Body Fat Distribution Research Articles

Association of body round index with chronic kidney disease: a population-based cross-sectional study from NHANES 1999-2018.

Complex nexuses between obesity and chronic kidney disease (CKD) have been reported. Nevertheless, the link between the body roundness index (BRI), an indicator utilized to measure body fat distribution, and CKD risk has been unexplored. We utilized publicly available data from ten survey cycles (1999-2018) of the National Health and Nutrition Examination Survey (NHANES) in the United States. We examined the association between BRI and CKD risk using multivariable logistic regression, subgroup analysis, interaction tests, and smooth curve fitting. The study ultimately involved 41,953 participants, 3,123 (7.44%) of whom had CKD. Multivariable logistic regression, adjusted for covariates, identified high BRI levels in quartile 4 as a risk factor for CKD (OR = 1.30, 95% CI 1.12-1.50, P = 0.0005). This association remained consistent across subgroups (P for interaction > 0.05). Smoothed curve fitting exhibited a roughly linear positive correlation between BRI and CKD. According to our study, BRI was related to CKD in a roughly linear way, suggesting a novel indicator for improving prevention and treatment for the CKD population. Nevertheless, additional research is needed to identify the association.

Associations of Phthalate Exposure with Adiposity and Metabolic Syndrome in US Adolescents and Adults, NHANES 2013-2018

Abstract Background/Objective Phthalates are ubiquitous endocrine-disrupting chemicals and suspected obesogens. However, the associations with fat distribution and associated cardiometabolic complications remain unclear. Therefore, we examined the associations between phthalate exposure, body fat (total and distribution patterns), and metabolic syndrome (MetS) among US adolescents and adults. Methods We analyzed cross-sectional data from 829 adolescents and 3905 adults in the 2013-2018 National Health and Nutrition Examination Survey. Total percent body fat (%BF), visceral adipose tissue (VAT) mass, and android to gynoid (A/G) ratio were determined using dual-energy x-ray absorptiometry. Associations between molar sums of low molecular weight (∑LMW), high molecular weight (∑HMW), and di(2-ethylhexyl) phthalate (∑DEHP) metabolites, and adiposity indicators and MetS were analyzed with multivariable linear and logistic regressions. Models included sex interaction terms, were stratified by age group, and adjusted for relevant covariates. Results ∑HMW and ∑DEHP exposures were positively associated with %BF in males, and all phthalate groups were associated with greater VAT mass and A/G ratio in adolescent males. Five-fold increases in ∑HMW and ∑DEHP metabolites were associated with 21.7% (95% CI: 10.5-33.9) and 18.0% (95% CI: 7.72-29.2) greater VAT mass among adolescent males, respectively. Sex modified the relationship between ∑HMW exposure and A/G ratio among adolescents (interaction p-value = 0.0185). Phthalates were not associated with odds of MetS. When assessing individual MetS components, phthalates were associated with hyperglycemia in adult males. Conclusion Greater exposure to phthalates was associated with greater %BF in all males, and with fat distribution in adolescent males; however, phthalates were not linked to MetS.

Obesity paradox, weight-free anthropometric measures, and major adverse cardiovascular events in the elderly: Insight from the Northern Shanghai Study

Abstract Aims Many studies have investigated the obesity paradox in the elderly. However, besides body mass index (BMI), many other anthropometric measures, such as the waist-to-hip ratio (WHR), provide a better indication of body fat distribution and may be more useful in a geriatric population. Methods 3285 participants aged over 65 years old from the Northern Shanghai Study were included in this analysis. Eight anthropometric measures, including weight-related measures (BMI, weight-adjusted-waist index, body shape index and body surface area) and weight-free measures (WHR, waist-to-height ratio, body roundness index, relative fat mass) were measured and calculated with standard methods. Major adverse cardiovascular events (MACEs) included the non-fatal myocardial infarction, non-fatal stroke or cardiovascular death. Results Participants had an average age of 71.4 years and 1428 (43.47%) were men. The median follow-up was 5.4 years (IQR, 4.4-7.3 years) and 218 events occurred. Participants with obesity (BMI ≥ 28 kg/m2) were associated with a higher risk of MACEs compared with the normal (adjusted Hazard ratio = 1.54, 95% confidence interval (CI): 1.07-2.22, P=0.020). Restricted cubic splines also highlighted the robust correlation between high BMI and high MACEs risk (Pfor overall=0.025, Pfor nonlinear=0.339). Similarly, the aHR for the incidence of MACEs in WHR quartile 4 versus quartile 1 was 1.96 (95% CI: 1.26-3.05, P=0.003). When WHR was examined as a continuous variable, the result remained unaltered (Pfor overall=0.020, Pfor nonlinear=0.353). In adjusted model, all four weight-free measures were significantly associated with increased risk of MACEs (all P<0.05), while only two weight-related measures were related to the risk of MACEs. Conclusion In the elderly, BMI and alternative anthropometric measures showed no evidence of an "obesity paradox". Weight-free measures were more relevant to a risk of MACEs.Take home message

Selected somatic parameters and body composition as predictors of cardiorespiratory fitness among Polish adolescents aged 11–14

The aim of the study was to verify whether selected somatic parameters and components of body composition were significant predictors of cardiorespiratory fitness (CRF) among a potentially healthy Polish population of adolescents aged 11–14 years. The cross-sectional study was conducted on a group of 375 subjects (164 girls, and 211 boys). A 20 m shuttle run test (20 m SRT) was used to assess CRF. The total number of rounds was taken into account. Basic somatic parameters were measured: body mass (BM), body height (BH), waist circumference (WC), hip circumference (HC), body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), and body composition components: body fat percentage (FM%), fat mass (FM kg), total body water (TBW), fat-free mass (FFM). Statistical analyses included basic statistical measures (mean and standard deviation) and Spearman rank correlation coefficient. Multiple linear regression analysis was performed to detect significant predictors of CRF. In each proposed model, the dependent variable was the number of rounds, and the independent variables were selected somatic parameters and components of body composition. More than half (65%) of the subjects had an average or lower level of CRF, and 35% of the population presented a good or above good level of CRF. The study showed a statistically significant negative correlation between BM, FM%, FM kg, HC, WC, BMI, WHR, WHtR and the number of laps in the total sample. The strongest correlation in the group of girls was noted for age (r = 0.34) and in the group of boys for FM% (r = -0.52\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$-0.52$$\\end{document}). Each regression model presented proved to be statistically significant, and the significant predictors of CRF in the group of girls were age (R2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$R^2$$\\end{document} = 16%) and FM% (R2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$R^2$$\\end{document} = 6%). In the group of boys, the significant predictors of CRF were WHtR (R2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$R^2$$\\end{document} = 8%) and age (R2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$R^2$$\\end{document} = 2%). Estimating body fat distribution is useful in assessing cardiorespiratory fitness, and this in turn indicates its usefulness in preventive screening of school-aged adolescents.

Associations of Urinary Cadmium with Body Composition and Fat Distribution in US Adults: Findings from NHANES 2011-2018.

The effects of cadmium (Cd) on metabolic physiology remain controversial. Given the varying metabolic impacts associated with different body compositions, investigating the relationship between Cd exposure and body composition may facilitate further research. Here, the associations of body composition and fat distribution with urine Cd (UCd) were evaluated. This analysis included 2979 adult participants from the 2011-2018 National Health and Demographic Survey (NHANES). UCd was measured using inductively coupled plasma mass spectrometry and adjusted for urinary creatinine. Body composition and fat distribution were estimated using dual-energy x-ray absorptiometry (DXA). The study results show that UCd was negatively associated with fat mass index (FMI) and percent fat mass (p for trend < 0.001), and the negative correlation between UCd and FMI was stronger in males and smokers (all p for interaction < 0.05). In terms of abdominal fat distribution, UCd was negatively associated with abdominal subcutaneous adipose tissue (SAT) mass (p for trend < 0.001), but with abdominal visceral adipose tissue (VAT) mass only in those with low percent fat mass (< 32.3%) (p for trend = 0.026 and p for interaction < 0.05). UCd was positively related to percent VAT (p for trend < 0.001) and visceral-to-subcutaneous (VAT/SAT) ratio (p for trend = 0.003). And there was a significant negative association between UCd and android-to-gynoid (A/G) ratio (p for trend = 0.001). Meanwhile, UCd was negatively correlated with fat-free mass index (FFMI) (p for trend < 0.001). And the negative correlation between UCd and FFMI was stronger in males, smokers, and individuals with < 32.3 percent fat mass (all p for interaction < 0.05). We found the association of UCd with body composition and fat distribution, with distinct patterns observed in different demographic groups. These findings underscore the importance of considering UCd exposure in the context of body composition and fat distribution.

A novel model of cardiovascular–kidney–metabolic syndrome combining unilateral nephrectomy and high-salt–sugar–fat diet in mice

The aim of this study was to explore biological interaction and pathophysiology mechanisms in a new mouse model of cardiovascular–kidney–metabolic (CKM) syndrome, induced by chronic moderate renal failure in combination with consumption of a customized Western diet rich in carbohydrates, fat and salt. Male C57BL/6J mice were subjected to unilateral nephrectomy, fed a customized Western diet rich not only in sugar and fat but also in salt, and followed for 12 weeks or 20 weeks. Sham-operated mice on a standard chow served as healthy controls. Body composition, weight gain, glucose metabolism, fat distribution, blood pressure, cardiac function, vascular reactivity, renal function, inflammation and mitochondrial function were measured and combined with biochemical and histopathological analyses. The novel triple-hit model of CKM syndrome showed signs and symptoms of metabolic syndrome, disturbed glucose metabolism, impaired adipocyte physiology and fat redistribution, cardiovascular dysfunction, renal damage and dysfunction, systemic inflammation, elevated blood pressure and cardiac remodeling. The pathological changes were more pronounced in mice after prolonged exposure for 20 weeks, but no deaths occurred. In the present mouse model of CKM syndrome, profound and significant metabolic, cardiac, vascular and renal dysfunctions and injuries emerged by using a Western diet rich not only in fat and carbohydrates but also in salt. This multisystem disease model could be used for mechanistic studies and the evaluation of new therapeutic strategies.

Association between Body Fat Distribution and Nonalcoholic Fatty Liver Disease/Fibrosis Based on Race/Ethnicity.

Body fat distribution may impact nonalcoholic fatty liver disease (NAFLD) and significant fibrosis differently according to race/ethnicity. We determined the relationship between body fat distribution and NAFLD/significant fibrosis according to race/ethnicity. A cross-sectional study of 2,395 participants used the National Health and Nutrition Examination Survey 2017 to 2018. NAFLD and significant fibrosis (≥F2) were defined by controlled attenuation parameter scores and liver stiffness measurements on transient elastography, respectively. Visceral and subcutaneous fat volumes were defined by dual-energy X-ray absorptiometry. The odds ratio (OR) for NAFLD per 1-standard deviation in visceral fat volume and subcutaneous fat volume was 2.31 (95% confidence interval [CI], 1.50 to 3.39) and 1.93 (95% CI, 1.43 to 2.61) in total population, respectively. Visceral fat in non-Hispanic Blacks had the highest odds for NAFLD (OR, 2.86; 95% CI, 1.45 to 5.62), and non-Hispanic Whites (OR, 2.29; 95% CI, 1.19 to 4.40) and non-Hispanic Asians (OR, 1.61; 95% CI, 1.13 to 2.29) were in order. Significant associations between subcutaneous fat volume (OR, 2.10; 95% CI, 1.34 to 3.29; P=0.003) or visceral fat volume (OR, 1.35; 95% CI, 1.05 to 1.73; P=0.023) and significant fibrosis were noted among individuals with NAFLD. Hispanics had the highest odds for NAFLD-associated significant fibrosis (OR, 2.74; 95% CI, 1.32 to 5.70), and non-Hispanic Whites (OR, 2.35; 95% CI, 1.11 to 4.98) and non-Hispanic Asians (OR, 2.01; 95% CI, 1.01 to 4.01) were in order. Visceral adiposity was associated with NAFLD and significant fibrosis despite the association of subcutaneous adiposity in NAFLD and significant fibrosis. Racial/ethnic differences in the association between body fat distribution on NAFLD and significant fibrosis were noted.

Quantitative analysis of fat distribution in men and women: contribution of diet, physical activity, and FTO genotype

BACKGROUND: The Russian Federation is among the top ten countries in terms of obesity prevalence among adults. AIM: To identify the endogenous (biological factors such as age and FTO genotype) and exogenous (diet and physical activity level) factors that influence body fat accumulation and distribution among a group of women and men from Moscow. MATERIAL AND METHODS: A total of 464 volunteers, consisting of 231 women and 233 men aged between 18 and 60 years, from Moscow took part in a single-center, cross-sectional, observational study. The program involved measuring body height, weight, body and limb girths, as well as conducting caliperometry, bioimpedance analysis, and administering questionnaires. Indices of body fat distribution were calculated. Additionally, differences in genotype, specifically the rs9939609 TA variant in the FTO gene, were also determined. RESULTS: Maintaining a vegetarian diet for at least three years was associated with lower fat and fat-free mass, but not with abdominal fat in both men and women. Engaging in regular physical activity had the most significant impact on abdominal fat in both genders. Furthermore, participating in amateur or professional sports activities for a minimum of 180 minutes per week was associated with lower overall body fat. We found no association between the FTO rs9939609 gene and fat accumulation or distribution, regardless of diet and physical activity levels. CONCLUSION: The results suggest that vegetarian diet and regular physical activity are likely to be the most effective total and abdominal fat loss strategy for male and female adult residents of Moscow.

Relationship between soft tissue envelope thickness of the lower extremity and acute periprosthetic joint infection of the knee.

The prevalence of obesity is increasing worldwide and it is known to be associated with many postoperative complications, including infection. Patients' body fat distribution may vary and body mass index (BMI) does not provide sufficient information about adipose tissue thickness of the lower extremities. The aim of this study is to investigate the relationship between thigh diameters and early postoperative prosthesis-related joint infections (PJI) in patients who underwent arthroplasty. The study included 76 patients and 114 knees who were operated on by a single surgeon and underwent total knee arthroplasty (TKA) due to primary knee osteoarthritis between May 2022 and September 2023 in a tertiary reference hospital. Circumference of the thickest part of the operated thigh (cm), preoperative erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, height, weight, BMI and the presence of early postoperative prosthesis-related joint infections were evaluated. The mean BMI was 32.6 ± 4.2 (kg/m2). Two (2.6%) were normal weight, 14 (18.5%) were overweight, 58 (76.3%) were obese and 2 (2.6%) were morbidly obese. The mean circumference of the thickest part of the thigh was 57.56 ± 6.38 (cm). 6 patients were diagnosed with PJI in the acute phase. The mean circumference of the thickest part of the thigh was statistically significantly greater in the group with acute PJI compared to the group without PJI (p = 0.048). The incidence of acute PJI was found to be significantly higher in patients with larger thigh diameters, whereas no such relationship was observed for BMI. The incorporation of preoperative soft tissue envelope measurements into routine clinical examination may prove beneficial in reducing the risk of PJI.

The association between food insecurity and obesity, a body shape index and body roundness index among US adults

Research has established a positive association between food insecurity and obesity, typically assessed by body mass index (BMI); However, studies examining the relationship between food insecurity and measures of body fat content and distribution are lacking. The aim of this study was to examine the association between food insecurity and obesity ([BMI] ≥ 30 kg/m2) and body fat indicators assessed by body roundness index ([BRI] > 6.72) and a body shape index ([ABSI] > 0.08). This is a cross-sectional study using NHANES data 2007–2020. Household food security was assessed by U.S. Food Security Survey Module questionnaire. Multivariable-adjusted binary logistic regression analyses were used to calculate odds ratios and 95% CIs. Compared to those with full food security, the adjusted ORs for obesity were 1.28 (95% CI:1.18, 1.39), 1.40 (95% CI:1.28, 1.53), and 1.43 (95% CI:1.30, 1.57) for those with marginal, low and very low food security, respectively. The corresponding ORs for high BRI were, respectively, 1.39 (95% CI:1.26, 1.52), 1.50 (95% CI:1.36, 1.66), and 1.60 (95% CI:1.43, 1.78). Similar results were observed for ABSI. The analyses of BMI suggested a potential sex difference, as significant associations were found in women, but not in men. This study confirms previous evidence of the positive association between food insecurity and obesity among US adults.

7004 Systems genetics analysis to identify candidate genes for fat distribution in BXD mice

Abstract Disclosure: N. Kim: None. D. Ryu: None. C. Oh: None. Obesity is defined as the accumulation of excess fat in the body. Although obesity is the main cause of metabolic disorders, not all obese people have metabolic disorders. Among many factors identified, the ratio of visceral (vWAT) to subcutaneous white adipose tissue (sWAT), representing body fat distribution, has been elucidated to be closely associated with metabolic health. Body fat distribution has been proposed as a possible explanation for this discrepancy. To investigate the regulation of body fat distribution, we performed a genetic analysis using the phenotype data and male subcutaneous fat microarray data from the BXD mouse genetic reference population. Our analysis identified H2-Ke6 (Hsd17b8), encoding hydroxysteroid 17-beta dehydrogenase, as a candidate target for adipose tissue plasticity. To further explore its role, we employed multiple approaches to reveal the effect of Hsd17b8 inhibition. First, lipid accumulation was attenuated in 3T3-L1 preadipocytes where Hsd17b8 was inhibited by CRISPER/Cas9 as well as lasalocid. Furthermore, we confirmed that the expression of adipogenesis-related transcription factor as well as mature adipocyte marker was decreased in terminally differentiated 3T3-L1. Specifically, CCAAT/enchancer binding protein α (Cebpa), peroxisome proliferator-activated receptor γ (Pparg), adiponectin (Adipoq), and fatty acid binding protein 4 (Fabp4) were transcriptionally downregulated. Consistently, in C. elegans, we used RNA interference (RNAi) to inhibit the expression of the Hsd17b8 ortholog, dhs-25, and observed a reduction in lipid accumulation. All these data suggest that the reduction in lipid accumulation in differentiated 3T3-L1 cells by the inhibition of Hsd17b8 is attributed to the suppression of early differentiation during the adipogenesis process. On top of that, to determine whether Hsd17b8 indeed influences body fat distribution in vitro, we utilized IngWAT Mouse Immortalized Preadipocyte Cell Line derived from subcutaneous white adipose tissue (sWAT) of a wild-type mouse. In contrast to the previous findings, we observed an increase in lipid accumulation of IngWAT when Hsd17b8 was inhibited. Surprisingly, the elevation of lipid accumulation in sWAT, as seen in gynoid obesity, has been revealed to be indicative of robust metabolic health compared to android obesity. Collectively, these data suggest that Hsd17b8 may represent a novel therapeutic target for the treatment of obesity. Our study provides valuable insights into the mechanisms underlying metabolic health in obesity and highlights the potential of Hsd17b8 as a therapeutic target for modulating adipose tissue plasticity. Presentation: 6/3/2024

7833 Gestational Diabetes Mellitus (GDM): A Weighted Spectrum of Clinical Outcomes

Abstract Disclosure: M. Moazzami: None. N. Venkatesan: None. K.S. Rajagopalan: None. A.V. Vella: None. A. Egan: None. Gestational diabetes mellitus (GDM) affects approximately 10% of pregnancies, with rates almost doubling in minority subgroups. Higher body mass index (BMI) is a significant GDM risk factor, and BMI ≥ 25kg/m2 is often used as a criterion in risk factor-based screening programs. However, up to 60% of individuals with GDM have a normal BMI, and it is unclear if this offers protection against associated adverse outcomes. Furthermore, many prior studies fail to address the fact that those of Asian descent require a lower BMI cut-off, given their different distribution of body fat. Our study evaluated GDM pregnancy outcomes using BMI as a risk indicator. We compared individuals with BMIs &amp;lt; 25 kg/m2, 25-30 kg/m2, and &amp;gt; 30 kg/m2. For individuals that self-identified as Asian, we adjusted BMI categories: &amp;lt;23 kg/m2 for normal weight, 23-30 kg/m2 for overweight, and &amp;gt;30 kg/m2 for obese. We identified 2212 subjects diagnosed with GDM via universal screening and Carpenter and Coustan criteria at our institution from 2018 - 22. In total, 508 (23.0%) were normal weight, 611 (27.6%) overweight, and 1093 (49.4%) obese. The average maternal age was 31 years. Higher proportions identified as Hispanic and non-White race in overweight and obese categories. Maternal adverse outcomes were higher in obese compared to overweight or normal BMI categories (cesarian delivery: normal 26.7 v overweight 28.3 v obese 22.7%, p&amp;lt;0.001; hypertensive disorders: normal 13.2 v overweight 12.5 v obese 22.7%, p &amp;lt;0.001). Pharmacological therapy was required in 50% with obesity versus 24.8% in normal, and 28.7% in overweight categories (p&amp;lt;0.001). While there were no differences in live birth rates across categories, infants born to mothers with obesity had a higher birthweight (normal 3.30 v overweight 3.38 v obese 3.45kg, p&amp;lt;0.001) and were more likely to have neonatal hypoglycemia (normal 28.7 v overweight 25.5 v obese 43.8%, p&amp;lt;0.001) and require intensive care unit admission (normal 8.4 v overweight 5.5 v obese 12.7%, p&amp;lt;0.001). Attendance at postpartum glucose testing varied across BMI categories with lower attendance in mothers with obesity followed by normal weight BMI (normal 40.75 v overweight 45.99 v obese 36.2%, p&amp;lt;0.001). Compared to overweight individuals, those with normal weight exhibited higher rates of postpartum glucose intolerance (12.4 v 6.9%, p =0.002). However, those with obesity had the highest rates of glucose intolerance (20.7%, p&amp;lt;0.0002). Individuals with normal weight had the highest rates of breastfeeding (normal 95.9 v overweight 92.8 v obese 91.4% p=0.006). This study highlights the nuanced relationship between BMI and pregnancy outcomes in GDM. While maternal obesity was associated with the poorest outcomes, those with normal BMI were not protected compared to overweight individuals, and experience higher rates of postpartum glucose intolerance. Presentation: 6/2/2024

Obese have comparable ankle brachial pressure index but higher β-cell function and insulin resistance as compared to normal-weight type 2 diabetes mellitus patients.

To compare ankle brachial pressure index (ABPI) in normal weight and obese/overweight type 2 diabetes mellitus patients (T2DM) to see the impact of obesity on the occurrence of peripheral artery disease (PAD) in T2DM patients. Secondly to investigate the relationship between ABPI, insulin resistance, and beta cell function and between adipocytokines and obesity parameters. A total of 120 BMI-categorized Normal weight (NW) T2DM (n = 53) patients and obese/overweight T2DM (n = 67) patients were recruited in this study. ABPI measurements were performed for the assessment of PAD. The anthropometry and body composition of the patients were measured. Plasma fasting insulin, adiponectin, and IL-6 levels were measured by ELISA kits. ABPI scores were found to be comparable between both groups of patients (p = 0.787). A significant positive correlation was observed between ABPI and beta cell function. Insulin resistance was found to correlate positively while adiponectin negatively with obesity parameters. The ABPI score was comparable between both groups of patients, suggesting that vascular complications may occur at the same rate in NW as well as in obese/overweight diabetic patients. The positive association of insulin resistance as well as the negative association of adiponectin with obesity parameters, are suggestive of the importance of body fat distribution in predicting insulin resistance and the inflammatory status of the cells.

Efficacy of WeChat-Based Digital Intervention Versus Metformin in Women With Polycystic Ovary Syndrome: Randomized Controlled Trial.

The first-line treatment for polycystic ovary syndrome (PCOS) is lifestyle modification. However, it is currently unknown whether digital medicine can assist patients with PCOS in maintaining a healthy lifestyle while alleviating PCOS symptoms. This study aims to evaluate the efficacy of WeChat-based digital intervention versus metformin treatment in women with PCOS and insulin resistance. A total of 80 women with PCOS and insulin resistance were recruited from an endocrinology clinic and randomly assigned to receive either a WeChat-based digital intervention (n=40, 50%) or metformin (n=40, 50%) for 12 weeks. The WeChat-based digital intervention consisted of 3 modules; a coach assisted the patients in using the intervention. The primary outcome was the change in a homeostatic model assessment for insulin resistance. At baseline and after the 12-week intervention, anthropometric parameters, menstruation frequency, sex hormone levels, metabolic factors, and body fat distribution were measured in the clinic. Furthermore, self-assessed web-based questionnaires on diet, exercise, sleep, anxiety, and depression were obtained. A total of 72 participants completed the follow-up (for a 90% follow-up rate), including 35 of 40 (88%) participants from the digital intervention group and 37 of 40 (93%) participants from the metformin group. The homeostatic model assessment for insulin resistance in the digital intervention group was significantly improved after 12 weeks of treatment with a mean change of -0.93 (95% CI -1.64 to -0.23), but no statistical difference was observed between the groups (least squares mean difference -0.20; 95% CI -0.98 to 0.58; P=.62). Both digital intervention and metformin treatment significantly improved menstruation frequency (digital intervention: P<.001; metformin: P<.001) and reduced body weight (digital intervention: P<.001; metformin: P<.001) and total fat mass (digital intervention: P<.001; metformin: P<.001). Furthermore, the digital intervention had a significant advantage over metformin in improving waist circumference (least squares mean difference -1.84; 95% CI -3.44 to -0.24; P=.03), waist-to-hip ratio (least squares mean difference -0.02; 95% CI -0.03 to 0.00; P=.03), total fat mass (least squares mean difference -1.59; 95% CI -2.88 to -0.30; P=.02), and dehydroepiandrosterone sulfate (least squares mean difference -69.73; 95% CI -129.70 to -9.75; P=.02). In terms of safety, the main adverse events were sensations of hunger in the digital intervention group (2/40, 5%) and gastrointestinal adverse events in the metformin group (12/40, 30%). Our data suggest that digital intervention is an effective treatment option for patients with PCOS, with an efficacy comparable to that of metformin, and that it can also alleviate the negative effects of medications and make it easier and more efficient to adhere to lifestyle treatments. WeChat-based digital interventions have the potential to provide a new path for the improvement and health of women with PCOS in China. ClinicalTrials.gov NCT05386706; https://clinicaltrials.gov/study/NCT05386706.

Relationship Between Body Composition, Body Fat Distribution, And Blood Lipids Among Law Enforcement Officers - Part 2

Relationship Between Body Composition, Body Fat Distribution, And Blood Lipids Among Law Enforcement Officers - Part 2

The Relationship Between Body Mass Index (BMI) and Pulmonary Function Among Healthcare Workers in Mosul City/Iraq

The study was designed to evaluate if there is a relationship between Body Mass Index (BMI) and pulmonary function. This highlights the mechanisms by which obesity and overweight status could affect lung health, through parameters such as Forced Expiratory Volume in 1 Second (FEV1%). To determine pulmonary function, spirometry is the main method. It defines the severity of pulmonary function impairment according to FEV1% as normal to mild: average ≥70%, moderate 40-69%, and severe ≤39%. Interestingly, the review even points out that a form of malnutrition can also cause pulmonary function decline. This is why nutritional status should be one consideration in clinical assessments for some types of diseases. Reflecting the fact that obesity is an important contributing factor to respiratory health. It is stated in the document that obesity results from some unwanted changes which can cause the development of smaller lung volumes and also reduce total capacity even less sucking capacities (compared to non-obese people). It also considers waist circumference and additional waist-to-hip ratio as potentially better predictors of pulmonary function than BMI only, because body fat distribution is not reflected by the presence or absence of obesity. The research likewise links this eating pattern to the worldwide rise in obesity and suggests a correlation with myriad health issues such as asthma. This indicates that mechanical consequences of increased body mass could exacerbate airway remodeling, predisposing to subclinical airway dysfunction. Second, it emphasizes the extra burden of breathing experienced by obese patients that may render them short of breath and possibly wheezy. In conclusion, whilst BMI remains a pragmatic measurement to reflect body fat content adequately and therefore pulmonary implications of obesity on lung physiology upstream from Acute exacerbations are also influenced not just by the quantitative trajectory of adiposity (BMI) but qualitative factors related to body distribution including abdominal girth as well as overall nutritional status.

Periprostatic adipose tissue inhibits tumor progression by secreting apoptotic factors: A natural barrier induced by the immune response during the early stages of prostate cancer.

Prostate cancer (PCa) is the second most prevalent malignancy in men worldwide. The risk factors for PCa include obesity, age and family history. Increased visceral fat has been associated with high PCa risk, which has prompted previous researchers to investigate the influence of body composition and fat distribution on PCa prognosis. However, there is a lack of studies focusing on the mechanisms and interactions between periprostatic adipose tissue (PPAT) and PCa cells. The present study investigated the association between the composition of pelvic adipose tissue and PCa aggressiveness to understand the role played by this tissue in PCa progression. Moreover, PPAT-conditioned medium (CM) was prepared to assess the influence of the PPAT secretome on the pathophysiology of PCa. The present study included 50 patients with localized PCa who received robot-assisted radical prostatectomy. Medical records were collected, magnetic resonance imaging scans were analyzed and body compositions were calculated to identify the associations between adipose tissue volume and clinical PCa aggressiveness. In addition, CM was prepared from PPAT and perivesical adipose tissue (PVAT) collected from 25 patients during surgery, and its effects on the PCa cell lines C4-2 and LNCaP, and the prostate epithelial cell line PZ-HPV-7, were investigated using a cell proliferation assay and RNA sequencing (RNA-seq). The results revealed that the initial prostate-specific antigen level was significantly correlated with pelvic and periprostatic adipose tissue volumes. In addition, PPAT volume was significantly higher in patients with extracapsular tumor extension. PCa cell proliferation was significantly reduced when the cells were cultured in PPAT-CM compared with when they were cultured in control- and PVAT-CM. RNA-seq revealed that immune responses, and the cell death and apoptosis pathways were enriched in PPAT-CM-cultured cells indicating that the cytokines or other factors secreted from PPAT-CM induced PCa cell apoptosis. These findings revealed that the PPAT secretome may inhibit PCa cell proliferation by activating immune responses and promoting cancer cell apoptosis. This mechanism may act as a first-line defense during the early stages of PCa.

Development and clinical application of bioelectrical impedance analysis method for body composition assessment.

Obesity, which is characterized by excessive body fat, increases the risk of chronic diseases, such as type 2 diabetes, cardiovascular diseases, and certain cancers. Sarcopenia, a decline in muscle mass, is also associated with many chronic disorders and is therefore a major concern in aging populations. Body composition analysis is important in the evaluation of obesity and sarcopenia because it provides information about the distribution of body fat and muscle mass. It is also useful for monitoring nutritional status, disease severity, and the effectiveness of interventions, such as exercise, diet, and drugs, and thus helps assess overall health and longevity. Computed tomography, magnetic resonance imaging, and dual-energy X-ray absorptiometry are commonly used for this purpose. However, they have limitations, such as high cost, long measurement time, and radiation exposure. Instead, bioelectrical impedance analysis (BIA), which was introduced several decades ago and has undergone significant technological advancements, can be used. It is easily accessible, affordable, and importantly, poses no radiation risk, making it suitable for use in hospitals, fitness centers, and even at home. Herein, we review the recent technological developments and clinical applications of BIA to provide an updated understanding of BIA technology and its strengths and limitations.

Obesity may impair response to ovarian stimulation. A retrospective observational study on oocyte quality.

Ovulatory dysfunction is more common in women with obesity. Body fat distribution is also crucial because anovulatory women have a greater waist circumference and more abdominal fat than ovulatory women of similar BMI. The primary aim of the present study is to determine whether there is a relationship between BMI and reproductive characteristics, including hormonal values, antral follicle count (AFC), endometrial assessment at transvaginal ultrasound evaluation (TVUS) during controlled ovarian stimulation (COS), and oocyte retrieval after Ovum Pick-Up (OPU). Data from a cohort of 183 patients were analyzed and divided into three groups based on weight status: normal weight, overweight, and obesity. Evaluated reproductive characteristics included: age, basal values of follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17-beta-estradiol (E2), thyroid stimulating hormone (TSH), anti-müllerian hormone (AMH), antral-follicle-count (AFC), duration of COS, E2, and progesterone at the last monitoring, TVUS endometrial thickness at the last monitoring before OPU, FOI after OPU. Additionally, the number of meiosis II oocytes retrieved (MII), the total dose of FSH administered, the ratio between MII and total FSH administered, and OSI were registered. AMH levels were significantly lower in obese patients compared to normal weight and overweight women (1.05 IQR 1.20, 1.58 IQR 2.16, 1.32 IQR 1.38, respectively, p-value = 0.032). When looking at the MII/FSH ratio, the normal weight group showed a median value of 3.3 with an IQR of 4.0, the overweight group showed a median value of 2.3 with an IQR of 1.9, and the obese group had a median value of 2.6 with an IQR of 2.8. Those data were statistically significant (p-value = 0.049). These results emphasize the importance of considering weight status in fertility assessment and treatment planning.

Quantitative Assessment of Body Composition in Cirrhosis.

Changes in body composition often accompany the progression of liver disease and seem to be an aggravating pathophysiological factor. Specifically, accelerated loss of skeletal muscle mass, lower muscle quality, and changes in body fat distribution have been shown to be associated with poor clinical outcomes. The aim of the present narrative review was to discuss the current status and relevance of commonly applied, advanced, non-invasive methods to quantify skeletal muscle mass, muscle fat infiltration-i.e., myosteatosis-and fat distribution. This review focuses in particular on Computed Tomography (CT), Dual-energy X-ray Absorptiometry (DXA), Bioelectrical Impedance Analysis (BIA), Magnetic Resonance Imaging (MRI), and Ultrasonography (US). We propose future directions to enhance the diagnostic and prognostic relevance of using these methods for quantitative body composition assessment in patients with cirrhosis.