Visceral Adipose Tissue Distribution Research Articles

Non-linear Associations Between Visceral Adipose Tissue Distribution and Anthropometry-Based Estimates of Visceral Adiposity.

BackgroundRecent evidence suggests that excess visceral adipose tissue (VAT) is associated with future loss of subcutaneous adipose tissue (SAT) and skeletal muscle (SM) with aging. In clinical settings (abdominal) circumferences are commonly used to estimate body composition (BC). We aimed to study the linearity of VAT distribution ratios (i.e., VAT/SAT ratio and VAT/SM ratio), waist-to-hip ratio (WHR) and waist circumference (WC) with age and the relationship of VAT distribution ratios with anthropometry (i.e., WHR and WC).Materials and MethodsBC was determined using whole body magnetic resonance imaging in a large multi-ethnic group of 419 adults (42% white, 30% black, 15% Hispanic, 13% Asian, 1% other) with a BMI ranging from 15.9 to 40.8kg/m2. Linear and non-linear regression analysis was used to examine the linearity of VAT distribution ratios and anthropometry from 18 to 88 years. The relation between VAT distribution ratios and anthropometry was assessed separately.ResultsIn both sexes non-linear relationships were found between BC estimates and age, and between BC measures mutually. The ratios of VAT/SAT and VAT/SM showed quadratic relationships with age. VAT distribution ratios showed exponential or quadratic relationships with anthropometry with coefficients of determination ranging between 18 and 55%.ConclusionIn both sexes, VAT distribution ratios showed curvilinear relationships with age and with anthropometry. Given the sex differences in VAT distribution ratios, WHR and WC represent different BC proportions in men and women. These results emphasize the challenge when interpreting changes in BC based upon linear extrapolations in clinical practice.

The Effect of The Body Composition to Prognosis in Young Breast Cancer Patients

Objective:In cancer patients, the effect of the body composition on prognosis is a new clinical area of interest. In patients with class 2 or 3 obesity (BMI >35), survival found to be worse control groups in a pooled analysis. BMI category is not truly representing body composition and hard to use to determine the true muscle and fat quantity. Computed tomography (CT) is a frequent method to determine body composition precisely. Methods:Axial CT images, including all abdominal muscles (psoas, erector spinae, quadratus lumborum) external and internal oblique and rectus abdominis) total skeletal muscle area (SMA), was calculated. Besides, axial CT images of the body fat subcutaneous adipose and visceral adipose tissue distribution (VAT, SAT) areas were calculated in cm2 using threshold values of -30 to -190 for adipose tissue. Results:Eighty-four women were included in the study. Most of the patients were normal or over-weighted. Invasive carcinoma NST was the dominant histological subtypes, with 94% of the study population. The count of the sarcopenic and non-sarcopenic patients was 11 and 68 respectively. Although the median OS cannot be reached at the end of the follow-up period for both groups, the difference between groups statistically insignificant. The median OS was not reached for both groups, the difference between low and high TVAT groups was statistically significant. In multivariate analysis, TVAT was found to be an independent risk factor. Conclusion:In this study, we demonstrate sarcopenia may be seen in patients with breast cancer under 40 years old, and it may not have a prognostic effect.

The effect of body composition on prognosis in critically ill COVID-19 patients

Aim: Although limited risk factors were observed with the accumulated evidence during the SARS-CoV-2 (COVID-19) pandemic, there is still a lack of evidence for markers distinguishing asymptomatic-mild disease from severe disease. In this study, we aimed to evaluate the prognostic impact of sarcopenia and visceral adipose tissue in ICU patients treated for COVID-19. Material and Methods: The study designed as a retrospective cross-sectional study for evaluating the effect of prognostic radiologic features in COVID-19 infected patients. The patient characteristics, intubation status and dates, transfer to ICU, and last control or death dates were recorded. Axial CT images, including all abdominal muscles, total skeletal muscle area, were calculated. The total and psoas sarcopenia index (PSI) was calculated by dividing the square of the patient’s height by the square meter (cm2/m2). Also, axial CT images of the body fat subcutaneous adipose and visceral adipose tissue distribution areas were calculated in cm2 using threshold values of-30 to-190 for adipose tissue. Results: In the study population, there were nine deaths that occurred among male patients. In univariate analysis, chronic obstructive pulmonary disease and PSI were found to be related to prognosis. The median survival was 14 days in PSI low group. The prognostic effect of the PSI was still valid in the male population. Other factors had no relationship with survival in univariate analysis. In multivariate analysis, the prognostic effect of TSI and PSI was related to prognosis, while COPD lost its prognostic effect. Discussion: In this study, we found a new prognostic factor in critically ill COVID-19 patients, which may be a new area of interest. In contrast to other studies, we found no effect of BMI and visceral adipose tissue on mortality in COVID-19 patients treated in ICU. This feasible method needs further evaluation and validation with prospective studies in a large patient population.

Thickness of carotid artery intima is an independent risk factor for psoriasis.

Psoriasis (PsO) has been associated with lipoprotein abnormalities, visceral adiposity, atherosclerosis, and coronary artery disease (CAD) in several studies; however, data concerning the risk of psoriasis relevant to these parameters is not well established. We aimed to evaluate the relation between PsO and small dense low-density lipoprotein cholesterol (sd-LDL-C), serum lipid profile (SLP), blood pressures, anthropometric measurements, intima media thickness of the common carotid artery (CIMT), distribution of visceral adipose tissue (VAT; evaluated at 3 different measurement sites including VATa, VATb, VATc) along with subcutaneous (Sc-d1) and preperitoneal (Pre-d2) adipose tissue, and disease characteristics, so as to define relevant risk factors for PsO. In this cross-sectional and observational study, 62 patients with plaque-type PsO and 31 age- and sex-matched controls were enrolled. Data about metabolic profile, CIMT and VAT were obtained. There was a significant association between PsO and hypertension, smoking, diastolic blood pressure, sd-LDL-C/LDL-C ratio, CIMT, VATc, and Pre-d2. Following adjustments for hypertension and smoking, sd-LDL-C/LDL-C ratio, CIMT, and Pre-d2 still remained different between patients and controls (P = 0.03, P = 0.043, and P = 0.05, respectively). Each 0.1 unit increase in the CIMT increased the risk of PsO 1.51-fold (95%CI: 1.08 - 2.12, P = 0.016). PsO associates with a predisposition to develop thick preperitoneal fat tissue and thick intima of carotid arteries, all of which contribute to the increased risk of atherosclerosis and subsequent CAD. CIMT was considered as an independent risk factor for PsO.

Perirenal and epicardial fat and their association with carotid intima-media thickness in children.

Recent data suggest that subclinical atherosclerosis is more related to visceral adipose tissue distribution than to overall fat mass. Both perirenal fat and epicardial fat are visceral fat depots surrounding the kidneys and the myocardium, respectively, which can be easily assessed by ultrasound. Their clinical relevance in children is largely unknown. This review describes studies relating perirenal and epicardial fat to cardiovascular disease or carotid intima-media thickness (cIMT), a well-established surrogate for subclinical atherosclerosis, and discusses this in context with our own data from children. In adults, both perirenal and epicardial fat are useful biological markers of visceral obesity. The former has been related to hypertension in overweight subjects and with atherosclerosis in patients with human immunodeficiency virus. The latter was associated with several metabolic syndrome components and with calcification of the carotid artery. In healthy prepubertal children, both epicardial and perirenal fat thickness, rather than total body fat mass, were related to cIMT. Ultrasonography measures of perirenal and epicardial fat are related to atherosclerosis in adults and may be convenient tools for the assessment of cardiometabolic risk in children.

82 - Features of distribution of visceral adipose tissue in patients with erectile dysfunction and in healthy men

82 - Features of distribution of visceral adipose tissue in patients with erectile dysfunction and in healthy men

β-cell dysfunction in women with previous gestational diabetes is associated with visceral adipose tissue distribution.

Glucose intolerance in pregnancy predicts an increased risk of future type 2 diabetes. The aim of the study was to evaluate glucose metabolism in women with and without gestational diabetes mellitus (GDM) at 5 years follow-up and identify risk factors associated with disturbed glucose metabolism post-partum. This follow-up study included 300 consecutively enrolled women from a previous population-based cohort study. The participants underwent oral glucose tolerance test under pregnancy and in the follow-up study, in addition to dual-energy X-ray absorptiometry in the follow-up study. Fifty-two women (17.7%) were found to have GDM in pregnancy with an odds ratio of 4.8 developing prediabetes 5 years later. β-cell function, but not insulin resistance or sensitivity, was reduced in the follow-up study after adjusting for known risk factors. Furthermore, visceral fat content at follow-up was increased in GDM women compared to non-GDM women, and the β-cell function declined with increasing visceral fat in both groups but was more pronounced in the women with previous GDM. Women with GDM are at increased risk of developing prediabetes and have a decreased β-cell function 5 years post-partum that is associated with increased visceral fat mass.

Measurements of total and regional body composition in preschool children: A comparison of MRI, DXA, and anthropometric data

There are clear sex differences in the distribution of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) in adults, with males having more VAT and less SAT than females. This study assessed whether these differences between the sexes were already present in preschool children. It also evaluated which measures of body composition were most appropriate for assessing abdominal obesity in this age group. One-hundred and five children (57 boys and 48 girls) participated in the study. Body composition was measured using dual-energy X-ray absorptiometry (DXA). Weight, height, and waist circumference (WC) were also recorded. Magnetic resonance imaging (MRI) of the entire abdomen using sixteen 10-mm-thick T1 -weighted slices was performed in a subgroup of 48 children (30 boys and 18 girls); SAT and VAT volumes were measured using semiautomated segmentation. Boys had significantly more VAT than girls (0.17 versus 0.10 l, P < 0.001). Results showed that VAT correlated significantly with all measurements of anthropometry (P < 0.01) after adjusting for SAT and for total fat mass measured with DXA. The mean limits of agreement between DXA and MRI regarding truncal FM were calculated to be -11.4 (range -17.8 to -3.6), using a Bland-Altman plot. Sex differences in adipose tissue distribution are apparent at an early age. MRI is the best method with which to study abdominal fat distribution in young children.

Prevalence and risk factors for non‐alcoholic fatty liver disease in Asian people who are not obese

Fatty liver (hepatic steatosis) is prevalent in industrialized countries. It is typically linked to obesity, central obesity and the presence of metabolic syndrome. With the introduction of a Westernized lifestyle and the increasing frequency of obesity in the Asia-Pacific region, the prevalence of non-alcoholic fatty liver disease (NAFLD) has been increasing over the past two decades. The risk factors are similar to those in other ethnic populations; but it is important to adopt the regional (ethnic-specific) anthropometric criteria to define overweight, obesity (including central obesity) and metabolic syndrome. To be noted, even using strict ethnic-specific criteria, a high percentage (15-21%) of Asia-Pacific NAFLD subjects in some series have been found to be non-obese, i.e. to have a normal body mass index (BMI) (17.5-22.4 kg/m(2)) or to be overweight (BMI 22.5-24.9 kg/m(2)). Differential distribution of visceral adipose tissue, recent increase in body weight, intake of high cholesterol diet and genetic background are factors likely associated with the development of NAFLD in these non-obese (but often overweight) Asia-Pacific subjects. Furthermore, insulin resistance may be the underlying key mechanism. In addition, since NAFLD may be the hepatic manifestation of metabolic syndrome, the presence of NAFLD is a predictor of future type 2 diabetes, metabolic syndrome and cardiovascular disease. Therefore, interventions at the public health level are indicated to halt the trend of overweight as well as obesity in Asia-Pacific region, particularly among those with relevant family history. Since the pathophysiology of NAFLD is closely related to metabolic derangement, lifestyle modification remains the cornerstone of management.

Adipose tissue distribution after weight restoration and weight maintenance in women with anorexia nervosa

BackgroundBody image distortions are a core feature of anorexia nervosa (AN). We, and others, previously reported abnormalities in adipose tissue distribution after acute weight restoration in adult women with AN compared with body mass index–matched healthy control women. Whether these abnormalities persist over time remains unknown. ObjectivesWe aimed to 1) replicate previous findings that showed preferential central accumulation of adipose tissue in recently weight-restored AN women compared with control subjects, 2) describe the change within patients with longer-term (1-y) weight maintenance, and 3) compare adipose tissue distribution after 1-y maintenance with that of control subjects. DesignBody composition and adipose tissue distribution were assessed by whole-body magnetic resonance imaging in women with AN shortly after weight normalization (n = 30) and again 1 y after hospital discharge (n = 16) and in 8 female control subjects at 2 time points. ResultsWith acute weight restoration, AN patients had significantly greater visceral and intermuscular adipose tissue compared with control women [visceral: 0.75 ± 0.26 compared with 0.51 ± 0.26 kg in AN patients and controls, respectively (P = 0.02); intermuscular: 0.46 ± 0.17 compared with 0.29 ± 0.13 kg in AN patients and controls, respectively (P = 0.01)]. With maintenance of normal weight for ≈1 y, visceral adipose tissue distribution in AN patients was not different from that in healthy control subjects. ConclusionsIn adult women with AN, normalization of weight in the short term is associated with a distribution of adipose tissue that is consistent with a central adiposity phenotype. This abnormal distribution appears to normalize within a 1-y period of weight maintenance. This research was registered at clinicaltrials.gov as NCT 00271921 and NCT 00368667.

Finding a way through the forest: A Biopsychosocial model of hot flashes.

Finding a way through the forest: A Biopsychosocial model of hot flashes.

Association of adipose tissue deposition and beta-2 adrenergic receptor variants: the IRAS family study

Adipose tissue distribution (visceral vs subcutaneous) has been shown to be an important predictor of insulin resistance, diabetes and cardiovascular disease, independent of body mass index. The beta-2 adrenergic receptor is a major lipolytic receptor in human fat cells and the gene that codes for this protein is an important candidate gene for measures of adiposity and fat deposition. We examined whether two common polymorphisms in codons 16 (Arg16Gly) and 27 (Gln27Glu) are associated with measures of fat distribution in participants of the IRAS Family Study. We recruited African-American (AA) and Hispanic-American (HA) families from Los Angeles, CA, USA (18 pedigrees, 272 AA individuals), San Antonio, TX, USA (33 pedigrees, 448 HA individuals) and San Luis Valley, CO, USA (12 pedigrees, 272 HA individuals). We estimated adipose tissue distribution via computed tomography. To test for an association between adiposity measures and these polymorphisms, we used generalized estimating equations, adjusting for age, gender, clinical site (ethnicity), body mass index, and familial correlation. Of the 992 individuals genotyped for these polymorphisms, 57% were female and 15% had been diagnosed with type 2 diabetes mellitus. The mean age was 42.7+/-14.6 y. The Glu27 allele of the Gln27Glu polymorphism was positively associated with (P-value for recessive model): body mass index (0.025), visceral adipose tissue (<0.0001) and visceral-to-subcutaneous adipose ratio (0.009), but not with subcutaneous adipose tissue (0.952). The Arg16Gly polymorphism was not associated with any of the adiposity measures. These findings suggest that genetic variation in the beta-2 adrenergic receptor gene influences fat deposition and body size in AAs and HAs. In particular, these results support a role for the gene in the distribution of visceral adipose tissue but not subcutaneous adipose tissue.

Effects of sex on the change in visceral, subcutaneous adipose tissue and skeletal muscle in response to weight loss.

To examine the influence of sex on whole body and regional subcutaneous, visceral, total adipose tissue (AT), skeletal muscle (SM), and lean tissue in response to weight loss induced by diet alone (DO) or the combination of diet and aerobic (DA) or resistance exercise (DR). Sixty upper-body obese men and women were randomly assigned to one of three treatments: DO, DA, or DR. All tissues were measured using a whole body, magnetic resonance imaging protocol. Within each group reductions were observed for body weight ( approximately 11 kg), subcutaneous and visceral AT (P<0.01). After controlling for pretreatment differences in tissue size, reductions in total adiposity, total and regional subcutaneous and visceral adipose tissue were not different between sexes (P>0.1). Independent of sex, the reduction in visceral AT was greater than subcutaneous AT (P<0.05) in response to DO and DA. With the exception of DA women, the reduction in abdominal subcutaneous AT was greater (P<0.05) than lower-body subcutaneous AT in response to diet and exercise, but not diet alone, in both sexes (P>0.05). Independent of sex, skeletal muscle mass was preserved within the exercise groups (P>0.05) but not diet alone (P<0.05). Peak VO2 (l/min) improved in the DA groups as did muscular strength in the DR groups (P<0.01). These findings indicate that in response to diet or diet and exercise-induced weight loss, reductions in total adiposity, subcutaneous and visceral adipose tissue distribution are not different in obese men and women. Independent of sex, the combination of diet and exercise results in a preservation of skeletal muscle mass, a preferential reduction of abdominal subcutaneous AT, and improved functional capacity by comparison to diet alone.

Adipose tissue distribution measured by magnetic resonance imaging in obese women

This study had two objectives: 1) to establish magnetic resonance imaging (MRI) as a tool for measuring subcutaneous and visceral adipose tissue (AT) distribution in obese women, and 2) to assess the relationship between selected anthropometric variables and MRI-measured AT. Fifteen healthy obese women aged 35.0 +/- 9.8 y (mean +/- SD) with a body mass index of 36.4 +/- 7.1 and a waist-to-hip ratio of 0.91 +/- 0.05 participated in the study. The mean difference for repeated measures of subcutaneous and visceral AT area at L4-L5 was 1.1% (P = 0.15) and 5.5% (P = 0.14), respectively. Large interindividual differences were observed for total (30.2-81.7 L), subcutaneous (27.1-76.8 L), and visceral AT volume (0.9-5.5 L). Subcutaneous and visceral AT represented 92.3% and 6.3% of the total AT volume, respectively. Hip (r2 = 0.96) and waist (r2 = 0.88) circumferences were significant predictors of subcutaneous AT volume. The combination of body weight, age, and height explained 89% of the variance in visceral AT volume. These results demonstrate that MRI provides reliable measures of subcutaneous and visceral AT distribution in obese women.