Subcutaneous Fat Accumulation Research Articles

Prevalence and Predictors of Normal-Weight Obesity among Women.

The present study aimed to (a) assess normal-weight obesity (NWO) and general obesity prevalence among women of different ages residing in urban areas, (b) evaluate subcutaneous fat thickness (SFT) in women with NWO, (c) establish SFT cutoff points for distinguishing NWO, and (d) explore eating habits linked to NWO. This cross-sectional study with 184 women aged 18-65 with NWO, normal weight without obesity (NWNO), overweight and general obesity included evaluation of body composition, SFT assessment using 2.5 MHz A-mode ultrasound (ISAK protocol, 7 sites) and lifestyle inquiries. The curvilinear relationship between body fat and BMI rendered BMI an unreliable indicator of adiposity in women with normal weight (BMI < 25 kg/m2). Almost 30% of women with a high body fat percentage (BFP ≥ 30%) were misclassified when BMI was used to measure adiposity. The overall obesity prevalence defined by BFP was almost four times higher than that defined by BMI (56.0 vs. 18.0%, p = 1 × 10-4). Women with NWO, overweight and general obesity shared a similar SFT profile and eating habits, setting them apart from those with NWNO. The mean SFT was the most reliable NWO predictor, with a threshold set at 12 mm equal to the 66th percentile. Mean SFT accurately classified 85% of women with NWO. While age did not significantly affect subcutaneous fat accumulation, total fat levels increased with age (R2 = 0.07 and R2 = 0.19, padj = 0.1 and padj = 9 × 10-4). Higher NWO prevalence in middle-aged women was linked to age-related increase in fat mass and decrease in fat-free mass. Engaging in regular physical activity and reducing snack consumption effectively countered age-related changes in body composition (padj < 0.05). Women under 45 years who consumed sweet bakery items, fast food, and snacks more frequently showed higher BFP and NWO status (padj < 0.05). Prevention strategies should focus on monitoring body composition and promoting healthy behaviors, particularly among young women transitioning into adulthood and women over 45 years.

Correlation between Pancreatic Fat Deposition and Metabolic Syndrome: Relationships with Location in the Pancreas and Sex.

Objective To investigate the correlation between pancreatic fat deposition and metabolic syndrome (MetS) parameters, focusing on the locations of fat deposition in the pancreas and sex differences. Methods Degrees of fat deposition in the head, body, and tail of the pancreas were evaluated using computed tomography (CT). We examined the relationships between pancreatic fat deposition and the age, body mass index (BMI), visceral and subcutaneous fat, serum lipid profiles, hepatic steatosis, diabetes mellitus (DM), and hypertension (HTN). Results In this retrospective study, greater fat deposition was associated with a higher BMI, visceral and subcutaneous fat accumulation, and hepatic steatosis, with the pancreatic head showing the strongest correlation. Correlations of pancreatic fat deposition with the BMI and visceral and subcutaneous fat accumulation were stronger in females than in males, while correlations with hepatic steatosis were stronger in males than in females. In addition, a multivariate analysis did not suggest a direct causal relationship between pancreatic fat deposition and DM and HTN, but there was a significant correlation between pancreatic fat deposition in the pancreatic head and visceral fat area. Conclusion Pancreatic fat deposition, as evaluated by CT, especially in the part of the pancreatic head adjacent to the ampulla of Vater, is a sensitive indicator of MetS. The correlations between pancreatic fat deposition and MetS parameters tended to be stronger in females than in males. These results may help further elucidate the pathophysiology of MetS and provide opportunities for its diagnosis.

Pu‐erh tea reduces the transmission of CRD‐mediated alopecia risk to offspring

AbstractCircadian rhythm disorder (CRD) is closely associated with hair regression and shedding, but whether this risk can be transmitted to the offspring is unknown. Whether Pu‐erh tea, with alleviating effects of CRD‐mediated syndrome, can act on the transmission of alopecia risk to offspring is also unproven. Here, we obtained CRD parental mice offspring and found that CRD‐mediated alopecia risk can be transmitted to offspring, especially male offspring. Parental consumption of Pu‐erh tea, especially in females or both parents, reduced the risk of CRD‐mediated alopecia transmitted to offspring by inhibiting subcutaneous fat accumulation (downregulation of Rab18, fat‐specific protein 27 (Fsp27), and perilipin 1 (Plin1)), reducing oxidative stress and inflammation in skin tissue (NADPH oxidase 4 (NOX4)/ nuclear factor kappa‐B (NF‐κB)), balancing androgen and hair growth factor release (hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), insulin‐like growth factor 1 (IGF‐1)), and restoring hair follicle DNA repair function (upregulation of Ku70, 8‐Oxoguanine DNA glycosylase 1 (OGG1), and Rad51). Transcriptomic analysis further clarified that the mechanism stemmed from the upregulation of gene expression in pathways such as the Wnt, Hippo, and other signaling pathways.

Ameliorative effect of bofutsushosan (Fangfengtongshengsan) extract on the progression of aging-induced obesity.

This study aimed to compare fat accumulation in young and aged mice raised on a high-fat diet and to characterize the obesity-reducing effects of a Kampo medicine, bofutsushosan (BTS; fangfengtongshengsan in Chinese). Aged mice fed a high-fat diet containing 2% BTS extract for 28days exhibited a significant reduction in weight gain and accumulation of visceral and subcutaneous fat, which were greater degree of reduction than those of the young mice. When the treatment period was extended to two months, the serum aspartate aminotransferase and alanine aminotransferase levels and the accumulation of fat droplets in the hepatocytes decreased. The mRNA expression of mitochondrial uncoupling protein 1 (UCP1) in the brown adipose tissue was significantly reduced in the aged mice compared to the young mice but increased by 2% in the BTS-treated aged mice. Additionally, the effect of BTS extract on oleic acid-albumin-induced triglyceride accumulation in hepatoblastoma-derived HepG2 cells was significantly inhibited in a concentration-dependent manner. Evaluation of the single crude drug extracts revealed that Forsythia Fruit, Schizonepeta Spike, and Rhubarb were the active components in BTS extract. These results suggest that BTS extract is effective against visceral, subcutaneous, and ectopic fats in the liver, which tend to accumulate with aging. Thus, BTS extract is useful in preventing and ameliorating the development of obesity and metabolic syndrome.

Heterogeneity of Intramuscular, Intermuscular, and Subcutaneous Fat in Laiwu Pigs: Insights from Targeted Lipidomics and Transcriptomics

In the livestock industry, an excessive accumulation of subcutaneous fat diminishes the proportion of lean meat, while elevated intramuscular fat (IMF) content is associated with enhanced meat quality. However, the heterogeneity of various fat depots in pigs remains incompletely understood. Comprehensive tissue section, lipidomic, and transcriptomic analyses indicated that the maturity of IMF was significantly less than that of both intermuscular and subcutaneous fats. We identified 467 lipids across 29 lipid classes in total, revealing that IMF exhibits unique lipid composition and transcriptional profiles. More importantly, several lipids, including GalCer, S1P, CL, AcCa, PC-O, PE-O, and sulfatide, are highly enriched in intramuscular fat and may play pivotal roles in neuromodulation, mitochondrial function, lipogenesis, and membrane signaling. In conclusion, we unveiled unique lipid composition and molecular regulatory pathways of porcine IMF, offering new insights for the synergistic breeding that aims at optimizing pig backfat thickness and IMF content.

IJCM_270A: Neck circumference as a potential predictor of blood pressure: An exploratory Case Control Study

Background: Hypertension (HTN) poses a substantial health challenge globally, affecting nearly one billion people. Due to its silent nature, early detection is crucial to prevent end-organ damage. Recent studies suggest a correlation between hypertension and upper body subcutaneous fat accumulation, particularly in the neck circumference (NC). This anthropometric measure is proposed as practical surrogate for assessing visceral obesity, surpassing traditional measures like waist circumference. Objectives: To correlate Neck Circumference (NC) with blood pressure in adults and to correlate other risk factors of HTN with NC. Methodology: This Case Control Study was conducted at Government Wenlock Hospital, KMC Attavar, and KMC outreach clinics. The study population included hypertensive cases and non-hypertensive controls, with a sample size of 110 in each group. Participants above 25 years of age were included, and those with specific conditions were excluded. Mercury Sphygmomanometer, Stethoscope, Flexible measuring tape, and Weighing scale were used as study instruments. Results: Overall, 79.5% of individuals with NC &gt; median consumed a non- vegetarian diet, and those with high salt intake were 1.42 times more likely to develop HTN. Although not statistically significant, 53% of those with a high cholesterol diet had NC greater than median. The study emphasizes the need for larger sample sizes for more conclusive results. Conclusion: The study establishes a positive correlation between blood pressure and NC, proposing NC as a practical and socially acceptable anthropometric marker. The non-invasive nature and simplicity of NC measurement make it a feasible tool for routine assessment, potentially impacting hypertension guidelines.

Diagnostics of the body composition of an elderly person to assess the prognosis of his health

Aging is associated with a change in body composition, which is an increase in the proportion of fat mass, usually against with decrease in muscle mass. In addition, obesity is often associated with metabolic syndrome, type 2 diabetes mellitus (DM2), and cardiovascular diseases. Visceral obesity is more dangerous than excessive accumulation of subcutaneous fat. An accurate assessment of body composition can provide useful information about the health and functions of the body. However, it can be difficult to determine the exact content of musculoskeletal and adipose tissue in the body of geriatric patients. Anthropometric methods are easy to use and do not require complex and expensive equipment, but they are uninformative and have low accuracy. The issue of timely diagnosis of the compositional composition of the body in older age groups is relevant for predicting the risk of developing chronic non-communicable diseases, disability.

Pubertal glyphosate-based herbicide exposure aggravates high-fat diet-induced obesity in female mice.

Glyphosate-based herbicides (GBH) are the most widely used pesticides globally. Studies have indicated that they may increase the risk of various organic dysfunctions. Herein, we verified whether exposure to GBH during puberty increases the susceptibility of male and female mice to obesity when they are fed a high-fat diet (HFD) in adulthood. From the 4th-7th weeks of age, male and female C57Bl/6 mice received water (CTL group) or 50mg GBH /kg body weight (BW; GBH group). From the 8th-21st weeks of age, the mice were fed a standard diet or a HFD. It was found that pubertal GBH exposure exacerbated BW gains and hyperphagia induced by HFD, but only in female GBH-HFD mice. These female mice also exhibited high accumulation of perigonadal and subcutaneous fat, as well as reduced lean body mass. Both male and female GBH-HFD displayed hypertrophic white adipocytes. However, only in females, pubertal GBH exposure aggravated HFD-induced fat accumulation in brown adipocytes. Furthermore, GBH increased plasma cortisol levels by 80% in GBH-HFD males, and 180% in GBH-HFD females. In conclusion, pubertal GBH exposure aggravated HFD-induced obesity, particularly in adult female mice. This study provides novel evidence that GBH misprograms lipid metabolism, accelerating the development of obesity when individuals are challenged by a second metabolic stressor, such as an obesogenic diet.

Association between Neck Circumference and Chronic Kidney Disease in Korean Adults in the 2019-2021 Korea National Health and Nutrition Examination Survey.

Chronic kidney disease (CKD) is a major public health problem and a leading cause of cardiovascular disease and death. Early recognition and management of CKD risk factors are necessary to prevent its onset and progression. Neck circumference (NC) is a non-invasive and easily accessible anthropometric measure associated with central obesity and subcutaneous fat accumulation in the upper body. Our study aimed to explore the relationship between NC and the prevalence of CKD using data from the nationally representative Korea National Health and Nutrition Examination Survey (2019-2021). We analyzed data from 10,219 subjects (age > 19 years, no missing values). CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. Logistic regression analysis was performed, which revealed a significant association between NC and CKD prevalence even after adjusting for confounding factors, both when NC was considered a continuous variable (OR [95% CI], 1.11 [1.03-1.19]) and in quartiles (Q1 as reference; Q2 OR [95% CI], 1.23 [0.91-1.67]; Q3 OR [95% CI], 1.59 [1.16-2.18]; Q4 OR [95% CI], 1.70 [1.16-2.50]). Our findings suggest that NC could be a simple and effective anthropometric measurement for identifying individuals at risk for CKD.

Ratio of visceral fat area to body fat mass (VBR) is a superior predictor of coronary heart disease.

Ratio of visceral fat area to body fat mass (VBR) is a superior predictor of coronary heart disease.

Postnatal Overfeeding during Lactation Induces Endothelial Dysfunction and Cardiac Insulin Resistance in Adult Rats.

Early overnutrition is associated with cardiometabolic alterations in adulthood, likely attributed to reduced insulin sensitivity due to its crucial role in the cardiovascular system. This study aimed to assess the long-term effects of early overnutrition on the development of cardiovascular insulin resistance. An experimental childhood obesity model was established using male Sprague Dawley rats. Rats were organized into litters of 12 pups/mother (L12-Controls) or 3 pups/mother (L3-Overfed) at birth. After weaning, animals from L12 and L3 were housed three per cage and provided ad libitum access to food for 6 months. L3 rats exhibited elevated body weight, along with increased visceral, subcutaneous, and perivascular fat accumulation. However, heart weight at sacrifice was reduced in L3 rats. Furthermore, L3 rats displayed elevated serum levels of glucose, leptin, adiponectin, total lipids, and triglycerides compared to control rats. In the myocardium, overfed rats showed decreased IL-10 mRNA levels and alterations in contractility and heart rate in response to insulin. Similarly, aortic tissue exhibited modified gene expression of TNFα, iNOS, and IL-6. Additionally, L3 aortas exhibited endothelial dysfunction in response to acetylcholine, although insulin-induced relaxation remained unchanged compared to controls. At the molecular level, L3 rats displayed reduced Akt phosphorylation in response to insulin, both in myocardial and aortic tissues, whereas MAPK phosphorylation was elevated solely in the myocardium. Overfeeding during lactation in rats induces endothelial dysfunction and cardiac insulin resistance in adulthood, potentially contributing to the cardiovascular alterations observed in this experimental model.

Evaluation of the acute basic biological effects of herbal formulation to control obesity: a preliminary study

SummaryObjectivesObesity is the accumulation of excessive visceral and subcutaneous fat in the body. The herbal formulation can help treat obesity, and our study aims to evaluate the acute basic biological effects of herbal formulation to control obesity.MethodsAntiobesity herbal formulation, prepared by the combination of Saussurea lappa root, Betula utilis bark, Aconitum heterophyllum root, Bunium periscum seed, and Bauhinia variegate leaf (4:3:1:1:1), was carried out on Wistar male and female rats. Obesity was induced in the rats by feeding the Chow diet, and the effect of herbal formulation on obesity was studied. The effect on obesity was measured by analysing variables like weight, water intake, pellet count, haematological parameters, renal function test, liver function test, and lipid profile test.ResultsIn the study, it was observed that the female rats treated at the highest dose showed a significantly (P &lt; 0.005) higher decrease in weight compared to male rats after 10 days. The food intake, haemoglobin, renal, liver function, and lipid profile showed significant improvement after the intake of herbal formulation.ConclusionsFrom the above results, it was inferred that herbal formulation increased the activity of metabolism, which is helpful in weight reduction; moreover, it has some beneficial biological effects.

Potential confounders of the obesity paradox in older patients following transcatheter aortic valve replacement.

A higher body mass index (BMI) is associated with lower mortality in older patients following transcatheter aortic valve replacement (TAVR) for severe aortic valve stenosis. The current study aimed to investigate potential confounders of association between BMI and prognosis. The retrospective single-center study included consecutive patients following TAVR and excluded those in whom subcutaneous fat accumulation (SFA), visceral fat accumulation (VFA), and major psoas muscle (MPM) volume were not assessed by computed tomography. Cachexia was defined as a combination of BMI < 20kg/m2 and any biochemical abnormalities. After 2 patients were excluded, 234 (age, 86 ± 5years; male, 77 [33%]; BMI, 22.4 ± 3.8kg/m2; SFA, 109 (54-156) cm2; VFA, 71 (35-115) cm2; MPM, 202 (161-267) cm3; cachexia, 49 [21%]) were evaluated. SFA and VFA were strongly correlated with BMI (ρ = 0.734 and ρ = 0.712, respectively), whereas MPM was weakly correlated (ρ = 0.346). Two-year all-cause mortality was observed in 31 patients (13%). Higher BMI was associated with lower mortality (adjusted hazard ratio [aHR], 0.86; 95% confidence interval [CI], 0.77-0.95). A similar result was observed in the multivariate model including SFA (aHR in an increase of 20 cm2, 0.87; 95% CI, 0.77-0.98) instead of BMI, whereas VFA was not significant. Cachexia was a worse predictor (aHR, 2.51; 95% CI 1.11-5.65). Association of higher BMI with lower mortality may be confounded by SFA in older patients following TAVR. Cachexia might reflect higher mortality in patients with lower BMI.

Omega-3 fatty acid-based self-microemulsifying drug delivery system (SMEDDS) of pioglitazone: Optimization, in vitro and in vivo studies

Pioglitazone (PGL) is an effective insulin sensitizer, however, side effects such as accumulation of subcutaneous fat, edema, and weight gain as well as poor oral bioavailability limit its therapeutic potential for oral delivery. Recent studies have shown that combination of both, PGL and fish oil significantly reduce fasting plasma glucose,improve insulin resistance, and mitigate pioglitazone-induced subcutaneous fat accumulation and weight gain. Nevertheless, developing an effective oral drug delivery system for administration of both medications have not been explored yet. Thus, this study aimed to develop a self-micro emulsifying drug delivery system (SMEDDS) for the simultaneous oral administration of PGL and fish oil. SMEDDS was developed using concentrated fish oil,Tween® 80, and Transcutol HP and optimized by central composite design (CCD). The reconstituted, optimized PGL-SMEDDS exhibited a globule size of 142 nm, a PDI of 0.232, and a zeta potential of −20.9 mV. The in-vitro drug release study of the PGL-SMEDDS showed a first-order model kinetic release and demonstrated remarkable 15-fold enhancement compared to PGL suspension. Additionally, following oral administration in fasting albino Wistar rats, PGL-SMEDDS exhibited 3.4-fold and 1.4-fold enhancements in the AUC0–24h compared to PGL suspension and PGL marketed product. The accelerated stability testing showed that the optimized SMEDDS formulation was stable over a three-month storage period. Taken together, our findings demonstrate that the developed fish oil-based SMEDDS for PGL could serve as effective nanoplatforms for the oral delivery of PGL, warranting future studies to explore its synergistic therapeutic potential in rats.

"Subzone-Counting" Method in Asian Facial Liposuction: A Retrospective Study.

Facial liposuction is a popular and reliable procedure for patients with subcutaneous fat accumulation pursuing the ideal face shape. However, complications like irregularities and asymmetry are still problems for plastic surgeons. To lower the incidence of the above complications, we developed the "subzone-counting" method. In this study, this technique was introduced and evaluated. By several lines all parallel to the earlobe-mouth corner line, the liposuction area was subdivided into several subzones. With consistent negative pressure, the paths of the cannula trip in all subzones were also parallel to the earlobe-mouth corner line. An objective index could be obtained by counting the number of aspiration in every subzone. Based on this index, the real-time adjustment was made to achieve smoothness and symmetry. This study identified 32 Chinese patients who accepted this method between January 2019 and January 2021. The follow-up ranged from 6 to 44 months. Twenty-nine and 3 patients were satisfied and somewhat satisfied with the postoperative outcome, respectively. No patient was unsatisfied with the outcome. And no major complication was reported. The "subzone-counting" method is safe and effective for facial liposuction. The approach helps intraoperative judgment and adjustment. According to the real-time counting results, contour smoothness and bilateral symmetry can be easily achieved and less dependent on the surgeon's experience.

Evaluating Neck Circumference as an Independent Predictor of Metabolic Syndrome and Its Components Among Adults: A Population-Based Study.

Background Metabolic syndrome (MetS), a public health problem worldwide, represents a high-risk condition for cardiovascular disease and diabetes. The reserve of subcutaneous fat in the upper torso is an important factor in the development of MetS and its risk factors. As neck circumference (NC) is a simple and reliable index that indicates upper-body subcutaneous fat accumulation, this study was conducted to investigate the association between NC with MetS and its components in a large population-based sample of Iranian adults. Methods The present cross-sectional study was conducted among 2094 individuals aged 20-70 years from Yazd Health Study (YaHS). MetS was defined based on the National Cholesterol Education Program Adult Treatment Panel III (ATP III) criteria. NC more than 40.25 cm for men and more than 35.75 cm for women was considered a high-risk NC. Logistic regression analysis was applied to obtain the associations of NC with MetS and its component. Results After adjusting for age, BMI, energy intake, physical activity, and smoking in those whose NC was higher than normal, the risk of the MetS (odds ratio {OR}: 2.32; 95%CI: 1.55-3.46, P<0.001 in men and OR: 2.56; 95%CI: 1.76-3.74, P<0.001 in women), abdominal obesity (OR: 4.39; 95%CI: 2.67-7.23, P<0.001 in men and OR: 1.92; 95%CI: 1.27-2.90, P=0.002 in women), high blood pressure (OR: 1.54; 95%CI: 1.07-2.21, P=0.02 in men and OR: 1.51; 95%CI: 1.06-2.14, P=0.02 in women), low high-density lipoprotein cholesterol (HDL-C) (OR: 1.47; 95%CI: 1.01-2.15, P=0.04 in men and OR: 1.69; 95%CI: 1.23-2.32, P=0.001 in women), and hypertriglyceridemia (OR: 1.41; 95%CI: 1.03-1.99, P=0.04 in men and OR: 1.68; 95%CI: 1.17-2.41, P=0.005 in women) were higher. There was no significant difference in the risk of hyperglycemia between the two NC groups in both sexes.The Pearson's correlation coefficients of NC with waist circumference, hip circumference, body mass index, and waist-to-height ratio were 0.52, 0.43, 0.41, and 0.31, respectively (P<0.001). Moreover, NC had a considerable correlation with serum triglyceride, high-density lipoprotein, systolic blood pressure, and diastolic blood pressure (0.27, -0.30, 0.29, 0.25, P<0.001), respectively. Conclusion Increased NC was significantly associated with higher odds of MetS and its components. Since NC measurement is simple, inexpensive, reliable, and less invasive, it can be used as a complementary tool in the screening and diagnosis of MetS and its risk factors in clinical and community programs especially in developing countries.

A Comparative Analysis to Dissect the Histological and Molecular Differences among Lipedema, Lipohypertrophy and Secondary Lymphedema.

Lipedema, lipohypertrophy and secondary lymphedema are three conditions characterized by disproportionate subcutaneous fat accumulation affecting the extremities. Despite the apparent similarities and differences among their phenotypes, a comprehensive histological and molecular comparison does not yet exist, supporting the idea that there is an insufficient understanding of the conditions and particularly of lipohypertrophy. In our study, we performed histological and molecular analysis in anatomically-, BMI- and gender-matched samples of lipedema, lipohypertrophy and secondary lymphedema versus healthy control patients. Hereby, we found a significantly increased epidermal thickness only in patients with lipedema and secondary lymphedema, while significant adipocyte hypertrophy was identified in both lipedema and lipohypertrophy. Interestingly, the assessment of lymphatic vessel morphology showed significantly decreased total area coverage in lipohypertrophy versus the other conditions, while VEGF-D expression was significantly decreased across all conditions. The analysis of junctional genes often associated with permeability indicated a distinct and higher expression only in secondary lymphedema. Finally, the evaluation of the immune cell infiltrate verified the increased CD4+ cell and macrophage infiltration in lymphedema and lipedema respectively, without depicting a distinct immune cell profile in lipohypertrophy. Our study describes the distinct histological and molecular characteristics of lipohypertrophy, clearly distinguishing it from its two most important differential diagnoses.

Women with lipoedema: a national survey on their health, health-related quality of life, and sense of coherence

BackgroundLipoedema is a chronic disease in adipose tissue that almost exclusively affects women during periods of hormonal alterations. Its main symptoms include an abnormal accumulation of subcutaneous fat in the buttock, hips, and legs, which is associated with pain, swelling, and easy bruising. Herein, a grading in three stages is used to determine disease progression. Problematically, lipoedema manifestations are often confused with lifestyle-induced obesity, which is why the various health problems among affected women often remain unrecognized. Overall, research on lipoedema is scarce. As such, this study examined the health, health-related quality of life (HRQOL), and sense of coherence (SOC) among women with lipoedema.MethodsWe conducted a national cross-sectional study using an online survey assessing sociodemographic data, lipoedema characteristics, symptom severity, comorbidities, HRQOL (RAND-36), and SOC (SOC-13). In total, 245 women with lipoedema, recruited from all Lipoedema Association groups in Sweden, participated. Data were compiled with descriptive statistics, and mean differences between groups were analysed by using parametric and non-parametric tests.ResultsModerate and severe leg heaviness, pain, numbness, cold skin, feeling cold, easy bruising, and sleep problems were found to occur in all lipoedema stages. Moreover, almost all participants reported having comorbidities. Worse physical health and most substantial limitations in daily life were reported among women with the most progressive lipoedema (i.e., stage 3). Social and emotional functioning and SOC were found to be, on the other hand, primarily related to respondents’ sociodemographic data and their ages at lipoedema onset. Even though approximately 70% of the women had experienced lipoedema onset before age 30, only three (1.6%) had been diagnosed by a healthcare professional before that age.ConclusionHaving lipoedema is associated with several health problems and a lower HRQOL. In addition, the extent of delay in diagnosis within this sample indicates that many women with lipoedema are often underdiagnosed and are left without support from healthcare. These findings call for the need for greater attention on lipoedema. Moreover, further studies on how women with lipoedema manage their health and symptoms, as well as on their experiences of healthcare services and lipoedema treatments, are needed.

Effects of Dried Onion Powder and Quercetin on Obesity-Associated Hepatic Menifestation and Retinopathy.

Onion (Allium cepa L.), rich in flavonoids (particularly quercetin), reportedly has anti-obesity properties, but the underlying mechanisms and associated health issues remain unclear. In this study, we compared the effects of dried onion powder (DO) with that of quercetin on high-fat diet (HFD)-induced obesity, nonalcoholic fatty liver disease, and retinal neovascularization. Briefly, rats (n = 9–10 per group) were divided into control, HFD alone (43% fat), HFD + DO (1% DO), HFD + 5DO (5% DO, w/w), and HFD + quercetin (180 mg/kg). After 12 weeks, body fat, markers of metabolism, fatty liver, steatohepatitis, and retinopathy were analyzed. The results revealed that DO and 5DO dose-dependently suppressed body weight, visceral and subcutaneous fat accumulation, and epididymal adipocyte in HFD-fed rats. DO also decreased HFD-induced ALT, AST, free fatty acid, glucose, proinflammatory cytokines, and oxidative stress. DO and 5DO groups had lower triglycerides, total cholesterol, proinflammatory cytokine levels, and ACC-α (a fatty acid synthesis–associated enzyme) expression but higher hepatic antioxidant enzyme activities and fecal lipids. 5DO exhibited better or similar efficacy to quercetin. Both 5DO and quercetin increased fecal levels of acetic acid and butyric acid similarly. They also reduced lipid peroxidation of the eye, retinal adiposity, and neovascularization. However, quercetin resulted in a more apparent decrease in regulation of the Raf/MAPK pathway than DO in eye specimens. Conclusively, DO suppresses visceral, subcutaneous, and liver fat accumulation better than quercetin likely due to higher fecal fat excretion and lower oxidative stress, proinflammatory cytokine levels, and ACC-α expression. Quercetin regulating signal pathways is better than DO at reducing retinal adiposity and neovascularization.

The Effect of a Low-Carbohydrate, High-Fat Diet versus Moderate-Carbohydrate and Fat Diet on Body Composition in Patients with Lipedema.

IntroductionLipedema is a disorder characterized by an excessive accumulation of subcutaneous body fat, mainly bilateral and symmetrical accumulation of fat deposits, particularly in the lower extremities excluding feet. Pain (spontaneous or with palpation) and increased capillary fragility with bruising are also part of clinical presentation. It is estimated to occur in approximately 11.0% of women worldwide. Management of obesity among patients with lipedema is a key component in its treatment.PurposeThe aim of this study was to compare effectiveness of two diets: low-carbohydrate-high-fat diet (LCHF) and medium-fat-medium-carbohydrate diet (MFMC) in body weight, body fat and limb circumference reduction in patients with lipedema.Material and MethodsThe studied women (n = 91) were divided into 2 groups and submitted to 1 of the 2 diets for 16 weeks. Anthropometric measurements such as body height [cm], body weight [kg], body fat percentage [%], body fat [kg], lean body mass [kg], and visceral fat level were collected at the beginning and end of the study.ResultsWe have not found any significant differences in anthropometric measurements at the baseline between groups. Body weight and all anthropometric parameters decreased significantly in both groups after 16 weeks of diets, excluding the circumference above the right ankle for the MFMC diet which did not change. The LCHF diet contributed to reduction of body weight (−8.2 ± 4.1 kg vs −2.1 ± 1.0 kg; p < 0.0001), body fat (−6.4 ± 3.2 kg vs 1.6 ± 0.8 kg; p < 0.0001), waist (−7.8 ± 3.9 cm vs −2.3 ± 1.1 cm; p < 0.0001), hips (−7.4 ± 3.7 cm vs −2.5 ± 1.3 cm; p < 0.0001), thighs and calves’ circumferences compared with the MFMC diet. We observed reduction of pain in the extremities and mobility improvement in LCHF group (data not shown).ConclusionThe LCHF diet was more effective than MFMC in body weight, body fat and lower limb circumferences reduction.