Fat Volume Research Articles

Hyperplasia of fat-containing cells with mature adipocyte marker is associated with pancreatic fat enlargement

Abstract Objectives: The purpose was to elucidate the specific characteristics of fat-containing cells in the pancreas and the mechanism of intra-pancreatic fat deposition (IPFD) in humans. Methods: 15 Japanese patients who had undergone pancreatic resection were enrolled and the normal region of pancreatic samples from each patient was examined. To evaluate the characteristics of fat-containing cells, immunostaining for adiponectin and perilipin 1 was performed and the relationships between the pancreatic fat-cell area or clinical parameters, and the density or the diameter of the fat cells was analyzed. Results: Expression of adiponectin in the cytoplasm and perilipin 1 along the plasma membrane were observed in fat-containing cells in the pancreas. The fat-containing cell area had a significant positive correlation with cell density (r = 0.58, p = 0.023). In addition, fat-containing cell density was significantly positively correlated with homeostasis model assessment insulin resistance (HOMA-IR) (r = 0.61, p = 0.045). Fat-containing cell area was not significantly correlated with cell diameter (r = 0.45, p = 0.095). The diameter of fat-containing cells had significant positive correlations with BMI (r = 0.79, p < 0.001), fasting immunoreactive insulin (r = 0.65, p = 0.029) and HOMA-IR (r = 0.80, p = 0.003). Of all fat-containing cells, 10.4% were intralobular cells, and the diameter of intralobular cells showed a tendency for positive correlation with age (r = 0.52, p = 0.057). Conclusions: The characteristics of fat-containing cells in the pancreas indicate that some of them may be mature adipocytes, and fat volume may be increased by hyperplasia of fat-containing cells associated with insulin resistance. Key terms: pancreatic fat, adipocytes markers, hyperplasia of fat-containing cells, insulin resistance.

Coronary Computed Tomography Angiography in Heart Transplant Patients: Current Insights and Future Directions

Cardiac allograft vasculopathy (CAV) remains a significant challenge after heart transplantation, necessitating effective surveillance methods. This review centers around the role of coronary computed tomography angiography (CCTA) in CAV surveillance, given its unique capabilities to visualize and quantify CAV in comparison with other imaging modalities, including invasive coronary angiography and intravascular ultrasound. CCTA has shown good diagnostic performance for detecting and monitoring CAV, exemplified by a higher sensitivity and negative predictive value compared with invasive coronary angiography. Additionally, CCTA can provide valuable functional insights with fractional flow reserve integration. An additional, considerable benefit of CCTA is that it allows for the opportunity to assess other imaging markers of cardiometabolic and general health, including coronary artery calcium score, epicardial fat volume, liver fat, vertebral bone density, and lung density, which allows for a comprehensive assessment of the overall health of the patient.

Abstract 4140191: ChREBP Drives Brown Adipocyte Differentiation and Lipid Utilization for Excess Energy Expenditure

Introduction: Although several anti-obesity drugs have become recently available, they reduce patients’ appetite, which might worsen cardiovascular disease (CVD) prognosis by malnutrition/cachexia. Brown adipose tissue (BAT) oxidizes glucose and lipids for thermogenesis, a process that requires excess energy expenditure provided by uncoupling protein 1 (UCP1) + cells. Recently, critical roles of BAT in cardio-protection have been discovered. Taken together, boosting BAT activity can be a novel anti-obesity treatment suitable for CVD patients. In this study, we aimed to establish anti-obesity strategy by manipulation of the glucose-sensing lipid-storage transcription factor, ChREBP, with unexpected function of boosting lipid utilization in BAT. Methods and Results: Through mouse/human single-cell/nucleus RNA sequencing analyses, we identified ChREBP as specifically expressed in highly thermogenic UCP1 + brown adipocytes ( Fig.A ). To investigate the role of ChREBP in BAT formation, we generated human brown adipocyte-like model from induced pluripotent stem cells (iPSC-BAT, Fig.B ). The iPSC-BAT exhibited high UCP1 and ChREBP expression, multi-locular lipid droplets, and vigorous oxygen consumption. Knocking down ChREBP strongly blocked iPSC-BAT differentiation ( Fig.C ) and impaired lipid utilization ( Fig.D ). Consistently, in vitro deletion of ChREBP in mouse BAT progenitors impeded differentiation, lipid droplet accumulation, and oxygen consumption ( Fig.E-F ). In vivo, BAT-specific deletion of all ChREBP isoforms reduced lipid accumulation and BAT characteristics. Conversely, using a new mouse model for Cre-mediated ChREBPβ overexpression, we showed that ChREBPβ overexpression in BAT (Chβ BATOX) increased BAT cellularity and activated lipogenic machineries, with paradoxical decreased lipid content, suggesting excessively activated lipid consumption in BAT ( Fig.G ). More importantly, Chβ BATOX maintained UCP1 expression and reduced fat volume ( Fig.H ) even after strongly inhibiting BAT activity. Conclusion: In summary, ChREBP is essential for BAT development and thermogenic capacity by affecting lipid utilization. Our results suggest that ChREBPβ activation may be a novel anti-obesity avenue for CVD patients.

Safety and aesthetic evaluation of autologous dermal fat grafts for lateral Skull base defect reconstruction

ObjectiveThe selection of appropriate materials and techniques for reconstructing skull base defects is crucial for restoring function, minimizing complications, and enhancing aesthetics. Dermal fat grafts (DFGs) have been established in many surgeries for contour correction. However, there is little literature describing the application of free dermal fat grafts for reconstruction of lateral skull base surgery defects. Therefore, the aim of this study was to evaluate the clinical effect of using free dermal fat grafts in the reconstruction of lateral skull base defects.MethodsIn this study, 32 patients who underwent primary autologous free dermal fat graft reconstruction for lateral skull base defects were enrolled. Postoperative complications both in the donor and recipient area were evaluated. Three-dimensional (3D) reconstruction techniques were applied to visualize the fat graft shape and volume variations for the assessment of postoperative restoring function. A telephone questionnaire was used for the assessment of postoperative facial aesthetics and patient satisfaction.ResultsA total of 32 patients who met the inclusion criteria were included in the study, showing satisfying results in safety and aesthetics. Participants’ ages averaged at 42.03 years, with the youngest being 18 and the oldest at 75 years old. No patient had postoperative complications of abdominal wounds in the donor area, only two patients had postoperative infections and one patient had a postoperative effusion in the recipient area. The volume of the grafts ranged from a minimum of 24.4 cm³ to a maximum of 131 cm³, with the highest recorded resorption volume being 33.63 cm³. The average resorption rate of the dermal fat graft was 24.36%, ranging from a minimum of 11% to a maximum of 43%. 3D reconstruction based on MRI imaging data indicated that DFGs have a lower resorption rate than traditional free fat grafts. The telephone questionnaire revealed high patient satisfaction with facial aesthetics, with the majority rating their outcomes positively.ConclusionsDermal fat grafts have fewer complication and can provide better resistance to infection and radiation aspect. Based on 3D reconstruction techniques via MRI imaging data, we found that dermal fat grafts have lower resorption rate than traditional free fat grafts, which can be a suitable material for reconstruction of lateral skull base defects.

A New Method of Orbital Septal Fat Flap in Transconjunctival Approach.

Orbital fat release is critical in blepharoplasty for correcting tear trough deformities, but traditional transconjunctival approaches often face limitations due to restricted fat volume and pedicle length. This study introduces an innovative technique by reconstructing the orbital fat flap, aiming to improve tear trough coverage and optimize Aesthet outcomes. The technique is achieved by reconstructing the orbital fat flap. To enhance fat survival, meticulous preservation of the pedicle's vascular supply was ensured during surgery. Microsurgical techniques were employed to precisely dissect and position the fat flap, ensuring full coverage of the tear trough area while maintaining facial symmetry. Postoperative follow-up was conducted to evaluate functional and Aesthet outcomes. The modified technique resulted in complete tear trough coverage and significant reduction in postoperative retraction. Patients reported improved Aesthet outcomes, with natural restoration of the lower eyelid contour and preservation of the culturally significant "Lower-lid Pretarsal Roll" appearance. No major complications such as fat atrophy or eyelid retraction were observed. This new technique for extending the orbital fat flap in blepharoplasty offers better coverage of tear trough deformities, reduces the risk of postoperative complications, and improves patient satisfaction, making it an important advancement in eye contour surgery. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Asymmetry of the Frontal Aslant Tract and Development of Supplementary Motor Area Syndrome

Background/Objectives: The purpose of this study was to investigate preoperative interhemispheric differences of the FAT in relation to the onset of postoperative SMA syndrome. Methods: This was a single-center retrospective analysis of patients who underwent surgical resection of diffuse gliomas involving the SMA between 2018 and 2022. Inclusion criteria were availability of preoperative and postoperative Magnetic Resonance Imaging, no previous surgery, and no neurological deficits at presentation. Diffusion-weighted data were processed by spherical deconvolution (SD) and diffusion tensor imaging tractography algorithms, and TrackVis was used to dissect the FAT of both hemispheres. The FAT data were analyzed for correlation with postoperative SMA syndrome onset. Results: N = 25 cases were included in the study, among which n = 23 had preoperative bilaterally identifiable FAT by SD. N = 12 developed an SMA syndrome, 6 demonstrated a motor-only syndrome, 4 had a verbal-only syndrome, and 2 had mixed verbal and motor features. The SMA syndrome incidence was significantly more frequent in lower-grade gliomas (p = 0.005). On the tumor side, the FAT identified by SD was smaller than the contralateral (mean volume 6.53 cm3 and 13.33 cm3, respectively, p < 0.001). In the 6 cases that developed a verbal SMA syndrome, a normalized FAT volume asymmetry (FAT-VA) demonstrated an asymmetry shifted towards the non-dominant side (mean FAT-VA = −0.68), while the cases with no postoperative verbal impairment had opposite asymmetry towards the dominant side (mean FAT-VA = 0.42, p = 0.010). Conclusions: Preoperative interhemispheric FAT volume asymmetry estimated according to functional dominance can predict postoperative onset of verbal SMA syndrome, with proportionally smaller FAT on the affected dominant hemisphere.

Relationship between physical activity and abdominal obesity and metabolic markers in postmenopausal women

This study aimed to investigate the impact of physical activity indicators monitored by the POLAR accelerometer on body obesity indicators, metabolic syndrome parameters, and energy metabolism hormones in postmenopausal women. Was included 71 participants from this study program (68.8 ± 4.3 years). We divided participants into LPA and MVPA groups based on their level of moderate to vigorous physical activity per week; Physical activity levels over 7 days were assessed using a POLAR accelerometer, with daily step counts and sedentary time recorded. Measurements included waist circumference, visceral fat volume, body fat percentage, blood pressure, fasting blood glucose, triglyceride levels, HDL cholesterol, and energy metabolism hormone levels (leptin, resistin, adiponectin). The MVPA group displayed lower waist circumference, body fat percentage, abdominal fat, and BMI compared to the LPA group (p < 0.05). A significant negative correlation was observed between daily step count and obesity indicators, including waist circumference (r = -0.301), body fat percentage (r = -0.295), abdominal fat (r = -0.318), and BMI (r = -0.238). Conversely, sedentary time showed a positive correlation with obesity indicators such as waist circumference (r = 0.258), body fat percentage (r = 0.239), and abdominal fat (r = 0.244). Moreover, daily step count exhibited a significant negative correlation with leptin levels (r = -0.245), while sedentary time was positively correlated with the energy metabolic factor leptin (r = 0.279). Waist circumference demonstrated significant positive correlations with triglycerides, blood glucose, adiponectin, resistin, and leptin levels. Postmenopausal women who engage in at least 150 min of MVPA weekly show lower obesity indices. There is a significant correlation between physical activity levels and obesity indicators, which relate to metabolic syndrome and energy metabolism factors. Thus, increased physical activity may help prevent metabolic syndrome and cardiovascular diseases in this population.

Noninvasive predictors of residual coronary microvascular dysfunction after elective percutaneous coronary intervention

Abstract Backgrounds Coronary computed tomographic angiography (CCTA) provides noninvasive assessments of coronary plaque morphologies and perivascular inflammation. Morphological features associated with residual coronary microvascular dysfunction (CMD) after elective percutaneous coronary intervention (PCI) remains unknown. Purpose This study aimed to examine prevalence and predictors of residual CMD and its phenotypes after elective PCI. Methods We investigated consecutive patients who were scheduled for elective fractional flow reserve (FFR)-guided PCI for de novo single lesions with pre-PCI CCTA data. Pre- and post-PCI comprehensive physiological assessments including coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) were performed by using pressure temperature sensor-tipped guidewire in all patients. Patients with periprocedural myocardial infarction were excluded. Residual CMD was defined as lesions with post-PCI coronary flow reserve (CFR) &amp;lt;2.0, which was further categorized as functional (IMR&amp;lt;25) or structural (IMR ≥25) CMD. Results A total of 198 de novo lesions in 198 patients were included in the final dataset. Pre- and post-PCI mean CFR were 1.79 [1.27, 2.53] and 2.72 [2.00, 4.04], respectively. Residual CMD was observed in 24.7% (49/198) of patients, categorized as functional (n=26) or structural (n=23). Patients with residual CMD showed older age, less frequent diabetes mellitus, current smoking and a culprit lesion in left anterior descending artery (LAD), and higher CCTA-defined calcium score in the culprit vessel compared with those in patients without residual CMD. Multivariable logistic regression analysis showed that age (adjusted odds ratio [OR]:1.04; 95% confidence interval [CI]: 1.00 to 1.08; p=0.04) and non-LAD (adjusted OR: 2.18; 95%CI: 1.03 to 4.63; p=0.04) were independently associated with residual CMD. In patients with residual CMD, patients with structural CMD tended to have more frequent diabetes mellitus (43.5% vs 19.2%, P=0.13) and atrial fibrillation (26.1% vs 7.7%) and showed significantly lower pericoronary adipose tissue attenuation (PCATA) in right coronary artery (RCA) by CCTA (-79.9 HU vs -74.6 HU, P=0.04) compared with patients with functional CMD. CCTA-detected epicardial fat volume and attenuation showed no significant differences between patients with residual functional CMD, those with residual structural CMD, and those without residual CMD. Multivariable analysis revealed that diabetes mellitus (adjusted OR: 5.18; 95%CI: 1.14 to 23.7; p=0.03) and PCATA in RCA (adjusted OR: 0.93; 95% CI: 0.85 to 1.00; p=0.05) were independently predictive of residual structural CMD. Conclusions Residual CMD was observed in approximately 25% of patients undergoing elective PCI. CCTA-defined calcium score and PCATA, along with clinical factors could be potential predictors of post-PCI residual CMD and its phenotypes.

The dynamic increment of epicardial adipose tissue is associated with reverse remodeling after guideline-directed medical treatment in dilated cardiomyopathy patients

Abstract Background/Introduction Epicardial adipose tissue (EAT) accumulation is associated with adverse prognosis in patients with HFpEF and a better prognosis in HFrEF patients. Whether EAT is playing a protective role in dilated cardiomyopathy (DCM) patients have been described sparingly. Purpose Aim to explore whether the epicardial fat would change along with the dynamic changes in cardiac function and volumes after receiving guideline-directed medical therapy (GDMT) in patients with DCM. Methods We prospectively enrolled 232 DCM patients who underwent complete baseline and follow-up Cardiac magnetic resonance (CMR) examinations. The measurement of the epicardial fat composition includes epicardial fat thickness, paracardial fat thickness, and paracardial fat volume, while the measurement of body fat composition includes subcutaneous and visceral abdominal fat, while We used univariable and multivariable logistic regression to evaluate the association between different body and cardiac fat depots with the changes in bi-ventricular structure (delta indexed EDV) and function (delta EF). Results The study included 232 patients (mean age 46.1±14.1 years, 157 (67.7%) males). After GDMT, we found that the visceral fat thickness and EAT (thickness and volume) tend to significantly increase. The increase in the (left ventricular reverse remodeling) LVRR group was significantly higher compared with the non-LVRR group. Independently with the changes of BMI and body fat depots, the increment of EAT was associated with the improvement in bi-ventricular function and volumes (significantly positively correlated with the improvement of LVEF (r = 0.499, p &amp;lt; 0.001), and RVEF (r = 0.482, p &amp;lt; 0.001), negatively correlated with delta LVEDVi (r = -0.407, p &amp;lt; 0.001), delta RVEDVi (r = -0.305, p &amp;lt; 0.001)). Conclusions After GDMT, the increment of EAT was positively correlated with the improvement of bi-ventricular structure and function, independent of the changes in BMI and body fat depots.Graphic Abstract

Evaluating the role of pericoronary adipose tissue on coronary artery disease: insights from CCTA on risk assessment, vascular stenosis, and plaque characteristics.

Pericoronary adipose tissue (PCAT) plays a significant role in the occurrence and progression of coronary artery disease (CAD). This study investigates the relationship between PCAT and CAD, focusing on the occurrence of the disease, the severity of vascular narrowing, and the characteristics of arterial plaques. We analyzed a cohort of 152 individuals with CAD and 55 individuals with non-coronary artery disease (N-CAD). Participants underwent both coronary computed tomography angiography (CCTA) and digital subtraction angiography (DSA). Utilizing United Imaging software for artificial intelligence delineation, we measured the fat attenuation index (FAI) and volume of PCAT in the left anterior descending (LAD), left circumflex (LCX), and right coronary arteries (RCA). Our findings demonstrate that while CCTA is effective in diagnosing CAD compared to DSA, its diagnostic power for individual coronary arteries remains limited. Further analysis revealed that the FAI of the RCA and the overall PCAT volume independently influenced CAD (OR: 1.057, 95% CI: 1.002 to 1.116; OR: 0.967, 95% CI: 0.936 to 0.999). FAI showed a significant independent effect on RCA stenosis (OR: 1.041, 95% CI: 1.003 to 1.081), while the fat volume of the LAD had a significant independent effect on LAD stenosis (OR: 0.884, 95% CI: 0.809 to 0.965). A higher FAI and a lower fat volume were significantly correlated with more severe vascular stenosis percentages in all three arteries (p < 0.05), except for the fat volume and stenosis of the LCX. Moreover, we found the significant differences in the fat volume of the LCX between different plaque types (H = 8.869, p = 0.012), with calcified plaques consistently exhibiting the lowest fat volume across all three arteries. Finally, the likelihood ratio test confirmed that incorporating the PCAT fat volume parameter of LAD significantly improved the diagnostic ability of CCTA for both CAD (p = 0.01543) and LAD stenosis (p = 0.001585). The quantification of PCAT has potential application value in the comprehensive assessment of CAD. It is recommended that cardiology and radiology departments consider incorporating PCAT into the assessment criteria for patients suspected of having CAD.

Association between Body Fat Distribution and Nonalcoholic Fatty Liver Disease/Fibrosis Based on Race/Ethnicity.

Body fat distribution may impact nonalcoholic fatty liver disease (NAFLD) and significant fibrosis differently according to race/ethnicity. We determined the relationship between body fat distribution and NAFLD/significant fibrosis according to race/ethnicity. A cross-sectional study of 2,395 participants used the National Health and Nutrition Examination Survey 2017 to 2018. NAFLD and significant fibrosis (≥F2) were defined by controlled attenuation parameter scores and liver stiffness measurements on transient elastography, respectively. Visceral and subcutaneous fat volumes were defined by dual-energy X-ray absorptiometry. The odds ratio (OR) for NAFLD per 1-standard deviation in visceral fat volume and subcutaneous fat volume was 2.31 (95% confidence interval [CI], 1.50 to 3.39) and 1.93 (95% CI, 1.43 to 2.61) in total population, respectively. Visceral fat in non-Hispanic Blacks had the highest odds for NAFLD (OR, 2.86; 95% CI, 1.45 to 5.62), and non-Hispanic Whites (OR, 2.29; 95% CI, 1.19 to 4.40) and non-Hispanic Asians (OR, 1.61; 95% CI, 1.13 to 2.29) were in order. Significant associations between subcutaneous fat volume (OR, 2.10; 95% CI, 1.34 to 3.29; P=0.003) or visceral fat volume (OR, 1.35; 95% CI, 1.05 to 1.73; P=0.023) and significant fibrosis were noted among individuals with NAFLD. Hispanics had the highest odds for NAFLD-associated significant fibrosis (OR, 2.74; 95% CI, 1.32 to 5.70), and non-Hispanic Whites (OR, 2.35; 95% CI, 1.11 to 4.98) and non-Hispanic Asians (OR, 2.01; 95% CI, 1.01 to 4.01) were in order. Visceral adiposity was associated with NAFLD and significant fibrosis despite the association of subcutaneous adiposity in NAFLD and significant fibrosis. Racial/ethnic differences in the association between body fat distribution on NAFLD and significant fibrosis were noted.

Subcutaneous adipose tissue measured by computed tomography could be an independent predictor for early outcomes of patients with severe COVID-19.

Patients with severe Coronavirus Disease 2019 (COVID-19) can experience protein loss due to the inflammatory response and energy consumption, impairing immune function. The presence of excessive visceral and heart fat leads to chronic long-term inflammation that can adversely affect immune function and, thus, outcomes for these patients. We aimed to explore the roles of prognostic nutrition index (PNI) and quantitative fat assessment based on computed tomography (CT) scans in predicting the outcomes of patients with severe COVID-19. A total of 130 patients with severe COVID-19 who were treated between December 1, 2022, and February 28, 2023, were retrospectively enrolled. The patients were divided into survival and death groups. Data on chest CT examinations following admission were collected to measure cardiac adipose tissue (CAT), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) and to analyze the CT score of pulmonary lesions. Clinical information and laboratory examination data were collected. Univariate and multivariate logistic regression analyses were used to explore the risk factors associated with death, and several multivariate logistic regression models were established. Of the 130 patients included in the study (median age, 80.5 years; males, 32%), 68 patients died and 62 patients survived. PNI showed a strong association with the outcome of severe COVID-19 (p < 0.001). Among each part of the fat volume obtained based on a CT scan, SAT showed a significant association with the mortality of severe COVID-19 patients (p = 0.007). However, VAT and CAT were not significantly correlated with the death of patients. In the multivariate models, SAT had a higher predictive value than PNI; the area under the curve (AUC) of SAT was 0.844, which was higher than that of PNI (AUC = 0.833), but in the model of the combination of the two indexes, the prediction did not improve (AUC = 0.830), and SAT lost its significance (p = 0.069). Subcutaneous adipose tissue measured by computed tomography and PNI were found to be independent predictors of death in patients with severe COVID-19.

Enhancing radiologist's detection: an imaging-based grading system for differentiating Crohn's disease from ulcerative colitis

BackgroundDelayed diagnosis of inflammatory bowel disease (IBD) is common, there is still no effective imaging system to distinguish Crohn's Disease (CD) and Ulcerative Colitis (UC) patients.MethodsThis multicenter retrospective study included IBD patients at three centers between January 2012 and May 2022. The intestinal and perianal imaging signs were evaluated. Visceral fat information from CT images was extracted, including the ratio of visceral to subcutaneous fat volume (VSR), fat distribution, and attenuation values. The valuable indicators were screened out in the derivation cohort by binary logistic regression and receiver working curve (ROC) analysis to construct an imaging report and data system for IBD (IBD-RADS), which was tested in the validation cohort.ResultsThe derivation cohort included 606 patients (365 CD, 241 UC), and the validation cohort included 155 patients (97 CD, 58 UC). Asymmetric enhancement (AE) (OR = 87.75 [28.69, 268.4]; P < 0.001), perianal fistula (OR = 4.968 [1.807, 13.66]; P = 0.002) and VSR (OR = 1.571 [1.087, 2.280]; P = 0.04) were independent predictors of CD. VSR improved the efficiency of imaging signs (AUC: 0.929 vs. 0.901; P < 0.001), with a threshold greater than 0.97 defined as visceral fat predominance (VFP). In IBD-RADS, AE was the major criterion, VFP and perianal fistula were auxiliary criteria, and intestinal fistula, limited small bowel disease, and skip distribution were special favoring items as their 100% specificity. Grade 3 to 5 correctly classified most CD patients (derivation: 96.5% (352/365), validation: 98.0% (95/97)), and 98% of those were eventually diagnosed with CD (derivation: 97.8% (352/360), validation: 98.0% (95/97)).ConclusionsIBD-RADS can help radiologists distinguish between CD and UC in patients with suspected IBD.

8740 Visceral Adipose Tissue Assessment in Patients With Mild Autonomous Cortisol Secretion Using Dual-Energy X-Ray Absorptiometry: A Cross-Sectional Study

Abstract Disclosure: J. Saini: None. C.D. Zhang: None. V. Fell: None. E. Atkinson: None. S. Achenbach: None. I. Bancos: None. Background: Several studies employing computed tomography (CT) scans for body composition measurements have reported lower muscle mass and a higher proportion of visceral fat in patients with mild autonomous cortisol secretion (MACS) compared to referent subjects. While a CT scan assesses visceral adipose tissue (VAT) at a single slice level (L3), no studies have evaluated the overall VAT in patients with MACS using Dual-Energy X-ray absorptiometry (DXA). Objective: To determine the impact of MACS on VAT using DXA scan as compared to referent subjects. Methods: We conducted a single-center cross-sectional study of adults with 75 MACS and 75 referent subjects. MACS was defined as serum cortisol&amp;gt;1.8 mcg/dL after 1 mg dexamethasone suppression test in patients with adrenal adenomas and no features of overt hypercortisolism. Referent subjects were included if they had abdominal imaging and had no adrenal disorders. All the participants underwent a full body DXA scan between 04/2019 and 07/2022. We applied the CoreScan software to estimate the (1) total lean and fat mass (2) visceral fat mass and volume (3) lean android, fat android, and android mass, and compared measurements of patients and referent subjects using linear regression models adjusted for sex and BMI. Results: A total of 75 patients with MACS (median age 57.0 years, IQR 47.8-65.6, 67% women) and 75 referent subjects (median age 57.6 years, IQR 49.1-65.8, 67% women) were included. Patients had a higher BMI compared to referent subjects (median 31.7 kg/m2, IQR 27.4-37.9 vs 28.7, IQR, 25.4-33.8, P=0.004). The median post-DST cortisol in patients was 3.1 mcg/dL (IQR, 2.2-5.2). When compared to referent subjects, and after adjustment for sex and BMI, patients had a similar total body fat (estimate=846, p-value=0.28) and lean mass (estimate=-201, p-value=0.83), similar android fat mass (estimate=59, p-value=0.64) but lower gynoid fat mass (estimate=400, 0.007). Notably, sex and BMI-adjusted analysis also showed that patients had a higher VAT fat mass (estimate= -225, p-value=0.084) and a higher VAT fat mass/total mass ratio (estimate= -0.007, p-value=0.026). Conclusions: When adjusted for BMI and sex, patients with MACS do not demonstrate differences in overall fat and lean mass. However, we showed that MACS is associated with increased visceral adiposity, a known cardiovascular risk factor. Body composition assessment by DXA could be a safer and less expensive alternative in the evaluation and follow-up of patients with MACS. Presentation: 6/2/2024

Bioelectrical impedance analysis predicts prehypertension and hypertension: A hospital-based cross-sectional study

ABSTRACT Background: Hypertension prediction using anthropometry and bioimpedance offers practical advantages for screening. We aimed to analyze various anthropometric and bioelectrical impedance (BIA) estimates as predictive markers of prehypertension and hypertension. Methods: This cross-sectional analysis included 432 adult participants recruited from the medicine outpatient department of a tertiary hospital. Blood pressure measurements; anthropometric measurements of weight, body mass index, waist circumference, and hip circumference; and BIA (Omron HBF 375) were performed for body fat%, resting metabolic rate, visceral fat level, and skeletal muscle percentage. Results: Of the 432 participants comprising 220 males and 212 females, 36.8% were normotensive, 42% were prehypertensive, and 21% were hypertensive. Visceral fat (r 0.662, 95% CI: 0.60–0.72, P &lt; 0.001) and resting metabolic rate (r 0.589, 95% CI: 0.52–0.65, P &lt; 0.001) had the highest positive correlation, while skeletal muscle percentage (r -0.551, 95% CI: -0.62 to -0.48, P &lt; 0.001) had a negative correlation with systolic blood pressure according to bivariate analysis. According to the receiver operating characteristic curve analysis for predicting hypertension, visceral fat volume had an area under curve (AUC) of 0.913, and resting metabolic rate had an AUC of 0.968, indicating the best predictive accuracy. Conclusion: Multiple BIA estimates, including high visceral fat content, resting metabolic rate, and adipose marker levels combined with low skeletal muscle percentage, were strongly associated with hypertension. Our analysis suggested the superiority of bioimpedance predictors over anthropometry-based prediction modeling alone for screening for hypertension in clinical practice.

Effects of a Sorghum Beverage with Lacticaseibacillus paracasei on Body Composition, Lipid Profiles, and Intestinal Health in Overweight and Obese Adults: A Randomized Single-Blind Pilot Study.

(1) Background: This study aimed to evaluate the effect of an extruded whole-grain sorghum beverage containing L. paracasei on body composition, lipid profiles, and intestinal health in overweight and obese adults. (2) Methods: A chronic, single-blind randomized controlled pilot study was conducted with 30 volunteers allocated to three groups (n = 10/group): extruded sorghum beverage (ESB), extruded sorghum beverage with L. paracasei (ESPB), and control beverage (CB) (waxy maize starch). The chemical composition of the beverages was analyzed. Volunteers consumed the beverages for ten weeks at breakfast, along with individual dietary prescriptions. Body composition, biochemical markers, gastrointestinal symptoms, stool consistency, intestinal permeability, short-chain fatty acids, fecal pH, and stool L. paracasei DNA concentration were analyzed at the beginning and end of the intervention period. (3) Results: The ESB showed better composition than the CB, particularly in terms of resistant starch content, total phenolic compounds, condensed tannins, and antioxidant capacity. Both the ESB and the ESPB had an effect on body composition (estimated total visceral fat and waist volume), biochemical markers (Castelli index I), and intestinal health (Bristol scale, diarrhea score, valeric acid, and L. paracasei DNA concentration). No changes were observed in the CB group after the intervention. (4) Conclusions: Whole-grain sorghum beverages demonstrated good nutritional value, and consumption of these beverages, with or without L. paracasei, provided health benefits, including improvements in body composition, Castelli index I scores, and intestinal health, in overweight and obese adults.

Evaluation of the Effect of Topical Prostaglandin Analog Treatment on Orbital Structures in Open-Angle Glaucoma with Computed Tomography

Background/Objectives: This study aims to evaluate the computed tomography (CT) scans of glaucoma patients using prostaglandin analogs (PGA) in one eye, investigate findings associated with prostaglandin-associated periorbitopathy (PAP), and compare these findings with those of the contralateral eyes. Methods: Patients with open-angle glaucoma who had CT images of the orbital region taken for another reason at least one month after starting PGA treatment in one eye were included in the study. Enophthalmos measurements from thin-slice CT images, along with 3D volume measurements of orbital fat tissue, periorbital muscles, and the optic nerve, were performed. Ophthalmological examination findings and treatment information were collected. The values were compared with those of the contralateral eyes of the same patients not using PGA. Intraclass correlation coefficients (ICCs) were computed to evaluate measurement repeatability. Results: Forty patients were included in the study. Among them, 29 (72.5%) used latanoprost, 9 (22.5%) used bimatoprost, and 2 (5%) used travoprost. The mean enophthalmos values on the treated side (15.5 ± 2.0 mm) were lower than on the untreated side (16.1 ± 1.4 mm), but this difference was not statistically significant (p = 0.07). In 29 patients (72.5%), enophthalmos measurements were smaller on the treated side, with 7 patients (17.5%) showing a difference of 2 mm or more. No significant correlation was found between the duration of PGA use and enophthalmos measurements (p = 0.768 r = −0.048). Additionally, no significant differences were found in orbital fat volume, total extraocular muscle volume, and optic nerve volume (p &gt; 0.05). ICC values demonstrated excellent reliability (ICC &gt; 0.75) for all measurements. Conclusions: We did not find significant differences in enophthalmos measurements, orbital fat volume, total muscle volume, and optic nerve volume between the PGA-treated and untreated eyes.

A full-face contouring using micro-autologous fat transplantation (MAFT)-gun technique in Vietnamese population

IntroductionMicro-autologous fat transplantation (MAFT)-gun technique is applied to accurately deliver small fat parcels to multiple fat layers in varied facial sites. Our study presented surgical and clinical outcomes of the MAFT-gun technique for full face contouring. MethodsFrom 01/2021 to 06/2023, 31 healthy participants undergoing fat grafting by MAFT-gun technique for volumization of their full face at our hospital were included. Data on fat volume grafted in different facial sites, complications, and satisfaction rate (%) were collected and analyzed. ResultsThe fat volumes grafted over the left and right cheek were 10.3 ± 0.31ml and 10.2 ± 0.30ml. The forehead and temples demanded lower fat volume by 9.8 ± 0.23ml and 4.5 ± 0.21ml. A small fat volume was required for the nasolabial fold, the tear trough, and the infraorbital areas, by 2.2 ± 0.11ml, 1.9 ± 0.10ml, and 1.4 ± 0.11ml. The fat volumes for the nasolabial fold and the tear trough were significantly different between young and old people. No complications including infection, necrosis, or vascular injury were noted. At the end of the follow-up, 26 patients (83.9%) expressed their satisfaction after the procedure. ConclusionThe MAFT-gun technique is safe and effective for full-face autologous fat grafting. Commercial closed-system processors could be an effective alternative to centrifugation for fat processing. The procedure contributed to the improvement of facial hollowness and brought a more attractive and satisfied appearance to people even after 12 months postoperatively.

Semaglutide “Ozempic” Face and Implications in Cosmetic Dermatology

ABSTRACTBackgroundSemaglutide, a glucagon‐like peptide‐1 receptor agonist, has been utilized for the treatment of type 2 diabetes. Recently, it has gained popularity for its ability to aid in weight loss. However, rapid weight loss induced by semaglutide has been shown to lead to noticeable facial volume loss and the appearance of a prematurely aged face referred to as “Ozempic face.” As this term gains more popularity and increasingly more nondiabetic patients seek rapid weight loss options, there is growing concern among patients and healthcare providers regarding using semaglutide for weight loss as it may have a negative impact on facial esthetics.ObjectiveThe purpose of this paper is to investigate the semaglutide face phenomenon associated with GLP‐1 agonist use for the treatment of obesity.MethodsA comprehensive search on PubMed was conducted to identify the available information related to semaglutide regarding Ozempic face. The search was conducted using a combination of keywords, including “semaglutide,” “semaglutide face,” and “Ozempic face.”Results“Semaglutide face” is recognized as having similar characteristics to a naturally occurring aging face. However, the characteristics of an Ozempic face occur in people much younger than what is seen with the natural aging process. While some believe that this phenomenon is attributed to acute weight loss at a faster rate than normal, many physicians argue that the semaglutide face phenomenon is more likely to occur with the amount of weight lost overall rather than whether that individual used a semaglutide medication to achieve the weight reduction or not. Overall, the semaglutide face phenomenon is characterized by elastin and collagen loss, fat and muscle volume loss, and excessive sagging skin.ConclusionsThe semaglutide face phenomenon highlights the esthetic implications of using semaglutide for the promotion of accelerated weight loss. While this term is not medically recognized, the hollow or sunken look following rapid weight loss sheds light on the effect of semaglutide in facial fat redistribution and volume loss. The metabolic changes induced by GLP‐1 agonists can impact adipose and muscle tissue, which can lead to changes in facial contour and overall appearance. While semaglutide‐induced facial changes may resemble signs of premature aging, they are distinct in their rapid onset and association with significant weight loss. Individuals experiencing semaglutide face have treatment options available depending on their own treatment goals.

Low visceral fat volume and hypoalbuminemia as prognostic markers in hospitalized patients with coronavirus disease 2019 during the Omicron variant epidemic

Background&AimsThe rate of severe cases of coronavirus disease 2019 (COVID-19) has decreased since the Omicron variant became epidemic. Visceral fat volume was a risk factor for COVID-19 severity with prior prevalent variants, but whether visceral fat volume remains a risk factor for the Omicron variant is unclear. We investigated the associations of clinical factors including visceral fat volume with severity and mortality among hospitalized patients with COVID-19 during the Omicron variant epidemic. MethodsThis was a single-center retrospective cohort study conducted at the Teikyo University Hospital in Japan. We included hospitalized patients with COVID-19 during the Omicron variant epidemic who underwent computed tomography of the abdomen. Clinical data were obtained from the medical records and visceral fat area (VFA) was measured using a 3-dimensional image analysis system volume analyzer. Severity was determined by the presence or absence of oxygen supplementation. ResultsAmong the 226 patients, 66 patients showed moderate severity and 29 patients were non-survivors. Hypoalbuminemia was associated with severity (odds ratio [OR] 3.93, 95% confidence interval [CI] 1.91–8.07; p=0.0002), and hypoalbuminemia (OR 8.38, 95%CI 2.37–29.58; p=0.0010) and low VFA (OR 3.40, 95%CI 1.15–10.06; p=0.027) were associated with mortality. Decision tree analysis showed that mortality rate in the hypoalbuminemia and low-VFA group (37.3%) was significantly higher than in other groups (p≤0.01). ConclusionsLow visceral fat volume and hypoalbuminemia were associated with mortality in hospitalized patients with COVID-19 during the Omicron variant epidemic. Classification by VFA and serum albumin may allow simple prediction of mortality risk among hospitalized patients with COVID-19.