Changes In Fat Research Articles

Clinical utility of liver function tests for resolution of metabolic dysfunction-associated steatotic liver disease after weight loss in the Diabetes Remission Clinical Trial.

Ectopic fat is reduced by effective weight management, but difficult to assess clinically. We evaluated paired data on 42 participants in the intervention group of the Diabetes Remission Clinical Trial (DiRECT) at baseline, 12 and 24 months after weight loss as indicators of liver fat content measured by 3-point Dixon MRI. Baseline liver fat was elevated at 13.0 [7.8-23.3]% with fasting plasma glucose 7.9 [7.1-10.1] mmol/L. Prevalence of baseline MASLD was 86.4%. After weight loss of 11.9 ± 1.2 kg (0-37 kg) at 12 months, remission of MASLD occurred in 74% and liver fat normalised for many (1.8 [1.2-5.2]%; p < 0.0001) as did fasting glucose (5.9 [5.5-7.2] mmol/L; p < 0.0001). Alanine aminotransferase (ALT) and gamma glutamyl transferase (GGT) decreased at 12 months by 38 [19-60]% (p < 0·0001) and 38 [16-53]% (p < 0.0001) respectively. The positive predictive value for decrease in liver fat, with baseline values of >40 IU/L, was 100% for ALT and 87.5% for GGT. As expected, change in liver fat correlated with change in ALT (r = 0.64; p < 0.0001), GGT (r = 0.38; p = 0.013), AST (r = 0.36; p = 0.018), fatty liver index (r = 0.50; p < 0.0001) and hepatic steatosis index (r = 0.44; p < 0.0001). Metabolic dysfunction-associated steatotic liver disease, an important marker of ill-health is improved by intentional weight loss. If enzyme levels are raised at baseline, following weight loss, changes in ALT and GGT usefully reflect change in liver fat content, with high positive predictive value. Monitoring liver enzymes can provide a simple way to assess change in liver fat following weight loss in day-to-day clinical practice.

The Role of GLP-1 Agonists in Esthetic Medicine: Exploring the Impact of Semaglutide on Body Contouring and Skin Health.

Glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide, have revolutionized the treatment of diabetes and obesity by promoting significant weight loss through incretin effects. However, rapid weight reduction induced by these medications often leads to esthetic challenges, including facial volume loss, skin laxity, and body contour irregularities. This commentary reviews the esthetic consequences of GLP-1-induced weight loss and explores solutions for managing these concerns in clinical practice. This review synthesizes available literature and clinical observations to identify key esthetic concerns associated with GLP-1-induced weight loss. It examines various treatment modalities, including dermal fillers, biostimulatory agents, energy-based devices, and surgical procedures. The discussion highlights gaps in empirical data, optimal timing for interventions, and the need for personalized, multimodal treatment strategies. Imaging tools and psychological support are also considered as complementary approaches. As GLP-1 agonists become a cornerstone in obesity management, their esthetic implications necessitate a proactive response from esthetic practitioners. Effective management of facial volume loss, skin laxity, and body contour challenges requires a combination of injectable treatments, energy-based devices, and, in some cases, surgical interventions. Future research should focus on understanding the molecular mechanisms of skin and fat changes and developing standardized guidelines for treating this unique patient population. Additionally, a holistic approach that addresses both physical and psychological outcomes is critical to ensuring patient satisfaction and long-term well-being.

Changes in the Structure, Function, and Fat Content of the Heart in Patients with Obesity After Bariatric Surgery-A Prospective Magnetic Resonance Imaging Study.

Changes in myocardial fat in addition to changes in cardiac structure and function have not been accurately evaluated in obese patients following surgery. Forty-four obese patients who underwent sleeve gastrectomy and completed preoperative and postoperative cardiac magnetic resonance imaging (CMR) before surgery and at 1, 3, and 6 months after surgery were enrolled, and their clinical and laboratory data were collected. The differences and correlations between clinical, laboratory, and CMR parameters between the preoperative and postoperative groups were analysed. The left ventricular mass (LVM), left ventricle cardiac output (LVCO), pericardial adipose tissue volume (PATV), and myocardial proton density fat fraction (M-PDFF) decreased after surgery (all P < 0.05). The left ventricle global longitudinal strain increased at 6 months after surgery (P = 0.004). A decrease in BMI was positively correlated with the LVCO (r = 0.58, P < 0.001) at 3months after surgery and was positively correlated with the LVM and PATV (r = 0.54, P < 0.05) at 6months after surgery. Six months after surgery, the changes in PATV were positively correlated with the changes in triglycerides (r = 0.61, P < 0.01). There was a moderately positive correlation between the decrease in the LVM and PATV (r = 0.54 ~ 0.71, P < 0.02) after surgery. After surgery, the cardiac structure and function of obese patients significantly improved, the PATV and M-PDFF decreased, and there was a correlation between the structure and function of the heart and several clinical and laboratory indicators.

MRI-PDFF Assessment of Intrahepatic Fat Changes Post-Bariatric Surgery: A Systematic Literature Review

Background and Objectives: Non-alcoholic fatty liver disease (NAFLD) is prevalent among obese individuals and can progress to non-alcoholic steatohepatitis (NASH). Bariatric surgery is known to induce significant weight loss and may improve NAFLD. This systematic review uniquely synthesizes current evidence on the effects of bariatric surgery on intrahepatic fat content, measured by magnetic resonance imaging proton density fat fraction (MRI-PDFF), and assesses study quality using the Newcastle–Ottawa Scale (NOS). Materials and Methods: The literature search was conducted across the PubMed, Scopus, and Web of Science databases up to October 2024, identifying 12 prospective cohort studies involving 613 patients who underwent bariatric surgery. Inclusion criteria included adult patients with NAFLD undergoing bariatric surgery, assessment of liver fat changes using MRI-PDFF before and after surgery, and studies reporting quantitative data on liver fat fraction and relevant clinical parameters. Data extraction focused on patient demographics, surgical procedures, specific weight loss outcomes (delta BMI), changes in intrahepatic fat content (delta MRI-PDFF), and quality assessment scores based on the NOS. Results: Significant reductions in intrahepatic fat content were observed across all studies, with delta MRI-PDFF reductions ranging from 6.9% to 14%. Weight loss outcomes varied, with excess weight loss percentages up to 81.3% and BMI reductions up to 12 kg/m². The quality assessment scores ranged from six to nine out of nine, indicating generally high-quality studies. Correlations were noted between the degree of weight loss and reduction in liver fat content. Several studies reported high rates of resolution of steatosis and NASH post-operatively. Conclusions: Bariatric surgery leads to significant reductions in intrahepatic fat content and improvements in NAFLD among obese patients. The degree of weight loss correlates with the reduction in liver fat. These findings underscore the clinical utility of bariatric surgery as a strategic intervention for managing NAFLD in obese individuals, potentially influencing clinical practice guidelines by integrating bariatric surgery as a viable treatment option for NAFLD-related hepatic conditions.

Longitudinal changes in regional fat and muscle composition and cardiometabolic biomarkers over 5 years of hormone therapy in transgender individuals.

Longitudinal studies investigating hormone therapy in transgender individuals are rare and often limited to 1- to 2-year follow-up periods. We examined changes in body composition, muscle volumes, and fat distribution as well as muscle strength, arterial stiffness, and cardiometabolic biomarkers in both transgender men (TM; n=17, age 25±5 years) and transgender women (TW; n=16, age 28±5 years) at baseline and after 1 and 5-6 years of hormone therapy in a longitudinal prospective cohort design. Whole-body and regional fat and muscle volumes were analyzed using magnetic resonance imaging, and blood samples were taken. Skeletal muscle size increased in TM (21% after 6 years) and decreased in TW (7% after 5 years). Muscle strength increased 18% after 6 years in TM (p=0.003) but was statistically unchanged in TW. Muscle fat infiltration changed (p<0.05) almost completely toward the affirmed sex phenotype after 1 year of therapy in both TM and TW. The most notable changes in fat volume distribution were that TW increased total adiposity but decreased visceral fat volume, whereas TM showed increased visceral fat (70%) and liver fat but relatively stable total adipose tissue levels. Although arterial stiffness and blood pressure did not change, there was a significant increase in triglyceride and LDL cholesterol levels and a decrease in HDL levels in TM after 6 years. These unique longitudinal data underscore the importance of continued clinical monitoring of the long-term health effects of gender-affirming hormone therapy in both TW and, perhaps especially, TM.

Association between total, regional and organ fat and type 2 diabetes risk factors among Latino youth: A longitudinal study

SummaryIntroductionTo examine whether within‐person changes in total, regional and organ fat were associated with within‐person changes in type 2 diabetes (T2D)‐related biomarkers following interventions.MethodsA secondary analysis from a randomised trial among Latino youth (30 males, 25 females) aged 12–16 years with obesity. The study sample combined participants randomised to either lifestyle intervention (N = 39) or usual care (N = 16). Total body composition was assessed by DEXA. Hepatic and pancreatic fat fractions were assessed using MRI. T2D risk factors included insulin sensitivity, beta‐cell function and post‐challenge glucose.ResultsSignificant changes in %body fat, lean mass, insulin sensitivity and 2‐h glucose were observed. Changes in fat mass were associated with changes in insulin sensitivity (β = −0.45, p &lt; 0.001), while changes in lean mass were associated with changes in 2‐h glucose concentrations (β = −0.50, p = 0.02). No association between changes in total, regional, or organ fat and beta cell function were noted.ConclusionsOur study revealed that within‐person changes in fat mass and lean mass were associated with increased insulin sensitivity and reduced 2‐h glucose concentrations, respectively, among high‐risk Latino youth. The impact of reductions in regional and organ fat deposition on T2D risk factors warrants further examination.

Pericarotid Fat as a Marker of Cerebrovascular Risk.

Vascular inflammation is widely recognized as an important factor in the atherosclerotic process, particularly in terms of plaque development and progression. Conventional tests, such as measuring circulating inflammatory biomarkers, lack the precision to identify specific areas of vascular inflammation. In this context, noninvasive imaging modalities can detect perivascular fat changes, serving as a marker of vascular inflammation. This review aims to provide a comprehensive overview of the key concepts related to perivascular carotid fat and its pathophysiology. Additionally, we examine the existing literature on the association of pericarotid fat with features of plaque vulnerability and cerebrovascular events. Finally, we scrutinize the advantages and limitations of the noninvasive assessment of pericarotid fat.

Association between weight and body composition changes with falls risk in the Malaysian Elders Longitudinal Research (MELoR) study

ObjectiveBoth changes in body composition and increased fall risk occur with increasing age. While weight management may be considered a component of falls prevention, the long-term consequences of changes in...

Storage of Rabbit Meat in Vacuum Extends the Oxidative Stability of Fat

ABSTRACTMeat quality is a very important factor for both food safety and consumer acceptance, and proper storage of meat can extend the time it stays fresh. This study thus looked at the effects of the atmosphere in which rabbit meat was stored on the oxidative stability of the meat and on its volatile compounds. Not only does the formation of oxidative products adversely affect the human body, but the compounds formed during oxidative changes also typically possess unpleasant aromas, leading to deterioration in the flavor of the meat. Our study analyzed three types of storage atmosphere for rabbit meat: vacuum (VAC), a modified atmosphere (LoOxMAP) composed of 60% CO2, 25% O2, and 15% N2, and an MAP (HiOxMAP) composed of 30% CO2 and 70% O2. The results show that the MAP with 70% oxygen (HiOxMAP) is the least beneficial variant of the three. Rabbit meat packed under HiOxMAP showed the greatest oxidative changes, and volatile compounds providing an unpleasant odor were detected. The fewest changes in meat stored for 21 days occurred in samples stored in VAC.Practical Applications: For the long‐term storage of rabbit meat at refrigerated temperature, it is best to use a vacuum atmosphere to slow down the oxidative changes in the meat fat.

Influence of storage time of fermented soghurt on the changes in fat and protein biomolecules through Confocal Laser Scanning Microscopy (CLSM) under refrigeration condition

The aim of the study is to assess the significance of storage duration on fermented Soghurt (soy curd), focusing on changes in fat and protein biomolecules analyzing with CLSM, viscosity measurements, and particle size distributions under refrigerated conditions. Soghurt prepared with 1% yogurt culture (Lactobacillus delbrueckii ssp. bulgaricus and Streptococcus thermophilus) was analyzed for storage stability under refrigerated conditions for up to 15 days measuring the pH, acidity, microbial counts, viscosity, particle size distribution and scanning electron microscopy for structural analysis. Even though lactic counts were not affected significantly during the storage periods, yeast & mold counts and coliform counts were absent up to 15 days during the storage. However, the product could be stored upto 7 days under refrigeration condition (6–8 °C). During the storage period, it was observed that the viscosity of soghurt increased with increase in storage time. Particle size distribution was estimated during the entire storage periods for soghurt and it was observed that smaller particle was mostly found in the range of 3.0–50.0 µm while bigger particles were in the range of 57.0–910.0 µm. Further, larger aggregates with big particle sizes were observed during prolonged storage period. The CLSM study showed the appearance of proteins and fats being dispersed slowly during the storage due to the proteolytic and lipolytic activities of yoghurt cultures after 5 days of storage under refrigeration condition.

The dynamic increment of epicardial adipose tissue is associated with reverse remodeling after guideline-directed medical treatment in dilated cardiomyopathy patients

Abstract Background/Introduction Epicardial adipose tissue (EAT) accumulation is associated with adverse prognosis in patients with HFpEF and a better prognosis in HFrEF patients. Whether EAT is playing a protective role in dilated cardiomyopathy (DCM) patients have been described sparingly. Purpose Aim to explore whether the epicardial fat would change along with the dynamic changes in cardiac function and volumes after receiving guideline-directed medical therapy (GDMT) in patients with DCM. Methods We prospectively enrolled 232 DCM patients who underwent complete baseline and follow-up Cardiac magnetic resonance (CMR) examinations. The measurement of the epicardial fat composition includes epicardial fat thickness, paracardial fat thickness, and paracardial fat volume, while the measurement of body fat composition includes subcutaneous and visceral abdominal fat, while We used univariable and multivariable logistic regression to evaluate the association between different body and cardiac fat depots with the changes in bi-ventricular structure (delta indexed EDV) and function (delta EF). Results The study included 232 patients (mean age 46.1±14.1 years, 157 (67.7%) males). After GDMT, we found that the visceral fat thickness and EAT (thickness and volume) tend to significantly increase. The increase in the (left ventricular reverse remodeling) LVRR group was significantly higher compared with the non-LVRR group. Independently with the changes of BMI and body fat depots, the increment of EAT was associated with the improvement in bi-ventricular function and volumes (significantly positively correlated with the improvement of LVEF (r = 0.499, p &amp;lt; 0.001), and RVEF (r = 0.482, p &amp;lt; 0.001), negatively correlated with delta LVEDVi (r = -0.407, p &amp;lt; 0.001), delta RVEDVi (r = -0.305, p &amp;lt; 0.001)). Conclusions After GDMT, the increment of EAT was positively correlated with the improvement of bi-ventricular structure and function, independent of the changes in BMI and body fat depots.Graphic Abstract

Body fat or muscle underneath body mass index in heart failure patients: characteristics and prognostic values

Abstract Background Body Mass Index (BMI) has been recognized as a prognosticator for heart failure (HF) in that higher BMI relates to lower mortality. However, limited data are available whether body composition underneath BMI would further differentiate patients with a better or worse outcome, especially in those with lower or normal BMI. Purpose To investigate the characteristics of body fat and body muscle in HF patient groups with different BMI, and their impact on prognosis. Methods Between July 2021 and July 2022, hospitalized HF patients who were suitable for the examination underwent body composition analysis by using bioelectrical analyses (BIA) in the stable state after decongestion therapy and before discharge. Percentage of body fat (PBF) and percentage of body muscle (PBM) were calculated by dividing the mass of body fat, or body muscle, respectively. Patients were divided into underweight (&amp;lt;18.5kg/m2), normal weight (20-24.9 kg/m2), overweight/obese (≥25kg/m2) based on BMI, who were followed for 180 days for all-cause death. Results 127 consecutive patients with obtained data were finally enrolled (60±15 years, 70% males), including 20 (15.75%) underweight, 75 (59.06%) normal weight, and 32 (25.19%) overweight/obese. As shown in Table 1, As shown in Table 1, the body fat mass and muscle mass varied with BMI, though they showed a different rate of change. Compared with patients with normal weight, the fat and muscle mass in those overweight/obese was 81.8% and 12.4% higher; whereas it was 39.2%, and 23.1% lower in those underweight, respectively. As results, the overweight/obesity group had a higher PBF, but a lower percentage of PBM. Consequently, the overweight/obesity group had a higher PBF, a lower PBM and a decreased muscle mass/fat mass ratio (MFR); conversely, the underweight group had a lower PBF, a higher PBM and an increased MFR. During 180-day follow-up, 17 (13.4%) died for all cause. By Cox regression analysis, MFR independently predict all-cause death (HR, 1.273, 95% CI: 1.056-1.534, p=0.011) after adjusted for age, BMI, ejection fraction and NT-proBNP. Of note, in patients with normal weight, Receiver Operating Characteristic (ROC) curve analysis suggested the capability of MFR (AUC=0.780, p=0.003) as well as its superiority over BMI in association with all-cause mortality (Figure 1). Conclusions The change of body fat or muscle mass with BMI displayed a different rate in HF patients, so that the MFR was higher in underweight but lower in overweight/obese when compared to normal weight group. Apart from BMI, MFR emerged as a predictor of mortality, in particular in patients with normal weight.

Regulating role of Pleurotus ostreatus insoluble dietary fiber in high fat diet induced obesity in rats based on proteomics and metabolomics analyses

This study aims to reveal the effects of Pleurotus ostreatus insoluble dietary fiber (POIDF) on liver protein and cecal metabolites in obese rats and its potential mechanism by intestinal microbes. It was found that POIDF contained the structural characteristics of cellulose and hemicellulose, as well as amorphous diffraction peaks. POIDF could reduce the body weight and organ index of obese rats, regulate dyslipidemia, and improve the pathological changes of liver and epididymis fat. Further experimental results showed that POIDF could regulate the abundance of bacteria related to lipid metabolism, and maintain intestinal homeostasis. The metabolomics results showed that the fatty acyls pathway in the cecum contents was the pathway with the highest concentration of small molecule metabolites. POIDF supplementation regulated the expression of liver key proteins, as well as biosynthesis of amino acids, steroid biosynthesis, arachidonic acid metabolism and PPAR signaling pathway. Omics association analysis found that POIDF could further regulate liver proteins and their signaling pathways, regulate the levels of fatty acyls and amino acid metabolites in the gut and the enrichment of related pathways, and play a therapeutic or preventive role in obesity after degradation by intestinal microbiota.

Body composition and muscle composition phenotypes in patients on waitlist and shortly after liver transplant – results from a pilot study

BackgroundSarcopenia is common in end-stage liver disease and negatively impacts patients awaiting or undergoing liver transplantation (LT). Magnetic resonance imaging (MRI) may be used to measure body composition and sarcopenia. We aimed to evaluate the feasibility of MRI-based LT body composition profiling, describe waitlist body composition, and assess the natural rate of change in body composition while on the waitlist and post-LT.MethodsThis prospective pilot study recruited adults listed for LT at an urban, tertiary care facility. Eighteen participants were scanned at time of waitlisting and 15 had follow-up MRIs (waitlist and/or post-LT). An 8-min MRI was used to measure body composition (AMRA® Researcher) including thigh fat-free muscle volume (FFMV) and fat infiltration (MFI), visceral (VAT) and abdominal subcutaneous (ASAT) adipose tissue volumes, and liver fat. A sex- and BMI invariant FFMV z-score (z-FFMV) was calculated, and muscle composition (MC) phenotypes were defined using the muscle assessment score (consisting of the FFMV z-score and sex-adjusted MFI). Rate of body composition change was calculated using mixed-effect modelling and is presented as rate per 30 days.ResultsAt time of waitlisting, 73% of the 18 participants had high MFI and 39% had the adverse MC (low FFMV z-score and high MFI) phenotype. Seven participants received an LT. Post-LT serial MRIs, at a median of 147 days apart within the first 200 days post-LT, demonstrated increased z-FFMV 0.22 SDs/(30 days) (p = 0.002), VAT 0.23 (p < 0.001), and ASAT 0.52 (p = 0.001) L/(30 days), but no change in MFI (p = 0.200) nor liver fat (p = 0.232).ConclusionMRI-based body composition profiling is feasible in LT patients and shortly after LT. This can be amended to routine clinical scans and may help in early identification of patients who may benefit from interventions to improve body composition. In addition, body composition changes significantly over time after LT.

5124 Increased Copeptin May Reflect Vasopressin-Related Metabolic Changes After Bariatric Surgery

Abstract Disclosure: F. Galbiati: None. A. Aulinas Maso: None. I. Becetti: None. M. Lauze: None. V. Singhal: None. E.A. Lawson: Research Investigator; Self; received research funding and study drug from Tonix Pharmaceuticals. M. Bredella: None. M. Bredella: None. M. Misra: Advisory Board Member; Self; key opinion leader for Lumos Pharma. Consulting Fee; Self; Up To Date, Receives royalties. Objective: Vasopressin (AVP) is a neurohormone that decreases fat mass, promotes muscle regeneration, improves glucose homeostasis, and protects against hypoglycemia in animals and humans. Copeptin, a stable cleavage product of AVP, is positively associated with body mass index (BMI), insulin resistance, and metabolic syndrome in adults, suggesting an adaptive increase in AVP to counteract metabolic disruption. Similarly, copeptin was positively correlated with BMI in children. Metabolic and bariatric surgery (MBS) is highly effective at reducing metabolic complications of obesity, and underlying mechanisms may provide insights into novel therapeutics for obesity management. No study has investigated copeptin pre- and post-MBS in humans. We hypothesized that after MBS, (1) copeptin would increase and (2) increased copeptin would be associated with improved metabolic parameters. Methods: Longitudinal study in 64 adolescents and young adults (78% females; age [mean±SD] 18.7±2.8 years) with obesity (BMI 45.6±6.8 kg/m2). 34 underwent MBS (sleeve gastrectomy or Roux-en-Y gastric bypass) and 30 underwent non-surgical (NS) lifestyle management. We measured fasting circulating copeptin, %fat, and lean mass by dual-energy X-ray absorptiometry, hemoglobin A1c (HbA1c), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) at baseline and 12 months. Results: Groups were similar for age, sex, race, and pubertal stage. Baseline BMI and %fat were higher in MBS (p≤.012). Baseline copeptin, %lean mass, HbA1c, and HOMA-IR did not differ across groups (p≥.103). MBS vs NS 12-month changes were [median(IQR)]: BMI -29.0 (-33.7, -16.5)% and 0.54 (-3.10, +4.37)%; %fat -8.03 (-13.33, -4.25) and -0.68 (-2.92, 0.64); %lean mass 7.73 (3.45, 12.38) and 0.83 (-.58, 2.73); HbA1c -0.40 (-0.52, -0.20) and -0.10 (-0.20, -0.02); HOMA-IR (mean±SD) -2.47±2.17 and 0.76±2.42 (ps≤.001). Baseline copeptin was correlated negatively with %fat (rho=-.25; p=.045), and positively with %lean mass (trend-level rho=.25, p=0.051). Copeptin increased in the MBS group and decreased in the NS group (time-x;-treatment effect: p=.017). Overall, copeptin change was correlated negatively with %fat change (rho=-.29; p=.025) and positively with %lean mass change (trend-level rho=0.24, p=.070). Copeptin change was positively correlated with changes in %lean mass (rho=.37, p=.045), HbA1c (rho=.46; p=.010), and HOMA-IR (rho=.53; p=.004), only after MBS. Conclusion: Overall, increase in copeptin over 12 months was associated with improved body composition, suggesting that increased AVP following MBS may contribute to its associated metabolic improvements. However, within the MBS group, improved glucose homeostasis was associated with reductions in copeptin, suggesting a possible protective mechanism against post-bariatric hypoglycemia. Presentation: 6/2/2024

6984 New Onset Diabetes After Transplant: Need for Strict Glucose Monitoring

Abstract Disclosure: T. Chaudhary: None. O. Syed: None. M. Nawaz: None. R. Kaur: None. Introduction: Immunosuppressant use comes at a cost of challenging side effects, which are being discovered more as its use increases. One such example is our case of new-onset diabetes after transplant (NODAT).Patient presentation: A 36-year-old male with a past medical history of end-stage renal disease status post renal transplant (6/2023), hypertension, and hyperlipidemia who presented to the hospital in 10/2023 with fever, chills, and diarrhea. His vitals at that time were as follows: temperature 36.1C, blood pressure 148/84 mmHg, pulse 87 bpm, and a respiratory rate of 22. Lab work was significant for blood glucose 1144, anion gap 22, bicarbonate 13, potassium 7.3, Sodium 135, lipase 427, pH 7.3, urine ketones 80, HbA1C 11.5 %. CT scan of the abdomen revealed loss of peripancreatic fat and inflammatory changes surrounding the pancreas. His medication review included Tacrolimus 12 mg daily, Mycophenolate 500 mg BID, Valtrex 500mg daily, and fluconazole 200mg every other day. He was treated with 2 liters of normal saline bolus and started on maintenance fluid, and insulin drip as per DKA protocol. Calcium gluconate and an albuterol nebulizer were given for hyperkalemia. Tacrolimus and prednisone were held. Endocrinology and Nephrology were consulted. The patient was thought to have diabetes due to steroid use which were discontinued and the patient was discharged on subcutaneous insulin regimen and lower dose of tacrolimus. Despite discontinuation of steroids, patients continued to have raised glucose readings confirming the causative agent as tacrolimus. Conclusion: The current guidelines for post-kidney transplant patients recommend checking fasting blood glucose weekly for the first four weeks, then biweekly for two months, and then monthly thereafter. HbA1C should be checked every 3 months and if it is &amp;gt;6% then home glucose monitoring should be done as well. Although the frequency of these check-ups decreases, it is imperative for physicians to remember that patients can still develop NODAT months post-transplant. It is also essential to reinforce the importance of these glucose checks for the patient as missed diagnosis can lead to dangerous complications such as DKA. Presentation: 6/2/2024

The effect of tele-nutrition education on fat percentages, cholesterol, and physical activity in adults with overweight

Overweight and obesity can be caused by lack of physical activity and an imbalance in energy intake and energy expenditure, which can lead to excess energy which will be stored in the form of fat tissue in the body. Efforts to improve healthy lifestyles can be done with nutritional education. Technological developments can provide opportunities to increase telehealth activities in Indonesia, one of which is tele-nutrition. This study aims to determine the effect of tele-nutrition education on changes in percent fat, cholesterol and physical activity in overweight adults. This research uses a pre-test post-test control group design. A total of 46 adult respondents aged 19-49 years. Both groups were first given an initial test (pre-test) with the same test. Then the experimental group was given special treatment, namely tele-nutrition-based nutrition education, while the control group was given direct leaflet-based nutrition education treatment. Data analysis was used using the Paired T Test and Wilcoxon Test. Based on the results of the analysis, there was no effect on body fat percentage before and after being given nutritional education in the experimental group and control group (p&gt;0.05). There was an effect on cholesterol levels and physical activity before and after being given nutrition education in the experimental group, while in the control group there was no effect on cholesterol levels and physical activity before and after being given nutrition education (p&lt;0.05). Keywords: cholesterol levels, percent body fat, physical activity, tele-nutrition education

Eggs, Dietary Choline, and Nonalcoholic Fatty Liver Disease in the Framingham Heart Study

BackgroundEggs are rich in bioactive compounds, including choline and carotenoids that may benefit cardiometabolic outcomes. However, little is known about their relationship with nonalcoholic fatty liver disease (NAFLD). ObjectivesWe investigated the association between intakes of eggs and selected egg-rich nutrients (choline, lutein, and zeaxanthin) and NAFLD risk and changes in liver fat over ∼6 y of follow-up in the Framingham Offspring and Third Generation cohorts. MethodsOn 2 separate occasions (2002–2005 and 2008–2011), liver fat was assessed using a computed tomography scan to estimate the average liver fat attenuation relative to a control phantom to create the liver phantom ratio (LPR). In 2008–2011, cases of incident NAFLD were identified as an LPR ≤0.33 in the absence of heavy alcohol use, after excluding prevalent NAFLD (LPR ≤0.33) in 2002–2005. Food frequency questionnaires were used to estimate egg intakes (classified as <1, 1, and ≥2 per week), dietary choline (adjusted for body weight using the residual method), and the combined intakes of lutein and zeaxanthin. Multivariable modified Poisson regression and general linear models were used to compute incident risk ratios (RR) of NAFLD and adjusted mean annualized liver fat change. ResultsNAFLD cumulative incidence was 19% among a total of 1414 participants. We observed no associations between egg intake or the combined intakes of lutein and zeaxanthin with an incident NAFLD risk or liver fat change. Other diet and cardiometabolic risk factors did not modify the association between egg intake and NAFLD risk. However, dietary choline intakes were inversely associated with NAFLD risk (RR for tertile 3 compared with tertile 1: 0.69, 95% CI: 0.51, 0.94). ConclusionsAlthough egg intake was not directly associated with NAFLD risk, eggs are a major source of dietary choline, which was strongly inversely associated with NAFLD risk in this community-based cohort.

Changes in Cardiac Morphology and Visceral Fat After the Use of Testosterone Associated with Aerobic Exercise in Wistar Rats Induced Diabetes

Changes in Cardiac Morphology and Visceral Fat After the Use of Testosterone Associated with Aerobic Exercise in Wistar Rats Induced Diabetes

Optimizing muscle preservation during weight loss in patients with cirrhosis: A pilot study comparing continuous energy restriction to alternate-day modified fasting for weight loss in patients with obesity and non-alcoholic cirrhosis of the liver.

Obesity is associated with increased morbidity in patients with advanced liver disease, but it is particularly challenging for these patients to preserve skeletal muscle mass during weight loss and accelerating sarcopenia is a concern. Alternate-day modified fasting (ADMF) may be particularly effective for weight loss in patients with concomitant cirrhosis and obesity due to preservation of fat-free mass (FFM). A weight loss program featuring either ADMF or a continuous low-calorie diet (LCD) was evaluated in a 24-week randomized clinical trial in 20 adult patients with Child-Pugh Class A cirrhosis and obesity. Participants were randomized to either ADMF (n=11) or LCD (n=9). Both groups received a remotely delivered exercise program. Body composition, sarcopenia measures, and functional outcomes were assessed pre-post. Thirteen participants completed the intervention (Age=57±10; BMI=37.7±5.8kg/m2). The median body weight lost in ADMF was 13.7±4.8kg (13.9% of initial body weight), while LCD lost 9.9±6.9kg (10.7% of initial body weight). Total body fat percentage decreased in both groups (ADMF: -4.1±4.0%; LCD=-2.8±1.4%). Fat-free mass accounted for 34±20% of total weight loss in ADMF and 38±10% in LCD. Functional measures, such as timed chair stands, improved in both groups. This pilot study demonstrates the feasibility of the ADMF and LCD interventions to produce significant weight loss while improving body composition in patients with cirrhosis and obesity. Further research is needed to validate these findings in larger cohorts and to assess changes in muscle quality and visceral fat. ClinicalTrials.gov Identifier: NCT05367596.