Subcutaneous Fat Distribution Research Articles

Correlation Between the Distribution of Abdominal, Pericardial and Subcutaneous Fat and Muscle and Age and Gender in a Middle-Aged and Elderly Population.

ObjectiveThe present study aimed to explore the relationships between the distribution of abdominal fat and muscle and age and gender in a middle-aged and elderly population.MethodsThe levels of abdominal (visceral and subcutaneous) fat, pericardial fat, and psoas major muscle were measured in subjects who had physical examinations at the Health and Medical Department of Peking Union Medical College Hospital from July 2019 to June 2020. The relationship between fat in different areas (ie, different types of fat) and the relationship between different types of fat and the psoas major muscle were investigated in the context of different genders and ages.ResultsThe distribution of fat and muscle differed between males and females of the middle-aged and elderly study sample. Volumes of pericardial fat, total abdominal fat, and visceral fat were significantly lower in females than in males, and the area of the psoas major muscle was also significantly lower in females than in males. Levels of subcutaneous fat and total abdominal fat showed no significant correlation with age. The level of muscle showed a significant negative correlation with age.Conclusion1) Within the middle-aged and elderly sample, male subjects had higher levels than females of all types of fat except for abdominal subcutaneous fat, and had higher levels of psoas muscle than females. 2) Pericardial fat increased with age, whereas levels of abdominal fat did not change significantly with age. 3) The area of psoas major muscle appears to be positively correlated with volumes of all types of fat: subjects with more fat tended to have higher levels of psoas major muscle.

Assessment of the body composition of football players based on anthropometry and bioimpedansometry data and a comparison of two registration methods

Objective: comparative analysis of body composition indicators obtained by two methods of data registration — anthropometry and bioimpedance measurement, and analysis of the distribution of subcutaneous fat on the body of football players in accordance with the playing role.Materials and methods: аnthropometric measurements and bioimpedance studies of body composition were carried out in 24 football players of the Moscow football club of the second division professional football league. The average age of the athletes was 24.16 ± 0.87 years.Results: the survey involved 24 football players of the Moscow football club of the professional football league of the second division. The average age of the players was 24.16 ± 0.87 years. When determining the composition of the body using two methods, it was found that the calculation method and the bioimpedance method give different results. On average, the calculation method shows higher indicators of body fat mass (%FBM = 18.9 ± 1.04) than the bioimpedance method (%FBM = 14.7 ± 0.76), the differences are significant (p < 0.05). Moreover, differences in muscle mass are insignificant — in terms of BIA %SMM = 47.06 ± 0.59, according to the calculation method %SMM = 47.0 ± 0.63 (the differences are unreliable, p > 0.05). There were no differences in the component composition of the body of football players depending on the game role. The topography of subcutaneous fat on the body of athletes-football players has certain patterns, but does not depend on the playing role of athletes.Conclusion: the analysis revealed differences in the body composition data of football players obtained using two registration methods. The data of the study can serve as model criteria for body composition and the distribution of subcutaneous fat on the body of athletes for selection in football activities and for comparative characterization and discussion of the results of similar studies.

Partial Lipodystrophy and LMNA p.R545H Variant.

Laminopathies are disorders caused by LMNA gene mutations, which selectively affect different tissues and organ systems, and present with heterogeneous clinical and pathological traits. The molecular mechanisms behind these clinical differences and tissue specificity have not been fully clarified. We herein examine the case of a patient carrying a heterozygous LMNA c.1634G>A (p.R545H) variant with a mild, transient myopathy, who was referred to our center for the suspicion of lipodystrophy. At physical examination, an abnormal distribution of subcutaneous fat was noticed, with fat accumulation in the anterior regions of the neck, resembling the fat distribution pattern of familial partial lipodystrophy type 2 (FPLD2). The R545H missense variant has been found at very low allelic frequency in public databases, and in silico analysis showed that this amino acid substitution is predicted to have a damaging role. Other patients carrying the heterozygous LMNA p.R545H allele have shown a marked clinical heterogeneity in terms of phenotypic body fat distribution and severity of organ system involvement. These findings indicate that the LMNA p.R545H heterozygous variant exhibits incomplete penetrance and highly variable expressivity. We hypothesized that additional genetic factors, epigenetic mechanisms, or environmental triggers might explain the variable expressivity of phenotypes among various patients.

Role of Baseline Computed-Tomography-Evaluated Body Composition in Predicting Outcome and Toxicity from First-Line Therapy in Advanced Gastric Cancer Patients.

Sarcopenia is recognised as a predictor of toxicity and survival in localised and locally advanced gastric cancer (GC). Its prognostication power in advanced unresectable or metastatic GC (aGC) is debated. The survival impact of visceral and subcutaneous fat distribution (visceral fat area (VFA)/subcutaneous fat area (SFA)) is ambiguous. Our aim was to determine the influence of body composition parameters (BCp) on toxicity and survival in aGC patients undergoing palliative treatment. BCp were retrospectively assessed by baseline computed tomography for 78 aGC patients who received first-line chemotherapy from March 2010 to January 2017. Correlations between BCp and toxicity and survival were calculated by χ2-test and by log-rank-test and Cox-model, respectively. Sarcopenia fails to show association with progression-free survival (PFS) (p = 0.44) and overall survival (OS) (p = 0.88). However, sarcopenia influences the development of high-grade neutropenia (p = 0.048) and mucositis (p = 0.054). VFA/SFA (high vs. all the rest) results as a strong predictor of objective response (p = 0.02) and outcome (PFS, p = 0.001; OS, p = 0.02). At multivariate analysis for PFS, prognostic factors are VFA/SFA (p = 0.03) and a neutrophil–lymphocyte ratio >3. The same factors remain significant for OS (each p = 0.03) along with Eastern Cooperative Oncology Group (ECOG) performance status (p = 0.008) and number of metastatic sites ≥2 (p < 0.001). In our cohort of aGC, VFA/SFA exhibit a robust impact on survival, with a higher sensitivity than sarcopenia.

Combination of Microneedling and 10% Trichloro-Acetic Acid Peeling Versus Platelet Rich Plasma in the Treatment of Infraorbital Dark Circles

Dark circles are a common benign facial cosmetic problem with multiple factorial etiologies. Though, there are a number of treatment options available for periorbital hyperpigmentation. It can be a significant cosmetic problem, and many individuals try to find a treatment for this condition. This condition affects individuals in a wide range of ages, both sexes and all races. Moreover, it worsens with the aging and the process of skin sagging and altered subcutaneous fat distribution. Assess those viability and safety about consolidation for microneedling What's more 10% trichloroacetic corrosive peeling Furthermore thinking about it with platelet rich plasma intradermal infusion in the medicine from claiming infraorbital dim circles. 60 members finished those study; assembly (a), included 30 patients were aPProached with microneedle help Furthermore topical anesthesia requisition from claiming trichloracetic corrosive 10% answer for each infraorbital range for 5 minutes. Compound peeling might have been performed each 2 weeks for four treatments; assembly (b), included 30 patients were treated for intradermal platelet rich plasma. Microneedle and PRP gatherings were connected with change for dull circles. Superior reaction What's more patients' fulfillment were fundamentally connected with microneedle At contrasted with PRP. Patients fulfillment might have been essentially connected with change. We inferred that those two routines for medicine were just as powerful in the medication of DC, with those change from claiming dc watched from the principal medication session for both Microneedling with compound peeling Eventually Tom's perusing 10% TCA Furthermore PRP infusion medication.

Incision site fat thickness and 90-day complications for direct anterior and posterior approach total hip arthroplasty.

Defining the distribution of subcutaneous fat around the hip in relation to different approaches for total hip arthroplasty (THA) may lead to a better understanding of the relationship between obesity and complications. The purpose of this study was to: (1) describe the intraoperative thickness of subcutaneous fat at the incision site for direct anterior (DAA) and posterior approaches (PA) for THA; and (2) examine the relationship between fat thickness and 90-day postoperative complications. Intraoperative fat measurements were obtained at the anterior incision site (AT-IS) of the DAA (n = 60) and the lateral incision site (LT-IS) of the PA (n = 64). Lateral hip fat thickness was measured from preoperative anteroposterior pelvis radiographs (LT-XR). Body mass index (BMI), sex, age, and 90-day complications were collected retrospectively. Patients within the same demographic groupings had significantly more fat laterally than anteriorly, between 9.6 mm and 17.96 mm. Return to the OR was significantly associated with BMI, AT-IS, and LT-IS. Wound complications were significantly associated with AT-IS. Periprosthetic joint infection (PJI) was significantly associated with BMI and LT-IS. No outcome variables were associated with LT-XR, approach, sex, or age. LT-XR was strongly correlated with AT-IS and LT-IS. Regardless of BMI, sex, or age more soft tissue was encountered with a PA compared to a DAA. General adiposity was associated with return to the OR. Excess incisional fat was associated with wound complications following a DAA and PJI after a PA. LT-XR and clinical examination near the proposed incision, may provide helpful data in making preoperative risk assessments.

Abstract 13081: Predictive Value of Visceral-to-subcutaneous Fat Ratio for Long-term Clinical Outcomes in Patients With Suspected Coronary Artery Disease

Introduction: Although visceral fat accumulation is an important risk factor for coronary artery diseases (CAD), the relationship between visceral fat accumulation and its long-term outcomes has not been extensively investigated. Hypothesis: In patients with suspected CAD, the distribution of subcutaneous fat and visceral fat is associated with cardiovascular events. Methods: Computed tomography (CT) angiographies (CTA) were performed on 945 consecutive patients with suspected CAD. Plain abdominal CT scanning was performed to measure the patients’ visceral fat area (VFA) and subcutaneous fat area (SFA). The VFA/SFA (V/S) ratios were calculated to assess the visceral fat accumulation. Based on the results of the CTA, the prevalence of CAD was assessed. The patients were classified into low (&lt;0.627), and high (≥0.627) V/S ratio groups, based on their median value, and the association between V/S ratio and long-term outcomes was evaluated. The primary endpoints were major cardiac adverse events (MACE), including all-cause death, new-onset acute coronary syndrome (ACS), emergent hospitalization due to cardiovascular disease, and any coronary revascularization. Results: The average follow-up period was 845.3 days. The baseline characteristics for patients in the high V/S ratio group were worse than those for patients in the low high V/S ratio group. As compared to the low V/S ratio group, a higher incidence of MACE and ACS, and a higher tendency of mortality was observed in the high V/S ratio group. After adjusting for traditional coronary risk factors, the V/S ratio was independently associated with incidence of MACE, ACS, and increase of mortality (table). Conclusions: The present study suggests that the V/S ratio is an independent predictor of long-term outcomes in patients with suspected CAD. The visceral fat accumulation indicated by high V/S ratio signifies a potential risk and may contribute to the future cardiovascular events in patients with suspected CAD.

The features of psychological state, eating behavior, hormonal and adipokine regulation of metabolism in men with subcutaneous and abdominal fat distribution

BACKGROUND: development of obesity and obesity related conditions are directly associated with eating disorders and psychological state. There is increasing focus on the assessment the characteristics of these indicators in men with subcutaneous and central fat distribution, which are associated with various hormonal and adipokine mechanisms that effect on parameters of metabolism and eating behavior.&#x0D; AIMS: to study the characteristics of the psychologycal state, eating behavior and their relationship with hormonal and adipokine status in men with different fat distribution.&#x0D; MATERIALS AND METHODS: a single-center, cross-sectional study of 99 men aged 27 to 68 years was performed. 4 groups of men were formed after anthropometric examination. Group 1 (comparison) consisted of men with normal body weight. Group 2 consisted of overweight men, class I obesity and lower subcutaneous fat distribution (SFD). Group 3 consisted of overweight men, men with class I obesity and abdominal fat distribution (AFD); group 4 - men with class II obesity and class III obesity AFD. Eating behavior were determined with DEBQ questionnaire, severity of anxiety-depressive disorders were investigated with the Hospital Anxiety and Depression Scale; body image satisfaction was assessed with body image questionnaire. Serum glucose, triglycerides, insulin, leptin and adiponectin were estimated.&#x0D; RESULTS: it was shown, that men with AFD had severe metabolic disorders: hyperglycemia, hypertriglyceridemia, hyperinsulinemia and insulin resistance, hyperleptinemia and hypoadiponectinemia, than men with SFD. Men with AFD had an external type of eating behavior, with sever expressed depressive disorders and body image dissatisfaction. Men with SFD had an emotional type of eating behavior and higher body image satisfaction. A comparative analysis between men from 3 and 4 groups with AFD showed that in group 4 in men had higher hyperleptinemia and insulin resistance and there are no differences in severity of eating disorders, anxiety and depression between the groups.&#x0D; CONCLUSIONS: adipose tissue topography is associated with the psychophysiological, metabolic, hormonal and adipokine characteristics that underlie the development of primary obesity in men.

CYP17A1 deficient XY mice display susceptibility to atherosclerosis, altered lipidomic profile and atypical sex development

CYP17A1 is a cytochrome P450 enzyme with 17-alpha-hydroxylase and C17,20-lyase activities. CYP17A1 genetic variants are associated with coronary artery disease, myocardial infarction and visceral and subcutaneous fat distribution; however, the underlying pathological mechanisms remain unknown. We aimed to investigate the function of CYP17A1 and its impact on atherosclerosis in mice. At 4–6 months, CYP17A1-deficient mice were viable, with a KO:Het:WT ratio approximating the expected Mendelian ratio of 1:2:1. All Cyp17a1 knockout (KO) mice were phenotypically female; however, 58% were Y chromosome-positive, resembling the phenotype of human CYP17A1 deficiency, leading to 46,XY differences/disorders of sex development (DSD). Both male and female homozygous KO mice were infertile, due to abnormal genital organs. Plasma steroid analyses revealed a complete lack of testosterone in XY-KO mice and marked accumulation of progesterone in XX-KO mice. Elevated corticosterone levels were observed in both XY and XX KO mice. In addition, Cyp17a1 heterozygous mice were also backcrossed onto an Apoe KO atherogenic background and fed a western-type diet (WTD) to study the effects of CYP17A1 on atherosclerosis. Cyp17a1 x Apoe double KO XY mice developed more atherosclerotic lesions than Apoe KO male controls, regardless of diet (standard or WTD). Increased atherosclerosis in CYP17A1 XY KO mice lacking testosterone was associated with altered lipid profiles. In mice, CYP17A1 deficiency interferes with sex differentiation. Our data also demonstrate its key role in lipidomic profile, and as a risk factor in the pathogenesis of atherosclerosis.

Relationship between Maternal Central Obesity and the Risk of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of Cohort Studies.

Objective Nowadays, body mass index (BMI) is used to evaluate the risk stratification of obesity-related pregnancy complications in clinics. However, BMI cannot reflect fat distribution or the proportion of adipose to nonadipose tissue. The objective of this study is to evaluate the association of maternal first or second trimester central obesity with the risk of GDM. Research Design and Methods. We searched in PubMed, Embase, and Web of Science for English-language medical literature published up to 12 May 2019. Cohort studies were only included in the search. Abdominal subcutaneous fat thickness, waist circumference, waist-hip ratio or body fat distribution were elected as measures of maternal central obesity, and all diagnostic criteria for GDM were accepted. The random effect meta-analysis was performed to evaluate the relationship between central obesity and the risk of GDM. Results A total of 11 cohort studies with an overall sample size of 27,675 women and 2,226 patients with GDM were included in the analysis. The summary estimate of GDM risk in the central obesity pregnant women was 2.76 (95% confidence interval [CI]: 2.35–3.26) using the adjusted odds ratio (OR). The degree of heterogeneity among the studies was low (I2 = 14.4, P = 0.307). The subgroup analyses showed that heterogeneity was affected by selected study characteristics (methods of exposure and trimesters). After adjusting for potential confounds, the OR of adjusted BMI was significant (OR = 3.07, 95% CI: 2.35–4.00). Conclusions Our findings indicate that the risk of GDM was positively associated with maternal central obesity.

Physical Fitness and Health-Related Physical Activity Programs in People With Down Syndrome: A Systematic Review

Objective: Down Syndrome (DS) is the most common genetic disease in people with intellectual disability, with a prevalence of 1 in 800-1000 live births. Youth and adolescents with DS are a unique population in terms of health-related physical fitness factors. Methods: In this review study, to investigate the physical fitness factors and physical activity programs for youth and adolescents with DS, a search was conducted in international and national databases such as EBSCO, Medline, PubMed, Elsevier, Google Scholar and SID among studies conducted during 1996-2016 using following keywords in Persian and English: Physical fitness, physical activity, Down syndrome, rehabilitation, intellectual disability, muscular strength, muscular endurance, aerobic fitness, balance, agility and flexibility. Results: Initial search yielded 130 articles. After removing duplicates, 35 were remained for the review. The studies indicated lower cardiorespiratory capacity and physical fitness in people with DS than in their normal peers in strength, endurance, balance and agility as well as increased subcutaneous fat and body fat distribution. Conclusion: Adolescents and youth with DS have low cardiovascular and muscular capacity and physical fitness, overweight/obesity, and reduces health-related physical activities. Future studies should focus on strength testing and training protocols, methods for determining physical activity levels, and practical interventions to increase physical activities in DS patients.

Identifying risk factors for suboptimal pelvic binder placement in major trauma

AimsThis study aimed to identify the frequency of sub-optimal pelvic binder placement at a tertiary-level trauma centre, produce a reproducible, quantitative measure of pelvic binder fit, and identify risk factors for sub-optimal placement. Patients and MethodsWe identified all consecutive patients who had a pelvic binder in place on arrival to the Royal Brisbane and Women's Hospital in Queensland, Australia from 2012–2016. The X-Rays were reviewed by two senior clinicians for position and measured for degree of displacement if not optimally placed between the greater and lesser trochanters. Risk factors for sub-optimal position of the binder were assessed using multiple logistic regression with inclusion of all variables that had a statistical association (to p<0.05) at the univariate analysis stage. Secondary assessment was conducted of patients who had undergone CT imaging for subcutaneous body fat distribution. ResultsIn total, 496 X-Rays were assessed for pelvic binder fit, finding 43.5% sub-optimally placed. 39.7% binders were superior to the greater trochanter line and 3.8% inferiorly placed below the lesser trochanter line. The majority of the sub-optimally placed binders were within 60 mm of the ideal position. Female patients had a greater risk of sub-optimal binder placement compared to males (62.5% vs 37%). Increasing intertrochanteric height was found to be protective for ideal binder placement with an aOR 0.62 for each cm in increased height. There was no association with sub-optimal placement and age, sex, mechanism of trauma, injury severity score, number of body regions injured or Glasgow Coma Scale. There was strong kappa agreement between the X-Ray assessors for binder position assessment on the plain radiological imaging. ConclusionSub-optimal positioning of pelvic binders is common in our trauma population. This study has described the risk factors associated with higher rates of sub-optimal fit and provides a description of rapid radiological assessment for optimal fit for the bedside clinician caring for injured patients in the resuscitation room.

Selected Articles from This Issue

With rising costs of cancer care, concerns about financial hardship are increasingly reported in the United States by providers and patients. Using recent data from a nationally representative survey, Han and colleagues found that medical financial hardship and nonmedical financial sacrifices due to cancer were common, with greater intensity for those ages 18 to 64 years than 65+ years. Moreover, lower socioeconomic status, comorbidity, lack of private insurance coverage, extended employment change, and recent cancer treatment were also associated with higher hardship intensity and/or sacrifices. The findings highlight the need to mitigate financial hardship for cancer survivors, especially for those at high risk.Personalized colorectal cancer (CRC) screening could optimize screening effectiveness and resource allocation. There are multiple CRC risk prediction tools with modest discriminatory ability. Ladabaum and colleagues explored the potential clinical and economic impact of CRC screening tailored to predicted CRC risk. This decision analysis suggests that tailored screening is preferable over a uniform approach if it is guided by a highly accurate and affordable risk prediction tool. However, a uniform approach may be preferred if risk stratification involves even modest levels of risk misclassification or modest incremental costs. Higher intensity screening in those with predicted higher risk could improve outcomes despite misclassification, but lower intensity screening in those with predicted lower risk may worsen outcomes due to misclassification.The reported stronger association of obesity with postmenopausal breast cancer in Asian compared to white women may be due to differences in the relative distribution of visceral and subcutaneous fat. Maskarinec and colleagues examined the relation of adiposity measures with percent mammographic density (PMD), a strong predictor of breast cancer incidence, among participants of the Multiethnic Cohort. The analysis of abdominal MRI images and PMD showed that a higher ratio of visceral to subcutaneous adipose tissue was positively associated with PMD and indicates a link between the propensity to accumulate fat as visceral fat and the amount of fat in the breast.High incidence and mortality rate suggest the desirability to identify high-risk Asian never-smoking females (NSF) who may benefit from low-dose CT (LDCT) screening. On the basis of an age-matched case–control study and an estimated age-specific 6-year lung cancer incidence rate among Taiwanese NSFs, Chien and colleagues developed the Taiwanese NSF Lung Cancer Risk Models (TNSF-SQ) using standard epidemiologic and genetic information. Validation studies suggest that TNSF-SQ seems potentially useful in selecting Taiwanese NSFs for LDCT screening and hence helps inform clinical practice and screening program design. Similar models could be developed for never-smoking females in other parts of Asia.

The Association between the Relative Visceral to Subcutaneous Abdominal Fat Distribution and the Presence of Coronary Artery Atherosclerosis

Introduction: Distribution of abdominal fat is more detrimental in the pathogenesis of coronary artery atherosclerosis (CAA) than its amount. Purpose: To detect the value of the amount of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT), and their distribution by abdominal computed tomography in the detection of CAA as assessed by multi-slice computed tomography coronary angiography (MSCT-CA). Methods: The abdominal muscular wall was traced manually to calculate SAT and VAT areas (cm²) (outside and inside abdominal muscular wall respectively) at L4-L5 in 63 consecutive patients with no risk factors for coronary artery disease (CAD) referred for evaluation of chest pain by MSCT-CA. Results: 40% of the studied patients (n=25) had CAA (Group 1), while the remaining 60%(n=38) had no CAA (Group 2). There was no statistically significant difference between both groups as regards weight, body mass index (BMI), waist circumference (WC), waist-to hip ratio (W/H ratio), VAT area, SAT area, and total fat area. Group 1 patients were predominantly males (53% vs 24%; p=0.023), with statistically significantly increased VAT/ SAT area ratio (0.40 ± 0.23 vs 0.29 ± 0.16; p=0.028), and increased age (55.7 ± 7.9 vs 44.0 ± 11.1; p&lt;0.001) as compared to Group 2 patients. Conclusion: VAT/SAT area ratio can be used in the detection of CAA in patients with no CAD risk factors.

Macroanatomical and Topographical Features of Body’s Adipose Component Content in Girls

The aim of the research is to study quantitative representation and features of adipose component distribution in girls of 16–20 years of age having different constitutional properties.Material and methods. In the investigated Slavic ethnos groups of 250 girls of 16–17 years of age and 250 girls of 18–20 years of age having no signs of pathological processes disturbing physical development dynamics absolute content of body’s adipose component and topographical features of subcutaneous fat distribution in different body areas are evaluated by the methods of caliperometry and bioimpedancometry. As provided by typing according to a constitutional group leptosomic, mesosomic, megalosomic and indefinite constitutional groups have been singled out. Statistical analysis was based on the method of confidence intervals and determination of arithmetical mean index and its error.Results. It has been determined that subcutaneous fat thickness regardless of age and constitutional group is maximal in the abdominal region and minimal in the area of medial forearm region, chest and posterior shoulder region. Constitutional conditionality of this sign is determined by the fact that in the majority of body’s areas subcutaneous fat thickness in mesosomic constitution is 1.8–3.4 times more (р&lt;0.05) in comparison with leptosomic constitution, 1.1–1.6 times more (р&lt;0.05) in comparison with megalosomic constitution, 1.1–1.5 times more (р&lt;0.05) in comparison with the girls of indefinite constitution. Absolute content of body’s adipose component in girls of leptosomic constitution is 2.2–2.3 times (р&lt;0.05) less than in girls of mesosomic constitution. In girls of megalosomic constitution absolute content of body’s adipose component is 1.5 times (р&lt;0.05) less than in girls with mesosomic constitution. In girls of indefinite constitution absolute content of body’s adipose component is 2.2 times (р&lt;0.05) less than in girls of mesosomic constitution. At the age from 16–17 to 18–20 years subcutaneous fat thickness in mesosomic, megalosomic and indefinite constitutions is increasing insignificantly while in the girls of leptosomic group subcutaneous fat thickness is practically invariable. The indices of minimal and maximal subcutaneous fat thickness regardless of constitution and age demonstrate significant individual variability.Conclusion. The carried out morphological analysis has revealed a wide range of individual variation in body’s adipose component content and its dependence on the constitutional type.

Using body mass index ignores the intensive training of elite special force personnel.

Body mass index is a common and well-known measure in daily life. A body mass index higher than 25 is assumed to be an indicator for overweight and obesity and a high amount of total body fat. But body mass index overestimates body fat in subjects with high muscle mass and underestimates it in persons with a low lean body mass, especially in elderly and diseased persons. In the present study, we investigate the performance of the body mass index as a measure of body fatness and its ability to distinguish between well-trained and untrained subjects. Twenty-one well-trained male members of a police task force named “Cobra” and 38 non-active controls, matched by age, weight and height were participants of the study. The age range of these subjects was between 30 and 45 years. Subcutaneous adipose tissue thicknesses and body fat distributions were measured non-invasively by an optical device named the “Lipometer.” Statistics were performed with SPSS. We found that the body mass index did not show a difference between the two groups, whereas all Lipometer results were able to discriminate significantly between the trained and untrained subjects. Furthermore, the receiver operating characteristic curve analysis was calculated and all Lipometer measurements provided significant results up to a correct classification of all subjects of 86.4%, which was for the lateral thigh body site. In conclusion, the body mass index was not able to recognize the difference between trained and untrained participants, while body fat distribution measured with the Lipometer was able to distinguish more clearly the large body fat differences between these two groups. Impact statement Body mass index (BMI) is a common measure of body fatness but overestimates body fat in subjects with high muscle mass. We have developed previously a device named “Lipometer,” an alternative way to measure body fatness. We show herein that the Lipometer is able to distinguish more clearly (than the BMI) the large body fat differences between well-trained and untrained subjects. Thus, the Lipometer is superior to BMI with respect to body fat measurements.

Subcutaneous Fat Distribution is a Prognostic Biomarker for Men with Castration Resistant Prostate Cancer

The relationship between body fat distribution and survival remains unclear in patients with castration resistant prostate cancer treated with docetaxel and androgen receptor axis targeted agents. We investigated whether body composition parameters could predict radiographic progression-free and cancer specific survival in patients with castration resistant prostate cancer. In this multicenter retrospective study we evaluated data on 282 consecutive patients diagnosed with castration resistant prostate cancer between September 2009 and March 2017. The subcutaneous fat index, the visceral fat index and the skeletal muscle index at the diagnosis of castration resistant prostate cancer were determined by computerized tomography data. Survival analyses were performed using the subcutaneous fat, visceral fat and skeletal muscle indexes dichotomized at 39.9, 58 and 52.4cm2/m2, respectively. At the diagnosis of castration resistant prostate cancer, cancer specific survival was independently predicted using prostate specific antigen levels, Gleason score 8 or greater, performance status, a shorter interval from androgen deprivation therapy to castration resistant prostate cancer and a subcutaneous fat index of less than 39.9 cm2/m2. During the median followup of 16.0 months patients with a subcutaneous fat index of 39.9 cm2/m2 or greater received more docetaxel cycles than patients with a subcutaneous fat index of less than 39.9 cm2/m2. Compared to patients with a subcutaneous fat index of less than 39.9 cm2/m2 those with an index of 39.9 cm2/m2 or greater had better 1-year progression-free and 2-year cancer specific survival (p = 0.009 and 0.021, respectively). Patients with a subcutaneous fat index of 39.9 cm2/m2 or greater at the diagnosis of castration resistant prostate cancer showed higher progression-free and cancer specific survival rates than those with a subcutaneous fat index of less 39.9 cm2/m2 at diagnosis. The subcutaneous fat index determined by computerized tomography data could serve as a useful objective prognostic factor to discuss patient therapeutic options. Further studies are needed to define the roles of each body composition parameter in relation to pharmacokinetics and oncologic outcome.

Association between central obesity and executive function as assessed by stroop task performance: A functional near-infrared spectroscopy study

Recent studies have suggested a link between executive function (EF) and obesity. Studies often adopt body mass index (BMI), which reflects the distribution of subcutaneous fat, as the sole marker of obesity; however, BMI is inappropriate to distinguish central obesity, which indicates the centralized distribution of visceral fat. Visceral fat compared with subcutaneous fat represents greater relative lipid turnover and may increase the risk of cognitive decline in older adults. However, the relationship between EF and central obesity is largely unknown, particularly in young adults. Therefore, we used waist circumference (WC) as a marker of central obesity and investigated different sensitivities between BMI and WC in the brain function. A total of 26 healthy young adults (aged 18–25 years; 42% female) underwent functional near-infrared spectroscopy assessments. EF was assessed using the Stroop task, which is a classical measurement of EF. A significant Stroop effect was observed in the behavioral and hemodynamic data. In addition, we observed that behavioral interference on the Stroop task varied much more in subjects with higher BMI and WC than those subjects with lower. Elevated BMI and WC were associated with a decreased hemodynamic response during the Stroop task specifically in the prefrontal cortex (PFC). Compared to BMI, WC was more closely connected with inhibitory control and revealed right lateralized PFC activation. Our findings suggest that WC is a reliable indicator of brain function in young adults and propose a relationship between EF and central obesity.

Pelvic MRI and CT Images are Interchangeable for Measuring Peripouch Fat

Introduction: CT and MRI images are reported to be interchangeable for quantifying abdominal subcutaneous fat and visceral fat distribution, but it is unknown for measuring peripouch fat. Our previous study showed that increased fat plane on MRI was associated with poor pouch outcomes. Our aim was to assess the agreement in measurement of peripouch fat between pelvic MRI-DIXON and CT imaging. Methods: Pouch patients with inflammatory bowel diseases, who underwent pelvic MRI-DIXON and CT scan within one year, were included. Peripouch fat areas were measured at the middle height level of pouch (AreaM) and the highest level of pouch (AreaH). Measurements of perianal fat thickness, AreaM and AreaH were gained from CT and MRI images. Intraobserver and interobserver agreements were assessed with scatter plots and Bland-Altman graphs. Results: A total of 27 patients with both pelvic MRI-DIXON and CT images were included. Scatter plots showed that measurements of perianal fat thickness, AreaM and AreaH based on MRI image were highly accurate and reproducible (correlation efficiency(r): intraobserver: 0.984-0.991; interobserver: 0.969-0.971; all P < 0.001). Bland-Altman graphs analysis showed that more than 92.593% (25/27) of dots fell within the limits of agreement. We also identified strong agreements between CT and MRI image in measuring perianal fat thickness(r=0.823, P < 0.001), AreaM (r=0.773, P < 0.001) and AreaH (r=0.862, P < 0.001). Interchangeable calculating formula to normalize measurements between CT and MRI images were created: Thickness_CT = 0.610×Thickness_MRI + 0.853; AreaM_CT = 0.865×AreaM_MRI + 1.392; AreaH_CT = 0.508×AreaH_MRI + 15.001. Conclusion: Pelvic MRI image is a feasible and reproducible method for quantifying peripouch fat. Pelvic MRI and CT images are interchangeable in retrospective measurements of peripouch fat, which will foster future investigation of the role of mesentery fat in colorectal diseases.

Truncal pattern of subcutaneous fat distribution is associated with obesity and elevated blood pressure among children and adolescents

Background: The association between elevated blood pressure (BP) and childhood obesity has been documented in several studies. However, little is known the difference in BP levels among children and adolescents with different patterns of fat distribution. The present study examined the association of subcutaneous fat distributional pattern with obesity and elevated BP among children and adolescents.Methods: A total of 38,687 students (19,386 boys and 19,301 girls) aged 7–17 years participated in the study. Body mass index (BMI) cutoff points recommended by the International Obesity Task Force (IOTF) were used to define overweight and general obesity. Abdominal obesity was defined as waist-to-height ratio (WHtR) ≥ 0.5. Relatively high BP (RHBP) status was defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥ 95th percentile for age and gender. All individuals were classified into four groups (Q1–Q4) according to the age and sex-specific quartiles of subscapular to triceps skinfold thickness ratio (STR), the prevalence rates of overweight, general obesity, abdominal obesity and RHBP among the four groups were compared.Results: In both boys and girls, significant differences in the prevalence rates of overweight, general obesity, abdominal obesity and RHBP were observed among the four groups, an increasing trend was observed from the Q1 (STR <25 th) group to the Q4 (STR ≥ 75th) group (p < 0.01). Children and adolescents with high STR had higher prevalence of overweight, obesity and RHBP than their counterparts with low STR (p < 0.01).Conclusion: Truncal pattern of subcutaneous fat distribution is associated with obesity and elevated BP among children and adolescents. Public health attention should not only focus on the amount of body fat, but also on the distributional pattern of body fat.