Adipose Tissue Thickness Research Articles

Increase in subcutaneous adipose tissue in the frontal scalp may be associated with androgenetic alopecia and metabolic syndrome.

Recent studies have suggested that androgenetic alopecia (AGA) may be associated with other disorders, especially metabolic syndrome (MetS). This study aimed to determine whether a connection exists between MetS and AGA based on the thickness of the subcutaneous adipose tissue in the scalp. This cross-sectional study included 34 participants with AGA who had MetS and 33 participants with AGA who did not have MetS. The Hamilton-Norwood scale was employed for classifying AGA and MetS was identified using the US National Cholesterol Education Programme Adult Treatment Panel III (NCEP-ATP III criteria). The body mass index (BMI), blood pressure, and lipid profiles of the participants were assessed. Hepatosteatosis and the thickness of the subcutaneous adipose tissue in the scalp were examined using ultrasonography. Compared with the control group, the MetS+AGA group had higher BMI (p = 0.011), systolic blood pressure (p < 0.001), diastolic blood pressure (p < 0.001) and waist circumference (p = 0.003). Furthermore, the MetS+AGA group had a higher prevalence of dyslipidemia, hypertension (HT) and diabetes mellitus (DM) and higher rates of grade 6 alopecia than the control group (p = 0.019). Compared with the control group, those with MetS had thicker subcutaneous adipose tissue in the frontal scalp (p = 0.018). The subcutaneous adipose tissue in the frontal scalp was thicker in individuals with AGA who had high Hamilton scores. The concomitance of AGA and MetS may be associated with a high increase in subcutaneous adipose tissue and less favorable metabolic parameters.

The Association Between Body Fat Index and Gestational Diabetes Mellitus: A Prospective Cohort Study.

Body mass index (BMI) has commonly been used to evaluate the risk of gestational diabetesmellitus (GDM), but BMI does not always represent body fat mass distribution.Body fat index (BFI), which includes the measurement of subcutaneousadipose tissue (SAT) and visceral adipose tissue (VAT), has beensuggested to bea better predictor for GDM than BMI. The objective of this study is to compare the risk of GDMamong pregnant females with BFI of >0.5 and ≤0.5. Maternal abdominal subcutaneousadipose tissue (SAT) and visceral adipose tissue (VAT) thickness were measured by ultrasonography before 14 weeks of gestation, and BFI was calculated (VAT×SAT/height). The study group was 160 females with BFI of >0.5, and the comparison group was 80 females with BFI of ≤0.5. All females received GDM screening during the first antenatal visit and at 24-28 weeks of gestation. The rate of GDM was compared between the two groups. The correlation between BFI and BMI and their diagnostic ability for GDM were evaluated. Logistic regression analysis was performed to determine the independent associated factors for GDM. Females with BFI of >0.5 were significantly older (p=0.033) and had higher body mass index (BMI) (p<0.001) and were more likely to be overweight or obese (p<0.001). BFI correlated well with BMI (correlation coefficient of 0.736, p<0.001). GDM was significantly more common in females with BFI of >0.5 (24.4% versus11.3%, p=0.017). The diagnostic ability for GDM between BFI and BMI was similar (areas under receiver operating characteristic {ROC} curves of 0.641 and 0.646, respectively). Significant independent risk factors for GDM were a BFI of >0.5 and a BMI of ≥25 kg/m2 (adjusted odds ratio {OR}, 3.8; 95% confidence interval {CI}, 1.5-9.2), age of ≥30 years (adjusted OR, 2.8; 95% CI, 1.2-6.4), and family history of diabetes mellitus (DM) (adjusted OR, 4.0; 95% CI, 1.9-8.3). Females with BFI of >0.5 were significantly more likely to have GDM. The diagnostic ability of BFI and BMI for GDM was comparable. Females with BFI of >0.5 and BMI of ≥25 kg/m2 have an increased risk for GDM.

Acute exercise affects dual-energy X-ray absorptiometry body composition estimates but not standardised ultrasound measurements of subcutaneous adipose tissue.

Ultrasound has been demonstrated to be a highly accurate and reliable tool for measuring subcutaneous adipose tissue thickness and is robust against changes in hydration status or acute food or fluid intake. However, the effect of prior acute exercise is unexamined. This study examined the impact of an acute endurance exercise and resistance exercise session on standardised brightness-mode ultrasound measurements of subcutaneous adipose tissue thickness compared to skinfolds and dual-energy X-ray absorptiometry body composition estimates. In a randomised cross-over design, 30 active adults (24.2 ± 4.9 years) undertook physique assessment via standardised brightness-mode ultrasound, skinfolds and dual-energy X-ray absorptiometry before, immediately and 45 min after an acute endurance or resistance exercise session. The mean sum of eight subcutaneous adipose tissue thickness measured via standardised brightness-mode ultrasound increased (0.6 mm, p = 0.04) immediately postendurance exercise but was not meaningful when evaluated against the technical error of measurement of the investigator. A significant (p = 0.01) but not meaningful decrease in the sum of eight skinfolds occurred immediately (-1.1 ± 0.4 mm) and 45 min (-1.3 ± 0.4 mm) postresistance exercise. Comparatively, endurance exercise elicited a meaningful decrease of total mass (460 ± 30 g) and trunk lean mass (680 ± 90 g) dual-energy X-ray absorptiometry estimates. Findings from this study indicate standardised client presentation may be unnecessary when employing either standardised brightness-mode ultrasound or skinfolds for body composition assessment unlike dual-energy X-ray absorptiometry.

Sex differences in NIRS derived values of reactive hyperemia persist after experimentally controlling for the ischemic vasodilatory stimulus.

Men and women exhibit different near-infrared spectroscopy (NIRS) outcomes in response to vascular occlusion tests (VOT), which may be due to phenotypic characteristics or different degrees of desaturation during ischemia. The minimum skeletal muscle tissue oxygenation (StO2min) observed during a VOT may be the primary determinant of reactive hyperemic (RH) responses. Our purpose was to determine the contribution StO2min and participant characteristics including adipose tissue thickness (ATT), lean body mass (LBM), muscular strength, and limb circumference to NIRS-derived indices of RH. Also, we aimed to determine if matching StO2min would eliminate NIRS-VOT sex differences. Thirty-one young adults completed one or two VOTs during which the vastus lateralis was continuously assessed for StO2. The men and women each completed a standard VOT with a 5-min ischemic phase. The men completed a second VOT with a shortened ischemic phase to produce a matching StO2min to the minimum of the women observed during the standard VOT. Mean sex differences were determined with t-tests and relative contributions were assessed with multiple regression and model comparison approaches. During the 5-min ischemic phase, the men exhibited greater upslopes (1.97±0.66 vs. 1.23±0.59%∙s-1) and greater StO2max than the women (80.3±4.17 vs. 76.2±2.86%). Analysis revealed StO2min was a greater contributor to upslope than sex and/or ATT. For StO2max, sex was the only significant predictor (r2=0.26, men ~ 4.09% > women). Experimentally matching StO2min did not eliminate the sex differences in upslope or StO2max, suggesting that characteristics other than the degree of desaturation primarily provoke sex differences in RH.

The relationship of epicardial adipose tissue and metabolic syndrome

Visceral obesity is a key link in the metabolic syndrome and can affect the development of cardiovascular diseases. Objective. The aim of the study was to identify the clinical, laboratory and instrumental characteristics of patients with coronary artery disease, to analyze adverse cardiovascular events after coronary bypass surgery, according to the thickness of the epicardial adipose tissue (EAT). Design and methods. The study included 178 patients who underwent coronary bypass surgery. The median values of the thickness of the EAT was 0,4 cm. The patients were divided into 2 groups: group 1 — epicardial fat &lt; 0,44 cm (n = 84) and group 2 — epicardial fat &gt; 0,44 cm (n = 94). Results. The frequency of metabolic syndrome in group 1 was 59,5 %, while in group 2 — 74,5 % (p = 0,017). The thickness of the EAT correlated with blood glucose (r = 0,28, p = 0,003), body mass index (BMI) (r = 0,27, p = 0,010), waist circumference (r = 0,26, p = 0,001). End-diastolic volume of the left ventricle (p = 0,016), stroke volume (p = 0,014), thickness of the interventricular septum (p = 0,010), mass of the left ventricular myocardium (p = 0,048), left ventricular myocardial mass index (p = 0,035) were higher in the group with a higher content of EAT. The metabolic syndrome was a significant predictor of the EAT thickness. Conclusions. The EAT thickness is associated with the metabolic syndrome and its components.

Structural and functional state of postinfarction myocardium and vascular endothelial growth factor: is there a connection?

Purpose of the study. To reveal the relationship between the serum concentration of vascular endothelial growth factor and the structural and functional state of the myocardium in patients in the post-infarction period at the stage of rehabilitation.Materials and methods. We examined 94 patients at the outpatient stage of rehabilitation after ad hoc stenting 6 weeks after myocardial infarction, 10 healthy volunteers without somatic pathology. All participants in the study underwent standard transthoracic echocardiography with assessment of thickness of epicardial fat, assessment of the concentration of vascular endothelial growth factor (VEGF) in peripheral blood by ELISA.Results and discussion. VEGF values above the median values were associated with lower left ventricular ejection fraction and left ventricular fraction shortening, which indirectly may indicate a more pronounced expression of VEGF in patients with left ventricular systolic dysfunction. Assessing the parameters of LV diastolic dysfunction in groups with different levels of VEGF, no significant differences were found in patients after myocardial infarction. Correlation relationships between the content of VEGF and the thickness of epicardial adipose tissue were not found either among patients or in the control group.Conclusions. Elevated VEGF values in patients with coronary artery disease at the 6th week of rehabilitation were accompanied by left ventricle systolic dysfunction, in contrast to diastolic dysfunction. There was no direct correlation between the thickness of epicardial fat and the concentration of VEGF in the blood serum in patients with coronary artery disease.

Assessment of the Efficacy of Cryolipolysis on Abdominal Fat Deposits: A Prospective Study.

Cryolipolysis is a non-invasive and efficacious procedure for body contouring. The effectiveness of cryolipolysis has been demonstrated on multiple areas of the body, but on a limited number of subjects. The aim of this study is to demonstrate the effectiveness and the safety of cryolipolysis in the lower abdomen adipose tissue thickness reduction. A prospective study on 60 healthy women was carried out using CryoSlim Hybrid device. Each patient underwent two cryolipolysis sessions centered on the abdominal area. The primary endpoint was to decrease the thickness of the abdominal fat deposits. The change in the abdominal circumference and the thickness of the subcutaneous fat layer were assessed. Patient satisfaction and tolerance of the procedure were also taken into account. A significant reduction of the abdominal circumference and subcutaneous fat layer thickness was observed. The mean decrease in abdominal circumference was 2.10 cm (3.1%) 3 months after the procedure and 4.03 cm (5.8%) 6 months after the procedure. The mean decrease in fat layer thickness was 1.25 cm (43.81%) 3 months after the procedure and 1.61 cm (41.73%) 6 months after the procedure. No major adverse events were noted. All patients were very satisfied, and minimal pain was reported. Cryolipolysis is an effective technique to treat abdominal localized fat deposits. No major adverse events have been described for this procedure. Our promising results should encourage further studies aimed at optimizing the efficacy of the procedure without a considerable increase in the risks. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .

Gynoid Fat Distribution and Adipocyte Trapping May Explain Virological Failure With Intramuscular Long-Acting Cabotegravir and Rilpivirine.

Intramuscular long-acting antiretroviral drugs can improve adherence to lifelong antiretroviral treatment. Nevertheless, adipose tissue thickness and distribution play a critical role with injectable drugs. We describe a virological failure with cabotegravir and rilpivirine in a Black African woman with human immunodeficiency virus type 1 with gynoid fat distribution (ie, adipose tissue prevailing in the pelvis and hip area) and body mass index <30 kg/m2.

A Genome-Wide Search of New Meat Productivity Candidate Genes in North Caucasian Meat and Wool Sheep Breed

The search for new genes that affect the growth and development of muscle tissue and associated with meat productivity traits in sheep is an actual task. The implementation of this is inextricably linked with the prospects for the development of marker-assisted and genomic selection. Research presents data of new approach in the detection of candidate genes for sheep meat productivity. Animal genotyping was performed using Ovine Infinium HD BeadChip 600K DNA, association search was performed using PLINK v1.07 software. As a result of the work, identified SNPs that were significantly associated with phenotypic traits directly related to the level of meat productivity in the North-Caucasian meat and wool sheep: height at the withers, live weight at birth, thickness of adipose tissue, width of the muscle “eye”. To search for candidate genes, 19 polymorphisms with the highest association reliability were selected. Determining the location of the analyzed SNPs made it possible to identify 16 new candidate genes associated with lifetime meat productivity traits in North-Caucasian meat and wool sheep: CILK1, ENO4, CTPS2, GABRB2, SLC44A1, C12ORF45, SLC41A2, CASD1, SINE2, SLC35F1, RP, SH3KBP1, LRRIQ1, SWAP70, THBS1 and FSIP. Animal genotyping for these genes should be used in marker-associated breeding to improve sheep meat productivity and study their effect on the phenotype.

Farklı vücut kondisyonlarındaki kedilerde karaciğer yağlanmasının ultrasonografik incelemesi ile obezite değerlendirme parametreleri arasındaki ilişkinin belirlenmesi

This study aimed to determine the relationship between ultrasonographic examination of hepatic lipidosis and obesity assessment parameters in cats of different body conditions. For this purpose, 27 cats in different body conditions which have not any systemic health problems were evaluated. Body condition score and body fat index were examined by inspection and palpation; subcutaneous adipose tissue thickness, hepatorenal index and hepatic lipidosis grade by ultrasonography. The relationship between parameters on the basis of all individuals was evaluated. Also, the cats were divided into three groups according to their body conditions, and whether there was any difference between these groups in terms of subcutaneous adipose tissue thickness, hepatorenal index and hepatic lipidosis grade were investigated. There was a significant positive correlation between body condition score and body fat index, subcutaneous adipose tissue thickness, hepatic lipidosis grade and hepatorenal index, respectively. Different degrees of hepatic lipidosis were observed in at least some individuals in all body condition groups. There was a significant difference between the different body condition groups in terms of subcutaneous adipose tissue thickness, hepatorenal index and hepatic lipidosis grade. This study showed that mild hepatic lipidosis can be seen even in cats with normal body condition; increased body condition and body fat cause an increased risk of hepatic lipidosis in cats; subcutaneous adipose tissue thickness measurement during clinical evaluation and hepatorenal index during ultrasonographic examination can be a use practical and reliable option for prediction and grading of hepatic lipidosis.

The relationship between epicardial adipose tissue thickness and arrhythmias in patients with hypertension: a 3.0T cardiac magnetic resonance study.

To investigate the relationship between epicardial adipose tissue (EAT) thickness using cardiac magnetic resonance imaging (CMR) and arrhythmias in hypertensive patients. Fifty-four hypertensive patients with arrhythmias (HTN [arrhythmias+]), 79 hypertensive patients without arrhythmias (HTN [arrhythmias-]), and 39 normal controls were retrospectively enrolled. EAT thickness was measured on cine images. Analysis of covariance with Bonferroni's post hoc correction, Pearson or Spearman analysis, receiver operating characteristic curve, and intraclass correlation coefficient analysis were performed. All hypertensive patients had impaired left ventricular (LV) and left atrial (LA) myocardial deformation, and HTN (arrhythmias+) patients displayed higher LV myocardial native T1, LA volume index, and increased EAT thickness than HTN (arrhythmias-) patients and normotensive controls. The presence of LV late gadolinium enhancement (LGE) was higher in hypertensive patients with arrhythmias than in those without arrhythmias. EAT thickness metrics significantly correlated with age, systolic blood pressure, body mass index, triglycerides and high-density lipoprotein levels, LV mass index and native T1 (all p < 0.05). EAT thickness parameters were able to differentiate hypertensive patients with arrhythmias from those without arrhythmias and normal controls, and the right ventricular free wall had the highest diagnostic performance. An accumulation of EAT thickness could further induce cardiac remodeling, promote myocardial fibrosis, and exaggerate function in hypertensive patients with arrhythmias. CMR-derived EAT thickness metrics could be a useful imaging marker for differentiating hypertensive patients with arrhythmias, which might be a potential target for the prevention of cardiac remodeling and arrhythmias.

Evaluation of epicardial adipose tissue by coronary multi-detector computed tomography: an independent predictor of obstructive coronary artery disease

BackgroundThe aim of this retrospective cross-sectional study was to investigate the relationship between epicardial adipose tissue and coronary artery disease and its severity.MethodsA total of 344 subjects with clinically suspected coronary artery disease underwent 256-slice multi-detector CT coronary angiography and were categorized as follows: no CAD, non-obstructive CAD (luminal narrowing < 50%) and obstructive CAD (luminal narrowing ≥ 50%). Calcium score was quantified using the Agatston method. Mean Epicardial adipose tissue (EAT) and mean pericoronary fat thickness (PCFT) were measured and utilized for data analysis.ResultsThere was a significant association between EAT thickness and PCFT with clinical risk factors of CAD including HTN, DM and obesity (P-value: < 0.001) and dyslipidemia (P-value: 0.003, P-value: 0.008 for EAT and PCFT, respectively). EAT thickness and PCFT were significantly higher in obstructive CAD compared to non-obstructive CAD and no CAD categories (P-value: < 0.001). Also, there is positive strong correlation between EAT thickness, PCFT and Calcium score (P-value: < 0.001). Optimal cut-off point of PCFT for estimating obstructive CAD was > 12.87 mm (sensitivity: 77.06%, specificity: 66.06% and AUC:0.76; 95%CI:0.69–0.81) via receiver operating characteristic curve. On multivariate logistic analysis which included conventional risk factors of CAD, PCFT was an independent predictor of obstructive CAD (Odds ratio:1.55; P-value: < 0.001).ConclusionsEAT thickness and PCFT were significantly increased in coronary artery disease. PCFT is a simple accessible marker for predicting obstructive CAD with acceptable diagnostic performance.

Ultrasound-assisted assessment of visceral and subcutaneous adipose tissue thickness. Methodological guidelines

Methodological guidelines have been developed for inpatient internists, general practitioners, paramedics providing healthcare care in accordance with the professional standard "internist", "general practitioner". The guidelines are based on consensus papers, accumulated clinical and scientific experience. The methodology for organizing and conducting an ultrasound-assisted assessment of visceral adipose tissue is described in detail. Algorithms for diagnosing visceral obesity are presented to help the practitioner. Particular attention is paid to visceral fat assessment using ultrasound-assisted examination. These guidelines will be of interest to doctors, heads of healthcare facilities, as well as students of medical universities.

Male Pectoralis Major Muscle Augmentation with Autologous Fat Transplantation Using VASER Lipoaspirate: Evaluation with MRI.

This is a prospective examination of 20 male patients (40 breasts) who underwent VASER-assisted liposuction and fat grafting surgery, and long-term fat graft viability was evaluated by magnetic resonance imaging scans. Participants had an average age of 34.85 ± 7.37 years with a mean BMI of 26.73 ± 2.63 kg/m2. The mean fat graft volume injected was 542.63 ± 144.78 mL on the right, and 548.95 ± 140.36 mL on the left side. On the magnetic resonance imaging follow-up, the mean intrapectoral adipose tissue thickness was 20.34 ± 6.31 mm on the right, and 18.94 ± 8.27 mm on the left sides and tissue viability was preserved in all cases. The mean follow-up duration was 22 ± 9.8 (range 14-44) months. VASER-assisted lipoaspiration and autologous fat grafting of the major pectoralis muscle provide a satisfactory outcome and long-term maintenance of the grafted adipose tissue.

Serum biomarkers and left ventricular mechanics in the diagnosis of diastolic dysfunction in patients with epicardial obesity

Highlights. Patients with epicardial obesity develop myocardial fibrosis (the underlying mechanism of left ventricular diastolic dysfunction) the preclinical diagnosis of which is difficult to perform. In this regard, the search for non-invasive methods for diagnosing diastolic dysfunction at an early stage, including the methods of determining the serum level of biomarkers of heart failure and studying the parameters of left ventricular mechanics using speckle-tracking echocardiography, seems quite relevant.Background. Currently, the search for serum biomarkers and non-invasive methods for diagnosing diastolic dysfunction (DD) of the left ventricle (LV) at the preclinical stage in obese patients is relevant.Aim. To study the levels of heart failure biomarkers and their association with profibrotic factors and LV mechanics in patients depending on the presence of epicardial obesity (EO).Methods. Out of 143 men with general obesity, depending on the severity of EO, determined by the thickness of epicardial adipose tissue (tEАT), 2 groups of patients were identified: the EO (+) group with tEАT 7 mm or more (n = 70), and the EO (–) group with tEАT less than 7 mm (n = 40). The exclusion criteria from the study were: arterial hypertension, type 2 diabetes mellitus, coronary artery disease, and the presence of LVDD detected by echocardiography (echo). Levels of profibrotic factors (type I and type III collagen, procollagen type I C-terminal propeptide (PICP), matrix metalloproteinase-3 (MMP-3), transforming growth factor-β (TGF-β), vascular endothelial growth factor A (VEGF-A), sST2, and NT-proBNP were determined in all patients using enzyme immunoassay. With the help of speckle-tracking echocardiography, the mechanics of LV were analyzed.Results. The EO (+) group presented with increased sST2 level (22.11±7.36 ng/mL) compared to the EO (–) group (sST2 level 9.79±3.14 ng/mL (p&lt;0.0001). In the EO (+) group, a significant influence of tEAT on sST2 level was identified (F = 8.57; p = 0.005). In the EO (+) group, an increase in the level of MMP-3, type I collagen, type III collagen, PICP, transforming growth factor-β, and VEGF-A was revealed. Moreover, in the EO (+) group, a statistically significant relationship between sST2 and type III collagen was revealed (p = 0.01). When comparing the parameters of speckle-tracking echo, the EO group (+) presented with increased LV untwisting rate of –128.31 (–142.0; –118.0) deg/s-1 (p = 0.002), and increased time to LV peak untwisting rate of – 476.44 (510.0; 411.0) msec compared with the EO group (–) (p = 0.03). Moreover, a significant association between LV untwisting rate and sST2 level was revealed in the EO (+) group (r = 0.35; p = 0.02).&gt;˂0.0001). In the EO (+) group, a significant influence of tEAT on sST2 level was identified (F = 8.57; p = 0.005). In the EO (+) group, an increase in the level of MMP-3, type I collagen, type III collagen, PICP, transforming growth factor-β, and VEGF-A was revealed. Moreover, in the EO (+) group, a statistically significant relationship between sST2 and type III collagen was revealed (p = 0.01). When comparing the parameters of speckle-tracking echo, the EO group (+) presented with increased LV untwisting rate of –128.31 (–142.0; –118.0) deg/s-1 (p = 0.002), and increased time to LV peak untwisting rate of – 476.44 (510.0; 411.0) msec compared with the EO group (–) (p = 0.03). Moreover, a significant association between LV untwisting rate and sST2 level was revealed in the EO (+) group (r = 0.35; p = 0.02).Conclusion. The data obtained indicate that patients with EO have LVDD, which could not be detected using echo criteria for LVDD, and the determination of serum levels of the heart failure biomarker - sST2 can be used for the diagnosis of LVDD at the early stage.

Epicardial Fat Tissue Thickness as a Cardiovascular Risk Marker and its Association with Microalbuminuria in Patients with Essential Hypertension

Objectives: Hypertension is one of the essential modifiable risk factors in causing stroke, renal disease, cardiovascular diseases, and peripheral artery disease. Epicardial fat tissue is regarded as endocrine organ and is metabolically active as it produces angiotensinogen and free fatty acids which are proinflammatory cytokines and are atherogenic. The presence of microalbuminuria has been associated with endothelial dysfunction that predisposes to cardiovascular events. The aim of this study is to determine the association of epicardial fat tissue with age, sex, serum creatinine, left ventricular (LV) mass, serum albumin, low-density lipoprotein (LDL), and triglycerides in patients with essential hypertension. Materials and Methods: One hundred patients with essential hypertension were divided into two groups each having 50 patients. Group A included urinary albumin creatinine ratio (UACR) &lt;30 mg/g. Group B included UACR &gt;30 mg/g. Age, body mass index, blood pressure, creatinine, urea, albumin, LDL, triglycerides, and epicardial adipose tissue thickness (EAT) were evaluated and compared between two groups. All patients underwent UACR, transthoracic echocardiography to determine EAT, LV mass, and ejection fraction. Results: In our study, EAT ranged from 2 mm to 6.9 mm, with mean value of 3.21 mm and 5.12 mm in Groups A and B, respectively. Mean EAT values were found to be higher in Group B compared to A and was found to be statistically significant. Similarly, LDL, triglycerides, serum albumin levels, and LV mass showed significant difference among two groups. Serum albumin level in Group B was significantly reduced than the patients with normal urine albumin creatinine ratio. Conclusion: EAT serve as an important indicator in patients with essential hypertension to determine target organ damage and to stratify high risk group.

Perirenal fat thickness and liver fat fraction are independent predictors of MetS in adults with overweight and obesity suspected with NAFLD: a retrospective study

BackgroundNonalcoholic fatty liver disease (NAFLD) has a multidirectional relationship with metabolic syndrome (MetS) and used to be considered a hepatic manifestation of MetS. Perirenal fat, as a part of visceral adipose tissue (VAT), was reported to be correlated with MetS components, but data for intraorgan fat are lacking. This study was undertaken to assess the value of peripheral and intraorgan fat to predict MetS in adults with overweight and obesity with suspected NAFLD.MethodsWe studied 134 sequential adults (mean age, 31.5 years; 47% female) with overweight and obesity with suspected NAFLD. All participants underwent abdominal magnetic resonance imaging (MRI) examination. Anthropometric and metabolic parameters and perirenal fat thickness (PRFT), subcutaneous adipose tissue thickness (SATT), liver fat fraction (LFF), pancreas fat fraction (PFF), and lumbar spine fat fraction (LSFF) were collected. MetS was defined according to the International Diabetes Federation (IDF) criteria. Statistical analyses included basic statistics, linear correlation and logistic regression analysis.ResultsA total of 63 adults with MetS and 71 adults with advanced liver steatosis (grades 2 and 3) were included in our study. Patients with MetS had greater PRFT (p = 0.026) and LFF (p < 0.001), as well as greater homeostasis model assessment of insulin resistance (HOMA-IR), alanine transaminase (ALT), aspartate transaminase (AST), and decreased SATT. MetS patients had a higher proportion of advanced steatosis than those without MetS (P < 0.001). The MetS score was associated with PRFT and LFF. Logistic regression analysis showed that the PRFT and LFF were independent predictors of MetS after adjusting for age and sex. A cutoff of 9.15 mm for PRFT and 14.68% for LFF could be predictive of MetS.ConclusionsThis study shows that the absolute cutoff level of 9.15 mm for PRFT and 14.68% for LFF may be clinically important markers for identifying patients who are at high risk of MetS among adults with overweight and obesity with suspected NAFLD, irrespective of sex and age. Moreover, ectopic fat levels in pancreas and lumbar spine are positively associated with PRFT.Trial registrationNot applicable.

Cardiovascular Disease Risk in Children and Adolescents with Attention Deficit/Hyperactivity Disorder.

The aim of this case-controlled study is to evaluate chronic inflammation, subclinical atherosclerosis and cardiovascular disease risk in children and adolescents with ADHD. A total of 51 medication-free children and adolescents with ADHD and 51 healthy controls were included in this study. K-SADS-PL was used to determine the diagnosis of ADHD and other psychiatric disorders. Conners' Parent Rating Scale-Revised Short Form and the Conners' Teacher Rating Scale-Revised Short Form severity of ADHD was used to evaluate severity of ADHD. In order to evaluate subclinical atherosclerosis, common carotid intima media thickness (IMT), epicardial adipose tissue thickness (EAT), and periaortic adipose tissue thickness (PAT) were assessed as well as clinical parameters. The IMT (0.037 ± 0.005 cm vs. 0.026 ± 0.003 cm), EAT (0.472 ± 0.076 cm vs. 0.355 ± 0.051 cm), and PAT (0.135 ± 0.016 cm vs. 0.118 ± 0.009 cm) measurements were significantly higher in the ADHD group than in the control group. Additionally, partial correlation analyses revealed that a positive correlation was observed between IMT and EAT, and PAT measurements separately. Multivariate linear regression analysis revealed that, body mass index (BMI) positively predicted IMT. Also, age and BMI positively predicted the EAT levels of the subjects with ADHD. Our results suggest that children and adolescents with ADHD have a risk for cardiovascular disease. For this reason, subclinical atherosclerosis should be taken into consideration in the follow-up and treatment of ADHD for cardiovascular disease risk.

Impact of overweight and obesity on epicardial adipose tissue in children with type 1 diabetes.

Epicardial adipose tissue (EAT) thickness, a novel marker of cardiovascular disease (CVD), is increased in children with a healthy weight and type 1 diabetes (T1D). The prevalence of obesity has increased in children with T1D and may confer additional CVD risk. The purpose of this study was to examine EAT thickness in youth with and without T1D in the setting of overweight/obesity. Youth with overweight/obesity and T1D (n=38) or without T1D (n=34) between the ages of 6-18 years were included in this study. Echocardiogram using spectral and color flow Doppler was used to measure EAT and cardiac function. Waist circumference, blood pressure, and HbA1c, were used to calculate estimated glucose disposal rate (eGDR) to estimate insulin resistance in children with T1D. EAT thickness was not significantly different in youth with T1D compared to controls (2.10±0.67mm vs. 1.90±0.59mm, p=0.19). When groups were combined, EAT significantly correlated with age (r=0.449, p≤0.001), BMI (r=0.538, p≤0.001), waist circumference (r=0.552, p≤0.001), systolic BP (r=0.247, p=0.036), myocardial performance index (r=-0.287, p=0.015), ejection fraction (r=-0.442, p≤0.001), and cardiac output index (r=-0.306, p=0.009). In the group with T1D, diastolic BP (r=0.39, p=0.02) and eGDR (r=-0.48, p=0.002) correlated with EAT. EAT was associated with measures of adiposity and insulin resistance but does not differ by diabetes status among youth with overweight/obesity. These findings suggest that adiposity rather than glycemia is the main driver of EAT thickness among youth with T1D.

Determinants of Arterial Stiffness in Patients with Morbid Obesity. The Role of Echocardiography and Carotid Ultrasound Imaging

Background and objective: Morbid obesity is accompanied by an increased cardiovascular (CV) risk, which justifies a multidisciplinary, integrative approach. Arterial stiffness has a well-defined additional role in refining individual CV risk. Given that echocardiography and carotid ultrasound are usual methods for CV risk characterization, we aimed to identify the imaging parameters with a predictive value for early-onset arterial stiffness. Material and methods: We conducted a study in which 50 patients (divided into two equal groups with morbid obesity and without obesity), age and gender matched, untreated for cardiovascular risk factors, were addressed to bariatric surgery or non-inflammatory benign pathology surgery. Before the surgical procedures, we evaluated demographics, anthropometric data and biochemical parameters including adipokines (chemerin, adiponectin). Arterial stiffness was evaluated using the Medexpert ArteriographTM TL2 device. Transthoracic echocardiography and carotid ultrasound were also performed. We also analyzed adipocyte size and vascular wall thickness in intraoperative biopsies. Results: Left ventricle (LV) mass index (p = 0.2851), LV ejection fraction (LVEF) (p = 0.0073), epicardial adipose tissue thickness (p = 0.0001) as echocardiographic parameters and carotid intima-media thickness (p = 0.0033), relative wall thickness (p = 0.0295), wall to lumen thickness ratio (p = 0.0930) and carotid cross-sectional area (p = 0.0042) as ultrasound parameters were significant measures in our groups and were assessed in relation to adipocyte size, blood vessel wall thickness and adipokines serum levels. Statistical analysis revealed directly proportional relationships between LV mass index (p = 0.008), carotid systolic thickness of the media (p = 0.009), diastolic thickness of the media (p = 0.007), cross-sectional area (p = 0.001) and blood vessel wall thickness. Carotid relative wall thickness positively correlates with adipocyte size (p = 0.023). In patients with morbid obesity, chemerin and adiponectin/chemerin ratio positively correlates with carotid intima-media thickness (p = 0.050), systolic thickness of the media (p = 0.015) and diastolic thickness of the media (p = 0.001). The multiple linear regression models revealed the role of epicardial adipose tissue thickness and carotid cross-sectional area in predicting adipocyte size which in turn is an independent factor for arterial stiffness parameters such as pulse wave velocity, subendocardial viability ratio and aortic augmentation index. Conclusions: Our results suggest that epicardial adipose tissue thickness, carotid intima-media thickness, relative wall thickness and carotid cross-sectional area might be useful imaging parameters for early prediction of arterial stiffness in patients with morbid obesity.