Excess Visceral Adipose Tissue Research Articles

Molecular insights into colorectal cancer stem cell regulation by environmental factors

Colorectal cancer remains a significant cause of cancer-related mortality worldwide, mainly because of tumor relapse and metastases. Cancer stem cells (CSCs) are considered to be the main cause of resistance to chemotherapeutic agents, as well as being responsible for distant metastases. Although CSCs themselves possess innate abilities for self-renewal and differentiation, the environment surrounding CSCs provides oxygen, nutrients and secreted factors, and also supports angiogenesis, thus it's responsible for maintaining their CSC properties. Furthermore, extensive investigations have revealed that obesity, accompanied by excess visceral adipose tissue, induces chronic inflammation, and is linked to the risk and progression of several gastrointestinal cancers, through modulating the capacities of the CSCs. This review presents the evidence linking colorectal CSCs and their environment and summarizes our current understanding of the molecular mechanisms underlying this relationship.

Metabolic Syndrome and Menopause: Pathophysiology, Clinical and Diagnostic Significance.

Menopause is a risk factor for cardiometabolic diseases, including metabolic syndrome (MetS), type 2 diabetes, and cardiovascular diseases. MetS is a constellation of interdependent factors such as insulin resistance, abdominal obesity, dyslipidemia, and hypertension. The prevalence of MetS in postmenopause is due to loss of the protective role of estrogens and increased circulating androgens resulting in changes to body fat distribution and development of abdominal obesity. Excessive visceral adipose tissue plays an important role due to synthesis and secretion of bioactive substances such as adipocytokines, proinflammatory cytokines, reactive oxygen species, prothrombotic, and vasoconstrictor factors. MetS may also impact risk assessment of breast cancer, osteoporosis and chronic kidney disease, and quality of life during the menopausal transition. Increased MetS has stimulated the exploration of new laboratory tests for early detection and therapies.

Exercise training reverses endothelial dysfunction in nonalcoholic fatty liver disease.

Nonalcoholic fatty liver disease (NAFLD) is an independent risk factor for cardiovascular disease (CVD). Endothelial dysfunction is an early manifestation of atherosclerosis and an important prognostic marker for future cardiovascular events. The aim of this study was twofold: to examine 1) the association between liver fat, visceral adipose tissue (VAT), and endothelial dysfunction in obese NAFLD patients and 2) the impact of supervised exercise training on this vascular defect. Brachial artery endothelial function was assessed by flow-mediated dilatation (FMD) in 34 obese NAFLD patients and 20 obese controls of similar age and cardiorespiratory fitness [peak oxygen uptake (V̇o2 peak)] (48 ± 2 vs. 47 ± 2 yr; 27 ± 1 vs. 26 ± 2 ml·kg−1·min−1−1). Magnetic resonance imaging and spectroscopy quantified abdominal and liver fat, respectively. Twenty-one NAFLD patients completed either 16 wk of supervised moderate-intensity exercise training (n = 13) or conventional care (n = 8). Differences between NAFLD and controls were compared using independent t-tests and effects of interventions by analysis of covariance. NAFLD patients had higher liver fat [11.6% (95% CI = 7.4, 18.1), P < 0.0005] and VAT [1.6 liters (95% CI = 1.2, 2.0), P < 0.0001] than controls and exhibited impaired FMD compared with controls [−3.6% (95% CI = −4.9, −2.2), P < 0.0001]. FMD was inversely correlated with VAT (r = −0.54, P = 0.001) in NAFLD, although the impairment in FMD remained following covariate adjustment for VAT [3.1% (95% CI = 1.8, 4.5), P < 0.001]. Exercise training, but not conventional care, significantly improved V̇o2 peak [9.1 ml·kg−1·min−1 (95% CI = 4.1, 14.1); P = 0.001] and FMD [3.6% (95% CI = 1.6, 5.7), P = 0.002]. Endothelial dysfunction in NAFLD cannot be fully explained by excess VAT but can be reversed with exercise training; this has potential implications for the primary prevention of CVD in NAFLD.

Indicadores antropométricos associados a hipertrigliceridemia na predição de gordura visceral

The accumulation of visceral fat is strongly associated with cardiometabolic changes. Alternative methods, such as the association between anthropometric indicators and hypertriglyceridemia, are used as the best estimate for the accumulation of visceral fat, preventing cardiovascular diseases. The aim of this study was to evaluate the association of anthropometric indicators with hypertriglyceridemia in the prediction of visceral fat in men and women. This was a cross-sectional study conducted with 192 individuals, of both genders, submitted to anthropometric evaluation (sagittal abdominal diameter [SAD], waist circumference [WC], and waist-hip ratio [WHR]), serum dosage of triglycerides (TG), and computed tomography scan, in order to measure the visceral adipose tissue (VAT) area. Descriptive analysis, Pearson’s Correlation, and multiple linear regression were performed. Anthropometric indicators had high correlation with the VAT area (p=0.000). Regardless of serum TG levels, individuals with high values of anthropometric indicators had excess VAT area (p&lt;0.05). For every centimeter increased in SAD, there was an average increase of 12.46 cm² in the VAT area. The study showed that both SAD and WC were good indicators to explain the variability in the VAT area, independently of changes in TG levels, making it possible to identify individuals with a risk of developing cardiovascular diseases.

Visceral fat content, clinical features, and prognosis in a database of 507 upper gastrointestinal cancers.

4054 Background: Excess visceral adipose tissue may promote cancer development and progression through obesity-related metabolic disturbances, such as adipocytokine-related Inflammation, insulin re...

Differential association of visceral adipose tissue with coronary plaque characteristics in patients with and without diabetes mellitus

BackgroundExcess visceral adipose tissue (VAT) is closely associated with the presence of coronary artery plaques that are vulnerable to rupture. Patients with diabetes mellitus (DM) have more VAT than patients without DM, but the extent to which VAT contributes to the characteristics of coronary plaques before and after the development of DM is not fully understood.MethodsWe retrospectively evaluated 456 patients (60% male, age 64 ± 16 years) who were suspected to have cardiovascular disease and underwent 64-slice computed tomography angiography (CTA). Seventy-one (16%) patients had vulnerable plaques (CT density < 50 Hounsfield Units, positive remodeling index > 1.05, and adjacent spotty areas of calcification).ResultsPatients were divided into tertiles according to the VAT area. There were stepwise increases in noncalcified and vulnerable plaques with increasing tertiles of VAT area in patients without DM, but not in patients with DM. Multivariate analysis showed that a larger VAT area was significantly associated with a higher risk of vulnerable plaque in patients without DM (odds ratio 3.17, 95% confidence interval 1.08–9.31, p = 0.04), but not in patients with DM.ConclusionsThe VAT area is associated with the characteristics of coronary plaques on CTA in patients without DM, but not in patients with DM. VAT may be a significant cardiometabolic risk factor that is associated with plaque vulnerability before the development of DM. CTA findings may help to improve risk stratification in such patients.

The associations between cardiometabolic risk factors and visceral fat measured by a new dual-energy X-ray absorptiometry-derived method in lean healthy Caucasian women

Excess visceral adipose tissue (VAT) is associated with a cluster of metabolic abnormalities. A new dual-energy X-ray absorptiometry (DXA)-based VAT measurement approach, CoreScan™, computes VAT mass and volume within the android region of a total body DXA scan. However, there have been no reference values developed for this method. The objective of this study was to determine the normal reference ranges for DXA-derived VAT in young, healthy, premenopausal women. We also sought associations between VAT, blood lipids, glucose, insulin and insulin resistance. In 120 randomly selected, normal weight, Caucasian women aged 20–40 years, we measured body fat (BF), VAT and lean mass by DXA. We also assessed blood pressure, waist and hip circumference, waist-to-hip ratio, body mass index, fasting glucose, insulin, triglycerides (TG), and high- (HDL) and low-density lipoproteins. Insulin resistance was evaluated by the homeostasis model assessment (HOMA). VAT mass accounted for 0.37 ± 0.3 % of weight and 1.11 ± 0.72 % of BF. Mean VAT mass and volume were 235.9 ± 183 g (95 % CI 202.7–269.1) and 250.3 ± 194.5 cm3 (95 % CI 215.1–285.4), respectively. Anthropometric indices moderately correlated with VAT. VAT significantly correlated with HDL (R = −0.193; P = 0.03), glucose (R = 0.252; P = 0.005) and HOMA (R = 0.184; P = 0.049). In this study, we provide normal values of VAT mass and volume measured by DXA and determined for healthy, normal weight, Caucasian women aged 20–40 years. Even in such strictly selected population VAT correlated positively with insulin resistance and inversely with HDL.

Abstract B73: Human omental-derived adipose stem cells: Modulator of ovarian cancer proliferation, migration and chemoresistance

Abstract Objectives: Adipose tissue contains a population of multipotent mesenchymal stromal cells (ASC) which exhibit tumor tropism, similar to bone marrow derived mesenchymal stem cells (MSC). Excess visceral adipose tissue increases the risk of ovarian cancer. The omentum is a prominent site for ovarian cancer metastasis. We hypothesize that the omentum serves as a source of ASC which promote ovarian cancer progression. Materials and Methods: ASC were isolated from the omentum (O-ASCs) of three patients with ovarian cancer. O-ASC1 was isolated from a patient with synchronous adenocarcinoma of endometrial and ovarian cancer without peritoneal metastasis; and O-ASC4 and O-ASC5 were isolated from patients with peritoneally disseminated serous ovarian cancer. Gene expression array profiling was performed with using Nimblegen arrays (Roche NimbleGen, Inc., Madison, WI). The impact of stromal cells on proliferation and chemoresistane and radio-protection of ovarian cancer cells was tested with co-culture assays using luciferase-labeled human ovarian cancer cell lines. Transwell migration assays were performed with conditioned media from O-ASC and control cell lines. To evaluate of O-ASCs tumor tropism in-vivo experiment was performed. Results: Human O-ASCs were detected engrafted within the stroma of human ovarian cancer xengrafts. O-ASC significantly promoted in-vitro proliferation and migration of ovarian cancer cell lines OVCA 429, OVCA 433, A2780. Co-culture of ovarian cancer cells with O-ASCs increased resistance to chemotherapeutic drugs and radiation. Gene expression array analysis revealed significant differences in expression profiles for group of 415 genes in sub-populations of O-ASCs. Conclusions: Adipose stem cells derived from human omentum promoted the proliferation, migration, chemoresistance and radioresistance of ovarian cancers. Clinical isolates demonstrate heterogenous effects in- vitro. Future studies will determine if tumor promoting effects of O-ASC can be predicted on the basis of clinical or disease related characteristics. Citation Format: Aleksandra Nowicka, Travis Solley, Frank C. Marini, Hadley J. Sharp, Russell R. Broaddus, Kolonin G. Mikhail, Samuel C. Mok, Wendy A. Woodward, Karen H. Lu, Ann H. Klopp. Human omental-derived adipose stem cells: Modulator of ovarian cancer proliferation, migration and chemoresistance. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research: From Concept to Clinic; Sep 18-21, 2013; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2013;19(19 Suppl):Abstract nr B73.

The impact of central obesity on accelerated progression of noncalcified coronary plaque assessed by coronary CT angiography: a 4-year-follow-up study

Purpose: Although excess visceral adipose tissue (VAT) is more strongly associated with risk factors of coronary artery disease (CAD) than body mass index (BMI) or waist circumference, an association between VAT and CAD progression has not been fully evaluated. The aim of this study was to investigate whether adding VAT measurements to CAD risk factors provides better risk assessment for progression of calcified and noncalcified coronary plaque on coronary CT angiography. Methods: This prospective cohort study comprised 553 CAD patients with calcified and noncalcified coronary plaque with ≤ 50% coronary stenosis as assessed by coronary CT angiography. Quantification of VAT area was performed using abdominal CT scanning. Results: After a mean 55±8 month follow-up, 332 patients underwent repeated CT scans for worsening angina symptoms without findings of positive ischemia. Increased segments of noncalcified plaque were seen in 161 (48%) and increases above the median calcium score were seen in 168 (51%) patients. The risk for progression of noncalcified plaque increased steadily with higher VAT quartiles, independent of CAD risk factors. Patients in the higher VAT quartiles were at increased risk of progression of noncalcified plaque (quartiles IV OR 5.5; 95% CI 2.8-11.0, p-value < 0.001). In contrast, increases above the median calcium score showed no independent correlation to VAT. Progression of noncalcified plaque showed no phased increase with either higher waist circumference or BMI quartiles. Conclusions: Excess VAT was positively associated with progression of noncalcified coronary plaque, but not of calcified plaque. This suggests that risk assessment of progression of noncalcified plaque can be improved by combining VAT measurements and CAD risk factors.

Differential impact of visceral abdominal adipose tissue on vulnerable plaque detected by coroanry multi-detector row CT in patients with or without diabetes

Background: Excess visceral abdominal adipose tissue (VAT) is strongly associated with atherosclerosis and cardiovascular disease, since VAT secrets many inflammatory cytokines. The significance of VAT in patients with or without DM has not fully investigated. The aim of this study was to investigate the association between VAT and the presence and characteristics of coronary artery plaques in the patients with or without DM using 64 slice computed tomography angiography. Methods and results: We retrospectively evaluated 456 consecutive patients (57% male, age 64±14 years) who were suspected CAD with MDCT. 71 (16%) patients had vulnerable plaque (VP) with low density area 60cm2 and ≤106cm2, T3 n=111 VAT >106cm2 and DM group: T1, n=40, ≤87cm2, T2, n=41, >87cm2 and ≤130cm2, T3, n=41, >130cm2) (Table). In non-DM patients, higher age, male, current smoking history, lower HDL cholesterol and VAT areas were significantly correlated with of VP. Multivariate analysis in no-DM patients revealed higher VAT area was independently associated with VP (odds ratio [OR]: 3.84; 95% confidence interval [CI]: 1.04-14.14,p=0.04). However, in DM patients, no association between VAT area and VP was found. View this table: Table 1. Multivariate analysis for VP Conclusion: VAT was significantly associated with VP independent of traditional measures of CAD in only non-DM patients. Risk assessment of cardiovascular disease could be improved by combining VAT measurements and traditional risk factors in non DM patients.

Visceral adipose tissue area is associated with coronary stenosis and noncalcified plaques

Few studies have investigated the relationships between visceral adipose tissue (VAT) and coronary stenosis and noncalcified plaques at the subclinical stage. The aim of this study was to investigate relationship between VAT and coronary lesions assessed by coronary computed tomography (CT) in an apparently healthy population. Retrospective cross-sectional study. One thousand six hundred and fifty-eight subjects free of cardiovascular disease underwent coronary CT and abdominal fat CT as part of a routine medical examination. VAT area was measured at the level of the umbilicus using CT. Coronary stenoses and plaques were evaluated using coronary CT. The mean age of the study population was 55.9±8.0 years, and 1198 (72.3%) subjects were men. There were 201 subjects (12.1%) with coronary stenosis <50% and 144 (8.7%) had significant stenosis. Noncalcified plaques were observed in 108 (6.5%) subjects. Coronary stenosis <50% and noncalcified plaques increased steadily as the VAT area increased (P<0.001). The 4th quartile of VAT area was significantly associated with prevalence of coronary stenosis <50% and the presence of noncalcified plaques when compared with the first through third VAT quartiles in the cardiovascular risk factor-adjusted model (odds ratio (OR): 1.58, 95% confidence interval (CI): 1.09-2.30 and OR: 1.66; 95% CI: 1.02-2.68, respectively). Excess VAT area was associated with coronary stenosis <50% and noncalcified plaques, independent of traditional cardiovascular risk factors, in an asymptomatic population without a history of coronary artery disease.

Association between abdominal adipose tissue mass with anthropometric and cardiometabolic variables in a subgroup of males and females from the Canola Oil Multicentre Intervention Trial (COMIT)

Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) differ metabolically. Excessive VAT is linked to obesity‐related disease. We evaluated the association between baseline abdominal SAT, VAT and cardiometabolic (glucose) and anthropometric measurements in a subgroup of participants from COMIT (F=7, M=7) with increased waist circumference (F: &gt;;80 cm; M: &gt;; 94 cm). MRI images were analyzed to separate the SAT and VAT; 3 slices centered between lumbar vertebrae L4–5 were calculated. Abdominal and total fat mass were measured by DXA. In females, SAT was positively correlated with abdominal (r=0.86, p=0.013) and total (r=0.82, p=0.02) fat mass and with waist circumference (r=0.84, p=0.02). In males, VAT was positively associated with abdominal fat mass (r=0.93, p=0.002) and demonstrated a strong tendency with waist circumference (r=0.75, p=0.051). SAT also correlated with total fat mass (r=0.73, p=0.06). Glucose levels were positively associated with SAT and VAT in females (r=0.84, p=0.02; r=0.86, p=0.04). In summary, in females, SAT is positively correlated with fat mass, waist circumference; SAT and VAT may contribute to elevated glucose levels. In males, VAT alone was positively associated with abdominal fat mass and increased waist circumference. Gender differences were observed for SAT and VAT depots; further research on differing metabolic responses between males and females is warranted.Grant Funding Source: Canola Council of Canada

Abstract 007: Nonalcoholic Fatty Liver Disease and Subclinical Atherosclerosis: Analyses from the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Background: Nonalcoholic Fatty Liver Disease (NAFLD) and excess visceral adipose tissue (VAT) are associated with cardiovascular disease (CVD). Recent studies suggest that NAFLD and coronary artery calcification (CAC) are related independent of VAT. In a population-based cross-sectional sample of black and white adults free from prevalent liver or heart disease, we tested the hypothesis that NAFLD is associated with the presence of CAC and abdominal aortoiliac calcification (AAC) independent of VAT and other CVD risk factors. Methods: Participants from the Coronary Artery Risk Development in Young Adults study (Y25 exam) with concurrent computed tomography quantification of liver fat, CAC and AAC were included (n=2,163). NAFLD was defined as liver attenuation ≤ 40 Hounsfield Units after exclusion of other causes of liver fat (medication/alcohol use). Using the Agatston method, CAC/AAC presence was defined as a score &gt; 0. Logistic regression models were used to calculate odds ratios and 95% confidence intervals. Results: Participant age was 49.9 (3.7) years and the sample was equally distributed by sex (55.6% female) and race (50.1% black). Mean BMI was 30.6 (7.1). The CAC and AAC prevalence was 26.5% and 49.6%. NAFLD prevalence was 9.6%. NAFLD participants were 50.1 (3.7) years old and more likely to be male (59.8% vs. 51.7%, p&lt;0.0001), white (56.5% vs. 49.3%, p&lt;0.05) and have the metabolic syndrome (70.1% vs. 22.6%, p&lt;0.0001) than those with no NAFLD. They were also more likely to have CAC (37.2%) and AAC (60.9%) than those with no NAFLD (25.4% and 49.4%, respectively). In multivariable analyses adjusted for demographics and health behaviors, NAFLD was associated with the presence of CAC and AAC (Table 1). This association was attenuated after adjustment for CVD risk factors and VAT. Effect modification by race and sex was not statistically significant. Conclusion: In contrast to prior studies, our results suggest that the relationship between NAFLD and subclinical CVD is mediated by the presence of other CVD risk factors.

The Effect of Exercise on Visceral Adipose Tissue in Overweight Adults: A Systematic Review and Meta-Analysis

Excessive visceral adipose tissue appears to trigger a cascade of metabolic disturbances that seem to coexist with ectopic fat storage in muscle, liver, heart and the ß-cell. Therefore, the reduction of visceral adipose tissue potentially plays a pivotal role in the treatment of the metabolic syndrome. The purpose of this systematic review and meta-analysis is to describe the overall effect of exercise on visceral adipose tissue and to provide an overview of the effect of different exercise regimes, without caloric restriction, on visceral adipose tissue in obese persons. A systematic literature search was performed according to the PRISMA statement for reporting systematic reviews and meta-analyses. The initial search resulted in 87 articles after removing duplicates. After screening on title, abstract and full-text 15 articles (totalling 852 subjects) fulfilled the a priori inclusion criteria. The quality of each eligible study was assessed in duplicate with “The Critical Review Form for Quantitative Studies”. Using random-effects weights, the standardized mean difference (Hedge's g) of the change in visceral adipose tissue was −0.497 with a 95% confidence interval of −0.655 to −0.340. The Z-value was −6.183 and the p-value (two tailed) was <0.001. A subgroup analysis was performed based on gender, type of training and intensity. Aerobic training of moderate or high intensity has the highest potential to reduce visceral adipose tissue in overweight males and females. These results suggest that an aerobic exercise program, without hypocaloric diet, can show beneficial effects to reduce visceral adipose tissue with more than 30 cm2 (on CT analysis) in women and more than 40 cm2 in men, even after 12 weeks.

Milk protein for improved metabolic health: a review of the evidence

Epidemiological evidence shows that consumption of dairy products is associated with decreased prevalence of metabolic related disorders, whilst evidence from experimental studies points towards dairy protein as a dietary component which may aid prevention of type 2 diabetes (T2DM). Poor metabolic health is a common characteristic of overweight, obesity and aging, and is the forerunner of T2DM and cardiovascular disease (CVD), and an ever increasing global health issue. Progressive loss of metabolic control is evident from a blunting of carbohydrate, fat and protein metabolism, which is commonly manifested through decreased insulin sensitivity, inadequate glucose and lipid control, accompanied by a pro-inflammatory environment and hypertension. Adverse physiological changes such as excess visceral adipose tissue deposition and expansion, lipid overspill and infiltration into liver, muscle and other organs, and sarcopaenia or degenerative loss of skeletal muscle mass and function all underpin this adverse profile. ‘Sarcobesity’ and sarcopaenic diabetes are rapidly growing health issues. As well as through direct mechanisms, dairy protein may indirectly improve metabolic health by aiding loss of body weight and fat mass through enhanced satiety, whilst promoting skeletal muscle growth and function through anabolic effects of dairy protein-derived branch chain amino acids (BCAAs). BCAAs enhance muscle protein synthesis, lean body mass and skeletal muscle metabolic function. The composition and processing of dairy protein has an impact on digestion, absorption, BCAA kinetics and function, hence the optimisation of dairy protein composition through selection and combination of specific protein components in milk may provide a way to maximize benefits for metabolic health.

Visceral adiposity in gastrointestinal and hepatic carcinogenesis

There is emerging evidence that the association between obesity and cancer is mediated by visceral rather than generalised body fat. Visceral fat has been directly implicated in the risk and progression of several gastrointestinal cancers including colorectal, oesophageal, pancreatic and hepatocellular carcinomas. Excess visceral adipose tissue induces a state of chronic systemic inflammation and altered metabolic activity that promotes a pro-oncogenic environment. This review examines the evidence linking visceral fat in gastrointestinal and hepatic carcinogenesis and explores our current understanding of the mechanisms underlying this relationship.

Abstract 19411: Inter-Atrial Regional Adipose Burden in Relation To Metabolic Abnormalities as a Novel Clinical Marker for Left Atrial Remodeling in Preserved Ejection Fraction Heart Failure

Background: Excessive visceral adipose tissue, a marker of abnormal metabolic process, has recently been shown to exert effects on cardiac struture and function. However, data regarding regional fat burden on left atrial (LA) mechanics and contractile function in subjects with heart failure and preserved ejection fraction (HFpEF) remained elusive. Methods: Totally studied 48 heart failure patients with preserved left ventricular ejection fraction (HFpEF) from heart failure (HF) outpatient clinics. Another 58 hypertensives and 26 normal volunteers were recruited from health evaluation center at the same time of patients enrollment. Myocardial deformation imaging from all directions, cardiac twist and left atrial (LA) strain analyzed. Global epicardial (EAT), thoracic peri-aortic (TAT) adipose tissue and regional inter-atrial fat burden (IAF, in thickness) were quantified by multi-detector Computed Tomography (MDCT) (Sensation 16, Siemens Medical Solutions, Forchheim, Germany) off-line analysis (Aquarius 3D Workstation, TeraRecon, San Mateo, CA, USA). Metabolic risk scoring (MS) was calculated by NCEP ATP III score. Results: Compared to hypertensives and normal group, patients with HFpEF tended to have higher LV mass index and LA diameter though similar LVEF (all p&lt;0.05) observed. In addition, EAT, TAT and IAF all correlated with MS (trend p&lt;0.05), and were all significantly higher in HFpEF group (ANOVA p&lt;0.05), which were accompanied by significantly reduced LV deformation from all three directions and cardiac twist as well as lower LA strain (all p&lt;0.05). In a multivariate model adjusting for age, gender, body mass index, blood pressure, MS and LV mass, for each increased standard deviation of IAF were independently associated with reduced LA strain (ß coef: -0.35, p=0.018). Conclusions: Fat pad surrounding inter-atrial region in relation to metabolic abnormalities may influence left atrial mechanical function in terms of atrial deformation. Our data suggested that such excessive regional adipose burden may partly play a role in the pathogenesis of early stage heart failure.

Oxidative stress is associated with visceral adipose tissue and subclinical atherosclerosis in a healthy multi-ethnic population

Oxidative stress plays an important role in the development of atherosclerosis. Excess visceral adipose tissue (VAT) and increased carotid intima-media thickness (IMT) are risk factors for coronary artery disease. We tested the hypothesis that VAT and IMT were associated with systemic oxidative stress. Healthy men and women (n = 565) matched for ethnicity (Aboriginal, Chinese, European, and South Asian) were recruited. Plasma malondialdehyde, a biomarker of oxidative stress, was measured as thiobarbituric acid reactive substances (TBARS). VAT and IMT were determined by computerized tomography and ultrasound scans, respectively. Plasma TBARS levels correlated with VAT and total atheroma burden (sum of IMT area and plaque area) in the entire cohort. When stratified by ethnicity, plasma TBARS levels correlated with distinct body composition and arterial measures in different ethnic populations with more associations present amongst Chinese and Europeans relative to Aboriginals and South Asians. VAT was associated with plasma TBARS levels independent of age, sex, ethnicity, smoking, and body mass index. Plasma TBARS levels were associated with IMT, the presence of plaques, and total atheroma burden, independent of age, sex, ethnicity, smoking, body mass index, and VAT. The association with total atheroma burden remained significant even when adjusted for apolipoprotein B. Results from the present study indicate that oxidative stress is positively associated with VAT as well as diffuse and focal carotid atherosclerosis in apparently healthy men and women.

Visceral and Not Subcutaneous Abdominal Adiposity Reduction Drives the Benefits of a 1‐Year Lifestyle Modification Program

Excess visceral adipose tissue (VAT) is associated with an increased cardiometabolic risk. The study examined whether changes in cardiometabolic risk markers after a 1-year lifestyle intervention in viscerally obese men were associated with changes in VAT or with changes in subcutaneous abdominal adipose tissue (SAT). The relative contributions of changes in global adiposity vs. changes in cardiorespiratory fitness to changes in VAT were also quantified. One hundred and forty four men were selected on the basis of an increased waist circumference (≥ 90 cm) associated with dyslipidemia (triglycerides ≥ 1.69 and/or high-density lipoprotein (HDL)-cholesterol <1.03 mmol/l); 117 men completed the 1-year intervention which consisted in a healthy eating, physical activity/exercise program. Body weight, body composition, and fat distribution were assessed by anthropometry and dual-energy X-ray absorptiometry (DEXA)/computed tomography. Cardiorespiratory fitness, plasma adipokine/inflammatory markers, fasting lipoprotein-lipid profile, and oral glucose tolerance test (OGTT) were assessed. VAT volume decreased by 26%, cardiorespiratory fitness improved by 20% (P < 0.0001) after 1 year. Plasma adipokine/inflammatory markers, lipids/lipoproteins, and glucose homeostasis were improved. One-year changes in triglyceride (r = 0.29), apolipoprotein B (r = 0.21), 120-min OGTT-glucose (r = 0.27), and fasting insulin (r = 0.27) levels correlated with changes in VAT (all P < 0.05) after adjustment for changes in SAT. Using a multilinear regression model, VAT reduction was independently associated with SAT reduction and with improvement in cardiorespiratory fitness (R(2) = 0.58, P < 0.0001). Therefore, this healthy eating-physical activity/exercise program improved the cardiometabolic risk profile of viscerally obese men in relation to the reduction of VAT. Furthermore, the reduction in VAT was independently related to the reduction in global adiposity and to the improvement in cardiorespiratory fitness.

Abstract MP028: Physical Activity Relates to Lower Visceral Adiposity in Children and Adolescents

Introduction: Expansion of visceral adipose tissue (VAT) associates with adverse metabolic changes. While regular moderate-to-vigorous activity is associated with lower total body fat in children and adolescents, it is unknown how physical activity relates to other adiposity indices, including VAT. Hypothesis: We hypothesized that regular physical activity in children and adolescents associates with lower body fat, percent body fat, abdominal subcutaneous adipose tissue (SAT), and VAT. Methods: The sample included 393 boys and girls aged 5–18 years (45.6% White, 50.6% African American, and 3.8% Other). Body fat and percent body fat were measured by dual-energy x-ray absorptiometry. Abdominal SAT and VAT mass were measured by magnetic resonance imaging between the highest point of the liver and the lower pole of the right kidney (using 5 to 8 cross-sectional slices, 4.76 cm apart). Participants were categorized as being regularly active by self-report: moderate-to-vigorous physical activity of ≥ 60 minutes/day, ≥ 4 days/week. Those who were physically active fewer than 4 days/week were categorized as not regularly active. Results: In this sample of children and adolescents, 45.6% of participants were regularly active. One-way ANCOVAs adjusted for age and sex demonstrated that regularly active youth had significantly less body fat (p&lt;0.01) and lower percent body fat (p&lt;0.01) than those who were not regularly active. One-way ANCOVAs adjusted for age, gender, and body fat, revealed that regularly active children and adolescents had no difference in SAT but had significantly lower amounts of VAT (p&lt;0.05) when compared to those who were not regularly active. Conclusion: Engagement in moderate-to-vigorous physical activity for at least 60 minutes on four or more days of the week in children and adolescents was related to lower body fat, percent body fat and VAT, when compared to those youth who were less active. The promotion of regular physical activity has significant public health implications for body fat accumulation and for controlling excess VAT during childhood and adolescence.