Measures Of Visceral Adiposity Research Articles

Can a Bedside Measure of Visceral Adiposity Predicts Progression of Prehypertension to Hypertension?

Can a Bedside Measure of Visceral Adiposity Predicts Progression of Prehypertension to Hypertension?

Impact of visceral fat on coronary artery disease as defined by quantitative computed tomography angiography.

Obesity is associated with all-cause mortality and cardiovascular disease (CVD). Visceral fat (VF) is an important CVD risk metric given its independent correlation with myocardial infarction and stroke. This study aims to clarify the relationship between the presence and severity of VF with the presence and severity of coronary artery plaque. In 145 consecutive asymptomatic patients, atherosclerosis imaging-quantitative computed tomography was performed for total plaque volume (TPV) and percentage atheroma volume, as well as the volume of noncalcified plaque (NCP), calcified plaque, and low-density NCP (LD-NCP), diameter stenosis, and vascular remodeling. This study also included VF analysis and subcutaneous fat analysis, recording of outer waist circumference, and percentage body fat analysis. The mean age of the patients was 56.1 [SD 8.5] years, and 84.0% were male. Measures of visceral adiposity (mean [SD, Q1-Q3 thresholds]) included estimated body fat, 28.7% (9.0%, 24.1%-33.0%); VF, 169.8 cm2 (92.3, 102.0-219.0 cm2 ); and subcutaneous fat, 223.6 mm2 (114.2, 142.5-288.0 mm2 ). The Spearman correlation coefficients of VF and plaque volume included TPV 0.22 (p = 0.0074), calcified plaque 0.12 (p = 0.62), NCP 0.25 (p = 0.0023), and LD-NCP 0.37 (p < 0.0001). There was a progression of the median coronary plaque volume for each quartile of VF including TPV (Q1: 19.8, Q2: 48.1, Q3: 86.4, and Q4: 136.6 mm3 [p = 0.0098]), NCP (Q1: 15.7, Q2: 35.4, Q3: 86.4, and Q4: 136.6 mm3 [p = 0.0032]), and LD-NCP (Q1: 0.6, Q2: 0.81, Q3: 2.0, and Q4: 5.0 mm3 [p < 0.0001]). These findings demonstrate progression with regard to VF and TPV, NCP volume, and LD-NCP volume. Notably, there was a progression of VF and amount of LD-NCP, which is known to be high risk for future cardiovascular events. A consistent progression may indicate the future utility of VF in CVD risk stratification.

471-P: The Visceral Adiposity Index Predicts MACE Both in Cardiovascular Disease Patients with and in Those without Diabetes

The Visceral Adiposity Index (VAI) is calculated based on waist circumference, BMI, triglyzeride and HDL-cholesterol levels and is a validated measure of visceral adiposity. In the general population, the VAI has been shown to be an independent risk factor for premature mortality. Its power to predict MACE in patients with established cardiovascular disease (CVD) with or without type 2 diabetes mellitus (T2DM) is not known and is addressed in the present study. We prospectively recorded MACE in 601 of 1499 patients with either angiographically diagnosed CAD (n=1261) or sonographically verified PAD (n=238) over a mean follow-up time of 9.6±5.1 years. At baseline, the VAI was significantly higher in patients with T2DM (n=489) than in those who did not have diabetes (6.7±6.0 vs. 4.7±4.5; p&amp;lt;0.001). Prospectively, the VAI significantly predicted the incidence of MACE both univariately (standardized HR 1.01 [1.00-1.03]; p=0.037) and after adjustment for age, gender, smoking, LDL cholesterol, hypertension and T2DM (standardized adjusted HR 1.01 [1.00-1.03]; p=0.011); also T2DM significantly predicted MACE in this fully adjusted model (adjusted HR 1.55 [1.31-1.84]; p&amp;lt;0.001). We conclude that the VAI and T2DM are mutually independent predictors of MACE in patients with CVD. Disclosure M.Maechler: None. C.H.Saely: None. L.Sprenger: None. A.Mader: None. B.Larcher: None. A.Vonbank: None. T.Plattner: None. A.Leiherer: None. A.Muendlein: None. H.Drexel: None.

Lipid accumulation product, visceral adiposity index and risk of chronic kidney disease

BackgroundLipid accumulation product (LAP) and visceral adiposity index (VAI) are novel, non-imaging markers of visceral adiposity that are calculated by using body mass index (BMI), waist circumference (WC) and serum lipid concentrations. We hypothesized that LAP and VAI are more strongly associated with adverse kidney outcomes than BMI and WC.MethodsUsing data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, we used multivariable logistic regression to evaluate associations of LAP, VAI, BMI and WC with incident chronic kidney disease (CKD), (incident eGFR < 60 ml/min/1.73m2 and > 25% decline).ResultsAmong the overall cohort of 27,550 participants, the mean baseline age was 65 years; 54% were women; and 41% were African American. After a median of 9.4 years (IQR 8.6, 9.9) of follow-up, a total of 1127 cases of incident CKD were observed. Each two-fold higher value of VAI (OR 1.12, 95% CI 1.04, 1.20), LAP (OR 1.21, 95% CI 1.13, 1.29), WC (OR 2.10, 95% CI 1.60, 2.76) and BMI (OR: 2.66, 95% CI 1.88, 3.77), was associated with greater odds of incident CKD.ConclusionsLAP and VAI as measures of visceral adiposity are associated with higher odds of incident CKD but may not provide information beyond WC and BMI.

Abstract 10942: The A Body Shape Index and Type 2 Diabetes Are Mutually Independent Predictors of Major Cardiovascular Events in Patients With Established Cardiovascular Disease

Introduction: The A Body Shape index (ABSI) is a validated measure of visceral adiposity that is calculated based on waist circumference, height and BMI. Hypothesis: We hypothesize that ABSI is a predictor of major cardiovascular events in patients with established cardiovascular disease (CVD). Methods: We prospectively recorded cardiovascular events in a large cohort of 1544 patients with established CVD (1297 patients with angiographically proven stable coronary artery disease and 247 patients with sonographically verified PAD) over a mean follow-up time of 10.0±4.6 years. Results: At baseline, the ABSI was higher in patients with type 2 diabetes (T2DM; n=502) than in those who did not have diabetes (8.4±0.6 vs. 8.3±0.6; p&lt;0.001). Prospectively, the ABSI significantly predicted the incidence of MACE (n=507) after adjustment for age, gender, smoking, hypertension, LDL cholesterol, HDL cholesterol, and T2DM (standardized adjusted HRs 1.14 [1.04-1.24]; p=0.004, respectively). T2DM in turn in this model also significantly predicted MACE with a HR of 1.61 [1.33-1.94]; p&lt;0.001 after adjustment for ABSI. Conclusions: We conclude that ABSI and T2DM are mutually independent risk factors for MACE in patients with established cardiovascular disease.

433-P: The A Body Shape Index and Type 2 Diabetes Are Mutually Independent Predictors of Major Cardiovascular Events in Patients with Established Cardiovascular Disease

The A Body Shape index (ABSI) is a validated measure of visceral adiposity that is calculated based on waist circumference, height and BMI. Its power to predict major cardiovascular events in patients with established cardiovascular disease (CVD) is unclear and is addressed in the present study. We prospectively recorded cardiovascular events in a large cohort of 1544 patients with established CVD (1297 patients with angiographically proven stable coronary artery disease and 247 patients with sonographically verified PAD) over a mean follow-up time of 10.0±4.6 years. At baseline, the ABSI was higher in patients with type 2 diabetes (T2DM; n=502) than in those who did not have diabetes (8.4±0.6 vs. 8.3±0.6; p&amp;lt;0.001) . Prospectively, the ABSI significantly predicted the incidence of MACE (n=507) after adjustment for age, gender, smoking, hypertension, LDL cholesterol, HDL cholesterol, and T2DM (standardized adjusted HRs 1.14 [1.04-1.24]; p=0.004, respectively) . T2DM in turn in this model also significantly predicted MACE with a HR of 1.61 [1.33-1.94]; p&amp;lt;0.0after adjustment for ABSI. We conclude that ABSI and T2DM are mutually independent risk factors for MACE in patients with established cardiovascular disease. Disclosure L.Sprenger: None. M.Maechler: None. A.Vonbank: None. B.Larcher: None. A.Mader: None. A.Leiherer: None. A.Muendlein: None. H.Drexel: None. C.H.Saely: None.

Changes in the Visceral Adiposity Index (VAI) Among Obese Older Adults After a 12-Month Exercise and Diet Intervention

ObjectivesThe Visceral Adiposity Index (VAI) was developed to estimate adipose tissue dysfunction as well as visceral fat distribution. In an ancillary analysis of the CROSSROADS Study (clinicaltrials.gov #NCT00955903), this study investigated the effects of exercise with and without intentional energy restriction on VAI changes among older adults with obesity. MethodsParticipants (n = 163, 37.4% male, 70.3 ± 4.7 years) were randomized to the following groups: exercise only, exercise + nutrient-dense weight maintenance diet, and exercise + nutrient-dense energy restriction of 500 kcal/d. Visceral adiposity determined by magnetic resonance imaging (MRI) and dual-energy X-ray absorptiometry (DXA), anthropometrics, and cardiometabolic biomarkers were assessed at baseline and 12 months. Waist circumference, body mass index, triglycerides, and high-density lipoprotein (HDL) cholesterol were used to compute VAI at both time points. Data were analyzed utilizing Spearman’s correlations and general linear models to determine differences among groups following adjustment for covariates. ResultsAmong all participants, significant correlations were observed between VAI and glucose, insulin, tumor necrosis factor-alpha (TNF-α), and the adiponectin: leptin ratio at baseline (r = 0.343, P < 0.001; r = 0.363, P < 0.001; r = 0.200, P = 0.011; r = –0.246, P = 0.002, respectively). DXA and MRI measures of visceral adiposity were not significantly correlated with VAI. Upon completion of the 12-month study period, there were significant differences in VAI among groups [F (2,137) = 5.957, P = 0.003)]. Post hoc analysis revealed that VAI was significantly lower in the exercise + nutrient-dense energy restriction group compared to the exercise only group (P = 0.002). ConclusionsResults suggest that VAI may be an adequate measure of adipose tissue dysfunction, yet its ability to estimate levels of visceral adiposity warrants further investigation to determine clinical utility. Nonetheless, results suggest that an exercise + nutrient-dense energy restriction intervention may reduce VAI among older adults with obesity. Funding SourcesNIH.

Gender-Specific Association of Body Fat Composition with Risk of Obstructive Sleep Apnea among People Living With HIV/AIDS: A Cross-Sectional Study

Background: Obesity and regional fat distribution are among the strongest risk factors for obstructive sleep apnea (OSA) in the general population. People living with HIV (PLHIV) may be at increased risk of OSA because of their distinct body fat composition. This study examined the association of body fat composition with the risk of OSA in PLHIV. Methods: We conducted a cross-sectional prospective study at a tertiary HIV care unit, recruiting 400 PLHIV [female: 317, 79.2%; median age of 44 years; median year of HIV duration of 5 years]. Participants were surveyed using standardized instruments to assess the risk of OSA, sleep duration and, sleepiness. Body fat composition was evaluated with anthropometric measurements and bioelectric impedance Results: Sixty-three of the participants (15.8%; 95% confidence interval [CI], 12.4%–19.8%) had risk of OSA, while 24 (6.0%) of them had risk of OSA and excessive day time sleepiness and 30 (7.5%) had risk of OSA with concomitant short sleep duration. BMI and markers of central obesity were significantly associated with risk of OSA in females but not in males. Waist circumference, Waist to hip ratio, Visceral fat level performed similarly in predicting the risk of OSA in females with Area Under the Curve (AUC) of 0.668, 95% CI (0.613, 0.719); 0.704, 95% CI (0.651, 0.754); 0.663, 95% CI (0.608, 0.715) respectively, with VFL having the best accuracy. Conclusions: The risk of OSA among PLHIV was associated with measures of visceral adiposity in females and not in males.

Echocardiographic Assessment of Epicardial Adipose Tissue - A Marker of Visceral Adiposity

Visceral adipose tissue predicts an unfavorable cardiovascular and metabolic risk profile in humans. Existing methods to assess visceral adipose tissue have been limited. Thus, echocardiographic assessment of epicardial adipose tissue as a marker of visceral adiposity was suggested. The technique has been shown to be a very reliable method and an excellent measure of visceral adiposity. In this article, epicardial adipose tissue's localization on the heart, function, method of assessment and reliability as a marker of visceral adiposity is briefly reviewed. Areas of the technique requiring further study are identified.

Use of Radiological Measures of Visceral Adiposity as an Adjunct for Assessment of Risk of Colorectal Adenoma

Qin Ng, Zi MBBS (Hons); Wijesuriya, Ruwan FRACS; Misur, Philip FRANZCR; Huei Tan, Jih MRCS; Soe Moe, Kyaw MBBS; Theophilus, Mary FRACS Author Information

Metabolic Score for Visceral Fat (METS-VF) Estimation - A Novel Cost-Effective Obesity Indicator for Visceral Adipose Tissue Estimation.

BackgroundVisceral adipose tissue (VAT) assessment is limited in clinical practice due to expensive, time consuming and limited availability of MRI and DXA machines. We explored the utility of a recently developed Metabolic Score for Visceral Fat (METS-VF) to assess VAT in south Asian individuals with morbid obesity.Patients and MethodsIndividuals with BMI ≥35 kg/m2 aged between 30 and 60 years were randomly selected from a database of individuals with morbid obesity, attending a multi-disciplinary bariatric clinic in a tertiary care teaching hospital in southern India. Body composition was assessed by using a Hologic Discovery A dual-energy X-ray absorptiometry (DXA) machine. METS-VF was used to estimate VAT by using a previously published algorithm.ResultsThe mean age and body mass index of the study subjects (N=350) were 38.2 years and 40.1 kg/m2. The MET-VF score performed satisfactorily (AUC of 0.78 (95% CI 0.72–0.85)) for predicting an increased visceral adipose tissue (VAT area ≥ 163 cm2) as detected by DXA. A METS-VF value of 7.3 was found to have a good sensitivity and reasonable specificity in predicting elevated VAT in this population.ConclusionThis is the first study to validate the utility of METS-VF as a surrogate measure of visceral adiposity in south Indian individuals with morbid obesity. Given the simplicity, easy availability, reliability and inexpensive nature of this obesity indicator, it may find its widespread use in lower middle-income countries.

Opportunistic use of radiological measures of visceral adiposity for assessment of risk of colorectal adenoma.

Recent evidence suggested that radiological measures of visceral adiposity are a better tool for risk assessment of colorectal adenomas. The aim of this study was to investigate the association of visceral adiposity with the development of colorectal adenomas. A retrospective review of all cases of computed tomography-confirmed acute diverticulitis from November 2015 to April 2018 was performed. Data collated included basic demographics, computed tomography scan results (uncomplicated versus complicated diverticulitis), treatment modality (conservative versus intervention), outcomes and follow-up colonoscopy results within 12 months of presentation. The patients were divided into no adenoma (A) and adenoma (B) groups. Visceral fat area (VFA), subcutaneous fat area (SFA) and VFA/SFA ratio (V/S) were measured at L4/L5 level. Statistical analysis was performed to evaluation the association of VFA, SFA, V/S and different thresholds with the risk of adenoma formation. A total of 169 patients were included in this study (A:B = 123:46). The mean ± standard deviation for VFA was higher in group B (201 ± 87 cm2 versus 176 ± 79 cm2 ) with a trend towards statistical significance (P = 0.08). There was no difference in SFA and V/S in both groups. When the VFA >200 cm2 was analysed, it was associated with a threefold risk of adenoma formation (odds ratio 2.7, 95% confidence interval 1.35-5.50, P = 0.006). Subgroup analysis of gender with VFA, SFA and V/S found that males have a significantly higher VFA in group B (220.0 ± 95.2 cm2 versus 187.3 ± 69.2 cm2 ; P = 0.05). The radiological measurement of visceral adiposity is a useful tool for opportunistic assessment of risk of colorectal adenoma.

423-P: The A Body Shape Index and Type 2 Diabetes Are Mutually Independent Predictors of Cardiovascular Events and Mortality in Patients with Established Cardiovascular Disease

The A Body Shape index (ABSI) is a validated measure of visceral adiposity that is calculated based on waist circumference, height and BMI. Its power to predict cardiovascular events and mortality in patients with established cardiovascular disease (CVD) is unclear and is addressed in the present study. We prospectively recorded cardiovascular events in a large cohort of 1546 patients with established CVD (1299 patients with angiographically proven stable coronary artery disease and 247 patients with sonographically verified PAD) over a mean follow-up time of 9.7±4.6 years. At baseline, the ABSI was higher in patients with type 2 diabetes (T2DM; n=502) than in those who did not have diabetes (8.4±0.6 vs. 8.3±0.5; p&amp;lt;0.001). Prospectively, the ABSI significantly predicted the incidence of cardiovascular events (n=749) and death (n=619) after adjustment for age, gender, smoking, hypertension, LDL cholesterol, HDL cholesterol, and T2DM (standardized adjusted HRs 1.11 [1.03-1.19]; p=0.006 and 1.18 [1.09-1.27]; p&amp;lt;0.001, respectively). T2DM in turn also significantly predicted cardiovascular events and death in this fully adjusted model independently from the ABSI, with adjusted HRs of 1.37 [1.17-1.0]; p&amp;lt;0.001 and 1.40 [1.18-1.6]; p&amp;lt;0.001, respectively. We conclude that the ABSI and T2DM are mutually independent of cardiovascular events and mortality in patients with PAD. Disclosure A. Vonbank: None. B. Larcher: None. A. Mader: None. M. Maechler: None. L. Sprenger: None. A. Leiherer: None. D. Purin: None. A. Muendlein: None. H. Drexel: None. C.H. Saely: None.

The role of quantitative radiological measures of visceral adiposity in diverticulitis.

Diverticular disease has been linked to obesity. Recent studies have assessed the role of visceral adiposity with diverticulitis and its complications. The aim of this study was to evaluate the association of quantitative radiological measures of visceral adiposity in patients with diverticulitis with vital signs, biochemistry results, uncomplicated versus complicated diverticulitis and its interventions. A retrospective analysis of all patients with diverticulitis admitted from November 2015 to April 2018 at a single institution was performed. Data collected included demographics, vital signs, biochemistry results, CT scan findings and management outcomes. The patients were divided into uncomplicated (U) and complicated diverticulitis (C) groups. Visceral fat area (VFA), subcutaneous fat area (SFA) and VFA/SFA ratio (V/S) were measured at L4/L5 level by the radiologist. Statistical analysis was performed to evaluate the association of VFA, SFA, V/S with the parameters in both U and C groups. 352 patients were included in this study (U:C = 265:87). There was no significant difference in vital signs and biochemistry results in both groups. There was no significant difference in VFA, SFA, V/S ratios in both groups. In patients with V/S ratio > 0.4, they were 5.06 times more likely to undergo emergency intervention (95% CI 1.10-23.45) (p = 0.03). On multivariate analysis, a heart rate > 100 (OR 2.9, 95% CI 1.2-6.7), CRP > 50 (OR 3.4, 95% CI 1.9-6.0), WCC < 4 or > 12 (OR 2.1, 95% CI 1.2-3.6) and V/S ratio > 0.4 (OR 2.8, 95% CI 1.5-5.4) were predictive of complicated diverticulitis. The quantitative radiological measurement of visceral adiposity is useful in prognostication in patients presenting with diverticulitis.

COMPONENTS OF A HEALTHFUL DIET ARE ASSOCIATED WITH WAIST CIRCUMFERENCE AMONG PRE- AND POSTMENOPAUSAL WOMEN

After menopause, women are at increased risk of diabetes and cardiovascular disease. A contributing factor to increased risk may be weight gain, especially visceral adiposity. Diet plays a role in maintaining weight at all ages but less is known about the specific contributions of a healthful dietary pattern after menopause. Therefore, we evaluated associations between diet and WC as a measure of visceral adiposity. We compared 869 pre- (aged 35-45 years) and 353 post-menopausal (aged 40-65 years) women from NHANES III (1988-94). Women were pre-menopausal if they self-reported menses in the past 2 months and postmenopausal if they reported no menses in past 12 months and were aged > 40 years. Compared to premenopausal women, postmenopausal women consumed fewer Calories (-200 kcal/d) and had a higher mean waist circumference (+4.43 cm, p=0.007), after adjusting for age, race-ethnicity, height, physical activity, and smoking. Higher intakes of dark green vegetables (p=0.03) and lower intakes of potatoes (p=0.03), refined grains (p=0.001), and meats (p=0.04) were associated with lower WC for all women. Higher intakes of nuts and seeds and fish high in Omega-3 fatty acids were associated with smaller WC while higher intakes of poultry and dairy products were associated with higher WC in post- but not pre-menopausal women. Our findings generally support a diet high in nuts and seeds, dark green vegetables, and fish, and low in potatoes, refined grains, and meats. After menopause it may be important to incorporate fatty fish, nuts and seeds into the diet for lower visceral adiposity.

Are quantitative measures of visceral adiposity obtained after neoadjuvant chemoradiation associated with postoperative morbidity in patients with locally advanced rectal cancer?

514 Background: Body mass index (BMI) is an inconsistent predictor of surgical morbidity in cancer patients. Increased visceral obesity measured before neoadjuvant chemoradiation (NCR) has been associated with post-operative morbidity in rectal cancer (RC). We sought to evaluate whether visceral obesity/BMI measured immediately after NCR correlates with postoperative complications in a heterogenous, largely underserved cohort of RC patients. Methods: 116 patients (64% white, 34% black, 2% other) underwent proctectomy for stage II/III RC after NCR. Automated CT segmentation software was used to determine body fat distribution at the L4/L5 level. Patients were classified as obese by BMI (≥ 30 kg/m2) and post-NCR CT measures of adiposity including visceral fat area (VFA; &gt; 100cm2), visceral to subcutaneous fat area ratio (V/S; &gt; 0.4), and perinephric fat thickness (PNF; &gt; median) were obtained. Complications were classified (Clavien-Dindo) into low (1-2) or high (3-4) grade. Associations between measures of adiposity, short-term surgical outcomes and clinicopathologic factors were evaluated with one-way ANOVA, Chi-square, and Fischer’s exact test as appropriate for overall, white, and non-white cohorts. Results: Obese patients by adiposity measures (but not BMI) were more likely to be male by V/S (91.4% vs. 54.3%, p ≤ 0.001) and PNF (62.9% vs. 26.1%, p ≤ 0.001), Caucasian by VFA (mean 135.2 cm2vs. 93.8 cm2, p = 0.002), and have preexisting metabolic comorbidities by VFA and PNF ( p &lt; 0.01). V/S was associated with the presence of key metabolic comorbidities in both white and non-white groups ( p &lt; 0.05). Obesity by V/S but not BMI was associated with development of postoperative complications in the non-white group (65.5% vs. 30.8%, p = 0.049), but not in the overall or white cohorts. Conclusions: V/S as measured after NCR is associated with presence of key metabolic comorbidities in the entire cohort but with postoperative complications only in non-white patients. Given these observations, further evaluation of the impact of socioeconomic factors and change in adiposity between pre- and post-NCR time periods is warranted.

Associations between CT-determined visceral fat burden, hepatic steatosis, circulating white blood cell counts and neutrophil-to-lymphocyte ratio.

Visceral adiposity is associated with cardiovascular disease, an association that may be mediated in part by inflammation. We hypothesized that regional measures of visceral adiposity would associate with commonly obtained clinical measures of immune status. We consecutively studied 3,291 subjects (mean age, 49.8±9.8 years) who underwent an annual cardiovascular risk survey. Peri-cardial (PCF) and thoracic peri-aortic adipose tissue (TAT) volumes were determined by dedicated computed tomography (CT) software (Aquarius 3D Workstation, TeraRecon, San Mateo, CA, USA). Hepatic steatosis was assessed by abdominal ultrasonography. We explored cross-sectional associations between visceral fat measures and high-sensitivity C-reactive protein (hs-CRP), leukocyte counts, and the neutrophil-to-lymphocyte ration (NLR). Among 3,291 study participants, we observed positive linear associations between PCF and TAT, higher degree of hepatic steatosis and hs-CRP, various leukocyte counts, either total and its differential counts, and NLR (all trend p<0.001). Multi-variate linear and logistic regression models showed independent associations between PCF/TAT (ß-Coef: 0.14/0.16, both p<0.05) and total WBC counts, with only TAT further demonstrated significant relations with neutrophil counts and NLR (both p<0.05) and independently identified abnormally high WBC and NLR (Odds ratio: 1.18 & 1.21, both p<0.05). C-statistics showed significant incremental model prediction for abnormally high WBC and NLR (both ΔAUROC<0.05) when TAT was superimposed on traditional cardiovascular risks and biochemical information. Greater visceral adiposity burden and hepatic steatosis may be associated with higher circulating leukocyte counts and markers for atherosclerosis, with more pronounced influences for peri-aortic adiposity. Our data suggested the differential biological impacts for region-specific visceral adiposity.

At similar weight loss, dietary composition determines the degree of glycemic improvement in diet-induced obese C57BL/6 mice.

BackgroundAchieving weight loss is the cornerstone of the treatment of the metabolic consequences of obesity, in particular of glucose intolerance.ObjectiveTo determine whether improvement in glucose control depends on dietary macronutrient composition of the diet at identical weight loss.Materials and methodsTwenty-two weeks old diet-induced obese C57BL/6 mice lost weight through caloric restriction on normal chow (R-NC) or high fat diet (R-HF). Control mice were fed normal chow (LEAN) or high fat diet (OBESE) ad libitum. Body weight and composition were assessed after 8 weeks of dietary intervention. Glucose homeostasis was evaluated by intraperitoneal glucose tolerance tests (IPGTT). Epididymal white adipose (eWAT) and hepatic tissues were analyzed by immunohistochemistry and RT-qPCR.ResultsBy 30 weeks of age, the body weight of the mice on R-NC (31.6±1.7g, mean±SEM) and R-HF (32.3±0.9g) was similar to LEAN mice (31.9±1.4g), while OBESE mice weighed 51.7±2.4g. Glucose tolerance in R-NC was better than in LEAN mice (69% AUC IPGTT, P 0.0168) whereas R-HF mice remained significantly less glucose tolerant (125% AUC IPGTT, P 0.0279 vs LEAN), despite identical weight loss. The eWAT pads and adipocyte size were similar in LEAN and R-NC mice, while the eWAT pad size of R-HF was 180% of R-NC (P < 0.0001) and the average adipocyte size of R-HF mice was 134% of R-NC fed mice (P 0.0285). No LEAN or R-NC mice had hepatic steatosis, in contrast to 28.6% of R-HF mice. Compared to OBESE mice, inflammatory markers were lower in eWAT and liver tissue of R-NC, but not in R-HF mice. Measures of visceral adiposity correlated well with glucose tolerance parameters.ConclusionsIn mice, caloric restriction on a normal chow diet improved glucose tolerance significantly more when identical weight loss was achieved on a high fat diet.

The A Body Shape Index and Type 2 Diabetes Are Mutually Independent Predictors of Cardiovascular Events in Patients with Peripheral Artery Disease

The A Body Shape index (ABSI) is calculated based on waist circumference, height and BMI and is a validated measure of visceral adiposity. In the general population, the ABSI has been shown to be an independent risk factor for premature mortality. Its power to predict cardiovascular events in patients with peripheral artery disease (PAD) is not known and is addressed in the present study. We prospectively recorded cardiovascular events in 319 patients with sonographically verified PAD over a mean follow-up time of 7.2±2.1 years. At baseline, the ABSI was significantly higher in patients with type 2 diabetes (T2DM) than in those who did not have diabetes (19.5±1.9 vs. 14.0±1.1; p&amp;lt;0.001). Prospectively, the ABSI significantly predicted the incidence of cardiovascular events (n=57) both univariately (standardized HR 1.36 [1.20-1.52]; p&amp;lt;0.001) and after adjustment for age, gender, smoking, LDL cholesterol, HDL cholesterol, hypertension and T2DM (standardized adjusted HR 1.17 [1.08-1.29]; p=0.010); also T2DM significantly predicted cardiovascular events in this fully adjusted model (adjusted HR 1.48 [1.25-1.74]; p&amp;lt;0.001). We conclude that the ABSI and T2DM are mutually independent of cardiovascular events in patients with PAD. Disclosure A. Vonbank: None. C.H. Saely: None. C. Heinzle: None. D. Zanolin: None. B. Larcher: None. A. Mader: None. A. Leiherer: None. A. Muendlein: None. H. Drexel: None.

THE A-BODY-SHAPE-INDEX AND TYPE 2 DIABETES ARE MUTUALLY INDEPENDENT PREDICTORS OF CARDIOVASCULAR EVENTS RISK IN ANGIOGRAPHIED CORONARY PATIENTS

The A-Body-Shape-Index (ABSI) is calculated based on waist circumference, height and BMI and provides a measure of visceral adiposity. In the general population, this index has been associated with premature mortality. Its power to predict cardiovascular events in high-risk patients is not known and