Abdominal Visceral Fat Volume Research Articles

Deep Learning Derived Visceral Abdominal Fat Predicts Brain Atrophy at Midlife in 10,001 Individuals

AbstractBackgroundVisceral abdominal fat can predict health outcomes with increasing interest in applications on brain health.MethodA total of 10,001 healthy participants from four sites were scanned on 1.5T MR machines with a short whole‐body MR imaging protocol. Core whole body sequences included coronal T1, STIR from vertex to feet, whole‐body axial DWI from vertex to proximal‐thighs and axial T2 TSE without fat suppression from skull base to pelvis. Brain sequences were T1 MPRAGE and 2D FLAIR. Deep learning with FastSurfer trained on 134 participants aged 27‐66 and segmented 96 brain regions. A separate deep learning model was trained to segment abdominal visceral fat from the whole‐body coronal T1. Partial correlation analysis of visceral abdominal fat volume and brain volumes were evaluated, controlling for age, sex, and total intracranial volume. Benjamini‐Hochberg False Discovery Rate of 5% controlled for multiple comparisons. Logistic regression models determined risk of brain total gray and white matter atrophy based upon the highest quartile of visceral fat and lowest quartile of these brain volumes.ResultThis cohort had an average age of 52.97 ± 13.04 years with a range of 11‐97 years with 52.8% men and 47.2% women. Mean visceral abdominal fat was 3417.81 ± 514.88 ml for overweight persons (BMI ³ 25) and 5355.24 ± 505.04 for obese persons (BMI ³ 30). Even accounting for co‐variates and multiple comparisons, deep learning segmented visceral abdominal fat predicted atrophy in multiple brain regions including: total gray matter volume (Partial R = ‐.09, p = 1.17e‐19), total white matter volume (Partial R = ‐.09, p = 2.25e‐21), hippocampus (Partial R = ‐.02, p = .005), frontal cortex (Partial R = ‐.09, p = 1.79e‐19), temporal lobes (Partial R = ‐.12, p = 2.6e‐30), parietal lobes (Partial R = ‐.04, p = .0004), occipital lobe (Partial R = ‐.03, p = .002), orbital frontal cortex (Partial R = ‐.09, p = 3.76e‐21). Visceral fat predicted increased risk for lower total gray matter (age 20‐39: OR = 5.9; age 40‐59, OR = 5.4; 60‐80, OR = 5.1) and white matter atrophy: (age 20‐39: OR = 3.78; age 40‐59, OR = 4.4; 60‐80, OR = 5.1).ConclusionDeep learning determined increased visceral abdominal fat volume predicts brain volume loss and may represent a novel modifiable factor in determining brain health.

Deep Learning Derived Visceral Abdominal Fat Predicts Brain Atrophy at Midlife in 10,001 Individuals

AbstractBackgroundVisceral abdominal fat can predict health outcomes with increasing interest in applications on brain health.MethodA total of 10,001 healthy participants from four sites were scanned on 1.5T MR machines with a short whole‐body MR imaging protocol. Core whole body sequences included coronal T1, STIR from vertex to feet, whole‐body axial DWI from vertex to proximal‐thighs and axial T2 TSE without fat suppression from skull base to pelvis. Brain sequences were T1 MPRAGE and 2D FLAIR. Deep learning with FastSurfer trained on 134 participants aged 27‐66 and segmented 96 brain regions. A separate deep learning model was trained to segment abdominal visceral fat from the whole‐body coronal T1. Partial correlation analysis of visceral abdominal fat volume and brain volumes were evaluated, controlling for age, sex, and total intracranial volume. Benjamini‐Hochberg False Discovery Rate of 5% controlled for multiple comparisons. Logistic regression models determined risk of brain total gray and white matter atrophy based upon the highest quartile of visceral fat and lowest quartile of these brain volumes.ResultThis cohort had an average age of 52.97 ± 13.04 years with a range of 11‐97 years with 52.8% men and 47.2% women. Mean visceral abdominal fat was 3417.81 ± 514.88 ml for overweight persons (BMI ³ 25) and 5355.24 ± 505.04 for obese persons (BMI ³ 30). Even accounting for co‐variates and multiple comparisons, deep learning segmented visceral abdominal fat predicted atrophy in multiple brain regions including: total gray matter volume (Partial R = ‐.09, p = 1.17e‐19), total white matter volume (Partial R = ‐.09, p = 2.25e‐21), hippocampus (Partial R = ‐.02, p = .005), frontal cortex (Partial R = ‐.09, p = 1.79e‐19), temporal lobes (Partial R = ‐.12, p = 2.6e‐30), parietal lobes (Partial R = ‐.04, p = .0004), occipital lobe (Partial R = ‐.03, p = .002), orbital frontal cortex (Partial R = ‐.09, p = 3.76e‐21). Visceral fat predicted increased risk for lower total gray matter (age 20‐39: OR = 5.9; age 40‐59, OR = 5.4; 60‐80, OR = 5.1) and white matter atrophy: (age 20‐39: OR = 3.78; age 40‐59, OR = 4.4; 60‐80, OR = 5.1).ConclusionDeep learning determined increased visceral abdominal fat volume predicts brain volume loss and may represent a novel modifiable factor in determining brain health.

Visceral fat percentage for prediction of outcome in uterine cervical cancer

ObjectiveThe prognostic role of adiposity in uterine cervical cancer (CC) is largely unknown. Abdominal fat distribution may better reflect obesity than body mass index. This study aims to describe computed tomography (CT)-assessed abdominal fat distribution in relation to clinicopathologic characteristics, survival, and tumor gene expression in CC. MethodsThe study included 316 CC patients diagnosed during 2004–2017 who had pre-treatment abdominal CT. CT-based 3D segmentation of total-, subcutaneous- and visceral abdominal fat volumes (TAV, SAV and VAV) allowed for calculation of visceral fat percentage (VAV% = VAV/TAV). Liver density (LD) and waist circumference (at L3/L4-level) were also measured. Associations between CT-derived adiposity markers, clinicopathologic characteristics and disease-specific survival (DSS) were explored. Gene set enrichment of primary tumors were examined in relation to fat distribution in a subset of 108 CC patients. ResultsHigh TAV, VAV and VAV% and low LD were associated with higher age (≥44 yrs.; p ≤ 0.017) and high International Federation of Gynecology and Obstetrics (FIGO) (2018) stage (p ≤ 0.01). High VAV% was the only CT-marker predicting high-grade histology (p = 0.028), large tumor size (p = 0.016) and poor DSS (HR 1.07, p < 0.001). Patients with high VAV% had CC tumors that exhibited increased inflammatory signaling (false discovery rate [FDR] < 5%). ConclusionsHigh VAV% is associated with high-risk clinical features and predicts reduced DSS in CC patients. Furthermore, patients with high VAV% had upregulated inflammatory tumor signaling, suggesting that the metabolic environment induced by visceral adiposity contributes to tumor progression in CC.

Piceatannol Prevents Obesity and Fat Accumulation Caused by Estrogen Deficiency in Female Mice by Promoting Lipolysis.

Postmenopausal women have a higher susceptibility to obesity and chronic disease. Piceatannol (PIC), a natural analog of resveratrol, was reported to inhibit adipogenesis and to have an antiobesity effect. In this study, PIC's effect on postmenopausal obesity and the mechanism of its action were investigated. C57BL/6J female mice were divided into four groups and half of them were ovariectomized (OVX). Both OVX and sham-operated mice were fed a high-fat diet (HFD) with and without the addition of 0.25% of PIC for 12 weeks. The abdominal visceral fat volume was higher in the OVX mice than the sham-operated mice, and PIC significantly decreased the fat volume only in the OVX mice. Unexpectedly, expression levels of adipogenesis-related proteins in white adipose tissue (WAT) were suppressed in the OVX mice, and PIC did not affect lipogenesis in either the OVX or sham-operated mice. Regarding the expression of proteins associated with lipolysis, PIC activated the phosphorylation of hormone-sensitive lipase much more in the OVX mice, but it did not affect the expression of adipose triglyceride lipase. PIC also tended to induce the expression of uncoupled protein 1 in brown adipose tissue (BAT). These results suggest that by promoting lipolysis in WAT and deconjugation in BAT, PIC is a potential agent to inhibit fat accumulation caused by menopause.

The relationship between physical activity and diabetes in middle-aged and elderly people.

To investigate the association between diabetes symptoms and physical activity (PA) levels among middle-aged and older Chinese adults. Data for this study were obtained from 2018 Charles data. Z test, logistic regression analysis, and linear hierarchical regression analysis were performed in 5352 individuals aged ≥50 years with complete information. In terms of diabetes, 6.8% of the middle-aged and elderly people with diabetes were detected, and 93.2% of the middle-aged and elderly people without diabetes symptoms. The proportion of middle-aged and elderly people with high PA levels was 50.5%, and the proportion of middle-aged and elderly people with low PA was 49.5%. There was a significant positive correlation between low PA and diabetes (P < .05). After adjusting demographic characteristics (gender, registered permanent residence type, education level, age, widowhood) and health status characteristics (poor mood, asthma, hyperlipidemia, disability, memory disease, self-assessment of health status, hypertension, smoking, stroke, depression), there was still a statistical significance between PA level and diabetes (P < .05). The risk of diabetes of middle-aged and elderly people in China increases with age, while the risk of diabetes of middle-aged and elderly people with low level of PA is higher. The risk of diabetes is high among middle-aged and elderly people who are old, have poor self-evaluation health, suffer from hyperlipidemia, memory disease, and asthma. The middle-aged and old people should increase their PA levels to prevent and improve diabetes.

Comparison between DXA and MRI for the Visceral Fat Assessment in Athletes.

The use of dual-energy X-ray absorptiometry (DXA) may be invalid for assessing athletes with larger bodies, larger lean body mass, and thicker trunks. This study compared the athletes' visceral adipose tissue (VAT) assessed using DXA and magnetic resonance imaging (MRI). Eighty-two Japanese male collegiate athletes from 18 sports participated in this study. VAT was assessed using the dual-energy scan that coincided with the 4th lumbar vertebra. The sum of eight magnetic resonance slices corresponding to the region of the dual-energy scan was used for comparison. The VAT volume was higher with the dual-energy scan than with MRI (difference: 35 cm 3 , p<0.01). A significant correlation was noted between the volumes measured using both modalities (r=0.88, p<0.01). Magnetic resonance-derived volumes less than 600 cm 3 showed a stronger significant correlation with dual-energy-derived volumes. However, magnetic resonance-derived VAT volumes exceeding 600 cm 3 were not significantly correlated with dual-energy-derived volumes. In conclusion, VAT volumes derived from DXA were larger and significantly correlated with those derived from MRI across a wide range of values. Methods using DXA for assessing the visceral fat volume may require adjustment to estimate abdominal visceral fat volume in athletes, with care taken when using such methods for heavyweight athletes.

Abdominal fat distribution and its relationship to sagittal abdominal diameter (SAD) and SAD-height ratio – An analytical cross-sectional study in the South Indian population

Background: The prevalence of obesity is increasing in developing countries like India. This will place a great burden on the health infrastructure of the country. Early identification and intervention are the keys to managing this important problem. Since Asians tend to have more visceral body fat for any given body mass index (BMI), lower cut-off values have been suggested for different anthropometric parameters. Studies determining the correlation of Sagittal abdominal diameter (SAD) and SAD-height ratio (SADHtR) with total visceral fat volumes measured by computed tomography (CT) scan abdomen quantification are limited in the South Indian population. Aims and Objectives: This study was conducted with the objectives of measuring BMI, SAD, SADHtR, and comparing the correlation of the measured anthropometric parameters with visceral and subcutaneous abdominal fat volumes measured using CT scan abdomen in both the genders in South Indian population. Materials and Methods: This analytical cross-sectional study was done in a hospital setting with a sample size of 566 (276 men and 290 women-aged 30–70 years). Weight, height, and BMI were measured. SAD was measured electronically from a CT image at the L4–L5 level. SADHtR was derived. Total abdominal fat volumes, subcutaneous abdominal fat volumes, and visceral abdominal fat volumes were measured in cm3 from the dome of the liver to the pubic symphysis using software for CT-based quantification of fat volumes between −190 and −30 Hounsfield units threshold limits. The data were tabulated and analyzed to compare mean values between men and women and to find the correlation between the anthropometric parameters and visceral fat volume using Pearson’s correlation test. Results: The difference in mean values of BMI, SAD, and SADHtR between the sexes was statistically significant. SAD showed the highest correlation with visceral fat volume in both genders. BMI showed a higher correlation with subcutaneous adipose tissue volume than with visceral adipose tissue volume. Conclusion: Both SAD and SADHtR can be used as simple and reproducible anthropometric tools to identify the presence of increased visceral fat volume in both genders in our population.

Obesity and visceral fat: Survival impact in high-grade endometrial cancer

BackgroundObesity is an important risk factor for the development of endometrial cancer (EC). Recent data showed that body fat distribution might be more relevant than Body Mass Index (BMI). High visceral fat percentage was shown to be an independent predictor for survival in EC, but mainly included grade 1-2 EC. ObjectiveTo evaluate body fat distribution and its relation to outcome in high-grade endometrial cancer. MethodsRetrospective study in women diagnosed with high-grade EC between February 2006 and August 2017 at the Royal Cornwall Hospital who had abdominal CT-scan as part of routine diagnostic work-up. Subcutaneous abdominal fat volumes and visceral abdominal fat volumes were quantified based on CT-scan measurements, and visceral fat percentage calculated. ResultsA total of 176 patients with high-grade EC were included. The median age was 70 years and median BMI was 29.4 kg/m2. The majority of patients had non-endometrioid endometrial cancer (NEEC; 62 %). High visceral fat percentage was associated with poor overall- and disease-specific survival (p = 0.006 and p = 0.026 respectively) in NEEC patients, but not in high-grade endometrioid EC (EEC). The most frequent obesity comorbidities hypertension and diabetes mellitus were significantly associated with high BMI and high visceral fat percentage. ConclusionIn high-grade EC, high visceral fat percentage was an independent predictor of poor survival only in NEEC. The strong correlation between high visceral fat and obesity-related comorbidities might be reflective of an unhealthy macroenvironment.

Rationale and design of a randomised controlled trial testing the effect of personalised diet in individuals with pre-diabetes or type 2 diabetes mellitus treated with metformin

IntroductionMetformin and diets aimed at promoting healthy body weight are the first line in treating type 2 diabetes mellitus (T2DM). Clinical practice, backed by clinical trials, suggests that many individuals...

The Effect of Visceral Abdominal Fat Volume on Oxidative Stress and Proinflammatory Cytokines in Subjects with NormalWeight, Overweight and Obesity.

PurposeThe increase of visceral abdominal fat (VAF) and oxidative stress (OS) are independent predictors for cardiovascular risk. This study aimed to determine the association of VAF with proinflammatory cytokines, oxidants, antioxidants, and oxidative damage to DNA in subjects with normal weight, overweight, and obesity.Patients and MethodsA cross-sectional study that included 21 men and 71 women who attended for a medical check-up was conducted. Dual-energy X-ray absorptiometry (DXA) was used to measure the VAF volume. ELISA and colorimetric techniques were used for chemical analysis.ResultsLow activity of superoxide dismutase (SOD) was found in overweight and obese subjects compared to the normal weight group (p=0.005). In contrast, the activity of glutathione peroxidase (GPx) was higher in the overweight and obesity groups compared to the normal weight subjects (p=0.017). The total antioxidant capacity (TAC) was also increased in the overweight group compared to the normal weight group (p=0.04). According to the volume of VAF, the levels of tumor necrosis factor alfa and interleukin 6 showed no differences between subjects with normal and high VAF. Subjects with high VAF show higher levels of 8-isoprostans compared to normal VAF group (p=0.039). Less concentration of 8-oxoguanine-DNA-N-glycosylase-1 (hOGG1) was found in the high VAF group (p=0.032) compared to the normal VAF subjects. VAF was positively correlated with lipoperoxides (LPO) (r=0.27, p<0.05) and 8-isoprostanes (r=0.25, p<0.05). We also found correlations between oxidative stress markers and anthropometric ratios for intra-abdominal fat. The waist-hip ratio was positively correlated with LPO (r=0.30, p<0.05) and TAC (r=0.24, p<0.05).ConclusionThese findings suggest that the predominantly oxidative damage associated with VAF in overweight or obesity is lipoperoxidation and oxidative DNA damage. Alterations in endogenous antioxidant defenses may not be linked to the amount of VAF.

Depressive symptoms, impaired glucose metabolism, high visceral fat, and high systolic blood pressure in a subgroup of women with recent gestational diabetes

Women with gestational diabetes (GDM) are a high risk group for early type 2 diabetes (T2D). Depression is a risk factor for T2D in the general population. We investigated in women after a recent pregnancy with GDM and without a clinical diagnosis of depression, whether mild to moderate depressive symptoms associate with pathologic glucose metabolism. In a cross-sectional analysis, we examined 173 women, 9 ± 3 months after delivery with several psychopathological assessments, 5-point oral glucose tolerance test with insulin, anthropometrics, and laboratory chemistry. In a subgroup of 101 women, abdominal visceral fat was quantified by magnetic resonance imaging (MRI).A total of 22 women (13%) showed mild to moderate depressive symptoms, and the proportion of women with pathologic glucose metabolism (impaired fasting glucose, impaired glucose tolerance, or T2D) was higher in this group than in the women without depressive symptoms (59.1% vs. 33.1%, p = 0.018). Women with depressive symptoms also had higher body mass index (BMI), systolic blood pressure, plasma leptin, plasma resistin, and abdominal visceral fat volume. Pathologic glucose metabolism (OR = 2.594, 95% CI: 1.021–6.592), systolic blood pressure (OR = 1.076, 95% CI: 1.027–1.128), and abdominal visceral fat volume (OR = 2.491, 95% CI: 1.142–5.433) remained, even after adjustment for BMI, associated with the presence of depressive symptoms.Taken together, we found depressive symptoms at a level not generally diagnosed in clinical practice in a subgroup of women with recent GDM. This subgroup also showed an unfavorable metabolic profile. Mild to moderate depressive symptoms may therefore help to identify this special subgroup.

High visceral fat percentage is associated with poor outcome in endometrial cancer.

Despite evidence of increased endometrial cancer (EC) risk in obese women, the impact of obesity on clinical and histological phenotype is poorly understood. This study explored abdominal fat volumes and fat distribution quantified by computed tomography (CT), in relation to tumor characteristics and outcome. 227 EC patients with preoperative abdominal CT scans were included. Total abdominal fat volume (TAV), subcutaneous abdominal fat volume (SAV) and visceral abdominal fat volume (VAV) were quantified, and visceral fat percentage calculated (VAV%=[VAV/TAV]x100). Waist circumference (WC) and liver density (LD) were measured, and body mass index (BMI) calculated. Data for estrogen, progesterone and androgen receptor (ERα/PR/AR) expression by immunohistochemistry were available for 149 tumors, and global gene expression data for 105 tumors. High BMI, TAV, SAV, VAV and WC, and low LD, were associated with low grade endometrioid tumors and PR and AR positivity (all p≤0.03). High VAV% was associated with high age (p<0.001), aneuploidy (p=0.01) and independently predicted reduced disease-specific survival (HR 1.05, 95% CI 1.00-1.11, p=0.041). Tumors from patients with low VAV% showed enrichment of gene sets related to immune activation and inflammation. In conclusion, high VAV% independently predicts reduced EC survival. Tumors arising in patients with low VAV% show enrichment of immune and inflammation related gene sets, suggesting that the global metabolic setting may be important for tumor immune response.

Ipragliflozin, a sodium glucose co-transporter 2 inhibitor, reduces intrahepatic lipid content and abdominal visceral fat volume in patients with type 2 diabetes

ABSTRACTObjective: We recently investigated the effect of ipragliflozin, a sodium glucose co-transporter-2 inhibitor (SGLT-2I), in Japanese patients with type 2 diabetes by a 24-week. SGLT-2Is also have an anti-obesity effect, and reduction of body fat has been demonstrated by indirect methods. However, evaluation of the effect on the total visceral fat volume and intrahepatic lipid content has not been performed.Research design and methods: We measured the abdominal subcutaneous fat volume (SFV) and visceral fat volume (VFV) by whole abdominal CT scanning, the intrahepatic lipid (IHL) content by proton magnetic resonance spectroscopy (1H-MRS), and the fat mass index (FI) and appendicular skeletal mass index (ASMI) by dual X-ray absorptiometry (DXA) in 20 patients from our previous study.Results: Administration of ipragliflozin at 50 mg/day for 24 weeks significantly reduced SFV, VFV, and IHL. FI and ASMI were also significantly decreased. Changes of VFV and IHL content at 12 weeks were significantly correlated with the change of HbA1c, but no correlation was observed at 24 weeks.Conclusion: These findings demonstrate that ipragliflozin decreases visceral and hepatic fat, with improvement of glycemic control possibly being attributable to these changes at least up to 12 weeks.

Effects of Oral Antidiabetic Drugs on Changes in the Liver-to-Spleen Ratio on Computed Tomography and Inflammatory Biomarkers in Patients With Type 2 Diabetes and Nonalcoholic Fatty Liver Disease

PurposeOral antidiabetic drugs (OADs) such as pioglitazone and metformin have beneficial effects in patients with nonalcoholic steatohepatitis. We prospectively assessed the effects of OADs on nonalcoholic fatty liver disease (NAFLD) in 886 men with type 2 diabetes mellitus and in a murine model of NAFLD. MethodsPatients were randomized to receive pioglitazone, metformin, sitagliptin, or a non-OAD (control) for 6 months. All the patients received dietary and exercise guidance once a month during this study. Changes in the liver-to-spleen ratio on computed tomography (CT) and NAFLD-related parameters were measured from baseline to the end of treatment. FindingsThe liver/spleen ratio improved significantly in the pioglitazone and metformin groups compared with the control group (both P < 0.01), but not in the sitagliptin group (P = 0.73). The mean changes from baseline were −3.464 ± 10.156%, 19.236 ± 9.896%, 4.783 ± 1.467%, and 1.328 ± 0.802% in the control, pioglitazone, metformin, and sitagliptin groups, respectively. Multivariable analysis showed that the liver/spleen ratio was strongly correlated with high-sensitivity C-reactive protein concentration in the pioglitazone group (F = 9.973; P < 0.01) and abdominal visceral fat volume in the metformin group (F = 6.049; P < 0.05). ConclusionsPioglitazone elicited the greatest improvements in features of NAFLD in type 2 diabetes mellitus. (Trial Registration: www.isrctn.org/, ISRCTN33414972, http://www.isrctn.org/)

Sa1494 Abdominal Visceral Fat Volume, Subcutaneous Fat Volume, or BMI: Which Best Predicts Pancreatic Necrosis?

Sa1494 Abdominal Visceral Fat Volume, Subcutaneous Fat Volume, or BMI: Which Best Predicts Pancreatic Necrosis?

Lack of association between leptin, leptin receptor, adiponectin gene polymorphisms and epicardial adipose tissue, abdominal visceral fat volume and atherosclerotic burden in psoriasis patients

Context: Identifying psoriasis patients who present a higher risk of developing cardiovascular co-morbidities is of upmost importance. Two key adipokines, leptin and adiponectin, may play a role connecting psoriasis and its major co-morbidities.Objective: To evaluate the potential contribution of LEPrs2167270(19 G/A), LEPRrs1137100(326 A/G) and ADIPOQrs1501299(276 G/T) gene polymorphisms in psoriasis susceptibility and their influence in epicardial adipose tissue and abdominal visceral fat volume and subclinical atherosclerosis in severe psoriasis patients.Materials and methods: One hundred severe psoriasis patients underwent clinical and laboratory evaluation, DNA genotyping and multi-detector computed tomography scan for epicardial adipose tissue, abdominal visceral fat and coronary artery calcification assessment. DNA control group was obtained from a previously anonymized biobank of 206 adult subjects without psoriasis.Results: No association was observed between the studied gene polymorphisms and psoriasis susceptibility, CAC or increased EAT or AVF volume.Discussion and conclusion: The studied polymorphisms do not seem, at least in this cohort of patients, to be a genetic risk factor for the development of atherosclerosis or increased adiposity in psoriasis.

Investigation of relation between visceral and subcutaneous abdominal fat volumes and calcified aortic plaques via multislice computed tomography.

The present study investigated effect of subcutaneous fat volume and abdominal visceral fat volume on aortic atherosclerosis via multislice computed tomography. The present study comprised 424 subjects who underwent non-contrast-enhanced abdominal CT in our clinic between June 2012 and June 2013. Using dedicated software visceral fat volume was calculated for each individual and then subcutaneous fat volume was calculated by subtracting visceral fat volume from total fat volume. By dividing visceral fat volume/subcutaneous fat volume participants were assigned to three groups according to their mean visceral fat volume/subcutaneous fat volume: Group 1 consisted of subjects with visceral fat volume/subcutaneous fat volume lower than 0.48 (Group 1 < 0.48); Group 2 consisted of subjects with visceral fat volume/subcutaneous fat volume equal to or higher than 0.48 and lower than 0.69 (0.48 ≤ Group 2 < 0.69); and Group 3 consisted of subjects with visceral fat volume/subcutaneous fat volume equal to or higher than 0.69 (Group 3 ≥ 0.69). The mean abdominal aortic calcium scores according to Agatston scoring (au) were 136.8 ± 418.7 au in Group 1, 179.9 ± 463 au in Group 2 and 212.2 ± 486.9 in Group 3, respectively. We have demonstrated a significant correlation between visceral fat volume and abdominal aorta atherosclerosis, while there was absence of significant correlation between subcutaneous fat volume and abdominal atherosclerosis.

Clinical significance of visceral adiposity assessed by computed tomography: A Japanese perspective.

Abdominal obesity, rather than total amount of fat, is linked to obesity-related disorders. Visceral adiposity is an important component of obesity-related disorders in Japanese individuals with a mild degree of adiposity compared with Western subjects. In 1983, our group reported techniques for body fat analysis using computed tomography (CT) and established the concept of visceral fat obesity in which intra-abdominal fat accumulation is an important factor in the development of obesity-related complications, such as diabetes, lipid disorders, hypertension and atherosclerosis. Our group also established ideal imaging conditions for determining abdominal fat area at the umbilical level CT scan. Visceral fat area (VFA) measured in a single slice at L4 level correlated significantly with the total abdominal visceral fat volume measured on multislice CT scan. In a large-scale study of a Japanese population, the mean number of obesity-related cardiovascular risk factors (hypertension, low high-density lipoprotein cholesterolemia and/or hypertriglyceridemia, and hyperglycemia) was greater than 1.0 at 100 cm(2) of VFA, irrespective of gender, age and body mass index. Our group also demonstrated that reduction of visceral fat accumulation subsequent to voluntary lifestyle modification, "Hokenshido", correlated with a decrease in the number of obesity-related cardiovascular risk factors. It is important to select the most appropriate subjects from the general population (e.g., non-obese subjects with a cluster of risk factors for the metabolic syndrome) that are most suitable for body weight reduction, with the goal of preventing atherosclerotic cardiovascular diseases.

Exercise and Type 2 Diabetes Mellitus: Changes in Tissue-specific Fat Distribution and Cardiac Function

To prospectively assess the effects of an exercise intervention on organ-specific fat accumulation and cardiac function in type 2 diabetes mellitus. Written informed consent was obtained from all participants, and the study protocol was approved by the medical ethics committee. The study followed 12 patients with type 2 diabetes mellitus (seven men; mean age, 46 years ± 2 [standard error]) before and after 6 months of moderate-intensity exercise, followed by a high-altitude trekking expedition with exercise of long duration. Abdominal, epicardial, and paracardial fat volume were measured by using magnetic resonance (MR) imaging. Cardiac function was quantified with cardiac MR, and images were analyzed by a researcher who was supervised by a senior researcher (4 and 21 years of respective experience in cardiac MR). Hepatic, myocardial, and intramyocellular triglyceride (TG) content relative to water were measured with proton MR spectroscopy at 1.5 and 7 T. Two-tailed paired t tests were used for statistical analysis. Exercise reduced visceral abdominal fat volume from 348 mL ± 57 to 219 mL ± 33 (P < .01), and subcutaneous abdominal fat volume remained unchanged (P = .9). Exercise decreased hepatic TG content from 6.8% ± 2.3 to 4.6% ± 1.6 (P < .01) and paracardial fat volume from 4.6 mL ± 0.9 to 3.7 mL ± 0.8 (P = .02). Exercise did not change epicardial fat volume (P = .9), myocardial TG content (P = .9), intramyocellular lipid content (P = .3), or cardiac function (P = .5). A 6-month exercise intervention in type 2 diabetes mellitus decreased hepatic TG content and visceral abdominal and paracardial fat volume, which are associated with increased cardiovascular risk, but cardiac function was unaffected. Tissue-specific exercise-induced changes in body fat distribution in type 2 diabetes mellitus were demonstrated in this study.

Exercise and Type 2 Diabetes Mellitus: Changes in Tissue-specific Fat Distribution and Cardiac Function

Purpose To prospectively assess the effects of an exercise intervention on organ-specific fat accumulation and cardiac function in type 2 diabetes mellitus. Materials and Methods Written informed consent was obtained from all participants, and the study protocol was approved by the medical ethics committee. The study followed 12 patients with type 2 diabetes mellitus (seven men; mean age, 46 years ± 2 [standard error]) before and after 6 months of moderate-intensity exercise, followed by a high-altitude trekking expedition with exercise of long duration. Abdominal, epicardial, and paracardial fat volume were measured by using magnetic resonance (MR) imaging. Cardiac function was quantified with cardiac MR, and images were analyzed by a researcher who was supervised by a senior researcher (4 and 21 years of respective experience in cardiac MR). Hepatic, myocardial, and intramyocellular triglyceride (TG) content relative to water were measured with proton MR spectroscopy at 1.5 and 7 T. Two-tailed paired t tests were used for statistical analysis. Results Exercise reduced visceral abdominal fat volume from 348 mL ± 57 to 219 mL ± 33 (P < .01), and subcutaneous abdominal fat volume remained unchanged (P = .9). Exercise decreased hepatic TG content from 6.8% ± 2.3 to 4.6% ± 1.6 (P < .01) and paracardial fat volume from 4.6 mL ± 0.9 to 3.7 mL ± 0.8 (P = .02). Exercise did not change epicardial fat volume (P = .9), myocardial TG content (P = .9), intramyocellular lipid content (P = .3), or cardiac function (P = .5). Conclusion A 6-month exercise intervention in type 2 diabetes mellitus decreased hepatic TG content and visceral abdominal and paracardial fat volume, which are associated with increased cardiovascular risk, but cardiac function was unaffected. Tissue-specific exercise-induced changes in body fat distribution in type 2 diabetes mellitus were demonstrated in this study. © RSNA, 2013