Abdominal Obesity Research Articles

Aerobic Exercise Prevents High-Fat-Diet-Induced Adipose Tissue Dysfunction in Male Mice

Background/Objectives: This study aimed to assess the effect of aerobic exercise on capillary density and vascular smooth muscle cell (VSMC) phenotype in the visceral and subcutaneous adipose tissue of high-fat-diet (HFD) mice in order to understand the mechanisms underlying improvements in insulin resistance (IR) and chronic inflammation in adipose tissue (AT). Methods: Male C57BL/6J mice were divided into HFD and normal diet groups for 12 weeks and then further split into sedentary and aerobic exercise subgroups for an additional 8 weeks. Various parameters including body weight, fat weight, blood glucose, lipid profile, insulin levels, glucose tolerance, and inflammatory cytokines were evaluated. Results: Aerobic exercise reduced HFD-induced weight gain, IR, and improved lipid profiles. HFD had a minimal effect on inflammatory cytokines except in visceral adipose tissue (VAT). IR was associated with capillary density in subcutaneous adipose tissue (SAT) and VSMC phenotype in VAT. Aerobic exercise promoted anti-inflammatory responses in VAT, correlating with VSMC phenotype in this tissue. Conclusions: Aerobic exercise can alleviate HFD-induced IR and inflammation through the modulation of VSMC phenotype in AT.

Associations of Plasma Erythritol with Dietary Factors, Cardiometabolic, Inflammatory, and Gut Health Markers in People with and without HIV: A Cross-Sectional Study.

Recently, elevated levels of plasma erythritol have been associated with major adverse cardiovascular events (MACE). It is known that people with HIV (PWH) have a higher cardiovascular disease burden. Whether PWH have higher levels of plasma erythritol has not been evaluated. This study aimed to assess if blood erythritol levels are elevated in PWH and to examine relationships between erythritol and dietary, cardiometabolic, inflammatory, and gut health markers. Plasma erythritol levels were measured using frozen samples from 162 participants, including 109 PWH and 53 people without HIV (PWoH) in a parent study. General linear models were used to assess the linear relationship between characteristics, cardiovascular measures, markers of body composition, inflammation, and gut integrity with plasma erythritol. Logistic regression was used to assess risk factors associated with PWH, and cumulative logit models were used to investigate which factors were associated with having the highest plasma erythritol levels among PWH. Compared to PWoH, PWH had higher plasma erythritol levels (p = 0.03). Every 10% increase in VLDL (p = 0.01), visceral adipose tissue (p < 0.0001), or TNFrI (p = 0.01) was associated with an approximately 1% increase in plasma erythritol. Among PWH, HgbA1c (p = 0.003), TNFrI (p = 0.002), and IFAB-P (p = 0.004) were associated with having the highest tertile of plasma erythritol (≥3.6 μM). Compared to PWoH, PWH were more than two times as likely (p = 0.03) to have plasma erythritol ≥ 3.6 μM. We identified positive associations between plasma erythritol levels and several factors, including HIV status, BMI, adipose tissue, TNFr1, HbA1c, and VLDL. These results underscore the importance of further investigating the role of elevated plasma erythritol levels in people with HIV, particularly in light of their increased vulnerability to cardiovascular and metabolic diseases.

Morphofunctional characterization of the three main adipose tissue depots in rainbow trout (Oncorhynchus mykiss)

Visceral adipose tissue (VAT) is the primary fat reservoir and energy source in fish. Other relevant fat depots include subcutaneous adipose tissue (SAT), located under epithelial layers, and intramuscular adipose tissue (IMAT), found between the myotomes. The present study investigates the morphological, gene expression and functional characteristics of these different depots in rainbow trout (Oncorhynchus mykiss). Commercial rainbow trout of two different average weights were sampled for histology, lipid quantification and fatty acids profile. Mature adipocytes were isolated for gene expression analyses of lipid metabolic markers. Both VAT and SAT showed large adipocytes, and high total lipid content, suggesting hypertrophic growth. Adipocytes in IMAT were consistently smaller regardless of fish size. While fatty acid composition was similar across depots, SAT had lower levels of palmitic acid and higher levels of polyunsaturated fatty acids that act as precursors of phospholipids and eicosanoids such as eicosapentaenoic acid, compared to VAT and IMAT. Gene expression analyses revealed higher levels of fatty acid transporters, lipolysis and β-oxidation markers in VAT and SAT compared to IMAT, suggesting a more active lipid metabolism. These data support the role of VAT as the main energy depot, while SAT may act as a secondary reservoir, and IMAT potentially serves as an occasional energy source for muscles. This study provides valuable insights into the distinct properties of the different fat depots in fish, which may help to optimize strategies to modulate adiposity for improved health, metabolism, and product quality.

Metabolic kinetics and muscle and brain health markers in older adults, and the role of age and presence of chronic morbidities: A large cross-sectional cohort study

Background & aimsOlder adults are at risk for muscle and cognitive function decline during advanced aging, but the underlying metabolic mechanisms and the role of aging-associated chronic morbidities remain unclear. In the present study, we examined whether protein and amino acid kinetics in older adults with and without chronic morbidities are different when 50-70 and 70-90 of age and related to markers of muscle and brain health declines. MethodsIn a large cross-sectional observational study, 575 older adults from 12 trials (2014-2022) were stratified based on their age (50-70y vs. 70-95y) and the presence of chronic morbidities. The main outcomes were whole-body production (WBP) and interconversions of amino acids by stable amino acid tracers, body composition, and muscle and cognitive performance. Additionally, the association between metabolic markers and muscle and brain health was assessed. ResultsOverall lower muscle strength, muscle and fat mass, and cognitive function (p<0.03), but no mood disturbances, were found in 70-95y compared to 50-70y older adults. Presence of morbidities was associated with lower muscle strength and mass, and cognitive function, but higher visceral adipose tissue, and mood disturbances (p<0.05). Aging was associated with suppressed WBP of most amino acids, de novo arginine production, and net protein breakdown, but higher myofibrillar protein breakdown (p<0.007). Presence of morbidities was associated with lower WBP of glutamine, glutamate, histidine, isoleucine, phenylalanine, tyrosine, and net protein breakdown, and higher WBP of valine and taurine (p<0.04). Age showed significant negative correlations with WBP of nearly all amino acids, de novo arginine production and net protein breakdown (r: [-0.407, -0.136], p<0.01) but a positive correlation with WBP of myofibrillar protein breakdown (r=0.133, p=0.009). Lean mass showed positive correlations with de novo arginine production and net protein breakdown and WBP of all amino acids except for isoleucine (r: [0.16, 0.799], p<0.005). Worse cognitive performance was positively associated with WBP of tau-methylhistidine and taurine (r: [0.13, 0.141], p<0.04), but negatively associated with WBP of glycine, valine, and net protein breakdown (r: [-0.222, -0.135], p<0.05). ConclusionComprehensive phenotyping of a large group of older adults revealed differences in metabolic health in response to advanced aging and chronic morbidities. Poor muscle health accompanied by advanced aging was associated with overall metabolic downregulation, except for enhanced myofibrillar (muscle) protein breakdown. Presence of chronic morbidities was further associated with disturbed muscle health, mood, arginine, and taurine pathways, and higher visceral adipose tissue. Therefore, different phenotypes among older adults need to be considered when evaluating therapeutic approaches to improve muscle and brain health.

Effects of Specially Designed Energy-Restricted Diet on Anthropometric Parameters and Cardiometabolic Risk in Overweight and Obese Adults: Pilot Study.

This study examined the effects of a specially designed energy-restricted diet with alternate carbohydrate intake on body composition and cardiometabolic risk factors in overweight and obese adults. The aim was to assess whether the intervention could lead to significant weight loss, improve body composition, and reduce cardiometabolic risks. Sixty-five participants (34 women, 31 men) with an average BMI of 31.8 ± 9.1 kg/m2 (women) and 34.1 ± 6.4 kg/m2 (men) participated in a 14-week intervention. The diet included different days of carbohydrate intake and a 20% reduction in total daily energy consumption. Anthropometric measurements and biochemical parameters, including predictive indices of cardiometabolic risk, were determined at baseline and after the intervention. The intervention resulted in a significant reduction in body weight (mean weight loss of 17%, p < 0.001), with 64.6% of participants achieving a weight loss of at least 10%. Muscle mass as a percentage of total body weight increased. Cardiometabolic improvements were observed in fasting blood glucose (from 5.4 to 4.9 mmol/L, p < 0.001) and LDL cholesterol (from 3.38 to 2.81 mmol/L, p < 0.001). Gender-specific differences were found, particularly in HDL-C, which decreased significantly in women (p = 0.013), while there was a non-significant increase in men. Cardiometabolic indices, including the Visceral Adiposity Index (VAI) and the Cardiometabolic Index (CMI), also improved significantly. The alternate carbohydrate diet improved body composition, cardiometabolic health, and treatment adherence through metabolic flexibility. However, the short duration of this study and the lack of a control group suggest that further research is needed to assess long-term sustainability.

Artificial intelligence-based assessment of pre-operative body composition is associated with early complications after radical cystectomy.

We aimed to use a validated artificial intelligence(AI) algorithm to extract muscle and adipose areas from CT images before radical cystectomy(RCx), and then correlate these measures with 90-day post-RCx complications. A tertiary referral center's cystectomy registry was queried for patients who underwent RCx between 2009-2017 for bladder cancer. 843 RCx patients with CT imaging within 90 days preceding surgery were included, to allow for extraction of body composition parameters by AI. We assessed complications within 90 days of surgery including: wound, infectious, major complications, re-admission, and death. Multivariable logistic regressions associated pre-RCx measures to post-RCx complications. Increasing subcutaneous adipose tissue(SAT) was associated with more wound complications while patients with increasing visceral adipose tissue(VAT) had greater odds of infectious related complications. After adjusting for patient characteristics, every 10 cm2 increases in fat mass index(FMI) were associated with more infectious (OR 1.04, p=0.002) and wound (OR 1.06, p<0.001) complications. On multivariable analysis, higher pre-operative skeletal muscle index(SMI) was associated with lower odds of major complications (OR 0.75 for every 10 cm2, p=0.008), while higher intramuscular adipose(IMA) was associated with higher odds of major complications (OR 1.93, p=0.008). Automated AI body composition measurements pre-operatively are associated with post-RCx complications. These measurements, in addition to patient (ECOG performance status, smoking status) and surgical (robotic approach, continent diversion) characteristics can then be utilized to individualize patient counseling and facilitate triage of nutritional and rehabilitation efforts.

Patterns of beverages consumption and prevalence of non-communicable chronic diseases.

Beverages consumption influences diet quality in general and has been associated with the development of non-communicable chronic diseases (NCCD). We aimed to verify the association between beverage consumption patterns and the prevalence of NCCD. A cross-sectional household and population-based study was conducted with 489 individuals aged 20 years and older. The presence of NCCD (arterial hypertension, diabetes, cancer and hypercholesterolemia) was obtained by self-report, while obesity was diagnosed by measuring body weight, height and waist circumference. Beverage consumption patterns were obtained by principal component analysis. The association between beverages patterns and the prevalence of NCCD was verified using Poisson regression, expressed as prevalence ratio (PR) and adjusted for potential confounding factors. Three beverage patterns were identified: ‘ultra-processed beverages’, ‘alcoholic beverages’ and ‘healthy beverages’. Individuals with greater adherence to the Ultra-processed Beverages Pattern had a 2·77 times higher prevalence of cancer (PR: 3·77; 95 % CI 1·57, 9·07). Higher adherence to the Alcoholic Beverages Pattern was associated with a higher prevalence of obesity (PR: 1·97; 95 % CI 1·13, 3·44). In contrast, individuals in the second tertile of adherence to the Healthy Beverages Pattern had a 39 % lower prevalence of hypercholesterolemia (PR: 0·61; 95 % CI 0·40, 0·92), and individuals in the third tertile had a 10 % lower prevalence of abdominal obesity estimated by the waist-to-height ratio (PR: 0·90; 95 % CI 0·83, 0·97). Beverage consumption patterns may be associated with a higher prevalence of NCCD, regardless of other risk factors. It is therefore important to conduct more studies investigating the impact of beverages patterns on health.

The relationship between weight-adjusted-waist index, body mass index and diabetic retinopathy among American adults: a population-based analysis

Diabetic retinopathy (DR) is a common complication of diabetes, with its prevalence increasing globally. While previous research has linked obesity indices such as body mass index (BMI) to DR, the association with weight-adjusted-waist index (WWI) remains unclear. Additionally, the relationship between WWI and DR has not been fully elucidated. This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey (2005–2008) to investigate these associations in Americans aged 40 and above. The study included 5436 participants (2705 men and 2731 women). Weighted logistic regression analysis revealed a significant increase in DR prevalence with higher WWI and BMI values. Smooth curve analysis demonstrated a linear correlation between WWI and DR. The findings suggest that both WWI and BMI are independently associated with DR risk among older US adults, highlighting the importance of considering central obesity measures in assessing diabetic complications.

Analysis of blood glucose control and influencing factors in 18-64 year-old community people with type 2 diabetes in Shenzhen

Objective: To describe the current situation of blood glucose control in 18-64 year-old people with type 2 diabetes in the Shenzhen community and analyze the influencing factors to provide a reference for enhancing the management effect of type 2 diabetes in community health service institutions. Methods: The data were from the Shenzhen Community Health Service Information System. A cross-sectional survey design was adopted to include 18-64 year-old patients with type 2 diabetes in Shenzhen community health service institutions in 2022. The blood glucose control rate was calculated through the physical examination data recorded by the information system in 2022, and the influencing factors of blood glucose control in this group of patients were analyzed using a multivariate logistic regression model. Results: A total of 120 174 patients were included in the study. The blood glucose control rate was 53.04%. The results of multivariate logistic regression analysis showed that women (OR=1.07, 95%CI: 1.04-1.10), ages 45-54 (OR=1.10, 95%CI: 1.01-1.19), 55-64 (OR=1.24, 95%CI: 1.14-1.35), middle school (OR=1.09, 95%CI: 1.05-1.13), high school and technical secondary school (OR=1.26, 95%CI: 1.21-1.31), junior college or above (OR=1.75, 95%CI: 1.67-1.83), basic medical insurance for urban employees (OR=1.05, 95%CI: 1.01-1.08), weekly exercise (OR=1.26, 95%CI: 1.22-1.31), daily exercise (OR=1.31, 95%CI: 1.28-1.35) and combined hypertension (OR=1.21, 95%CI: 1.18-1.24) were more likely to reach the standard of blood glucose control; while unmarried (OR=0.85, 95%CI: 0.77-0.95), divorced (OR=0.84, 95%CI: 0.73-0.97), insurance status was fully self-funded (OR=0.95, 95%CI: 0.91-0.99), disease duration was 5- years (OR=0.65, 95%CI: 0.63-0.66), ≥10 years (OR=0.41, 95%CI: 0.39-0.42), the treatment method was diabetes drug therapy (OR=0.74, 95%CI: 0.71-0.76), low weight (OR=0.89, 95%CI: 0.80-1.00), obese group (OR=0.85, 95%CI: 0.82-0.88), combined with central obesity (OR=0.83, 95%CI: 0.81-0.86), combined with dyslipidemia (OR=0.69, 95%CI: 0.68-0.71), current smoking (OR=0.74, 95%CI: 0.72-0.77), and current drinking (OR=0.97, 95%CI: 0.93-1.00) were less likely to reach the standard of blood glucose control. Conclusions: The blood glucose control rate of 18-64 year-old people with type 2 diabetes in Shenzhen still has room for improvement. More attention should be paid to 18-64 year-old patients with type 2 diabetes, especially for patients with dyslipidemia, central obesity, and diabetes with a long course, and supervision and guidance should be strengthened for patients with bad habits such as smoking, drinking alcohol, and lack of exercise.

Association of diabetic retinopathy with plasma atherosclerotic index, visceral obesity index, and lipid accumulation products: NHANES 2005–2008

BackgroundAbdominal obesity, a significant risk factor for the progression of diabetic retinopathy (DR), may lead to improved visual outcomes through early assessment. This study aims to evaluate any potential associations between DR and novel lipid metabolism markers, including the Atherogenic Index of Plasma (AIP), Visceral Adiposity Index (VAI), and Lipid Accumulation Product (LAP).MethodsThis study aimed to elucidate the association between various lipid markers and DR by screening the National Health and Nutrition Examination Survey (NHANES) database in the United States from 2005 to 2008. To examine the correlation, multifactor logistic regression analysis, subgroup analysis, threshold effect analysis, interaction test, and smooth curve fitting were used.ResultsAmong the 2591 participants included, the incidence of DR was 13.6% and the mean age was 59.55 ± 12.26 years. After adjusting for important confounding covariates, logistic regression studies suggested a possible positive association between LAP, VAI, AIP, and DR occurrence (odds ratio [OR] = 1.004; 95% confidence interval [CI]: 1.002, 1.006; P < 0.0001; [OR] = 1.090; 95% [CI]: 1.037, 1.146; P = 0.0007; [OR] = 1.802; 95% [CI]: 1.240, 2.618; P = 0.0020). The nonlinear association between LAP and DR was further illustrated using an S-shaped curve by smoothing curve fitting, with the inflection point of the curve located at 63.4. Subgroup analyses and interaction tests were performed with full variable adjustment (P > 0.05 for all interactions).ConclusionStudies have shown that elevated levels of LAP, VAI, and AIP increase the likelihood of DR, suggesting that they have the potential to be predictive markers of DR, emphasizing their potential utility in risk assessment and prevention strategies, and advocating for early intervention to mitigate the likelihood of DR.

Great debate: pre-diabetes is not an evidence-based treatment target for cardiovascular risk reduction.

With the increasing burden of diabetes as a cause of macro- and microvascular disease linked to the epidemics of obesity, attention is being paid to dysglycaemic states that predict and precede the development of type 2 diabetes. Such conditions, termed pre-diabetes, are characterized by fasting plasma glucose, or plasma glucose levels on an oral glucose tolerance test, or values of glycated haemoglobin intermediate between 'normal' values and those characterizing diabetes. These last are by definition associated, in epidemiological terms, with a higher incidence of microvascular disease-mostly retinopathy. Pre-diabetes overlaps with the components of the 'metabolic syndrome'-among which are excess visceral adiposity; hypertension; hypertriglyceridaemia; high levels of small, dense low-density lipoproteins; and metabolic-associated fatty liver disease. There is little doubt that pre-diabetes has important prognostic implications, especially for the occurrence of myocardial infarction, ischaemic stroke, and peripheral arterial disease. It is disputed, however, whether pre-diabetes is itself an actionable disease entity, in addition to the risk factors characterizing it. Because of this uncertainty, the latest European Society of Cardiology guidelines chose not to include pre-diabetes as a treatment target for atherosclerotic cardiovascular disease, at variance from the three previous editions of such guidelines. This is spurring a debate, the Pro and Contra arguments featured in the present debate article.

Causality of visceral adipose tissue on chronic kidney disease and renal function measure indicators, and mediation role of hypertension: Mendelian randomization study.

Although chronic kidney disease (CKD) is associated with obesity, few studies have used visceral adipose tissue (VAT) as an indicator to investigate its causal effect on CKD. Therefore, Mendelian randomization (MR) was employed to study the causal effects of VAT on CKD and its potential mediation by hypertension. Genome-wide association study (GWAS) statistics on VAT exposure were obtained from the UK Biobank, while GWAS datasets of CKD outcomes were obtained from CKDGen and FinnGen (validation study). Furthermore, VAT was considered the exposure, with the estimated glomerular filtration rate based on creatinine (eGFR (crea)), estimated glomerular filtration rate based on cystatin C (eGFR(cys)), and blood urea nitrogen (BUN) employed to assess the causal effect of VAT on kidney test indicators. Lastly, a two-step MR method was used to study the mediating role of hypertension in the pathogenesis of VAT among patients with CKD. VAT exhibited a positive causal association with CKD, irrespective of whether the GWAS datasets from CKDGen (odds ratio [OR] = 1.18, 95% CI: 1.08 to 1.29, P = 1.433140e-04) or FinnGen (1.47, 1.30 to 1.67, p = 2.500000e-09). VAT was not causally associated with eGFR (crea) (1.00, 0.99 to 1.00, p = 0.53), was negatively associated with eGFR (cys) (0.95, 0.93 to 0.97, P = 5.070000e-10), and was positively associated with BUN (1.02,1.01 to 1.02, P = 7.824860e-04). The mediating effect of VAT on CKD via hypertension was 45.8% (95% CI: 26.4 65.1). VAT has a positive causal effect on CKD, with hypertension playing a significant role. However, the effects of VAT on renal function indicators require further investigation.

Lipid Accumulation Product Is Predictive of Cardiovascular Hospitalizations among Patients with Stable Ischemic Heart Disease: Long-Term Follow-Up of the LAERTES Study.

(1) Background: Lipid accumulation product (LAP) is an anthropometric index of abdominal adiposity that has been associated with increased cardiovascular risk. We aimed to explore the association of LAP with cardiovascular hospitalizations and compare its predictive accuracy with other indices such as body mass index (BMI) and waist circumference. (2) Methods: LAERTES was a prospective, population-based cohort that recruited consecutive patients with stable ischemic heart disease (SIHD) from two Greek hospitals in Athens. Data from 770 participants (13% women, median age 62 years) with a median follow-up of 4.3 years were analyzed in relation to the occurrence of adverse cardiovascular events mandating hospital admission (non-fatal myocardial infarction [MI], non-fatal ischemic stroke and malignant ventricular arrhythmias). (3) Results: A total of 127 (16.5%) of the participants were admitted to cardiology clinics over the follow-up period; 12.4% of them developed MI, 2.6% ventricular arrhythmia and 1.5% ischemic stroke. Patients with cardiovascular hospitalization had higher BMI, larger waist circumference, higher LAP and triglycerides and lower HDL-cholesterol than patients without hospitalization. Upper LAP quartile and hypertension were independent predictors for cardiovascular hospitalization (HR: 2.20, 95% CI: 1.12-4.34, p = 0.02 and HR: 1.57, 95% CI: 1.03-2.39, p = 0.03, respectively). (4) Conclusions: Higher LAP quartiles are predictive of adverse cardiovascular events leading to hospital admission and deserve further evaluation in dedicated studies.

Sex-differential effect of waist circumference on new-onset cerebral infarction: a nationwide cohort study.

Excessive abdominal adiposity represents a cardiovascular disease risk factor. Waist circumference (WC) reflects abdominal adiposity and is known as an easy-to-measure indicator of obesity. This study aimed to evaluate the relationship between WC level and the development of cerebral infarction in Koreans. 209,442 Koreans were included among the general population registered in the National Health Information Database. Depending on the degree of WC, the possibility of cerebral infarction was tracked for 4.37 person-years. Identification of patients with cerebral infarction was confirmed through the diagnostic code ICD I63 of inpatient or outpatient. Participants' data were analyzed by sex. The hazard ratios (HRs) and confidence interval (CI) for cerebral infarction were calculated using the Cox proportional hazards model. Between 2009 and 2013, 2,403 cases (1.15%) of cerebral infarction occurred during the follow-up period of 915,223.6 person-years. The HRs (95% CI) for incident cerebral infarction in men was adjusted for multiple covariates, and comparison of WC levels second, third, and fourth quartile with the first quartile showed 1.10 (0.94-1.28), 1.11 (0.95-1.30), and 1.24 (1.07-1.45), respectively (P for trend 0.045). This association was not significant in women (P for trend 0.619). The severity of WC levels in men is significantly associated with the risk of developing cerebral infarction in Koreans. This finding indicates that other measurements for excessive adipose visceral tissue, except abdominal circumference, need to be taken into account to identify the risk of cerebral infarction in women.

Environmentally utilization and chemical analysis of catfish (Pangasianodon hypophthalmus) industrial waste

Catfish (Pangasianodon hypothalamus) are known in Asia, specifically in Southeast Asia. Currently, this fish has been exported to almost all countries in the world. This research aimed to examine the existing conditions of the solid waste produced, analyze the chemical composition of the waste, and look for alternatives for the policy and economical use of waste in the catfish processing business. Using the survey method, data were gathered through measurement at the research location and laboratory, interviews with business owners, and field observations. Proximate analysis was conducted on pink slime meat, belly fat, bones, and fish innards. Analysis of acid number, saponification number, iodine number, and fat fatty acid was carried out on stomach fat. Meanwhile, amino acid analysis was carried out for pink slime meat. Handling catfish industrial waste has yet to be carried out properly, which causes a foul smell and disturbs the environment. The catfish industry waste’s chemical content (protein, fat, water content, carbohydrates, and fatty acids) (pink slime meat, belly fat, fish bones, and innards) is still relatively applicable. The study processed fish waste into products like instant porridge, analogous fish sago rice, and fish sago noodles. The proximate analysis results of these products show figures that exceed the minimum standards for similar products.

Body composition and muscle composition phenotypes in patients on waitlist and shortly after liver transplant – results from a pilot study

BackgroundSarcopenia is common in end-stage liver disease and negatively impacts patients awaiting or undergoing liver transplantation (LT). Magnetic resonance imaging (MRI) may be used to measure body composition and sarcopenia. We aimed to evaluate the feasibility of MRI-based LT body composition profiling, describe waitlist body composition, and assess the natural rate of change in body composition while on the waitlist and post-LT.MethodsThis prospective pilot study recruited adults listed for LT at an urban, tertiary care facility. Eighteen participants were scanned at time of waitlisting and 15 had follow-up MRIs (waitlist and/or post-LT). An 8-min MRI was used to measure body composition (AMRA® Researcher) including thigh fat-free muscle volume (FFMV) and fat infiltration (MFI), visceral (VAT) and abdominal subcutaneous (ASAT) adipose tissue volumes, and liver fat. A sex- and BMI invariant FFMV z-score (z-FFMV) was calculated, and muscle composition (MC) phenotypes were defined using the muscle assessment score (consisting of the FFMV z-score and sex-adjusted MFI). Rate of body composition change was calculated using mixed-effect modelling and is presented as rate per 30 days.ResultsAt time of waitlisting, 73% of the 18 participants had high MFI and 39% had the adverse MC (low FFMV z-score and high MFI) phenotype. Seven participants received an LT. Post-LT serial MRIs, at a median of 147 days apart within the first 200 days post-LT, demonstrated increased z-FFMV 0.22 SDs/(30 days) (p = 0.002), VAT 0.23 (p < 0.001), and ASAT 0.52 (p = 0.001) L/(30 days), but no change in MFI (p = 0.200) nor liver fat (p = 0.232).ConclusionMRI-based body composition profiling is feasible in LT patients and shortly after LT. This can be amended to routine clinical scans and may help in early identification of patients who may benefit from interventions to improve body composition. In addition, body composition changes significantly over time after LT.

Exploring lipodystrophy gene expression in adipocytes: unveiling insights into the pathogenesis of insulin resistance, type 2 diabetes, and clustering diseases (metabolic syndrome) in Asian Indians.

Studying the molecular mechanisms of lipodystrophy can provide valuable insights into the pathophysiology of insulin resistance (IR), type 2 diabetes (T2D), and other clustering diseases [metabolic syndrome (MetS)] and its underlying adipocentric disease (MetS disease). A high-confidence lipodystrophy gene panel comprising 50 genes was created, and their expressions were measured in the visceral and subcutaneous (both peripheral and abdominal) adipose depots of MetS and non-MetS individuals at a tertiary care medical facility. Most lipodystrophy genes showed significant downregulation in MetS individuals compared to non-MetS individuals in both subcutaneous and visceral depots. In the abdominal compartment, all the genes showed relatively higher expression in visceral depot as compared to their subcutaneous counterpart, and this difference narrowed with increasing severity of MetS. Their expression level shows an inverse correlation with T2D, MetS, and HOMA-IR and with other T2D-related intermediate traits. Results also demonstrated that individualization of MetS patients could be done based on adipose tissue expression of just 12 genes. Adipose tissue expression of lipodystrophy genes shows an association with MetS and its intermediate phenotypic traits. Mutations of these genes are known to cause congenital lipodystrophy syndromes, whereas their altered expression in adipose tissue contributes to the pathogenesis of IR, T2D, and MetS.

Association of obesity status and the risk of long-COVID: Isfahan COVID cohort study.

People with COVID-19 infection continue to have their symptoms or develop new ones after recovery. This is called long-COVID syndrome. We aimed to examine the association of general and abdominal obesity with long COVID. This study was conducted using Isfahan COVID Cohort (ICC). Totally 4008 including 3213 hospitalized and 795 non-hospitalized patients with positive RT-PCR were included. Body mass index (BMI) and waist circumference (WC) were calculated. BMI >25 kg/m2 and WC >88 cm in women and 102 cm in men were considered generally and abdominally obese, respectively. By using an open-ended questionnaire, subjects were asked whether they had any new or persistent symptom. Reported symptoms were categorized in three different fields including general, cardiac, and respiratory symptoms. Higher BMI and WC tended to increase general symptoms (odds ratio [OR] for BMI = 1.16, 95 % confidence interval (95% CI): 0.97, 1.38, and OR for WC = 1.14, 95% CI: 0.99, 1.32). Higher BMI significantly increased cardiovascular (OR = 1.38, 95% CI: 1.14, 1.67) and respiratory symptoms (OR = 1.43, 95% CI: 1.15, 1.78). Compared with patients with normal WC, the risk of cardiovascular (OR = 1.44, 95% CI: 1.24, 1.69) and respiratory symptoms was significantly higher in subjects with abdominal obesity (OR = 1.31, 95% CI: 1.10, 1.56). We found that general and abdominal obesity were associated with increased risk of cardiovascular and respiratory symptoms in patients with long-COVID symptoms. However, only general obesity was associated with increased risk of general symptoms.

Association between "a body shape index" (ABSI) with periodontitis in a hypertension population from the NHANES 2009-2014.

A body Shape index (ABSI), defined as waist circumference (WC)/(body mass index (BMI)2/3 × height1/2), is unique in that the ABSI is positively associated with visceral obesity and is independent of BMI. The ABSI has also been shown to be positively and linearly correlated with the amount of visceral adiposity in the general population and with all-cause and cardiovascular disease (CVD). However, it is uncertain whether ABSI is associated with periodontitis in hypertensive patients. A cross-sectional study of 2,482 hypertensive patients (mean age 65.2 ± 9.1 years) was conducted using the ABSI Z score, periodontitis as a dichotomous variable, the ABSI Z score as a continuous variable, and multiple covariates such as age, gender, and race. The data were analyzed using descriptive statistics, multiple regression model, subgroup analysis with EmpowerStats (version 4.2), and curve transformation plots were generated. In multiple regression model analysis, ABSI Z score showed a significant positive association with periodontitis in the hypertensive population in all three models. When ABSI Z score was divided into low, moderate, and high three groups, we observed that those with the highest ABSI Z score had a 20% increased risk of periodontitis among people with hypertension (OR 1.2; 95% CI 1.0, 1.5; p = 0.046). We used smooth curve fitting to confirm the results and found that these results were still supported, and additional subgroup analyses showed that the positive association between ABSI Z score and periodontitis in hypertensive population was stable and consistent in the general population. The present cross-sectional investigation showed a positive association between ABSI Z score and periodontitis in a hypertensive population.

B-cell Interleukin 1 Receptor 1 (IL1R1) modulates the female adipose tissue immune microenvironment during aging.

Myeloid cell production of interleukin-1β (IL-1β) drives inflammaging in visceral adipose tissue (vWAT) and contributes to the expansion of interleukin-1 receptor 1 (Il1r1) positive aged adipose B-cells (AABs). AABs promote metabolic dysfunction and inflammation under inflammatory challenges. However, it is unclear whether IL-1β contributes to AAB-associated inflammation during aging. Using a B-cell specific knockout of Il1r1 (BKO mice), we characterized old vWAT in the absence of IL-1β - B-cell signaling. In addition to sex-specific metabolic improvements in females, we identified a reduction in the proportion of B-cells and a sex-specific increase in the B1:B2 B-cell ratio in BKO vWAT. Using single cell RNA-sequencing of vWAT immune cells, we observed that BKO differentially affected inflammatory signaling in vWAT immune cells. These data suggest that IL-1β - B-cell signaling supports the inflammatory response in multiple cell types and provides insight into the complex microenvironment in aged vWAT.