BACKGROUND . Changes in the human nutrition profile have led to excessive consumption of fats and carbohydrates, which is accompanied by the development of metabolic syndrome (MS). The main studies of the mechanisms of MS are performed on males, the features of MS in females have not been sufficiently studied. OBJECTIVE . The objective was to assess the state of lipid and carbohydrate metabolism, the functional state of the mesenteric arteries in intact and ovariectomized female Wistar rats under a high-fat dietary load. MATERIALS AND METHODS . Four groups of female rats were used: HFD (high fat diet, n=14), intact, receiving 50% fat in the diet, HFD (n=14) — ovariectomized, receiving 50% fat, CG (n=12) — intact, receiving a standard diet, OvCG (n=12) — ovariectomized, receiving a standard diet. After 10 weeks, the responses of mesenteric arteries precontracted with phenylephrine to acetylcholine (ACh) in the absence and with the use of an NO synthase blocker (L-NAME), as well as to sodium nitroprusside (NP), were studied using microphoto- and video recording of the vessel diameter in vivo. The state of carbohydrate and lipid metabolism, arterial pressure (BP), and the level of visceral obesity were assessed. The study refers to an interventional single-sample controlled study. RESULTS . In the absence of differences in body weight in HFD and OvHFD rats, excess fat intake leads to visceral obesity, increased triglyceride and LDL levels, increased blood pressure, and insulin resistance compared to CG and OvCG. Evaluation of mesenteric artery dilation at an ACh concentration of 10–5 mol/L showed that in HFD females the relaxation amplitude was 19.9% lower than in CG, and in OvHFD it was 21.3% lower than in OvCG. Compared with the magnitude of dilation on ACh without blockers, pre-incubation of vessels with L-NAME led to a decrease in the amplitude of ACh-induced vascular relaxation in CG by 68.0±3.6%, in OvCG by 70.1±3.4%, in HFD by 48.4±2.9%, in OvHFD by 55.1±3.9%. NP-induced vasodilation was reduced in HFD rats by 32.3%, in OvHFD by 32.2% compared with CG and OvCG. CONCLUSION . Excessive fat consumption by female rats is accompanied by visceral obesity, increased blood pressure, dyslipidemia, and impaired carbohydrate metabolism, dyslipidemia. The development of MS is accompanied by endothelial dysfunction, manifested by a decrease in ACh-induced dilation due to both the suppression of NO production by the endothelium and a decrease in the sensitivity of SMC to NO, while in ovariectomized females, visceral obesity without a decrease in vascular reactivity compared to intact animals.

BACKGROUND : Androgen deficiency associated with type 2 diabetes mellitus (T2DM) is one of the components of the metabolic syndrome, which is followed by visceral obesity. The pathogenetic features of the functioning of adipose tissue in patients with a combination of pathologies such as T2DM and hypogonadism have been studied extremely little. AIMS : To measure the effect of testosterone (T) deficiency on metabolic parameters and secretory activity of adipose tissue in men suffering from T2DM. MATERIALS AND METHODS : Patients with T2DM and hypogonadism were subjected to a series of general clinical studies, studied the degree of disturbance of carbohydrate and lipid metabolism, as well as the lipid accumulation index LAP, and also the level of hormones produced by adipose tissue (resistin, adiponectin and leptin) and sex hormones. RESULTS : The study involved 276 male patients with T2DM (aged 54.0 (8.0) years), divided into 2 groups: group 1 consisted of patients with hypogonadism (n=124); 2nd — eugonadal patients (n=152). Along with insulin resistance, men suffering from T2DM in combination with hypogonadism have hyperinsulinemia and dyslipidemia, more significant disturbances in the secretory activity of adipose tissue: an increase in leptin concentration by 18.4% (p=0.03), resistin by 2 times (p < 0.001), and a 1.7-fold decrease in the level adiponectin (p=0.006). This pattern clearly demonstrates the fundamental importance T deficiency in men with T2DM in the formation of metabolic disorders, as well as dysfunction of adipose tissue. CONCLUSIONS : Decreased T production in patients with T2DM worsens the disturbance of carbohydrate and lipid metabolism, and also the dysfunction of adipose tissue, the main pathophysiologic basis for cardiometabolic diseases.

Background: Visceral fat mass index (vFMI), a key visceral obesity marker, is linked to insulin resistance and cardiovascular impairment. This study examined the relationship between vFMI, people living with diabetes, and its vascular complications. Methods: Data from NHANES (2011–2018) were used, including participants aged 18 years and older. Multivariable logistic regression models examined associations between vFMI and diabetes, diabetic nephropathy (DN), and cardiovascular disease (CVD). Result: A total of 4,847 participants were included, comprising 2,469 (50.9%) males and 2,378 (49.1%) females, with a mean age of 40 years. The prevalence of diabetes, DN, and CVD was 11.6% (567), 2.8% (136), and 4.3% (208), respectively. Participants in the highest vFMI quartile had a markedly higher risk of diabetes [odds ratio (OR): 5.85, 95% confidence interval (CI): 3.25 to 10.55], DN (OR: 2.84, 95% CI: 0.89 to 9.08), and CVD (OR: 2.55, 95% CI: 1.10 to 5.93) versus the lowest quartile. Nonlinear regression identified critical thresholds for log-transformed vFMI, beyond which risks sharply increased: 0.252 for diabetes and 0.241 for DN. Subgroup analysis showed stronger associations in younger participants (≤40 years), those with lower triglyceride levels, and those with higher β-cell function. Conclusion: Higher vFMI correlates with greater prevalence of diabetes and related complications, indicating that visceral fat plays a critical role in their development.

Estrogen deficiency after menopause promotes visceral fat accumulation and insulin resistance, thereby increasing the risk of type 2 diabetes. Although hormone replacement therapy is partially effective, its use is limited by increased risks of cardiovascular disease and breast cancer, underscoring the need for safer preventive strategies. The rare sugar D-allulose has been reported to stimulate secretion of glucagon-like peptide-1 (GLP-1), a gut hormone, and improve obesity and glucose metabolism, suggesting its potential as a novel intervention for postmenopausal metabolic dysfunction. Here, we examined whether D-allulose improves obesity and glucose intolerance in a GLP-1-dependent manner under sucrose-fed conditions, using ovariectomized (OVX) female C57BL/6J mice as a model of menopause. OVX mice, but not sucrose-fed sham mice, developed exacerbated visceral obesity and glucose intolerance in response to dietary sucrose, despite similar total energy intake. Daily oral administration of D-allulose for two weeks significantly suppressed visceral fat accumulation, improved insulin resistance, and ameliorated glucose intolerance in sucrose-fed OVX mice. These beneficial effects were markedly attenuated in GLP-1 receptor knockout mice. Taken together, we found that sucrose intake after ovariectomy exacerbates visceral obesity and glucose intolerance, and that D-allulose effectively ameliorates these metabolic abnormalities. GLP-1-stimulating dietary components such as D-allulose may represent a safe and promising preventive strategy for metabolic dysfunction associated with menopause.

Obesity, especially visceral obesity, is highly prevalent in women with polycystic ovary syndrome (PCOS) and may adversely affect fertility outcomes. Body roundness index (BRI) is an anthropometric indicator of visceral adiposity, yet evidence linking BRI to key reproductive outcomes remains limited in PCOS. This secondary analysis included 998 Chinese women from the Polycystic Ovary Syndrome Acupuncture and Clomiphene Trial (PCOSAct). Baseline BRI was calculated from waist circumference and height measurements, and reproductive outcomes were obtained after interventions. Baseline BRI was calculated from height, weight, and waist circumference and analyzed as quartiles (Q1: < 2.97, Q2: 2.97-3.78, Q3: 3.78-4.87, Q4: ≥ 4.87) and as a continuous variable. Logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs) for ovulation, conception, clinical pregnancy, and live birth, adjusting for interventions, age, systolic and diastolic blood pressure (SBP and DBP). Nonlinearity was assessed using restricted cubic splines (RCS), with model fit compared against linear models using likelihood ratio tests. In total, 780 participants regained ovulation, 320 achieved conception, 218 attained clinical pregnancy, and 205 had a live birth. Higher BRI quartiles were associated with worse anthropometric, metabolic, and hormonal profiles at baseline. In regression analyses, higher BRI quartiles were generally associated with lower odds of reproductive outcomes, with significant trends across quartiles after adjustment. Restricted cubic spline analyses showed no evidence of nonlinearity for ovulation or conception (P-nonlinear = 0.951 and 0.301), but significant nonlinearity for clinical pregnancy and live birth (P-nonlinear = 0.016 and 0.025). Higher BRI was associated with poorer reproductive outcomes in women with PCOS, with evidence of nonlinear associations for clinical pregnancy and live birth. BRI may provide clinically relevant information beyond general adiposity for reproductive risk stratification in PCOS.

Visceral obesity-induced METTL27 regulation of the FABP5/PPARD/CPT1A axis in promoting colorectal cancer progression.

While the gut microbiota plays a critical role in host metabolism, epidemiological evidence linking microbiota-targeted dietary patterns to visceral fat obesity (VFO) remains limited. Using data from 8080 adults aged 20-59 years participating in the National Health and Nutrition Examination Survey (NHANES) 2011-2018, we examined the associations of the Dietary Index for Gut Microbiota (DI-GM) and dietary live microbe intake with visceral fat area (VFA) and VFO, and further explored the potential mediating role of serum vitamin D. Multivariable linear and logistic regression models were applied to assess associations with VFA and VFO, respectively, with restricted cubic spline analyses (RCS) used to evaluate potential non-linear relationships. Higher DI-GM quartiles were significantly associated with lower odds of VFO (Q4 vs. Q1, OR = 0.58; 95% CI: 0.43-0.79; p < 0.001), independent of demographic, lifestyle, and dietary covariates. Similar inverse associations were observed for higher dietary live microbe intake (G3 vs. G1, OR = 0.66; 95% CI: 0.55-0.81; p < 0.001). RCS analyses indicated an approximately linear inverse association between DI-GM and VFA (nonlinear p = 0.097) and a significant nonlinear inverse relationship between MedHi and VFA (nonlinear p < 0.001). Mediation analyses revealed that serum vitamin D partially mediated the associations between DI-GM and VFO (16.8% mediated, p < 0.001), and between dietary live microbe intake and VFO (17.0% mediated, p < 0.001). In summary, higher adherence to gut microbiota-targeted diets (DI-GM and live microbe intake) was associated with lower VFA and VFO, with serum vitamin D statistically mediating part of these associations. These findings highlight potential links among diet, vitamin D status, and VFO and warrant further investigation in longitudinal and interventional studies.

Visceral Obesity as a Predictor of Clinical Relapse in Inflammatory Bowel Disease.

High prevalence of visceral obesity and its associated complications underscore the importance of accurately quantifying visceral adipose tissue (VAT) depots. While whole-body MRI offers comprehensive insights into adipose tissue distribution, it is resource-intensive. Alternatively, evaluation of defined single slices provides an efficient approach for estimation of total VAT volume. This study investigates the influence of sex-, age-, and BMI on VAT distribution along the craniocaudal axis and total VAT volume obtained from single slice versus volumetric assessment in 3D MRI and aims to identify age-independent locations for accurate estimation of VAT volume from single slice assessment. This secondary analysis of the prospective population-based German National Cohort (NAKO) included 3D VIBE Dixon MRI from 11,191 participants (screened between May 2014 and December 2016). VAT and spine segmentations were automatically generated using fat-selective images. Standardized craniocaudal VAT profiles were generated. Axial percentage of total VAT was used for identification of reference locations for volume estimation of VAT from a single slice. Data from 11,036 participants (mean age, 52 ± 11 years, 5681 men) were analyzed. Craniocaudal VAT distribution differed qualitatively between men/women and with respect to age/BMI. Age-independent single slice VAT estimates demonstrated strong correlations with reference VAT volumes. Anatomical locations for accurate VAT estimation varied with sex/BMI. The selection of reference locations should be different depending on BMI groups, with a preference for caudal shifts in location with increasing BMI. For women with obesity (BMI >30 kg/m2), the L1 level emerges as the optimal reference location.

ANTHROPOMETRIC, SOCIODEMOGRAPHIC AND METABOLIC FACTORS ASSOCIATED WITH CLINICALLY EXPRESSED INSULIN RESISTANCE IN INDIVIDUALS WITH TYPE 2 DIABETES

The triglyceride-glucose (TyG) index has been recognized as a surrogate marker for insulin resistance (IR) and an independent risk factor for cardiovascular disease (CVD). However, the combined effect of the TyG index and visceral obesity on CVD incidence remains unclear. We aimed to investigate the interaction, joint association, and potential mediators between the TyG index and comprehensive anthropometric indices with CVD risk in middle-aged and older adults. We analyzed 7046 participants aged ≥ 45years without baseline CVD from the China Health and Retirement Longitudinal Study (CHARLS) over a 9-year follow-up period. Retrospective collection included sociodemographic details, health status, physical examination results, and blood biomarkers. Adjusted Cox proportional hazards models were used to examine the interaction between TyG levels and anthropometric indices and their joint associations with CVD incidence. Subgroup analyses were conducted to evaluate the associations across different populations, and mediation analysis was performed to identify potential mediating pathways. The predictive value was determined using the area under the curve (AUC) of receiver operating characteristic curves. In addition, we validated the findings in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. In the CHARLS study, 1768 (25.1%) participants developed CVD. All TyG-anthropometric indices exhibited significant positive associations with the incidence of CVD. TyG-waist-to-height ratio (WHtR) showed the strongest association, with each 1-SD increase correlating with a 25% increase in CVD risk. Elevated systolic and diastolic blood pressure (BP) levels partially mediated these associations. TyG-weight-adjusted waist index (WWI) indicated the highest predictive performance in CHARLS, while TyG-conicity index (ConI) was the most predictive in the MESA cohort. Across both cohorts, TyG-WHtR provided the most substantial incremental improvement to the baseline model. Models combining TyG-anthropometric indices showed higher prediction accuracy and goodness of fit than the basic model combining TyG or anthropometric indices alone. Decision curve analysis showed that TyG-WC and TyG-ConI yielded the superior net clinical benefits for CVD prediction. Subgroup analyses demonstrated consistent associations between TyG-anthropometric indices and CVD incidence across different clinical characteristics and sociodemographic groups. The integration of TyG with anthropometric indices strengthened its association with CVD incidence. While TyG-WWI and TyG-ConI exhibited the highest predictive ability in the CHARLS and MESA cohorts, respectively, TyG-WHtR consistently yielded the greatest improvement to traditional risk models. Elevated BP levels partially mediated this association. Early intervention targeting visceral adiposity and impaired insulin sensitivity is crucial for mitigating CVD incidence in middle-aged and older adults.

This study aimed to investigate the association between early-onset type 2 diabetes (EOT2D) and the risk of falls, focusing on the role of sarcopenic obesity. A total of 580 patients (290 with EOT2D and 290 with late-onset type 2 diabetes [LOT2D]) were selected through propensity score matching. Participants were categorized into four groups: non-sarcopenia/non-obesity, obesity-only, sarcopenia-only, and sarcopenic obesity. Binary logistic regression models were employed to examine the relationships between age at diabetes onset, sarcopenic obesity, and fall risk. Additionally, 472 patients were followed longitudinally to assess the associations between EOT2D, LOT2D, sarcopenic obesity, and fall risk. Patients with EOT2D exhibited a higher prevalence of sarcopenic obesity compared to those with LOT2D. EOT2D was significantly associated with an increased risk of falls, both directly and indirectly via sarcopenic obesity (β = 0.81, ORSO-VFA = 2.25, 95% CI: 1.79-2.82). EOT2D patients with sarcopenic obesity, particularly characterized by visceral fat area (VFA), demonstrated a substantially higher fall risk (HREOT2D+SO-VFA = 3.98; 95% CI: 2.57-6.16) compared to those with sarcopenia or obesity alone. Patients with EOT2D are more prone to developing sarcopenic obesity, and visceral obesity contributes to the elevated risk of falls in this population. Therefore, interventions to preserve muscle mass and strength while reducing visceral fat accumulation are critical in mitigating fall risk among patients with EOT2D.

THE AIM : to study the genetic aspects of metabolically healthy and metabolically complicated obesity in Uzbek women - the prevalence of polymorphisms of the PPARGC1A Gly482Ser gene, as well as to assess its relationship with the functional state of the kidneys, clinical, metabolic, hormonal parameters. PATIENTS AND METHODS : The study involved 224 obese Uzbek women, who were divided into 2 groups: group 1 consisted of 133 women with metabolically complicated obesity, and group 2 consisted of 91 women with metabolically healthy obesity. The control group consisted of 45 healthy women with representative data. In the observation groups, anthropometric parameters, blood pressure, and body composition were determined - the amount of fluid in the body, the visceral obesity index, fat mass, the proportion of active cell mass, the musculoskeletal mass index, and the body water content were studied. We also studied biochemical analyses and the lipid spectrum, the levels of leptin, insulin, cystatin C and uromodulin, IL-6, alpha-TNF, CRP in blood serum, gradations of microalbuminuria in urine, calculated GFR for cystatin C and creatinine, and compared the obtained indicators. The results of all the above studies were compared with the frequency of occurrence of Gly and Ser allele genotypes, GlyGly, GlySer, and SerSer genotypes of the Gly482Ser polymorphism of the PPARGC1A gene in all groups. RESULTS : When studying the functional state of the kidneys, depending on the occurrence of genotypes of the Gly482Ser polymorphism of the PPARGC1A gene in the MOO group, the following was found. Serum creatinine and cystatin C levels in carriers of the SerSer genotype in the MOO group were significantly higher than in carriers of the GlySer and GlyGly genotypes, as well as in carriers of the SerSer genotype in the comparison groups; the highest MAU and the lowest GFR were found, calculated on the basis of both uromodulin and creatinine and cystatin. When studying the distribution of genotypes depending on the gradation of MAU, the following was revealed. The prevalence of the SerSer genotype in the MOO group is consistent with an increase in the MAU graduation rate. On the contrary, the frequency of occurrence of the GlyGly genotype was higher in patients in the group with optimal MAU. In the MZO group, the SerSer genotype was more common with a slightly increased MAU. On the contrary, the prevalence of the GlyGly genotype decreased with an increase in the MAU graduation rate. CONCLUSION . Thus, when analyzing the frequency of alleles and genotypes of the Gly482Ser polymorphism of the PPARGC1A gene, depending on the degree of obesity in the groups, the following was revealed. The Ser allele has an aggressive character in relation to an increase in BMI and the development of MOO, and the Gly allele of this polymorphism has demonstrated a protective character in relation to the development of MOO. The SerSer genotype was significantly more common in the MOO group with grade III obesity, while the GlyGly genotype was significantly more common in the control group. Consequently, in the MOO group, the prevalence of the Ser allele and the SerSer genotype of the Gly482Ser polymorphism of the PPARGC1A gene corresponded to an increase in BMI. In the MHO group, the prevalence of the Ser allele and the SerSer genotype of this polymorphism increased in accordance with an increase in BMI. In this group, the prevalence of the Gly allele and the GlyGly genotype decreased, as opposed to an increase in BMI. It was also found that the SerSer genotype of the Gly482Ser polymorphism of the PPARGC1A gene has a pathogenetic significance in the deterioration of the functional state of the kidneys in both phenotypes of obesity, while the GlyGly genotype, on the contrary, has a protective effect on the progression of this patholo

Cushing syndrome (CS) is caused by an increase in endogenous or exogenous glucocorticoids, leading to major alterations in body composition, including visceral obesity, sarcopenia, osteoporosis, type 2 diabetes, and dyslipidemia. Cardiovascular complications resulting from CS are often lethal. We previously demonstrated that CS induced by oral corticosterone (CORT) supplementation in mice can be prevented by inhibition of the peptide hormone acyl-CoA binding protein (ACBP), encoded by the gene diazepam binding inhibitor (DBI). Here, we investigated whether ACBP/DBI inhibition could be used to treat, rather than prevent, CS. To this end, we initiated treatment with anti-ACBP/DBI monoclonal antibodies (mAbs) in mice three weeks after the start of CORT supplementation, when hyperphagia and body weight gain were already established. Two anti-ACBP/DBI mAbs, 7G4a (specific for mouse ACBP/DBI only) and 82 (which recognizes both mouse and human ACBP/DBI), were able to normalize food intake and halt weight gain in mice under continuous CORT treatment. In addition, both mAbs attenuated CORT-induced sarcopenia, adiposity in inguinal, perigonadal, and visceral fat depots, and fully restored metabolic parameters, including type-2 diabetes, insulinemia, free fatty acids, triglycerides, and liver transaminases. In conclusion, neutralization of ACBP/DBI may serve as an effective therapeutic strategy for the treatment of established CS.

Abstract Background: While obesity is associated with increased risk of aggressive prostate cancer, mechanisms remain unclear. Periprostatic adipose tissue (PPAT), a visceral fat depot surrounding the prostate, may influence tumourigenesis via inflammatory and metabolic pathways. Prior research is limited to small studies of men with prostate cancer. This study characterises PPAT in a large, longitudinal cohort of prostate cancer-free men and examines its relationship with anthropometric, metabolic, demographic and lifestyle factors. Methods: Using magnetic resonance images (MRIs) from 27,748 male UK Biobank participants, an nnUNet autosegmentation model was used to quantify the volume of PPAT, defined as adipose tissue surrounding the prostate and anterior to the rectal wall. Spearman and partial correlation assessed the relationship of PPAT volume with other adiposity and anthropometric measures, and with markers of systemic metabolic health. Age and race-adjusted linear regression examined associations of log-transformed, standardised measures of PPAT volume, and of other adiposity measures, with demographic and lifestyle characteristics. Beta coefficients were exponentiated to estimate percentage differences. Results: Men had a median PPAT volume of 14ml (interquartile range (IQR), 8-23ml) and median abdominal visceral adipose tissue (VAT) volume of 4.7L (IQR 3.2-6.3L). PPAT volume correlated more strongly with VAT volume (r=0.61) than with other anthropometric measures, including body mass index (BMI; r=0.47) or waist circumference (r=0.48). Correlations of PPAT with systemic measures of metabolic health were weak (all r&amp;lt;0.3) and attenuated (all r&amp;lt;0.1) after adjusting for VAT using partial correlation. While VAT volume was 19% higher in older (65+ years) relative to younger men (&amp;lt;45 years), PPAT volume more than doubled over this age range (+104%). By contrast, BMI was lower in older vs younger men (-19%). While black men had higher BMI relative to white men (+20%), they had less VAT (-56%) and PPAT (-31%). Associations of PPAT volume with lifestyle characteristics followed similar patterns as for VAT, although slightly less pronounced. Men completing higher level education vs high school only had less PPAT (-14%) and less VAT (-23%). Relative to sedentary men, those reporting physical activity equating to an hour moderate intensity or 30 minutes high intensity activity per day had less PPAT (-20%) and less VAT (-28%). Men with benign prostatic hyperplasia (BPH) had higher PPAT (+9%) but no significant difference in VAT volume. Conclusions: In the largest study to date in prostate cancer-free men, we find that PPAT is closely associated with visceral obesity and more strongly associated with aging than other adiposity measures. Weak correlations of PPAT with measures of systemic metabolic health imply any influence on prostate growth and tumorigenesis may be through local effects. Associations of PPAT volume with lifestyle characteristics may support its modifiable nature, potentially through interventions to reduce visceral adiposity. Citation Format: Jade Dorrian, Emma H. Allott, Ryan O’Keeffe, Angela O'Neill, Sarah Winter, Joshua Atkins, Mahboubeh Parsaeian, Karl Smith-Byrne, Amy Dawes, Vilmundur Guðnason, Ruth Travis, Tom Gaunt, Michelle Leech. Characterization of periprostatic adipose tissue in 27,748 Men: Links to visceral fat, aging, and factors relevant to prostate cancer [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Innovations in Prostate Cancer Research and Treatment; 2026 Jan 20-22; Philadelphia PA. Philadelphia (PA): AACR; Cancer Res 2026;86(2_Suppl):Abstract nr B015.

BACKGROUNDElderly patients with colorectal cancer (CRC) can judge the risk of postoperative complications and oncological outcomes due to visceral obesity, which can provide data reference for the early prediction of prognosis.AIMTo explore the effect of visceral obesity on postoperative complications and oncological outcomes in elderly patients with CRC.METHODSA total of 150 elderly patients who underwent radical surgery for CRC at Inner Mongolia Medical University and Inner Mongolia Autonomous Region People’s Hospital from January 2021 to June 2024 were retrospectively analyzed. Patients were divided into the abdominal [visceral fat area (VFA) ≥ 100.00 cm2, n = 80] and non-abdominal (VFA < 100.00 cm2, n = 70) obesity groups according to the VFA measured by preoperative computed tomography. The two groups showed no significant differences in age, sex, tumor location, tumor-node-metastasis stage, and underlying disease (P > 0.05). All patients underwent standardized laparoscopic assisted surgery and received unified perioperative management. Complications, nutritional status, changes in biochemical indicators, and tumor recurrence and metastasis were evaluated postoperatively.RESULTSThe overall incidence of postoperative complications was significantly higher in the abdominal obesity group than in the non-abdominal obesity group (P < 0.05). The pulmonary infection on postoperative day (POD) 3 (P = 0.038), anastomotic leakage on POD 7 (P = 0.042), and moderate-to-severe complications (Clavien-Dindo class III, P = 0.03) were significantly different. With respect to biochemical indicators, the white blood cell count, neutrophil percentage, and C-reactive protein level in the abdominal obesity group continuously increased after surgery (P < 0.05); the albumin level on POD 1 was even lower (P = 0.024). Regarding tumor markers, carcinoembryonic antigen (P = 0.039) and carbohydrate antigen 19-9 (P = 0.048) levels were significantly higher in the abdominal obesity group at 3 months after surgery, and local recurrence rates were higher than those in the non-abdominal obesity group at 30 days and 3 months after surgery (P < 0.05). Abdominal obesity was an independent risk factor for postoperative complications (odds ratio: 3.843, P = 0.001), overall survival [hazard ratio (HR): 1.937, P = 0.011], and disease-free survival (HR: 1.769, P = 0.018).CONCLUSIONVisceral obesity significantly increases the risk of postoperative complications in elderly patients with CRC and may adversely affect short-term tumor prognosis. Preoperative risk identification and interventions for abdominal obesity should be strengthened to improve perioperative safety and postoperative rehabilitation quality.

BackgroundThe majority of studies have predominantly used body mass index or waist circumference as measures to establish a link between urinary metals and obesity, leading to inconsistent outcomes. Visceral fat index was a simple, practical and non-invasive physical examination indicator for measuring visceral obesity, and the association between urinary metal and VFI is unclear.MethodsThis study utilized a cross-sectional design and based on the baseline data of the Prospective Cohort Study of Chronic Diseases in Ethnic Minority Natural Population in Guangxi from May 2019 to December 2019. Information on demographics, health status, lifestyle, and additional variables was obtained through structured face-to-face interviews. The study employed multiple statistical models, including lasso regression, logistic regression, restricted cubic spline, quantile g-computation, weighted quantile sum, and Bayesian kernel machine regression.ResultsThis study encompassed a total of 5794 participants, comprising 2641 males and 3153 females. Among the participants, 1423 (24.6%) were individuals with visceral obesity. The natural log-transformed urinary concentrations of metals are denoted as “ln” followed by the element symbol (e.g., lnSb for antimony, lnZn for zinc, lnRb for rubidium). LnSb (OR = 1.260, 95% CI: 1.149–1.383, P < 0.001) and lnZn (OR = 1.343, 95% CI: 1.134–1.591, P < 0.001) showed a positive association with visceral obesity. In contrast, lnRb (OR = 0.741, 95% CI: 0.624–0.881, P < 0.001) exhibited a negative association with this condition. A dose–response relationship was observed for lnSb (P-overall < 0.001, P-nonlinear = 0.244), lnZn (P-overall = 0.048, P-nonlinear = 0.592), lnRb (P-overall = 0.035, P-nonlinear = 0.482), and lnMg (female: P-overall = 0.005, P-nonlinear = 0.004; 60–74 years: P-overall = 0.089, P-nonlinear = 0.028) in relation to visceral obesity. The mixed effects on visceral obesity revealed significant differences in both positive (P = 0.003) and negative (P = 0.043) directions. In addition, an interaction effect was observed between lnSb (lnRb or lnZn) and the other six metals.ConclusionUrinary Sb and Zn as potential risk factors, and Rb as a potential protective factor, for visceral obesity, demonstrating significant overall and interactive effects arising from metal co-exposure. These findings underscored the critical role of environmental metal exposure, especially from mixtures, in the prevention and management of obesity and associated metabolic disorders.Graphical Supplementary InformationThe online version contains supplementary material available at 10.1186/s40001-026-03880-5.

BackgroundInsulin resistance and visceral obesity are key pathologic mechanisms of CVD. However, the combined effect of the triglyceride glucose (TyG) index and body roundness index (BRI) on CVD risk in the diabetic population has not been thoroughly investigated.MethodsThe cohort study used data from four waves of the China Health and Retirement Longitudinal Study (CHARLS) conducted from 2011 to 2018, involving 1,010 participants with diabetes. Participants were categorized according to the median TyG index and/or BRI. Cox proportional risk regression models were used to examine the individual and joint associations of the two metrics with CVD risk. The study further estimated additive and multiplicative interaction effects.ResultsDuring a median follow-up of 7 years, 251 participants developed CVD. The study confirmed a significant joint association between TyG index and BRI and the development of CVD in middle-aged and elderly persons with diabetes. Specifically, after adjusting for confounders, participants with both high TyG index and high BRI had a 123% increased risk of CVD compared with participants with both low TyG index and low BRI, and 85% for high BRI alone. In addition, the study did not find an additive and multiplicative interaction between BRI and TyG index on CVD.ConclusionThis study found that high TyG index and high BRI were significantly associated with increased risk of new-onset CVD in a Chinese middle-aged and elderly diabetic population, and the combined assessment of the TyG index and BRI enhanced the prediction of CVD.

Sex, location, and visceral adipose tissue (VAT) influence the course of Crohn’s disease (CD). However, the combined impact of these factors has not been consistently or thoroughly considered in anti-tumour necrosis factor-α (anti-TNF-α) therapy. This study aims to investigate how sex, location, and VAT levels affect the efficacy of IFX treatment in CD patients. This retrospective multicenter study included 182 CD patients (120 males and 62 females) who received IFX therapy between January 2014 and January 2024. There was a statistically significant difference in remission rates between male visceral obesity group (M-VATH) and male non-visceral obesity group (M-VATL) at 6 months (p < 0.001) and 12 months (p < 0.001). Similar differences in remission rates were observed between the male colon-uninvolved visceral obesity group and the male colon-uninvolved non-visceral obesity group at 6 months (p < 0.001) and 12 months (p < 0.001). Additionally, serum TNF-α concentrations (p = 0.010)and IFX trough concentrations (p = 0.003) showed significant differences between M-VATH and M-VATL. The VAT area was identified as a predictor of IFX efficacy in male patients, with an area under the receiver operating characteristic curve of 0.813, sensitivity of 73.9%, and specificity of 78.1% (95% CI, 0.730–0.896). Sex and location influence the predictive function of VAT for IFX efficacy. VAT may be an accurate predictor of IFX efficacy in male colon-uninvolved CD patients.

The effect of myopenia, myosteatosis and visceral obesity on postoperative complications and inflammation in colorectal surgery.