle), high adiposity/high muscle was associated with higher odds of TNBC (AOR, 5.54 [95% CI = 2.12–14.7]). These associations were mainly in premenopausal women and among patients with the CT performed after breast cancer surgery. Specific adipose tissue and low-density muscle can be associated with the TNBC subtype in breast cancer patients. The direction of association warrants confirmation by prospective studies.

Histological Comparison of Buccal and Lingual Mucosa Grafts for Urethroplasty: Do They Share Tissue Structures and Vascular Supply?

Comparable outcomes were published using a buccal mucosa graft (BMG) from the cheek and a lingual mucosa graft (LMG) from the sublingual area, for urethral augmentation or substitution. To date, no histological comparison between both grafts has been conducted. We histologically assessed BMG and LMG harvested during urethral surgeries, aiming to compare graft properties and vascular support. We conducted a prospective single cohort study, including oral mucosa urethroplasty patients. During surgery, graft dimensions and donor sites were collected, and a 0.5 × 0.5 cm sample was obtained from the prepared graft. Formalin-fixed paraffin-embedded samples were sliced at 4 micrometres (µm) and hematoxylin-eosin stained. Using a telepathology tool, all slides were digitalized and measured from 10× to 40× magnification. In each graft, global and individual layers thicknesses were assessed, including vascular density and area. Descriptive and comparative (parametrical and non-parametrical) statistical analysis occurred. We collected 57 grafts during 33 urethroplasties, with 30 BMG and 22 LMG, finally, included. The mean age was 56.6 (SD 15.2) years, and the mean graft length was 5.8 (SD 1.7) cm and the width was 1.7 (SD 0.4) cm. The median graft thickness was 1598.9 (IQR 1200–2100) µm, the mean epithelium layer was 510.2 (SD 223.7) µm, the median submucosa was 654 (IQR 378–943) µm. the median muscular was 477.6 (IQR 286–772) µm, the median vascular area was 5% (IQR 5–10), and the median adipose tissue area was 5% (IQR 0–20). LMG were significantly longer and narrower than BMG. Total graft thickness was similar between LMG and BMG, but the epithelium and submucosa layers were significantly thinner in LMG. The muscular layer was significantly thicker in LMG. Vascular density and vascular areas were not significantly different between both types of grafts. LMG showed significantly less adipose tissue compared with BMG. Our findings show LMG and BMG for urethroplasty surgeries share the same thickness and blood supply, despite having significantly different graft sizes as well as mucosal and submucosal layers thickness.

Associations of pulmonary and extrapulmonary computed tomographic manifestations with impaired physical activity in symptomatic patients with chronic obstructive pulmonary disease

In patients with chronic obstructive pulmonary disease (COPD), emphysema, airway disease, and extrapulmonary comorbidities may cause various symptoms and impair physical activity. To investigate the relative associations of pulmonary and extrapulmonary manifestations with physical activity in symptomatic patients, this study enrolled 193 patients with COPD who underwent chest inspiratory/expiratory CT and completed COPD assessment test (CAT) and the Life-Space Assessment (LSA) questionnaires to evaluate symptom and physical activity. In symptomatic patients (CAT ≥ 10, n = 100), emphysema on inspiratory CT and air-trapping on expiratory CT were more severe and height-adjusted cross-sectional areas of pectoralis muscles (PM index) and adjacent subcutaneous adipose tissue (SAT index) on inspiratory CT were smaller in those with impaired physical activity (LSA < 60) than those without. In contrast, these findings were not observed in less symptomatic patients (CAT < 10). In multivariable analyses of the symptomatic patients, severe air-trapping and lower PM index and SAT index, but not CT-measured thoracic vertebrae bone density and coronary artery calcification, were associated with impaired physical activity. These suggest that increased air-trapping and decreased skeletal muscle and subcutaneous adipose tissue quantity are independently associated with impaired physical activity in symptomatic patients with COPD.

Computed tomography reference values for visceral obesity and increased metabolic risk in a Caucasian cohort.

Visceral obesity is associated with the metabolic syndrome. The metabolic risk differs per ethnicity, but reference values for visceral obesity for body composition analyses using Computed Tomography (CT) scans in the Caucasian population are lacking. Therefore, the aim of this study was to define gender specific reference values for visceral obesity in a Caucasian cohort based upon the association between the amount of visceral adipose tissue (VAT) and markers of increased metabolic risk. Visceral Adipose Tissue Area Index (VATI cm2/m2) at the level of vertebra L3 was analyzed using CT scans of 416 healthy living kidney donor candidates. The use of antihypertensive drugs and/or statins was used as an indicator for increased metabolic risk. Gender specific cut-off values for VATI with a sensitivity ≥80% were calculated using receiver operating characteristic (ROC) curves. In both men and women who used antihypertensive drugs, statins or both, VATI was higher than in those who did not use these drugs (p≤0.013). In males and females respectively, a value of VATI of ≥38.7cm2/m2 and ≥24.9cm2/m2 was associated with increased metabolic risk with a sensitivity of 80%. ROC analysis showed that VATI was a better predictor of increased metabolic risk than BMI (area under ROC curve (AUC)=0.702 vs AUC=0.556 in males and AUC=0.757 vs AUC=0.630 in females). Gender and ethnicity specific cut-off values for visceral obesity are important in body composition research, although further validation is needed. This study also showed that quantification of VATI is a better predictor for metabolic risk than BMI.

Coronary microvascular function and visceral adiposity in patients with normal body weight and type 2 diabetes.

ObjectiveThis study sought to assess whether diabetes affects coronary microvascular function in individuals with normal body weight.MethodsSeventy‐five participants (30 patients with type 2 diabetes [T2D] who were overweight [O‐T2D], 15 patients with T2D who were lean [LnT2D], 15 healthy volunteers who were lean [LnHV], and 15 healthy volunteers who were overweight [O‐HV]) without established cardiovascular disease were recruited. Participants underwent magnetic resonance imaging for assessment of subcutaneous, epicardial, and visceral adipose tissue areas, adenosine stress myocardial blood flow (MBF), and cardiac structure and function.ResultsStress MBF was reduced only in the O‐T2D group (mean [SD], LnHV = 2.07 [0.47] mL/g/min, O‐HV = 2.08 [0.42] mL/g/min, LnT2D = 2.16 [0.36] mL/g/min, O‐T2D = 1.60 [0.28] mL/g/min; p ≤ 0.0001). Accumulation of visceral fat was evident in the LnT2D group at similar levels to the O‐HV group (LnHV = 127 [53] cm2, O‐HV = 181 [60] cm2, LnT2D = 182 [99] cm2, O‐T2D = 288 [72] cm2; p < 0.0001). Only the O‐T2D group showed reductions in left ventricular ejection fraction (LnHV = 63% [4%], O‐HV = 63% [4%], LnT2D = 60% [5%], O‐T2D = 58% [6%]; p = 0.0008) and global longitudinal strain (LnHV = −15.1% [3.1%], O‐HV= −15.2% [3.7%], LnT2D = −13.4% [2.7%], O‐T2D = −11.1% [2.8%]; p = 0.002) compared with both control groups.ConclusionsPatients with T2D and normal body weight do not show alterations in global stress MBF, but they do show significant increases in visceral adiposity. Patients with T2D who were overweight and had no prior cardiovascular disease showed an increase in visceral adiposity and significant reductions in stress MBF.

Magnetic Resonance Imaging Assessment of Abdominal Ectopic Fat Deposition in Correlation With Cardiometabolic Risk Factors.

PurposeEctopic fat accumulation and abdominal fat distribution may have different cardiometabolic risk profiles. This study aimed to assess the associations between various magnetic resonance imaging (MRI)-acquired fat depots and cardiometabolic risk factors.MethodsA total of 320 subjects with median age of 59 years, 148 men and 172 women, were enrolled in the study. Visceral adipose tissue (VAT) area and fat fraction (FF), subcutaneous adipose tissue (SAT) area and FF at the L1–L2 levels, preperitoneal adipose tissue (pPAT) area and FF, hepatic FF, pancreatic FF, and intramuscular FF were assessed by MRI FF maps. The associations of various MRI-acquired fat depots with blood pressure, glucose, and lipid were examined using sex-stratified linear regression. Logistic regression stratified by sex was used to analyze the association of various MRI-acquired fat depots with the risk of hypertension, T2DM, and dyslipidemia.ResultsThe intraclass correlation coefficient (ICC) values were >0.9, which suggested good interobserver and intraobserver agreement. VAT area, V/S, hepatic fat, pancreatic fat, and pPAT rather than SAT area were significantly associated with multiple cardiometabolic risk factors (all p < 0.05). However, the patterns of these correlations varied by sex and specific risk factors. Also, VAT and SAT FF were only significantly associated with multiple cardiometabolic risk factors in women (all p < 0.05).ConclusionsVAT, hepatic fat, pancreatic fat, and pPAT were associated with cardiovascular metabolic risk factors independent of BMI. The patterns of these correlations were related to gender. These findings further the understanding of the association between ectopic fat deposition and cardiometabolic risk factors and help to better understand the obesity heterogeneity.

Visceral Adipose Tissue Indices Independently Correlated with Obstructive Sleep Apnea in Patients with Type 2 Diabetes.

Aims We aimed to explore whether visceral adiposity indices were significantly associated with obstructive sleep apnea (OSA) in type 2 diabetes (T2DM) patients. Methods 100 patients with T2DM who underwent overnight polysomnography were analyzed in this study. Anthropometric data, lipid profiles, and glycemic parameters were recorded. Body fat percentage (BFP) and visceral adipose tissue area (VAT area) were collected from a whole body scan using dual-energy X-ray absorptiometry (DXA). Multivariate logistic regression analysis was performed to explore the associations of AHI with BFP, VAT area, and CVAI. Results The prevalence rate of OSA was 80%, and the mean (±SD) of age was 47.0 ± 13.6 years. Apnea-hypopnea index (AHI) was significantly and positively associated with either VAT area (r = 0.433, p ≤ 0.001) or Chinese visceral adiposity index (CVAI) (r = 0.355, p ≤ 0.001) but not for BFP (r = 0.107, p = 0.294). Multivariate logistic regression analyses showed that VAT area and CVAI were significantly associated with increased risk of OSA, and the adjusted ORs were (95% CI) 1.025 (1.003-1.047, p = 0.023) and 1.018 (1.002-1.034, p = 0.030), respectively. However, there was no significant association between BFP and increased risk of OSA. Conclusions VAT area and CVAI were independent risk factors of OSA in the patients with T2DM.

Impact of visceral adipose tissue on long-term outcomes after gastrectomy for advanced gastric cancer

ObjectivesThe aim of this study was to examine the effects of a decrease in visceral adipose tissue on the long-term outcomes of patients with gastric cancer after surgery. MethodsThis single-institution, retrospective study included a cohort of 485 patients who underwent gastrectomy for P-T2 (MP; or a more advanced gastric cancer) from April 2008 to April 2018. The preoperative visceral adipose tissue area and the skeletal muscle area were measured on computed tomography images. The areas were divided by height (m2) to obtain the visceral adipose tissue index (VAI) and skeletal muscle mass index (SMI). ResultsOf the 485 patients, 243 (50.1%) were in the low-VAI group and 242 (49.9%) were in the high-VAI group. For overall survival, the low-VAI group, compared with the high-VAI group, had a significantly poorer prognosis (P < 0.001). Multivariate analysis indicated that both low VAI (hazard ratio [HR], 1.666; 95% confidence interval [CI], 1.127–2.461; P = 0.010) and low SMI (HR, 1.467; 95% CI, 1.057–2.035; P = 0.022) were independent prognostic factors. ConclusionBoth loss of preoperative skeletal muscle mass and a decrease in visceral adipose tissue have an effect on the long-term outcomes of advanced gastric cancer.

Association of the Kynurenine Pathway of Tryptophan Metabolism With Human Immunodeficiency Virus-Related Gut Microbiota Alterations and Visceral Adipose Tissue Accumulation.

The aim of the study was to investigate the association between human immunodeficiency virus (HIV)-related gut microbiota changes, alterations in the kynurenine (Kyn) pathway of tryptophan (Trp) metabolism, and visceral adipose tissue in the context of HIV infection. Three hundred eighty-three people with HIV (PWH) were included from the Copenhagen comorbidity in HIV infection (COCOMO) study. Gut microbiota composition was analyzed by 16S ribosomal ribonucleic acid sequencing. Plasma metabolites were analyzed by liquid chromatography-tandem mass spectrometry. Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) areas were measured by single-slice computed tomography (CT) scan (4th lumbar vertebra). The HIV-related gut microbiota alterations were associated with lower Trp (β -.01; 95% confidence interval [CI], -0.03 to -0.00) and higher Kyn-to-Trp ratio (β 0.03; 95% CI, 0.01-0.05), which in turn was associated with higher VAT-to-SAT ratio (β 0.50; 95% CI, 0.10-0.90) and larger VAT area (β 30.85; 95% CI, 4.43-57.28). In mediation analysis, the Kyn-to-Trp ratio mediated 10% (P = .023) of the association between the VAT-to-SAT ratio and HIV-related gut microbiota. Our data suggest HIV-related gut microbiota compositional changes and gut microbial translocation as potential drivers of high Kyn-to-Trp ratio in PWH. In turn, increased activity in the Kyn pathway of Trp metabolism was associated with larger visceral adipose tissue area. Taken together, our findings suggest a possible role for this pathway in the gut-adipose tissue axis in the context of HIV infection.

Opportunistic skeletal muscle metrics as prognostic tools in metastatic castration-resistant prostate cancer patients candidates to receive Radium-223

ObjectiveAndrogen deprivation therapy alters body composition promoting a significant loss in skeletal muscle (SM) mass through inflammation and oxidative damage. We verified whether SM anthropometric composition and metabolism are associated with unfavourable overall survival (OS) in a retrospective cohort of metastatic castration-resistant prostate cancer (mCRPC) patients submitted to 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) imaging before receiving Radium-223.Patients and methodsLow-dose CT were opportunistically analysed using a cross-sectional approach to calculate SM and adipose tissue areas at the third lumbar vertebra level. Moreover, a 3D computational method was used to extract psoas muscles to evaluate their volume, Hounsfield Units (HU) and FDG retention estimated by the standardized uptake value (SUV). Baseline established clinical, lab and imaging prognosticators were also recorded.ResultsSM area predicted OS at univariate analysis. However, this capability was not additive to the power of mean HU and maximum SUV of psoas muscles volume. These factors were thus combined in the Attenuation Metabolic Index (AMI) whose power was tested in a novel uni- and multivariable model. While Prostate-Specific Antigen (PSA), Alkaline Phosphatase (ALP), Lactate Dehydrogenase and Hemoglobin, Metabolic Tumor Volume, Total Lesion Glycolysis and AMI were associated with long-term OS at the univariate analyses, only PSA, ALP and AMI resulted in independent prognosticator at the multivariate analysis.ConclusionThe present data suggest that assessing individual 'patients' SM metrics through an opportunistic operator-independent computational analysis of FDG PET/CT imaging provides prognostic insights in mCRPC patients candidates to receive Radium-223.Graphical abstract

Impaired Bone Fracture Healing in Type 2 Diabetes Is Caused by Defective Functions of Skeletal Progenitor Cells.

The mechanisms of obesity and type 2 diabetes (T2D)-associated impaired fracture healing are poorly studied. In a murine model of T2D reflecting both hyperinsulinemia induced by high-fat diet and insulinopenia induced by treatment with streptozotocin, we examined bone healing in a tibia cortical bone defect. A delayed bone healing was observed during hyperinsulinemia as newly formed bone was reduced by -28.4±7.7% and was associated with accumulation of marrow adipocytes at the defect site +124.06±38.71%, and increased density of SCA1+ (+74.99±29.19%) but not Runx2+ osteoprogenitor cells. We also observed increased in reactive oxygen species production (+101.82±33.05%), senescence gene signature (≈106.66±34.03%), and LAMIN B1- senescent cell density (+225.18±43.15%), suggesting accelerated senescence phenotype. During insulinopenia, a more pronounced delayed bone healing was observed with decreased newly formed bone to -34.9±6.2% which was inversely correlated with glucose levels (R2 = 0.48, P < .004) and callus adipose tissue area (R2 = .3711, P < .01). Finally, to investigate the relevance to human physiology, we observed that sera from obese and T2D subjects had disease state-specific inhibitory effects on osteoblast-related gene signatures in human bone marrow stromal cells which resulted in inhibition of osteoblast and enhanced adipocyte differentiation. Our data demonstrate that T2D exerts negative effects on bone healing through inhibition of osteoblast differentiation of skeletal stem cells and induction of accelerated bone senescence and that the hyperglycemia per se and not just insulin levels is detrimental for bone healing.

The Correlation between Type 2 Diabetes and Fat Fraction in Liver and Pancreas: A Study using MR Dixon Technique.

The increased obesity results in ectopic fat deposits in liver and pancreas, which will affect insulin resistance and elevated plasma glucose with type 2 diabetes. To assess the relationship between obesity and ectopic fat deposits and diabetes, this study used the MR Dixon method for the quantification of liver and pancreas fat fraction (FF) in type 2 diabetes mellitus (T2DM) patients and healthy controls. The FF of whole liver (FFWL) and pancreas (FFWP), the maximum diameters of the pancreas, the abdominal subcutaneous adipose area (SAT), the visceral adipose tissue area (VAT), and the total abdominal adipose tissue area (TAT) were measured for 157 subjects using the MR Dixon data. Four groups were established on the basis of BMI value. For statistics, intra- and intergroup comparisons were made by employing independent sample t-test. FFWL, FFWP, and VAT varied significantly between T2DM (BMI < 25) and control group (BMI < 25), T2DM (BMI ≥ 25) and control group (BMI ≥ 25), T2DM (BMI < 25) and T2DM (BMI ≥ 25) (all P < 0.05). The FF of pancreas tail, SAT, and TAT varied significantly between control group (BMI < 25) and control group (BMI ≥ 25) (P < 0.05). FFWP and the FF of pancreas tail varied significantly between T2DM and normal volunteers (P < 0.05), with normal or mild liver fat content. The tissue FF, which has a close relationship with T2DM, can be assessed by the MR Dixon technique. T2DM patients should pay attention to tissue fat content regardless of BMI values.

Хирургическая тактика при рецидивирующем липоматозе (болезни Маделунга). Клинический случай

The article presents the results of a clinical observation of patient K. with multiple symmetrical lipomatosis, also known as Madelung’s disease. It is a rare disease of unclear etiology, characterized by the growth of unencapsulated fat masses primarily around the head, upper shoulder girdle and back. Lipomatosis is the appearance of numerous lipomas in the subcutaneous tissue that have a connective tissue capsule or pass into the area of normal adipose tissue without a clear boundary. Primarily, the treatment of lipomatosis is carried out only by the surgical method. Surgery is the only way to remove fatty growths from the patient’s body.

A Statistical Evaluation of Uncoupling Protein 1 in the Limited Area of Brown Adipose Tissue by Immunoelectron Microscopy

Uncoupling protein 1 (UCP1) expressed by the brown adipose tissue (BAT) in the mitochondrial crista acts as a homeostatic thermogenerator of eutherians. The evaluation of UCP1 expression in the BAT offers significant scientific insight, especially in studies targeting limited areas such as the periarterial and pericardial regions of small experimental mammals. However, the negligible amount of this adipose tissue would render the general quantitative evaluation of the protein unreliable because of lipid contamination and low protein concentration. To address this problem, we quantitatively evaluated UCP1 expression in the mitochondrion of the mouse interscapular BAT using immunoelectron microscopy and immunohistochemical studies using a combination of primary and secondary antibodies in scheme A (rabbit anti-UCP1 IgG/gold particle-conjugated goat anti-rabbit IgG), B (rabbit IgG/gold particle-conjugated goat anti-rabbit IgG), C (rabbit anti-UCP1 IgG/gold particle-unconjugated goat anti-rabbit IgG), and D (rabbit IgG/gold particle-unconjugated goat anti-rabbit IgG). Scheme A shows the immunopositive reaction of obvious gold particles in the mitochondrial area, whereas other procedures revealed less distinctive reactions. The distinctive gold particle immunoreaction comprised electrical high-density spots with a mean diameter of >5 nm. However, in scheme B, the electrical high-density spots were scattered outside the mitochondrion and were significantly smaller than 4 nm; schemes C and D demonstrated few immunoreactions. Logistic regression analysis between schemes A and B showed that the threshold diameter of the electrical high-density spots measuring >5 nm indicated a true positive immunoreaction to anti-UCP1 antibody specifically in the mitochondrial area. Minor statistical difference was observed in the primary anti-UCP1 antibody between polyclonal IgG and monoclonal antibodies. Therefore, immunoelectron microscopy might be useful for evaluating negligible protein expression in some limited areas, such as UCP1 expression in the BAT of small experimental animals.

MORPHOMETRIC INDICATORS OF THE MEMBRANES OF THE VAGINAL PROCESS OF THE PERITONEUM IN CHILDREN OF DIFFERENT AGE GROUPS

Background. According to statistics, such diseases as inguinal hernia, testicular hydrocele are the causes of infertility. The anatomical basis for the occurrence of these nosologies is a violation of the process of obliteration of the processus vaginalis of the peritoneum. It was found that the presence of smooth muscle elements in its wall is the morphological basis for the preservation of patency in the processus vaginalis of the peritoneum. Aim. The purpose of the work was to improve scientific data on the etiology of diseases that occur as a result of the violation of the obliteration of the processus vaginalis of the peritoneum, with further use of the obtained knowledge to improve the quality of surgical correction of pathological conditions. Materials and methods. Children with diagnosed inguinal hernias and testicular hydrocele were treated surgically (Duhamel and Ross operations were performed). During the surgical correction, the wall fragments of the processus vaginalis of the peritoneum were selected for further histological examination. The obtained samples of histological preparations were studied in order to evaluate the morphometric criteria. Morphometric analysis criteria: relative area of muscle tissue, relative area of adipose tissue, relative area of fibrous tissue, thickness of muscle fibers, cross-sectional area of muscle fiber. Results. All children were divided into groups by gender and age. In each age group (first year of life, first three years of life, first five years of life and first seven years of life) an increase in both relative and absolute morphometric indicators was observed. The same tendency of the results was observed in both the male and female parts of the studied children. Conclusions. Therefore, the probability of independent obliteration of the processus vaginalis of the peritoneum increases inversely proportionally with the age of the child, that is, the younger the age of the child, the greater the probability of independent obliteration of the processus vaginalis of the peritoneum.

Morphometric indicators of the membranes of the vaginal process of the peritoneum in children of different age groups

Background. According to statistics, such diseases as inguinal hernia, testicular hydrocele are the causes of infertility. The anatomical basis for the occurrence of these nosologies is a violation of the process of obliteration of the processus vaginalis of the peritoneum. It was found that the presence of smooth muscle elements in its wall is the morphological basis for the preservation of patency in the processus vaginalis of the peritoneum. Aim. The purpose of the work was to improve scientific data on the etiology of diseases that occur as a result of the violation of the obliteration of the processus vaginalis of the peritoneum, with further use of the obtained knowledge to improve the quality of surgical correction of pathological conditions. Materials and methods. Children with diagnosed inguinal hernias and testicular hydrocele were treated surgically (Duhamel and Ross operations were performed). During the surgical correction, the wall fragments of the processus vaginalis of the peritoneum were selected for further histological examination. The obtained samples of histological preparations were studied in order to evaluate the morphometric criteria. Morphometric analysis criteria: relative area of muscle tissue, relative area of adipose tissue, relative area of fibrous tissue, thickness of muscle fibers, cross-sectional area of muscle fiber. Results. All children were divided into groups by gender and age. In each age group (first year of life, first three years of life, first five years of life and first seven years of life) an increase in both relative and absolute morphometric indicators was observed. The same tendency of the results was observed in both the male and female parts of the studied children. Conclusions. Therefore, the probability of independent obliteration of the processus vaginalis of the peritoneum increases inversely proportionally with the age of the child, that is, the younger the age of the child, the greater the probability of independent obliteration of the processus vaginalis of the peritoneum.

Relation between adipose tissue and the musculoskeletal unit in a group of postmenopausal women.

Involutional changes observed during aging increase rapidly in the postmenopausal period. These changes include body composition by affecting bone, muscle and fat tissue. A number of studies have investigated the mutual interaction between bone and muscle tissue, whereas adipose tissue had not been studied thoroughly.The aim of the present study was to assess the relation between fat tissue parameters and the musculoskeletal unit. The study was conducted in a group of 120 postmenopausal women with an average age of 69 years (59-81; SD 5.3). All women had been asked to complete a questionnaire (medical history) and underwent a total body composition analysis [bone mineral density (BMD)] testing (spine and/or neck) followed by a handgrip test. The study revealed strong correlations between appendicular skeletal muscle mass index - appen.lean/height2, visceral adipose tissue area (VAT) and fat/mass/height2 index (r = 0.589 and 0.658 respectively; p < 0.001). The results were not supported by muscle strength (handgrip). The authors identified correlations between the bone parameters and adipose tissue but these were identified as weak or moderate (p < 0.05). Special emphasis should be placed on the relation between the trabecular bone score (TBS) and VAT area (r = -0.385, p < 0.001). There is a strong dependence between muscle and adipose tissues. Despite the fact that the increase in fat is correlated with the growth of muscle tissue, it is not accompanied by better quality of the muscle (handgrip). Bone microarchitecture is more related to VAT area than neck/spine BMD.