Fat Thickness Measurements Research Articles

Intra‐abdominal fat measurement by ultrasonography: association with anthropometry and metabolic syndrome in adolescents

ObjectiveTo associate intra‐abdominal fat thickness measured by ultrasonography to the factors related to metabolic syndrome and to determine cutoff points of intra‐abdominal fat measurement associated with a greater chance of metabolic syndrome in adolescents. MethodsThis was a cross‐sectional study, with 423 adolescents from public schools. Intra‐abdominal fat was measured by ultrasonography. Anthropometric data were collected, and biochemical analyses were performed. ResultsIntra‐abdominal fat was measured by ultrasonography, showing a statistically significant association with the diagnosis of metabolic syndrome (p=0.037), body mass index (p<0.001), elevated triglyceride levels (p=0.012), decreased plasma HDL levels (p=0.034), and increased systemic blood pressure values (p=0.023). Cutoff values of intra‐abdominal fat thickness measurements were calculated by ultrasound to estimate the individuals most likely to develop metabolic syndrome. In the logistic regression models, the cutoff values that showed the highest association with metabolic syndrome in males were 4.50, 5.35, 5.46, 6.24, and 6.50cm for the ages of 14, 15, 16, 17, and 18/19 years, respectively. In the female gender, the cutoff values defined for the same age groups were 4.46, 4.55, 4.45, 4.90, and 6.46cm. In an overall analysis using the ROC curve, without gender and age stratification, the cut‐off of 3.67cm showed good sensitivity, but low specificity. ConclusionUltrasonography is a useful method to estimate intra‐abdominal adipose tissue in adolescents, which is associated with the main factors related to obesity and metabolic syndrome.

Does peritrochanteric fat thickness increase the risk of early reoperation for infection or wound complications following total hip arthroplasty?

BackgroundRadiographically measured subcutaneous peri-incisional tissue depth has been correlated with post-operative surgical site infection after cardiac, cervical spine, and total knee surgery. Its impact following primary total hip arthroplasty (THA) has not been studied. We compare the interobserver reliability of measuring peritrochanteric fat thickness on pre-operative radiographs and hypothesize that these measurements are a reproducible way to predict acute post-operative wound complications and infection in patients undergoing THA. MethodsA retrospective case-control analysis was performed at a single institution. Patients taken to the operating room within 90 days of their primary THA for a wound complication or deep infection between 2008 and 2016 were identified. Patients <18 years old, those with history of open surgery on the affected hip, or with inadequate radiographs were excluded. Patients were matched 1:1 for gender, age, BMI, and ASA score to THA patients without early wound complications. ResultsAll radiographic measurements performed were found to have excellent inter-rater reliabilities (range 0.96–0.98). There was no difference in peritrochanteric fat thickness measurements between the two groups including the sourcil to skin surface (89.5 mm vs. 91.9 mm, p = 0.5), tip of greater trochanter to skin surface (52.9 mm vs. 53.7 mm, p = 0.8), and lateral greater trochanter to skin surface (36.0 mm vs. 37.8 mm, p = 0.6) measurements. ConclusionContrary to other previously reported surgical procedures, radiographic measurement of subcutaneous depth is not a valid tool for predicting a return to the OR for wound complications in the early post-operative period following primary total hip arthroplasty.

Are visceral adiposity index and ultrasonographic visceral fat thickness measurements correlated to endometrial thickness in postmenopausal women?

During the postmenopausal period, visceral fat tissue is responsible not only for increased cardiometabolic risk, but also for endocrine function leading to increased endometrial thickness (ET).

Investigation of the Relationship between Asthma and Visceral Obesity by Epicardial Fat Thickness Measurement.

Obesity is a risk factor defined in recent years for asthma. It is associated not only with asthma but also with many cardiovascular diseases. Visceral obesity is a more significant risk factor than general obesity in cardiovascular diseases. Although the association of visceral obesity with cardiovascular diseases is well known, the relationship in patients with asthma is not fully understood. The aim of the present study was to investigate whether there is a relationship between asthma and visceral fat by using epicardial fat thickness (EFT) measurement. A total of 401 subjects (229 patients with persistent asthma and 172 controls) were enrolled in the study. In our study, EFT was measured, recorded by echocardiography, and was evaluated whether there was a statistical significant difference between the two groups. The mean EFT was 5.84±0.79 mm in the patient group and 5.71±0.93 mm in the control group. There was no statistically significant difference between the groups (p=0.145). Similarly, when we compared control and asthma severity subgroups, we did not find statistically significant differences (control group mean 5.71±0.93 mm, mild group mean 5.86±0.81 mm, moderate group mean 5.8±0.84 mm, and severe group mean 5.83±0.67 mm, p=0.505). In the present study, we observed that the EFT did not increase in patients with asthma compared with the normal population. Based on our results, we suggest that visceral obesity may not be a significant risk factor for asthma.

The association of epicardial fat thickness and disease severity among Fabry patients

Aim: Patients with Fabry disease frequently die due to cardiovascular causes. There are numerous findings of cardiovascular involvement in patients with Fabry disease. Epicardial fat thickness is a surrogate for various cardiovascular diseases. In this study, we evaluated epicardial fat thickness and parameters of diastolic dysfunction among Fabry patients as a possible indicator of disease severity.Materials and Methods: We enrolled 14 patients with Fabry disease who receive enzyme replacement therapy. Detailed echocardiographic examination was performed including diastolic functions and measurement of epicardial fat thickness. Disease severity was assessed using DS3 scoring system. Based on DS3 scores, patients are grouped into mild (10 points), moderate (10-28 points) and severe (29-32 points) disease.Results: There were two female and twelve male patients with Fabry disease. Patients were classified into three groups based on DS3 scores. Epicardial fat thickness was significantly increased among patients with advanced disease compared to patients with mild disease (p:0.002). Also, epicardial fat thickness had significant positive correlation with average E/E’ ratio (p:0.014), left atrial volume (p:0.004) and left atrial volume index (p:0.022).Conclusion: Epicardial fat thickness seems as a promising new marker of disease severity among patients with Fabry disease.Keywords: Fabry’s disease; inflammation; echocardiography.

Role of carboxytherapy in localized lipolysis: a clinical and radiological study

Background Localized obesity is a result of accumulation of adipose tissue present in small quantities in specific area. It is an important issue to search for novel noninvasive fat elimination modalities which help in body contouring.Objective To estimate the efficacy as well as safety of subcutaneous injection of CO2 in management of localized fat deposits.Patients and methods This interventional study was conducted on 34 females)22–45years old) having localized fat deposits in abdomen, chin, arm, and thigh. For all history and clinical examination including circumferential tape measurements were done. Digital photographic registration and ultrasound measurements of subcutaneous fat thickness, as well as circumferences of the treated areas before and after eight carboxytherapy sessions (once/week) were performed.Results There were observed improvement in carboxytherapy treated areas (abdomen, chin, arm, and thigh) in all studied subjects indicated by significant decrease in circumferences of abdomen (P<0.0001), arms (P=0.0003), and thighs (P<0.0001), and ultrasound fat thickness measurements in abdomen (P≤0.0001), chin (P=0.012), arms (P=0.0004), and thighs (P<0.0001). This improvement was achieved in arm (P=0.0004) and chin (P=0.012) better than abdomen and thighs. Half of our patients (17, 50%) recorded an excellent degree of satisfaction, the highest satisfaction rate was among patients who had lipolysis in the chin region (P=0.027). Pain (mild and moderate) and ecchymosis were the only observed adverse effects.Conclusion Carboxytherapy may be an effective method that could be used in the management of localized obesity, without remarkable adverse effects. Treatment of localized obesity by CO2 sessions once weekly for 8 weeks has a significantly better outcome in arms and chin than in abdomen and thighs.

Ultrasonography Measurement of Abdominal Subcutaneous Fat Thickness and Its Correlation with Hyperlipidemia and Steatohepatitis in Obese People

Introduction&#x0D; Unhealthy dietary practices, sedentary lifestyle and obesity have emerged as major risk factors of Non communicable diseases (NCD).[1] In India there is shift in dietary patterns to more ‘Western’ diets rich in saturated fat, refined foods and sugar and low in fibre[2] due to which there is a higher prevalence of traditional cardiovascular disease risk factors such as obesity, physical inactivity, tobacco use and high intake of saturated fat.[3] In 2000, the International Obesity Task Force of the WHO (IOTF-WHO) proposed a modification of National Heart, Lung, and Blood Institute guidelines on overweight/obesity which is as follows : Overweight, 23 to &lt;25; class I obesity, 25 to &lt;30; and class II obesity, ≥30. Redefining the obesity cut-off (BMI &gt;25) creates an “obesity burden” in urban India.[4]

Body fat percentage assessment by ultrasound subcutaneous fat thickness measurements in middle-aged and older adults

B-mode ultrasound accurately measures both muscle mass, body density and percent body fat (% BF) in younger adults, but how well it can estimate % BF in middle-aged and older adults using DXA-derived %BF as the criterion is unclear. We sought to develop % BF prediction equations for middle-aged and older adults using ultrasound subcutaneous fat thickness (SFT). A cross-sectional study of Japanese adults (n=414, 50-79 years) where 276 subjects were randomly assigned to a model development group and the other 138 subjects were assigned to a cross-validation group. B-mode ultrasound measured SFT at nine sites. Dual energy X-ray absorptiometry (DXA) measured % BF, arm fat mass (FM) and leg FM. Stepwise multiple linear regression developed prediction equations from anthropometric data (body mass, height, waist and hip circumference) and ultrasound SFT sites. Bland-Altman plots assessed validity of the prediction equations to measure % BF in the cross-validation group. The best prediction equation for % BF was the following: [% BF=15.709+(1.753*anterior trunk SFT)+(5.626*Sex)+(3.635*posterior upper arm SFT) - (4.428*anterior lower leg SFT) - (0.170*height)+(0.264*waist)+(anterior thigh SFT*2.241); r2=0.809, standard error of the estimate (SEE)=3.3kg]. Arm FM and leg FM prediction equations had r2 values ranging from 0.690 to 0.812 and SEEs of 0.29 and 0.75kg. A small mean bias was noted for estimating % BF (-0.14%), but large limits of agreement were found (-8.0-7.7%) and systematic error was noted in all of the equations (r=0.275 to 0.515, p<0.05). Despite high r2 values and a small mean bias found between predicted and DXA % BF, wide limits of agreement were found with some systematic error present. Therefore, these prediction equations for middle-aged and older adults may not be sufficiently accurate to use in a clinical setting.

Developmental and reproductive characteristics of beef heifers classified by number of estrous cycles experienced by start of first breeding.

A retrospective analysis was conducted to evaluate the effect of number of estrous cycles exhibited before breeding on growth and reproductive performance of replacement beef heifers fed ad-libitum or restricted by 20% less than ad-libitum during postweaning development over a 9-yr period. Progesterone concentration in blood samples collected at 9- to 11-d intervals were used to assign heifers into groups by number of estrous cycles exhibited before the start of breeding: 0 (nonpubertal; n = 395), 1 (n = 205), 2 (n = 211), 3 (n = 116), or >3 (n = 249). Heifers (P < 0.01) in the 0 cycle group were born 6 d later than the 1, 2, or 3 cycle groups, which were born 4 d later (P < 0.01) than the >3 cycle group. Weight of heifers at birth decreased (P < 0.05) as the number of cycles increased. Weaning weight and ultrasound measures of loin area and fat thickness over the loin at 1 yr age increased as the number of cycles increased (P < 0.01). Postwean weight gain, hip height at 1 yr age, and weights from the start of breeding through precalving increased with cycle numbers in a quadratic fashion (P < 0.02) and were greater (P < 0.05) in ad-libitum than restricted-fed heifers. Pregnancy rate in the 0 cycle group was lower (84%; P < 0.05) than the 1 (90%) or >3 (94%) estrous cycles groups and tended to differ (P < 0.1) from the 2 (88%) and 3 (89%) estrous cycle groups. Interval from the start of breeding to calving was 3 to 5 d longer (P < 0.05) for the 0 cycle group (300 ± 1 d) than other groups. Proportion of heifers calving in the first 21 d was less (P < 0.05) in the 0 or 1 cycle groups than other groups. Pregnancy rates of 2-yr-old cows (n = 898) were lowest (P < 0.05) for the 0 (73%) and 2 (79%) estrous cycle groups than the 1 (85%), 3 (90%), or >3 (92%) estrous cycle groups. Restricted level of feeding during postweaning development resulted in greater (P < 0.05) proportion of heifers in 0 cycle group and lower (P < 0.05) proportion in >3 cycle group, but reproductive performance was not influenced (P > 0.1) by level of feeding or interaction of feeding and estrous cycle grouping. In summary, date of birth and rate of physical maturation (weight, height, and fat deposition) were associated with timing of puberty. Pregnancy rate was greater in heifers that exhibited estrus before the start of breeding, but did not improve from having more than one estrous cycle. Proportion conceiving early was greater for heifers having two or more cycles before breeding.

Measurement of mean subcutaneous fat thickness: eight standardised ultrasound sites compared to 216 randomly selected sites

Ultrasound (US) provides the most accurate technique for thickness measurements of subcutaneous adipose tissue (SAT) layers. This US method was recently standardised using eight sites to capture SAT patterning and allows distinguishing between fat and embedded fibrous structures. These eight sites chosen for fat patterning studies do not represent the mean SAT thickness measured all over the body that is necessary for determining subcutaneous fat mass. This was obtained by SAT measurements at 216 sites distributed randomly all over the body. Ten participants with BMI below 28.5kgm−2 and SAT means (from eight sites) ranging from 3 mm to 10 mm were selected. The means from eight sites overestimated the means obtained from 216 sites (i.e. 2160 US measurements in the ten participants); the calibration factor of 0.65 corrects this; standard deviation (SD) was 0.05, i.e. 8%. The SD of the calibration factor transforms linearly when estimating the error range of the whole body’s SAT volume (body surface area times the calibrated mean SAT thickness). The SAT masses ranged from 3.2 to 12.4 kg in this group. The standard deviations resulting from solely the calibration factor uncertainty were ±0.3 and ±1.0 kg, respectively. For these examples, the SAT percentages were 4.9(±0.4)% and 13.3(±1.0)%.

Increasing body mass index and abdominal subcutaneous fat thickness are associated with increased skin-to-epidural space distance in pregnant women

BackgroundBody mass index does not indicate the distribution of adipose tissue. Central adiposity may be measured using ultrasound measurement of subcutaneous fat thickness. This study determined if the abdominal subcutaneous fat thickness measured correlated with skin-to-epidural space distance at delivery, and compared this with the booking body mass index. MethodsWe analysed a sub-set of participants from a single-centre, prospective cohort study that assessed the relationship between subcutaneous fat thickness and maternity outcomes. Abdominal subcutaneous fat thickness measurements were obtained during the routine fetal anomaly scan. The skin-to-epidural space distance was obtained in those having epidural or combined spinal-epidural analgesia. Linear regression was used to test for strength of association and adjusted R2 values calculated to determine if subcutaneous fat thickness or body mass index was more strongly associated with skin-to-epidural space distance. ResultsThe 463 women had a median (IQR) booking body mass index of 25.0 kg/m2 (21.8–29.3) and subcutaneous fat thickness of 16.2 mm (13.0–21.0). The median (IQR) skin-to-epidural space distance was 5.0 cm (4.5–6.0). Both parameters significantly correlated with skin-to-epidural space distance (r=0.53 and 0.68 respectively, P <0.001). Adjusted linear regression coefficient (95% CI) for subcutaneous fat thickness was 0.09 (0.08 to 0.11), R2=0.30 and for body mass index 0.12 (0.11 to 0.13), R2=0.47. ConclusionsBooking body mass index had a stronger relationship with skin-to- epidural space distance at delivery than subcutaneous fat thickness, explaining 47% of the variation in the skin-to-epidural distance.

Variations in the Temperature-Humidity Index and Dorsal Fat Thickness during the Last Trimester of Gestation and Early Postpartum Period Affect Fertility ofBos indicusCows in the Tropics

In order to measure the influence of the temperature-humidity index (THI) and the variation of fat thickness on reproductive performance, ninety-two Bos indicus cows kept under grazing conditions were used in two farms in Veracruz (Mexico) and Puntarenas (Costa Rica). THI was calculated with the average environmental temperature and relative humidity. Measurements of fat thickness (FAT) were taken two weeks apart from the last trimester of gestation to approximately 80 days postpartum (dpp). Natural breeding was used in both farms. Time to conception was calculated based on the interval from days at risk to conception (DRC), which had to be at least 28 dpp. THI was between 65.4 ± 2.9 and 73.2 ± 1.5 in Veracruz and 75.4 ± 0.26 and 76.5 ± 0.55 in Puntarenas. Variations in THI were observed in Puntarenas whereas in Veracruz THI variations were more prominent. In Veracruz, loss of fat during the last trimester of gestation was on average 8.5%, whereas in the postpartum period it was 18.4% (P = 0.042). In Puntarenas, the variation in the last trimester of gestation was on average 18.7% and in the postpartum period was 10.5% (P = 0.012). The relative change in FAT in Veracruz was 36.7%, and in Puntarenas it was 29.3%. Overall, 60% of the cows became pregnant. FAT decreased the interval of DRC (R2=0.06; P=0.033) with a high relationship (R2=0.76; P< 0.0001) between THI and time to conception, in both farms. In conclusion, THI levels influence the reproductive performance in early postpartum period affecting DRC.

Body fat index: A novel alternative to body mass index for prediction of gestational diabetes and hypertensive disorders in pregnancy

ObjectivesTo evaluate the association of ultrasound measurement of maternal abdominal subcutaneous and pre-peritoneal fat thickness in relation to the subsequent diagnosis of gestational diabetes (GDM), and to assess the association of body fat index (BFI), compared to conventional body mass index (BMI), with respect to the development of some obstetric related complications. Study designA prospective study included non-diabetic pregnant women who were scheduled for fetal anatomic survey. Women underwent fat measurements and BFI (pre-peritoneal fat x subcutaneous fat/height) was calculated. They underwent routine glucose screening and diagnostic tests for GDM. Obstetric complications, mode of delivery, and delivery related events were reported. Multivariable logistic regression was used to test potential predictors for development of obesity-related complications. Primary outcome was development of GDM. Secondary outcomes included development of hypertensive disorders during pregnancy and need for cesarean delivery due to labor dystocia. The optimal cut-off points for continuous variables were obtained using a receiver operating characteristic (ROC) curve analyses. Results389 women met study criteria. Median gestational age at time of ultrasound evaluation was 19.1 weeks. Positive family history of diabetes (adjusted odds ratio “OR” 2.30, 95% CI 1.35–3.92), history of GDM (adjusted OR 6.87, 95% CI 3.03–15.61), subcutaneous fat≥13 mm (adjusted OR 4.63, 95% CI 1.60–13.38) and pre-peritoneal fat≥12 mm (adjusted OR 3.32, 95% CI 1.06–10.42) were significant predictors for development of GDM.ROC analysis demonstrated that a BFI > 0.5 was statistically superior to a BMI > 25 or 30 as a predictor of gestational diabetes (adjusted OR 6.24, 95% CI 1.86–20.96). A Similar ROC analysis demonstrated that a BFI > 0.8 was associated with a higher risk for the development of hypertensive disorders of pregnancy (adjusted OR 2.70 [95% CI 1.60–4.55]), and need for cesarean delivery (adjusted OR 2.01[95% CI 1.23–3.28]) than a BMI > 25 or 30. ConclusionValues obtained by ultrasound measurement of subcutaneous and pre-peritoneal fat are associated with development of GDM and hypertensive disorders in pregnancy. Our data suggest that BFI was a better predictor than BMI for development of GDM and hypertensive disorders in pregnancy and should be studied further.

Intra-abdominal fat measurement by ultrasonography: association with anthropometry and metabolic syndrome in adolescents

ObjectiveTo associate intra-abdominal fat thickness measured by ultrasonography to the factors related to metabolic syndrome and to determine cutoff points of intra-abdominal fat measurement associated with a greater chance of metabolic syndrome in adolescents. MethodsThis was a cross-sectional study, with 423 adolescents from public schools. Intra-abdominal fat was measured by ultrasonography. Anthropometric data were collected, and biochemical analyses were performed. ResultsIntra-abdominal fat was measured by ultrasonography, showing a statistically significant association with the diagnosis of metabolic syndrome (p=0.037), body mass index (p<0.001), elevated triglyceride levels (p=0.012), decreased plasma HDL levels (p=0.034), and increased systemic blood pressure values (p=0.023). Cutoff values of intra-abdominal fat thickness measurements were calculated by ultrasound to estimate the individuals most likely to develop metabolic syndrome. In the logistic regression models, the cutoff values that showed the highest association with metabolic syndrome in males were 4.50, 5.35, 5.46, 6.24, and 6.50cm for the ages of 14, 15, 16, 17, and 18/19 years, respectively. In the female gender, the cutoff values defined for the same age groups were 4.46, 4.55, 4.45, 4.90, and 6.46cm. In an overall analysis using the ROC curve, without gender and age stratification, the cut-off of 3.67cm showed good sensitivity, but low specificity. ConclusionUltrasonography is a useful method to estimate intra-abdominal adipose tissue in adolescents, which is associated with the main factors related to obesity and metabolic syndrome.

Physiological variations in reproductive and metabolic features of white-tailed deer (Odocoileus virginianus) bucks throughout the rutting season

White-tailed deer farming is a growing industry in the United States, yet there is still a need to improve breeding practices in captive cervids. The objective of this study was to compare reproductive and somatic characteristics of white-tailed bucks early in the breeding season (September), at peak rut (December), and late breeding season (March). We hypothesized that reproductive parameters would improve at the peak of the breeding season. Young, mature bucks (n = 7–11, ages 2–3 yr) were anesthetized via projector with tiletamine-zolazepam and xylazine. Semen was collected by electroejaculation and evaluated for sperm output, motility, and morphology. The bulbourethral, vesicular, and prostate glands were measured by transrectal ultrasound. Body condition score, thoracic circumference, rump fat thickness, scrotal circumference, and testicular measurements were also recorded. Serum testosterone, estradiol, and IGF-I concentrations were measured. Body condition score and rump fat thickness were highest in September, intermediate in December, and lowest in March (p < 0.01), whereas thoracic circumference was lowest in September (p = 0.02). In September, serum IGF-I was highest (p < 0.01) and estradiol was lowest (p ≤ 0.02). Serum testosterone levels were lowest in March and highest in December (p < 0.01). Testicular volume and scrotal circumference were highest in September, intermediate in December, and lowest in March (p < 0.01). Bulbourethral gland length was greatest in March (p ≤ 0.05), whereas prostate length was greatest in September (p ≤ 0.02). Vesicular gland length and width were highest in December, intermediate in September, and lowest in March (p ≤ 0.02). Both overall and progressive sperm motilities were lowest in March (p < 0.01), but did not differ between September and December (p ≥ 0.12). In December, bucks had the highest percentage of normal sperm and lowest percentage of primary sperm defects (p ≤ 0.01). Collectively, our results demonstrated variation in reproductive and metabolic characteristics of white-tailed deer bucks throughout the breeding season at 40°N. The physiological variations described here will be useful for veterinarians and researchers performing reproductive evaluations in white-tailed deer bucks.

A-mode and B-mode ultrasound measurement of fat thickness: a cadaver validation study.

With technological advances, there has been a resurgence in ultrasound as a method to measure subcutaneous fat thickness. Despite the increased interest in this methodology, research comparing A-mode and B-mode ultrasound devices is lacking. Subcutaneous fat thickness measured by a low resolution (2.5 MHz) A-mode ultrasound and a high resolution (12 MHz) B-mode ultrasound were compared to the actual fat thickness in dissected cadavers. Subcutaneous fat thickness of six cadavers was measured at the abdomen, thigh, triceps, and calf (plus chest for males and suprailiac for females) with both ultrasound devices before the cadavers were dissected and site-specific thickness was measured. Correlations between both ultrasounds and the dissected measurement exceeded 0.90 at all sites with a few exceptions. At the abdomen, the relationship between the ultrasounds was 0.76, and the B-mode and dissected measurement was also 0.76. The correlation between dissection and A-mode was 0.75 for the suprailiac site, but it was not possible to discern the separation of tissue at this site when using the B-mode device. There were no significant differences (P > 0.05) between the devices and the dissected measurement at any of the six sites. The mean difference in fat thickness between A-mode and B-mode was <0.7 mm at all sites except the calf (1.2 mm) CONCLUSION: With the exception of the suprailiac site, both A-mode and B-mode ultrasound are equally capable of providing measurements of subcutaneous fat thickness with an accuracy of <1 mm at most sites.

Point-of-Care Ultrasound to Evaluate Thickness of Rectus Femoris, Vastus Intermedius Muscle, and Fat as an Indicator of Muscle and Fat Wasting in Critically Ill Patients in a Multidisciplinary Intensive Care Unit.

Background:Muscular atrophy is the universal feature in patients with ICUAW. Muscles of the lower limb are more prone to early atrophy. Measurement of fat thickness is used to assess malnutrition. This study was designed to evaluate if, subcutaneous fat also reduces along with muscle thickness and if it can be reliably used as an indicator of nutritional assessment in critically ill patients using point of care ultrasound.Materials and Methods:An observational clinical study of 100 patients admitted to multidisciplinary intensive care units (ICUs). Total anterior thigh thickness, thickness of the rectus femoris muscle, fat thickness, and the combined thickness of vastus intermedius and rectus femoris were taken on day 1, 3, and 7 of ICU admission.Results:There was progressive loss of muscle mass from day 1 to day 7. Muscle loss was not only limited to rectus femoris, but vastus intermedius also showed a significant decrease as indicated by the bone to muscle measurement. Skin to bone measurement which includes both muscle and fat compartment showed a decline.Conclusions:There is potential utility of ultrasound for early detection and probable corrective measures to prevent ICUAW. The rectus femoris thickness, skin to bone, and bone to muscle thickness show statistically significant difference on day 3, day 7 compared to day 1. Fat layer did not show statistically significant decrease.

Association of Body Fat Thickness with Vitamin D Levels in Obese Adolescent

Background: The number of obese people in children and adolescents is increasing. Along with that, comorbidity due to obesity will increase. One comorbid in obesity is low vitamin D levels. Obese children and adolescents with vitamin D deficiency have a higher BMI and thicker fat tissue. Objective: To determine the relationship between body fat thickness and vitamin D levels in obese adolescents. Methods: This study is an analytical cross-sectional study with the subject of obese adolescents, recruited consecutively at several junior secondary schools in the city of Denpasar from September 2016 to June 2017. Measurement of body fat thickness using Holtain Skinfold Caliper and examination of vitamin D levels with chemiluminescent immunoassay. The relationship between body fat thickness and vitamin D levels was tested using linear regression. Result: Thirty-three subjects analyzed had mean BMI 30.85 kg/m2 average suprailiac fat thickness is 3.62, with standard deviation 0.79. Mean vitamin D levels is 19.23 ng/mL, standard deviation 4.14 ng/mL. There was a weak negative relationship between the suprailiac body fat thickness and vitamin D levels (r=0.390; p=0.025). Conclusion: Body fat thickness with vitamin D levels in obese adolescent has a weak negative relationship.

Pericardial Fat Volume Measured on Cardiac Magnetic Resonance is an Independent Predictor of Infarct Scar Characteristics and Left Ventricular Function in Patients with ST-Elevation Myocardial Infarction

Background: Measurements of right ventricular free-wall fat thickness on echocardiogram correlate with severity of ST-elevation myocardial infarction (STEMI), but not with ex vivo pericardial fat mass, and thus does not predict coronary artery disease severity. The relationship between pericardial fat and infarct scar (IS) characteristics has not been well established. Our study aimed to analyse how pericardial fat volume (PFV) predicts IS characteristics and left ventricular function (LVF).

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.