Changes In Visceral Fat Research Articles

Effectiveness of Adherence to a Mediterranean Diet in the Management of Overweight Women: The Prospective Interventional Cohort Study

Evidence indicates that unhealthy eating habits constitute multilevel obstacles threatening health and well-being. Studies suggest that consumer choices have turned irremovably towards Western diets. The Mediterranean diet (MD) is considered one of the most effective in preventing and treating overweight and obesity, yet its results and associations are ambiguous. This explanatory research aims to examine the effect of the MD on anthropometric and biochemical variables in 181 females from an Eastern European country. The sample was divided into three distinct clusters based on age (tricenarian, quadragenarian, and quinquagenarian). Anthropometric and biochemical examinations in the three-month MD program plan failed to provide convincing evidence of the benefits of the MD on selected integrands. However, total body fat (FATP) values between groups showed a significant difference (p ≤ 0.032) between groups A and C (p ≤ 0.029), which can be attributed to the age of the cohort (30-39 vs. 50-60 years). Values in groups A and B (p ≤ 0.001) and C and A (p ≤ 0.001) were significant between the cohorts but did not indicate any changes in visceral fat (VFATL) in the individual groups. The presented findings can have implications for further investigation and the development of more comprehensive instruments, incorporating critical add-on constituents that will be appropriate to monitor, evaluate, and predict body weight management in experimentation.

Metabolic Biomarkers Assessed with PET/CT Predict Sex-Specific Longitudinal Outcomes in Patients with Diffuse Large B-Cell Lymphoma.

Simple SummaryThere is a sex disparity in lymphoma where males have higher incidence and mortality compared to females. Sex differences in metabolism may be a significant factor underlying this phenomenon where visceral obesity, a known biomarker for poor outcomes in multiple pathophysiological states, is higher in males compared to females. Here, we report that visceral fat, although higher in males with diffuse large B-cell lymphoma (DLBCL), selectively predicted worse outcomes in females. Moreover, females that selectively gained visceral fat during chemotherapy did worse, and combining the change in visceral fat over the course of chemotherapy and tumor glucose uptake measured by FDG-PET at end of treatment identified a subgroup of females with extremely poor outcomes.In many cancers, including lymphoma, males have higher incidence and mortality than females. Emerging evidence demonstrates that one mechanism underlying this phenomenon is sex differences in metabolism, both with respect to tumor nutrient consumption and systemic alterations in metabolism, i.e., obesity. We wanted to determine if visceral fat and tumor glucose uptake with fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) could predict sex-dependent outcomes in patients with diffuse large B-cell lymphoma (DLBCL). We conducted a retrospective analysis of 160 patients (84 males; 76 females) with DLBCL who had imaging at initial staging and after completion of therapy. CT-based relative visceral fat area (rVFA), PET-based SUVmax normalized to lean body mass (SULmax), and end-of-treatment FDG-PET 5PS score were calculated. Increased rVFA at initial staging was an independent predictor of poor OS only in females. At the end of therapy, increase in visceral fat was a significant predictor of poor survival only in females. Combining the change in rVFA and 5PS scores identified a subgroup of females with visceral fat gain and high 5PS with exceptionally poor outcomes. These data suggest that visceral fat and tumor FDG uptake can predict outcomes in DLBCL patients in a sex-specific fashion.

Effect of a six-week times restricted eating intervention on the body composition in early elderly men with overweight

The main aim of the study was to determine the effectiveness of time-restricted eating (TRE) in reducing body fat and lowering body mass index in early elderly men with overweight (65–74 years). An additional goal was to determine the feasibility of applying TRE for extensive use in elderly men. This study included a group of 46 healthy men (EXP = 23 persons, CON = 23 persons). The six-week intervention in the experimental group involved complete abstinence from food intake for 16 h per day, from 08:00 to 12:00 p.m. After the intervention, the body weight decreased in the EXP group (− 1.92 kg) with a 95% CI (1.14–2.70) compared to the CON group. There was also a decrease in the Visceral fat mass (− 0.64 l) with 95% CI (0.46–0.82) and in the waist circumference (− 3.11 cm) with 95% CI (1.89–4.33) in the EXP group compared to the CON group. The skeletal muscle mass did not change significantly. There was no significant change in the control group, either. The application of TRE in early elderly overweight men resulted in positive changes in body composition and visceral fat. All participants succeed in the prescribed diet plan, which shows that TRE is easy to maintain for early elderly overweight men and may become an essential obesity treatment tool in these age groups.

Weight Loss Associated With Time Restricted Eating Is Not Reflected in Changes in the Human Gut Microbiome

ObjectivesTime-restricted eating (TRE) is a novel approach to obesity treatment that recently received attention. Very limited data exist regarding gut microbiome changes during TRE interventions in humans. Our objective was to characterize the gut microbiome of human participants before and after a 12-week TRE intervention.MethodsIn a randomized controlled trial of an 8-hour TRE intervention in human participants over 12 weeks, Chow, et al. demonstrated reduction in weight, lean mass, and visceral fat with TRE compared to control. Stool samples were collected before and after the intervention by study participants using home kits, placed in RNAlater Stabilization Solution (Ambion), and kept < at room temperature for < 7 days before storage in a −80°C freezer. Samples were submitted as a batch to the University of Minnesota Genomics Center for DNA extraction, amplification, and shotgun metagenomic DNA sequencing (Illumina HiSeq platform). Quality-controlled sequences were aligned to the GTDB Genome Taxonomy Database (https://gtdb.ecogenomic.org).ResultsSixteen study participants provided stool samples which were used in this analysis (8 TRE and 8 control). Participants undergoing the TRE intervention successfully restricted their eating window (mean ± SD 15.3 ± 0.8 hours at baseline to 9.3 ± 1.7 hours during intervention, p < 0.001). The control group's eating window remained unchanged. Weight loss, visceral fat loss, and BMI reduction were significantly greater for the TRE group. There was no significant effect of the TRE intervention on alpha diversity (Shannon index, Simpson index, and number of taxa, linear mixed models), beta diversity (Bray-curtis, PERMANOVA), or overall microbiome composition controlling for weight change and visceral fat change.ConclusionsOur analyses did not show any difference in gut microbiome composition or diversity indices in participants completing a TRE intervention as compared to control, but are limited by small sample size, short study duration, and stool-sampling at only two study timepoints.Funding SourcesThis work was supported by the University of Minnesota and grants from the National Institute of Diabetes and Digestive and Kidney Diseases and National Center for Advancing Translational Sciences.

Altered Visceral Adipose Tissue Predictors and Women's Health: A Unicenter Study.

(1) Background: The excess visceral adipose tissue (VAT) accumulation in women may reflect an early or advanced state of a metabolic disorder and a higher risk of cardiovascular disease than other types of obesity. This study aimed to determine the predictor variables (demographic information, anthropometric data, and blood biomarkers) for changes in VAT in adult women. (2) Methods: This cross-sectional study was conducted with women aged 18–59 years attending nutritional consultation at the Centro Universitário de Brasília (CEUB)’s nutrition school clinic, Brazil. All participants’ medical records were reviewed throughout the study and data of interest were collected. Various anthropometric measurements and biochemical exams were performed and analyzed in a univariate logistic regression model to identify the possible risk factors predictors for the presence of altered VAT. (3) Results: Our logistic regression model considered body mass index (BMI) greater than 25 kg/m2, lipid accumulation product (LAP), and waist–hip ratio (WHR) as predictors of altered VAT. (4) Conclusion: LAP has a robust predictive capacity for changes in visceral fat in adult women, followed by WHR and BMI, making these variables effective in assessing the risk for changes in visceral fat and their inclusion essential in the individual and collective clinical practice.

Effects of Diet-Induced Weight Loss on Plasma Markers for Cholesterol Absorption and Synthesis: Secondary Analysis of a Randomized Trial in Abdominally Obese Men.

Cross-sectional studies have shown that obesity is associated with lower intestinal cholesterol absorption and higher endogenous cholesterol synthesis. These metabolic characteristics have also been observed in patients with type 2 diabetes, metabolic syndrome, steatosis or cholestasis. The number of intervention studies evaluating the effect of weight loss on these metabolic characteristics is, however, limited, while the role of the different fat compartments has not been studied into detail. In a randomized trial, abdominally obese men (N = 54) followed a 6-week very low caloric (VLCD) diet, followed by a 2 week weight-maintenance period. Non-cholesterol sterols were measured at baseline and after 8 weeks, and compared to levels in lean participants (N = 25). After weight loss, total cholesterol (TC)-standardized cholestanol levels increased by 0.18 µmol/mmol (p < 0.001), while those of campesterol and lathosterol decreased by 0.25 µmol/mmol (p < 0.05) and 0.39 µmol/mmol (p < 0.001), respectively. Moreover, after weight loss, TC-standardized lathosterol and cholestanol levels were comparable to those of lean men. Increases in TC-standardized cholestanol after weight loss were significantly associated with changes in waist circumference (p < 0.01), weight (p < 0.001), BMI (p < 0.001) and visceral fat (p < 0.01), but not with subcutaneous and intrahepatic lipids. In addition, cross-sectional analysis showed that visceral fat fully mediated the association between BMI and TC-standardized cholestanol levels. Intrahepatic lipid content was a partial mediator for the association between BMI and TC-standardized lathosterol levels. In conclusion, diet-induced weight loss decreased cholesterol synthesis and increased cholesterol absorption. The increase in TC-standardized cholestanol levels was not only related to weight loss, but also to a decrease in visceral fat volume. Whether these metabolic changes ameliorate other metabolic risk factors needs further study.

Yoghurt consumption is associated with changes in the composition of the human gut microbiome and metabolome

BackgroundYoghurt contains live bacteria that could contribute via modulation of the gut microbiota to its reported beneficial effects such as reduced body weight gain and lower incidence of type 2 diabetes. To date, the association between yoghurt consumption and the composition of the gut microbiota is underexplored. Here we used clinical variables, metabolomics, 16S rRNA and shotgun metagenomic sequencing data collected on over 1000 predominantly female UK twins to define the link between the gut microbiota and yoghurt-associated health benefits.ResultsAccording to food frequency questionnaires (FFQ), 73% of subjects consumed yoghurt. Consumers presented a healthier diet pattern (healthy eating index: beta = 2.17 ± 0.34; P = 2.72x10−10) and improved metabolic health characterised by reduced visceral fat (beta = −28.18 ± 11.71 g; P = 0.01). According to 16S rRNA gene analyses and whole shotgun metagenomic sequencing approach consistent taxonomic variations were observed with yoghurt consumption. More specifically, we identified higher abundance of species used as yoghurt starters Streptococcus thermophilus (beta = 0.41 ± 0.051; P = 6.14x10−12) and sometimes added Bifidobacterium animalis subsp. lactis (beta = 0.30 ± 0.052; P = 1.49x10−8) in the gut of yoghurt consumers. Replication in 1103 volunteers from the LifeLines-DEEP cohort confirmed the increase of S. thermophilus among yoghurt consumers. Using food records collected the day prior to faecal sampling we showed than an increase in these two yoghurt bacteria could be transient. Metabolomics analysis revealed that B. animalis subsp. lactis was associated with 13 faecal metabolites including a 3-hydroxyoctanoic acid, known to be involved in the regulation of gut inflammation.ConclusionsYoghurt consumption is associated with reduced visceral fat mass and changes in gut microbiome including transient increase of yoghurt-contained species (i.e. S. thermophilus and B. lactis).

Hip BMD is associated with visceral fat change: a registry study of osteoporosis and sarcopenia

Osteoporosis increases the risk of fractures. Visceral fat is associated with cardiovascular disease (CVD). There is inadequate knowledge on the relationship between osteoporosis and visceral fat. The study aimed to evaluate the relationship between bone mineral density (BMD) and visceral fat mass in the elderly. This was a prospective cohort study. Subjects were enrolled from the Rheumatology Clinic. All subjects underwent baseline bone mineral density and body composition measurements using dual-energy X-ray absorptiometry. A total of 321 patients including 288 females and 33 males were enrolled in this study. We followed up DEXA for 1 year for fat and muscle mass change and found that 162 (50.5%) had a decrease in fat mass, 129 (40.2%) had decreased visceral fat, and 138 (43%) had decreased muscle mass. Furthermore, we found that the baseline hip T score was correlated with visceral fat decrease. Using visceral fat decrease as the outcome, we found that hip T score could predict visceral fat loss: the higher the T score, the more visceral fat loss was found [p < 0.001, OR: 1.6, CI: (1.3-2.1)]. A high hip T score was associated with a future decrease in visceral fat, which may decrease the risk of atherosclerosis and CV risk. Therefore, evaluation of visceral fat may be useful for assessing CVD risk in patients with osteoporosis. Effective management of the risk of atherosclerosis and CVD is important in improving the life expectancy of these patients.

Is an Exercise Intervention the only way to Reduce Visceral Fat without Reducing Fat-free Mass in Children and Adolescents?

Objectives: To maintain proper development, it is recommended that children/adolescents focus more on increasing physical activity than dietary restriction when treating obesity. In other words, adults are better able to tolerate the reductions in fat-free body mass that often occur when trying to lose fat mass. In contrast, children and adolescents should avoid losses in fat-free mass in order to ensure proper development. Therefore, when trying to reduce visceral fat in children via a negative energy balance (i.e., exercise with or without calorie restriction), it is necessary to set desirable conditions in order to minimize the loss of fat-free mass. To determine whether this is possible, we reviewed literature discussing the relationship between changes in visceral fat obtained by abdominal imaging and changes in total body fat and fat-free mass after exercise training with and without calorie restriction in children and adolescents.Methods: Literature review.Results and Conclusions: Previous work found no reduction in fat-free mass in the exercise interventions in which there was no dietary-induced calorie restriction. This supports the idea that reducing visceral fat by increasing physical activity is the preferred strategy over dietary restriction in children and adolescents. Although factors such as the type (e.g. aerobic and/or resistance) of exercise and the amount (i.e. energy expenditure) of exercise will likely have an effect on the magnitude of change in intra-abdominal visceral fat, the quantity of each that is needed without reducing fat-free mass is currently unknown.

A 24-month metformin treatment study of children with obesity: Changes in circulating GDF-15 and associations with changes in body weight and visceral fat.

Metformin treatment for 24 months in children with obesity lowers body mass index (BMI), reduces liver fat, and normalizes endocrine-metabolic parameters. Here we study whether circulating GDF-15 levels were raised by such metformin treatment and whether they related to changes in body weight and visceral fat in children with obesity. The study population consisted of 18 pre-pubertal/early pubertal children with obesity who had participated in a randomized double-blind clinical trial receiving metformin (850 mg/day) or placebo for 24 months. Circulating GDF-15, BMI and abdominal visceral and liver fat (magnetic resonance imaging) were assessed at 0, 6, 12 and 24 months. Results showed that metformin-treated children had higher GDF-15 levels at 6 and 12 months. Higher rises of circulating GDF-15 associated with more loss of body weight and visceral fat. In conclusion, the concept that GDF-15 is among the mediators of metformin's normalizing effects in individuals with obesity is herewith extended into childhood.

Change in Visceral Fat and Total Body Fat and the Effect on Cardiometabolic Risk Factors During Transgender Hormone Therapy.

IntroductionExcess visceral fat increases the risk of type 2 diabetes and cardiovascular disease and is influenced by sex hormones. Our aim was to investigate changes in visceral fat and the ratio of visceral fat to total body fat (VAT/TBF) and their associations with changes in lipids and insulin resistance after 1 year of hormone therapy in trans persons.MethodsIn 179 trans women and 162 trans men, changes in total body and visceral fat estimated with dual-energy X-ray absorptiometry before and after 1 year of hormone therapy were related to lipids and insulin resistance [homeostatic model assessment of insulin resistance (HOMA-IR)] with linear regression analysis.ResultsIn trans women, total body fat increased by 4.0 kg (95% CI 3.4, 4.7), while the amount of visceral fat did not change (−2 grams; 95% CI −15, 11), albeit with a large range from −318 to 281, resulting in a decrease in the VAT/TBF ratio of 17% (95% CI 15, 19). In trans men, total body fat decreased with 2.8 kg (95% CI 2.2, 3.5), while the amount of visceral fat did not change (3 g; 95% CI −10, 16; range −372, 311), increasing the VAT/TBF ratio by 14% (95% CI 10, 17). In both groups, VAT/TBF was not associated with changes in blood lipids or HOMA-IR.ConclusionsHormone therapy in trans women and trans men resulted in changes in VAT/TBF, mainly due to changes in total body fat and were unrelated to changes in cardiometabolic risk factors, which suggests that any unfavorable cardiometabolic effects of hormone therapy are not mediated by changes in visceral fat or VAT/TBF.

Association between Visceral Fat and Brain Structural Changes or Cognitive Function.

Visceral fat accumulation is an independent risk factor for cardiovascular disease and mortality. Visceral fat is a causal risk factor for hypertension and type 2 diabetes, which was reported as one of the risk factors for dementia. Visceral fat areas (VFA) might be clinically important to prevent dementia; however, the association between VFA and cognitive function in the elderly remains unknown. We aimed to evaluate the association between brain structural abnormalities using magnetic resonance imaging (MRI) and VFA, and the association between cognitive function and VFA, in the elderly. A total of 2364 healthy individuals were enrolled, and we excluded those diagnosed with dementia. Participants were divided into a high-VFA and a low-VFA group based on median VFA. The high-VFA group had significantly lower cognitive function than the low-VFA group (p = 0.025), after adjustment for related factors using a linear regression model. Regarding brain structure in MRI, VFA remained significantly associated with white matter lesions (odds ratio (OR), 1.90; 95% confidence interval (1.33–2.70); adjusted p < 0.001) and perivascular space (OR, 1.28; 95% confidence interval (1.02–1.61); adjusted p = 0.033). Further follow-up studies are needed, but reducing visceral fat might be important, not only to prevent cardiovascular disease but also to prevent dementia.

PPAR-γ-induced changes in visceral fat and adiponectin levels are associated with improvement of steatohepatitis in patients with NASH.

Background and AimsPeroxisome proliferator‐activated receptor (PPAR)‐γ agonists decrease hepatic/visceral fat (VF) and improve necroinflammation despite subcutaneous (SC) fat weight‐gain. Understanding the impact of changes in VF, VF‐to‐SC fat distribution (VF/SC) and adiponectin (ADPN) levels in relation to histological improvement after weight‐loss or pioglitazone is relevant as novel PPAR‐γ agonists are being developed for treating non‐alcoholic steatohepatitis (NASH).MethodsFifty‐five patients with NASH received a −500 kcal/d hypocaloric diet and were randomized (double‐blind) to pioglitazone (45 mg/d) or placebo for 6‐months. Before and after treatment patients underwent a liver biopsy and measurement of hepatic/peripheral glucose fluxes, hepatic/adipose tissue‐IR and, in 35 patients, hepatic and VF/SC‐fat was measured by magnetic resonance spectroscopy/imaging. Data were examined by multivariable statistical analyses combined with machine‐learning techniques (partial least square discriminant analysis [PLS‐DA]).ResultsBoth pioglitazone (despite weight‐gain) and placebo (if weight‐loss) reduced steatosis but only pioglitazone ameliorated necroinflammation. Using machine‐learning PLS‐DA showed that the treatment differences induced by a PPAR‐γ agonist vs placebo on metabolic variables and liver histology could be best explained by the increase in ADPN and a decrease in VF/SC, and to a lesser degree, improvement in oral glucose tolerance test‐glucose concentrations and ALT. Decrease in steatosis and disease activity score (ballooning plus lobular inflammation) kept a close relationship with an increase in ADPN (r = −.71 and r = −.44, P < .007, respectively) and reduction in VF/SC fat (r = .41 and r = .37, P < .03 respectively).ConclusionsReduction in VF and improved VF/SC‐distribution, combined with an increase in ADPN, mediate the histological benefits of PPAR‐γ action, highlighting the central role of fat metabolism and its distribution on steatohepatitis disease activity in patients with NASH.

Comparisons of calorie restriction and structured exercise on reductions in visceral and abdominal subcutaneous adipose tissue: a systematic review.

Exercise and low-calorie diets are common approaches taken to produce an energy deficit for weight loss in obesity. Changes in visceral and abdominal subcutaneous fat associated with weight loss are important questions but have not yet been concluded. We investigated the relationship between changes in visceral (VAT) and subcutaneous adipose tissue (SAT) areas obtained by abdominal imaging with the change in total body fat. The relevant databases were searched through January 2021 according to the PRISMA guidelines. Sixty-five studies were included. We found that the change in total body fat was associated with changes in both VAT and abdominal SAT areas, but the relationship between total body fat and the abdominal SAT area appeared stronger. Baseline values of VAT and abdominal SAT area were similar in the three treatment groups (calorie restriction, calorie restriction plus exercise, and exercise alone). The reduction in abdominal SAT area for a loss of 1 kg of total body fat was about 10 cm2, which was similar among all the treatments. The change in VAT area (-26.3 cm2) was a similar level as the change in abdominal SAT area (-31.5 cm2) in the exercise, whereas in the calorie restriction with and without exercise, the change in VAT area (-33.6 and -51.6 cm2, respectively) was approximately half of the reduction of SAT area (-65.1 and -87.2 cm2, respectively). Absolute changes in VAT and abdominal SAT areas might differ between interventions for the exercise and calorie restriction with and without exercise.

Abstract 075: Differences In Body Composition At Baseline And In Response To Exercise Training By Metabolic Health And Weight Status

Background: Body composition is known to differ across metabolic health and weight phenotypes. Regular exercise improves body composition, yet little is known about differences in exercise response across metabolic health and weight phenotypes. Methods: Normal weight (n=376) and overweight/obese (OWOB) adults (n=456) from the HERITAGE Family Study (56% female, 38% Black) completed a 20-week endurance training program. Four groups based on baseline BMI and metabolic risk were created: metabolically healthy normal weight, MHNW; metabolically unhealthy normal weight, MUNW; metabolically healthy OWOB, MHO; and metabolically unhealthy OWOB, MUO. Unhealthy was defined as having ≥2 metabolic syndrome components. General linear models tested for differences in baseline and change in measures of body composition (fat mass [FM], fat-free mass [FFM], % body fat [%BF], visceral fat) after adjusting for age, sex, and ethnicity (and baseline value in change models). Results: Table 1 shows adjusted mean baseline and change in body composition values by group. Baseline body composition tended to track with weight status, with NW adults having lower FM, %BF, and visceral fat compared to obese adults (p&lt;0.05), regardless of metabolic health. However, the MHO group had lower baseline values of these traits compared to MUO (p&lt;0.05). Body composition measures significantly improved with exercise training in all groups, however, the magnitude of change differed between groups. For example, both NW groups had larger decreases in %BF compared to the obese groups, with MUNW showing the largest decrease. Conversely, MHNW showed the largest decrease in visceral fat, which was greater than both obese groups, but change in visceral fat was similar between MHO and MUNW. Conclusions: Normal weight adults tended to have better body composition profiles at baseline and larger improvements with exercise compared to obese adults, regardless of metabolic health. Within weight groups, body composition improved regardless of metabolic health status.

Reversing the effects of androgen-deprivation therapy in men with metastatic castration-resistant prostate cancer.

To investigate whether bipolar androgen therapy (BAT), involving rapid cyclic administration of high-dose testosterone, as a novel treatment for metastatic castration-resistant prostate cancer (mCRPC) promotes improvements in body composition and associated improvements in lipid profiles and quality of life. Men from two completed trials with computed tomography imaging at baseline and after three cycles of BAT were included. Cross-sectional areas of psoas muscle, visceral and subcutaneous fat were measured at the L3 vertebral level. Functional Assessment of Chronic Illness Therapy - Fatigue questionnaire and 36-item short-form health survey were used to assess quality of life. The 60 included patients lost a mean (sd) of 7.8(8.2)% of subcutaneous fat, 9.8(18.2)% of visceral fat, and gained 12.2(6.7)% muscle mass. Changes in subcutaneous and visceral fat were positively correlated with each other (Spearman's correlation coefficient 0.58, 95% confidence interval 0.35-0.71) independent of the effects of age, body mass index, and duration of androgen-deprivation therapy. Energy, physical function, and measures of limitations due to physical health were all significantly improved at 3months. The improvements in body composition were not correlated with decreases in lipid levels or observed improvements in quality of life. In the present study, BAT was associated with significant improvements in body composition, lipid parameters, and quality of life. This has promising implications for the long-term health of men with mCRPC.

Changes in Visceral Fat and Its Correlation With Changes in Metabolic Variables After Bariatric Surgery

Obesity is a health problem. There is a relationship between visceral adipose tissue (VAT) and various metabolic components. So far the most effective treatment for weight reduction and control of comorbidities is bariatric surgery. After bariatric surgery there is a reduction in VAT and a correlation with better control of metabolic variables would be expected. Objective: To determine the decrease in VAT, calculated by bioimpedance at 3 and 6 months after bariatric surgery and its correlation with changes in metabolic parameters (fasting glucose, HOMA, HbA1c, lipid profile). MATERIAL AND Methods: Patients belonging to the HECMNSXXI Obesity Clinic undergoing bariatric surgery during 2020 who agreed to participate in the study were included. VAT volume was determined before surgery and at 3 and 6 months after the procedure by bioimpedance using the SECA mBCA525 body analyzer. At the same time, biochemical metabolic markers were determined (fasting glucose, HOMA, HbA1c, CT, HDL, LDL, and triglycerides). The results were reported using descriptive statistics. A Pearson or Spearman correlation was carried out according to the distribution of the variables. P <0.05 was taken as significant. Results: Eleven patients with a mean age of 49 ± 7 years were included, 73% of them were women. Their average initial BMI was 42 ± 4 kg/m2. VAT prior to surgery had a mean of 10.6 ± 2.5L for men and 6.4 ± 2.4L for women. Eighty-two percent of the patients fulfilled harmonized criteria for metabolic syndrome. There was a statistically significant decrease in VAT at 3 and 6 months after surgery in both men and women (Baseline 7.5 ± 3L, 3 months 3.8 ± 2.8 L (p <0.001), 6 months 2.5 ± 2 L (p = 0.001). An average decrease in visceral adipose tissue of 57 ± 24% in women and 34 ± 18% in men (p = 0.18) was found 3 months after surgery and 70 ± 22% in women and 60 ± 21% in men (p = 0.53) 6 months after surgery. Laparoscopic one-anastomosis gastric bypass (OAGB) was the type of surgery with the highest percentage of VAT loss at 3 and 6 months, however, this was not statistically significant when compared with Y-Roux Gastric bypass (YRGB). A statistically significant decrease in HbA1c, HOMA, total cholesterol, LDL, and triglycerides levels were found at 3 and 6 months after surgery. However, when correlating the proportion of VAT lost with the metabolic variables, only a significant correlation was found with the HbA1c levels. The higher the proportion of VAT lost, the lower the HbA1c levels (R2 -0.72 p = 0.01). Conclusions: Bariatric surgery produces a statistically significant reduction in visceral adipose tissue from 3 months after surgery. In this study, an inversely proportional correlation was found between the proportion of VAT lost and HbA1c levels.

Effect of One Month Exposure to Components of Reprometabolic Syndrome on Physical Activity &amp; Body Composition in Lean Women

Abstract Background: Subfertility in obese women is associated with chronic pituitary suppression, reduced sensitivity to GnRH and decreased sex steroid production. We have found evidence for a combined effect of hyperinsulinemia and high circulating fatty acids to acutely (4h infusion) suppress pituitary gonadotropin secretion and are currently investigating the effects of one-month exposure to a eucaloric high-fat diet (HFD) on gonadotropin levels in lean women. The aim of this study is to examine the effect of the one-month HFD on physical activity and body composition. Methods: 12 normal weight (BMI &amp;lt; 25 kg/m2), normally cycling female participants of reproductive age were given a one-month eucaloric HFD, from the onset of menses in one cycle through the next, with 48% calories from fat. A Fitbit was provided to monitor changes in daily activity and sleep throughout the study. Measurement of gonadotropin pulsatility and reproductive hormones were done using frequent blood sampling and daily urine excretion, respectively. These measurements were obtained for a total of 4 menstrual cycles: 1 pre-diet cycle, the HFD cycle, and 2 post-diet cycles. DEXA body composition was measured at baseline and at the end of the 2nd post diet cycle. Pre and post diet comparisons were done using linear mixed model testing and reported as estimated means ± standard error. Results: Mean number of daily steps were (9,226 ± 1,140) pre diet, (9,132 ± 1,140) during the diet and (7,533 ± 1,140) post diet. Daily active calories were (1,982 ± 99) pre diet, (1,975 ± 99) during the diet and (1,856 ± 99) post diet. Means in the HFD cycle did not differ from the pre-diet cycle. Daily sleeping minutes pre diet were (443 ± 19), (451 ± 20) during the diet and (412 ± 19) post diet, with no statistical difference between the 3 time points. BMI did not differ between pre-diet (21.84 ± 0.52) and post-diet (21.77 ± 0.52). DEXA body composition measurements indicated a statistically significant decrease in total fat percentage, (32.26 ± 1.53) pre diet and (31.31 ± 1.53) post diet, which does not appear clinically significant as the difference of less than 1% falls within the anticipated measurement error of the method. Visceral fat volume (cm3) did not differ between pre diet (299.51 ± 27.76) and post diet (295.53 ± 27.76). Conclusions: The complete cohort has not yet been fully recruited and analyzed. These preliminary findings indicate that women consuming a one-month, HFD maintain their usual level of physical activity and sleep patterns, and do not appear to sustain change in visceral fat. Further accrual of participants should clarify the small decrease in total body fat observed without a change in BMI. Supported by HD087314 ROI to NS UL1TR002535 to the Colorado Clinical and Translational Sciences Institute.

Early benefits of bariatric surgery on subclinical cardiac function: Contribution of visceral fat mobilization

AimsWe explored the early effects of bariatric surgery on subclinical myocardial function in individuals with severe obesity and preserved left ventricular (LV) ejection fraction. MethodsThirty-eight patients with severe obesity [body mass index (BMI) ≥35 kg/m2] and preserved LV ejection fraction (≥50%) who underwent bariatric surgery (biliopancreatic diversion with duodenal switch [BPD-DS]) (Surgery group), 19 patients with severe obesity managed with usual care (Medical group), and 18 age and sex-matched non-obese controls (non-obese group) were included. Left ventricular global longitudinal strain (LV GLS) was evaluated with echocardiography speckle tracking imaging. Abnormal myocardial function was defined as LV GLS <18%. ResultsAge of the participants was 42 ± 11 years with a BMI of 48 ± 8 kg/m2 (mean ± standard deviation); 82% were female. The percentage of total weight loss at 6 months after bariatric surgery was 26.3 ± 5.2%. Proportions of hypertension (61 vs. 30%, P = 0.0005), dyslipidemia (42 vs. 5%, P = 0.0001) and type 2 diabetes (40 vs. 13%, P = 0.002) were reduced postoperatively. Before surgery, patients with obesity displayed abnormal subclinical myocardial function vs. non-obese controls (LV GLS, 16.3 ± 2.5 vs. 19.6 ± 1.7%, P < 0.001). Six months after bariatric surgery, the subclinical myocardial function was comparable to non-obese (LV GLS, 18.2 ± 1.9 vs. 19.6 ± 1.7%, surgery vs. non-obese, P = NS). On the contrary, half of individuals with obesity managed medically worsened their myocardial function during the follow-up (P = 0.002). Improvement in subclinical myocardial function following bariatric surgery was associated with changes in abdominal visceral fat (r = 0.43, P < 0.05) and inflammatory markers (r = 0.45, P < 0.01), whereas no significant association was found with weight loss or change in insulin sensitivity (HOMA-IR) (P > 0.05). In a multivariate model, losing visceral fat mass was independently associated with improved subclinical myocardial function. ConclusionsBariatric surgery was associated with significant improvement in the metabolic profile and in subclinical myocardial function. Early improvement in subclinical myocardial function following bariatric surgery was related to a greater mobilization of visceral fat depot, linked to global fat dysfunction and cardiometabolic morbidity.

Increasing changes in visceral adiposity is associated with higher risk for colorectal adenoma: Multilevel analysis in a prospective cohort.

While many studies demonstrated an association between visceral adiposity and colorectal adenoma (CRA), the effect of longitudinal changes in body fat composition on CRA is unclear. We investigated the longitudinal association between changes in visceral adiposity and CRA occurrence. Between 2006 and 2018, 732 (62.8%) of the 1165 subjects in a prospective cohort voluntarily underwent follow-up abdominal fat computed tomography and colonoscopy. We defined incident and recurrent CRA as adenoma detected at follow-up colonoscopy from negative and positive adenoma at baseline colonoscopy, respectively. Multilevel survival analysis examined the longitudinal association between changes in visceral fat and CRA. During a median follow-up of 7.4years, 400 (54.6%) subjects developed CRA. In multivariable analysis, increasing changes in visceral adipose tissue (VAT) area were associated with higher risk of incident adenoma (hazard ratio [HR] 1.21, 95% confidence interval [CI] 1.00-1.46 for change per 10cm2 increase; HR 1.79, 95% CI 1.08-2.97 for highest vs lowest quartile, P values for trend=0.045). Likewise, increasing changes in VAT area were independently associated with a higher risk of recurrent adenoma (HR 1.35, 95% CI 1.13-1.62 for change per 10cm2 increase; HR 1.62, 95% CI 1.04-2.52 for highest vs lowest quartile, P values for trend=0.001). Changes in subcutaneous adipose tissue area were not independently associated with CRA. Increasing changes in VAT area were longitudinally associated with a higher risk of incident and recurrent CRA, independent of risk factors, suggesting that visceral adiposity may be an important target in CRA prevention.