Differences In Fat Distribution Research Articles

Sex Differences in Fat Distribution and Muscle Fat Infiltration in the Lower Extremity: A Retrospective Diverse-Ethnicity 7T MRI Study in a Research Institute Setting in the USA.

Background: Fat infiltration in skeletal muscle is related to declining muscle strength, whereas excess subcutaneous fat is implicated in the development of metabolic diseases. Methods: Using multi-slice axial T2-weighted (T2w) MR images, this retrospective study characterized muscle fat infiltration (MFI) and fat distribution in the lower extremity of 107 subjects (64M/43F, age 11-79 years) with diverse ethnicities (including White, Black, Latino, and Asian subjects). Results: MRI data analysis shows that MFI, evaluated by the relative intensities of the pixel histogram profile in the calf muscle, tends to increase with both age and BMI. However, statistical significance was found only for the age correlation in women (p < 0.002), and the BMI correlation in men (p = 0.04). Sex disparities were also seen in the fat distribution, which was assessed according to subcutaneous fat thickness (SFT) and the fibula bone marrow cross-sectional area (BMA). SFT tends to decrease with age in men (p < 0.01), whereas SFT tends to increase with BMI only in women (p < 0.01). In contrast, BMA tends to increase with age in women (p < 0.01) and with BMI in men (p = 0.04). Additionally, MFI is positively correlated with BMA but not with SFT, suggesting that compromised bone structure may contribute to fat infiltration in the surrounding skeletal muscle. Conclusions: The findings of this study highlight a sex factor affecting MFI and fat distribution, which may offer valuable insights into effective strategies to prevent and treat MFI in women versus men.

Poor muscle health and cardiometabolic risks associated with antidepressant treatment.

This study aims to investigate whether antidepressant users display differences in fat distribution and muscle composition relative to non-users and to explore risk factors for developing cardiovascular disease (CVD) and type 2 diabetes. The study used quantitative adipose and muscle tissue measures derived from magnetic resonance imaging data from UK Biobank (N = 40,174). Fat distribution and muscle composition of selective serotonin reuptake inhibitor (SSRI) and tricyclic antidepressant (TCA) users were compared with sex-, age-, and BMI-matched control individuals. Cox regression models were used to test for increased risk of developing CVD and type 2 diabetes. SSRI users had more visceral fat, smaller muscle volume, and higher muscle fat infiltration compared with matched control individuals. Female users showed a larger increase in BMI over time compared with male users. However, male users displayed an unhealthier body composition profile. Male SSRI users also had an increased risk of developing CVD. Both male and female TCA users showed lower muscle volume and an increased risk of developing type 2 diabetes. Adverse changes in body composition of antidepressant users are not captured by tracking the body weight or the BMI of the patients. These changes may lead to a worsened cardiometabolic risk profile.

Measurement of periarticular subcutaneous fat on CT images and adverse outcomes following total knee arthroplasty

BackgroundObesity is associated with a higher rate of wound complications following primary total knee arthroplasty (TKA). With readily available computer tomography (CT) images from robotic-assisted TKA, we analyzed measurement of fat content on preoperative CT images as a possible predictor of wound complications following primary TKA. MethodsPatients who underwent robotic-assisted TKA at one institution in 2018 were included in this retrospective cohort study. Two independent reviewers measured three SCF areas at different axial CT cuts and normalized them by dividing the area of the distal femur. These areas were distributed into 4 groups. Any wound complication that required clinical or surgical intervention was reviewed and analyzed. For further comparison, prepatellar SCF thickness ratio measured on CT scan and BMI were grouped and analyzed similarly for wound complications. We also analyzed any association of SCF measurement with secondary outcomes such as operative time, length of stay, readmission, and reoperation. ResultsOne hundred fifty patients with diagnosis of osteoarthritis, mean age of 64 years and BMI of 34.3 kg/m2 were included in this study. Ninety-one patients (61 %) were female. Normalized SCF measurements at 2 cm above the patella, mid-patella, and tibial tubercle had excellent intraclass correlation coefficient at 0.987, 0.989, and 0.989, respectively. When SCF at 2 cm above patella was analyzed, Group 1 (smallest amount of SCF) had a significantly higher wound complication rate compared with Groups 2 and 3 combined (18.9 vs 5.3 %, p = 0.036). Group 4 (largest amount of SCF) also had a significantly higher wound complication rate compared with Groups 2 and 3 combined (18.9 vs 5.3 %, p = 0.036). ConclusionsAccurate and consistent measurement of periarticular fat around the knee based on axial CT images demonstrated that moderate amount of fat is associated with better clinical outcomes following primary TKA. Our study did not find any clinical significance of gender difference in fat distribution. Therefore, more studies should be undertaken to evaluate for any clinical association of gender-specific fat distribution and to confirm our finding that a certain amount of fatty tissue is necessary for improved outcomes following TKA.

MRI-derived abdominal adipose tissue is associated with multisite and widespread chronic pain

IntroductionMusculoskeletal pain typically occurs in multiple sites; however, no study has examined whether excessive visceral and subcutaneous adipose tissue are associated with musculoskeletal pain. This study therefore aimed to describe...

Abstract P341: Physical Activity and Dual Energy X-ray Absorptiometry Measured Body Composition in Global Multi-Ethnic Cohorts

Background: Obesity is an important risk factor for the development of heart disease, and unfortunately rates of obesity have been growing worldwide. Obesity is often defined by body mass index (BMI) ≥30kg/m 2 , however, BMI cannot distinguish between fat or lean mass nor differences in fat distribution. Dual energy x-ray absorptiometry (DXA) provides more detailed measurements of body composition, but research assessing the association between physical activity and detailed body composition measures in diverse populations is lacking. This study therefore examined associations between physical activity and DXA-derived measures of adiposity in Chinese, Malay, Indian and White European adults from two large-scale prospective cohort studies. Methods: From 2006-2010, adults from the general population were recruited to both The Malaysian Cohort (TMC) study (N=119 555) and the UK Biobank (N=502 487). Physical activity was self-reported by questionnaire at baseline assessment and approximately 5-yearly resurveys in both cohorts. Between 2020-2023, 5489 participants underwent a DXA scan in TMC; while between 2014-2023, 60 280 participants had DXA scans in UK Biobank. Analyses excluded participants with missing data and prior diseases that may impact body composition. Multivariable linear regression (adjusted for demographic and lifestyle confounders) was used to examine associations between physical activity and body composition measures across ethnic groups, and estimates were corrected for regression dilution bias by using estimates of ‘usual physical activity’ derived from repeat measurements. Results: After exclusions, 1723 Chinese, 1245 Malay and 609 Indian participants were included in the TMC analyses and 56 758 White Europeans in the UK Biobank (mean age 57.1 years, 41.2% male in TMC and 54.7 years, 47.7% male in UK). In TMC, physical activity was not associated with BMI, however it was inversely associated with DXA adiposity measures and positively associated with lean mass. Comparing the highest quintile of physical activity to the lowest, total fat mass was 0.7 kg lower (95%CI: -1.1- -0.3) and total lean mass was 0.6 kg higher (0.3-0.9). There was no evidence of effect modification by ethnicity in TMC, but results in White Europeans were stronger: total fat mass was 3.9 kg lower (-4.1- -3.6) and lean mass was 1.2 kg higher (1.1-1.4) comparing the highest to lowest quintiles of physical activity. Interpretation: This is the first large-scale study to examine associations between physical activity and DXA-derived measures of body composition in multi-ethnic cohorts from Malaysia and the UK. The findings support physical activity interventions to reduce obesity-related disease across diverse populations and highlight the value of using detailed body composition measures.

Three-dimensional Volumetric Visceral and Subcutaneous Fat Analysis on Opportunistic Computed Tomography Imaging of Patients With Greater Trochanteric Pain Syndrome Compared With Those With Predominant Osteoarthritis: A Case-Control Study.

This study aimed to address the gap in knowledge assessing the impact of visceral and subcutaneous body fat on 3-dimensional computed tomography imaging in patients with greater trochanteric pain syndrome (GTPS) in comparison with those primarily diagnosed with osteoarthritis (OA). We evaluated adult patients with a confirmed diagnosis of GTPS from our institutional hip-preservation clinic spanning 2011 to 2022. Selection criteria included their initial clinic visit for hip pain and a concurrent pelvis computed tomography scan. These patients were age- and sex-matched to mild-moderate OA patients selected randomly from the database. Visceral and subcutaneous fat areas were measured volumetrically from the sacroiliac joint to the lesser trochanter using an independent software. Interreader reliability was also calculated. A total of 93 patients met the study criteria, of which 37 belonged to the GTPS group and 56 belonged to the OA group. Both groups were sex and race matched. Average age in GTPS and OA groups was 59.3 years and 56 years, respectively. For GTPS group, average body mass index was 28.9 kg/m 2 , and for the OA group, average body mass index was 29.9 kg/m 2 , with no significant difference ( P > 0.05). Two-sample t test showed no significant differences in the visceral fat, subcutaneous fat, or the visceral fat to total fat volume ratio between the GTPS and OA groups. There was excellent interreader reliability. Our results indicate that there is no significant difference in fat distribution and volumes among GTPS and OA patients. This suggests that being overweight or obese may not be directly linked or contribute to the onset of GTPS. Other factors, such as gluteal tendinopathy, bursitis, or iliotibial band syndrome, might be responsible and need further investigation.

Characteristics and correlation of body fat distribution and brachial-ankle pulse wave velocity in adults aged 20–59 years: a cross-sectional study

BackgroundFat distribution is closely related to vascular stiffness. This study aimed to investigate age and sex differences in fat distribution and brachial-ankle pulse wave velocity (baPWV), and the association between fat parameters and baPWV.MethodsA total of 10,811 participants aged 20–59 years were recruited. Measures included waist and hip circumference, waist-to-hip ratio (WHR), body mass index (BMI), percentage body fat (PBF), subcutaneous fat area (SFA), visceral fat area (VFA), and baPWV.ResultsThe results confirm that fat accumulates with age and that men tend to carry more abdominal fat than women in the same age group. The findings also indicate that baPWV increases with age and is significantly higher in men than in women in the same age group. In addition, WHR, VFA, and baPWV were more strongly correlated than baPWV and BMI, SFA, and PBF. Finally, the effects of age, PBF, WHR, and VFA on baPWV were greater for the higher quantiles.ConclusionsThere are age and sex differences in fat distribution and baPWV. Abdominal obesity is more closely linked to arterial stiffness than overall obesity, and people with higher baPWV are more affected by obesity parameters.

Behind BMI: The Potential Indicative Role of Abdominal Ectopic Fat on Glucose Metabolism

Introduction: The purpose of this study was to compare the difference in abdominal fat distribution between different metabolic groups and find the ectopic fat with the most risk significance. Methods: A total of 98 subjects were enrolled; there were 53 cases in the normal glucose metabolism group and 45 cases in the abnormal glucose metabolism group. Chemical shift-encoded magnetic resonance imaging was applied for quantification of pancreatic fat fraction (PFF) and hepatic fat fraction (HFF), subcutaneous adipose tissue (SAT), and visceral adipose tissue (VAT). The correlation and the difference of fat distribution between different metabolism groups were analyzed. The receiver operating characteristic (ROC) curve was used to analyze the suggestive effect of different body fat fraction. Results: Correlation analysis showed that body mass index (BMI) had the strongest correlation with fasting insulin (r = 0.473, p < 0.001), HOMA-IR (r = 0.363, p < 0.001), and C-reactive protein (r = 0.245, p < 0.05). Pancreatic fat has a good correlation with fasting blood glucose (r = 0.247, p < 0.05) and HbA1c (r = 0.363, p < 0.001). With the increase of BMI, PFF, VAT, and SAT showed a clear upward trend, but liver fat was distributed relatively more randomly. The pancreatic fat content in the abnormal glucose metabolism group is significantly higher than that in the normal group, and pancreatic fat is also a reliable indicator of abnormal glucose metabolism, especially in the normal and overweight groups (the area under the curve was 0.859 and 0.864, respectively). Conclusion: MR-based fat quantification techniques can provide additional information on fat distribution. There are differences in fat distribution among people with different metabolic status. People with more severe pancreatic fat deposition have a higher risk of glucose metabolism disorders.

Kiosk 9R-TA-08 - Sex Differences in Fat Distribution Are Associated with Cardiovascular Ageing

Kiosk 9R-TA-08 - Sex Differences in Fat Distribution Are Associated with Cardiovascular Ageing

Impact of Sex-Specific Preoperative Fat Mass Assessment on Long-Term Prognosis after Gastrectomy for Gastric Cancer

We investigated the impact of the difference in fat distribution between men and women on long-term prognosis after gastrectomy in patients with advanced gastric cancer. Patients with advanced gastric cancer deeper than p-T2 who underwent gastrectomy between April 2008 and June 2018 were included. Visceral fat mass index (VFI) and subcutaneous fat mass index (SFI) were calculated by dividing the cross-sectional area at the umbilical level by the height squared. The medians of VFI and SFI by sex were defined as cut-off values, below which values were defined as low VFI and low SFI. Of the 485 patients, 323 (66.6%) were men and 162 (33.4%) were women. Men with a low VFI had a significantly worse overall survival (OS) (p = 0.004) and women with a low SFI had a significantly worse OS (p = 0.007). Patients with a low VFI and low SFI had the worst prognosis. Multivariate analysis showed that a low VFI was an independent poor prognostic factor in men, while a low SFI was an independent poor prognostic factor in women. In conclusion, a low visceral fat mass in men and a low subcutaneous fat mass in women were independent poor prognostic factors after radical gastrectomy for advanced gastric cancer.

The relationship between fat distribution in central region and comorbidities in obese people: Based on NHANES 2011-2018.

Central obesity is closely related to comorbidity, while the relationship between fat accumulation pattern and abnormal distribution in different parts of the central region of obese people and comorbidity is not clear. This study aimed to explore the relationship between fat distribution in central region and comorbidity among obese participants. We used observational data of NHANES 2011-2018 to identify 12 obesity-related comorbidities in 7 categories based on questionnaire responses from participants. Fat distribution is expressed by fat ratio, including Android, Gynoid, visceral, subcutaneous, visceral/subcutaneous (V/S), and total abdominal fat ratio. Logistic regression analysis were utilized to elucidate the association between fat distribution and comorbidity. The comorbidity rate was about 54.1% among 4899 obese participants (weighted 60,180,984, 41.35 ± 11.16 years, 57.5% female). There were differences in fat distribution across the sexes and ages. Among men, Android fat ratio (OR, 4.21, 95% CI, 1.54-11.50, Ptrend=0.007), visceral fat ratio (OR, 2.16, 95% CI, 1.42-3.29, Ptrend<0.001) and V/S (OR, 2.07, 95% CI, 1.43-2.99, Ptrend<0.001) were independent risk factors for comorbidity. Among these, there was a "J" shape correlation between Android fat ratio and comorbidity risk, while visceral fat ratio and V/S exhibited linear relationships with comorbidity risk. The Gynoid fat ratio (OR, 0.87, 95%CI, 0.80-0.95, Ptrend=0.001) and subcutaneous fat ratio (OR, 0.81, 95%CI, 0.67-0.98, Ptrend=0.016) both performed a protective role in the risk of comorbidity. In women, Android fat ratio (OR, 4.65, 95% CI, 2.11-10.24, Ptrend=0.020), visceral fat ratio (OR, 1.83, 95% CI, 1.31-2.56, Ptrend=0.001), and V/S (OR, 1.80, 95% CI, 1.32-2.45, Ptrend=0.020) were also independent risk factors for comorbidity, with a dose-response relationship similar to that of men. Only the Gynoid fat ratio (OR, 0.93, 95% CI, 0.87-0.99, Ptrend=0.016) had a protective effect on female comorbidity. This association was also seen in obese participants of different age groups, comorbidity numbers, and comorbidity types, although it was more statistically significant in older, complex comorbidity, cardiovascular, cerebrovascular, and metabolic diseases. In the obese population, there were strong correlation between fat distribution in central region and comorbidity, which was affected by sex, age, number of comorbidities, and type of comorbidity.

The role of fat distribution and inflammation in the origin of endometrial cancer, study protocol of the ENDOCRINE study.

Obesity is a growing problem worldwide, especially in countries with improved socioeconomic circumstances. Also, in the Netherlands the incidence of overweight and obesity is rising. There is increasing evidence on the association between obesity and tumorigenesis. Of all cancer types, endometrial cancer (EC) has the strongest positive correlation with obesity. Obesity is generally defined as a body mass index (BMI) >30, yet does not cover the differences in fat distribution in visceral and subcutaneous compartments. Visceral fat is assumed to be relatively more metabolically active and likely negative prognostic biomarker in non-endometrioid EC. Whereas subcutaneous fat is mainly responsible for oestrogen production through increased aromatase activity. The aim of this study is to compare hormone levels and inflammatory markers after bilateral salpingo-oophorectomy (BSO) in obese and non-obese patients. Secondary objectives are to compare the effect of fat distribution and diagnosis (benign vs. EC) on the observed changes in hormone levels and inflammatory markers, and to compare the effect of BSO on menopausal complaints. Prospective multicentre observational cohort study. A total of 160 patients will be included, of which 80 patients with a normal BMI (18-25 kg/m2) and 80 patients with an obese BMI >32-35 kg/m2. Preoperative abdominal CT will be performed and fasting venous blood samples are obtained for hormone levels and inflammation markers analysis. During surgery, adipose tissue biopsies of subcutaneous and visceral (omental and intestinal epiploic fat) compartments will be collected and stored fresh frozen. In addition a fasting blood draw six weeks after surgery will be obtained. All subjects will fill in two questionnaires before surgery and one after surgery. We hypothesize that BMI, the type of fat distribution, and possibly the underlying pathology significantly influence in hormone levels, and systemic inflammation changes after BSO. Previous studies have found several clues for a relationship between obesity and endometrial cancer. We expect that our study will contribute to pinpoint the exact differences between 'healthy obesity' and 'unhealthy obesity' and will help to identify patients that are more at risk of developing cancer (or possibly suffer from other related problems such as cardiovascular problems e.g.).

Sex hormones, intestinal inflammation, and the gut microbiome: Major influencers of the sexual dimorphisms in obesity.

Obesity is defined as the excessive accumulation of body fat and is associated with an increased risk of developing major health problems such as cardiovascular disease, diabetes and stroke. There are clear sexual dimorphisms in the epidemiology, pathophysiology and sequelae of obesity and its accompanying metabolic disorders, with females often better protected compared to males. This protection has predominantly been attributed to the female sex hormone estrogen and differences in fat distribution. More recently, the sexual dimorphisms of obesity have also been attributed to the differences in the composition and function of the gut microbiota, and the intestinal immune system. This review will comprehensively summarize the pre-clinical and clinical evidence for these sexual dimorphisms and discuss the interplay between sex hormones, intestinal inflammation and the gut microbiome in obesity. Major gaps and limitations of this rapidly growing area of research will also be highlighted in this review.

A Wars2 mutant mouse shows a sex and diet specific change in fat distribution, reduced food intake and depot-specific upregulation of WAT browning.

Background: Increased waist-to-hip ratio (WHR) is associated with increased mortality and risk of type 2 diabetes and cardiovascular disease. The TBX15-WARS2 locus has consistently been associated with increased WHR. Previous study of the hypomorphic Wars2 V117L/V117L mouse model found phenotypes including severely reduced fat mass, and white adipose tissue (WAT) browning, suggesting Wars2 could be a potential modulator of fat distribution and WAT browning. Methods: To test for differences in browning induction across different adipose depots of Wars2 V117L/V117L mice, we measured multiple browning markers of a 4-month old chow-fed cohort in subcutaneous and visceral WAT and brown adipose tissue (BAT). To explain previously observed fat mass loss, we also tested for the upregulation of plasma mitokines FGF21 and GDF15 and for differences in food intake in the same cohort. Finally, to test for diet-associated differences in fat distribution, we placed Wars2 V117L/V117L mice on low-fat or high-fat diet (LFD, HFD) and assessed their body composition by Echo-MRI and compared terminal adipose depot weights at 6 months of age. Results: The chow-fed Wars2 V117L/V117L mice showed more changes in WAT browning marker gene expression in the subcutaneous inguinal WAT depot (iWAT) than in the visceral gonadal WAT depot (gWAT). These mice also demonstrated reduced food intake and elevated plasma FGF21 and GDF15, and mRNA from heart and BAT. When exposed to HFD, the Wars2 V117L/V117L mice showed resistance to diet-induced obesity and a male and HFD-specific reduction of gWAT: iWAT ratio. Conclusion: Severe reduction of Wars2 gene function causes a systemic phenotype which leads to upregulation of FGF21 and GDF15, resulting in reduced food intake and depot-specific changes in browning and fat mass.

Tumour grade and stage are associated with specific body composition phenotypes with visceral obesity predisposing the host to a less aggressive tumour in colorectal cancer

BackgroundSarcopenia, myosteatosis and visceral obesity (VO) are known to negatively impact on outcomes from colorectal cancer (CRC). Little is known about tumour factors associated with these body composition (BC) phenotypes. We aimed to identify whether histopathological tumour characteristics were associated with various BC phenotypes. MethodsA prospectively collected database of patients undergoing surgery for primary CRC at a tertiary referral unit in the United Kingdom was analysed. Sarcopenia, myosteatosis and VO were identified on preoperative CT. Binary logistic regression modelling was performed to determine significant associations between tumour stage, grade and BC phenotype. ResultsFinal analysis included 795 patients; median age 69, 56% male, 65% were sarcopenic, 72% myosteatotic, 52% VO and 20% had sarcopenic obesity (SO). VO patients were significantly less likely to have advanced T Stage (T3-4) OR0.62(95%CI 0.44–0.86, p = 0.005); nodal metastases OR0.60(95%CI 0.44–0.82, p = 0.001); vascular invasion OR0.63(95%CI 0.46–0.88, p = 0.006) and poor tumour differentiation OR0.49(95%CI 0.28–0.86, p = 0.012). Myosteatotic patients were more likely to have metastatic disease OR2.31(95%CI 1.15–4.63, p = 0.018) but less likely to have poorly differentiated tumours OR0.48(95%CI 0.27–0.86, p = 0.013). SO patients were significantly more likely to have poorly differentiated tumours OR2.01(95%CI 1.04–3.87, p = 0.037). ConclusionVO predisposes to earlier stage tumours with a less aggressive tumour phenotype. The SO group have adverse tumour characteristics which may be explained by differences in fat distribution. Myosteatosis relates to increased likelihood of distant metastasis that may be related to a systemic inflammatory response, despite the association with better differentiated tumours.

Sex differences in cardiometabolic abnormalities in a middle-aged Maltese population.

There are sex differences in distribution of fat and in the prevalence of overweight and obesity. We therefore sought to explore sex differences in the prevalence of adiposity-metabolic health phenotypes, in anthropometric and cardio-metabolic parameters, and in the relationship between body mass index (BMI) categories and metabolic health. We conducted a cross-sectional study carried out between January 2018 and June 2019, of a nationally representative sample of the Maltese Caucasian population aged 41 ± 5years. Metabolic health was defined as presence of ≤ 1 parameter of the metabolic syndrome as defined by the National Cholesterol Education Program-Adult Treatment Panel III criteria. Males exhibited the unhealthy metabolic phenotype more frequently than women (41.3% vs 27.8%). In total, 10.3% of normal weight men and 6.3% of normal weight women were metabolically unhealthy. Males had a higher median BMI, but a lower proportion of males exhibited an abnormally high waist circumference as compared with females. A significant difference in sex distribution was noted for each body composition phenotype. In a contemporary sample of middle-aged individuals, males were more metabolically unhealthy and more insulin resistant than their female counterparts in spite of exhibiting an abnormal waist circumference less frequently and having similar waist index. This suggests that the currently used cut-offs for normal waist circumference should be revised downwards in men. Since even normal weight men were more often metabolically unhealthy than normal weight women, BMI cut-offs may also need to be lowered in men.

PD45-11 DOES THE SKIN TO VESSEL DISTANCE FOR RENAL TRANSPLANT RECIPIENTS PREDICT SURGICAL OUTCOMES?

You have accessJournal of UrologyRenal Transplantation & Vascular Surgery II (PD45)1 Sep 2021PD45-11 DOES THE SKIN TO VESSEL DISTANCE FOR RENAL TRANSPLANT RECIPIENTS PREDICT SURGICAL OUTCOMES? Braden Millan, Yuding Wang, Rosemary Nam, Kevin Piercey, Anil Kapoor, and Shahid Lambe Braden MillanBraden Millan More articles by this author , Yuding WangYuding Wang More articles by this author , Rosemary NamRosemary Nam More articles by this author , Kevin PierceyKevin Piercey More articles by this author , Anil KapoorAnil Kapoor More articles by this author , and Shahid LambeShahid Lambe More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002059.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Body mass index (BMI) does not denote differences in fat distribution or muscle mass. It is unknown whether differences exist between body fat distribution and surgical outcomes in renal transplant recipients. The objective of this study was to identify whether the distance from external iliac vessels to skin correlates with findings in both surgical and long-term outcomes. METHODS: A retrospective chart review was completed of patients who underwent a renal transplant from 2016 to the end of 2019 at a single center. The Clavien-Dindo classification system was used to define post-operative complications. Descriptive statistics were analyzed, logistic regression determined predictors of differences between skin to vessel distance and other variables. RESULTS: Complete data were available for 96 patients undergoing renal transplant in 2016 to the end of 2019. 48% of patients (n=46) had 1 post-operative complication in the year following renal transplantation. Patients with complications had a significantly higher mean vessel to skin distance (138.8±4.5 mm vs. 123.8±4.1 mm; p=0.017) without a significant difference in BMI (28.3±0.8 kg/m2vs. 27.4±0.8 kg/m2; P=0.49). Median overall survival was longer in those without a post-operative complication (38 vs. 21.5 months; p=0.0295). There were no significant differences in warm ischemic time, sex, age, or other comorbidities. In the cohort with the greater skin to vessel distance, there were higher rates of delayed graft function (15 vs. 8 patients; p=0.0349) and longer lengths of stay (11.6±1.5 vs. 7.1±0.3; p=0.0021). Logistic regression for the skin to vessel distance and BMI revealed an area under the ROC curve of 0.641 (p=0.0175) and 0.541 (p=0.4860), respectively. CONCLUSIONS: These data suggest that a longer skin to external iliac vessel distance, as determined by cross sectional imaging, is more predictive (p=0.0175) of post-operative complications than BMI. Additionally, longer distances from skin to the external iliac vessels were associated with higher rates of delayed graft function, longer length of hospital stay and shorter median overall survival. Source of Funding: No source of funding was obtained for this project © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e746-e746 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Braden Millan More articles by this author Yuding Wang More articles by this author Rosemary Nam More articles by this author Kevin Piercey More articles by this author Anil Kapoor More articles by this author Shahid Lambe More articles by this author Expand All Advertisement Loading ...

Impact of Menopause and Body Composition Status on Dyslipidemia in Women.

Objective: The aim of this study was to identify the effects of menopausal and body composition statuses on measures of total and regional body composition and dyslipidemia in women. Methods: Sedentary, non-smoking women (N = 212), not currently treated for dyslipidemia were grouped based on 2 categories: (1) menstrual status: premenopausal or postmenopausal and (2) body composition status: normal weight (NW; BMI < 25 kg/m² and body fat (BF) < 36%), normal weight obese (NWO; BMI < 25 kg/m² and BF > 36%), or obese (BMI > 25 kg/m² and BF > 36%), to determine differences in total and regional body composition and measures of lipid and lipoprotein-cholesterol concentrations. Results: Overall, a greater prevalence of NWO was observed in postmenopausal versus premenopausal women. Being postmenopausal was associated with higher TC, LDL-C, non-HDL-C, HDL-C, and HDL₃-C. Premenopausal NWO women had elevated LDL-C and VLDL-C comparable to obese women. Postmenopausal NWO women had elevated Tg and VLDL-C and lower HDL-C similar to obese women. Conclusions: Menopausal status was not associated with differences in fat distribution, however, the age-related differences in lipids and lipoproteins appear to be due to a difference in menopausal status exacerbated in women who are NWO.

A Stronger Effect of Body Mass Index and Waist Circumference on the Prevalence of Uncontrolled Hypertension among Caucasian Men than Women

Background: Gender-related differences in fat distribution may affect blood pressure (BP) control in hypertensive subjects. The aim of the study was to assess how body mass (BM), BMI, and waist circumference (WC) influence the effectiveness of antihypertension therapy in hypertensive men and women in daily clinical practice. Patients and Methods: The observational study involved 12,289 adult hypertensive Caucasians (6,163 women) declaring regular use of antihypertensive drugs. BP control was scored based on the mean values of 2 attended office BP measurements. WC thresholds for visceral obesity were adopted from definitions of the International Diabetes Federation (≥94/80 cm for men/women) and National Cholesterol Education Program Adult Treatment Panel III (≥102/88 cm for men/women). Stepwise backward multivariable logistic regression was used to analyse correlates of the effectiveness of hypertension therapy. Results: The predictive value of BMI ≥30 (for uncontrolled hypertension) was stronger than that of visceral obesity, regardless of the criteria used. In men, BP control rapidly deteriorated with BMI (odds ratio [OR] up to 8.58 [95% CI: 5.74–12.83]) and WC (OR up to 5.09 [3.84–6.74]), while in women, the association was more flattened (OR up to 3.63 [2.78–4.74] and 1.93 [1.59–2.35], respectively). However, the highest risk of uncontrolled BP occurred in women with BM ≥110 kg (OR = 10.47 [5.05–21.71]) and men with BM ≥125 kg (OR = 9.66 [5.86–15.94]). Conclusions: (1) Obesity and visceral obesity limit the effectiveness of antihypertension therapy more in men than in women. (2) This phenomenon should be taken into account in the prescription of adequate doses of antihypertensive drugs.

Abstract 14724: Sex Differences in the Associations of Visceral Adipose Tissue and Cardiometabolic and Cardiovascular Disease Risk: The Framingham Heart Study

Background: The current clinical practice of defining obesity based on body mass index (BMI) does not capture differences in fat distribution between men and women. Visceral adipose tissue (VAT) as measured by computed tomography (CT), is an advanced measure of obesity that closely correlates with cardiometabolic risk independent of BMI. However, it remains unknown whether VAT adds additional prognostic significance over BMI in men or women. Methods: In participants of the Framingham Heart Study, we tested the associations of BMI and VAT with incident cardiometabolic events (diabetes, hypertension, low HDL, hypertriglyceridemia), and incident cardiovascular events and death. Mean follow-up was 12.7±2.1 years. Logistic and Cox-regression models were adjusted for age and smoking and adjusted odds and hazard ratios (adj. OR, adj. HR), are presented per 1-SD increase of each measure of body fat. Results: The study cohort comprised 3,482 participants (48.1% women, 50.8±10.3 years old). In men, VAT, as compared to BMI, had a similar strength of association with all cardiometabolic outcomes and incident cardiovascular disease (Figure). In women, however, VAT conferred a markedly greater association with incident cardiometabolic and cardiovascular disease compared to BMI (Figure). Conclusion and Relevance: BMI adequately captures VAT-associated cardiometabolic and cardiovascular risk in men but not in women. In women, abdominal CT-based VAT measures permit more precise assessment of obesity-associated cardiometabolic and cardiovascular risk.