Objective: To analyze the correlation between visceral fat area and insulin resistance index (HOMA-IR) in patients with type 2 diabetes mellitus (T2DM) and abdominal obesity and to provide a reference for screening an...Objective: To analyze the correlation between visceral fat area and insulin resistance index (HOMA-IR) in patients with type 2 diabetes mellitus (T2DM) and abdominal obesity and to provide a reference for screening and related research of such patients. Methods: Two hundred patients with T2DM admitted to Guandu People’s Hospital of Kunming were included. The study was carried out from October 2022 to December 2023. The patients were divided into three groups according to different abdominal visceral fat areas (VFA): Group A (n = 65) was less than 75cm2, Group B (n = 75) was 75-100 cm2, and Group C (n = 60) was greater than 100 cm2. The subjects in the three groups were all tested for glycated hemoglobin (HbA1c), fasting insulin (FINS), and fasting blood glucose (FPG). Height and weight were measured to calculate body mass index (BMI). The HOMA-IR and TYG (fasting triglyceride and glycemic index) were also calculated. Changes in the BMI, VFA, HOMA-IR, and TYG levels were observed in the three groups. Results: The VFA, BMI, HbA1c, FPG, FINS, HOMA-IR, and TYG of the patients all increased, with a more significant increase in the BMI, FINS, HOMA-IR, and TYG levels (P < 0.01). Multiple linear stepwise regression analyses used visceral fat area (VFA) as the dependent variable. The results showed that VFA was closely related to BMI, FINS, HOMA-IR, and TYG. Conclusion: Early reduction of VFA to reduce insulin resistance may be a better treatment and effective method for T2DM, providing powerful measures and new strategies for effective blood sugar control and early prevention in the treatment of metabolic diseases.展开更多
BACKGROUND The preoperative prediction of peritoneal metastasis(PM)in gastric cancer would prevent unnecessary surgery and promptly indicate an appropriate treatment plan.AIM To explore the predictive value of viscera...BACKGROUND The preoperative prediction of peritoneal metastasis(PM)in gastric cancer would prevent unnecessary surgery and promptly indicate an appropriate treatment plan.AIM To explore the predictive value of visceral fat(VF)parameters obtained from preoperative computed tomography(CT)images for occult PM and to develop an individualized model for predicting occult PM in patients with gastric carcinoma(GC).METHODS A total of 128 confirmed GC cases(84 male and 44 female patients)that underwent CT scans were analyzed and categorized into PM-positive(n=43)and PM-negative(n=85)groups.The clinical characteristics and VF parameters of two regions of interest(ROIs)were collected.Univariate and stratified analyses based on VF volume were performed to screen for predictive characteristics for occult PM.Prediction models with and without VF parameters were established by multivariable logistic regression analysis.RESULTS The mean attenuations of VF_(ROI 1)and VF_(ROI 2)varied significantly between the PM-positive and PMnegative groups(P=0.044 and 0.001,respectively).The areas under the receiver operating characteristic curves(AUCs)of VF_(ROI 1)and VF_(ROI 2)were 0.599 and 0.657,respectively.The mean attenuation of VF_(ROI 2)was included in the final prediction combined model,but not an independent risk factor of PM(P=0.068).No significant difference was observed between the models with and without mean attenuation of VF(AUC:0.749 vs 0.730,P=0.339).CONCLUSION The mean attenuation of VF is a potential auxiliary parameter for predicting occult PM in patients with GC.展开更多
Objective:The present study was conducted to demonstrate the age-dependent changes in skeletal muscle mass and visceral fat area in a population of Chinese adults aged 30-92 years old.Methods:A total of 6669 healthy C...Objective:The present study was conducted to demonstrate the age-dependent changes in skeletal muscle mass and visceral fat area in a population of Chinese adults aged 30-92 years old.Methods:A total of 6669 healthy Chinese men and 4494 healthy Chinese women aged 30-92 years old were assessed for their skeletal muscle mass and visceral fat area.Results:The results showed age-dependent decreases in the total skeletal muscle mass indexes in both men and women aged 40-92 years old as well as age-dependent increases in the visceral fat area in men aged 30-92 years old and in women aged 30-80 years old.Multivariate regression models showed that the total skeletal muscle mass index was positively associated with the body mass index and negatively associated with the age and visceral fat area in both sexes.Conclusion:The loss of skeletal muscle mass becomes obvious at approximately 50 years of age,and the visceral fat area commences to increase at approximately 40 years of age in this Chinese population.展开更多
AIM： To examine whether visceral fat is associated with non-alcoholic steatohepatitis （NASH）, to assess for parameters associated with visceral adiposity and to investigate for factors associated with fibrotic seve...AIM： To examine whether visceral fat is associated with non-alcoholic steatohepatitis （NASH）, to assess for parameters associated with visceral adiposity and to investigate for factors associated with fibrotic severity in NASH. METHODS： Thirty NASH and 30 control subjects underwent biochemical tests, anthropometric assessment, bioelectrical impedance, dual energy X-ray absorptiometry and abdominal fat study by CT scan. Liver biopsies were graded according to the Brunt criteria. RESULTS： NASH subjects had elevated blood pressure, body mass index, waist circumference and waist-to-hip ratio. A greater number of diabetes rnellitus, impaired glucose tolerance test and HOMA-IR 〉 3.5 were found in NASH patients. HOMA-IR 〉 2.8 （OR 20.98, 95% CI 3.22-136.62; P 〈 0.001） and visceral fat area 〉 158 cm^2 （OR 18.55, 95% CI 1.60-214.67; P = 0.019） were independent predictors for NASH. Advanced stage of NASH was found in 15 （50%） patients. HOMA-IR 〉 3.5 （OR 23.12, 95% CI 2.00-266.23; P = 0.012） and grading of portal inflammation （OR 7.15, 95% CI 1.63-31.20; P = 0.009） were determined as independent risk factors for advanced stage of NASH. CONCLUSION： Obesity （especially central obesity） and metabolic syndrome are common in Thai NASH. Insulin resistance and elevated visceral fat are risk factors for the presence of NASH. The advanced stage of thedisease is related to insulin resistance.展开更多
BACKGROUND Obesity is a risk factor for non-alcoholic fatty liver disease(NAFLD),although obese patients with NAFLD do not always develop significant fibrosis.The distribution of body fat could predict the risk of NAF...BACKGROUND Obesity is a risk factor for non-alcoholic fatty liver disease(NAFLD),although obese patients with NAFLD do not always develop significant fibrosis.The distribution of body fat could predict the risk of NAFLD progression.AIM To investigate the role of bioelectrical impedance-estimated visceral fat(VF)in assessing NAFLD severity.METHODS In this cross-sectional study,patients with biopsy-proven NAFLD were prospectively included.All patients underwent anthropometric evaluation,blood tests and bioelectrical impedance analysis.RESULTS Between 2017 and 2020,119 patients were included[66.4%male,56 years(SD 10.7),62.2%obese,61.3%with metabolic syndrome].Sixty of them(50.4%)showed significant fibrosis(≥F2)in liver biopsy.Age,VF and metabolic syndrome were associated with significant fibrosis(61 years vs 52 years,16.4 vs 13.1,73.3%vs 49.2%,respectively;P<0.001 for all).In the multivariate analysis,VF and age were independently associated with significant fibrosis(VF,OR:1.11,95%CI:1.02-1.22,P=0.02;age,OR:1.08,95%CI:1.03-1.12,P<0.01).A model including these variables showed and area under the receiver operating characteristic curve(AUROC)of 0.75,which was not inferior to transient elastography or NAFLD fibrosis score AUROCs.We developed a nomogram including age and VF for assessing significant fibrosis in routine practice.CONCLUSION VF is a surrogate marker of liver fibrosis in patients with NAFLD.Bioelectrical impedance analysis is an inexpensive and simple method that can be combined with age to guide patient referral when other resources may be unavailable.展开更多
This study was aimed to examine the effect of ovariectomy on visceral fat, serum adi- ponectin levels and lipid profile. Forty-five female Sprague DawIey rats were divided into three groups （n=15 each）： ovariectomi...This study was aimed to examine the effect of ovariectomy on visceral fat, serum adi- ponectin levels and lipid profile. Forty-five female Sprague DawIey rats were divided into three groups （n=15 each）： ovariectomized group （OVX）, ovariectomized plus estrogen-treated group （OVX＋E2）, and sham-operated group （SHAM）. Body weight, abdominal adipose tissues, serum adiponectin and lipid profile were measured and compared among the groups after three-month feeding post-surgery. Signifi- cant increases in body weight and visceral fat were found in ovariectomized rats when compared with sham-operated ones and significant increases were also observed in serum adiponectin, triglyceride and very low density lipoprotein cholesterol levels in ovariectomized rats. Body weight, visceral fat and se- rum adiponectin levels were profoundly reduced in OVX＋E2 group as compared with OVX group. It was concluded that ovarian hormone deficiency induced by ovariectomy leads to significant increases in body weight and visceral fat, along with increased serum adiponectin, triglyceride and very low density lipoprotein cholesterol levels in rats. Attenuation in these changes can be achieved by estrogen supple- mentation.展开更多
Visceral fat is a specifi c fat that is produced in the body,transformed into cholesterol,and circulated in the blood to other parts of the body.The circulated cholesterol usually in the form of low-density lipoprotei...Visceral fat is a specifi c fat that is produced in the body,transformed into cholesterol,and circulated in the blood to other parts of the body.The circulated cholesterol usually in the form of low-density lipoproteins forms plaque on the walls of the arteries,thereby constricting and blocking them and preventing the free fl ow of nutrients to various vital organs in the body.Visceral fat is deleterious to the health of elderly people because it is mostly found in the region of the abdomen that houses vital organs such as the pancreas,liver,and digestive tract,and it further affects the normal functioning of hormones in the body.Globally,15 million people die of a noncommunicable disease(NCD)annually between the age of 30 years and the age of 69 years,and there is an increase in NCD morbidity among people older than 70 years.Accumulated visceral fat in elderly people could have deleterious health consequences,as it is a predisposing factor for many other NCDs and chronic health conditions.Sedentary lifestyle,unhealthy eating,stress,and inactivity are the major causes of excessive visceral fat.However,measures to prevent the accumulation of visceral fat are straightforward,and impressive results are achieved with regular physical exercise,healthy diet choices,and proper stress management.展开更多
Background and Aims:Intra-abdominal visceral fat accumulation and patatin-like phospholipase domain containing 3(PNPLA3)rs738409 G/C gene polymorphism confer a greater susceptibility to nonalcoholic fatty liver diseas...Background and Aims:Intra-abdominal visceral fat accumulation and patatin-like phospholipase domain containing 3(PNPLA3)rs738409 G/C gene polymorphism confer a greater susceptibility to nonalcoholic fatty liver disease(NAFLD).We examined whether the relationship between visceral fat accumulation and liver disease severity may be influenced by PNPLA3 rs738409 polymorphism.Methods:The variant of PNPLA3 rs738409 was genotyped within 523 Han individuals with biopsy-confirmed NAFLD.Visceral fat area(VFA)was measured by bioelectrical impedance.Significant liver fibrosis(SF),defined as stage F≥2 on histology,was the outcome measure of interest.Results:The distribution of PNPLA3 genotypes was CC:27.5%,CG:48.2%,and GG:24.3%.Higher VFA was associated with greater risk of having SF(adjusted-odds ratio[OR]:1.03;95%confidence interval[CI]:1.02–1.04,p<0.05),independent of potential confounders.Among subjects with the same VFA level,the risk of SF was greater among carriers of the rs738409 G genotype than among those who did not.Stratified analysis showed that PNPLA3 rs738409 significantly influenced the association between VFA and SF.VFA remained significantly associated with SF only among the rs738409 G-allele carriers(adjusted-OR:1.05;95%CI:1.03–1.08 for the GG group;and adjusted-OR:1.03;95%CI:1.01–1.04 for the GC group).There was a significant interaction between VFA and PNPLA3 rs738409 genotype(Pinteraction=0.004).Conclusions:PNPLA3 rs738409 G allele has a moderate effect on the association between VFA and risk of SF in adult individuals with biopsy-proven NAFLD.Existence of the PNPLA3 rs738409 G allele and VFA interact to increase risk of SF。展开更多
Objective: this study set out to investigate the association between abdominal obesity ultrasound measurements, waist circumference and body mass index (BMI), metabolic syndrome (MS) components and subclinical atheros...Objective: this study set out to investigate the association between abdominal obesity ultrasound measurements, waist circumference and body mass index (BMI), metabolic syndrome (MS) components and subclinical atherosclerosis. Methods: sixty patients were recruited and divided equally into two groups, according to the presence of MS. All subjects had an ultrasound examination for measurement of visceral and subcutaneous fat thickness and carotid IMT. Results: the values of visceral fat thickness, preperitoneal circumference and carotid IMT were higher in patients with MS than in control subjects. Visceral fat thickness showed significant correlations with many cardiovascular risk factors (waist circumference, BMI, fasting plasma glucose, HDL and LDL cholesterol). All abdominal obesity measurements were correlated with BMI. Carotid IMT showed correlations with age, visceral fat and preperitoneal circumference. Visceral fat was independently associated with systolic and diastolic blood pressures and fasting plasma glucose. Systolic and diastolic blood pressures and BMI were independent determinants of carotid IMT. Conclusion: visceral fat thickness showed the best correlation with MS components, suggesting that it could be a useful parameter in cardiovascular risk assessment. Age, systolic and diastolic blood pressures and BMI were independent determinants of subclinical atherosclerosis. MS was associated with a higher carotid IMT.展开更多
BACKGROUND In recent years,the prevalence of obesity and metabolic syndrome in type 1 diabetes(T1DM)patients has gradually increased.Insulin resistance in T1DM deserves attention.It is necessary to clarify the relatio...BACKGROUND In recent years,the prevalence of obesity and metabolic syndrome in type 1 diabetes(T1DM)patients has gradually increased.Insulin resistance in T1DM deserves attention.It is necessary to clarify the relationship between body composition,metabolic syndrome and insulin resistance in T1DM to guide clinical treatment and intervention.AIM To assess body composition(BC)in T1DM patients and evaluate the relationship between BC,metabolic syndrome(MS),and insulin resistance in these indi-viduals.METHODS A total of 101 subjects with T1DM,aged 10 years or older,and with a disease duration of over 1 year were included.Bioelectrical impedance analysis using the Tsinghua-Tongfang BC Analyzer BCA-1B was employed to measure various BC parameters.Clinical and laboratory data were collected,and insulin resistance was calculated using the estimated glucose disposal rate(eGDR).RESULTS MS was diagnosed in 16/101 patients(15.84%),overweight in 16/101 patients(15.84%),obesity in 4/101(3.96%),hypertension in 34/101(33.66%%)and dyslip-idemia in 16/101 patients(15.84%).Visceral fat index(VFI)and trunk fat mass were significantly and negatively correlated with eGDR(both P<0.001).Female patients exhibited higher body fat percentage and visceral fat ratio compared to male patients.Binary logistic regression analysis revealed that significant factors for MS included eGDR[P=0.017,odds ratio(OR)=0.109],VFI(P=0.030,OR=3.529),and a family history of diabetes(P=0.004,OR=0.228).Significant factors for hypertension included eGDR(P<0.001,OR=0.488)and skeletal muscle mass(P=0.003,OR=1.111).Significant factors for dyslipidemia included trunk fat mass(P=0.033,OR=1.202)and eGDR(P=0.037,OR=0.708).CONCLUSION Visceral fat was found to be a superior predictor of MS compared to conventional measures such as body mass index and waist-to-hip ratio in Chinese individuals with T1DM.BC analysis,specifically identifying visceral fat(trunk fat),may play an important role in identifying the increased risk of MS in non-obese patients with T1DM.展开更多
Objective To evaluate the sensitivity and specificity of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) measurements in diagnosing abdominal visceral obesity. Methods BMI, WC, and WHR wer...Objective To evaluate the sensitivity and specificity of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) measurements in diagnosing abdominal visceral obesity. Methods BMI, WC, and WHR were assessed in 690 Chinese adults (305 men and 385 women) and compared with magnetic resonance imaging (MRI) measurements of abdominal visceral adipose tissue (VA). Receiver operating characteristic (ROC) curves were generated and used to determine the threshold point for each anthropometric parameter. Results 1) MRI showed that 61.7% of overweight/obese individuals (BMI≥25 kg/m2) and 14.2% of normal weight (BMI<25 kg/m2) individuals had abdominal visceral obesity (VA≥100 cm2). 2) VA was positively correlated with each anthropometric variable, of which WC showed the highest correlation (r=0.73-0.77, P<0.001). 3) The best cut-off points for assessing abdominal visceral obesity were as followed: BMI of 26 kg/m2, WC of 90 cm, and WHR of 0.93, with WC being the most sensitive and specific factor. 4) Among subjects with BMI≥28 kg/m2 or WC≥95 cm, 95% of men and 90% of women appeared to have abdominal visceral obesity. Conclusion Measurements of BMI, WC, and WHR can be used in the prediction of abdominal visceral obesity, of which WC was the one with better accuracy.展开更多
AIM: To evaluate the relationship between hepatic fat infiltration and abdominal fat volume by using computed tomography (CT).METHODS: Three hundred and six patients who visited our obesity clinic between November 200...AIM: To evaluate the relationship between hepatic fat infiltration and abdominal fat volume by using computed tomography (CT).METHODS: Three hundred and six patients who visited our obesity clinic between November 2007 and April 2008 underwent fat protocol CT scans.The age range of the patients was 19 to 79 years and the mean age was 49 years.The male to female ratio was 116:190.Liver and spleen attenuation measurements were taken with three regions of interests (ROIs) from the liver and two ROIs from the spleen.Hepatic attenuation indices (HAIs) were measured as follows: (1) hepatic parenchymal attenuation (CTLP);(2) liver to spleen attenuation ratio (LS ratio);and (3) difference between hepatic and splenic attenuation (LSdif).Abdominal fat volume was measured using a 3 mm slice CT scan starting at the level of the umbilicus and was automatically calculated by a workstation.Abdominal fat was classified into total fat (TF),visceral fat (VF),and subcutaneous fat (SF).We used a bivariate correlation method to assess the relationship between the three HAIs and TF,VF,and SF.RESULTS: There were significant negative correlations between CTLP,LS ratio,and LSdif with TF,VF,and SF,respectively.The CTLP showed a strong negative correlation with TF and VF (r = -0.415 and -0.434,respectively,P < 0.001).The correlation between CTLP and SF was less significant (r = -0.313,P < 0.001).CONCLUSION: Fatty infiltration of the liver was correlated with amount of abdominal fat and VF was more strongly associated with fatty liver than SF.展开更多
Non-alcoholic fatty liver disease(NAFLD)has become a significant public health burden affecting not only obese individuals but also people with normal weight.As opposed to previous beliefs,this particular subset of pa...Non-alcoholic fatty liver disease(NAFLD)has become a significant public health burden affecting not only obese individuals but also people with normal weight.As opposed to previous beliefs,this particular subset of patients has an increased risk of all-cause mortality and worse outcomes than their obese counterparts.The development of NAFLD in lean subjects seems to be interconnected with metabolic phenotype,precisely visceral fat tissue,sarcopenia,and insulin resistance.Here,we summarize available data focusing on the co-dependent relationship between metabolic phenotype,insulin resistance,and development of NAFLD in lean individuals,suggesting more appropriate tools for measuring body fat distribution for the screening of patients at risk.展开更多
AIM: To analyze the associations of pancreatic fat with other fat depots and β-cell function in pediatric nonalcoholic fatty liver disease(NAFLD).METHODS: We examined 158 overweight/obese children and adolescents, 80...AIM: To analyze the associations of pancreatic fat with other fat depots and β-cell function in pediatric nonalcoholic fatty liver disease(NAFLD).METHODS: We examined 158 overweight/obese children and adolescents, 80 with NAFLD [hepatic fat fraction(HFF) ≥ 5%] and 78 without fatty liver. Visceral adipose tissue(VAT), pancreatic fat fraction(PFF) and HFF were determined by magnetic resonance imaging. Estimates of insulin sensitivity were calculated using the homeostasis model assessment of insulin resistance(HOMA-IR), defined by fasting insulin and fasting glucose and whole-body insulin sensitivity index(WBISI), based on mean values of insulin and glucose obtained from oral glucose tolerance test and the corresponding fasting values. Patients were considered to have prediabetes if they had either:(1) impaired fasting glucose, defined as a fasting glucose level ≥ 100 mg/d L to < 126 mg/d L;(2) impaired glucose tolerance, defined as a 2 h glucose concentration between ≥ 140 mg/d L and < 200 mg/d L; or(3) hemoglobin A1 c value of ≥ 5.7% to < 6.5%.RESULTS: PFF was significantly higher in NAFLD patients compared with subjects without liver involvement. PFF was significantly associated with HFF and VAT, as well as fasting insulin, C peptide, HOMA-IR, and WBISI. The association between PFF and HFF was no longer significant after adjusting for age, gender, Tanner stage, body mass index(BMI)-SD score, and VAT. In multiple regression analysis withWBISI or HOMA-IR as the dependent variables, against the covariates age, gender, Tanner stage, BMI-SD score, VAT, PFF, and HFF, the only variable significantly associated with WBISI(standardized coefficient B,-0.398; P = 0.001) as well as HOMA-IR(0.353; P = 0.003) was HFF. Children with prediabetes had higher PFF and HFF than those without. PFF and HFF were significantly associated with prediabetes after adjustment for clinical variables. When all fat depots where included in the same model, only HFF remained significantly associated with prediabetes(OR = 3.38; 95%CI: 1.10-10.4; P = 0.034).CONCLUSION: In overweight/obese children with NAFLD, pancreatic fat is increased compared with those without liver involvement. However, only liver fat is independently related to prediabetes.展开更多
Background:It is well-known that body composition metrics can influence the prognosis of various diseases.This study investigated how body composition metrics predict acute respiratory distress syndrome(ARDS)prognosis...Background:It is well-known that body composition metrics can influence the prognosis of various diseases.This study investigated how body composition metrics predict acute respiratory distress syndrome(ARDS)prognosis,focusing on the ratio of visceral fat area(VFA)to subcutaneous fat area(SFA),SFA to standard body weight(SBW),VFA to SBW,and muscle area(MA)to SBW.These metrics were assessed at the level of the twelfth thoracic vertebra(T12 computed tomography[CT]level)to determine their correlation with the outcomes of ARDS.The goal was to utilize these findings to refine and personalize treatment strategies for ARDS.Methods:Patients with ARDS admitted to the intensive care units(ICUs)of three hospitals from January 2016 to July 2023 were enrolled in this study.Within 24 hours of ARDS onset,we obtained chest CT scans to mea-sure subcutaneous fat,visceral fat,and muscle area at the T12 level.We then compared these ratios between survivors and non-survivors.Logistic regression was employed to identify prognostic risk factors.Receiver oper-ating characteristic(ROC)curve analysis was utilized to determine the optimal cutofffor predictors of in-hospital mortality.Based on this cutoff,patients with ARDS were stratified.To reduce confounding factors,1:1 propensity score matching(PSM)was applied.We conducted analyses of clinical feature and prognostic differences pre-and post-PSM between the stratified groups.Additionally,Kaplan-Meier survival curves were generated to compare the survival outcomes of these groups.Results:Of 258 patients with ARDS,150 survived and 108 did not.Non-survivors had a higher VFA/SFA ra-tio(P<0.001)and lower SFA/SBW and MA/SBW ratios(both P<0.001).Key risk factors were high VFA/SFA ratio(OR=2.081;P=0.008),age,acute physiology and chronic health evaluation(APACHE)II score,and lac-tate levels,while MA/SBW and albumin were protective.Patients with a VFA/SFA ratio≥0.73 were associated with increased mortality,while those with an MA/SBW ratio>1.55 cm^(2)/kg had lower mortality,both pre-and post-PSM(P=0.001 and P<0.001,respectively).Among 170 patients with pulmonary-origin ARDS,87 survived and 83 did not.The non-survivor group showed a higher VFA/SFA ratio(P<0.001)and lower SFA/SBW and MA/SBW(P=0.003,P<0.001,respectively).Similar risk and protective factors were observed in this cohort.For VFA/SFA,a value above the cutoffof 1.01 predicted higher mortality,while an MA/SBW value below the cutoffof 1.48 cm2/kg was associated with increased mortality(both P<0.001 pre-/post-PSM).Conclusions:Among all patients with ARDS,the VFA to SFA ratio,MA to SBW ratio at the T12 level,age,APACHE II score,and lactate levels emerged as independent risk factors for mortality.展开更多
AIM To investigate the association between carotid atherosclerosis and cystatin C(CysC) and to determine the optimal CysC cut-off value.METHODS One hundred twenty-eight subjects were included in this study. Atheroscle...AIM To investigate the association between carotid atherosclerosis and cystatin C(CysC) and to determine the optimal CysC cut-off value.METHODS One hundred twenty-eight subjects were included in this study. Atherosclerosis was defined as a maximum carotid plaque thickness(MCPT) of greater than 2 mm. A receiver operating characteristic curve analysis was used to determine the diagnostic value of serum CysC for atherosclerosis. The subjects were divided into two groups according to the CysC cut-off value. We screenedfor diabetes, hypertension, dyslipidemia, smoking status, alcohol consumption, and exercise behavior. The association between atherosclerosis and CysC levels was assessed using multivariate analysis.RESULTS The subjects were then divided into two groups according to the CysC cut-off value(0.73 mg/L). The median age of the high CysC group was 72 years(85% males), whereas that of the low CysC group was 61 years(63% males). The CysC levels were significantly correlated with Cr and estimated glomerular filtration rate(eGFR) values. Bodymass index, visceral fat area, hypertension, diabetes mellitus, and MCPT were significantly higher in the high CysC group than in the low CysC group. Furthermore, the eG FR was significantly lower in the high CysC group. Regarding lifestyle habits, only the exercise level was lower in the high CysC group than in the low CysC group. Multivariate analysis, adjusted for age and sex, revealed that high CysC levels were significantly associated with an MCPT of ≥ 2 mm(odds ratio: 2.92; 95%CI: 1.13-7.99).CONCLUSION Higher CysC levels were associated with an MCPT of ≥ 2 mm. The CysC cut-off value of 0.73 mg/L appears to aid in the diagnosis of atherosclerosis.展开更多
BACKGROUND New-onset prediabetes/diabetes after acute pancreatitis(NODAP)is the most common sequela of pancreatitis,and it differs from type 2 prediabetes/diabetes mellitus(T2DM).AIM To study the associations between ...BACKGROUND New-onset prediabetes/diabetes after acute pancreatitis(NODAP)is the most common sequela of pancreatitis,and it differs from type 2 prediabetes/diabetes mellitus(T2DM).AIM To study the associations between circulating levels of pancreatic amylase,pancreatic lipase,chymotrypsin and fat phenotypes in NODAP,T2DM,and health.METHODS Individuals with NODAP(n=30),T2DM(n=30),and sex-matched healthy individuals(n=30)were included.Five fat phenotypes(intra-pancreatic fat,liver fat,skeletal muscle fat,visceral fat,and subcutaneous fat)were determined using the same magnetic resonance imaging protocol and scanner magnet strength for all participants.One-way analysis of covariance,linear regression analysis,and relative importance analysis were conducted.RESULTS Intra-pancreatic fat deposition(IPFD)was higher in NODAP(9.4%±1.8%)and T2DM(9.8%±1.1%)compared with healthy controls(7.8%±1.9%)after adjusting for covariates(P=0.003).Similar findings were observed in regards to visceral fat volume(P=0.005),but not subcutaneous fat volume,liver fat,or skeletal muscle fat.Both IPFD(β=-2.201,P=0.023)and visceral fat volume(β=-0.004,P=0.028)were significantly associated with circulating levels of pancreatic amylase in NODAP,but not in T2DM or healthy individuals.Of the five fat phenotypes,IPFD explained the highest amount of variance in pancreatic amylase concentration(R2=15.3%out of 41.2%).None of the phenotypes contributed meaningfully to the variance in pancreatic lipase or chymotrypsin.CONCLUSION Both NODAP and T2DM are characterized by increased IPFD and visceral fat volume.However,only NODAP is characterized by significant inverse associations between the two fat phenotypes and pancreatic amylase.展开更多
We examined SARS-CoV-2(Covid-19)available treatments and prophylactic methods that included interventions associated with inhibiting the“type II transmembrane serine protease”(TMPRSS2)to limit the fusion between the...We examined SARS-CoV-2(Covid-19)available treatments and prophylactic methods that included interventions associated with inhibiting the“type II transmembrane serine protease”(TMPRSS2)to limit the fusion between the Covid-19 Spike proteins and ACE2 receptors,or newly developed therapeutics like Remdesivir that interferes with the viral RNA replication.We explored the dilemma of ACE2 receptors that have a protective function against high blood pressure associated disorders,yet,they serve as the viral points of entry,elevating the probability of infection.Human tissues’analysis reveals a higher ACE2 expression in adipose tissue,placing obesity-related conditions in the eye of the pandemic storm.It primarily exposes males due to the surge of ACE2 receptors in the testes along with other tissues.Males manifest a relatively higher positive ACE2 correlations with certain immune cells in the lungs,thyroid,adrenals,liver and colon,while females evidence higher ACE2 correlations with immune cells in the heart.The remaining tissues’ACE2/immunity expressions are equivalent in both sexes,indicating that despite its preference for males,the threat of Covid-19 can easily target females.Recent reports indicate that Covid-19 is empowered by hindering the critical process of viral recognition during the adaptive immune response leading to the“cytokine storm”,the aggravated immune response that indiscriminately perseveres,rampaging the host’s vital organs.Sedentary lifestyle,age-related hormonal imbalance,and adiposity induced inflammation predispose the body to the immune collapse following Covid-19 invasion,spotlighting the detrimental aftermath of metabolic dysfunction,and excess food consumption provoked by elevated cortisol and dysregulated appetite hormones.ACE 2 expression is suppressed in the skeletal muscle,rendering fitness and weight management an effective Covid-19 preventive intervention,along with social distancing,hygiene,and facial coverings.Physical activity,or exercise alternative methods have recently demonstrated statistically significant reductions of the inflammatory marker C-Reactive Protein(CRP),triglycerides,visceral fat,cortisol and the orexigenic hormone ghrelin,juxtaposed by optimal increases of IGF-1,skeletal muscle mass,Free T3,HDL,and the anorexic hormone leptin.展开更多
Background This study explored the diagnostic performance of visceral adiposity to predict the degree of intestinal inflammation and fibrosis.Methods The patients with Crohn’s disease(CD)who underwent surgical small ...Background This study explored the diagnostic performance of visceral adiposity to predict the degree of intestinal inflammation and fibrosis.Methods The patients with Crohn’s disease(CD)who underwent surgical small bowel resection at the First Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)between January 2007 and December 2017 were enrolled.We evaluated the intestinal imaging features of computed tomography enterography(CTE),including mesenteric inflammatory fat stranding,the target sign,mesenteric hypervascularity,bowel wall thickening,lymphadenopathy,stricture diameter,and maximal upstream diameter.We used A.K.software(Artificial Intelligence Kit,version 1.1)to calculate the visceral fat(VF)and subcutaneous fat(SF)volumes at the third lumbar vertebra level.Pathological tissue information was recorded.Diagnostic models were established based on the multivariate regression analysis results,and their effectiveness was evaluated by area under the curve(AUC)and decision curve analyses.Results Overall,48 patients with CD were included in this study.The abdominal VF/SF volume ratio(odds ratio,1.20;95%confidence interval,1.05–1.38;P=0.009)and the stenosis diameter/upstream intestinal dilatation diameter(ND)ratio(odds ratio,0.90;95%confidence interval,0.82–0.99;P=0.034)were independent risk factors for the severe fibrosis of the small intestine.The AUC values of the VF/SF ratio,the ND ratio,and their combination were 0.760,0.673,and 0.804,respectively.The combination of the VS/SF volume ratio and ND ratio achieved the highest net benefit on the decision curve.Conclusion The VF volume on CTE can reflect intestinal fibrosis.The combination of the VF/SF volume ratio and ND ratio of CD patients assessed using CTE can help predict severe fibrosis stenosis of the small intestine.展开更多
Background:There are no published studies on the impact of visceral adipose tissue(VAT)change on outcomes of restorative proctocolectomy and ileal pouch-anal anastomosis(IPAA).The aim of this historic cohort study was...Background:There are no published studies on the impact of visceral adipose tissue(VAT)change on outcomes of restorative proctocolectomy and ileal pouch-anal anastomosis(IPAA).The aim of this historic cohort study was to evaluate the impact of excessive VAT gain on the outcomes of inflammatory bowel disease(IBD)patients with IPAA.Methods:We evaluated all eligible patients with at least two sequential CT scans after pouch construction from our prospectively maintained Pouchitis Registry between 2002 and 2014.The visceral fat area(VFA)was measured on CT images.The study group comprised patients with a significant VAT gain(>15%),and the control group was those without.The adverse outcomes of the pouch were defined as the new development of chronic pouch inflammation(chronic pouchitis,chronic cuffitis or Crohn’s disease of the pouch),anastomotic sinus and the combination of above(the composite adverse outcome)or pouch failure,after the inception CT.Results:Of 1564 patients in the Registry,59(3.8%)with at least 2 CT scans after pouch surgery were included.Twenty-nine patients(49.2%)were in the study group,and 30(50.8%)were in the control group.The median duration from the inception to the latest CT was 552(range:31–2598)days for the entire cohort.We compared the frequency of new chronic pouch inflammation(13.8%vs 3.3%,P=0.195),new pouch sinus(10.3%vs 0%,P=0.112),composite adverse pouch outcome(24.1%vs 3.3%,P=0.026)or pouch failure(10.3%vs 6.7%,P=0.671)between the two groups.Kaplan-Meier plot for time-to-pouch failure between the pouch patients with or without excessive body mass index(BMI)gain(>10%)showed statistical difference(P=0.011).Limited stepwise multivariate analysis showed that excessive VAT gain(odds ratio=12.608,95%confidence interval:1.190–133.538,P=0.035)was an independent risk factor for the adverse pouch comes.Conclusions:In this cohort of ileal pouch patients,excessive VAT gain as well as gain in BMI after pouch construction was found to be associated with poor long-term outcomes.展开更多
文摘Objective: To analyze the correlation between visceral fat area and insulin resistance index (HOMA-IR) in patients with type 2 diabetes mellitus (T2DM) and abdominal obesity and to provide a reference for screening and related research of such patients. Methods: Two hundred patients with T2DM admitted to Guandu People’s Hospital of Kunming were included. The study was carried out from October 2022 to December 2023. The patients were divided into three groups according to different abdominal visceral fat areas (VFA): Group A (n = 65) was less than 75cm2, Group B (n = 75) was 75-100 cm2, and Group C (n = 60) was greater than 100 cm2. The subjects in the three groups were all tested for glycated hemoglobin (HbA1c), fasting insulin (FINS), and fasting blood glucose (FPG). Height and weight were measured to calculate body mass index (BMI). The HOMA-IR and TYG (fasting triglyceride and glycemic index) were also calculated. Changes in the BMI, VFA, HOMA-IR, and TYG levels were observed in the three groups. Results: The VFA, BMI, HbA1c, FPG, FINS, HOMA-IR, and TYG of the patients all increased, with a more significant increase in the BMI, FINS, HOMA-IR, and TYG levels (P < 0.01). Multiple linear stepwise regression analyses used visceral fat area (VFA) as the dependent variable. The results showed that VFA was closely related to BMI, FINS, HOMA-IR, and TYG. Conclusion: Early reduction of VFA to reduce insulin resistance may be a better treatment and effective method for T2DM, providing powerful measures and new strategies for effective blood sugar control and early prevention in the treatment of metabolic diseases.
基金Supported by Henan Province 2023 Scientific Research Projects Focused on Higher Education Project,China,No.23A320059.
文摘BACKGROUND The preoperative prediction of peritoneal metastasis(PM)in gastric cancer would prevent unnecessary surgery and promptly indicate an appropriate treatment plan.AIM To explore the predictive value of visceral fat(VF)parameters obtained from preoperative computed tomography(CT)images for occult PM and to develop an individualized model for predicting occult PM in patients with gastric carcinoma(GC).METHODS A total of 128 confirmed GC cases(84 male and 44 female patients)that underwent CT scans were analyzed and categorized into PM-positive(n=43)and PM-negative(n=85)groups.The clinical characteristics and VF parameters of two regions of interest(ROIs)were collected.Univariate and stratified analyses based on VF volume were performed to screen for predictive characteristics for occult PM.Prediction models with and without VF parameters were established by multivariable logistic regression analysis.RESULTS The mean attenuations of VF_(ROI 1)and VF_(ROI 2)varied significantly between the PM-positive and PMnegative groups(P=0.044 and 0.001,respectively).The areas under the receiver operating characteristic curves(AUCs)of VF_(ROI 1)and VF_(ROI 2)were 0.599 and 0.657,respectively.The mean attenuation of VF_(ROI 2)was included in the final prediction combined model,but not an independent risk factor of PM(P=0.068).No significant difference was observed between the models with and without mean attenuation of VF(AUC:0.749 vs 0.730,P=0.339).CONCLUSION The mean attenuation of VF is a potential auxiliary parameter for predicting occult PM in patients with GC.
基金supported by the Basic Public Welfare Research Program of Zhejiang Province(No.LGF20H020009)a Taizhou Science and Technology Plan Project(No.22ywb105)。
文摘Objective:The present study was conducted to demonstrate the age-dependent changes in skeletal muscle mass and visceral fat area in a population of Chinese adults aged 30-92 years old.Methods:A total of 6669 healthy Chinese men and 4494 healthy Chinese women aged 30-92 years old were assessed for their skeletal muscle mass and visceral fat area.Results:The results showed age-dependent decreases in the total skeletal muscle mass indexes in both men and women aged 40-92 years old as well as age-dependent increases in the visceral fat area in men aged 30-92 years old and in women aged 30-80 years old.Multivariate regression models showed that the total skeletal muscle mass index was positively associated with the body mass index and negatively associated with the age and visceral fat area in both sexes.Conclusion:The loss of skeletal muscle mass becomes obvious at approximately 50 years of age,and the visceral fat area commences to increase at approximately 40 years of age in this Chinese population.
文摘AIM： To examine whether visceral fat is associated with non-alcoholic steatohepatitis （NASH）, to assess for parameters associated with visceral adiposity and to investigate for factors associated with fibrotic severity in NASH. METHODS： Thirty NASH and 30 control subjects underwent biochemical tests, anthropometric assessment, bioelectrical impedance, dual energy X-ray absorptiometry and abdominal fat study by CT scan. Liver biopsies were graded according to the Brunt criteria. RESULTS： NASH subjects had elevated blood pressure, body mass index, waist circumference and waist-to-hip ratio. A greater number of diabetes rnellitus, impaired glucose tolerance test and HOMA-IR 〉 3.5 were found in NASH patients. HOMA-IR 〉 2.8 （OR 20.98, 95% CI 3.22-136.62; P 〈 0.001） and visceral fat area 〉 158 cm^2 （OR 18.55, 95% CI 1.60-214.67; P = 0.019） were independent predictors for NASH. Advanced stage of NASH was found in 15 （50%） patients. HOMA-IR 〉 3.5 （OR 23.12, 95% CI 2.00-266.23; P = 0.012） and grading of portal inflammation （OR 7.15, 95% CI 1.63-31.20; P = 0.009） were determined as independent risk factors for advanced stage of NASH. CONCLUSION： Obesity （especially central obesity） and metabolic syndrome are common in Thai NASH. Insulin resistance and elevated visceral fat are risk factors for the presence of NASH. The advanced stage of thedisease is related to insulin resistance.
文摘BACKGROUND Obesity is a risk factor for non-alcoholic fatty liver disease(NAFLD),although obese patients with NAFLD do not always develop significant fibrosis.The distribution of body fat could predict the risk of NAFLD progression.AIM To investigate the role of bioelectrical impedance-estimated visceral fat(VF)in assessing NAFLD severity.METHODS In this cross-sectional study,patients with biopsy-proven NAFLD were prospectively included.All patients underwent anthropometric evaluation,blood tests and bioelectrical impedance analysis.RESULTS Between 2017 and 2020,119 patients were included[66.4%male,56 years(SD 10.7),62.2%obese,61.3%with metabolic syndrome].Sixty of them(50.4%)showed significant fibrosis(≥F2)in liver biopsy.Age,VF and metabolic syndrome were associated with significant fibrosis(61 years vs 52 years,16.4 vs 13.1,73.3%vs 49.2%,respectively;P<0.001 for all).In the multivariate analysis,VF and age were independently associated with significant fibrosis(VF,OR:1.11,95%CI:1.02-1.22,P=0.02;age,OR:1.08,95%CI:1.03-1.12,P<0.01).A model including these variables showed and area under the receiver operating characteristic curve(AUROC)of 0.75,which was not inferior to transient elastography or NAFLD fibrosis score AUROCs.We developed a nomogram including age and VF for assessing significant fibrosis in routine practice.CONCLUSION VF is a surrogate marker of liver fibrosis in patients with NAFLD.Bioelectrical impedance analysis is an inexpensive and simple method that can be combined with age to guide patient referral when other resources may be unavailable.
基金supported by grants from the National Natural Science Foundation of China(No.30671765)Scientific Research Foundation for Returned Overseas Chinese Scholars,Ministry of Education of China(No.20101561)
文摘This study was aimed to examine the effect of ovariectomy on visceral fat, serum adi- ponectin levels and lipid profile. Forty-five female Sprague DawIey rats were divided into three groups （n=15 each）： ovariectomized group （OVX）, ovariectomized plus estrogen-treated group （OVX＋E2）, and sham-operated group （SHAM）. Body weight, abdominal adipose tissues, serum adiponectin and lipid profile were measured and compared among the groups after three-month feeding post-surgery. Signifi- cant increases in body weight and visceral fat were found in ovariectomized rats when compared with sham-operated ones and significant increases were also observed in serum adiponectin, triglyceride and very low density lipoprotein cholesterol levels in ovariectomized rats. Body weight, visceral fat and se- rum adiponectin levels were profoundly reduced in OVX＋E2 group as compared with OVX group. It was concluded that ovarian hormone deficiency induced by ovariectomy leads to significant increases in body weight and visceral fat, along with increased serum adiponectin, triglyceride and very low density lipoprotein cholesterol levels in rats. Attenuation in these changes can be achieved by estrogen supple- mentation.
文摘Visceral fat is a specifi c fat that is produced in the body,transformed into cholesterol,and circulated in the blood to other parts of the body.The circulated cholesterol usually in the form of low-density lipoproteins forms plaque on the walls of the arteries,thereby constricting and blocking them and preventing the free fl ow of nutrients to various vital organs in the body.Visceral fat is deleterious to the health of elderly people because it is mostly found in the region of the abdomen that houses vital organs such as the pancreas,liver,and digestive tract,and it further affects the normal functioning of hormones in the body.Globally,15 million people die of a noncommunicable disease(NCD)annually between the age of 30 years and the age of 69 years,and there is an increase in NCD morbidity among people older than 70 years.Accumulated visceral fat in elderly people could have deleterious health consequences,as it is a predisposing factor for many other NCDs and chronic health conditions.Sedentary lifestyle,unhealthy eating,stress,and inactivity are the major causes of excessive visceral fat.However,measures to prevent the accumulation of visceral fat are straightforward,and impressive results are achieved with regular physical exercise,healthy diet choices,and proper stress management.
基金supported by grants from the National Natural Science Foundation of China(82070588)High Level Creative Talents from Department of Public Health in Zhejiang Province(S2032102600032)the Project of New Century 551 Talent Nurturing in Wenzhou.GT was supported in part by grants from the University School of Medicine of Verona,Verona,Italy.CDB was supported in part by the Southampton NIHR Biomedical Research Centre(ISBRC-20004),UK.
文摘Background and Aims:Intra-abdominal visceral fat accumulation and patatin-like phospholipase domain containing 3(PNPLA3)rs738409 G/C gene polymorphism confer a greater susceptibility to nonalcoholic fatty liver disease(NAFLD).We examined whether the relationship between visceral fat accumulation and liver disease severity may be influenced by PNPLA3 rs738409 polymorphism.Methods:The variant of PNPLA3 rs738409 was genotyped within 523 Han individuals with biopsy-confirmed NAFLD.Visceral fat area(VFA)was measured by bioelectrical impedance.Significant liver fibrosis(SF),defined as stage F≥2 on histology,was the outcome measure of interest.Results:The distribution of PNPLA3 genotypes was CC:27.5%,CG:48.2%,and GG:24.3%.Higher VFA was associated with greater risk of having SF(adjusted-odds ratio[OR]:1.03;95%confidence interval[CI]:1.02–1.04,p<0.05),independent of potential confounders.Among subjects with the same VFA level,the risk of SF was greater among carriers of the rs738409 G genotype than among those who did not.Stratified analysis showed that PNPLA3 rs738409 significantly influenced the association between VFA and SF.VFA remained significantly associated with SF only among the rs738409 G-allele carriers(adjusted-OR:1.05;95%CI:1.03–1.08 for the GG group;and adjusted-OR:1.03;95%CI:1.01–1.04 for the GC group).There was a significant interaction between VFA and PNPLA3 rs738409 genotype(Pinteraction=0.004).Conclusions:PNPLA3 rs738409 G allele has a moderate effect on the association between VFA and risk of SF in adult individuals with biopsy-proven NAFLD.Existence of the PNPLA3 rs738409 G allele and VFA interact to increase risk of SF。
文摘Objective: this study set out to investigate the association between abdominal obesity ultrasound measurements, waist circumference and body mass index (BMI), metabolic syndrome (MS) components and subclinical atherosclerosis. Methods: sixty patients were recruited and divided equally into two groups, according to the presence of MS. All subjects had an ultrasound examination for measurement of visceral and subcutaneous fat thickness and carotid IMT. Results: the values of visceral fat thickness, preperitoneal circumference and carotid IMT were higher in patients with MS than in control subjects. Visceral fat thickness showed significant correlations with many cardiovascular risk factors (waist circumference, BMI, fasting plasma glucose, HDL and LDL cholesterol). All abdominal obesity measurements were correlated with BMI. Carotid IMT showed correlations with age, visceral fat and preperitoneal circumference. Visceral fat was independently associated with systolic and diastolic blood pressures and fasting plasma glucose. Systolic and diastolic blood pressures and BMI were independent determinants of carotid IMT. Conclusion: visceral fat thickness showed the best correlation with MS components, suggesting that it could be a useful parameter in cardiovascular risk assessment. Age, systolic and diastolic blood pressures and BMI were independent determinants of subclinical atherosclerosis. MS was associated with a higher carotid IMT.
基金Supported by the“SDF-sweet doctor cultivation”Project of Sinocare Diabetes Foundation,No.2022SD11 and No.2021SD09.
文摘BACKGROUND In recent years,the prevalence of obesity and metabolic syndrome in type 1 diabetes(T1DM)patients has gradually increased.Insulin resistance in T1DM deserves attention.It is necessary to clarify the relationship between body composition,metabolic syndrome and insulin resistance in T1DM to guide clinical treatment and intervention.AIM To assess body composition(BC)in T1DM patients and evaluate the relationship between BC,metabolic syndrome(MS),and insulin resistance in these indi-viduals.METHODS A total of 101 subjects with T1DM,aged 10 years or older,and with a disease duration of over 1 year were included.Bioelectrical impedance analysis using the Tsinghua-Tongfang BC Analyzer BCA-1B was employed to measure various BC parameters.Clinical and laboratory data were collected,and insulin resistance was calculated using the estimated glucose disposal rate(eGDR).RESULTS MS was diagnosed in 16/101 patients(15.84%),overweight in 16/101 patients(15.84%),obesity in 4/101(3.96%),hypertension in 34/101(33.66%%)and dyslip-idemia in 16/101 patients(15.84%).Visceral fat index(VFI)and trunk fat mass were significantly and negatively correlated with eGDR(both P<0.001).Female patients exhibited higher body fat percentage and visceral fat ratio compared to male patients.Binary logistic regression analysis revealed that significant factors for MS included eGDR[P=0.017,odds ratio(OR)=0.109],VFI(P=0.030,OR=3.529),and a family history of diabetes(P=0.004,OR=0.228).Significant factors for hypertension included eGDR(P<0.001,OR=0.488)and skeletal muscle mass(P=0.003,OR=1.111).Significant factors for dyslipidemia included trunk fat mass(P=0.033,OR=1.202)and eGDR(P=0.037,OR=0.708).CONCLUSION Visceral fat was found to be a superior predictor of MS compared to conventional measures such as body mass index and waist-to-hip ratio in Chinese individuals with T1DM.BC analysis,specifically identifying visceral fat(trunk fat),may play an important role in identifying the increased risk of MS in non-obese patients with T1DM.
文摘Objective To evaluate the sensitivity and specificity of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) measurements in diagnosing abdominal visceral obesity. Methods BMI, WC, and WHR were assessed in 690 Chinese adults (305 men and 385 women) and compared with magnetic resonance imaging (MRI) measurements of abdominal visceral adipose tissue (VA). Receiver operating characteristic (ROC) curves were generated and used to determine the threshold point for each anthropometric parameter. Results 1) MRI showed that 61.7% of overweight/obese individuals (BMI≥25 kg/m2) and 14.2% of normal weight (BMI<25 kg/m2) individuals had abdominal visceral obesity (VA≥100 cm2). 2) VA was positively correlated with each anthropometric variable, of which WC showed the highest correlation (r=0.73-0.77, P<0.001). 3) The best cut-off points for assessing abdominal visceral obesity were as followed: BMI of 26 kg/m2, WC of 90 cm, and WHR of 0.93, with WC being the most sensitive and specific factor. 4) Among subjects with BMI≥28 kg/m2 or WC≥95 cm, 95% of men and 90% of women appeared to have abdominal visceral obesity. Conclusion Measurements of BMI, WC, and WHR can be used in the prediction of abdominal visceral obesity, of which WC was the one with better accuracy.
文摘AIM: To evaluate the relationship between hepatic fat infiltration and abdominal fat volume by using computed tomography (CT).METHODS: Three hundred and six patients who visited our obesity clinic between November 2007 and April 2008 underwent fat protocol CT scans.The age range of the patients was 19 to 79 years and the mean age was 49 years.The male to female ratio was 116:190.Liver and spleen attenuation measurements were taken with three regions of interests (ROIs) from the liver and two ROIs from the spleen.Hepatic attenuation indices (HAIs) were measured as follows: (1) hepatic parenchymal attenuation (CTLP);(2) liver to spleen attenuation ratio (LS ratio);and (3) difference between hepatic and splenic attenuation (LSdif).Abdominal fat volume was measured using a 3 mm slice CT scan starting at the level of the umbilicus and was automatically calculated by a workstation.Abdominal fat was classified into total fat (TF),visceral fat (VF),and subcutaneous fat (SF).We used a bivariate correlation method to assess the relationship between the three HAIs and TF,VF,and SF.RESULTS: There were significant negative correlations between CTLP,LS ratio,and LSdif with TF,VF,and SF,respectively.The CTLP showed a strong negative correlation with TF and VF (r = -0.415 and -0.434,respectively,P < 0.001).The correlation between CTLP and SF was less significant (r = -0.313,P < 0.001).CONCLUSION: Fatty infiltration of the liver was correlated with amount of abdominal fat and VF was more strongly associated with fatty liver than SF.
文摘Non-alcoholic fatty liver disease(NAFLD)has become a significant public health burden affecting not only obese individuals but also people with normal weight.As opposed to previous beliefs,this particular subset of patients has an increased risk of all-cause mortality and worse outcomes than their obese counterparts.The development of NAFLD in lean subjects seems to be interconnected with metabolic phenotype,precisely visceral fat tissue,sarcopenia,and insulin resistance.Here,we summarize available data focusing on the co-dependent relationship between metabolic phenotype,insulin resistance,and development of NAFLD in lean individuals,suggesting more appropriate tools for measuring body fat distribution for the screening of patients at risk.
基金Supported by Sapienza University of Rome(Progetti di Ricerca Universitaria 2011-2012)
文摘AIM: To analyze the associations of pancreatic fat with other fat depots and β-cell function in pediatric nonalcoholic fatty liver disease(NAFLD).METHODS: We examined 158 overweight/obese children and adolescents, 80 with NAFLD [hepatic fat fraction(HFF) ≥ 5%] and 78 without fatty liver. Visceral adipose tissue(VAT), pancreatic fat fraction(PFF) and HFF were determined by magnetic resonance imaging. Estimates of insulin sensitivity were calculated using the homeostasis model assessment of insulin resistance(HOMA-IR), defined by fasting insulin and fasting glucose and whole-body insulin sensitivity index(WBISI), based on mean values of insulin and glucose obtained from oral glucose tolerance test and the corresponding fasting values. Patients were considered to have prediabetes if they had either:(1) impaired fasting glucose, defined as a fasting glucose level ≥ 100 mg/d L to < 126 mg/d L;(2) impaired glucose tolerance, defined as a 2 h glucose concentration between ≥ 140 mg/d L and < 200 mg/d L; or(3) hemoglobin A1 c value of ≥ 5.7% to < 6.5%.RESULTS: PFF was significantly higher in NAFLD patients compared with subjects without liver involvement. PFF was significantly associated with HFF and VAT, as well as fasting insulin, C peptide, HOMA-IR, and WBISI. The association between PFF and HFF was no longer significant after adjusting for age, gender, Tanner stage, body mass index(BMI)-SD score, and VAT. In multiple regression analysis withWBISI or HOMA-IR as the dependent variables, against the covariates age, gender, Tanner stage, BMI-SD score, VAT, PFF, and HFF, the only variable significantly associated with WBISI(standardized coefficient B,-0.398; P = 0.001) as well as HOMA-IR(0.353; P = 0.003) was HFF. Children with prediabetes had higher PFF and HFF than those without. PFF and HFF were significantly associated with prediabetes after adjustment for clinical variables. When all fat depots where included in the same model, only HFF remained significantly associated with prediabetes(OR = 3.38; 95%CI: 1.10-10.4; P = 0.034).CONCLUSION: In overweight/obese children with NAFLD, pancreatic fat is increased compared with those without liver involvement. However, only liver fat is independently related to prediabetes.
基金supported by a grant from Suzhou Science and Tech-nology Project Plan(No.SZM2021006).
文摘Background:It is well-known that body composition metrics can influence the prognosis of various diseases.This study investigated how body composition metrics predict acute respiratory distress syndrome(ARDS)prognosis,focusing on the ratio of visceral fat area(VFA)to subcutaneous fat area(SFA),SFA to standard body weight(SBW),VFA to SBW,and muscle area(MA)to SBW.These metrics were assessed at the level of the twelfth thoracic vertebra(T12 computed tomography[CT]level)to determine their correlation with the outcomes of ARDS.The goal was to utilize these findings to refine and personalize treatment strategies for ARDS.Methods:Patients with ARDS admitted to the intensive care units(ICUs)of three hospitals from January 2016 to July 2023 were enrolled in this study.Within 24 hours of ARDS onset,we obtained chest CT scans to mea-sure subcutaneous fat,visceral fat,and muscle area at the T12 level.We then compared these ratios between survivors and non-survivors.Logistic regression was employed to identify prognostic risk factors.Receiver oper-ating characteristic(ROC)curve analysis was utilized to determine the optimal cutofffor predictors of in-hospital mortality.Based on this cutoff,patients with ARDS were stratified.To reduce confounding factors,1:1 propensity score matching(PSM)was applied.We conducted analyses of clinical feature and prognostic differences pre-and post-PSM between the stratified groups.Additionally,Kaplan-Meier survival curves were generated to compare the survival outcomes of these groups.Results:Of 258 patients with ARDS,150 survived and 108 did not.Non-survivors had a higher VFA/SFA ra-tio(P<0.001)and lower SFA/SBW and MA/SBW ratios(both P<0.001).Key risk factors were high VFA/SFA ratio(OR=2.081;P=0.008),age,acute physiology and chronic health evaluation(APACHE)II score,and lac-tate levels,while MA/SBW and albumin were protective.Patients with a VFA/SFA ratio≥0.73 were associated with increased mortality,while those with an MA/SBW ratio>1.55 cm^(2)/kg had lower mortality,both pre-and post-PSM(P=0.001 and P<0.001,respectively).Among 170 patients with pulmonary-origin ARDS,87 survived and 83 did not.The non-survivor group showed a higher VFA/SFA ratio(P<0.001)and lower SFA/SBW and MA/SBW(P=0.003,P<0.001,respectively).Similar risk and protective factors were observed in this cohort.For VFA/SFA,a value above the cutoffof 1.01 predicted higher mortality,while an MA/SBW value below the cutoffof 1.48 cm2/kg was associated with increased mortality(both P<0.001 pre-/post-PSM).Conclusions:Among all patients with ARDS,the VFA to SFA ratio,MA to SBW ratio at the T12 level,age,APACHE II score,and lactate levels emerged as independent risk factors for mortality.
文摘AIM To investigate the association between carotid atherosclerosis and cystatin C(CysC) and to determine the optimal CysC cut-off value.METHODS One hundred twenty-eight subjects were included in this study. Atherosclerosis was defined as a maximum carotid plaque thickness(MCPT) of greater than 2 mm. A receiver operating characteristic curve analysis was used to determine the diagnostic value of serum CysC for atherosclerosis. The subjects were divided into two groups according to the CysC cut-off value. We screenedfor diabetes, hypertension, dyslipidemia, smoking status, alcohol consumption, and exercise behavior. The association between atherosclerosis and CysC levels was assessed using multivariate analysis.RESULTS The subjects were then divided into two groups according to the CysC cut-off value(0.73 mg/L). The median age of the high CysC group was 72 years(85% males), whereas that of the low CysC group was 61 years(63% males). The CysC levels were significantly correlated with Cr and estimated glomerular filtration rate(eGFR) values. Bodymass index, visceral fat area, hypertension, diabetes mellitus, and MCPT were significantly higher in the high CysC group than in the low CysC group. Furthermore, the eG FR was significantly lower in the high CysC group. Regarding lifestyle habits, only the exercise level was lower in the high CysC group than in the low CysC group. Multivariate analysis, adjusted for age and sex, revealed that high CysC levels were significantly associated with an MCPT of ≥ 2 mm(odds ratio: 2.92; 95%CI: 1.13-7.99).CONCLUSION Higher CysC levels were associated with an MCPT of ≥ 2 mm. The CysC cut-off value of 0.73 mg/L appears to aid in the diagnosis of atherosclerosis.
文摘BACKGROUND New-onset prediabetes/diabetes after acute pancreatitis(NODAP)is the most common sequela of pancreatitis,and it differs from type 2 prediabetes/diabetes mellitus(T2DM).AIM To study the associations between circulating levels of pancreatic amylase,pancreatic lipase,chymotrypsin and fat phenotypes in NODAP,T2DM,and health.METHODS Individuals with NODAP(n=30),T2DM(n=30),and sex-matched healthy individuals(n=30)were included.Five fat phenotypes(intra-pancreatic fat,liver fat,skeletal muscle fat,visceral fat,and subcutaneous fat)were determined using the same magnetic resonance imaging protocol and scanner magnet strength for all participants.One-way analysis of covariance,linear regression analysis,and relative importance analysis were conducted.RESULTS Intra-pancreatic fat deposition(IPFD)was higher in NODAP(9.4%±1.8%)and T2DM(9.8%±1.1%)compared with healthy controls(7.8%±1.9%)after adjusting for covariates(P=0.003).Similar findings were observed in regards to visceral fat volume(P=0.005),but not subcutaneous fat volume,liver fat,or skeletal muscle fat.Both IPFD(β=-2.201,P=0.023)and visceral fat volume(β=-0.004,P=0.028)were significantly associated with circulating levels of pancreatic amylase in NODAP,but not in T2DM or healthy individuals.Of the five fat phenotypes,IPFD explained the highest amount of variance in pancreatic amylase concentration(R2=15.3%out of 41.2%).None of the phenotypes contributed meaningfully to the variance in pancreatic lipase or chymotrypsin.CONCLUSION Both NODAP and T2DM are characterized by increased IPFD and visceral fat volume.However,only NODAP is characterized by significant inverse associations between the two fat phenotypes and pancreatic amylase.
文摘We examined SARS-CoV-2(Covid-19)available treatments and prophylactic methods that included interventions associated with inhibiting the“type II transmembrane serine protease”(TMPRSS2)to limit the fusion between the Covid-19 Spike proteins and ACE2 receptors,or newly developed therapeutics like Remdesivir that interferes with the viral RNA replication.We explored the dilemma of ACE2 receptors that have a protective function against high blood pressure associated disorders,yet,they serve as the viral points of entry,elevating the probability of infection.Human tissues’analysis reveals a higher ACE2 expression in adipose tissue,placing obesity-related conditions in the eye of the pandemic storm.It primarily exposes males due to the surge of ACE2 receptors in the testes along with other tissues.Males manifest a relatively higher positive ACE2 correlations with certain immune cells in the lungs,thyroid,adrenals,liver and colon,while females evidence higher ACE2 correlations with immune cells in the heart.The remaining tissues’ACE2/immunity expressions are equivalent in both sexes,indicating that despite its preference for males,the threat of Covid-19 can easily target females.Recent reports indicate that Covid-19 is empowered by hindering the critical process of viral recognition during the adaptive immune response leading to the“cytokine storm”,the aggravated immune response that indiscriminately perseveres,rampaging the host’s vital organs.Sedentary lifestyle,age-related hormonal imbalance,and adiposity induced inflammation predispose the body to the immune collapse following Covid-19 invasion,spotlighting the detrimental aftermath of metabolic dysfunction,and excess food consumption provoked by elevated cortisol and dysregulated appetite hormones.ACE 2 expression is suppressed in the skeletal muscle,rendering fitness and weight management an effective Covid-19 preventive intervention,along with social distancing,hygiene,and facial coverings.Physical activity,or exercise alternative methods have recently demonstrated statistically significant reductions of the inflammatory marker C-Reactive Protein(CRP),triglycerides,visceral fat,cortisol and the orexigenic hormone ghrelin,juxtaposed by optimal increases of IGF-1,skeletal muscle mass,Free T3,HDL,and the anorexic hormone leptin.
基金supported by the National Natural Science Foundation of China[grant numbers 81772699,81472999,81272350]the Guangzhou People’s Livelihood Science and Technology Project[grant number 201803010052].
文摘Background This study explored the diagnostic performance of visceral adiposity to predict the degree of intestinal inflammation and fibrosis.Methods The patients with Crohn’s disease(CD)who underwent surgical small bowel resection at the First Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)between January 2007 and December 2017 were enrolled.We evaluated the intestinal imaging features of computed tomography enterography(CTE),including mesenteric inflammatory fat stranding,the target sign,mesenteric hypervascularity,bowel wall thickening,lymphadenopathy,stricture diameter,and maximal upstream diameter.We used A.K.software(Artificial Intelligence Kit,version 1.1)to calculate the visceral fat(VF)and subcutaneous fat(SF)volumes at the third lumbar vertebra level.Pathological tissue information was recorded.Diagnostic models were established based on the multivariate regression analysis results,and their effectiveness was evaluated by area under the curve(AUC)and decision curve analyses.Results Overall,48 patients with CD were included in this study.The abdominal VF/SF volume ratio(odds ratio,1.20;95%confidence interval,1.05–1.38;P=0.009)and the stenosis diameter/upstream intestinal dilatation diameter(ND)ratio(odds ratio,0.90;95%confidence interval,0.82–0.99;P=0.034)were independent risk factors for the severe fibrosis of the small intestine.The AUC values of the VF/SF ratio,the ND ratio,and their combination were 0.760,0.673,and 0.804,respectively.The combination of the VS/SF volume ratio and ND ratio achieved the highest net benefit on the decision curve.Conclusion The VF volume on CTE can reflect intestinal fibrosis.The combination of the VF/SF volume ratio and ND ratio of CD patients assessed using CTE can help predict severe fibrosis stenosis of the small intestine.
文摘Background:There are no published studies on the impact of visceral adipose tissue(VAT)change on outcomes of restorative proctocolectomy and ileal pouch-anal anastomosis(IPAA).The aim of this historic cohort study was to evaluate the impact of excessive VAT gain on the outcomes of inflammatory bowel disease(IBD)patients with IPAA.Methods:We evaluated all eligible patients with at least two sequential CT scans after pouch construction from our prospectively maintained Pouchitis Registry between 2002 and 2014.The visceral fat area(VFA)was measured on CT images.The study group comprised patients with a significant VAT gain(>15%),and the control group was those without.The adverse outcomes of the pouch were defined as the new development of chronic pouch inflammation(chronic pouchitis,chronic cuffitis or Crohn’s disease of the pouch),anastomotic sinus and the combination of above(the composite adverse outcome)or pouch failure,after the inception CT.Results:Of 1564 patients in the Registry,59(3.8%)with at least 2 CT scans after pouch surgery were included.Twenty-nine patients(49.2%)were in the study group,and 30(50.8%)were in the control group.The median duration from the inception to the latest CT was 552(range:31–2598)days for the entire cohort.We compared the frequency of new chronic pouch inflammation(13.8%vs 3.3%,P=0.195),new pouch sinus(10.3%vs 0%,P=0.112),composite adverse pouch outcome(24.1%vs 3.3%,P=0.026)or pouch failure(10.3%vs 6.7%,P=0.671)between the two groups.Kaplan-Meier plot for time-to-pouch failure between the pouch patients with or without excessive body mass index(BMI)gain(>10%)showed statistical difference(P=0.011).Limited stepwise multivariate analysis showed that excessive VAT gain(odds ratio=12.608,95%confidence interval:1.190–133.538,P=0.035)was an independent risk factor for the adverse pouch comes.Conclusions:In this cohort of ileal pouch patients,excessive VAT gain as well as gain in BMI after pouch construction was found to be associated with poor long-term outcomes.
