Total Adiposity Research Articles

P57-T Relationship of adiposity indices with carpal tunnel syndrome: A clinical and electrophysiological evaluation

Background Since body mass index (BMI) is a poor indicator of adiposity therefore more accurate measures of obesity such as total and segmental body composition relationships with carpal tunnel syndrome (CTS) need further studies. We aimed to study the relationship of adiposity indices with electrophysiological and clinical features of CTS. Methods We studied 103 hands in a total of 61 patients (mean age 54 ± 5 years) with clinical CTS. All patients underwent nerve conduction studies (NCS) and body composition analysis by bio-impedance analysis. Patients were grouped according to BMI, total body adiposity, visceral fat rating and segmental adiposity in the upper limbs. NCS parameters, clinical features were compared between different groups. Results CTS severity score correlated significantly with BMI (r = .343, p β = 0.613, P β = 0.317, P Conclusions Body adiposity indices are significantly related with clinical severity of CTS and electro-physiological parameters especially visceral adiposity. Large scale prospective studies are required to explore the true predictive value of body composition in CTS.

The Impact of Muscle and Adipose Tissue on Long-term Survival in Patients With Stage I to III Colorectal Cancer.

Computed tomography-derived body composition parameters are emerging prognostic factors in colorectal cancer. This study aimed to determine the roles of sarcopenia, myosteatosis, and obesity as independent and overlapping parameters in stage I to III colorectal cancer. This is a retrospective cohort study from a prospectively collected database. Multivariate Cox proportional hazards models were performed to assess the associations between body composition parameters and survival. All patients were seen in a tertiary care cancer center. Adult patients with stage I to III colorectal cancer, undergoing curative resection from 2007 to 2009, were included. Computed tomography-derived quantification of skeletal muscle and adipose tissues was used to determine population-specific cutoffs for sarcopenia, myosteatosis, and total adiposity. Primary outcome measures were overall, recurrence-free, and cancer-specific survival. In the 968 patients included, there were a total of 254 disease recurrences and 350 deaths. Body mass index and CT-derived measures of adiposity did not result in worse survival outcomes. Sarcopenia was independently predictive of worse overall (HR, 1.45; 95% CI, 1.16-1.84), recurrence-free (HR, 1.32; 95% CI, 1.00-1.75), and cancer-specific survival (HR, 1.46; 95% CI, 1.09-1.94) in a multivariate model. Myosteatosis was also independently predictive of overall survival (HR, 1.53; 95% CI, 1.19-1.97). In a model considering joint effects of sarcopenia and myosteatosis, the presence of both predicted the worst overall (HR, 2.23; 95% CI, 1.62-3.06), recurrence-free (HR, 1.53; 95% CI, 1.06-2.21), and cancer-specific survival (HR, 2.40; 95% CI, 1.69-3.42) in a multivariate model. The limitations of this study are inherent in retrospective observational studies. Sarcopenia and myosteatosis are independent predictors of worse survival in stage I to III colorectal cancer, and their joint effect is highly predictive of reduced overall, recurrence-free, and cancer-specific survival. See Video Abstract at http://links.lww.com/DCR/A923.

Skipping breakfast is associated with adiposity markers especially when sleep time is adequate in adolescents

Adolescence is a critical stage of development and has an important influence on energy balance-related behaviours (EBRBs). When adolescents are associated with obesity it can lead to increased cardiometabolic risk. Here we assess if EBRBs adopted by adolescents included in a subsample are associated with markers of total and abdominal adiposity in a multicentre European study, Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA-CSS) and a Brazilian study, Brazilian Cardiovascular Adolescent Health (BRACAH study), and whether sleep duration influence the association between skipping breakfast, physical activity and sedentary behaviours, with total and abdominal obesity (AO). Multilevel linear regression models using fixed and random intercepts were used to analyse the association between markers of obesity and EBRBs. Skipping breakfast was the prevalent behaviour in association with obesity among European and Brazilian boys besides European girls, even after stratification by sleep time. Moreover, European boys who slept properly and skipped breakfast had an increased waist circumference (WC), while body mass index (BMI) increased in Brazilian boys. Among Brazilian boys less sleep was protective for total obesity (β = −0.93 kg/m2; 95% CI: −1.80; −0.07). European girls when they were more sedentary, showed an increase in WC, especially for those who reported they slept adequately. Skipping breakfast was associated with total and AO in adolescents independent of sleep duration.

SUN-262 Total and Central Adiposity Is Associated with Earlier Puberty in Chilean Boys

Background. In recent years worldwide, there has been an increase in childhood obesity together with an advance in the age at which puberty begins in girls; however, in boys the evidence has been controversial (i.e. Crocker MK JCEM 2014, Lee JM pediatrics 2016). Objective. To determine whether total and central body obesity in pre-pubertal children evaluated since age 4 is associated with precocious puberty through the measurement of testicular volume. Methods. We included 527 boys for the Growth and Obesity Cohort Study longitudinal cohort. The anthropometric measures (weight, height, waist circumference) were registered and Body Mass index SDS calculated. Trained personnel valuated the onset of puberty through a Prader Orchidometer and precocious puberty was defined as reaching a testicular volume greater than 3 cc before 9 years of age in any of the testicles. The association between obesity (total body adiposity and central body adiposity) and precocious puberty, were analyzed through logistic regression models and the Odds Ratio (OR) and 95% confidence interval (CI) were estimated. Results. There was an increase in BMI SDS and prevalence of total obesity and central obesity through the years :at 6 - 7 yr, 0.99±1.32 SDS and 22.0% & 11.8 % respectively, and at Tanner 2 ,age 11.4±1.4 yr (n = 494) , 1.15±1.22 SDS and 28.6 % & 17.4% respectively. Forty ive boys initiated puberty before 9 yrs (9.1%). A positive and statistically significant association was found between total body obesity and precocious puberty from 4 to 7 years of age (i.e. between 5 and 6 years of age, OR: 2.68 95% CI: 1.09 - 6.57) and at the time of pubertal onset OR: 3.59 95% CI: 1.92 - 6.70. When analyzing BMI SDS as a continuous variable, the association remained positive and significant at birth and from 4 to 8 years of age and at the time of pubertal onset. Likewise, a positive and significant association was found between central obesity and precocious puberty from 4 to 7 years of age (example between 5 and 6 years, OR: 6.36 95% CI: 2.03-19.92). Conclusions. Total and central body obesity in boys aged 4 to 7 years is associated with earlier puberty. Our observation supports the association of adiposity and earlier pubertal events in Chilean boys. Early puberty might increase the risk of behavior problems. In addition, it has been postulated that precocious puberty in boys, could be related to higher incidence of testicular cancer in adulthood. Our results suggest that controlling the obesity epidemic could be useful in decreasing these risks. Additional studies are needed to understand the possible relationships among race/ethnicity, gender, BMI, and the timing of pubertal development

Synergistic Effect of Inflammatory Cytokines and Body Adiposity on Insulin Resistance and Endothelial Markers in Patients With Stages 3-5 Chronic Kidney Disease

High body adiposity, inflammatory cytokines, insulin resistance (IR), and the endothelial markers-soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular adhesion molecule-1 (sVCAM-1)-are among cardiovascular risk factors observed in chronic kidney disease (CKD). Synergistic interaction of inflammatory cytokines with adiposity on IR, sICAM-1, and sVCAM-1 has not been reported in nondialysis-dependent CKD (NDD-CKD) patients. Thus the study aim was to evaluate the interaction of inflammatory cytokines on the association of body adiposity with the cardiometabolic risk factors-IR, sICAM-1, and sVCAM-1-in NDD-CKD patients. Cytokines association with estimated glomerular filtration rate (eGFR) and body adiposity was also examined. A cross-sectional study was conducted in an interdisciplinary outpatient Nephrology Clinic. NDD-CKD adults with eGFR ≤60mL/minute/1.73m2 under regular treatment. Inflammatory cytokines, homeostasis model assessment of insulin resistance (HOMA-IR), sICAM-1, sVCAM-1, eGFR (by CKD-Epidemiology collaboration equation)-EPI equation, and body composition assessed by dual-energy X-ray absorptiometry and anthropometry were evaluated. Synergistic effects of inflammatory markers with body adiposity on studied cardiometabolic risk factors were assessed by interaction and mediation analysis. The study cohort comprised 241 NDD-CKD patients (54.8% men; eGFR=29.4±12.9mL/minute/1.73m2). Variables evaluated: Inflammatory cytokines were not associated with eGFR and not different among CKD stages. Percentage of total body adiposity (%TBA) was independently associated with tumor necrosis factor-alpha (TNFα) and HOMA-IR. Waist-to-height ratio was independently associated with TNFα, interleukin-8, monocyte chemoattractant protein-1 (MCP1), and HOMA-IR. Interaction analysis showed TNFα, interleukin-8, and MCP1 as independent mediators of the effects of high percentage of total body adiposity and waist-to-height ratio on HOMA-IR (P<.0001). Body adiposity did not associate with sICAM-1 and sVCAM-1. TNFα (β=0.40) and MCP1 (β=0.31) were independently associated with sVCAM-1 (P<.01). In NDD-CKD patients, inflammatory cytokines synergistically mediated the effects of body adiposity, enhancing the cardiometabolic risk. Inflammation was associated with sVCAM-1, but not with eGFR.

Inverse correlation between trabecular bone volume and bone marrow adipose tissue in rats treated with osteoanabolic agents.

There is currently an unmet clinical need for improved treatments for skeletal diseases such as osteoporosis and cancer-induced bone disease. This is due in part to a paucity of novel targets and an incomplete understanding of the mechanisms of action for established therapies. We defined the effects of anabolic treatments on bone and the bone marrow adipocyte (BMA). Sclerostin-neutralizing antibodies (Scl-Ab), romosozumab, human parathyroid hormone (hPTH, 1-34), and hPTH/hPTHrP analogues (e.g. teriparatide and abaloparatide) stimulate bone formation and have been studied in clinical trials for severe osteoporosis. In this study, eight-week-old male and female rats were administered vehicle, Scl-Ab (3 mg/kg or 50 mg/kg) weekly, or hPTH (1-34) (75 μg/kg) daily for 4 or 26 weeks. Histological analyses of distal femura were performed using a novel ImageJ method for trabecular bone and bone marrow adipose tissue (BMAT). Adipocyte number, circumference, and total adipose area were compared within the tissue area (T.Ar) or the marrow area (Ma.Ar), (defined as the T.Ar minus the trabecular bone area). After 26 weeks of treatment, a significant inverse correlation between bone and tissue adiposity (total adipocyte area divided by T.Ar) were observed in males and females (p < 0.0001). However, there were no significant correlations between bone and marrow adiposity (total adipocyte area divided by Ma.Ar) for either sex after 26 weeks of treatments. Scl-Ab treatments also resulted in no effect on adipocytes based on marrow adiposity for either sex after 26 weeks. However, chronic hPTH treatments significantly reduced adipocyte number and adiposity within the T.Ar and within the Ma.Ar in males. Overall, our data suggest that with long-term treatment, Scl-Abs decrease total tissue adiposity mainly by increasing trabecular bone, resulting in an overall reduction in the space in which adipocytes can reside. These findings were determined by developing and comparing two different methods of assessment of the marrow cavity, defined to either include or exclude trabecular bone. Thus, researchers should consider which adiposity measurement is more informative and relevant for their studies. Overall, our findings should help design improved therapies or combination treatments to target a potential new contributor to bone diseases: the bone marrow adipocyte.

Association between Habitual Coffee Consumption and Indices of Body Fat

BackgroundDespite strenuous public health efforts, obesity rates continue to rise globally, and contribute importantly to increased cardiometabolic morbidity and mortality. Dietary habits play a key role in the development and progression of obesity, and are the target of choice in preventative and therapeutic programs. Although preclinical studies have shown that caffeine may exert anti‐adipogenic effects, in humans the implications of coffee consumption on risks of excess adiposity are unclear.ObjectiveThe objective of this study was to investigate the association between habitual coffee consumption and indices of total and regional body fat in healthy adults.MethodsSeventy‐eight subjects (46 males, mean age 27.3±6.1 years) who took part in research studies conducted at the Mayo Clinic Cardiovascular/Sleep Laboratory and underwent body composition assessment were selected. Absence of cardiovascular or metabolic diseases was ascertained by physical exam and review of medical charts. Height, weight, waist and hip circumference measures were collected for computation of body mass index (BMI, kg/m2) and waist‐to‐hip ratio (WHR). Measurements of total body fat percentage, upper body fat (kg), and lower body fat (kg) were obtained from dual‐energy X‐ray absorptiometry (DXA). Abdominal computed tomography (CT) was used to quantify subcutaneous adipose tissue (SAT, cm2) and visceral adipose tissue (VAT, cm2). Habitual coffee consumption (cups/day; range 0–3) was self‐reported and coded as a binary variable (yes/no).ResultsSixty percent of the subjects (n=47) reported habitual coffee consumption. Age and gender distribution were comparable between groups (P=0.52 and P=0.73, respectively). There was no significant difference between those who reported consuming coffee and those who did not in terms of BMI (23.6±2.7 kg/m2 vs 24±2.8 kg/m2, P=0.56) and WHR (0.85±0.08 vs 0.85±0.07, P=0.7). Likewise, body composition and fat distribution indices were similar between groups: total body fat percentage (coffee drinkers vs non‐coffee drinkers: 30.5±7.2% vs 28.6±7.8%, P=0.27), upper body fat mass (6.6±2.4 kg vs 6.6±3.1 kg, P=0.99), lower body fat mass (9.4±5.2 kg vs 8.4±4.1 kg, P=0.39), SAT (143.4±61.3 cm2 vs 135.9±63.7 cm2, P=0.6), and VAT (57.7±35.5 cm2 vs 70.3±44 cm2, P=0.22). Analysis stratified by gender did not reveal any differential effect of regular coffee consumption on body fat (all Ps&gt;0.26).ConclusionIn healthy, young individuals moderate habitual coffee consumption is not associated with measures of total or regional adiposity. Whether the anti‐obesity effects of caffeine emerge only when it is consumed in larger quantities remains to be determined.Support or Funding InformationResearch support: NC is supported by American Heart Association grant 16SDG27250156 and Mayo Clinic Center for Clinical and Translational Science grant Marie Ingalls Cardiovascular Research Career Development Fund.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Obesity‐induced metabolic and vascular dysregulation: Implication of arginase

Obesity epidemic continues to rise worldwide, currently affecting more than 2 billion people. Visceral (central) obesity is of great importance as it correlates with metabolic and cardiovascular pathologies associated with chronic inflammation. Arginase, a ureahydrolase enzyme with two isoforms (A1‐cytosolic and A2‐mitochondrial). A2 expression is upregulated 3‐fold in differentiated adipocytes (3T3‐L1) exposed to high levels of palmitate (250 μM) and glucose (25 mM), a mimic of the obese state, as compared to adipocytes in control media. Also, visceral adipose tissue (VAT) from obese WT male and female mice showed a significantly higher expression of A2 compared to lean mice (p&lt;0.05). Our study aimed to examine the involvement of A2 in obesity‐associated metabolic and vascular disorders. Male and female WT mice and those globally lacking A2 (−/−) were fed either high fat, high sucrose (HFHS) or normal diet (ND) for 16 weeks. Body weight was measured weekly and metabolic parameters were determined by indirect calorimetry. The HFHS diet‐induced increases in body and VAT weights, as well as total body adiposity, were prevented or reduced in A2−/− mice. In concert, A2−/− HFHS mice exhibited 30% reduction in blood glucose and increased energy expenditure by 20% in males and 40% in females compared to WT HFHS mice (p&lt;0.05). WT and A2−/− mice fed HFHS showed a significantly reduced respiratory exchange ratio compared to ND mice. However, there was no significant difference in food consumption or locomotor activity. One strategy to combat obesity is to induce energy expenditure in white adipose tissue through elevated fatty acid oxidation. Mature adipocytes isolated using collagenase digestion from VAT of WT HFHS male mice showed significantly reduced expression of PGC‐1α, PPAR‐Ɣ and adiponectin compared to WT ND (p&lt;0.05). A2 deletion markedly blunted their reduction with a concomitant increase of VAT p‐AMPK‐α and adipocyte expression of genes involved in fatty acid metabolism. It also prevented the HFHS‐induced loss of mitochondrial density. Inflammation and fibrosis are involved in VAT metabolic dysfunctions. Flow cytometry revealed a 2‐fold increased infiltration of inflammatory M1‐like macrophages in VAT stromal vascular fraction from WT HFHS vs ND mice. VAT fibrosis was significantly greater in WT HFHS vs ND mice. These effects were prevented in A2−/− HFHS mice. Studies using primary preadipocytes isolated from VAT of male A2−/− mice showed increased expression of adiponectin and p‐AKT following insulin treatment vs WT mice, which indicates higher insulin sensitivity. Aortic rings from WT HFHS mice showed impaired endothelium‐dependent vasorelaxant responses to acetylcholine vs ND mice. Vasorelaxant responses were maintained in A2−/− HFHS and even more prominently in A1+/− HFHS mice. In conclusion, A2 is critically involved in HFHS‐induced VAT inflammation and metabolic dysregulation.Support or Funding InformationR01 HL070215, R01 EY01176 &amp; AHA17PRE33660321This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Evolution of total body and regional adiposity from late adolescence to early adulthood in a birth cohort study

BackgroundDifferences in total body and regional adiposity according to sex are observed from an early age, but these differences become more evident after puberty due to hormonal changes. We aimed to assess the evolution of total body and regional adiposity from 18 to 22 years of age and the associated sociodemographic and nutritional characteristics.MethodsIn total, 3274 individuals from the 1993 Pelotas birth cohort study followed up at 18 and 22 years of age. Measures of total body and regional adiposity were assessed using whole-body dual-energy X-ray absorptiometry (DXA) and the TC2 Three-Dimensional Photonic Scanner. We used fat mass index obtained from DXA as a measure of total body adiposity, and android and gynoid fat mass percentages (android or gynoid fat mass [kg]/total fat mass [kg])*100) as measures of regional adiposity. In addition, waist, hip and thigh circumferences from the photonic scanner were also used as measures of regional adiposity. We evaluated these measurements at 18 and 22 years of age by sex and estimated differences between them according to sociodemographic and nutritional characteristics.ResultsWhile men and women did not differ in terms of BMI, females exhibited a higher fat mass index, gynoid fat mass percentage, and hip and thigh circumferences; men exhibited higher android fat mass percentage and waist circumference at both time points. Increases in all body measurements from age 18 to 22 were observed in men and women, except for gynoid fat mass percentage, which decreased in both sexes. Socioeconomic position and race were the independent variables most associated with adiposity rising from age 18 to 22 in women, with black women and women of lower socioeconomic positions exhibiting larger increases in adiposity.ConclusionThere was an increase in adiposity and a centralization of body shape from late adolescence to early adulthood, indicating possible early risks for noncommunicable diseases in this cohort.

Obesity and calcification of the ligaments of the spine: a comprehensive CT analysis of the entire spine in a random trauma population

Background ContextObesity, which is currently surging to epidemic levels within the United States, has been linked to hyperostotic conditions like diffuse idiopathic skeletal hyperostosis (DISH) and ossification of the posterior longitudinal ligament (OPLL). Excess adipose tissue and insulin-resistance may cause a systemic increase in serum levels of proinflammatory cytokines and these signals can affect bone metabolism. Spinal ligaments and discs may have receptors for these signaling molecules. Anecdotal observations at this institution suggested that there is a clinically important subset of younger patients with obesity and multilevel stenosis in the presence of unusual calcification of the spinal ligaments that is distinct from DISH. PurposeTo determine if there is an association between truncal obesity and calcifications of the spine in nonelderly adults. Study Design/SettingThis is a retrospective analysis of 214 sequential trauma patients between the ages of 29 and 50. Patients’ age, sex, truncal obesity, history of hypertension, and diabetes were assessed for association with ligamentous calcification of the spine. Patient SampleSequential trauma patients were chosen from our institution's trauma database between 2006 and 2007. MethodsFull spine computed tomography (CT) imaging was examined for bone formation in the region of the anterior longitudinal ligament (ALL) and annulus, posterior longitudinal ligament (PLL) and annulus, and the ligamentum flavum (LF). Visceral and subcutaneous abdominal fat were also evaluated. The authors report no study funding sources or conflicts of interest. Outcome MeasuresCalcification of the ALL, PLL, and LF were assigned a score at each level and then combined for a total calcification score (TCS) for the entire spine. Obesity was estimated using a truncal body mass index (TBMI) by using a previously validated CT derived truncal total adiposity volume (TAV). ResultsALL calcification was associated with age, male gender, hypertension, and increased adiposity. PLL calcification was significantly associated with age and hypertension. LF calcification was only associated with increased obesity. ConclusionsIn our analysis of nonelderly patients, LF calcification was independently associated with truncal obesity. This implies obesity plays a greater role in calcification than could be accounted for by simply age-related degeneration or gender.

Total Body Adiposity, Triglycerides, and Leg Fat are Independent Risk Factors for Diabetic Peripheral Neuropathy in Chinese Patients with type 2 Diabetes Mellitus

To evaluate the risk factors associated with diabetic peripheral neuropathy (DPN) in Chinese patients with type 2 diabetes mellitus (T2DM). Between January 2014 and December 2017, 107 participants who had obesity with T2DM and 349 participants who had normal weight with T2DM, matched for age, sex, and duration of diabetes, were recruited. The clinical and biochemical parameters were measured in each patient. DPN was diagnosed based on neuropathy symptom score and neuropathy deficit score. Motor and sensory nerve conduction velocities were measured by electromyography. Body fat mass was estimated by dual-energy X-ray absorptiometry, while hepatic steatosis was evaluated by ultrasonography. The group with obesity had a significant higher prevalence of DPN (66.62%) than that (46.99%) of the group with normal weight. Compared to the patients with normal weight, the sural sensory nerve in the right lower limbs of the patients with obesity was more susceptible to damage. Hypertriglyceridemia in the patients with obesity was a significant independent risk factor for DPN (odds ratio [OR], 3.90 [95% confidence interval (CI), 1.01 to 15.02]; P = .04), while the duration of diabetes (OR, 1.33 [95% CI, 1.07 to 1.65]; P<.01) and leg subcutaneous fat mass (OR, 0.72 [95% CI, 0.57 to 0.90]; P<.01) in the patients with normal weight were independent risk factors for DPN. The presence of obesity alone in patients with T2DM could predict high DPN risk (OR, 3.09 [95% CI, 1.11 to 8.65]; P = .04). Reducing total body adiposity and triglyceride levels, as well as avoiding leg subcutaneous fat atrophy, could be new prevention strategies for DPN in Chinese patients with T2DM. ALB = albumin; ALT = alanine transaminase; AST = aspartate transaminase; AUC = area under the curve; AUCc-p/AUCglu = AUC of C-peptide/AUC of glucose; BMI = body mass index; BP = blood pressure; CI = confidence interval; Cr = creatinine; DBP = diastolic blood pressure; DPN = diabetic peripheral neuropathy; FC-P = fasting C-peptide; FPG = fasting plasma glucose; FFA = free fatty acid; γ-GGT = γ-glutamyl transferase; HbA1c = glycated hemoglobin A1c; HDL-C = high-density-lipoprotein cholesterol; ISI = insulin sensitivity index; ISSI-2 = insulin secretion-sensitivity index-2; LDL-C = low-density-lipoprotein cholesterol; MNCS = motor nerve conduction velocity; OGTT = oral glucose tolerance test; PG = plasma glucose; SAT = subcutaneous adipose tissue; SBP = systolic blood pressure; SNCS = sensory nerve conduction velocity; T2DM = type 2 diabetes mellitus; TC = total cholesterol; TG = triglyceride; UA = uric acid; VAT = visceral adipose tissue; WC = waist circumference.

The TyG index cutoff point and its association with body adiposity and lifestyle in children

ObjectiveTo investigate the factors associated with insulin resistance in children aged 4–7 years, and to identify the cutoff point of the triglyceride‐glucose index for the prediction of insulin resistance in this population. MethodsA cross‐sectional study was conducted with 403 children from a retrospective cohort. Insulin resistance was also evaluated in a sub‐sample using the HOMA index. Four indicators of body adiposity were assessed: body mass index, waist‐to‐height ratio, and the percentages of total and central body fat. Food habits were evaluated by the identification of dietary patterns, using principal component analysis. Information was also collected on lifestyle, socioeconomic status, and breastfeeding time. ResultsThe median index observed in the sample was 7.77, which did not differ between the genders. The shorter the time spent in active activities, the higher the triglyceride‐glucose value; and increase in the values of body adiposity indicators was positively associated with triglyceride‐glucose. The cutoff point with the best balance between sensitivity and specificity values was 7.88 (AUC=0.63, 95% CI: 0.51–0.74). ConclusionThe present study identified that total and central body adiposity and shorter time spent in lively activities was positively associated with insulin resistance, evaluated through the triglyceride‐glucose index. The cutoff point of 7.88 may be used in this population for insulin resistance risk screening, but caution is required when using it in other populations.

Fitness Mediates Activity and Sedentary Patterns Associations with Adiposity in Youth.

We aimed to examine the cross-sectional associations of patterns of sedentary time (ST) and moderate-to-vigorous physical activity (MVPA) with total fat mass index (FMI) and abdominal FMI (FMIabd) in children, and additionally, to analyze if cardiorespiratory fitness (CRF) mediated these associations. Fat mass index and FMIabd were assessed with dual-energy X-ray absorptiometry in 333 participants (172 girls) age 9 to 11 yr. MVPA, ST, breaks in ST per sedentary hour (BST/ST) and the number of daily sedentary bouts with various lengths (1-4, 5-9, 10-14, and ≥15 min) were assessed with accelerometry and CRF using a maximal cycle test. Hayes' PROCESS macro for SPSS was used for mediation analysis. The number of shorter sedentary bouts (1-4 min) was inversely associated with FMI (β = -0.108), whereas longer sedentary bouts (5-9 min, β = 0.169; 10-14 min, β = 0.193; ≥15 min, β = 0.377) had a positive association, independent of MVPA (P < 0.05). A similar trend was found for FMIabd. Moderate-to-vigorous physical activity was negatively related to FMI (β = -0.029) and to FMIabd (β = -0.003). There were no main associations for ST and BST/ST (P > 0.05). Cardiorespiratory fitness was inversely related to total and abdominal adiposity, and a large portion (40.9-65.7%) of the associations of MVPA and sedentary bouts with both FMI and FMIabd were mediated by CRF. Time in MVPA and accumulating ST in shorter sedentary bouts is inversely related to adiposity. However, these associations may be mediated by CRF. Emphasis should be given to programs that target increases in MVPA, which may influence CRF while reducing sedentary recreational behaviors.

Strength training and aerobic exercise alter mitochondrial parameters in brown adipose tissue and equally reduce body adiposity in aged rats.

With aging, there is a reduction in mitochondrial activity, and several changes occur in the body composition, including increased adiposity. The dysfunction of mitochondrial activity causes changes and adaptations in tissue catabolic characteristics. Among them, we can mention brown adipose tissue (BAT). BAT's main function is lipid oxidation for heat production, hence playing a role in adaptive thermogenesis induced by environmental factors such as exercise. It is known that exercise causes a series of metabolic changes, including loss body fat; however, there is still no consensus in the academic community about whether both strength and aerobic exercise equally reduces adiposity. Therefore, this study aimed to evaluate the effects of strength training and aerobic exercise regimes on adiposity, proteins regulating mitochondrial activity, and respiratory complexes in BAT of old rats. The rats were divided in two control groups: young control (YC; N = 5), and old control (OC; N = 5), and two exercise groups: strength training (OST; N = 5), and aerobic treadmill training (OAT; N = 5). Rats were subjected to an 8-week exercise regime, and their body composition parameters were evaluated (total body weight, adiposity index, and BAT weight). In addition, mitochondrial biogenesis proteins (PGC-1α, SIRT1, and pAMPK) and respiratory chain activity (complexes I, II/III, III, and IV) were evaluated. Results showed that OST and OAT exercise protocols significantly increased the mitochondrial regulatory molecules and respiratory chain activity, while body fat percentage and adiposity index significantly decreased. Taken together, both OST and OAT exercise increased BAT weight, activity of respiratory complexes, and regulatory proteins in BAT and equally reduced body adiposity.

Maternal High-Protein Diet during Pregnancy Modifies Rat Offspring Body Weight and Insulin Signalling but Not Macronutrient Preference in Adulthood.

Diet of mothers during gestation may impact offspring phenotype. This study evaluated the consequences of a maternal High-Protein (HP) diet during gestation on food preferences and phenotypic characteristics in adult rat offspring. Dams were fed a HP or a Normal-Protein (NP) isocaloric diet during gestation only. Weaned female pups were divided into 3 diet groups: NP control or one of two dietary self-selection (DSS) conditions. In DSS1, offspring had a free choice between proteins (100%) or a mix of carbohydrates (88%) and lipids (12%). In DSS2, the choice was between proteins (100%), carbohydrate (100%) or lipids (100%). DSS2 groups consumed more of their energy from protein and lipids, with a decreased carbohydrate intake (p < 0.0001) compared to NP groups, regardless of the maternal diet. Offspring from HP gestation dams fed the DSS2 diet (HPDSS2) had a 41.2% increase of total adiposity compared to NPDSS2 (p < 0.03). Liver Insulin receptor and Insulin substrate receptor 1 expression was decreased in offspring from HP compared to NP gestation dams. These results showed the specific effects of DSS and maternal diet and data suggested that adult, female offspring exposed to a maternal HP diet during foetal life were more prone to adiposity development, in response to postweaning food conditions.

Association of Waist-Height-Ratio, Waist Circumference, and Body Mass Index with Serum Testosterone Level in Apparently Healthy Men

Previous studies have shown that waist circumference (WC) may be a better predictor of serum testosterone level than body mass index (BMI). The determination of the waist-to-height ratio (WHt ratio) is reported to have certain advantages over other adiposity measures. Our study thus aimed at examining the utility of WHt ratio in addition to WC and BMI in determining their association with testosterone level. The case-control study involved apparently healthy male participants aged between 40 to 60 years. The study participants were divided into normal and abnormal groups according to WC, BMI, WHt ratio with their mean total testosterone level compared. The correlations of total testosterone and adiposity measures along with age adjustments were also determined. Individuals with WC>100cm had a significant low (P=0.003) testosterone level compared to their counterparts with WC<100cm. A significantly lowered (P=0.042) testosterone was observed in the study group with BMI>25kg/m² compared to the group with <25kg/m². The study group with a WHt ratio of >0.5 had a significantly lower (P=0.012) testosterone than the group with <0.5. An inverse correlation of testosterone was observed with age (r=-0.567), BMI (r=-0.265), WC (r=-0.406), and WHt ratio (r=-0.412) in the apparently healthy Men studied. After adjustment for age, the correlation observed between testosterone and BMI (P=0.010), testosterone and WC (P=0.004), testosterone and WHt ratio (P=0.014) remained significant. After height adjustment, the correlation between testosterone and WHt ratio (P=0.002) also remained significant. In conclusion, the WHt ratio and WC independent of age were the best predictors of the total testosterone level in men.

Effects of Exercise Modality on Insulin Resistance and Ectopic Fat in Adolescents with Overweight and Obesity: A Randomized Clinical Trial

To examine whether a combined aerobic exercise and resistance exercise is more effective than either aerobic exercise or resistance exercise alone in improving insulin sensitivity and reducing total adiposity and ectopic fat in adolescents. A total of 118 sedentary adolescents with overweight/obesity (body mass index >85th percentile, 12-17 years) were recruited from October 2013 through April 2017 at Children's Hospital of Pittsburgh. Participants were randomized to 1 of the following 6-month exercise groups (3 d/wk, 180 min/wk): aerobic exercise (n = 38), resistance exercise (n = 40), and combined aerobic exercise and resistance exercise (n = 40). The primary outcome was the change in insulin-stimulated glucose disposal by a 3-hour hyperinsulinemic-euglycemic clamp. The secondary outcomes were changes in liver fat by proton magnetic resonance spectroscopy and intermuscular adipose tissue by computed tomography. Of the 118 participants randomized, 85 participants (72%) completed the study with 90% exercise attendance. Total adiposity reduced similarly in all groups (-2%, P < .05). After adjusting for age and sex, insulin-stimulated glucose disposal increased (P < .05) in all groups, with the increase in the aerobic exercise group being greater than the resistance exercise group (1.7 ± 0.1 vs 0.7 ± 0.1 mg/kg/min, P < .05) but not different from the combined group (1.2 ± 0.1 mg/kg/min). Liver fat was reduced (P < .05) in the aerobic exercise (-0.6%) and combined (-0.6%) groups but not in the resistance exercise group (-0.3%, P > .05). Intermuscular adipose tissue decreased (P < .05) similarly in all groups. Combined aerobic exercise and resistance exercise and aerobic exercise alone are similarly beneficial in improving insulin sensitivity and reducing ectopic fat in adolescents with obesity. ClinicalTrials.gov: NCT01938950.

Changes in Body Adiposity, Dietary Intake, Physical Activity and Quality of Life of Obese Individuals Submitted to Intragastric Balloon Therapy for 6 Months.

Obesity is an important risk factor for several chronic diseases and also is associated with worse quality of life. Intragastric balloon (IGB) is an effective method for weight loss. Although changes in lifestyle are critical to weight loss during and after IGB therapy, only a few studies evaluated dietary intake and none evaluated changes in physical activity with a validated questionnaire during the treatment. The aim of this study was to evaluate changes in total and central body adiposity, dietary intake, physical activity, and quality of life of patients with obesity submitted to IGB treatment for 6months. Prospective observational study involving 42 patients with obesity using IGB for 6months. The patients were evaluated, on the day of insertion and withdrawal or adjustment of IGB for total and central body adiposity (anthropometry and bioelectrical impedance), dietary intake, physical activity (Baecke questionnaire), and quality of life (SF-36 questionnaire). There was a significant decrease in total and central body adiposity. The mean % total weight loss and % excess weight loss were 15.88 ± 1.42 and 56.04 ± 4.90, respectively and waist circumference decreased 13.33 ± 1.39cm. There was a reduction in energy intake, an increase in physical activity, and an improvement of quality of life during IGB treatment. The present study suggests that IGB treatment during 6months in individuals with obesity is effective for decreasing total and central body adiposity being associated with reduction in energy intake, increase in physical activity, and improvement in quality of life.

Reduced Lean Body Mass and Cardiometabolic Diseases in Adult Males with Overweight and Obesity: A Pilot Study.

Little is known about the reduction in lean body mass (LBM) and its health consequences in overweight and in obesity, especially in males. Therefore, we aimed to assess the prevalence of low LBM in treatment-seeking adult males with overweight and obesity and the association with cardiometabolic diseases, i.e., type 2 diabetes, cardiovascular diseases and dyslipidemia. A body composition assessment was conducted by a bio-impedance analyzer (InBody 170) among a total of 110 males, of whom 72 were overweight and obese and were referred to the Outpatient Clinic in the Department of Nutrition and Dietetics at Beirut Arab University (BAU) in Lebanon, and 38 were normal-weight participants of similar ages. The participants with overweight and obesity were then categorized as being with or without low LBM. Of the sample of 72 participants, 50 (69.4%) met the criteria for reduced LBM and displayed a significantly higher prevalence of cardiometabolic diseases (i.e., type 2 diabetes, cardiovascular diseases and dyslipidemia) than those with normal LBM (36.0% vs. 9.1%; p = 0.019). Logistic regression analysis showed that low LBM increases the odds of having cardiometabolic diseases by nearly 550% (odds ratio (OR) = 5.46, 95% confidence interval (CI) = 1.31–26.39, p < 0.05) after adjusting for total fat and central adiposity. Treatment-seeking adult males with overweight and obesity displayed a great prevalence of reduced LBM, which seems to be strongly associated with cardiovascular and metabolic diseases.

Dietary patterns and body adiposity in children in Brazil: a cross-sectional study.

Many factors are associated with the increase in total and central body adiposity in children, especially eating habits. This has led to an increasing number of studies analysing food patterns, which consider the synergistic effect of food and nutrient intake on the nutritional status. The objective of this study was to identify the dietary patterns of children aged 4-7 years and associate these with different indicators of total and central body adiposity. Cross-sectional study METHODS: The study consisted of 403 children from a retrospective cohort in Minas Geraes, Brazil. Four indicators of body adiposity were evaluated: body mass index (BMI), waist-to-height ratio (WHtR) and percentages of total and central body fat (assessed by dual-energy X-ray absorptiometry). The dietary habits of the children were evaluated by identifying the dietary patterns using principal component analysis. The adjustment predictor variables were related to the socio-economic characteristics, lifestyle and duration of exclusive breastfeeding. Food patterns were identified by factor analysis. Linear regression was used to estimate the regression coefficient and the confidence interval, considering statistical significance of α=5%. Five dietary patterns were identified, which explained 42.3% of the data variance: 'Traditional', 'Unhealthy', 'Milk and chocolate', 'Snack' and 'Healthy'. The multiple linear regression model showed that a greater adherence to the 'Traditional' and 'Unhealthy' patterns was related to higher BMI, WHtR, and total and central body adiposity. Children with a higher intake of food from the 'Traditional' and 'Unhealthy' patterns showed an increase in total and central body adiposity.