Visceral Fat Distribution Research Articles

Artificial intelligence-enhanced electrocardiography derived body mass index as a predictor of future cardiometabolic disease

Abstract Background Obesity, a key risk factor for cardiometabolic diseases, is poorly evaluated by body mass index (BMI), which doesn't account for visceral fat and fat distribution. Given that obesity-related cardiac changes can manifest in surface ECG changes, we hypothesised that an AI-ECG model could predict BMI, and the discrepancy between AI-predicted and actual BMI (delta-BMI) could indicate cardiometabolic health. We also sought to understand the biological mechanisms contributing to the AI-ECG-derived delta-BMI. Methods The AI-ECG model was developed using a data split of 60/10/30% in a USA secondary care dataset of 512,950 ECGs and externally validated in the UK Biobank (N = 42,386), employing a residual neural network architecture. Model performance was evaluated using Mean Absolute Error (MAE), Pearson correlation coefficient (r), and coefficient of determination (R2). The study aimed at identifying incident cardiometabolic diseases, using Cox regression analyses adjusted for BMI, age, and sex. To assess the underlying biological associations of delta-BMI, phenome-wide, genome-wide, metabolome-wide, and proteome-wide association studies were performed. Results In the test set, the model achieved an MAE of 3.95 (3.93–3.97), r of 0.65 (0.65-0.66), and R2 of 0.43 (0.42-0.43). In the UKB, the model achieved an MAE of 2.94 (2.91–2.96), r of 0.62 (0.62–0.63) and R2 of 0.39 (0.38-0.40). The top tertile of delta-BMI showed an increased risk of future cardiometabolic disease (test set: HR 1.15, p<0.001; UKB: HR 1.58, p<0.001) and diabetes mellitus (test set: HR 1.25, p<0.001; UKB: HR 2.28, p<0.001) after adjusting for covariates including measured BMI. Phenotypic profiling highlighted associations between delta-BMI and cardiometabolic diseases, anthropometric measures of truncal obesity, and pericardial fat mass. Metabolic and proteomic profiling associates delta-BMI positively with valine, lipids in small HDL, syntaxin-3, and carnosine dipeptidase 1, and inversely with glutamine, glycine, colipase, and adiponectin. A genome-wide association study revealed associations with regulators of cardiovascular/metabolic traits. These results highlight delta-BMI's potential as a non-invasive, ECG-based biomarker for cardiometabolic risk stratification. Conclusion Our study demonstrates the effectiveness of an AI-enhanced ECG model in accurately predicting BMI, validated across diverse populations. The introduction of delta-BMI as a predictor of cardiometabolic disease offers valuable additional prognostic insights beyond traditional BMI assessments. Our exploration of biological pathways, spanning phenotypic, genotypic, metabolomic, and proteomic associations, contributes to a comprehensive understanding of the association between delta-BMI and cardiometabolic disease. The clinical implications could extend to enhanced screening strategies, personalised risk assessment, and motivation for lifestyle interventions.

Association between visceral adiposity index and bowel habits and inflammatory bowel disease: a cross-sectional study

Obesity has become a global public health problem, and its relationship with gastrointestinal diseases has become a major concern. The visceral adiposity index (VAI) is a novel index to assess the distribution and content of visceral fat, and this study aimed to investigate the association between VAI and bowel habits (chronic diarrhea, chronic constipation) and inflammatory bowel disease (IBD). The 2005–2010 National Health and Nutrition Examination Survey (NHANES) dataset was used for the cross-sectional survey. Bowel habits and IBD were defined by self-report. Multiple logistic regression models were used to test the linear association of VAI with bowel habits and IBD. Fitted smoothed curves and threshold effects analyses were used to characterize nonlinear relationships. This cross-sectional study included 10,391 adults (≥ 20 years). After adjusting for covariates, there was a significant negative association between VAI and chronic constipation (OR [95% CI]: 0.97 [0.95, 1.00]) but no significant association with IBD (OR [95% CI]: 0.97 [0.87, 1.07]). Additionally, there was a nonlinear association between VAI and chronic diarrhea with a breakpoint of 3.08, with a positive correlation between the two on the left side of the breakpoint and no statistical significance on the right side. Subgroup analyses and interaction tests showed that maintaining sleep health was associated with a low risk of chronic constipation. Elevated VAI levels were negatively associated with chronic constipation, and elevated levels were positively associated with chronic diarrhea at VAI < 3.08. This reminds us that maintaining moderate levels of visceral fat may prevent the onset of chronic constipation and circumvent the risk of chronic diarrhea. Notably, maintaining healthy sleep may play a positive role in reducing chronic constipation.

The relationship of visceral adiposity with endothelial functions and subclinical atherosclerosis in obese individuals.

On the cardiovascular system, obesity accelerates atherosclerosis progression, inducing pathophysiological changes that are detectable already from young adults. Endothelial dysfunction is one of the earliest vascular alterations observed in obesity. In this study, we aimed to determine endothelial functions and carotid intima-media thickness in patients with obesity without overt cardiovascular disease. The study was conducted with 112 individuals with obesity without overt cardiovascular disease and any chronical diseases (BMI>30 kg/m2) (84 female, 28 male, mean age: 46.3±11.2 years) and 49 healthy individuals with no diseases (33 female, 16 male, mean age: 44.6±10.2 years). All patients were examined for endothelial functions by the flow-mediated dilatation (FMD) method and carotid intima-media thicknesses (CIMT). All measurements were performed by the same imaging specialist, averaging 3 different measurements. In addition to the body mass index and waist circumference visceral adiposity index (VAI) and triponderal mass index (TPI) also calculated. The percentage of FMD obtained by brachial artery ultrasound was significantly lower, visceral adipose tissue, perirenal adipose tissue thicknesses measured by abdominal ultrasound and CIMT were significantly thicker in Group 1 compared to Group 2. FMD had a negative significant correlation with body mass index, visceral adipose tissue thickness, perirenal adipose tissue thickness, and waist and hip circumferences, and carotid intima-media thickness and CIMT had a significant correlation with visceral adipose tissue thickness, perirenal adipose tissue thickness, VAI, TPI and waist, hip circumferences. Individuals with obesity have impaired endothelial functions and greater carotid intima-media thicknesses compared to healthy individuals. This impairment in endothelial functions is proportional to the amount of visceral and perirenal fat accumulation. Parameterss reflecting visceral fat distribution such as VAI and TPI are also related with these impairment.

Radiological biomarkers reflecting visceral fat distribution help distinguish inflammatory bowel disease subtypes: a multicenter cross-sectional study

ObjectivesTo achieve automated quantification of visceral adipose tissue (VAT) distribution in CT images and screen out parameters with discriminative value for inflammatory bowel disease (IBD) subtypes.MethodsThis retrospective multicenter study included Crohn’s disease (CD) and ulcerative colitis (UC) patients from three institutions between 2012 and 2021, with patients with acute appendicitis as controls. An automatic VAT segmentation algorithm was developed using abdominal CT scans. The VAT volume, as well as the coefficient of variation (CV) of areas within the lumbar region, was calculated. Binary logistic regression and receiver operating characteristic analysis was performed to evaluate the potential of indicators to distinguish between IBD subtypes.ResultsThe study included 772 patients (365 CDs, median age [inter-quartile range] = 31.0. (25.0, 42.0) years, 255 males; 241 UCs, 46.0 (34.0, 55.5) years, 138 males; 166 controls, 40.0 (29.0, 53.0) years, 80 males). CD patients had lower VAT volume (CD = 1584.95 ± 1128.31 cm3, UC = 1855.30 ± 1326.12 cm3, controls = 2470.91 ± 1646.42 cm3) but a higher CV (CD = 29.42 ± 15.54 %, p = 0.006 and p ˂ 0.001) compared to UC and controls (25.69 ± 12.61 % vs. 23.42 ± 15.62 %, p = 0.11). Multivariate analysis showed CV was a significant predictor for CD (odds ratio = 6.05 (1.17, 31.12), p = 0.03). The inclusion of CV improved diagnostic efficiency (AUC = 0.811 (0.774, 0.844) vs. 0.803 (0.766, 0.836), p = 0.08).ConclusionCT-based VAT distribution can serve as a potential biomarker for distinguishing IBD subtypes.Critical relevance statementVisceral fat distribution features extracted from CT images using an automated segmentation algorithm (1.14 min) show differences between Crohn’s disease and ulcerative colitis and are promising for practical radiological screening.Key points• Radiological parameters reflecting visceral fat distribution were extracted for the discrimination of Crohn’s disease (CD) and ulcerative colitis (UC).• In CD, visceral fat was concentrated in the lower lumbar vertebrae, and the coefficient of variation was a significant predictor (OR = 6.05 (1.17, 31.12), p = 0.03).• The differences between CD, UC, and controls are promising for practical radiological screening.Graphical

Association of sex-specific abdominal adipose tissue with WHO/ISUP grade in clear cell renal cell carcinoma

ObjectivesTo explore the association between computed tomography (CT)-measured sex-specific abdominal adipose tissue and the pathological grade of clear cell renal cell carcinoma (ccRCC).MethodsThis retrospective study comprised 560 patients (394 males and 166 females) with pathologically proven ccRCC (467 low- and 93 high-grade). Abdominal CT images were used to assess the adipose tissue in the subcutaneous, visceral, and intermuscular regions. Subcutaneous fat index (SFI), visceral fat index (VFI), intermuscular fat index (IFI), total fat index (TFI), and relative visceral adipose tissue (rVAT) were calculated. Univariate and multivariate logistic regression analyses were performed according to sex to identify the associations between fat-related parameters and pathological grade.ResultsIFI was significantly higher in high-grade ccRCC patients than in low-grade patients for both men and women. For male patients with high-grade tumors, the SFI, VFI, TFI, and rVAT were significantly lower, but not for female patients. In both univariate and multivariate studies, the IFI continued to be a reliable and independent predictor of high-grade ccRCC, regardless of sex.ConclusionsIntermuscular fat index proved to be a valuable biomarker for the pathological grade of ccRCC and could be used as a reliable independent predictor of high-grade ccRCC for both males and females.Critical relevance statementSex-specific fat adipose tissue can be used as a new biomarker to provide a new dimension for renal tumor-related research and may provide new perspectives for personalized tumor management decision-making approaches.Key points• There are sex differences in distribution of subcutaneous fat and visceral fat.• The SFI, VFI, TFI, and rVAT were significantly lower in high-grade ccRCC male patients, but not for female patients.• Intermuscular fat index can be used as a reliable independent predictor of high-grade ccRCC for both males and females.Graphical

Visceral and ectopic fat are more predictively associated with primary liver cancer than overall obesity from genetic sights: A Mendelian randomization study.

Several observational studies have reported an association between obesity and primary liver cancer (PLC), while the causality behind this association and the comparison of the risk effects of different obesity indicators on PLC remain unclear. In this study, we performed two-sample Mendelian randomization (MR) analyses to assess the associations of genetically determined liver fat, visceral adipose tissue (VAT), and body mass index (BMI) with the risk of PLC. The summary statistics of exposures were obtained from two genome-wide association studies (GWASs) based on the UK Biobank (UKB) imaging cohort and the Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort. GWAS summary statistics for PLC were obtained from FinnGen consortium R7 release data, including 304 PLC cases and 218 488 controls. Inverse-variance weighted (IVW) was used as the primary analysis, and a series of sensitivity analyses were performed to further verify the robustness of these findings. IVW analysis highlighted a significant association of genetically determined liver fat (OR per SD increase: 7.14; 95% CI: 5.10-9.99; P = 2.35E-30) and VAT (OR per SD increase: 5.70; 95% CI: 1.32-24.72; P = .020) with PLC but not of BMI with PLC. The findings were further confirmed by a series of MR methods. No evidence of horizontal pleiotropy between these associations existed. Our study suggested that genetically determined liver fat and VAT rather than BMI were associated with an increased risk of PLC, which suggested that visceral fat distribution is more predictive of the clinical risk of PLC than common in vitro measures.

Subtype-specific Body Composition and Metabolic Risk in Patients With Primary Aldosteronism.

Primary aldosteronism (PA) is associated with increased metabolic risks. However, controversy exists as to which subtype of PA has a higher metabolic risk between bilateral and lateralized PA. This study aimed to assess the body composition of 2 PA subtypes, bilateral PA and lateralized PA, according to sex and autonomous cortisol secretion (ACS) and their contribution to comorbidities. A total of 400 patients with PA (females, n = 210) and 1:10 age- and sex-matched healthy controls (n = 4000) were enrolled. The skeletal muscle area (SMA), subcutaneous fat area, and visceral fat area (VFA) at the third lumbar spine were calculated using abdominal computed tomography-based body composition analysis. Patients with bilateral PA had higher body mass index (BMI) in both sexes (all P < .05). Hemoglobin A1c level and the prevalence of diabetes were higher in female patients with bilateral PA than in those with lateralized PA (all P < .05). The VFA/BMI ratio was significantly higher in bilateral PA patients than in lateralized PA patients (5.77 ± 2.69 vs 4.56 ± 2.35 in men; 4.03 ± 2.58 vs 2.53 ± 2.05 in women, all P < .001). PA patients with ACS showed decreased SMA compared to those without ACS. Compared with healthy controls, all patients with bilateral PA and female patients with lateralized PA showed significantly higher VFA and VFA/BMI. Patients with bilateral PA were more obese and had higher VFA levels than those with lateralized PA. Despite a milder form of PA, this metabolically unfavorable visceral fat distribution may lead to a higher metabolic risk in patients with bilateral PA.

Body Composition as Prognostic Markers for Survival of Patients with Non-Metastatic Non-Small-Cell Lung Cancer

Objective: Lung cancer is the leading cause of cancer-related deaths. Although, previous research have shown that patients with non-small-cell lung cancer (NSCLC), with a higher body mass index (BMI), have a lower risk of death, only a few studies have examined the effects of body composition. Hence, this study examined the prognostic value of skeletal muscle mass and fat mass in patients with non-metastatic NSCLC. Material and Methods: This was a retrospective cohort study; from 2008 to 2012. Eighty-eight of 130 non-metastatic NSCLC patients underwent computed tomography to assess paravertebral skeletal muscle, subcutaneous adipose tissue (SAT), and visceral adipose-tissue (VAT) at the 3rd lumbar vertebral level. Spearman correlation analysis was used to analyze body-composition correlations. Cox regression analysis was used to determine prognostic markers. Results: Higher SAT and VAT indices were associated with a higher-survival probability (HR, 0.79; p-value=0.001 and, HR 0.88; p-value=0.016, respectively). In contrast, higher SAT density and VAT/SAT ratio were associated with a lower survival probability (HR 1.16, p-value=0.012; HR 1.28, p-value=0.006, respectively). Lower performance status and TNM stage 3 were associated with lower-survival probability (HR 2.60; p-value=0.004, HR 1.92; p-value=0.035, respectively).Conclusion: The VAT index predicts a better prognosis for patients with non-metastatic lung cancer; however, visceral-fat distribution, as measured by a high VAT/SAT ratio, is associated with a worse prognosis.

Аналіз показників фізичного розвитку офіцерів оперативного рівня різних вікових груп

Knowledge about the age dynamics of physical development indicators of operational level officers has significant importance in the context of scientific research and practical activities of military personnel. The aim is to determine the age dynamics of physical development indicators among operational level officers in the first and second periods of mature age. Material and methods. We used anthropometric research methods, including measuring body length, body weight, and girth sizes of different body parts. Also, we used bioelectrical impedance analysis to determine body composition, including fat amount, muscle mass, water content, and other parameters. In addition, we measured skin-fat folds to assess the distribution of fat tissue in different parts of the body. Using the obtained results, we performed mathematical analysis, such as descriptive statistics and significance criteria. Parametric criteria were used to compare indicators of physical development between age groups of officers, too. Research results. We found out that the age indicator between the studied groups had a statistically significant difference (p &lt;0.05). However, we found the absence of statistically significant differences (p &gt;0.05) in anthropometric characteristics, such as body length, body weight, body mass index, total fat content and its distribution in individual parts of the body, total water content, muscle weight and bone mass between the officer groups. But also, we found that the content of visceral fat in officers of the second period of adulthood was statistically significantly higher (p &lt;0.05), which indicates the presence of age-related changes in the distribution of visceral fat in the body. Comparison of the average group results of five skin-fat folds in the studied groups of officers did not reveal statistically significant differences (p &gt;0.05). These results indicate that the distribution of fat mass in officers of the operational level of the first and second periods of adulthood may be similar and the age factor does not significantly affect this aspect of anthropometry. We established the absence of a statistically significant (p &gt;0.05) difference in girth measurements of various body parts (neck, shoulder, wrist, chest, waist, pelvis, hip) between operational level officers of both age groups. This means that the indicators of physical development of operational-level servicemen remain stable during the first and second periods of adulthood. Conclusion. The obtained results of the study indicate the absence of a statistically significant (p &gt;0.05) difference between the vast majority of the studied indicators. Also, that the physical development of operational level officers of both age groups remains stable, except for certain aspects such as visceral fat content.

Analysis of volume and topography of adipose tissue in the trunk: Results of MRI of 11,141 participants in the German National Cohort

This research addresses the assessment of adipose tissue (AT) and spatial distribution of visceral (VAT) and subcutaneous fat (SAT) in the trunk from standardized magnetic resonance imaging at 3 T, thereby demonstrating the feasibility of deep learning (DL)-based image segmentation in a large population-based cohort in Germany (five sites). Volume and distribution of AT play an essential role in the pathogenesis of insulin resistance, a risk factor of developing metabolic/cardiovascular diseases. Cross-validated training of the DL-segmentation model led to a mean Dice similarity coefficient of >0.94, corresponding to a mean absolute volume deviation of about 22 ml. SAT is significantly increased in women compared to men, whereas VAT is increased in males. Spatial distribution shows age- and body mass index-related displacements. DL-based image segmentation provides robust and fast quantification of AT (≈15 s per dataset versus 3 to 4 hours for manual processing) and assessment of its spatial distribution from magnetic resonance images in large cohort studies.

The Influence of FAM13A and PPAR-γ2 Gene Polymorphisms on the Metabolic State of Postmenopausal Women

Recently, we have observed two significant pandemics caused by communicable (COVID-19) and non-communicable factors (obesity). Obesity is related to a specific genetic background and characterized by immunogenetic features, such as low-grade systemic inflammation. The specific genetic variants include the presence of polymorphism of the Peroxisome Proliferator-Activated Receptors gene (PPAR-γ2; Pro12Ala, rs1801282, and C1431T, rs3856806 polymorphisms), β-adrenergic receptor gene (3β-AR; Trp64Arg, rs4994), and Family With Sequence Similarity 13 Member A gene (FAM13A; rs1903003, rs7671167, rs2869967). This study aimed to analyze the genetic background, body fat distribution, and hypertension risk in obese metabolically healthy postmenopausal women (n = 229, including 105 lean and 124 obese subjects). Each patient underwent anthropometric and genetic evaluations. The study has shown that the highest value of BMI was associated with visceral fat distribution. The analysis of particular genotypes has revealed no differences between lean and obese women except for FAM13A rs1903003 (CC), which was more prevalent in lean patients. The co-existence of the PPAR-γ2 C1431C variant with other FAM13A gene polymorphisms [rs1903003(TT) or rs7671167(TT), or rs2869967(CC)] was related to higher BMI values and visceral fat distribution (WHR > 0.85). The co-association of FAM13A rs1903003 (CC) and 3β-AR Trp64Arg was associated with higher values of systolic (SBP) and diastolic blood pressure (DBP). We conclude that the co-existence of FAM13A variants with C1413C polymorphism of the PPAR-γ2 gene is responsible for body fat amount and distribution.

Application of food exchange portion method in home-based nutritional intervention for elderly patients with chronic heart failure

BackgroundThe home treatment of elderly patients with chronic heart failure (CHF) is often accompanied by malnutrition, which increases the risk of re-hospitalisation and affects the prognosis. Therefore, how to effectively improve the nutritional self-management of patients is a current focus of medical research. This study aims to test the effect of home-based nutritional intervention method on improving the nutritional status of elderly patients with CHF.MethodsA total of 90 hospitalised elderly patients with CHF were randomly divided into the experimental group (n = 45) and the control group (n = 45). The patients in both groups were given standardised drug therapy and their nutritional status was evaluated using a body composition analyser prior to discharge (protein, body fat percentage, visceral fat area, skeletal muscle, upper arm muscle circumference, left lower limb and right lower limb muscle mass), with the cardiopulmonary function evaluated using a six-minute walk test and the metabolic equivalents method. The control group was given general nutrition education and routine dietary guidance from cardiac rehabilitation nurses, while the experimental group was given an individualised nutrition prescription by dietitians based on the evaluation results, according to which one-to-one food exchange dietary intervention training was given until the patients mastered the process.ResultsThe nutritional indexes at the end of the study were significantly higher in the experimental group than in the control group and were higher than those before the intervention (P < 0.05). The muscle circumference of the upper arm, the muscle mass of the left lower limb and the right lower limb had no statistical significance following the intervention compared to the control group and before the intervention (P > 0.05). The cardiopulmonary function indexes were significantly better in the experimental group at the end of the study than before the intervention and were better than those in the control group, with statistically significant differences (P < 0.05), while no significant changes were observed in the control group before and after the intervention (P > 0.05).ConclusionThe home-based nutritional intervention method of food exchange portions can effectively improve the nutritional status of elderly patients with CHF, with the distribution of visceral fat more reasonable and the cardiopulmonary function and exercise endurance improved.

Obesity and Cardiovascular Risk among South Asian Americans.

South Asian Americans experience higher cardiometabolic risk and disproportionately high rates of cardiovascular disease (CVD) compared to other racial and ethnic groups in the United States. The purpose of this review is to summarize recent evidence about the role of obesity in CVD risk in South Asian Americans and identify key evidence gaps and future directions for research and interventions for obesity in this group. South Asian Americans are predisposed to abdominal obesity and have a higher distribution of visceral fat, intermuscular fat, and intrahepatic fat compared to adults of other race and ethnic groups. In this population, the risk for cardiometabolic disease appears to be elevated even at a normal body mass index. Social, cultural, religious, interpersonal, and environmental factors are related to obesity and obesity-related behaviors among South Asian Americans. There is a relatively high prevalence of obesity in South Asian-origin populations in the United States, who have unique socio-cultural determinants of overweight and obesity. Future research should clarify why the risk for metabolic disease and CVD is elevated at normal BMI in the South Asian American population, and environmental and other structural factors that may influence obesity in this group. Interventions must be adapted to the social and cultural context of South Asian Americans to improve effectiveness and implementation.

Correlation of Triglyceride/HDL-Cholesterol Ratio and Visceral Adiposity Index with 25(OH)D in Obese Female

Obesity is a condition of excess body fat mass with cardiometabolic complications. The levels of serum 25-hydroxyvitamin D (25(OH)D) decrease in obesity because it is stored in adipose tissue compartments and is related to dyslipidemia conditions. A high triglyceride/HDL-cholesterol (TG/HDL-C) ratio in obesity is related to dyslipidemia. Visceral Adiposity Index (VAI) is one of the parameters indicating central obesity related to visceral fat distribution in dyslipidemia conditions. This study aimed to prove a correlation between TG/HDL-C ratio and VAI with 25(OH)D levels in obese females. Observational study with cross-sectional design in 66 female patients. HDL-C examinations and triglyceride using the enzymatic colorimetry method. The TG/HDL-C ratio was calculated by dividing TG by HDL. The equation obtained visceral adiposity index (WC/(36.58+(1.89xBMI)) x (TG/0.81) x (1.52/HDL). 25(OH)D examinations used the Enzyme Linked Fluorescent Immunoassay (ELFA) method. Relationship status used the spearman rank test (p&lt;0.05). Median 25(OH) levels were 9.75 (8-18.6)ng/mL. There was a weak negative correlation between TG/HDL-C ratio with 25(OH)D levels in obese females (p=0.020; r= -0.287) and VAI with 25(OH)D in obese females (p=0.019; r= 0.287). There was a weak negative correlation between TG/HDL ratio and VAI with 25(OH)D in obese female patients.

Selective targeting of visceral adiposity by polycation nanomedicine.

Obesity is a pandemic health problem with poor solutions, especially for targeted treatment. Here we develop a polycation-based nanomedicine polyamidoamine generation 3 (P-G3) that-when delivered intraperitoneally-selectively targets visceral fat due to its high charge density. Moreover, P-G3 treatment of obese mice inhibits visceral adiposity, increases energy expenditure, prevents obesity and alleviates the associated metabolic dysfunctions. In vitro adipogenesis models and single-cell RNA sequencing revealed that P-G3 uncouples adipocyte lipid synthesis and storage from adipocyte development to create adipocytes that possess normal functions but are deficient in hypertrophic growth, at least through synergistically modulating nutrient-sensing signalling pathways. The visceral fat distribution of P-G3 is enhanced by modifying P-G3 with cholesterol to form lipophilic nanoparticles, which is effective in treating obesity. Our study highlights a strategy to target visceral adiposity and suggests that cationic nanomaterials could be exploited for treating metabolic diseases.

Association between the visceral adiposity index and risks of all-cause and cause-specific mortalities in a large cohort: Findings from the UK biobank

Background and aimsThe visceral adiposity index (VAI) has been recently established as a measure of visceral fat distribution and is shown to be associated with a wide range of adverse health events. However, the precise associations between the VAI score and all-cause and cause-specific mortalities in the general population remain undetermined. Methods and resultsIn this large-scale prospective epidemiological study, 357,457 participants (aged 38–73 years) were selected from the UK Biobank. We used Cox competing risk regression models to estimate the association between the VAI score and all-cause, cardiovascular disease (CVD), cancer, and other mortalities. The VAI score was significantly correlated with an increased risk of all-cause mortality (hazard ratio [HR], 1.200; 95% confidence interval [CI], 1.148–1.255; P < 0.0001), cancer mortality (HR, 1.224; 95% CI, 1.150–1.303; P < 0.0001), CVD mortality (HR, 1.459; 95% CI, 1.148–1.255; P < 0.0001), and other mortalities (HR, 1.200; 95% CI, 1.148–1.255; P < 0.0001) after adjusting for a series of confounders. In addition, the subgroup analyses showed that HRs were significantly higher in participants who were male, aged below 65 years, and body mass index less than 25. ConclusionIn summary, VAI was positively associated with an increased risk of all-cause and cause-specific mortalities in a nationwide, well-characterised population identified in a UK Biobank. The VAI score might be a complementary traditional predictive indicator for evaluating the risk of adverse health events in the population of Western adults aged 38 years and older.

Effects of age and gender on body composition indices as predictors of mortality in middle-aged and old people

To determine whether body composition indices interact with age and gender as a predictor of all-cause mortality, 1200 participants at least 40 years of age were recruited in 2009 and 2010. A multi-frequency bioelectrical impedance analysis device was used to measure each participant’s body composition indices, including the fat mass index (FMI), fat free mass index (FFMI), skeletal muscle mass index (SMMI), and visceral fat area index (VFAI). A baseline questionnaire was used to collect demographic information about lifestyle habits, socioeconomic status, and medical conditions. All claimed records of death from 2009 to 2018 in the National Health Insurance Research Databank were identified. The all-cause mortality rate was 8.67% after a mean follow-up period of 5.86 ± 2.39 person-years. The Cox proportional hazard model analysis showed significantly negative associations between FFMI or SMMI with all-cause mortality in the total group and those aged geq 65 y/o. The FFMI and SMMI were negative predictors of mortality in both genders. The FMI and VFAI were positive predictors of mortality exclusively in females. In conclusion, the SMMI is a better predictor of mortality than the BMI, FMI, and FFMI, especially in older adults. A higher fat mass or visceral fat distribution may predict higher mortality in females.

Correlation of Menopausal Status with Body Composition and Abdominal Fat Distribution

Background: Body composition parameters changes in women before and after menopause which makes ageing more complex and stressful in women.&#x0D; Objective: to compare the body composition parameters among pre and post menopausal women.&#x0D; Methods: A cross-sectional study, conducted in the population around Rural Health Training Centre (RHTC), Barabanki district between May to December 2016 among women in the age group 25-65 years. Body composition parameters of 348 women (total and visceral fat distribution) by bioelectric impedance method (for Model: OMRON Hbf 375) was noted for all the pre-menopausal and post-menopausal women. The variables included -weight, BMI, body fat percentage (BF %) and visceral fat percentage (VF %), Body Surface Area (BSA), Body volume index (BVI), Body volume (BV) and Lean body weight (LBM).&#x0D; Result: The difference in body composition parameters in the pre and post-menopausal groups is found to be statistically significant in waist circumference, waist-hip ratio, BMI and visceral fat p&lt;0.05.&#x0D; Conclusion: There is increase in body composition parameters during post-menopausal period. A deeper aspect on prevention of obesity after menopause is required to be studied.

Relationship of Visceral Adiposity Index with New-Onset Hyperuricemia in Hypertensive Patients

Background: Visceral adiposity index is a new type of indicator that accurately reflects distribution and function of visceral fat. The relation between VAI and new-onset hyperuricemia remains largely understudied. Purpose: This study sought to further investigate the prospective association between VAI and the risk of hyperuricemia by examining possible effect modifies in hypertensive patients. Methods: We enrolled 10,513 hypertensive patients with normal uric acid (UA) concentrations (&lt;357 μmol/L (6 mg/dL)) who participated the UA Sub-study of the China Stroke Primary Prevention Trial (CSPPT). Our primary outcome was new-onset hyperuricemia, which was defined as a UA concentration ≥417 μmol/L (7 mg/dL) in men or ≥357 μmol/L (6 mg/dL) in women at the exit visit. Results: Over a median follow-up of 4.4 years, 1,642 (15.6%) participants developed new-onset hyperuricemia. When VAI was assessed as quartiles, a significantly higher risk of new-onset hyperuricemia was found in participants in quartile 4 (≥2.98; odds ratio, 1.17; 95% CI: 1.01-1.36) compared with those in quartile 1-3 (&lt;2.98). Furthermore, we discovered that the positive relation was independent of abnormal VAI components or numbers of abnormal VAI components (all P-interactions &gt; 0.05). Conclusion: There was a positive relationship between baseline VAI and the risk of new-onset hyperuricemia in a sample of Chinese hypertensive individuals.

Increased visceral fat distribution and body composition impact cytokine release syndrome onset and severity after CD19 chimeric antigen receptor T-cell therapy in advanced B-cell malignancies.

Chimeric antigen receptor T-cell (CAR-T) therapy is associated with a distinct toxicity profile that includes cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). CRS is characterized by the release of pro-inflammatory cytokines such as interleukin 6 (IL-6) and is closely linked to CAR-T expansion and bystander cells like monocytes/macrophages. In other hyperinflammatory states, obesity contributes to inflammatory cascades and acts as a risk factor for disease severity. We aimed to study the influence of anthropometric and body composition (BC) measurements on CAR-T-related immunotoxicity in 64 patients receiving CD19-directed CAR-T for relapsed/refractory B-cell malignancies. Patients with grade ≥2 CRS presented with a significantly higher median body mass index (BMI), waist circumference, waist-to-height ratio (WtHR) and visceral adipose tissue (VAT). These parameters were also found to be associated with an earlier CRS onset. Other adipose deposits and muscle mass did not differ between patients with grade 0-1 CRS versus grade ≥2 CRS. Moreover, BC parameters did not influence ICANS severity or onset. In a multivariate binary logistic regression incorporating known risk factors of immunotoxicity, the factors BMI, waist circumference, WtHR and VAT increased the probability of grade ≥2 CRS. Receiver operating characteristic analyses were utilized to determine optimal discriminatory thresholds for these parameters. Patients above these thresholds displayed markedly increased peak IL-6 levels. Our data imply that increased body composition and VAT in particular represent an additional risk factor for severe and early CRS. These findings carry implications for risk-stratification prior to CD19 CAR-T and may be integrated into established risk models.