Subcutaneous Adipose Tissue Volume Research Articles

Visceral adipose tissue reduction measured by deep neural network architecture improved reflux esophagitis endoscopic grade.

Visceral obesity is a risk factor for reflux esophagitis (RE). We investigated the risk of RE according to visceral adipose tissue (VAT) measured by deep neural network architecture using computed tomography and evaluated the longitudinal association between abdominal adipose tissue changes and the disease course of RE. Individuals receiving health checkups who underwent esophagogastroduodenoscopy (EGD) and abdominal computed tomography (CT) at Seoul National University Healthcare System Gangnam Center between 2015 and 2016 were included. Visceral and subcutaneous adipose tissue areas and volumes were measured using a deep neural network architecture and CT. The association between the abdominal adipose tissue area and volume and the risk of RE was evaluated. Participants who underwent follow-up EGD and abdominal CT were selected; the effects of changes in abdominal adipose tissue area and volume on RE endoscopic grade were investigated using Cox proportional hazards regression. We enrolled 6570 patients who underwent EGD and abdomen CT on the same day. RE was associated with male sex, hypertension, diabetes, excessive alcohol intake, current smoking status, and levels of physical activity. The VAT area and volume increased the risk of RE dose-dependently. A decreasing VAT volume was significantly associated with improvement in RE endoscopic grade (HR:3.22, 95%CI:1.82-5.71). Changes in subcutaneous adipose tissue volume and the disease course of RE were not significantly correlated. Visceral obesity is strongly associated with RE. VAT volume reduction was prospectively associated with improvement in RE endoscopic grade dose-dependently. Visceral obesity is a potential target for RE treatment.

Pre-operative visceral adipose tissue radiodensity is a potentially novel prognostic biomarker for early endoscopic post-operative recurrence in Crohn's disease.

Evidence suggests inflammatory mesenteric fat is involved in post-operative recurrence (POR) of Crohn's disease (CD). However, its prognostic value is uncertain, in part, due to difficulties studying it non-invasively. To evaluate the prognostic value of pre-operative radiographic mesenteric parameters for early endoscopic POR (ePOR). We conducted a retrospective cohort study of CD subjects ≥ 12 years who underwent ileocecal or small bowel resection between 1/1/2007 to 12/31/2021 with computerized tomography abdomen/pelvis ≤ 6 months pre-operatively and underwent ileocolonoscopy ≤ 15 months post-operatively. Visceral adipose tissue (VAT) volume (cm3), ratio of VAT:subcutaneous adipose tissue (SAT) volume, VAT radiodensity, and ratio of VAT:SAT radiodensity were generated semiautomatically. Mesenteric lymphadenopathy (LAD, largest lymph node > 10 mm) and severe vasa recta (VR) engorgement (diameter of the VR supplying diseased bowel ≥ 2 × VR supplying healthy bowel) were derived manually. The primary outcome was early ePOR (Rutgeert's score ≥ i2 on first endoscopy ≤ 15 months post-operatively) and the secondary outcome was ePOR severity (Rutgeert's score i0-4). Regression analyses were performed adjusting for demographic and disease-related characteristics to calculate adjusted odds ratio (aOR) and 95% confidence interval (CI). Of the 139 subjects included, 45% of subjects developed early ePOR (n = 63). VAT radiodensity (aOR 0.59, 95%CI: 0.38-0.90) and VAT:SAT radiodensity (aOR 8.54, 95%CI: 1.48-49.28) were associated with early ePOR, whereas, VAT volume (aOR 1.23, 95%CI: 0.78-1.95), VAT:SAT volume (aOR 0.80, 95%CI: 0.53-1.20), severe VR engorgement (aOR 1.53, 95%CI: 0.64-3.66), and mesenteric LAD (aOR 1.59, 95%CI: 0.67-3.79) were not. Similar results were observed for severity of ePOR. VAT radiodensity is potentially a novel non-invasive prognostic imaging marker to help risk stratify CD patients for POR.

Correlation between magnetic resonance imaging proton density fat fraction (MRI-PDFF) and liver biopsy to assess hepatic steatosis in obesity

Obesity is highly associated with Non-alcoholic fatty liver disease (NAFLD) and increased risk of liver cirrhosis and liver cancer-related death. We determined the diagnostic performance of the complex-based chemical shift technique MRI-PDFF for quantifying liver fat and its correlation with histopathologic findings in an obese population within 24 h before bariatric surgery. This was a prospective, cross-sectional, Institutional Review Board-approved study of PDFF-MRI of the liver and MRI-DIXON image volume before bariatric surgery. Liver tissues were obtained during bariatric surgery. The prevalence of NAFLD in the investigated cohort was as high as 94%. Histologic hepatic steatosis grades 0, 1, 2, and 3 were observed in 3 (6%), 25 (50%), 14 (28%), and 8 (16%) of 50 obese patients, respectively. The mean percentages of MRI-PDFF from the anterior and posterior right hepatic lobe and left lobe vs. isolate left hepatic lobe were 15.6% (standard deviation [SD], 9.28%) vs. 16.29% (SD, 9.25%). There was a strong correlation between the percentage of steatotic hepatocytes and MRI-PDFF in the left hepatic lobe (r = 0.82, p < 0.001) and the mean value (r = 0.78, p < 0.001). There was a strong correlation between MRI-derived subcutaneous adipose tissue volume and total body fat mass by dual-energy X-ray absorptiometry, especially at the L2–3 and L4 level (r = 0.85, p < 0.001). MRI-PDFF showed good performance in assessing hepatic steatosis and was an excellent noninvasive technique for monitoring hepatic steatosis in an obese population.

Clinical and imaging features of women with polygenic partial lipodystrophy: a case series.

Familial partial lipodystrophy (FPLD) is an inherited disorder of white adipose tissue that causes premature cardiometabolic disease. There is no clear diagnostic criteria for FPLD, and this may explain the under-detection of this condition. This pilot study aimed to describe the clinical features of women with FPLD and to explore the value of adipose tissue measurements that could be useful in diagnosis. In 8 women with FPLD and 4 controls, skinfold measurements, DXA and whole-body MRI were undertaken. Whole genome sequencing was negative for monogenic metabolic causes, but polygenic scores for partial lipodystrophy were elevated in keeping with FPLD type 1. The mean age of diagnosis of DM was 31 years in the FPLD group. Compared with controls, the FPLD group had increased HOMA-IR (10.3 vs 2.9, p = 0.028) and lower mean thigh skinfold thickness (19.5 mm vs 48.2 mm, p = 0.008). The FPLD group had lower percentage of leg fat and an increased ratio of trunk to leg fat percentage on DXA. By MRI, the FPLD group had decreased subcutaneous adipose tissue (SAT) volume in the femoral and calf regions (p < 0.01); abdominal SAT, visceral adipose tissue, and femoral and calf muscle volumes were not different from controls. Women with FPLD1 in Singapore have significant loss of adipose but not muscle tissue in lower limbs and have early onset of diabetes. Reduced thigh skinfold, and increased ratio of trunk to leg fat percentage on DXA are potentially clinically useful markers to identify FPLD1.

Automated abdominal adipose tissue segmentation and volume quantification on longitudinal MRI using 3D convolutional neural networks with multi-contrast inputs.

Increased subcutaneous and visceral adipose tissue (SAT/VAT) volume is associated with risk for cardiometabolic diseases. This work aimed to develop and evaluate automated abdominal SAT/VAT segmentation on longitudinal MRI in adults with overweight/obesity using attention-based competitive dense (ACD) 3D U-Net and 3D nnU-Net with full field-of-view volumetric multi-contrast inputs. 920 adults with overweight/obesity were scanned twice at multiple 3T MRI scanners and institutions. The first scan was divided into training/validation/testing sets (n = 646/92/182). The second scan from the subjects in the testing set was used to evaluate the generalizability for longitudinal analysis. Segmentation performance was assessed by measuring Dice scores (DICE-SAT, DICE-VAT), false negatives (FN), and false positives (FP). Volume agreement was assessed using the intraclass correlation coefficient (ICC). ACD 3D U-Net achieved rapid (< 4.8s/subject) segmentation with high DICE-SAT (median ≥ 0.994) and DICE-VAT (median ≥ 0.976), small FN (median ≤ 0.7%), and FP (median ≤ 1.1%). 3D nnU-Net yielded rapid (< 2.5s/subject) segmentation with similar DICE-SAT (median ≥ 0.992), DICE-VAT (median ≥ 0.979), FN (median ≤ 1.1%) and FP (median ≤ 1.2%). Both models yielded excellent agreement in SAT/VAT volume versus reference measurements (ICC > 0.997) in longitudinal analysis. ACD 3D U-Net and 3D nnU-Net can be automated tools to quantify abdominal SAT/VAT volume rapidly, accurately, and longitudinally in adults with overweight/obesity.

Versatile MRI acquisition and processing protocol for population‐based neuroimaging

AbstractBackgroundNeuroimaging plays an essential role in epidemiological studies and a special focus is directed towards the employment of versatile MRI acquisition and processing. The proposed multi‐purpose MRI protocol was designed for large‐scale and long‐term population neuroimaging and includes structural, diffusion‐weighted, and functional MRI modalities. It directly links the acquisition of an extensive set of MRI contrasts with fully automated data processing pipelines and quality assurance of the MRI data and image‐derived phenotypes.MethodThe MRI acquisition protocol is largely based on in‐house developed MR sequences. With a total scan time below one hour per participant, it allows to acquire multiple MR contrasts at 3T with whole‐brain coverage and high isotropic image resolution, while keeping potential subject discomfort and motion artifacts at manageable levels. Designed to be kept constant, but also adaptive, the scan protocol separates into a core imaging protocol with MR contrasts of high relevance acquired for all study participants, and a free protocol to accommodate alternative promising MRI techniques in smaller sub‐populations. The analysis protocol handles large‐scale imaging data by means of fast and fully automated processing pipelines that incorporate state‐of‐the‐art image analysis tools and innovative machine learning methods, particularly using deep learning. Dedicated quality assessment (QA) includes visual rating and inspection for incidental findings on structural MRI and QA workflows tailored for each postprocessing pipeline to automatically identify problematic data based on the distribution of subject‐specific QA metrics with respect to the population average.ResultThe MRI protocol has been successfully applied in the Rhineland Study, a prospective cohort study in Bonn, Germany, with currently over 10,000 participants. Image‐derived phenotypes include: global and regional brain tissue volume, thickness and surface measures from multi‐modal structural MRI, global and regional microstructural measures based on diffusion‐weighted MRI, brain functional connectivity using resting‐state functional MRI, and volumes of subcutaneous and visceral adipose tissue based on a single‐breathhold abdominal MRI (Figure 1).ConclusionWe present a versatile MRI protocol with acquisition and analysis methods that are generally applicable and not geared towards a specific disease or research question. Thus, this protocol may be of specific interest for many neuroimaging applications including population imaging studies.

Versatile MRI acquisition and processing protocol for population‐based neuroimaging

AbstractBackgroundNeuroimaging plays an essential role in epidemiological studies and a special focus is directed towards the employment of versatile MRI acquisition and processing. The proposed multi‐purpose MRI protocol was designed for large‐scale and long‐term population neuroimaging and includes structural, diffusion‐weighted, and functional MRI modalities. It directly links the acquisition of an extensive set of MRI contrasts with fully automated data processing pipelines and quality assurance of the MRI data and image‐derived phenotypes.MethodThe MRI acquisition protocol is largely based on in‐house developed MR sequences. With a total scan time below one hour per participant, it allows to acquire multiple MR contrasts at 3T with whole‐brain coverage and high isotropic image resolution, while keeping potential subject discomfort and motion artifacts at manageable levels. Designed to be kept constant, but also adaptive, the scan protocol separates into a core imaging protocol with MR contrasts of high relevance acquired for all study participants, and a free protocol to accommodate alternative promising MRI techniques in smaller sub‐populations. The analysis protocol handles large‐scale imaging data by means of fast and fully automated processing pipelines that incorporate state‐of‐the‐art image analysis tools and innovative machine learning methods, particularly using deep learning. Dedicated quality assessment (QA) includes visual rating and inspection for incidental findings on structural MRI and QA workflows tailored for each postprocessing pipeline to automatically identify problematic data based on the distribution of subject‐specific QA metrics with respect to the population average.ResultThe MRI protocol has been successfully applied in the Rhineland Study, a prospective cohort study in Bonn, Germany, with currently over 10,000 participants. Image‐derived phenotypes include: global and regional brain tissue volume, thickness and surface measures from multi‐modal structural MRI, global and regional microstructural measures based on diffusion‐weighted MRI, brain functional connectivity using resting‐state functional MRI, and volumes of subcutaneous and visceral adipose tissue based on a single‐breathhold abdominal MRI (Figure 1).ConclusionWe present a versatile MRI protocol with acquisition and analysis methods that are generally applicable and not geared towards a specific disease or research question. Thus, this protocol may be of specific interest for many neuroimaging applications including population imaging studies.

Associations of cord plasma per- and polyfluoroakyl substances (PFAS) with neonatal and child body composition and adiposity: The GUSTO study

BackgroundThe influence of prenatal exposure to per- and poly- fluoroalkyl substances (PFAS) on birth size and offspring adiposity is unclear, especially for the newer, shorter-chained replacement PFAS. MethodsIn the GUSTO multi-ethnic Singaporean mother-offspring cohort, 12 PFAS were measured in 783 cord plasma samples using ultra-performance-liquid chromatography-tandem-mass-spectrometer (UPLC-MS/MS). Outcomes included offspring anthropometry, other indicators of body composition/metabolic health, and MRI-derived abdominal adiposity (subset) at birth and 6 years of age. PFAS were modeled individually, in categories of long-chain and short-chain PFAS, and as scores of three principal components (PC) derived using PC analysis (PC1, PC2, and PC3 reflect predominant exposure patterns to “very-long-PFAS”, “long-PFAS”, and “short-PFAS”, respectively). Associations with outcomes were assessed using multivariable linear regressions, adjusted for important covariates such as maternal sociodemographic and lifestyle factors. ResultsOverall, cord PFAS levels showed either no or positive associations (mostly for long-chain PFAS) with birth weight, length and head circumference. In general, PFAS were associated with higher neonatal abdominal adiposity, driven by shorter-chain PFAS. Perfluoroheptanoic acid (PFHpA) was associated with higher volumes of superficial subcutaneous adipose tissue (sSAT) (3.75 [1.13, 6.37] mL per SD increase in PFAS) and internal adipose tissue (IAT) (1.39 [0.41, 2.38] mL). Higher levels of perfluorobutanesulfonic acid (PFBS), short-chain PFAS, and PC3 were associated with higher IAT volume (β range 1.22–1.41 mL/SD, all P < 0.02), especially in girls. Higher PC3 score was additionally associated with higher sSAT (3.12 [0.45, 5.80] mL) volume. At age 6 years, most observed associations did not persist. No consistent associations were observed between PFAS and whole-body adiposity measures. ConclusionsFetal exposure to emerging short-chain PFAS was associated with higher abdominal adiposity at birth but not at age 6 years. Further research is needed to replicate the findings and to determine if these effects may reappear beyond early childhood. Population exposure to newer PFAS and consequent health impact must be monitored.

The causal relationship between air pollution, obesity, and COVID-19 risk: a large-scale genetic correlation study.

Observational evidence reported that air pollution is a significant risk element for numerous health problems, such as obesity and coronavirus disease 2019 (COVID-19), but their causal relationship is currently unknown. Our objective was to probe the causal relationship between air pollution, obesity, and COVID-19 and to explore whether obesity mediates this association. We obtained instrumental variables strongly correlated to air pollutants [PM2.5, nitrogen dioxide (NO2) and nitrogen oxides (NOx)], 9 obesity-related traits (abdominal subcutaneous adipose tissue volume, waist-to-hip ratio, body mass index, hip circumference, waist circumference, obesity class 1-3, visceral adipose tissue volume), and COVID-19 phenotypes (susceptibility, hospitalization, severity) from public genome-wide association studies. We used clinical and genetic data from different public biological databases and performed analysis by two-sample and two-step Mendelian randomization. PM2.5 genetically correlated with 5 obesity-related traits, which obesity class 1 was most affected (beta = 0.38, 95% CI = 0.11 - 0.65, p = 6.31E-3). NO2 genetically correlated with 3 obesity-related traits, which obesity class 1 was also most affected (beta = 0.33, 95% CI = 0.055 - 0.61, p = 1.90E-2). NOx genetically correlated with 7 obesity-related traits, which obesity class 3 was most affected (beta = 1.16, 95% CI = 0.42-1.90, p = 2.10E-3). Almost all the obesity-related traits genetically increased the risks for COVID-19 phenotypes. Among them, body mass index, waist circumference, hip circumference, waist-to-hip ratio, and obesity class 1 and 2 mediated the effects of air pollutants on COVID-19 risks (p < 0.05). However, no direct causal relationship was observed between air pollution and COVID-19. Our study suggested that exposure to heavy air pollutants causally increased risks for obesity. Besides, obesity causally increased the risks for COVID-19 phenotypes. Attention needs to be paid to weight status for the population who suffer from heavy air pollution, as they are more likely to be susceptible and vulnerable to COVID-19.

Otonom kortizol sekresyonu olan hastalarda ve fonksiyonel olmayan adrenal kitleleri olan hastalarda viseral yağ dokusunun karşılaştırılması

Purpose: This study aimed to explore the impact of continuous autonomous cortisol secretion on visceral (VAT), abdominal subcutaneous (SAT) adipose tissue, and total body fat.&#x0D; Materials and Methods: A total of 57 patients (36 female, 21 male) with adrenal masses, referred to our single center, were included in this study. Among them, 31 patients had adrenal cortical carcinoma (ACS) and 26 had nonfunctional adrenal mass (NFAM). Hormonal evaluation was conducted for all patients. Measurements of total, visceral, and subcutaneous adipose tissue were performed using 3.0 T magnetic resonance imaging (Ingenia, Philips Medical Systems, Best, The Netherlands).&#x0D; Results: Mean age, gender distribution, and body mass index (BMI) were comparable between patients with ACS and NFAM. Patients with ACS exhibited higher volumes of both total (422.1±131.3 vs. 346.2±86.0 cm3) and visceral adipose tissue (199.9±77.3 vs. 160.6±60.8 cm3) compared to those with NFAM. Incidence rates of diabetes mellitus and hepatosteatosis were similar in both groups. Subcutaneous adipose tissue volumes, visceral-to-subcutaneous ratio, and visceral-to-total fat ratio showed no significant differences between the two groups.&#x0D; Conclusion: Patients with ACS demonstrated increased total and visceral fat tissue volumes compared to NFAM patients matched for gender, age, and BMI. This observation may elucidate the potential influence of continuous mild autonomous cortisol secretion in ACS patients. Such findings could serve as indicators of heightened cardiovascular risk among ACS patients.

Can lung semi-quantitative measurements and mediastinal adipose tissue volume predict prognosis in patients with idiopathic pulmonary fibrosis (IPF)? A CT-based preliminary study.

The aim of this study was to assess the potential of subcutaneous adipose tissue volume, mediastinal adipose tissue volume, lung density, and lung volume (as measured on high-resolution computed tomography) to predict disease progression in patients with idiopathic pulmonary fibrosis (IPF). Additionally, the study aimed to evaluate the changes in these semiquantitative measures over time. The HRCT images of 57 patients diagnosed with IPF were retrospectively screened. Subcutaneous adipose tissue volume, mediastinal adipose tissue volume, and mean lung density and volume were measured at the time of diagnosis and at the 12th month. The ability of these parameters to predict progression was evaluated using the univariate and multivariate Cox regression analyses. Low mediastinal adipose tissue volume at diagnosis had a 0.991-fold effect [odds ratio (OR)= 0.991, 95% confidence interval (CI)= 0.984-0.997, p< 0.001] on progression. Low mediastinal adipose tissue volume at diagnosis had a 0.993-fold effect [odds ratio (OR)= 0.993, 95% confidence interval (CI)= 0.975-1.011, p< 0.001] and progression development at the 12th month had a 6.5-fold effect [odds ratio (OR)= 6.516, 95% confidence interval (CI)= 1.594-26.639, p< 0.009] on mortality. This study indicate that the prognosis was better in those with a large mediastinal adipose tissue volume among the patients with IPF.

Hemodynamic Determinants of Elevated Blood Pressure and Hypertension in the Middle to Older-Age UK Population: A UK Biobank Imaging Study.

Increased systemic vascular resistance and, in older people, reduced aortic distensibility, are thought to be the hemodynamic determinants of primary hypertension but cardiac output could also be important. We examined the hemodynamics of elevated blood pressure and hypertension in the middle to older-aged UK population participating in the UK Biobank imaging studies. Cardiac output, systemic vascular resistance, and aortic distensibility were measured from cardiac magnetic resonance imaging in 31 112 (distensibility in 21 178) participants (46.3% male, mean age±SD 63±7 years). Body composition including visceral adipose tissue volume and abdominal subcutaneous adipose tissue volume were measured in 19 645 participants. Participants with higher blood pressure had higher cardiac output (higher by 17.9±26.6% in hypertensive compared with those with optimal blood pressure) and higher systemic vascular resistance (higher by 11.4±27.9% in hypertensive compared with those with optimal blood pressure). These differences were little changed after adjustment for body size and adiposity. The contribution of cardiac output relative to systemic vascular resistance was more marked in younger compared with older subjects. Aortic distensibility decreased with age and was lower in participants with higher compared with lower blood pressure but with a greater difference in younger compared with older subjects. In the middle to older-aged UK population, cardiac output plays an important role in contributing to elevated mean arterial blood pressure, particularly in younger compared with older subjects. Reduced aortic distensibility contributes to a rise in pulse pressure and systolic blood pressure at all ages.

Adiposity and Coagulation: Predicting Postinjury Coagulation With Advanced Imaging Analysis

IntroductionAnatomic distribution of adipose tissue has demonstrated variable associations with hypercoagulability. Utilizing a retrospective analysis of a previously enrolled prospective cohort, we assessed computed tomography (CT) scan-based anthropometric and volumetric measures of adiposity as predictors of postinjury hypercoagulability. MethodsSegmentation analysis of arrival CT scans in significantly injured patients at a single level-I trauma center enrolled from December 2017 to August 2021 were analyzed for anthropometric indices of waist circumference (WC) and sagittal abdominal diameter (SAD), and volumetric parameters of visceral adipose tissue, superficial/deep subcutaneous adipose tissue, psoas/paravertebral muscle volume, and abdominal wall muscle volume. Associations with thromboelastography (TEG) were explored. ResultsData from 91 patients showed strong correlations between body mass index and standard anthropometric measures of WC and SAD (P < 0.001); calculated volumes of subcutaneous adipose tissue and visceral adipose tissue (P < 0.001); and ratios of subcutaneous adipose:psoas muscle (SP ratio) and visceral adipose:psoas muscle ratio (both with P < 0.001, respectively). Correlation between TEG maximal amplitude (MA) and body mass index and SAD were not significant, with only weak correlation between TEG-MA and WC (r = 0.238, P = 0.041). Moderate but significant correlations existed between SP ratio and TEG-MA (r = 0.340, P = 0.005), but not visceral adipose:psoas muscle ratio (r = 0.159, P = 0.198). The relationship between TEG-MA and SP ratio remained significant when adjusted for injury severity score and lactate level (b = 0.302, P = 0.001). ConclusionsSP ratio is more strongly correlated with TEG-MA than standard obesity measures, and independently predicts increasing clot strength/stability after injury. Coagulation-relevant measures of sarcopenic obesity can be measured on CT scan, and may be used to optimize thromboprophylaxis strategies for obese injured patients.

Similarities and differences in skeletal muscle and body composition between sexes: an MRI study of recreational cyclists

ObjectivesThis study aims to quantitatively evaluate whether there are muscle mass differences between male and female recreational cyclists and compare muscle quality and body composition in the pelvis region between...

Injectable ice slurry for reducing pericardial adipose tissue.

Excess pericardial adipose tissue (PAT) is associated with a higher risk of cardiovascular diseases. Currently, available methods for reducing PAT volume include weight loss through diet and exercise, weight loss with medications, and bariatric surgery. However, these methods are all limited by low patient compliance to maintain the results. We have developed an injectable ice slurry that could selectively target and reduce subcutaneous adipose tissue volume. The aim of this study was to investigate the feasibility and safety of using injectable slurry to selectively reduce PAT volume in a preclinical large animal model. PAT in Yucatan swine was injected with slurry or room temperature control solution. All animals were imaged with baseline chest computed tomography (CT) before slurry injection and at 2 months after injection to quantify PAT volume. Specimens from injected and noninjected PAT were harvested for histology. Slurry treatment of PAT was well tolerated in all animals. Slurry-induced selective cryolipolysis in treated PAT. CT imaging showed decrease in PAT volume in treated area at 8 weeks posttreatment compared to baseline, that was significantly different from control solution treated group (median [range]: -29.66 [-35.07 to -27.92]% vs. -1.50 [-11.69 to 8.69]% in control animals respectively, p < 0.05). This study demonstrated that slurry injection into PAT is feasible in a large animal model. Slurry injection was safe and effective in inducing selective cryolipolysis in PAT and reducing PAT volume. Slurry reduction of PAT could potentially serve as a novel treatment for cardiovascular diseases.

Long-term aspartame and saccharin intakes are related to greater volumes of visceral, intermuscular, and subcutaneous adipose tissue: the CARDIA study

BackgroundArtificial sweetener (ArtSw) intakes have been previously associated with higher BMI in observational studies and may promote visceral and skeletal muscle adipose tissue (AT) accumulation. This study aimed to determine whether habitual, long-term ArtSw or diet beverage intakes are related to greater AT depot volumes and anthropometry-related outcomes.MethodsA validated diet history questionnaire was administered at baseline, year 7, and year 20 examinations in 3088 men and women enrolled in the Coronary Artery Risk Development in Young Adults cohort (CARDIA), mean age of 25.2 years and mean BMI of 24.5 kg/m2 at baseline. Volumes of visceral (VAT), intermuscular (IMAT), and subcutaneous adipose tissue (SAT) were assessed by computed tomography at year 25. Linear regression evaluated associations of aspartame, saccharin, sucralose, total ArtSw, and diet beverage intakes with AT volumes, anthropometric measures, and 25-year change in anthropometry. Cox regression estimated associations of ArtSw with obesity incidence. Adjustments were made for demographic and lifestyle factors, total energy intake, and the 2015 healthy eating index.ResultsTotal ArtSw, aspartame, saccharin, and diet beverage intakes were positively associated with VAT, SAT, and IMAT volumes (all ptrend ≤ 0.001), but no associations were observed for sucralose intake (all ptrend > 0.05). In addition, total ArtSw, saccharin, aspartame, and diet beverage intakes were associated with greater body mass index, body weight, waist circumference, and their increases over a 25-year period. Except for saccharin (ptrend = 0.13), ArtSw, including diet soda, was associated with greater risks of incident obesity over a median 17.5-year follow-up (all ptrend < 0.05).ConclusionsResults suggest that long-term intakes of aspartame, saccharin, or diet soda may increase AT deposition and risk of incident obesity independent of diet quality or caloric intake. Coupled with previous evidence, alternatives to national recommendations to replace added sugar with ArtSw should be considered since both may have health consequences.

758-P: Changes in Liver and Abdominal Fat in Tirzepatide-Treated Patients Achieving Normoglycemia in the SURPASS-3 MRI Substudy

Tirzepatide (TZP), a novel, once-weekly GIP/GLP-1 receptor agonist, significantly reduced liver fat content (LFC) and volumes of visceral and abdominal subcutaneous adipose tissue (VAT and ASAT) vs insulin degludec in a subpopulation of patients in the SURPASS-3 phase 3 trial. This post-hoc analysis evaluated changes from baseline to Week 52 in these outcomes and other clinical and laboratory parameters in TZP-treated patients achieving or not achieving normoglycemia (HbA1c &amp;lt;5.7%) at Week 52. LFC, VAT and ASAT volumes were assessed with MRI prior to randomization and at Week 52 in insulin-naïve patients with type 2 diabetes inadequately controlled on metformin with/without SGLT-2i and fatty liver index ≥60 at baseline. Analyses used pooled data from all TZP arms (5, 10, and 15 mg). Patients achieving HbA1c &amp;lt;5.7% were slightly younger and had lower baseline HbA1c and VAT vs those not achieving HbA1c &amp;lt;5.7%. Substantial reductions in LFC, VAT and ASAT volumes, weight, HbA1c, and overall improvement in lipids profile were observed in both subsets of patients (Table). Among patients achieving HbA1c &amp;lt;5.7% and ≥5.7%, respectively, 56% and 27% achieved LFC &amp;lt;6%, and 91% and 64% achieved ≥30% reduction in LFC. In summary, in TZP-treated patients, changes in LFC, VAT and ASAT, and lipids were more pronounced in those achieving normoglycemia. Disclosure Á.Rodríguez: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. K.Cusi: Consultant; Poxel SA, Altimmune, Arrowhead Pharmaceuticals, Inc., AstraZeneca, 89bio, Inc., Bristol-Myers Squibb Company, Lilly, Madrigal Pharmaceuticals, Inc., Merck &amp; Co., Inc., Medscape, Myovant, Novo Nordisk, ProSciento, Quest Diagnostics, Sagimet, Sonic Incytes, Terns, Research Support; Echosens, Inventiva, LabCorp, Zydus. A.Gastaldelli: Advisory Panel; Pfizer Inc., Novo Nordisk, Merck Sharp &amp; Dohme Corp., Boehringer Ingelheim International GmbH, Consultant; Boehringer Ingelheim International GmbH, Eli Lilly and Company, Fractyl Health, Inc., Merck Sharp &amp; Dohme Corp., Other Relationship; Pfizer Inc., Speaker's Bureau; Eli Lilly and Company. C.Nicolay: Employee; Eli Lilly and Company. A.Torcello-gomez: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. L.Fernandez lando: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. Funding Eli Lilly and Company

Abstract #1400837: Skewness in Body Fat Distribution Pattern Links to Specific Cardiometabolic Disease Risk Profiles

Research on body fat distribution illustrates a heterogeneity within obesity and indicates that the pattern in which a person carries their fat could help determine each individual’s cardiometabolic risk profile. The aim of this study was to evaluate the association between balance of different fat compartments (visceral, subcutaneous, and liver) with incident type 2 diabetes (T2D) and cardiovascular disease (CVD) in the UK Biobank imaging study. Magnetic resonance images were collected in 40,174 participants using a 6-minute neck-to-knee protocol and analyzed for visceral adipose tissue (VAT) volume, abdominal subcutaneous adipose tissue (aSAT) volume, and liver proton density fat fraction (LF) using AMRA® Researcher. To assess body fat distribution patterns independent of BMI, personalized body fat z-scores (VATz, aSATz, and LFz) were calculated for each participant using the distribution of least N=150 matched controls with the same sex and similar BMI. Participants without prevalent T2D and CVD (N=35,138), were partitioned in 3 ways: based on the balance between (1) VATz & LFz using z-scores=0 as cut-points (thus creating 4 groups: VATz< 0 & LFz< 0 (reference [lower VAT and LF than predicted by BMI]); VATz< 0 & LFz >0; VATz >0 & LFz< 0; VATz >0 & LFz >0, (2) VATz & aSATz, and (3) LFz & aSATz. Logistic regression and Cox proportional-hazards models were used to investigate the association of the balance between body fat z-scores with incident T2D and CVD respectively. Models were crude and subsequently adjusted for sex, age, and BMI. The strongest association with incident T2D were found for VATz >0 & LFz >0 (crude odds ratio (cOR) 4.31, 95% CI 2.83-6.78, p< 0.001), VATz >0 & aSATz< 0 (cOR 4.43, 95% CI 2.85-7.11, p< 0.001), and LFz >0 & aSATz< 0 (cOR 2.47, 95% CI 1.62-3.83, p< 0.001). When adjusted for sex, age, and BMI, those with VATz >0 and/or LFz >0 remained significant. For incident CVD, the strongest associations were found for VATz >0 & LFz< 0 (crude hazard ratio (cHR) 1.53, 95% CI 1.34-1.76, p< 0.001) and VATz >0 & aSATz< 0 (cHR 1.54, 95% CI 1.34-1.76, p< 0.001). When adjusted for sex, age, and BMI, only VATz >0 & LFz< 0 remained significant. Excessive accumulation of VAT in relation to BMI (VATz >0) was consistently linked to both T2D and CVD. Excessive accumulation of LF in relation to BMI (LFz >0) was linked to T2D only. Groups with skewed fat distribution patterns showed the highest risk for incident CVD (VATz >0 & LFz< 0 and VATz >0 & aSATz< 0) and T2D (VATz >0 & aSATz< 0). Descriptions of body fat distribution pattern could inform diagnosis and treatment strategies for obesity and related conditions.

Determination of lower radiation dose limit for automatic measurement of adipose tissue.

The purpose of this study was to determine the lower limit of radiation dose required to measure visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) volumes when a fat quantification and noise reduction techniques (NRTs) are combined. For this purpose, we utilized CT colonography (CTC) images taken at low doses and manually segmented VAT and SAT fat volumes as ground truth. In order to derive the acceptable precision of the measurements needed to estimate the lower limit of radiation dose, we estimated the effect of different positioning during CT scanning on fat measurements using manually segmented VAT and SAT against normal dose. As a result, the acceptable accuracy of SAT and VAT was found to be 94.5% and 85.2%, respectively. Using these thresholds, the lower radiation dose limit required to accurately measure SAT using 5.25-mm slice-thick images was 1.5mGy of size-specific dose estimates (SSDE), while the lower radiation dose limit required to accurately measure VAT was 0.4mGy of SSDE. The lower dose limit for SAT and VAT combined was 1.5mGy, which was equivalent to an estimated effective dose of 0.38mSv. Alternatively, without noise reduction, SAT could not achieve acceptable accuracy even for images with a slice thickness of 5.25mm, while VAT required noise reduction for images with a slice thickness of 1.25mm, but could achieve acceptable accuracy without noise reduction for images with a slice thickness of 5.25mm.

Mid-life cyclists preserve muscle mass and composition: a 3D MRI study

Physical activity and a healthy lifestyle are crucial factors for delaying and reducing the effects of sarcopenia. Cycling has gained popularity in the last decades among midlife men. While the cardiovascular benefits of cycling and other endurance exercises have been extensively proved, the potential benefits of lifelong aerobic exercise on muscle health have not been adequately studied. Our aim was to quantify the benefits of cycling in terms of muscle health in middle-aged men, using magnetic resonance imaging. We ran a cross-sectional study involving two groups of middle-aged male adults (mean age 49 years, range 30–65) that underwent Dixon MRI of the pelvis. The groups consisted of 28 physically inactive (PI) and 28 trained recreational cyclists. The latter had cycled more than 7000 km in the last year and have been training for 15 years on average, while the PI volunteers have not practiced sports for an average of 27 years. We processed the Dixon MRI scans by labelling and computing the fat fraction (FF), volume and lean volume of gluteus maximus (GMAX) and gluteus medius (GMED); and measuring the volume of subcutaneous adipose tissue (SAT). We found that the cyclists group had lower FF levels, a measure of intramuscular fat infiltration, compared to the PI group for GMAX (PI median FF 21.6%, cyclists median FF 14.8%, p < 0.01) and GMED (PI median FF 16.0%, cyclists median FF 11.4%, p < 0.01). Cyclists had also larger GMAX and GMED muscles than the PI group (p < 0.01), after normalizing it by body mass. Muscle mass and fat infiltration were strongly correlated with SAT volume. These results suggest that cycling could help preserve muscle mass and composition in middle-aged men. Although more research is needed to support these results, this study adds new evidence to support public health efforts to promote cycling.