Abdominal Visceral Fat Volume Research Articles

Abdominal visceral and subcutaneous fat increase, insulin resistance and hyperlipidemia in testicular cancer patients treated with cisplatin-based chemotherapy

Background. Testicular cancer survivors treated with chemotherapy are at increased risk for metabolic syndrome (MetS) and cardiovascular disease (CVD). We explored acute effects of chemotherapy by assessing metabolic factors, abdominal fat volume, hepatic triglyceride content (HTC) and aortic wall stiffness. Material and methods. We studied 19 testicular cancer patients (age 20–54 years) before, at three and nine months after the start of chemotherapy. Blood serum was analyzed for lipids, glucose and insulin. Abdominal visceral and subcutaneous fat volume and aortic pulse wave velocity were assessed by magnetic resonance imaging (MRI) techniques; HTC was measured by proton MR spectroscopy. Results. Three months after start of chemotherapy visceral abdominal fat volume had significantly increased from 202 ± 141 to 237 ± 153 ml (p = 0.009) whereas body mass index and subcutaneous fat volume significantly increased nine months after treatment from 24.4 ± 4.0 to 26.4 ± 4.1 kg/m2 (p = 0.01) and from 556 ± 394 to 668 ± 460 ml (p = 0.002) respectively. Serum total cholesterol, low-density lipoprotein cholesterol and insulin also significantly increased three months after start of treatment from 4.88 ± 1.1 to 5.61 ± 1.50 mmol/l (p = 0.002), 3.31 ± 1.16 to 3.73 ± 1.41 mmol/l (p = 0.02) and 5.7 ± 4.4 to 9.6 ± 6.3 mU/ml (p = 0.03), respectively. Nine months after start of chemotherapy serum lipid and insulin concentrations had returned to baseline. HTC increased in seven of the 19 patients (36.8%) during follow-up. Aortic pulse wave velocity remained unchanged at the three time points measured. Conclusion. Cisplatin-based chemotherapy was associated with acute insulin resistance, dyslipidemia and an immediate increase in abdominal visceral adipose tissue and abdominal subcutaneous adipose tissue in testicular cancer patients. A large prospective cohort study with long follow-up is warranted to characterize the time course and relationship between acutely induced obesity and hypercholesterolemia and the development of metabolic syndrome and CVD years later in individual testicular cancer survivors.

Unfavorable metabolic changes are accompanied by impaired myocardial function shortly after chemotherapy

Background Cardiovascular morbidity is a well known late complication of chemotherapy, for example for treatment of testicular cancer. In addition, development of a combination of overweight, hypertension and abnormal lipid profiles has been observed in these patients suggesting increased risk of developing the metabolic syndrome and diabetes. The early effects of chemotherapy on myocardial function and metabolic profile are largely unknown. Therefore, the purpose of this study was to assess short-term effects of chemotherapy in testicular cancer on myocardial function in relationship with alterations in metabolic profile. Methods Fourteen patients with testicular cancer were treated with bleomycin, etoposide and cisplatin. Before and after chemotherapy, magnetic resonance imaging techniques were used to assess cardiac systolic and diastolic function, and abdominal fat volume (summation of 3 slices at the level of the L5 vertebra). In addition, hepatic and myocardial triglyceride content were assessed using MR spectroscopy. Blood samples were taken at both occasions to obtain plasma lipid profile and to estimate insulin sensitivity. Results After chemotherapy, an unfavorable shift in metabolic profile was observed: Visceral abdominal fat volume was increased significantly (from186 ± 125 ml to 227 ± 162 ml. P< 0.05) without significant changes in BMI. Hepatic triglyceride content increased, although non-significant

Development of associations among central adiposity, adiponectin and insulin sensitivity from adolescence to young adulthood

To examine associations of central adiposity, serum adiponectin and clamp-derived insulin sensitivity in a single longitudinal cohort from early adolescence to young adulthood. The cohort was examined three times at mean ages 15 years (n = 308), 19 years (n = 218) and 22 years (n = 163). Insulin sensitivity was measured with the euglycaemic hyperinsulinaemic clamp. Circulating adiponectin was measured by enzyme-linked immunosorbent assay. Computed tomography scans were used at mean age 22 to compute subcutaneous and visceral abdominal fat volume. Partial Pearson correlations and linear regression were used to examine cross-sectional associations at each examination. The moderate negative correlation between waist circumference and adiponectin was significant and essentially unchanged from mean age 15 (-0.32, P < 0.0001) to mean age 22 (-0.29, P < 0.002), whereas the negative correlation between waist circumference and insulin sensitivity and the positive correlation between adiponectin and insulin sensitivity increased steadily in magnitude to mean age 22 (-0.29, P = 0.0002; and 0.32, P < 0.0001, respectively). In regression models including both visceral and subcutaneous fat, only visceral fat was significantly associated with insulin sensitivity, while only subcutaneous fat was nearly significantly associated with adiponectin. This study shows that the significant negative relationship between waist circumference and adiponectin predated the development of significant relationships between insulin sensitivity and both waist circumference and adiponectin. It also shows that adiponectin is more closely related to subcutaneous fat and insulin sensitivity is more closely related to visceral fat in young adults.

Impaired Insulin Sensitivity as Indexed by the HOMA Score Is Associated With Deficits in Verbal Fluency and Temporal Lobe Gray Matter Volume in the Elderly

OBJECTIVEImpaired insulin sensitivity is linked to cognitive deficits and reduced brain size. However, it is not yet known whether insulin sensitivity involves regional changes in gray matter volume. Against this background, we examined the association between insulin sensitivity, cognitive performance, and regional gray matter volume in 285 cognitively healthy elderly men and women aged 75 years from the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study.RESEARCH DESIGN AND METHODSInsulin sensitivity was calculated from fasting serum insulin and plasma glucose determinations using the homeostasis model assessment of insulin resistance (HOMA-IR) method. Cognitive performance was examined by a categorical verbal fluency. Participants also underwent a magnetic resonance imaging (MRI) brain scan. Multivariate analysis using linear regression was conducted, controlling for potential confounders (sex, education, serum LDL cholesterol, mean arterial blood pressure, and abdominal visceral fat volume).RESULTSThe HOMA-IR was negatively correlated with verbal fluency performance, brain size, and temporal lobe gray matter volume in regions known to be involved in speech production (Brodmann areas 21 and 22, respectively). No such effects were observed when examining diabetic (n = 55) and cognitively impaired (n = 27) elderly subjects as separate analyses.CONCLUSIONSThese cross-sectional findings suggest that both pharmacologic and lifestyle interventions improving insulin signaling may promote brain health in late life but must be confirmed in patient studies.

Intrahepatic lipid content is linked to insulin resistance in obese subjects

Abdominal visceral fat (VAT) and intrahepatic lipid (IHL) are associated with insulin resistance in obese subjects, but VAT is usually measured on CT scans at the umbilical level or on MRI images of the partial abdomen. Thus, the association of the total abdominal visceral fat volume (VFV) with insulin resistance is unclear. In this study, we evaluated the correlations of obesity-related factors, including VFV and IHL, with clinical markers of insulin resistance (HOMA-R and the MATSUDA Index), and then assessed the effect of weight loss on these factors and markers. The study population consisted of 30 obese Japanese subjects with a BMI > 25 kg/m(2) (13 men and 17 women) who underwent a 75-g oral glucose tolerance test to calculate HOMA-R and the MATSUDA Index, dual energy X-ray absorptiometry (DEXA) for measurement of body fat (%-Fat), proton magnetic resonance spectroscopy ((1)H MRS) to assess IHL, and whole abdominal CT scanning (from the top of the liver to the floor of the pelvic cavity = about 700 slices) to determine the total abdominal subcutaneous fat volume (SFV) and VFV. Seven subjects from the original population were placed on a diet and exercise program, and these indices were examined again after 5% reduction of body weight. Abdominal SFV, VFV, and IHL were mutually independent, but BMI and %-Fat were not independent of the other factors. According to multiple regression analysis, IHL (but not SFV or VFV) was significantly correlated with both HOMA-R and the MATSUDA Index in obese patients. Weight reduction by 5% led to improvement of the MATSUDA Index and decreased the number of subjects with metabolic syndrome, and the reduction of IHL was greater than that of SFV or VFV. These results suggest that IHL may be a superior marker of insulin resistance.

Evaluation of whole-abdominal fat volume by 700-slice CT scanning and comparison with the umbilical fat area anthropometric indices

The fat area at the umbilical region on CT scans is widely used to identify visceral obesity. However, whether it precisely represents the abdominal visceral fat volume is uncertain, because of technical difficulty in evaluating whole-abdominal visceral fat volume. In this study, we compared the whole-abdominal visceral fat and subcutaneous fat volumes with the visceral fat area at the umbilical region and anthropometric indices. The study population consisted of 131 Japanese diabetic and non-diabetic subjects (72 males and 59 females) who underwent anthropometric measurements (height, weight, waist circumference, and hip circumference) and CT scanning from the top of the liver to the pelvic floor (about 700 slices) to analyze the whole-abdominal and umbilical contents of visceral and subcutaneous fat. The visceral fat volume of the male group was 1.3-fold higher than that of the female group, while the subcutaneous fat volume of the female group was 1.3-fold higher than that of the male group. The visceral fat area at the umbilical region was strongly correlated with visceral fat volume (r = 0.921 in males and 0.931 in females). Both visceral and subcutaneous fat volumes were strongly correlated with the waist circumference (r = 0.768 and 0.809 in males and 0.744 and 0.803 in females), but not with the BMI or waist/hip ratio. The visceral fat area at the umbilical region is an optimal indicator for whole-abdominal visceral fat volume, and the waist circumference is the anthropometric index that reflects visceral obesity more closely than BMI or the waist/hip ratio.

CAN HIP AND WAIST CIRCUMFERENCES PREDICT HABITUAL EXERCISERS?? ABDOMINAL VISCERAL FAT VOLUME ?

Many studies have used waist circumference (WC) and hip circumference (HC) to predict abdominal fat distribution. However, most of these studies have focused on the general population. PURPOSE To determine whether abdominal fat distribution can be predicted by body circumferences, and to understand the relationship between abdominal visceral fat volume and leptin. METHODS Thirty-four (age 33.8 ± 13.2 years, body mass index 23.3 ± 2.3 kg/m2) individuals who had been regular joggers, swimmers and weight lifters for more than 5 years served as the subjects. Magnetic resonance imaging (MRI) was used to determine abdominal fat volume distribution. Fasting blood samples were analyzed for leptin. The WC and HC were gauged by a non-elastic ruler. RESULTS The subjects' abdominal fat volume, WC, HC, waist and hip ratio (WHR) and leptin were 0.66±0.41 L, 79.3±4.8 cm, 94.0 ±4.3 cm, 0.84±0.1, and 1.99 ±0.92 ug/L respectively. Abdominal visceral fat volume was significantly correlated with WHR, WC and leptin (0.68, 0.62, 0.64 respectively, p < 0.01). Using stepwise regression, WHC could explain 47% the variance of the abdominal fat volume. When leptin was added to the equation, the variance explanation could reach 60%. CONCLUSION The waist and hip circumference can predict the visceral fat volume of people who exercise regularly; leptin alos plays a minor role. Supported in part by grant NSC 90-2413-H-003-055, TAIWAN