Influence of body composition on short- and long-term clinical outcomes in patients undergoing laparoscopic gastrectomy.

The joint effect of cardiometabolic index and high-sensitivity C-reactive protein on incident cardiovascular disease: A prospective cohort study.

Pathophysiology and pharmacotherapy of cardiovascular complications in metabolic syndrome.

South Asians exhibit an unfavourable metabolic phenotype characterized by visceral obesity, insulin resistance and dyslipidemia. While various hormones play a critical role in regulating postprandial energy metabolism, it remains unclear whether they respond differently to food intake. We aimed to compare the meal-induced excursion of incretin hormones (GLP-1 and GIP) and glucagon between South Asians and Europids. Forty nine young, lean South Asian (n = 24), and Europid (n = 25) males and females underwent an extended (up to 240 min) mixed meal tolerance test (MMTT). At seven time points circulating incretins (active and total GLP-1 and GIP), glucagon, and parameters related to glucose (i.e., glucose, insulin) and lipid metabolism were measured. In response to the MMTT, Europids generally exhibited a single peak in glucose levels at t = 30 min, while South Asians tended to display a biphasic glucose response, with peaks at t = 30 and t = 90 min. Among South Asian males, this was accompanied by an increased insulin response, characterized by elevated levels at the corresponding glucose peaks. South Asian females, however, demonstrated a marked drop in circulating glucagon at t = 90 min, and biphasic excursions of total and active GLP-1 and GIP (t = 30 and t = 120 min). Postprandial lipid excursions did not differ between ethnicities. In contrast to a monophasic glucose response to the MMTT of Europids, South Asians tended to exhibit a biphasic glucose response, with sex-specific hormonal patterns, suggesting altered incretin and insulin dynamics despite similar postprandial lipid excursions. ClinicalTrials.gov (NCT05829018; registration date: 25-04-2023).

Arterial stiffness with aging predicts cardiovascular diseases (CVDs) and target organ damage. While sarcopenia has been linked to arterial stiffness, the association of myosteatosis and visceral adiposity with arterial stiffness remains underexplored. As age-related fat redistribution, including myosteatosis and visceral obesity, often precedes the overt sarcopenia, their early evaluation may be beneficial in preventing arterial stiffness. Therefore, this cross-sectional study aimed to assess whether myosteatosis and visceral obesity are associated with increased arterial stiffness. A total of 6,004 subjects without CVD who underwent abdominal computed tomography and brachial-ankle pulse wave velocity (baPWV) between 2012 and 2013 during health examinations were included. Visceral fat area and total abdominal muscle area (TAMA) were measured at the L3 vertebral level. Muscle quality was assessed using the normal attenuation muscle area (NAMA)/TAMA index, where a lower value indicates a reduced proportion of healthy muscle (NAMA) and a higher presence of myosteatosis. After adjusting for multiple cardiovascular risk factors, including myosteatosis, visceral obesity was significantly associated with elevated baPWV in men (odds ratio [OR]=1.32; 95% confidence interval [CI]=1.10 to 1.60; P=0.004). In contrast, in women, myosteatosis was significantly associated with elevated baPWV in a fully adjusted model that included visceral obesity (OR=3.26; 95% CI=1.13 to 9.44; P=0.029). Ectopic fat infiltration, including visceral obesity and myosteatosis, was significantly associated with increased arterial stiffness. Notably, visceral obesity was significantly associated with elevated baPWV in men, while myosteatosis was significant in women after adjustment.

Background: There are numerous concerns that women have regarding menopause. The purpose of this study was to identify any changes in hormone levels or visceral fat that laser acupuncture could alleviate in postmenopausal women. Methods: This randomized controlled trial involved 40 menopausal women aged from 50 to 65 years with visceral obesity, body mass index (BMI) > 30 Kg/m2, and waist-tohip ratio (WHR) > 0.8. All cases were classified into two groups: Group A was given laser acupuncture in addition to traditional lifestyle change in a low-calorie diet and aerobic exercise, and Group B received traditional treatment only. Results: Pre-intervention (weight, BMI, waist circumference, WHR, serum insulin, and satiety-hunger zone) were insignificantly different in both groups (P > 0.05); in contrast to Group B, Group A experienced a substantial decrease in post-intervention (P < 0.05). The satiety zone was markedly lower at post-intervention in Group A compared to Group B (P < 0.05). After-intervention BMI, weight, WHR, waist circumference, and serum insulin were significantly lower than pre-intervention values in both groups (P < 0.05). Conclusion: Laser acupoints were associated with an improvement in visceral fat and serum insulin levels in postmenopausal women, demonstrating reduced satiety and increased hunger.

Background: Proper nutrition plays a crucial role in post-kidney transplantation care, influencing graft function, body composition, and the risk of metabolic complications. Protein intake is of particular importance due to its role in preserving muscle mass and preventing protein energy wasting. Objective: This study aimed to assess dietary intake, with emphasis on protein consumption, and to analyze its associations with nutritional status, anthropometric indices, and metabolic complications in kidney transplant recipients. Materials and Methods: A cross-sectional study was conducted in 71 adult kidney transplant recipients. Dietary intake was assessed using a 24 h dietary recall and the FFQ-6 questionnaire. Anthropometric measurements were performed, and multiple indices of body composition and central obesity were calculated. Associations between dietary intake, anthropometric parameters, age, and kidney graft function were analyzed. Results: Mean BMI was within the upper normal range; however, a high prevalence of central adiposity was observed. Age was positively correlated with indices of visceral obesity (ABSI, AVI, WHtR, and CI). Protein intake was positively associated with calf circumference, indicating a relationship with muscle mass preservation. Dietary analysis revealed excessive sodium intake and insufficient intake of potassium, calcium, vitamin D, and unsaturated fatty acids. Post-transplant diabetes mellitus was present in 25.35% of participants. Conclusions: Kidney transplant recipients frequently present with unfavorable body composition and dietary imbalances that are not adequately reflected by BMI alone. Comprehensive nutritional assessment and individualized dietary counseling are important strategies that may help reduce the risk of metabolic complications and support long-term transplant outcomes.

Ultrasound-measured visceral adipose tissue thickness and carotid atherosclerosis in patients with inflammatory bowel diseases.

Changes in body composition (BC) are associated with outcomes in colorectal cancer (CRC), with adverse features such as sarcopenia, myosteatosis, and excess adiposity linked to the systemic inflammatory response (SIR). Whilst ethnic differences in BC have been identified in healthy populations, little is known about how ethnicity influences BC and SIR in patients with CRC. This study is aimed at assessing the impact of ethnicity on preoperative BC and SIR in patients undergoing surgery for CRC. A multivariate analysis was conducted on a prospectively collected database of CRC patients treated between May 2007 and January 2017. Retrospective augmentation of the dataset included CT-derived BC data and inflammatory markers. BC was assessed at the third lumbar vertebra using Slice-O-Matic v5.0 with the ABACS L3 plug-in. Predefined thresholds were applied to classify sarcopenia, myosteatosis, visceral obesity (VO), and sarcopenic obesity (SO). SIR was defined using clinically relevant cut-offs: neutrophil-to-lymphocyte ratio (NLR) > 3, platelet-to-lymphocyte ratio (PLR) > 150, and modified Glasgow Prognostic Score (mGPS) > 0. Ethnicity was recorded using the UK Office for National Statistics 2001 coding and categorised as White (WBB), Black or Black British (BBB), Asian or Asian British (AAB), or Other. WBB served as the reference group for all comparisons. A total of 776 patients were included in the final analysis (56% male; median age 69years, IQR 60-78). Compared to WBB, BBB patients were significantly less likely to be sarcopenic (OR 0.35, 95% CI 0.194-0.624, p = 0.0001), whilst AAB patients were more likely to be sarcopenic (OR 2.02, 95% CI 1.26-3.24, p = 0.003). BBB patients were also significantly less likely to be myosteatotic (OR 0.39, 95% CI 0.21-0.73, p = 0.003). AAB patients showed a trend toward lower BMI-defined obesity (OR 0.58, 95% CI 0.32-1.04, p = 0.067). No significant ethnic differences were observed for VO or SO. With respect to inflammation, AAB and BBB patients were significantly less likely to exhibit an NLR > 3 (OR 0.34, 95% CI 0.20-0.56, p = 0.0001 and OR 0.35, 95% CI 0.17-0.74, p = 0.006 respectively). AAB patients were also significantly less likely to have a PLR > 150 (OR 0.57, 95% CI 0.36-0.92, p = 0.021). No significant association was found between ethnicity and mGPS. Ethnicity significantly influences body composition and systemic inflammation in patients with CRC. These findings challenge previous models that have not accounted for ethnic variation and highlight the need for ethnicity to be considered in both prognostic modelling and personalised supportive care. Future studies should explore the relationship between BC, inflammation, and oncological outcomes within individual ethnic groups to inform tailored interventions and risk stratification strategies.

Previous studies have demonstrated a link between visceral obesity and depression. Nevertheless, there is a lack of sufficient studies examining the relationship between visceral adipose tissue volume (VATV) and depression, particularly concerning the combined influence of physical activity on this connection. The study analyzed data from the National Health and Nutrition Examination Survey cycles spanning 2011-2018. A total of 7460 individuals aged between 20 and 59 years were included. VATV was evaluated using either dual-energy x-ray absorptiometry or magnetic resonance imaging. Multivariate logistic regression models were applied to investigate the relationship between VATV and depression. Mendelian randomization analysis was carried out to examine potential causal relationships. In the fully adjusted multivariate logistic regression model, a significant positive association was found between VATV and depression (OR, 1.04; 95% CI, 1.01-1.07). Lower VATV levels combined with effective physical activity significantly reduced depression prevalence. Mendelian randomization analysis identified a causal relationship between VATV and depression. Our study highlights a positive association between visceral fat and depression. Furthermore, participants who regularly engage in physical activity and have low VATV levels are more strongly associated with a reduced prevalence of depression. Importantly, the causal association between them was confirmed. These findings underscore the potential of managing visceral fat to prevent depression.

Recent experimental and clinical studies have expanded the understanding of the mechanisms underlying metabolic and gastrointestinal adverse effects of olanzapine, an atypical antipsychotic widely used in the treatment of psychotic disorders and associated with the development of obesity. The present study aimed to elucidate the mechanisms of pathological changes in the esophageal mucosa of rats under conditions of administration of different doses of olanzapine. A total of 15 male rats were included and randomly assigned to experimental groups. Biochemical parameters of the esophageal mucosa were assessed, including the content of glycosaminoglycans (GAGs), free fucose, hydroxyproline, thiobarbituric acid-reactive substances (TBARS), oxidatively modified proteins (OMP), as well as the activity of catalase, proteinases, and their inhibitors. It was found that endogastric administration of olanzapine at doses of 4 mg/kg and 8 mg/kg body weight resulted in the development of visceral obesity, as evidenced by a significant increase in body mass index, Lee index, and visceral fat mass in experimental animals compared with intact controls. Analysis of changes in the esophageal mucosa revealed that olanzapine-induced visceral obesity led to the activation of free radical processes, as indicated by a significant increase in the levels of OMP and TBARS compared to intact animals. Additionally, a significant increase in GAGs, hydroxyproline, and free fucose content in the esophageal mucosa of experimental rats was observed compared with the control group, indicating enhanced catabolism of glycoproteins and proteoglycans in the connective tissue of the rat esophagus. Thus, the use of atypical antipsychotics, particularly olanzapine, contributes to the development of oxidative stress, activation of proteolysis, and intensified degradation of fucoproteins, proteoglycans, and collagen proteins of the esophagus.

Obesity is a known risk factor for recurrence following ventral hernia repair. BMI is often used to define obesity, and we have previously shown a BMI > 33.67 associated with higher recurrence. In 2023, AMA policy highlighted BMI as an imperfect measurement of obesity and recommended limitations to its use. This study's objective was to evaluate the association between anterior-to-posterior abdominal wall depth (APD) in CT measurements with hernia recurrence as an alternative to BMI. Data was retrospectively collected for patients from a county healthcare system, undergoing elective ventral hernia repair from 2014 to 2020 with fascial defects > 4cm and preoperative CT scans. CART analysis was performed to determine the APD threshold for recurrence. Receiver operating characteristic (ROC) curve analysis was performed to compare APD and BMI as predictors of recurrence. Kaplan-Meier analysis was used to depict the recurrence-free survival period. 267 patients met our inclusion criteria. Mean APD at L4 was 27.67cm. APD of 29.7cm was determined as the threshold for recurrence. Area under the curve for APD > 29.7cm and BMI > 33.67 were 0.617 (p = 0.046) and 0.577 (p=0.189) respectively. Five-year recurrence free survival was 70% for APD ≤ 29.7cm and 37% for APD > 29.7cm. In our study, the use of APD CT measurements provided an objective, reproducible, and rapid method to augment preoperative evaluation for visceral obesity and the risk for hernia recurrence that was not reliant on traditional BMI, and, in fact, improved upon a simple BMI threshold.

Background To further assess the relationship between obesity and infertility, we employed a novel anthropometric index, specifically designed to assess the relationship between a body shape index (ABSI) and infertility in women of childbearing age. Furthermore, we examined the correlation between ABSI and visceral obesity index (VAI) in relation to infertility. Methods A total of 1989 female participants of childbearing age were included, based on National Health and Nutrition Examination Survey (NHANES) data from 2013 to 2016. The ABSI is calculated by dividing waist circumference by body mass index (BMI) 2/3* height1/2. VAI was calculated using the following formula: waist circumference/(36.58 + (1.89*BMI)) x (triglycerides/0.81) × (1.52/HDL cholesterol). Infertility or fertility status was defined by interviewing female participants of childbearing age through a reproductive health questionnaire. Weighted multifactorial logistic regression analysis was used to explore the independent relationship between ABSI and infertility. Smoothed curve fitting, subgroup analyses and interaction tests were also performed. Results Among the 1989 participants, 183 (9.2%) women were categorized as infertile. Logistic regression modeling showed that ABSI was positively associated with infertility and remained significant even after adjusting for all confounders(OR = 1.31, 95% CI: 1.07–1.60, p = 0.0098). This association was consistent across all subgroups (age, race, smoking, alcohol consumption, hypertension, diabetes mellitus, and the regularity of menstruation over the previous 12 months), (p > 0.05 for all interactions). The results of the smooth curve fitting demonstrated a linear, positive association between ABSI and infertility. Conclusion There is a statistically significant positive correlation between body mass index and infertility. As a body shape index rises, women of childbearing age are at greater risk of infertility.

Visceral obesity contributes to hypertension through pathways of insulin resistance and inflammation. The joint association of C-reactive protein-triglyceride-glucose index (CTI), which integrates these pathways, and anthropometric indices with incident hypertension remains unclear, especially across different baseline blood pressure. The data for this study were obtained from the China Health and Retirement Longitudinal Study (CHARLS) across the 2011 to 2020 survey waves. Participants were stratified based on the median values of anthropometric indices and CTI. The associations with incident hypertension risk were evaluated using Kaplan-Meier curves, multivariable Cox regression, and restricted cubic spline (RCS) methods. Predictive performance was assessed by receiver operating characteristic (ROC) curve analysis, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Mediation and interaction analyses were conducted to explore potential mediating effects and the robustness of the findings. Among 4,735 eligible participants, the median age was 56years, and 46.04% were male. During the 9-year follow-up period, 1,852 participants (39.37%) developed hypertension. Cox regression analysis revealed that Compared with subjects with lower levels of both anthropometric indices and CTI, those with higher levels of both exhibited the highest risk of hypertension. Individuals with both BRI and CTI above the median consistently exhibited the highest risk of hypertension across all subgroups: HR = 1.51, 95% CI: 1.33-1.71 in the total population; HR = 1.58, 95% CI: 1.29-1.93 in the normal BP group; and HR = 1.45, 95% CI: 1.23-1.71 in the elevated BP group. After incorporating anthropometric indices and CTI into the basic model, the predictive performance for hypertension was significantly improved. The integrated model of BRI and CTI demonstrated the best overall predictive performance (AUC = 0.747). Mediation analysis revealed that CTI significantly mediated the association between anthropometric indices and hypertension. These anthropometric indices and CTI effectively predicted hypertension risk across populations with different baseline blood pressures, both independently and in combination. Among all evaluations, the combination of BRI and CTI emerged as the optimal approach, most robustly associated with incident hypertension and providing the greatest improvement in risk discrimination and reclassification.

BackgroundComputed tomography (CT) enables non-invasive, comprehensive assessment of body composition in patients with cancer. In pancreatic ductal adenocarcinoma (PDAC), where weight and body composition change during treatment are common, serial CT evaluation may provide prognostic insights.MethodsPatients with non-metastatic PDAC treated with first-line mFOLFIRINOX between January 2017 and December 2020 were retrospectively included. Body composition at the L3 vertebral level was quantified at baseline and 12-week CT scans using a previously validated AI tool (AID-U™; iAID Inc.). Skeletal muscle area, muscle attenuation, and body fat area were used to derive skeletal muscle index (SMI), normal-to-total attenuation muscle area ratio (NAMA/TAMA), visceral fat area (VFA), and subcutaneous fat index (SFI), representing muscle mass, muscle quality, and visceral and subcutaneous adiposity, respectively.ResultsA total of 733 patients with baseline CT scans were included in the analyses, and 595 patients with paired CT scans at baseline and at 12 weeks after initiation of mFOLFIRINOX were included in longitudinal change analyses. Subsequent curative resection was performed in 269 (34.6%) patients. Overall, SMI, VFA, SFI, and body mass index (BMI) declined significantly over the first 12 weeks, particularly among patients who did not undergo curative resection and in those with progressive disease. In resected patients, baseline visceral obesity was associated with worse OS. In non-resected patients, larger 12-week decreases in SMI, SFI, and BMI were associated with poorer OS.ConclusionSerial CT-based assessment of body composition during chemotherapy may provide valuable prognostic information in non-metastatic PDAC.

Introduction/Objectives: Body composition changes and diet quality may contribute to metabolic complications and graft outcomes after kidney transplantation. We evaluated the relationships between diet quality and CT-derived body composition components (skeletal muscle mass, muscle quality/myosteatosis, and visceral adiposity) and explored their associations with metabolic markers and graft function. Materials and Methods: In this single-center retrospective cross-sectional study, we included 161 adult first kidney transplant recipients (KTRs) with a functioning graft and ≥12 months of follow-up. Body composition was quantified on routine abdominal CT at the L3 level using skeletal muscle index (SMI), mean muscle attenuation (Hounsfield units) for myosteatosis, and visceral adipose tissue area (VAT). Diet quality was scored using the Revised Diet Quality Index (DQI-R). Graft function was followed with creatinine-based estimated glomerular filtration rate (eGFR) calculated by the CKD-EPI equation. Results: Mean age was 45.7 ± 13.2 years and 58% were men. The prevalence of low muscle mass was 26.0%, myosteatosis 73.5%, and visceral obesity (VAT ≥ 100 cm2) 45.6%. No participant had "good" diet quality; 48.4% had poor diet quality. DQI-R showed a weak positive correlation with SMI (r = 0.157; p = 0.047) but was not significantly related to VAT, subcutaneous adipose tissue (SAT), Kidney transplant recipient (VSR) or myosteatosis. In multivariable models, age and VAT were associated with HbA1c, whereas body composition and diet quality variables were not independent predictors of eGFR. Myosteatosis was independently associated with older age. Conclusions: Visceral adiposity and impaired muscle quality frequently clustered and were linked to metabolic status. These findings support post-transplant follow-up strategies that go beyond BMI and integrate body composition and nutritional assessment within a multidisciplinary care model.

Visceral obesity is considered an important risk factor for hypertension. However, there is little research on visceral obesity and hypertension in patients with diabetes or prediabetes. Body roundness index (BRI) serves as a proxy for visceral adiposity. Therefore, the purpose of this study is to investigate the relationship between BRI and hypertension and blood pressure in diabetes (DM) or prediabetes (preDM). This study includes data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018, including 5368 participants with DM and preDM. Weighted multiple regression, restricted cubic spline (RCS), and subgroup analysis were used to evaluate the correlation between BRI and hypertension risk as well as blood pressure. This study included a total of 1565 DM subjects and 3803 preDM participants. The prevalence of hypertension in the two groups was 67.80% and 42.28%, respectively. After adjusting for potential confounding factors, BRI was significantly positively correlated with the risk of hypertension, systolic blood pressure (SBP), and diastolic blood pressure (DBP) in both DM and preDM. In the fully adjusted model, an increase in BRI was positively associated with the risk of hypertension in both DM and preDM participants (DM OR: 1.25, 95% CI: 1.16-1.34, P < 0.0001; preDM OR: 1.20, 95% CI: 1.14-1.26, P < 0.0001). Further RCS analysis revealed a significant nonlinear relationship between BRI and hypertension and DBP in DM and preDM, while there was a linear positive correlation with SBP. Interaction analysis indicated that in male preDM, BRI was associated with a higher risk of hypertension (male OR: 1.28, 95% CI: 1.19-1.39, female OR: 1.12, 95% CI: 1.07-1.17, P for interaction <0.01). Additionally, in preDM under the age of 60, BRI showed a stronger positive correlation with SBP and DBP (OR: 1.23, 95% CI: 0.94-1.52, P < 0.0001; OR: 0.68, 95% CI: 0.45-0.90, P < 0.0001). However, these findings were not observed in DM. In diabetes and prediabetes, BRI exhibits a significant positive correlation with the risk of hypertension, as well as with systolic and diastolic blood pressure. Based on these findings, BRI may serve as a biomarker for managing the progression of hypertension in patients with DM and preDM.

Aim. To evaluate the association between abdominal fat distribution and metabolic score of insulin resistance (IR) — Mets-IR, depending on the presence of metabolic syndrome (MS) in patients with stable coronary artery disease (CAD). Material and methods. Sixty-one patients with chronic CAD. The significance of coronary atherosclerosis was determined using the Gensini Score. MS was defined according to the International Diabetes Federation criteria (2005). Abdominal magnetic resonance imaging (MRI) was performed at the L4-L5 level to determine the volume of abdominal fat depots. Blood glucose and insulin levels, lipid profile parameters, and adipokines were determined. Insulin resistance was assessed by calculating the homeostatic model assessment of IR (HOMA-IR) and Mets-I R. Results. The MS group had significantly higher body mass indices and waist circumference, and between-group differences were found in glucose, serum leptin, and Mets-IR levels. In the MS group, abdominal subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) showed a strong correlation with Mets-I R. Patients with severe IR were characterized by increased VAT and SAT volumes; no difference in the VAT/SAT ratio was found. Body mass index, waist circumference, serum glucose, triglyceride, and high-sensitivity C-reactive protein levels were significantly higher, while high-density lipoprotein cholesterol levels were lower with greater IR severity. Conclusion. The relationship between IR and abdominal adipose tissue volume varies depending on the severity of IR and differs depending on the presence of metabolic syndrome. Among individuals with chronic coronary artery disease (CAD), abdominal visceral obesity is associated with metabolic syndrome. The use of Mets-IR has demonstrated its validity in assessing IR in patients with CAD and metabolic syndrome, as well as a strong association with magnetic resonance imaging (MRI) parameters of abdominal fat depot volume.

Background: Green tea catechins and inulin may improve metabolic health and modulate the gut microbiota; however, double-blind trials evaluating visceral fat, insulin resistance, and microbiota concurrently are limited. Methods: We conducted a double-blind, parallel-group, randomized, placebo-controlled trial in Japanese adults aged 20-75 years with visceral fat area (VFA) ≥ 80 cm2 and BMI ≥ 23 kg/m2 (trial registration: Japan Registry of Clinical Trials (jRCT), jRCTs021230004 (registered 16 May 2023)). Participants were randomized to a catechin + inulin beverage (catechins 400 mg/day; inulin 2.3 g/day) or placebo for 12 weeks. The primary outcome was the change in VFA (bioelectrical impedance). Secondary outcomes included HOMA-IR, metabolic markers, liver fat assessed by the controlled attenuation parameter (CAP), and genus-level gut microbiota. Results: Ninety-six participants were randomized (catechin + inulin, n = 49; placebo, n = 47); 47 and 44, respectively, were included in the full analysis set for the primary outcome. The 12-week change in VFA did not differ between groups (mean change: +0.91 vs. +4.61 cm2; p = 0.243). HOMA-IR decreased in the catechin + inulin group and increased in the placebo group, yielding a significant between-group difference (mean change: -0.32 vs. +0.18; p = 0.020). No other secondary outcomes showed significant between-group differences. In exploratory microbiota analyses, no genus remained significant after false discovery rate correction; however, Coprococcus and Bifidobacterium showed nominal between-group differences (unadjusted p < 0.05). Changes in Coprococcus were inversely correlated with changes in HOMA-IR (r = -0.28; p = 0.010). Conclusions: Catechin plus inulin for 12 weeks did not reduce visceral fat but was associated with improved insulin resistance. Exploratory analyses suggest a potential association between increased Coprococcus and improved HOMA-IR, warranting further investigation.

Obesity is an established risk factor for chronic kidney disease (CKD). However, excess visceral adipose tissue (VAT) termed visceral obesity (VO) can occur in individuals with normal body mass index (BMI) or overweight. VO is associated with impaired kidney function but its effect on kidney morphology remains unclear. This study aimed to examine the association of VO with glomerular ultrastructure, podocyte morphometry (podometrics), and the kidneys' ability for compensation after uninephrectomy in normal BMI and overweight individuals. VAT was retrospectively quantified in computed tomography (CT) of 52 patients (BMI < 30 kg/m2) who underwent nephrectomy for nonmetastatic renal tumor without previous chemotherapy or immunotherapy. VO was defined as VAT area ≥ 100 cm2. Histological sections from nontumorous kidney regions were examined using deep learning-supported glomerular morphometry and podometrics (podocyte count, density, and nuclear volume). Renal compensation in the first year after nephrectomy (change in estimated glomerular filtration rate [ΔeGFR]) was assessed using linear regression. Of the 52 subjects with normal BMI or overweight, 35 were diagnosed with VO and exhibited a larger glomerular volume (2.6 ± 0.7 vs. 2.0 ± 0.5 ×106 μm3; P = 0.004), lower podocyte density (194 ± 50 vs. 243 ± 59 per 106 μm3; P = 0.003), and podocyte nuclear hypertrophy (226 ± 27 vs. 195 ± 22 μm3; P < 0.001). VO was associated with impaired eGFR compensation after uninephrectomy (ΔeGFR: -24 ± 15 vs. -12 ± 12 ml/min per 1.73 m2, P = 0.03). Structural changes, including glomerular enlargement (P = 0.005), podocyte density (P = 0.01), and nuclear hypertrophy (P = 0.003), were significantly associated with reduced ΔeGFR. VO was associated with glomerular and podocyte changes, and impaired kidney function compensation after nephrectomy in normal BMI and overweight individuals. These data suggest that VAT quantification could guide individual decision making in subjects planned for nephrectomy.