Intra-abdominal Fat Volume Research Articles

Intra-abdominal fat volume estimation by multi-detector rows computed tomography: relevance in surgical fellowship training program in Shanghai: a retrospective study.

Intra-abdominal fat volume (IFV) has been shown to have a negative impact on surgical outcomes in gastric cancer (GC) and other gastrointestinal surgeries. The purpose of this study is to look into the relationship between IFV and perioperative outcomes in GC patients using multi-detector rows computed tomography (MDCT) and assess the importance of implementing this observation in current surgical fellowship training programs. Patients with GC who underwent open D2 gastrectomy between May 2015 and September 2017 were included in the study. Based on MDCT estimation, patients were divided into high IFV (IFV ≥ 3,000 ml) and low IFV (IFV < 3,000 ml) groups. Perioperative outcomes for cancer staging, type of gastrectomy, intraoperative blood loss (IBL), anastomotic leakage, and hospital stay were compared between the two groups. This study was registered as CTR2200059886. Out of 226 patients, 54 had early gastric carcinoma (EGC), while 172 had advanced gastric carcinoma (AGC). There were 64 patients in the high IFV group and 162 in the low IFV group. The high IFV group had significantly higher IBL mean values (p = 0.008). Therefore, having a high IFV was a risk factor for the occurrence of perioperative complications (p = 0.008). High IFV estimated by MDCT prior to GC surgery was associated with increased IBL and postoperative complications. Incorporating this CT-IFV estimation into surgical fellowship programs may aid aspiring surgeons in selecting patients during independent practice in their learning curve and surgical practice for the most appropriate approach for treating GC patients.

Intra-abdominal fat volume estimation by multi-detector rows computed tomography: relevance in surgical fellowship training program in Shanghai: a retrospective study

Intra-abdominal fat volume estimation by multi-detector rows computed tomography: relevance in surgical fellowship training program in Shanghai: a retrospective study

Association of Serum Myostatin with Body Weight, Visceral Fat Volume, and High Sensitivity C-Reactive Protein But Not With Muscle Mass and Physical Fitness in Premenopausal Women.

The myokine myostatin regulates muscle mass and has been linked to insulin resistance and metabolic syndrome. However, data on its role in humans is still limited. We, therefore, investigated the associations of serum myostatin with muscle mass, physical fitness, and components of the metabolic syndrome in a cohort of premenopausal women. We undertook a cross-sectional analysis of 233 women from the monocenter study PPSDiab, conducted in Munich, Germany. Participants had recently completed a pregnancy with or without gestational diabetes. Our analysis included medical history, anthropometrics, oral glucose tolerance testing, laboratory chemistry, cardiopulmonary exercise testing, and magnetic resonance imaging (n=142) of visceral fat volume, left quadriceps muscle mass, and muscle fat content. Serum myostatin was quantified by a competitive enzyme-linked immunosorbent assay. We observed positive correlations of serum myostatin with body mass index (ρ=0.235; p=0.0003), body fat percentage (ρ=0.166; p=0.011), waist circumference (ρ=0.206; p=0.002), intraabdominal fat volume (ρ=0.182; p=0.030) and high-sensitivity C-reactive protein (ρ=0.175; p=0.008). These correlations were reproduced in linear regression analyses with adjustment for age and time after delivery. We saw no correlations with muscle mass, physical fitness, insulin sensitivity, triglycerides, HDL cholesterol, and blood pressure. Our observation of elevated serum myostatin in women with a higher body fat percentage, visceral obesity, and elevated c-reactive protein suggests that this myokine contributes to the altered muscle-adipose tissue crosstalk in metabolic syndrome. Elevated myostatin may advance this pathophysiologic process and could also impair the efficacy of exercise interventions. Further mechanistic studies, therefore, seem warranted.

Relationships between carotid artery intima-media thickness and echogenicity and body composition using a new magnetic resonance imaging voxel-based technique.

BackgroundWe evaluated how carotid artery intima-media thickness (IMT) and the echogenicity of the intima-media (IM-GSM), measured by ultrasound, were related to body composition, evaluated by both traditional imaging techniques, as well as with a new voxel-based “Imiomics” technique.MethodsIn 321 subjects all aged 50 years in the POEM study, IMT and IM-GSM were measured together with a DXA scan for determination of fat and lean mass. Also a whole-body MRI scan was performed and the body volume was divided into >1 million voxels in a standardized fashion. IMT and IM-GSM were related to each of these voxels to create a 3D-view of how these measurements were related to size of each part of the body.ResultsIM-GSM was inversely related to almost all traditional measurements of body composition, like fat and lean mass, liver fat, visceral and subcutaneous fat, but this was not seen for IMT. Using Imiomics, IMT was positively related to the intraabdominal fat volume, as well of the leg skeletal muscle in women. In males, IMT was mainly positively related to the leg skeletal muscle volume. IM-GSM was inversely related to the volume of the SAT in the upper part of the body, leg skeletal muscle, the liver and intraabdominal fat in both men and women.ConclusionThe voxel-based Imiomics technique provided a detailed view of how the echogenicity of the carotid artery wall was related to body composition, being inversely related to the volume of the major fat depots, as well as leg skeletal muscle.

Associations Between Brain Gray Matter Volumes and Adipose Tissue Metabolism in Healthy Adults.

Gray matter (GM) volume in different brain loci has been shown to vary in obesity and diabetes, and elevated fasting plasma nonesterified fatty acid (NEFA) levels have been suggested as one potential mechanism. The hypothesis presented in this study is that brown adipose tissue (BAT) activity may correlate with GM volume in areas negatively associated with obesity and diabetes. A total of 36 healthy patients (M/F: 12/24, age 39.7 ± 9.4 years, BMI 27.5 ± 5.6 kg/m2 ) were imaged with positron emission tomography using fatty acid analog [18 F]FTHA to measure NEFA uptake and with [15 O]H2 O to measure perfusion during cold exposure, at room temperature during fasting, or during a postprandial state. A 2-hour hyperinsulinemic euglycemic clamp was performed to measure whole-body insulin sensitivity (M value, mean 7.6 ± 3.9 mg/kg/min). T1-weighted magnetic resonance imaging at 1.5 T was performed on all patients. BAT NEFA uptake was associated directly with GM volume in anterior cerebellum and occipital lobe (P ≤ 0.04) when adjusted for age, gender, and intra-abdominal fat volume and with anterior cerebellum, limbic lobe, and temporal lobe GM volumes when adjusted for M value. BAT NEFA metabolism may participate in protection from cognitive degeneration associated with cardiometabolic risk factors, such as central obesity and insulin resistance. Potential causal relationships between BAT activity and GM volumes remain to be examined.

Evaluation and Comparative Correlation of Abdominal Fat Related Parameters in Obese and Non-obese Groups Using Computed Tomography.

Obesity is a significant risk factor for cardiovascular (CV) disease. Abdominal fat is composed of abdominal subcutaneous fat and intra-abdominal (visceral) fat. Computed tomography (CT) is considered one of the most accurate and reliable methods for assessing abdominal fat. The present study was based on evaluating abdominal fat by computed tomography and the determination of association between CT obtained abdominal fat volumes, anthropometric indices, and lipid profile. The prospective study was carried out on 120 subjects referred to the Radiology department for a CT scan. Non - contrast CT scan was performed with 5 mm slice thickness. Abdominal fat volumes were recorded by using CT attenuation values (- 250 to -50 HU). The section was selected at the level of the umbilicus (L4-L5). Intra-abdominal fat and subcutaneous fat volumes were calculated. Body Mass Index (BMI) and lipid profile were recorded for each subject. A comparative study of the CT values, BMI, and lipid profile was undertaken. In the present study, by comparing the anthropometric parameters, CT findings, and lipid profile and blood parameters of the obese and non-obese groups by sex revealed significant sex differences in all the parameters under study. It was also found that the obese male and female groups showed a high prevalence of diabetes, Non-Alcoholic fatty liver disease (NAFLD), and hypertension than non-obese groups. This finding also adds to the chances of getting cardiovascular diseases, specifically in obese individuals. The results found that in obese males and females the abdominal fat-related parameters Visceral fatty acid (VFA) and subcutaneous fatty acid (SFA) showed highly significant relation to anthropometric parameters like BMI, waist circumference (WC) and waist/hip (W/H) ratio on the other hand blood parameters high-density lipoprotein (HDL), low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), total cholesterol and triglycerides to some extent have a significant relation to abdominal fat-related parameters. In non-obese groups, by studying the influence of anthropometric parameters on abdominal fat-related parameters, it was revealed that WC was strongly affected by the VFA in both sexes. In obese females, more fat was accumulated in the VFA and SFA and for obese males in SFA and for non-obese males in total fatty acid (TFA). Computed tomography assessed visceral fat area remains the most sensitive independent predictor of cardiovascular risk.

Outcomes specific to patient sex after open ventral hernia repair

BackgroundMale and female hernia patients often have different surgical history, fat distribution, and medical comorbidities. Female surgical patients seemingly experience worse outcomes after open ventral hernia repair. This study evaluates the impact of sex and the distribution of abdominal adiposity on outcomes after open ventral hernia repair. MethodsA prospective hernia database was queried for patients from 2007 to 2018 with a computed tomography within 1 year of open ventral hernia repair. Three-dimensional volumetric analysis was performed. Demographics, abdominal fat distribution, operative characteristics, and outcomes were evaluated by sex using univariate and multivariate analysis. ResultsA total of 1,178 patients were identified, 57.8% were female. Compared with males, females had higher mean body mass index (34.8 ± 8.5 vs 31.7 ± 6.4 kg/m2, P < .0001), previous abdominal operations (3.3 ± 1.5 vs 2.6 ± 1.3, P < .0001), and preoperative chronic pain (33.5 vs 26.4%, P = .009). There was no difference in history of recurrence, age, steroid use, smoking, diabetes, or hernia volume between sexes (P ≥ .17 all values). Males had larger defects (168.1 ± 148.2 vs 138.8 ± 126.8 cm2, P = .001) and intra-abdominal volume (intra-abdominal fat volume; 6,279 ± 2,614 vs 4,454 ± 2,196 cm3, P < .0001). Females had larger subcutaneous fat volume (subcutaneous fat volume; 7,453 ± 6,600 vs 5,708 ± 3,275 cm3, P < .0001), and ratio of hernia to intra-abdominal volume (hernia volume to intra-abdominal fat volume; 0.33 ± 0.52 vs 0.22 ± 0.42, P < .0001). On univariate analysis, females had higher rates of readmission, wound complication, and intervention for pain after open ventral hernia repair (P ≤ .02 all values). On multivariate analysis, females had shorter duration of stay (–1.36 day, standard error 0.49, P = .006) with higher readmission rate (odd ratio, 1.64; 95% confidence interval, 1.15–2.34). ConclusionFemale hernia patients in our population are more comorbid, with higher body mass index, thicker subcutaneous fat volume and a higher ratio of hernia volume to intra-abdominal fat volume. These differences are associated with more extensive surgical intervention, such as panniculectomy and higher rates of adverse outcomes after open ventral hernia repair. However, these differences are not fully explained by identified comorbidities and warrant further investigation.

Change in body composition in patients with achalasia before and after peroral endoscopic myotomy.

Patients with achalasia experience weight loss because of dysphagia caused by impaired relaxation of the lower esophageal sphincter. This study aimed to use dual bioelectrical impedance analysis (BIA) to determine the change in bodyweight and body composition in patients with achalasia before and after peroral endoscopic myotomy (POEM). Patients with achalasia who underwent POEM from 2013 to 2018 (n=72) were retrospectively analyzed for change in bodyweight before and after 3months. Additionally, change in body composition was prospectively investigated in the final 10 of 72 patients using non-radiation dual BIA. Twenty patients (27.8%) were underweight (body mass index<18.5) before undergoing POEM. No clinical parameters were identified to be associated with the underweight condition before POEM and be predictive of an increase in bodyweight after POEM. Low visceral fat volume observed on dual BIA correlated closely with the result obtained using computed tomography (Pearson correlation coefficient: r=0.850, P<0.01). Patients with achalasia had a statistically significant increase in visceral (P<0.01) and subcutaneous fat volumes (P<0.01) after POEM. Skeletal muscle mass index slightly increased (P=0.02), although the value after POEM was still low. No blood biomarkers were indicators for low bodyweight or low visceral fat volume. Dual BIA is an effective non-invasive tool to evaluate the change in body composition of underweight patients with achalasia. Skeletal muscle volume was not enough after POEM, although a rapid increase in the intra-abdominal fat volume was observed. Additional studies are warranted to understand the pathological implications.

No Correlation of Pancreatic Fat and β-Cell Function in Young Women With and Without a History of Gestational Diabetes.

Pancreatic steatosis may contribute to β-cell dysfunction in type 2 diabetes (T2D), but data are controversial. Women who had gestational diabetes mellitus (GDM) are at high risk for developing T2D. To examine the association of pancreatic fat content with early/first-phase insulin secretion (as markers of β-cell function). Cross-sectional analysis of a subcohort of the monocentric, prospective cohort study titled Prediction, Prevention, and Subclassification of Type 2 Diabetes. Ludwig Maximilians University Hospital, Munich, Germany. Ninety-seven women, 3 to 16 months after pregnancy [41 normoglycemic women post-GDM, 19 women post-GDM with pathological glucose metabolism, and 37 normoglycemic women after a normoglycemic pregnancy (controls)]. Correlation of MRI-measured pancreatic fat content with early insulin release in an oral glucose tolerance test (OGGT) [insulin increment within the first 30 minutes of the OGTT (IR30)] and first-phase insulin response (FPIR) in an intravenous glucose tolerance test (n = 65), both adjusted for insulin sensitivity index (ISI). Pancreatic fat content did not correlate with IR30 and FPIR adjusted for ISI. It correlated positively with body mass index, waist circumference, liver fat, and intraabdominal fat volume. Pancreatic fat content does not correlate with β-cell function in a cohort of young women with different degrees of T2D risk.

Proposed cut-off values of the waist circumference for metabolic syndrome based on visceral fat volume in a Japanese population.

Aim/IntroductionWaist circumference (WC) is the most important parameter for diagnosis of metabolic syndrome. The present study was carried out to obtain optimal WC cut‐off values for diagnosis of metabolic syndrome in a Japanese population based on the measurement of total intra‐abdominal visceral fat volume (VFV), which could be expected to reflect visceral obesity more precisely than visceral fat area.Materials and MethodsA total of 405 Japanese persons undergoing health screening were investigated. visceral fat volume was calculated from the data in 700–800 computed tomography slices from the top of the liver to the floor of the pelvic cavity. Then, receiver operating characteristic analysis was used to determine the cut‐off value of the VFV/height ratio. Subsequently, the corresponding WC value was obtained by linear regression analysis.ResultsThe cut‐off value of the VFV/height ratio was 2,317 cm3/m in men and 1,425 cm3/m in women. The sensitivity and specificity of the ratio were 52.9 and 86.4% in men vs 63.4 and 82.2% in women, respectively. The corresponding cut‐off value of WC was 86.0 cm in men and 80.9 cm in women.ConclusionsThe proposed cut‐off values of WC for metabolic syndrome are 85 cm in Japanese men and 80 cm in Japanese women.

Value of MRI and MRS fat measurements to complement conventional screening methods for childhood obesity.

To evaluate a protocol combining abdominal fat-water magnetic resonance imaging (MRI) and liver single voxel magnetic resonance spectroscopy (MRS) for studies of childhood obesity. Six obese male children and five age-matched normal-weight controls underwent abdominal fat-water Dixon MRI based on a gradient echo sequence with multiple echo times and single voxel liver MRS at a field strength of 3T. The MRI/MRS data were compared with data previously acquired from an obese adult cohort and with anthropometric and blood parameters that are typically acquired for screening in childhood obesity. There was a very strong correlation (r = 0.96) between the body mass index standard deviation score (BMI-SDS) and the subcutaneous fat volume fraction in the examined children, but only a moderate correlation (r = 0.62) between the BMI-SDS index and the intraabdominal fat volume fraction, which is much lower in the obese children (5.3 ± 1.1%) than in the obese adult cohort (19.4 ± 2.9%). Furthermore, a significant difference between the two child cohorts was observed in the intrahepatic lipid (IHL) content as obtained with MRS (P = 0.017). However, even the obese child cohort shows an IHL content that is 1-2 orders of magnitude lower (1.0 ± 0.5%) than in the obese adult cohort (17.0 ± 8.7%). The proposed method was successfully applied in children and may complement traditional clinical screening methods for childhood obesity such as anthropometry and laboratory tests to better characterize the obesity-associated metabolic risk.

Body fat composition impacts the hematologic toxicities and pharmacokinetics of doxorubicin in Asian breast cancer patients

Body surface area (BSA)-based dosing leads to wide inter-individual variations in drug pharmacokinetics and pharmacodynamics, whereas body composition has been shown to be a more robust determinant of efficacy and toxicity of certain chemotherapeutic agents. We correlated various parameters of body composition with doxorubicin pharmacokinetics and hematologic toxicities in Asian patients with locally advanced or metastatic breast cancer. Our analysis included 84 patients from two studies who received pre- or post-operative single-agent doxorubicin; pharmacokinetic parameters were available for 44 patients. Body composition parameters were derived from CT cross-sectional images and population pharmacokinetic analysis was conducted using mixed-effects modeling. Higher intra-abdominal fat volume and fat ratio (intra-abdominal:total abdominal fat volume) correlated with greater incidence of grade 4 leukopenia on cycle 1 day 15 (mean intra-abdominal fat volume: 97.4 ± 46.5 cm(3) vs 63.4 ± 30.9 cm(3), p = 0.014; mean fat ratio: 0.43 ± 0.11 vs 0.33 ± 0.09, p = 0.012, grade 4 vs grade 0-3 leukopenia). On subset analysis, this relationship was maintained even in underweight patients. Concordantly, there were positive correlations between doxorubicin AUC and intra-abdominal fat volume as well as total abdominal fat volume (r (2) = 0.324 and 0.262, respectively, all p < 0.001). BSA and muscle volume did not predict for doxorubicin pharmacokinetics or toxicities. High-intra-abdominal fat volume but not BSA predicted for greater doxorubicin exposure and hematologic toxicities, suggesting that body composition is superior to BSA in determining doxorubicin pharmacokinetics and pharmacodynamics. Body composition has an emerging role in chemotherapy dose determination.

Abstract 17990: Ectopic Fat is Associated With Gender-specific Reductions in Left Ventricular Myocardial Perfusion Index During Dobutamine Stress

Background: Obesity and visceral adiposity are increasingly recognized risk factors for cardiovascular disease. Visceral fat may reduce myocardial perfusion by impairing endothelial function. Accordingly, we evaluated the association of visceral fat and quantitative myocardial perfusion during peak dose dobutamine stress using MRI. Methods: We evaluated MRI myocardial perfusion index (MPI) in 59 individuals at risk for their first episode of symptomatic heart failure with a left ventricular (LV) ejection fraction &gt;45% and no MRI evidence of previous myocardial infarction or inducible ischemia. MPI was calculated after the first pass of gadolinium (by dividing the upslope of the signal intensity over time curve of the mid LV septum by the upslope of the LV cavity blood curve) after dobutamine and atropine were administered to achieve 80% of the maximum predicted heart rate response for age. Pericardial, subcutaneous (SQ), intraabdominal (IA) and retroperitoneal (RP) fat volumes were quantified using validated MRI techniques. All analyses were blinded to participant identifiers. Pearson’s coefficients were determined and a p-value of &lt; 0.05 was considered significant. Results: Participants averaged 66 ± 7 years in age; 34% were men, 27% African American, 43% diabetic, and 93% were hypertensive. Overall, pericardial, IA, and RP fat were negatively associated with MPI (Table). No fat depots were associated with reduced MPI in men. However pericardial (r=-0.57, p=0.02), IA (r=-0.34, p=0.04) and SQ fat (r=-0.42, p=0.01) were all negatively associated with MPI in women. Conclusions: Higher pericardial, IA and RP fat volumes are associated with reduced LV myocardial perfusion at peak dobutamine stress in women. These findings suggest visceral fat may contribute to abnormal microcirculatory coronary arterial perfusion syndromes, explaining why some women may exhibit more anginal symptoms despite typically lower grade coronary artery stenoses than men.

Plasma Lipopolysaccharide Is Closely Associated With Glycemic Control and Abdominal Obesity

OBJECTIVEIt is of vital importance to elucidate the triggering factors of obesity and type 2 diabetes to improve patient care. Bariatric surgery has been shown to prevent and even cure diabetes, but the mechanism is unknown. Elevated levels of lipopolysaccharide (LPS) predict incident diabetes, but the sources of LPS are not clarified. The objective of the current study was to evaluate the potential impact of plasma LPS on abdominal obesity and glycemic control in subjects undergoing bariatric surgery.RESEARCH DESIGN AND METHODSThis was a prospective observational study involving a consecutive sample of 49 obese subjects undergoing bariatric surgery and 17 controls. Main assessments were plasma LPS, HbA1c, adipose tissue volumes (computed tomography), and quantified bacterial DNA in adipose tissue compartments.RESULTSPlasma levels of LPS were elevated in obese individuals compared with controls (P < 0.001) and were reduced after bariatric surgery (P = 0.010). LPS levels were closely correlated with HbA1c (r = 0.56; P = 0.001) and intra-abdominal fat volumes (r = 0.61; P < 0.001), but only moderately correlated with subcutaneous fat volumes (r = 0.33; P = 0.038). Moreover, there was a decreasing gradient (twofold) in bacterial DNA levels going from mesenteric via omental to subcutaneous adipose tissue compartments (P = 0.041). Finally, reduced LPS levels after bariatric surgery were directly correlated with a reduction in HbA1c (r = 0.85; P < 0.001).CONCLUSIONSOur findings support a hypothesis of translocated gut bacteria as a potential trigger of obesity and diabetes, and suggest that the antidiabetic effects of bariatric surgery might be mechanistically linked to, and even the result of, a reduction in plasma levels of LPS.

Effects of sugar‐sweetened beverages on plasma acylation stimulating protein, leptin and adiponectin: Relationships with Metabolic Outcomes

ObjectiveWe determined the effects of fructose and glucose consumption on plasma acylation stimulating protein (ASP), adiponectin, and leptin concentrations relative to energy intake, body weight, adiposity, circulating triglycerides, and insulin sensitivity.Design and Methods32 overweight/obese adults consumed glucose- or fructose-sweetened beverages (25% energy requirement) with their ad libitum diets for 8 weeks, followed by sweetened beverage consumption for 2 weeks with a standardized, energy-balanced diet. Plasma variables were measured at baseline, 2, 8 and 10 weeks, and body adiposity and insulin sensitivity at baseline and 10 weeks.ResultsFasting and postprandial ASP concentrations increased at 2 and/or 8 weeks. ASP increases correlated with changes in late-evening triglyceride concentrations. At 10 weeks, fasting adiponectin levels decreased in both groups, and decreases were inversely associated with baseline intra-abdominal fat volume. Sugar consumption increased fasting leptin concentrations; increases were associated with body weight changes. 24-h leptin profiles increased during glucose consumption and decreased during fructose consumption. These changes correlated with changes of 24-h insulin levels.ConclusionsThe consumption of fructose and glucose beverages induced changes in plasma concentrations of ASP, adiponectin and leptin. Further study is required to determine if these changes contribute to the metabolic dysfunction observed during fructose consumption.

Body mass index is inversely associated with mortality in patients with peripheral vascular disease

BackgroundCurrent guidelines contain no advice on how to manage obesity and underweight in patients with peripheral vascular disease (PVD). ObjectivesThe aim of this study was to assess the association of underweight, overweight and obesity with mortality in patients with PVD. Patients and MethodsWe recruited 1472 patients with a broad range of presentations of PVD. Underweight, overweight and obesity were defined by body mass index (BMI) and associated with mortality using Kaplan Meier and Cox proportional hazard analyses. ResultsSurvival at 3 years was 37.5, 78.1, 86.8 and 87.0% for patients that were underweight, normal weight, overweight and obese at recruitment, respectively, p<0.001. Patients that were underweight had approximately twice the risk of dying (RR 2.15, 95% CI 1.31–3.55, p=0.003), while patients that were overweight (RR 0.67, 95% CI 0.49–0.91, p=0.011) or obese (RR 0.59, 95% CI 0.41–0.85, p=0.005) had approximately half the risk of dying, after adjustment for other risk factors and using normal weight subjects as the reference group. 823 patients had waist circumference measured at recruitment. Patients with waist circumference in the top quartile had half the risk of dying (RR 0.50, 95% CI 0.26–0.98, p=0.045). In 267 patients we assessed the relationship between BMI and abdominal fat volumes using computed tomography. BMI was highly correlated with both intra-abdominal and subcutaneous fat volumes. ConclusionsObesity whether assessed by BMI or central fat deposition is associated with reduced risk of dying in patients with established PVD. Underweight is highly predictive of early mortality in patients with PVD.

Resveratrol Supplementation Does Not Improve Metabolic Function in Nonobese Women with Normal Glucose Tolerance

Resveratrol has been reported to improve metabolic function in metabolically abnormal rodents and humans, but it has not been studied in nonobese people with normal glucose tolerance. We conducted a randomized, double-blind, placebo-controlled trial to evaluate the metabolic effects of 12weeks of resveratrol supplementation (75mg/day) in nonobese, postmenopausal women with normal glucosetolerance. Although resveratrol supplementation increased plasma resveratrol concentration, it did not change body composition, resting metabolic rate, plasma lipids, or inflammatory markers. A two-stage hyperinsulinemic-euglycemic clamp procedure, in conjunction with stable isotopically labeled tracer infusions, demonstrated that resveratrol did not increase liver, skeletal muscle, or adipose tissue insulin sensitivity. Consistent with the absence of invivo metabolic effects, resveratrol did not affect its putative molecular targets, including AMPK, SIRT1, NAMPT, and PPARGC1A, in either skeletal muscle or adipose tissue. These findings demonstrate that resveratrol supplementation does not have beneficial metabolic effects innonobese, postmenopausal women with normal glucose tolerance.

A STUDY ON BODY COMPOSITION AND LIPID PROFILE IN POSTMENOPAUSAL WOMEN

The interactions between the various physiological risk factors for cardiovascular disease are complex in women, the risk increases markedly after menopause and eventually becomes equivalent to that of men. This observation has suggested, but has not proven, that estrogens have a protective effect against cardiovascular disease This study was done to find out the body composition and lipid profile in postmenopausal women of North-West Karnataka, and any variation between them. The present study was conducted in the department of physiology, Al-Ameen medical college, Bijapur. Sixty nine postmenopausal women attending the hospital, Bijapur were selected and divided into two groups. Group-I: 32 Early postmenopausal women (up to 5years of postmenopausal duration) Group-II: 37 Late postmenopausal women (> 5years of postmenopausal duration). Then physical parameters noted and venous blood sample drown to determine lipid profile in semi auto analyzer. The BMI matched obese postmenopausal women, had significantly higher, WC, WHR and intra-abdominal fat volume compared with premenopausal women. TC and TG were significantly higher and HDL-C was significantly lower in postmenopausal women. When age matched pre- and postmenopausal women were compared only TC was significantly higher in postmenopausal group. However, older postmenopausal women (>50years) had significantly higher WC and WHR compared with younger postmenopausal women (<50years).In healthy women, during the time from premenopausal to first year Postmenopausal examinations, the changes in LDL-C, TG, and BMI were larger than those between first and fifth year Postmenopausal examinations.

Vagus nerve preservation results in visceral fat maintenance after distal gastrectomy.

Although preservation of the vaguas nerve is recommended in surgery for earlystage gastric cancer, the physiological effect of vagotomy on the postoperative course has not been well documented. We assessed the effect of vagotomy on the change in fat volume after gastrectomy. Subcutaneous fat area (SFA) and visceral fat area (VFA) were separately measured in computed tomographic images taken before and more than 6 months after surgery, using Fat Scan software. The ratios of postoperative/ preoperative values of these two fat areas as well as body weight were calculated in 45 patients who underwent DG with (n=24) or without (n=21) vagotomy. Vagotomy did not affect the change in body weight (91.3±1.7% vs. 92.1±1.7%). In patients with vagotomy, VFA was reduced to 59.0±5.1%, which was significantly greater than the reduction in SFA (74.3±8.7%, p=0.042). In contrast, the reduction ratios of VFA and SFA were equal in vagus nerve-preserved patients (78.4±6.7% vs. 78.2±6.9%, p=0.97). The vagus nerve may have a function to locally regulate the intra-abdominal fat volume and preservation of the vagus nerve results in the maintenance of visceral fat after DG.

Normal Appendix in Adults: Reproducibility of Detection with Unenhanced and Contrast-Enhanced MDCT

The purposes of this study were to investigate whether readers' interpretations are reproducible and whether readers are confident in identifying a normal appendix with CT and to assess the influence of patient characteristics and IV contrast enhancement on visualization of the appendix. One hundred two patients without a history of abdominal surgery underwent unenhanced and contrast-enhanced CT for the evaluation of cancer. Three radiologists with varying degrees of experience read scans twice in separate sessions. They were asked to identify the appendix, to score their confidence in identification, and to mark the appendix on the images. Intraabdominal fat volume was measured with a computer-assisted method. Independent experts compared the readers' markings and indicated whether the findings were reproducible. Reproducibility differed significantly between reading sessions (p < 0.001) and readers (p = 0.003). On the images of 71% of the patients, there was perfect intrareader and interreader agreement with statistically significant and positive influences of patient body mass index (p = 0.005) and intraabdominal fat volume (p = 0.001). Contrast enhancement influenced intrareader reproducibility only for the reader who made less-reproducible interpretations (p = 0.033). Intrareader and interreader agreement in categorizing confidence in identification of the appendix ranged from fair to good (kappa = 0.221-0.620). Confidence was not influenced by contrast enhancement (p = 0.433-0.953), body mass index, or intraabdominal fat volume (p = 0.058-0.798). Reproducibility in identifying a normal appendix is reader dependent. Perfect intrareader and interreader agreement in marking the appendix occurs approximately 70% of the time and increases with patient body mass index and intraabdominal fat volume. Contrast enhancement does not influence the rate of identification of the appendix or reader confidence but may influence the reproducibility of findings.