VAT Mass Research Articles

Long-term Outcome of Body Composition, Ectopic Lipid, and Insulin Resistance Changes With Surgical Treatment of Acromegaly.

Acromegaly presents a unique pattern of lower adiposity and insulin resistance in active disease but reduction in insulin resistance despite a rise in adiposity after surgery. Depot-specific adipose tissue masses and ectopic lipid are important predictors of insulin resistance in other populations, but whether they are in acromegaly is unknown. Long-term persistence of body composition changes after surgery is unknown. To determine how depot-specific body composition and ectopic lipid relate to insulin resistance in active acromegaly and whether their changes with surgery are sustained long-term. Cross-sectional study in patients with active acromegaly and longitudinal study in newly diagnosed patients studied before and in long-term follow-up, 3 (1-8) years (median, range), after surgery. Seventy-one patients with active acromegaly studied cross-sectionally and 28 with newly diagnosed acromegaly studied longitudinally. Main outcome measures were visceral (VAT), subcutaneous (SAT), and intermuscular adipose tissue masses by whole-body magnetic resonance imaging; intrahepatic lipid (IHL) by proton magnetic resonance spectroscopy; insulin resistance measures derived from fasting; and oral glucose tolerance test insulin and glucose levels. SAT and insulin-like growth factor 1 level, but not VAT or IHL, were independent predictors of insulin resistance in active acromegaly. VAT, SAT, and IHL gains were sustained long-term after surgery. VAT mass rise with surgery correlated inversely with rise in QUICKI while SAT rise correlated with fall in the Homeostatic Model Assessment score. SAT and disease activity are important predictors of insulin resistance in active acromegaly. Adiposity gains are sustained long-term after surgical treatment and impact on the accompanying improvement in insulin resistance.

RF30 | PSAT148 Bone Mass and Body Composition Analysis in Transgender Men: A 1 Year Follow Up

Abstract Introduction Sex steroid hormones play a key role in bone health, however medical therapies for gender dysphoria lead to hormonal changes. Purpose Understanding the changes in bone mass and body composition is extremely important, because this treatment will be carried out over a long period of time. Methods In a prospective study, we included 19 transgender men (female-to-male transgender persons) before treatment and after 1 year of treatment with undecanoate (1000 mg i.m./12 weeks). Bone densitometry model Hologic-Discovery performed at baseline and after 6, 12 months of therapy. All participants signed the TCLE, project approved by CEP-CAAE: 36823220.6.0000.0062. Results Analysis of 19 transgender men with a mean age of 24 years +/- 10 years. LS-BMD (lumbar spine) at initial time (0m) 1,075±0,238 g/cm2 and after 6 months (6m) 1,044±0,117 g/cm2 and 12 months (12m) after 1,052±0.122 g/cm2, p=0.21; FN-BMD (Femur Neck) 0m= 0.904±0.121 g/cm2; 6m= 0.918±0.108 g/cm2 and 12m= 0.905±0.107 g/cm2; p=0.90. TH-BMD (Total Hip) 0m=1.017±0.139 g/cm2; and 6m= 1.023±0.134 g/cm2; 12m= 1.032±0.136g/cm2; p=0.05. About body composition: the percentage of body fat: 0m=38.8±6.7%, 6m=34.5±7.1%; 12m=34.9±9.0; p=0.09; android/gynecoid ratio: 0.93±0.16, 6m=0.94±0.17; 12m=0.94±0.18 p=0.06, VAT mass (cm3) 431.8±262.1, 6m= 401.8±298.6, 12m= 455.5±322.7 and Lean/Height2 (kg/m2) 0m= 15.52±3.24 6m= 16.15±2.19 kg/ m2; 12m= 15.86±2.22 kg/m2; p<0.01 and Appen. Lean/Height2 (kg/m2) 6.92±1.74, 6m= 7.32±1.22 and 12m= 7.31±1.07; p<0.01 Conclusion In 1 year of hormone therapy with testosterone, we did not observe significant differences in bone mass, but in body composition there was a gain in appendicular lean mass. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m., Monday, June 13, 2022 1:00 p.m. - 1:05 p.m.

ODP082 Bone mass and body composition analysis in transgender women: a 1 year follow up.

Abstract Introduction Sex steroid hormones play a key role in bone health, however medical therapies for gender dysphoria lead to hormonal changes. Purpose Understanding the changes in bone mass and body composition is extremely important, because this treatment will be carried out over a long period of time. Methods In a prospective study, we included 19 trans women (male-to-female trans persons) before and after 1 year of therapy with estrogen and cyproterone acetate. Bone densitometry model Hologic-Discovery performed at baseline and after 6, 12 months of therapy. All participants signed the TCLE, project approved by CEP-CAAE: 36823220.6. 0000. 0062. Results Analysis of 19 transgender women with a mean age of 25 years +/- 10 years. LS-BMD (lumbar spine) at initial time (0m) 1,070±0,155g/cm2 and after 6 months (6m) 0,995±0,092g/cm2 and 12 months (12m) after 1,020±0,096 g/cm2, p=0,04; FN-BMD (Femur Neck) 0m= 1. 047±0.205g/cm2; 6m= 0.917±0.127g/cm2 and 12m= 0.909±0.120 g/cm2; p=0. 01. TH-BMD (Total Hip) 0m= 1.100±0.162 g/cm2; and 6m= 1. 021±0. 099g/cm2; 12m= 1. 015±0.119g/cm2; p=0. 02. About body composition: the percentage of body fat: 0m= 30.2±8. 0%, 6m= 31.3±7.9%; 12m= 33.2±10.2%; p=0.10; android/gynecoid ratio: 1. 00±0.26, 6m= 0.95±0.22; 12m= 1. 00±0.39; p=0,76, VAT mass (cm3) 411.8±252.1, 6m= 357.6±145.3, 12m= 395.5±167.7 p= 0,67 and Lean/Height2 (kg/m2) 0m= 17. 03±2.98, 6m= 15.94±1.8, 12m= 16.74±2.10; p=0.46 and Appen. Lean/Height2 (kg/m2) 7.89±1.67, 6m= 7.42±1.10 and 12m= 7.52±1. 01; p=0.90 Conclusion: In 1 year of hormone therapy with estrogen and cyproterone acetate, we found decrease in bone mass in the analyzed sites and no change in body fat and lean mass. Presentation: No date and time listed

Validity Of The Inbody Bioelectrical Impedance Analyzer Visceral Adiposity Estimates

Excess visceral adipose tissue is linked to health risks. However, methods for measuring VAT are expensive and not available to the general public (i.e., MRI, CT, DXA). The InBody bioelectrical impedance analysis (BIA) system could be a cheaper and practical method to provide VAT estimates. PURPOSE: To determine the validity of the InBody BIA visceral adiposity estimates. METHODS: A diverse sample of 210 participants completed the study (56 white females, 60 black females, 51 white males, and 59 black males). The InBody S10 estimates VAT area (VFA) while DXA estimates VAT mass and VAT volume. Thus, it was not possible to test absolute agreement. Pearson correlations were used to test the relationship between InBody VAT area and DXA VAT volume for the whole sample and by sex by race groups. The relationship between measured VAT and common cardiometabolic risk factors were also tested. RESULTS: The overall sample correlation between InBody VFA and DXA VAT mass was 0.76. The correlations were 0.85, 0.72, 0.80, and 0.73 for white females, black females, white males, and black males, respectively. The correlation between measured VAT and cardiometabolic factors is shown in Table 1. CONCLUSIONS: The correlations for the total sample and for black participants were moderately-high and high for white participants. Overall, the relationship between InBody VFA, DXA VAT mass, and cardiometabolic risk factors were similar. However, there were large differences (≥ 0.10) between the InBody and DXA for some cardiometabolic risk factors, notably DBP and HB1c. In addition, these large differences were present more often for black women and men. Overall, the InBody BIA performance was acceptable, and results tended to be better in white than black participants. Table 1. Pearson correlation between InBody VFA, DXA VAT mass, and cardiometabolic risk factors.

AMPK Activation Is Important for the Preservation of Insulin Sensitivity in Visceral, but Not in Subcutaneous Adipose Tissue of Postnatally Overfed Rat Model of Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is a well-known reproductive syndrome usually associated with obesity, insulin resistance, and hyperinsulinemia. Although the first signs of PCOS begin early in adolescence, it is underexplored whether peripubertal obesity predisposes women to PCOS metabolic disturbances. To highlight that, we examined the impact of postnatal overfeeding-induced obesity, achieved by litter size reduction during the suckling period, on metabolic disturbances associated with visceral and subcutaneous adipose tissue (VAT and SAT) function in the 5α-dihydrotestosterone (5α-DHT)-induced animal model of PCOS. We analyzed markers of insulin signaling, lipid metabolism, and energy sensing in the VAT and SAT. Our results showed that postnatally overfed DHT-treated Wistar rats had increased VAT mass with hypertrophic adipocytes, together with hyperinsulinemia and increased HOMA index. In the VAT of these animals, insulin signaling remained unchanged while lipogenic markers decreased, which was accompanied by increased AMPK activation. In the SAT of the same animals, markers of lipogenesis and lipolysis increased, while the activity of AMPK decreased. Taken together, obtained results showed that postnatal overfeeding predisposes development of PCOS systemic insulin resistance, most likely as a result of worsened metabolic function of SAT, while VAT preserved its tissue insulin sensitivity through increased activity of AMPK.

Inflammatory status, body composition and ethnic differences in bone mineral density: The Southall and Brent Revisited Study.

Ethnic differences in bone mineral density (BMD) and fracture risk are well-described; the aim of this study was to investigate whether central adiposity or inflammatory status contribute to these ethnic differences in BMD in later life.The Southall and Brent Revisited study (SABRE) is a UK-based tri-ethnic cohort of men and women of European, South Asian or African Caribbean origin. At the most recent SABRE follow-up (2014–2018), in addition to measures of cardiometabolic phenotype, participants had dual-energy X-ray absorptiometry (DXA) bone and body composition scans. Multiple linear regression was used to determine whether markers of body composition, central adiposity or inflammatory status contributed to ethnic differences in BMD.In men and women, age- and height-adjusted BMD at all sites was higher in African Caribbeans compared to Europeans (femoral neck: standardised β (95% confidence interval): men: 1.00SD (0.75, 1.25); women: 0.77SD (0.56, 0.99)). South Asian men had higher BMD than European men at the hip (femoral neck: 0.34SD (95%CI: 0.15, 0.54)). Although adjustment for body mass index (BMI) or lean mass index (LMI) at the lumbar spine reduced the size of the difference in BMD between African Caribbean and European men (age and height adjusted difference: 0.35SD (0.08, 0.62); age and BMI adjusted difference: 0.25SD (−0.02, 0.51)), in both men and women ethnic differences remained after adjustment for measures of central adiposity (estimated visceral adipose tissue mass (VAT mass) and android to gynoid ratio) and inflammation (interleukin-6 (logIL-6) and C-reactive protein (logCRP)). Furthermore, in women, we observed ethnic differences in the relationship between BMI (overall interaction: p = 0.04), LMI (p = 0.04) or VAT mass (p = 0.009) and standardised lumbar spine BMD.In this tri-ethnic cohort, ethnic differences in BMD at the femoral neck, total hip or lumbar spine were not explained by BMI, central adiposity or inflammatory status. Given ethnic differences in fracture incidence, it is important to further investigate why ethnic differences in BMD exist.

Almond Consumption Decreases Android Fat Mass Percentage in Adults With High Android Subcutaneous Adiposity but Does Not Change HbA1c

ObjectivesThe purpose of this study was to determine if the mixed evidence of almond consumption on HbA1c stems from testing people with different body fat distributions (BFD) associated with different risks of glucose intolerance. MethodsA 6-month RCT in 134 adults was conducted. Participants were randomly assigned to the almond or control treatment based on their BFD. Those in the almond group consumed 0.75 oz of almonds with their breakfast and as their afternoon snack (1.5 oz almonds/day) every day, and were instructed not to consume any other nuts. Those in the control treatment continued their habitual breakfast and afternoon snack routines, but were instructed not to consume any nuts. At 0 and 6 months, body composition was measured and blood samples were collected for analyses of HbA1c, glycemia and lipemia. Appetite and dietary intake data were recorded at 0, 2, 4, and 6 months and a blood sample was obtained for compliance testing. Body weight was measured every two weeks. An intention-to-treat linear mixed model analysis was performed with Bonferroni pairwise comparisons on diet quality, energy intake, HbA1c, and body composition change values. ResultsIncorporating almonds into the diet increased total diet quality by 8.3 ± 2.1% over the intervention (P = 0.001). Participants consuming almonds ingested 195 ± 87 kcals/day more than participants in the control group (P = 0.027), but this did not result in differences in body weight (P > 0.3). The almond, high android subcutaneous adiposity (SAT) group had a greater reduction in android fat mass % (P = 0.038), preserved android lean mass % (P = 0.042), and tended to decrease android VAT mass (P = 0.079) compared to those in the control, high SAT group. There were no differences of HbA1c between groups (P > 0.05). ConclusionsIncorporating 1.5-oz of almonds into the diet improves diet quality without promoting positive energy balance and weight gain. Long-term consumption of almonds may also improve android composition in those with high android SAT. However, testing people with different BFD does not account for the mixed evidence on almond consumption and HbA1c. Funding SourcesThis study was funded by the Almond Board of California.

Multigenerational study of the obesogen effects of bisphenol S after a perinatal exposure in C57BL6/J mice fed a high fat diet.

Bisphenol S is an endocrine disruptor exhibiting metabolic disturbances, especially following perinatal exposures. To date, no data are available on the obesogen effects of BPS in a mutligenerational issue. We investigated obesogen effects of BPS in a multigenerational study by focusing on body weight, adipose tissue and plasma parameters in male and female mice. Pregnant C57BL6/J mice were exposed to BPS (1.5μg/kgbw/day ie a human equivalent dose of 0.12μg/kgbw/day) by drinking water from gestational day 0 to post natal day 21. All offsprings were fed with a high fat diet during 15 weeks. Body weight was monitored weekly and fat mass was measured before euthanasia. At euthanasia, blood glucose, insuline, triglyceride, cholesterol and no esterified fatty acid plasma levels were determined and gene expressions in visceral adipose tissue were assessed. F1 males and females were mated to obtain the F2 generation. Likewise, the F2 mice were cross-bred to obtain F3. The same analyses were performed. In F1 BPS induced an overweight in male mice associated to lipolysis gene expressions upregulation. In F1 females, dyslipidemia was observed. In F2, BPS exposure was associated to an increase in body weight, fat and VAT masses in males and females. Several plasma parameters were increased but with a sex related pattern (blood glucose, triglycerides and cholesterol in males and NEFA in females). We observed a down-regulation in mRNA expression of gene involved in lipogenesis and in lipolysis for females but only in the lipogenesis for males. In F3, a decrease in VAT mass and an upregulation of lipogenesis gene expression occurred only in females. BPS perinatal exposure induced sex-dependent obesogen multigenerational effects, the F2 generation being the most impacted. Transgenerational disturbances persisted only in females.

SUN-355 Associations of Trabecular Bone Score and Bone Mineral Density with Cardiorespiratory Fitness and Body Composition in Men with and Without Paraplegia

Introduction: Following spinal cord injury (SCI) lower extremity bone mineral density (BMD) losses are as high as 40% due to mechanical unloading and autonomic dysfunction. While lumbar spine (LS) BMD appears to be relatively spared, evidence suggests BMD by dual-energy radiographic absorptiometry (DXA) may overlook bone pathology in this region. Trabecular Bone Score (TBS), representative of bone microarchitecture, may be a more informative measurement of LS pathology in SCI. Our objective was to determine differences in BMD and TBS within the LS in humans with and without SCI. Correlation of fitness and body composition measures with TBS and BMD were also explored to determine their role in bone health after SCI. Methods: Seven male participants with paraplegia (level T3 – T7) were recruited through The Miami Project to Cure Paralysis, and 6 males without SCI were recruited from local advertisement. DXA scans of the lumbar spine and whole body were performed using Hologic Discovery A densitometer. TBS score (unitless) was derived from L1-L4 scans using TBS iNsight software v3.0.2. A graded arm exercise test directly measured cardiorespiratory fitness (VO2peak) for all subjects. An independent samples t-test determined between-group differences in LS BMD and TBS. Pearson correlation analysis investigated within-group relations among LS BMD, TBS and VO2peak (ml/kg/min), weight (kg), total body fat (%), and visceral adipose tissue (estimated VAT mass(g)). Results: In SCI, the mean duration of injury was 8.6 years. Mean LS BMD was not different (p=.47) between non-injured (1.10 ±0.11 g/cm2) and SCI (1.10 ±0.13 g/cm2) groups. However, mean TBS score was different (p=.053) between non-injured (1.55±0.09) and SCI (1.47±0.07) groups. In non-injured, VO2peak was correlated with LS BMD (r=.356) and TBS (r=.244). In SCI, VO2peak was correlated with LS BMD (r=.111) and TBS (r=.822). In non-injured, TBS was correlated with body mass (r=.244), total body fat (%) (r=.382), and visceral adipose tissue (r=.361). In SCI, negative correlations were observed; TBS was correlated with body mass (r= -.255), total body fat (%) (r= -.474), and visceral adipose tissue (r= -.513). LS BMD was positively correlated with body mass, total body fat (%) and visceral adipose tissue in both non-injured and SCI groups. Conclusion: Men with and without SCI displayed similar BMD but differed in TBS at the LS. Correlations with measures of fitness and body composition were similar for LS BMD but discordant for TBS between non-injured and SCI groups. The data suggest changes in the relationships between cardiorespiratory fitness, metabolism and bone quality in SCI. TBS may capture alterations in bone microarchitecture at the spine after SCI that are undetected by conventional DXA.

Altered body composition and increased visceral adipose tissue in premenopausal and late postmenopausal patients with SLE

ObjectiveVisceral adipose tissue (VAT) is becoming a recognized cardiovascular (CV) risk factor. This study aimed to evaluate body composition, especially VAT, in systemic lupus erythematosus (SLE) and to explore the association between VAT and SLE disease-related factors.MethodNinety-eight inpatients with SLE and 108 age- and body mass index (BMI)–matched healthy controls were included. Demographic and clinical parameters were recorded. The VAT was measured by dual-energy x-ray absorptiometry.ResultThe mean age and disease duration of patients were 46.4 ± 13.0 years and 8.0 ± 7.0 years, respectively. Patients with SLE had higher VAT volume (p = 0.0015) and mass (p = 0.0017) than controls, especially in premenopausal and postmenopausal groups. The subanalysis of subjects with BMI less than 25 kg/m2 indicated that patients had lower lean mass (p = 0.0005), fat-free mass (p = 0.0005), and fat-free mass index (p = 0.0001), but increased adiposity distribution than controls, including VAT volume and mass. However, overweight/obese patients had similar body composition with controls. The VAT volume correlated with BMI, age, menopausal status, hypertension, uric acid, creatinine, non-high-density lipoprotein cholesterol, and triglyceride in both groups. In the patient group, the VAT volume correlated with disease duration, Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR-DI), and low serum complement, but not with SLEDAI and glucocorticoid dose.ConclusionThis study suggested that SLE patients had some traditional CV risk factors such as altered body composition and increased VAT. The higher VAT in patients with SLE was associated with traditional cardiometabolic risks, which may contribute to CV events in SLE populations.Key Points• Patients with SLE had increased VAT volume and mass than controls.• The VAT volume correlated with traditional cardiometabolic risk factors.• In SLE patient group, the VAT volume correlated with disease duration, SLICC/ACR-DI, and low serum complementC3/C4, but not with SLEDAI and glucocorticoid dose.

Effects Of Dietary And Hiit On Lipid Metabolism Of The Liver Tissue In Obese Rats

PURPOSE: This study aimed to investigate the effects of diet and High Intensity Interval Training (HIIT) on body mass gain, serum inflammatory markers and hepatic lipid metabolism of obese rats. METHOD: Male Sprague-Dawley rats were fed with a normal standard diet (N) or a high fat diet (H; 45% kcal as fat) for eight weeks without exercise stimuli. Obese rats were defined as increased at least 20% body weight than normal diet rats. Normal diet rats were then continue fed with a normal diet (N), and half of obese rats were fed with a normal diet (ON), while the other half were continue fed with a high-fat diet (OH). Each diet type group was then divided into two subgroups, control (NC, ONC, OHC groups) and High Intensity Interval training (NHI, ONHI, OHHI groups) (n=10-12). The HIIT training consisted of a swimming exercise performed over eight weeks. RESULTS: Obese high fat diet rats showed greater body weight, visceral adipose mass, serum lipid levels (LDL, TG, TC), and inflammatory markers(MCP-1,IL-1β,TNF-α)in values than normal diet rats, but were significantly reduced with HIIT, but this phenomenon was not observed in obese normal diet rats, except MCP-1. In addition, compared to normal rats, OHC group rats exhibited high levels of hepatic wet weight and liver triglycerides, but not in ONC group. HIIT significantly deceased liver TG content compared with control groups, which consistent with liver oil red O stain images. Moreover, compare to the control groups, mitochondrial CS activity and the biogenesis marker PGC-1α expression were upregulated with HIIT in obese high fat diet rats, meanwhile, the activity of mitochondrial fatty acid oxidation enzymes, include CPT-1α,β-HAD were significantly increased in HIIT groups. However, the activity of LPL and FAT/CD36 enzymes, which are key regulators of tissue fatty acid uptake from plasma were not changed with HIIT. CONCLUSION: HIIT was shown to be effective in controlling body weight, adiposity levels and serum lipid contents in high-fat diet fed obese rats, HIIT displayed positive effects on mitochondrial lipid oxidation enzyme activities and significantly attenuated lipid accumulation of liver tissue in obese rats. Additionally, diet and exercise was more effective than exercise alone in reducing body weight, VAT mass, serum inflammatory and liver TG content.

Effects of Interval Training on Visceral Adipose Tissue in Centrally Obese 70-Year-Old Individuals: A Randomized Controlled Trial.

To investigate the effects of 10 weeks of progressive vigorous-intensity interval training as a single intervention on body composition among 70-year-old individuals with central obesity. Randomized controlled trial (ClinicalTrials.gov registration No. NCT03450655). Community-dwelling 70-year-old men and women living in the Umeå municipality in Sweden. Seventy-seven 70-year-old men and women with central obesity (greater than 1 kg visceral adipose tissue [VAT] for women and greater than 2 kg VAT for men). Participants allocated to the intervention group were offered a 10-week progressive concurrent exercise program performed three times per week. All participants in both groups had received tailored lifestyle recommendations focused on diet and physical activity at one occasion within 12 months prior to trial initiation. The primary outcome was changes in VAT, and secondary outcomes included changes in total fat mass (FM), total lean body mass (LBM), and body mass index. Comparing the groups, there were no significant differences in decrease of VAT mass (P = .10), although the intervention group significantly decreased FM by 716 g (P = .01) and gained LBM by 508 g (P = .03), compared to the control group. Furthermore, the effects of the training were significantly greater in the male subcohort (P < .05 for interaction), with positive effects also on VAT and FM, where men in the intervention group decreased VAT by 175 g (P < .05) and FM by 1364 g (P = .004), compared to the male controls. The present trial demonstrates that 10 weeks of progressive vigorous interval training is sufficient to significantly decrease FM in older adults with central obesity, with positive effects also on LBM. J Am Geriatr Soc 67:1625-1631, 2019.

SAT-438 Visceral and Marrow Adiposity in Patients with Acromegaly; Relationships to Disease Activity, Markers of Bone Turnover, Bone Mineral Density, and Peripheral Bone Microarchitecture

Adipose tissue (AT) mass, especially visceral (VAT), is reduced in active acromegaly and rises with treatment. Although the effect of acromegaly and its therapy on marrow AT(MAT) is unknown, data in other populations and in vitro, suggest a reciprocal relationship between GH and marrow adiposity. In other groups, VAT and MAT are associated with reduced bone quality and increased vertebral fracture (VF) risk. Therefore, since acromegaly patients have an increased VF incidence, we examined the relationships of VAT and MAT to bone quality in acromegaly. We studied 65 acromegaly subjects (40 men, 25 women, range 18.7-74 yr.) before (n=20) or before and after (n=45) acromegaly therapy by total body multi-slice MRI(n=159)(measurement of VAT, subcutaneous (SAT) and total (TAT) adipose tissue mass), DXA (BMD (n=120) and body composition (n=145)) and HRpQCT (n=35) (microarchitecture of the tibia and radius). Marrow lipid spectra of the tibial diaphysis were acquired by 1H MRS (PRESS technique)(1.5T MR scanner, Philips) and percentages of bone marrow lipids were quantified (n=53). GH and IGF-1 (n=159) and bone turnover markers (BTM)(n=49) were measured. We examined the relationship between MAT or VAT and GH, IGF-1, age, weight, mass of other MRI measured AT depots, and selected DXA and HRpQCT parameters previously shown to differ in acromegaly compared to healthy subjects and to be associated in other groups with fracture. Data were analyzed by Pearson correlation and the generalized estimating equation (GEE). MAT directly correlated with VAT (r=.249, p=.023) and by HRpQCT (n=13) with bone size (radius: total area (r=.678, p=.01), tibia: total area (r=.535, p=.05)) and trabecular number (r=.543, p=.055). VAT was inversely associated with GH (β= -.017, p<.001), IGF-1 level (expressed as % upper normal limit) (β= -0.004, p=.049) and BTMs (N-Mid Osteocalcin (β= -.0223, p<0.001); CTX (β= -.7283, p=.0134)). VAT was positively associated with age (β=.034, p=.053), weight (β=.072, p <.0001) and with HRpQCT measured bone size (radius: total area (β=.0073, p=.0098); tibia: total area (β= .0049, p <.0001)) and trabecular number (tibia: β=1.9321, p=.0096), and inversely associated with cortical thickness (radius: β= -2.8477, p= .074; tibia: β= -2.3341, p=.0497), trabecular thickness (tibia: β= -92, p<.0001) and total body density (radius β= -.0102, p=.0353; tibia: β= -.0149, p=.003). In summary, VAT is inversely related to acromegaly disease activity, consistent with its known rise as acromegaly is treated. We found that greater VAT is associated with larger bone size and lower bone turnover, but also with some less favorable aspects of bone microarchitecture. MAT correlated with VAT and, in a small number of subjects, with bone size. Whether rising adiposity and reductions in bone turnover with acromegaly therapy are relevant to the skeletal fragility reported in treated acromegaly warrants further study.

The effect of visceral fat and elevated blood glucose on anxiety levels in college age students

Anxiety is prevalent among young adults; research shows metabolic inflexibility, the inability to oxidize fat, can increase the occurrence of hyper-aroused states. Fasting blood glucose is the current protocol for assessing metabolic impairment. However, recent studies have shown young adults may have normal fasting blood glucose levels with underlying irregularities in postprandial glucose regulation, insulin secretion and cortisol release, which causes a pattern of visceral fat accumulation. Visceral fat of the volunteers was assessed using the DXA (Dual-energy X-ray absorptiometry) full body scanning method; the waist was assessed by taking the circumference at the midpoint between the lower margin of the last palpable rib and the top of the iliac crest to formulate a waist to height ratio (WHtR); fasting glucose levels were measured via point-of-care (POC) finger-stick method using the Abbott Precision blood glucose meter and anxiety levels. The Pearson R correlation test showed significance between GAD-7 and VAT Volume at r = 0.513 VAT Mass r = 0.514 body fat percentage r = 0.407 and Android r = 0.419. This correlation between GAD-7 and VAT Volume and VAT Mass shows the physiological connection between elevated visceral fat and heightened anxiety. High amounts of visceral fat may lead to an increase in insulin and cortisol levels. The study may suggest that increased fasting blood glucose is not necessarily the best predictor of metabolic dysregulation in a population of healthy college students.

Macrophage Area Content and Phenotype in Hepatic and Adipose Tissue in Patients with Obesity Undergoing Roux‐en‐Y Gastric Bypass

To investigate hepatic and adipose tissue macrophage content in subjects with obesity and the role of adipose tissue macrophages in weight loss-induced improved insulin sensitivity (IS). A cross-sectional and a longitudinal study were combined to investigate the role of macrophages in subcutaneous (SAT) and visceral (VAT) adipose tissue and the liver in obesity-induced impaired IS and improvements with weight loss. Macrophage markers (CD68, CD163, and CD206) in SAT, VAT, and the liver from patients with obesity were investigated. The same macrophage markers were investigated in SAT from 18 patients with obesity before and ∼18 months after a diet- and Roux-en-Y gastric bypass-induced weight loss. SAT macrophage markers did not decrease with weight loss, but macrophage concentration may have increased, concomitant with improved IS. Hepatic macrophage markers did not correlate to VAT mass or macrophage markers, but they were higher in patients with obesity compared with patients without obesity. Hepatic anti-inflammatory macrophage markers correlated positively with hepatic IS. VAT and SAT macrophage markers did not correlate. The results indicate that decreased SAT macrophage content is not a primary driver for weight loss-induced IS improvements, but a better hepatic CD163 and CD206 macrophage profile may contribute to improved glycemic control. SAT macrophage markers were not predictive for VAT macrophage markers.

Visceral Adipose Tissue as a Risk Factor for Diabetes Mellitus in Patients with Chronic Pancreatitis: A Cross-sectional, Observational Study.

IntroductionVisceral adipose tissue (VAT) is a risk factor for diabetes and we investigated the amount of VAT in patients with chronic pancreatitis (CP).MethodsSerial patients with CP seen between January 2015 and June 2016 were included in this cross-sectional, observational study. The study population was divided into alcoholic CP (group 1; N = 67) and tropical CP (group 2; N = 35). VAT was estimated using bioelectric impedance analysis (BIA) and dual energy X-ray absorptiometry (DEXA) methods. The results were analyzed by appropriate statistical methods.ResultsThe study participants (85 male, 17 female) had a mean (SD) age of 40.8 (12.6) years, CP duration of 3.7 (4.7) years, and body mass index of 22.5 (3.2) kg/m2. Pancreatogenic diabetes was seen in 54 patients and the total body fat percentage was lower in the alcoholic CP group. VAT mass was similar in both the groups (p = 0.8749). CP patients with diabetes had a higher VAT mass (436 vs. 341 g) than those without diabetes (p = 0.0132). DEXA and BIA correlated in estimation of total body fat (p < 0.0001) but not in VAT (p = 0.0922).ConclusionVAT is a determinant in the development of diabetes, even in patients with CP. DEXA is a better modality for VAT estimation in comparison to BIA.

Visceral fat mass: is it the link between uric acid and diabetes risk?

BackgroundUric acid (UA) has been suggested as a novel risk factor for diabetes. However, its definite role in this prevalent disease is still the subject of much discussion because it is always accompanied with other major risk factors such as obesity and high visceral adiposity. In order to clarify the role of UA in diabetes, this study aimed to investigate the associations between plasma UA and fasting plasma glucose, HbA1c, lipid profile and inflammatory markers after accounting for the contribution of other diabetes risk factors such as BMI and VAT fat mass.MethodsIn the present cross-sectional study, 100 non-diabetic middle-aged males (n = 48) and females (n = 52) were recruited. Central fat distribution measures including android to gynoid fat ratio, VAT and subcutaneous adipose tissue (SAT) fat mass were determined using dual-energy X-ray absorptiometry (DXA). Biochemical analysis was done using methods well established for clinical and research laboratories. Multiple linear regression analysis was performed to analyse the association between plasma UA and the biochemical and central fat distribution measures.ResultsUA was positivly associated with body mass index (BMI) (r (98) = 0.42, P ≤ 0.001), android to gynoid fat ratio (r (98) = 0.62, P ≤ 0.001) and VAT fat mass (r (96) = 0.55, P ≤ 0.001). UA was also positively associated with plasma glucose (r (98) = 0.33, P ≤ 0.001), hemoglobin A1c (r (93) = 0.25, P = 0.014), plasma triglyceride (rs (95) = 0.40, P ≤ 0.001), HDL cholesterol (r (98) = − 0.61, P ≤ 0.001) and CRP (rs (98) = 0.23, P = 0.026). However, these associations were no longer significant after accounting for BMI or/and VAT fat mass. No significant association was observed between UA and SAT fat mass (r (97) = 0.02, P ≥ 0.05), Total cholesterol (r (98) = 0.03, P ≥ 0.05), LDL cholesterol (r (98) = 0.13, P ≥ 0.05), TNF-α (r (97) = 0.12, P ≥ 0.05) and IL-6 (r (96) = −0.02, P ≥ 0.05).ConclusionResults from this study suggest, for the first time, that the association between plasma UA and glucose in a non-diabetic population is not direct but rather dependent on VAT fat mass.

Least Significant Change of Body Composition and Bone Mineral Density Measured by Dual energy X‐Ray Absorptiometry

IntroductionThis study is designed to determine the least significant (LSC), or the least amount of change that can be considered significant when measuring body composition with Dual Energy X‐ray Absorptiometry (DXA). In the past five years, researchers have focused on measuring the LSC of bone mineral DXA scans or body composition DXA scans in athletic populations. However, none have measured LSC for body composition in non‐ athletic populations or the LSC of each component of body composition.MethodsForty‐six adults (39 female; 7 male) partook in the study aged between 50.78 ± 15.27 years. They weighed 157.90 ± 38.83 pounds, and had a of height 64.83 ± 3 inches. Any participant who that was pregnant was excluded from the study. DXA scans for body composition and BMD was taken by the same technician. Each scan was consecutively taken 3 times, and after each scan the participant got up from the table, and was repositioned for the next scan. Results were calculated with the International Society of Clinical Densitometry's calculator.ResultsDXA scans for WB‐ Bone Area, WB‐ BMD, WB‐ Lean Mass + BMC, WB‐ Lean Mass, and WB‐ Total Mass measured less than 1% of coefficient variation, where as AP Spine BMD, WB‐ Bone Mass, WB‐Fat Mass, and WB‐% Body Fat were just over 1%, between 1.07‐ 1.3% coefficient variation. However, the WB‐ VAT Mass had a significantly higher percent (15.9%) coefficient of variation.ConclusionsDXA scans for whole body and spine all come with a 1% error as reported by DXA manufacturers, with the exception of WB VAT mass that had a significantly higher percent error.

Differences in body composition between metabolically healthy obese and metabolically abnormal obese adults

Potential differences in body composition between metabolically healthy obese (MHO) and metabolically abnormal obese (OA) adults were explored with 395 obese adults from the Pennington Center Longitudinal Study (18-68 years). Adults were classified as OA (≥2 risk factors: blood pressure ≥130/85 mmHg; triglycerides ≥150 mg dl(-1); high-density lipoprotein cholesterol: men <40, women <50 mg dl(-1); fasting glucose ≥100 mg dl(-1); waist circumference: ≥102 cm men, women ≥88 cm) or MHO (<2 risk factors). Whole-body bone mineral density and content, percent body fat, fat mass, lean mass and trunk adipose tissue mass were measured with dual-energy X-ray absorptiometry. Visceral (VAT), subcutaneous (SAT) and total abdominal adipose tissue (TAT) were measured with computed tomography. Gender-specific general linear regression models were used to determine differences in body composition between MHO and OA controlling for age, race, smoking status and menopause status. In men, MHO had lower fat mass (kg and %), trunk adipose tissue, VAT, SAT, TAT and lean mass compared with OA. MHO women had lower fat mass (kg), lean mass, trunk adipose tissue, VAT and TAT when compared with OA women. In conclusion, OA and MHO cardiometabolic profiles are characterized by differences in body composition consistent between genders.

Associations of visceral and abdominal subcutaneous adipose tissue with markers of cardiac and metabolic risk in obese adults

Visceral (VAT) and abdominal subcutaneous (SAT) adipose tissues contribute to obesity but may have different metabolic and atherosclerosis risk profiles. Among obese participants in the Dallas Heart Study, we examined the cross-sectional associations of abdominal VAT and SAT mass, assessed by magnetic resonance imaging (MRI) and indexed to body surface area (BSA), with circulating biomarkers of insulin resistance, dyslipidemia, and inflammation (n=942); and with aortic plaque and liver fat by MRI and coronary calcium by computed tomography (n=1200). Associations of VAT/BSA and SAT/BSA were examined after adjustment for age, sex, race, menopause, and body mass index. In multivariable models, VAT significantly associated with the homeostasis model assessment of insulin resistance (HOMA-IR), lower adiponectin, smaller LDL and HDL particle size, larger VLDL size, and increased LDL and VLDL particle number (p<0.001 for each). VAT also associated with prevalent diabetes, metabolic syndrome, hepatic steatosis, and aortic plaque (p<0.001 for each). VAT independently associated with C-reactive protein but not with any other inflammatory biomarkers tested. In contrast, SAT associated with leptin and inflammatory biomarkers, but not with dyslipidemia or atherosclerosis. Associations between SAT and HOMA-IR were significant in univariable analyses but attenuated after multivariable adjustment. In conclusion, VAT associated with an adverse metabolic, dyslipidemic, and atherogenic obesity phenotype. In contrast, SAT demonstrated a more benign phenotype, characterized by modest associations with inflammatory biomarkers and leptin, but no independent association with dyslipidemia, insulin resistance, or atherosclerosis in obese individuals. These findings suggest that abdominal fat distribution defines distinct obesity sub-phenotypes with heterogeneous metabolic and atherosclerosis risk.