Subcutaneous Adipose Tissue Density Research Articles

Computed tomography-based body composition parameters can predict short-term prognosis in ulcerative colitis patients.

Emerging evidence suggests a potential relationship between body composition and short-term prognosis of ulcerative colitis (UC). Early and accurate assessment of rapid remission based on conventional therapy via abdominal computed tomography (CT) images has rarely been investigated. This study aimed to build a prediction model using CT-based body composition parameters for UC risk stratification. In total, 138 patients with abdominal CT images were enrolled. Eleven quantitative parameters related to body composition involving skeletal muscle mass, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) were measured and calculated using a semi-automated segmentation method. A prediction model was established with significant parameters using a multivariable logistic regression. The receiver operating characteristic (ROC) curve was plotted to evaluate prediction performance. Subgroup analyses were implemented to evaluate the diagnostic efficiency of the prediction model between different disease locations, centers, and CT scanners. The Delong test was used for statistical comparison of ROC curves. VAT density, SAT density, gender, and visceral obesity were significantly statistically different between remission and invalidation groups (all p < 0.05). The accuracy, sensitivity, specificity, and area under the ROC curve (AUC) of the prediction model were 82.61%, 95.45%, 69.89%, and 0.855 (0.792-0.917), respectively. The positive predictive value and negative predictive value were 70.79% and 93.88%, respectively. No significant differences in the AUC of the prediction model were found in different subgroups (all p > 0.05). The predicting model constructed with CT-based body composition parameters is a potential non-invasive approach for short-term prognosis identification and risk stratification. Additionally, VAT density was an independent predictor for escalating therapeutic regimens in UC cohorts. The CT images were used for evaluating body composition and risk stratification of ulcerative colitis patients, and a potential non-invasive prediction model was constructed to identify non-responders with conventional therapy for making therapeutic regimens timely and accurately. • CT-based prediction models help divide patients into invalidation and remission groups in UC. • Results of the subgroup analysis confirmed the stability of the prediction model with a high AUC (all > 0.820). • The visceral adipose tissue density was an independent predictor of bad short-term prognosis in UC.

MP08-11 BODY COMPOSITION CAN PREDICT ONCOLOGICAL OUTCOME IN NON-MUSCLE INVASIVE BLADDER CANCER PATIENTS WHO RECEIVE INTRAVESICAL INSTILLATION WITH BACILLUS CALMETTE-GUERIN AFTER TRANSURETHRAL RESECTION OF BLADDER TUMOR

You have accessJournal of UrologyCME1 Apr 2023MP08-11 BODY COMPOSITION CAN PREDICT ONCOLOGICAL OUTCOME IN NON-MUSCLE INVASIVE BLADDER CANCER PATIENTS WHO RECEIVE INTRAVESICAL INSTILLATION WITH BACILLUS CALMETTE-GUERIN AFTER TRANSURETHRAL RESECTION OF BLADDER TUMOR Fan-Ting Liao, Liang-Kang Huang, Chun-Te Wu, Cheng-Keng Chuang, See-Tong Pang, Kai-Jie Yu, Po-Hung Lin, I-Hung Shao, Hung-Cheng Kan, Yuan-Cheng Chu, Ying-Hsu Chang, and Li-Jen Wang Fan-Ting LiaoFan-Ting Liao More articles by this author , Liang-Kang HuangLiang-Kang Huang More articles by this author , Chun-Te WuChun-Te Wu More articles by this author , Cheng-Keng ChuangCheng-Keng Chuang More articles by this author , See-Tong PangSee-Tong Pang More articles by this author , Kai-Jie YuKai-Jie Yu More articles by this author , Po-Hung LinPo-Hung Lin More articles by this author , I-Hung ShaoI-Hung Shao More articles by this author , Hung-Cheng KanHung-Cheng Kan More articles by this author , Yuan-Cheng ChuYuan-Cheng Chu More articles by this author , Ying-Hsu ChangYing-Hsu Chang More articles by this author , and Li-Jen WangLi-Jen Wang More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003223.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Review of previous literature showed still conflicted opinions on influence of obesity in bladder cancer (BC) prognosis, while high body mass index(BMI) being an independent risk factor of BC. This study was aimed to find out the impact of body composition, including sarcopenia and obesity, on the oncological prognosis of non-muscle invasive bladder cancer (NMIBC) patients receiving transurethral resection of bladder tumor (TURBT) with adjuvant intravesical instillation (IVI) with Bacillus Calmette-Guerin (BCG). METHODS: We retrospectively recruited patients with NMIBC who had received TURBT with adjuvant IVI with BCG from March 2005 to April 2021. Body composition parameters were evaluated according to analysis of computed tomography (CT) L3 images with artificial intelligence (AI) models and BMI, and was further categorized into sarcopenia and obesity groups. Oncological outcomes including recurrence-free survival (RFS), progression-free survival (PFS) and overall survival (OS) after treatment of TURBT with adjuvant IVI with BCG were analyzed using uni- and multivariate analysis. Impact of sarcopenia and obesity was analyzed with Kaplan-Meier survival exam. RESULTS: Total of 269 patients were enrolled. All patients were diagnosed with NMIBC and majority were Ta or T1, accounting for 44.6% and 50.9% respectively. Among them, 80 patients were sarcopenic and 53 were obese, accounting for 29.7% and 19.7% respectively. Subcutaneous adipose tissue density on CT was a significant predictor for RFS (p=0.011) and psoas muscle density also had significant impact on OS (p=0.044) in multivariate analysis. Sarcopenic or non-obese patients endured significantly fewer BCG IVI than non-sarcopenic or obese patients. Patients with sarcopenia had poorer RFS (p=0.030) and OS (p=0.033). In contrast, obese patients had better OS (p=0.008). CONCLUSIONS: In our study, we first demonstrated that body composition, sarcopenia, and obesity had significant impact on the RFS, PFS and OS in NMIBC patients. Non-sarcopenic and obese patients can significantly endure more BCG IVI and thus may result in superior oncological outcome. In patients with NMIBC, obese group had better OS while sarcopenic patients had worse OS and RFS. Body composition measurements has potentials in assessments of oncological outcomes of NMIBC patients. Source of Funding: No source of funding © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e98 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Fan-Ting Liao More articles by this author Liang-Kang Huang More articles by this author Chun-Te Wu More articles by this author Cheng-Keng Chuang More articles by this author See-Tong Pang More articles by this author Kai-Jie Yu More articles by this author Po-Hung Lin More articles by this author I-Hung Shao More articles by this author Hung-Cheng Kan More articles by this author Yuan-Cheng Chu More articles by this author Ying-Hsu Chang More articles by this author Li-Jen Wang More articles by this author Expand All Advertisement PDF downloadLoading ...

Role of smoking on body fat distribution and coronary artery disease

Abstract Introduction Smoking and obesity are recognized as important modifiable risk factors for coronary artery disease (CAD). However, the general perception that smoking protects against obesity is a common reason for starting, and/or not quitting smoking. Purpose To detect the quantity, quality and relative distribution of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) estimated by abdominal computed tomography in smokers versus non- smokers. Methods The abdominal muscular wall was traced manually to calculate SAT and VAT areas (cm2) (outside and inside abdominal muscular wall respectively) as well as SAT density [Hounsfield units (HU)] at L4-L5 in 409 consecutive patients referred for evaluation of chest pain by multi-slice computed tomography coronary angiography (MSCT-CA). Results 26% of the studied patients (n=107) were current smokers, while the remaining 74% (n=302) never smoked. Coronary artery atherosclerosis was more prevalent in smokers compared to non-smokers (64.5% vs 55.0%; p=0.09). Smokers had statistically significantly lower body mass index (BMI) (31.2±4.3 vs. 32.5±4.7 kg/m2; p=0.015), hip circumference (HC) (98.6±22.5 vs. 103.9±20.9 cm; p=0.031), total fat area (441.62±166.34 vs. 517.95±169.51cm2; p&amp;lt;0.001), and SAT area (313.07±125.54 vs. 390.93±143.28 cm2; p&amp;lt;0.001) as compared to non-smokers. However, smokers had statistically significantly greater waist-to-hip ratio (0.98±0.08 vs. 0.96±0.08; p=0.010), VAT/SAT area ratio (0.41±0.23 vs. 0.35±0.20; p=0.013), and denser SAT depot (−98.91±7.71 vs. −102.08±6.44 HU; p&amp;lt;0.001). Conclusion Smoking contributes to CAD and to the pathogenic redistribution of body fat towards VAT, through limiting SAT potential to expand. Funding Acknowledgement Type of funding source: None

Prognostic significance of adipose tissue distribution and metabolic activity in PET-CT images of patients with metastatic colorectal cancer.

e16038 Background: The metabolic activity in visceral and subcutaneous adipose tissue have different metabolic risk profiles for colorectal cancer. The aim of this study was to investigate the prognostic significance of adipose tıssue distribution and metabolic activity in PET-CT and predict the overall survival in patients with metastatic colorectal cancer (mCRC). Methods: A total of 83 patients diagnosed with mCRC between 2010-2018 were evaluated retrospectively. Pretreatment PET-CT images were reevaluated to determine adipose tissue distribution and metabolic activity. Volume and metabolic activity of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) on FDG PET-CT images were measured. SAT volume, SAT density (HU), SAT ratio (SAT volume/ SAT density) were calculated. The maximum standardized uptake (SUV) of tumor tissue was measured. The relationship between adipose tissue and overall survival was examined. Results: 53 patients died during follow-up and the median overall survival was 33.76 months (95% CI: 28.185-39.349). According to univariate analysis results, tumor location (HR:2.5; 95% CI 1.27-4.98, p = 0.008) and SAT ratio (HR:0.5; 95% CI 0.34-1.00, p = 0.053) were the significant parameters for the OAS. VAT volume (p = 0.774), VAT density (p = 0.899), VAT suv mean (p = 0.831) and SAT volume (p = 0.423), SAT density (p = 0.353), SAT suv mean (p = 0.575), tumor suv max (p = 0.589) values were not correlated with OAS. In the multivariate analysis, SAT ratio (p = 0.011) and tumor location (p = 0.001) were correlated significantly with OAS. The median OAS for the patients with SAT ratio value &lt; -1.1 and -1.1 were 38.5 (95% CI 31.54-45.58) and 24.5 (95% CI 14.13-34.93) months, respectively (p = 0.05). Conclusions: This study showed that SAT ratio was an independent prognostic factor for OAS in patients with mCRC. We need prospective studies for to observe the relationship between adipose tissue distribution and response to treatment in mCRC.

Antiretroviral Therapy Initiation Is Associated With Decreased Visceral and Subcutaneous Adipose Tissue Density in People Living With Human Immunodeficiency Virus.

Adipose tissue (AT) alterations are common in people living with human immunodeficiency virus (PLWH). Decreases in AT density suggest disrupted adipocyte function/hypertrophy. We assessed changes in AT density after antiretroviral therapy (ART) initiation and associations with immunometabolic parameters. In a prospective randomized clinical trial of ART initiation, L4-L5 abdominal CT scans measured subcutaneous AT (SAT) and visceral AT (VAT) area and density in treatment-naive PLWH randomized to tenofovir-emtricitabine plus ritonavir-boosted atazanavir, ritonavir-boosted darunavir, or raltegravir. Linear regression models compared week 0 and week 96 levels, and 96-week changes, in SAT and VAT density (in Hounsfield units [HU]). Spearman correlations assessed relationships between AT density and immunometabolic parameters. Of the 228 participants, 89% were male and 44% were white non-Hispanic. Median age was 36 years, baseline HIV-1 RNA was 4.6 log10 copies/mL, and CD4+ T-cell count was 344 cells/μL. Over 96 weeks, SAT and VAT HU decreased significantly in all arms. Less dense week 96 SAT and VAT density correlated with higher high-density lipoprotein (HDL) cholesterol and adiponectin (r = 0.19-0.30) levels and lower interleukin 6, non-HDL cholesterol, triglyceride, leptin, and homeostatic model assessment of insulin resistance (r = -0.23 to -0.68) levels at week 96 after adjusting for baseline CD4+ T-cell count, HIV-1 RNA, and baseline AT area. Following virologic suppression, lower SAT and VAT density was associated with greater plasma measures of systemic inflammation, lipid disturbances, and insulin resistance independent of AT area, suggesting that changes in AT density with ART may lead to adverse health outcomes independent of AT quantity. NCT00851799.

Impact of adipose tissue on prostate cancer aggressiveness - analysis of a high-risk population.

Background We investigated whether visceral adiposity is associated with more aggressive disease at prostatectomy. Materials and methods Four hundred and seventy-four patients referred for postoperative adjuvant or salvage radiotherapy were included in this study. Primary endpoints were positive surgical margins (pSM) or extracapsular extension (ECE). Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were manually contoured. Univariate and multivariate logistic regression was performed. Results In univariate analysis, VAT volume (p = 0.006), adipose tissue ratio (VAT/SAT, p = 0.003), density of the SAT (p = 0.04), as well as age (p < 0.001) were associated with pSM. In the univariate analysis, SAT density was associated with a trend towards a higher rate of ECE (p = 0.051) but visceral fat volume (p = 0.01), as well as the adipose tissue ratio (p = 0.03) were both protective factors. None of the adipose tissue measurements or BMI had an influence on biochemical recurrence or overall survival (all p ≥ 0.5). Conclusions SAT-volume and increased SAT-density were generally associated with more aggressive prostate cancers whereas VAT as a protective factor. These findings emphasize a possible mechanism for the association between obesity and prostate cancer aggressiveness.

Adipose Tissue Density, a Novel Biomarker Predicting Mortality Risk in Older Adults

Knowledge of adipose composition in relation to mortality may help delineate inconsistent relationships between obesity and mortality in old age. We evaluated relationships between abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) density, mortality, biomarkers, and characteristics. VAT and SAT density were determined from computed tomography scans in persons aged 65 and older, Health ABC (n = 2,735) and AGES-Reykjavik (n = 5,131), and 24 nonhuman primates (NHPs). Associations between adipose density and mortality (4-13 years follow-up) were assessed with Cox proportional hazards models. In NHPs, adipose density was related to serum markers and tissue characteristics. Higher density adipose tissue was associated with mortality in both studies with adjustment for risk factors including adipose area, total fat, and body mass index. In women, hazard ratio and 95% CI for the densest quintile (Q5) versus least dense (Q1) for VAT density were 1.95 (1.36-2.80; Health ABC) and 1.88 (1.31-2.69; AGES-Reykjavik) and for SAT density, 1.76 (1.35-2.28; Health ABC) and 1.56 (1.15-2.11; AGES-Reykjavik). In men, VAT density was associated with mortality in Health ABC, 1.52 (1.12-2.08), whereas SAT density was associated with mortality in both Health ABC, 1.58 (1.21-2.07), and AGES-Reykjavik, 1.43 (1.07-1.91). Higher density adipose tissue was associated with smaller adipocytes in NHPs. There were no consistent associations with inflammation in any group. Higher density adipose tissue was associated with lower serum leptin in Health ABC and NHPs, lower leptin mRNA expression in NHPs, and higher serum adiponectin in Health ABC and NHPs. VAT and SAT density provide a unique marker of mortality risk that does not appear to be inflammation related.