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Summary: Excess fat on the body impacts obesity‐related co‐morbidity risk; however, the location of fat stores affects the severity of these risks. The purpose of this study was to examine segmental fat accumulation patterns by sex and ethnicity using international datasets. An amalgamated and cross‐calibrated dataset of dual x‐ray absorptiometry (DXA)‐measured variables compiled segmental mass for bone mineral content (BMC), lean mass (LM), and fat mass (FM) for each participant; percentage of segment fat (PSF) was calculated as PSFsegment = (FMsegment/(BMCsegment + LMsegment + FMsegment)) × 100. A total of 30 587 adults (N = 16 490 females) from 13 datasets were included. A regression model was used to examine differences in regional fat mass and PSF. All populations followed the same segmental fat mass accumulation in the ascending order with statistical significance (arms < legs < trunk), except for Hispanic/Latinx males (arms < [legs = trunk]). Relative fat accumulation patterns differed between those with greater PSF in the appendages (Arab, Mexican, Asian, Black, American Caucasian, European Caucasian, and Australasian Caucasian females; Black males) and those with greater PSF in the trunk (Mexican, Asian, American Caucasian, European Caucasian, and Australasian Caucasian males). Greater absolute and relative fat accumulation in the trunk could place males of most ethnicities in this study at a higher risk of visceral fat deposition and associated co‐morbidities. [ABSTRACT FROM AUTHOR]

Objective To investigate the relationship between body fat distribution and insulin resistance (IR) in patients with type 2 diabetes mellitus (T2DM）.Methods A total of 2 790 T2DM patients hospitalized in the department of endocrinology of the hospital from January 2019 to December 2020 were selected and divided into the IR group (1 915 cases) and the non-IR group (875 cases) according to the presence or absence of IR.IR status was assessed by TyG index, and the correlation between visceral adipose tissue (VAT）,subcutaneous adipose tissue (SAT) area and other clinical indicators (body mass index (BMI）,glycosylated hemoglobin (HbA1c）,triglyceride (TG）,low density lipoprotein (LDL) and high density lipoprotein (HDL）,etc.）,and the influence of body fat distribution area on IR were analyzed.Results BMI,waist circumference, hip circumference, waist-to-hip ratio, diastolic blood pressure, TG, TyG index, uric acid, creatinine level and VAT area in male patients were higher than those in female patients, while age, waist-to-height ratio, systolic blood pressure, cholesterol, HDL,LDL level and SAT area were lower than those in female patients, with statistical significance (P＜0.05）.VAT area were positively correlated with BMI,systolic blood pressure, diastolic blood pressure, waist circumference, waist-to-hip ratio,TG,TyG index, and uric acid level (r＞0,P＜0.05）,and negatively correlated with HbA1c and HDL level (r＜0,P＜0.05）.SAT area was positively correlated with BMI,waist circumference, waist-to-hip ratio,cholesterol, LDL, TyG index, and uric acid level (r＞0,P＜0.05）,and negatively correlated with HDL level (r＜0,P＜0.05）.Diastolic blood pressure, waist-to-hip ratio, HbA1c, uric acid level, VAT and SAT area in the IR group were higher than those in the non-IR group, while age, systolic blood pressure and HDL level were lower than those in the non-IR group, with statistical significance (P＜0.05）.VAT area, diastolic blood pressure and HbA1c were independent risk factors for IR (OR＞1,P＜0.05）,while HDL was protective factor (OR＜1,P＜0.05）.Conclusion There is gender difference in body fat distribution in T2DM patients, and VAT is a risk factor for IR. [ABSTRACT FROM AUTHOR]

Background: Body composition and body fat distribution are important predictors of cardiometabolic diseases. The etiology of cardiometabolic diseases is heterogenous, and partly driven by inter-individual differences in tissue-specific insulin sensitivity. Objectives: To investigate (1) the associations between body composition and whole-body, liver and muscle insulin sensitivity, and (2) changes in body composition and insulin sensitivity and their relationship after a 12-week isocaloric diet high in mono-unsaturated fatty acids (HMUFA) or a low-fat, high-protein, high-fiber (LFHP) diet. Methods: This subcohort analysis of the PERSON study includes 93 individuals (53% women, BMI 25–40 kg/m2, 40–75 years) who participated in this randomized intervention study. At baseline and after 12 weeks of following the LFHP, or HMUFA diet, we performed a 7-point oral glucose tolerance test to assess whole-body, liver, and muscle insulin sensitivity, and whole-body magnetic resonance imaging to determine body composition and body fat distribution. Both diets are within the guidelines of healthy nutrition. Results: At baseline, liver fat content was associated with worse liver insulin sensitivity (β [95%CI]; 0.12 [0.01; 0.22]). Only in women, thigh muscle fat content was inversely related to muscle insulin sensitivity (-0.27 [-0.48; -0.05]). Visceral adipose tissue (VAT) was inversely associated with whole-body, liver, and muscle insulin sensitivity. Both diets decreased VAT, abdominal subcutaneous adipose tissue (aSAT), and liver fat, but not whole-body and tissue-specific insulin sensitivity with no differences between diets. Waist circumference, however, decreased more following the LFHP diet as compared to the HMUFA diet (-3.0 vs. -0.5 cm, respectively). After the LFHP but not HMUFA diet, improvements in body composition were positively associated with improvements in whole-body and liver insulin sensitivity. Conclusions: Liver and muscle insulin sensitivity are distinctly associated with liver and muscle fat accumulation. Although both LFHP and HMUFA diets improved in body fat, VAT, aSAT, and liver fat, only LFHP-induced improvements in body composition are associated with improved insulin sensitivity. Trial registration: NCT03708419 (clinicaltrials.gov). [ABSTRACT FROM AUTHOR]

Background: Obesity is often associated with multiple comorbidities. However, whether obese subjects with hyperlipidemia in the absence of other complications have worse cardiac indices than metabolically healthy obese subjects is unclear. Therefore, we aimed to determine the effect of hyperlipidemia on subclinical left ventricular (LV) function in obesity and to evaluate the association of cardiac parameters with body fat distribution. Materials and methods: Ninety-two adults were recruited and divided into 3 groups: obesity with hyperlipidemia (n = 24, 14 males), obesity without hyperlipidemia (n = 25, 13 males), and c ntrols (n = 43, 25 males). LV strain parameters (peak strain (PS), peak diastolic strain rate (PDSR), peak systolic strain rate) derived from cardiovascular magnetic resonance tissue tracking were measured and compared. Dual-energy X-ray absorptiometer was used to measure body fat distribution. Correlations of hyperlipidemia and body fat distribution with LV strain were assessed by multivariable linear regression. Results: Obese individuals with preserved LV ejection fraction showed lower global LV longitudinal, circumferential, and radial PS and longitudinal and circumferential PDSR than controls (all P < 0.05). Among obese patients, those with hyperlipidemia had lower longitudinal PS and PDSR and circumferential PDSR than those without hyperlipidemia (− 12.8 ± 2.9% vs. − 14.2 ± 2.7%, 0.8 ± 0.1 s−1 vs. 0.9 ± 0.3 s−1, 1.2 ± 0.2 s−1 vs. 1.4 ± 0.2 s−1; all P < 0.05). Multivariable linear regression demonstrated that hyperlipidemia was independently associated with circumferential PDSR (β = − 0.477, P < 0.05) in obesity after controlling for growth differences, other cardiovascular risk factors, and central fat distribution. In addition, android fat had an independently negative relationship with longitudinal and radial PS (β = − 0.486 and β = − 0.408, respectively; all P < 0.05); and visceral fat was negatively associated with longitudinal PDSR (β = − 0.563, P < 0.05). Differently, gynoid fat was positively correlated with circumferential PS and PDSR and radial PDSR (β = 0.490, β = 0.481, and β = 0.413, respectively; all P < 0.05). Conclusion: Hyperlipidemia is independently associated with subclinical LV diastolic dysfunction in obesity. Central fat distribution (android and visceral fat) has a negative association, while peripheral fat distribution (gynoid fat) has a positive association on subclinical LV function. These results suggest that appropriate management of hyperlipidemia may be beneficial for obese patients, and that the differentiation of fat distribution in different regions may facilitate the precise management of obese patients. Clinical trials registration Effect of lifestyle intervention on metabolism of obese patients based on smart phone software (ChiCTR1900026476). [ABSTRACT FROM AUTHOR]

Background: Considering the close link between polycystic ovary syndrome (PCOS) and metabolic syndrome considerable research has been devoted to studying the pattern of fat distribution in PCOS. Objectives: The study aims to assess the usefulness of dual-energy X-ray absorptiometry (DEXA) based regional fat distribution indices as a predictor of the development of PCOS. Methods: This case–control study recruited diagnosed cases of PCOS using Rotterdam Criteria (cases n = 86) and healthy age-matched controls (n = 90). DEXA was performed in both groups for assessment of total and regional body fat distribution after undergoing ultrasonography (USG) and baseline/biochemical evaluation. Results: The study revealed a significant difference between cases and controls in trunk fat percentage (40.2% ± 9.1% vs 26.5% ± 9.1%; p < 0.001), android fat percentage (42.4% ± 41%vs 27.8% ± 1.51%; p < 0.001), total fat percentage (43.8% ± 8% vs28.5% ± 1.6%; p < 0.001), fat mass/ht2 (fat mass index) (8.82 ± 3% vs 4.8 ± 1.7%; p < 0.001), android/gynoid ratio (1.05 ± 0.1 vs 0.7 ± 0.2; p < 0.001), and trunk/limb fat mass ratio (1.06 ± 0.3 vs 0.69 ± 0.3; p 0.001). Multivariate analysis revealed a significant relation of trunk fat mass with android % fat, gynoid fat mass, and android-gynoid ratio. Conclusions: The study demonstrates that there is a central pattern of fat distribution in patients with PCOS while the overall fat might not be increased which is well analyzed by DEXA. Hence, we suggest its use in the initial diagnostic workup and follow-up of PCOS patients for their body fat distribution and content. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is a common endocrinopathy of reproductive-aged women, characterized by hyperandrogenism, oligo-anovulation and insulin resistance and closely linked with preferential abdominal fat accumulation. As an ancestral primate trait, PCOS was likely further selected in humans when scarcity of food in hunter–gatherers of the late Pleistocene additionally programmed for enhanced fat storage to meet the metabolic demands of reproduction in later life. As an evolutionary model for PCOS, healthy normal-weight women with hyperandrogenic PCOS have subcutaneous (SC) abdominal adipose stem cells that favor fat storage through exaggerated lipid accumulation during development to adipocytes in vitro. In turn, fat storage is counterbalanced by reduced insulin sensitivity and preferential accumulation of highly lipolytic intra-abdominal fat in vivo. This metabolic adaptation in PCOS balances energy storage with glucose availability and fatty acid oxidation for optimal energy use during reproduction; its accompanying oligo-anovulation allowed PCOS women from antiquity sufficient time and strength for childrearing of fewer offspring with a greater likelihood of childhood survival. Heritable PCOS characteristics are affected by today's contemporary environment through epigenetic events that predispose women to lipotoxicity, with excess weight gain and pregnancy complications, calling for an emphasis on preventive healthcare to optimize the long-term, endocrine-metabolic health of PCOS women in today's obesogenic environment. [ABSTRACT FROM AUTHOR]

Obesity and diabetes mellitus epidemics exert a measurable impact on the liver transplant (Ltx) population. This study aimed to investigate the metabolic profile of Ltx recipients and its association with body fat distribution. Adults who underwent de novo elective cadaveric-donor Ltx were eligible. Metabolic syndrome (MS) was diagnosed based on the adapted International Diabetes Federation, the American Heart Association, and the National Heart, Lung, and Blood Institute guidelines. We recruited 100 patients with a mean age of 54 years, of whom 70% were men. Overall, 54% met the criteria for MS, most of which comprised new-onset cases. Excessive fat accumulation in liver donors was found to be associated with an increased metabolic risk in liver recipients. Haemoglobin A1C (OR: 8.962, 95% CI: 2.188–84.545, p = 0.013), ferritin (OR: 1.024, 95% CI: 1.005–1.054, p = 0.038), and de novo hypertriglycaeridemia (OR 27.957, 95% CI: 2.626–752.121, p = 0.014) were found to be independently associated with de novo MS. After a step-wise multivariate analysis, only the anthropometric obesity indices were significantly associated with abdominal fat distribution in Ltx recipients. Metabolic complications were common in liver recipients. Both pre- and post-Ltx factors impacted MS development in liver recipients and determined abdominal fat distribution. [ABSTRACT FROM AUTHOR]

Body fat distribution is a heritable risk factor for cardiovascular and metabolic disease. In humans, rare Inhibin beta E (INHBE, activin E) loss-of-function variants are associated with a lower waist-to-hip ratio and protection from type 2 diabetes. Hepatic fatty acid sensing promotes INHBE expression during fasting and in obese individuals, yet it is unclear how the hepatokine activin E governs body shape and energy metabolism. Here, we uncover activin E as a regulator of adipose energy storage. By suppressing β-agonist-induced lipolysis, activin E promotes fat accumulation and adipocyte hypertrophy and contributes to adipose dysfunction in mice. Mechanistically, we demonstrate that activin E elicits its effect on adipose tissue through ACVR1C, activating SMAD2/3 signaling and suppressing PPARG target genes. Conversely, loss of activin E or ACVR1C in mice increases fat utilization, lowers adiposity, and drives PPARG-regulated gene signatures indicative of healthy adipose function. Our studies identify activin E-ACVR1C as a metabolic rheostat promoting liver-adipose cross talk to restrain excessive fat breakdown and preserve fat mass during prolonged fasting, a mechanism that is maladaptive in obese individuals. [ABSTRACT FROM AUTHOR]

Background: The Chinese visceral adiposity index (CVAI) and new visceral adiposity index (NVAI) are novel indices of visceral adiposity used to predict metabolic and cardiovascular diseases in Asian populations. However, the relationships of CVAI and NVAI with chronic kidney disease (CKD) have not been investigated. We aimed to characterize the relationships of CVAI and NVAI with the prevalence of CKD in Korean adults. Methods: A total of 14,068 participants in the 7th Korea National Health and Nutrition Examination Survey (6,182 men and 7,886 women) were included. Receiver operating characteristic (ROC) analyses were employed to compare the associations between indices of adiposity and CKD, and a logistic regression model was used to characterize the relationships of CVAI and NVAI with CKD prevalence. Results: The areas under the ROC curves for CVAI and NVAI were significantly larger than for the other indices, including the visceral adiposity index and lipid accumulation product, in both men and women (all P<0.001). In addition, high CVAI or NVAI was significantly associated with a high CKD prevalence in both men (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.31 to 3.48 in CVAI and OR, 6.47; 95% CI, 2.91 to 14.38 in NVAI, P<0.05) and women (OR, 4.87; 95% CI, 1.85 to 12.79 in CVAI and OR, 3.03; 95% CI, 1.35 to 6.82 in NVAI, P<0.05); this association remained significant after adjustment for multiple confounding factors in men and women. Conclusion: CVAI and NVAI are positively associated with CKD prevalence in a Korean population. CVAI and NVAI may be useful for the identification of CKD in Asian populations, including in Korea. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to examine the relationships of disease activity and risk factors with serum levels of orexigenic and anorexigenic hormones in patients with obstructive sleep apnea syndrome (OSAS). Methods: Fasting blood samples were taken for hormonal analysis of all participants, abdominal/neck bioimpedance measurements were recorded, and polysomnography (PSG) analyses were performed. According to the apnea–hypopnea index (AHI), 34 patients with newly diagnosed OSAS and 34 participants without OSAS were compared. Results: The median body mass index (BMI) measured in the OSAS group was 30.39 kg/m2 and AHI was 18.95 and these values were 25.40 kg/m2 and 1.55 in the control group. There was a higher level of visceral adiposity and neuropeptide Y (NPY) in the moderate-to-severe OSAS group compared to the mild OSAS and control groups, and in the mild OSAS group compared to the control group (p = 0.001, p < 0.001). A positive correlation between the level of NPY and AHI and BMI (p < 0.001, p = 0.011), and a negative correlation between NPY levels and oxygen saturation (p = 0.001) was found. Oxygen saturation and desaturation rates were correlated with body fat percentage, body fat mass, abdominal adiposity, visceral adiposity, resting metabolic rate, and NPY levels. Conclusions: The visceral adiposity ratio and increase in NPY levels are important parameters that increase the severity of OSAS. Considering the negative effects of NPY on vascular endothelium, measurement of basal NPY level before PSG in patients with OSAS is considered a parameter related to disease severity. [ABSTRACT FROM AUTHOR]

Earlier age at menarche is one of the well-documented antecedents of a range of adverse health effects in adulthood including obesity and psychopathological effects. Yet, few researchers have examined the potential association of menarcheal age with body fat distribution, self-perception, and body image. We retrospectively tested a sample (N = 392) of adult women (18–80 years) to examine the associations of age at menarche with body composition and body image indices. Analyses of covariance and multivariable logistic and linear regression were fitted adjusting for age, physical activity level, smoking, and alcohol consumption. Further adjustment was made for body mass index (BMI) and percentage of fat mass. Earlier age at menarche was associated with slightly increased odds of higher BMI and abdominal fat percentage; of note is the positive correlation with lower body composition indices including hip and calf circumferences/skinfolds. Additionally, earlier age at menarche was associated with higher scores in the negative body image scales, namely overweight preoccupation and self-classified weight, whereas lower risks were found for higher scores in the positive body image scales, namely appearance evaluation and body area satisfaction scales. These findings remained significant after correcting for body fat percentage. The present results showed positive associations for earlier age at menarche with gross indices of obesity with the associations mainly confined to distribution of body fat in the lower part of the body, whereas an increased risk of negative body image was also found. Future research could refine our understanding of the biological and psychological mechanisms underlying these associations. [ABSTRACT FROM AUTHOR]

Introduction: Considering the issue in the population of postmenopausal women, no study has been conducted in Iran so far on the relationship between body fat distribution and quality of life. This study aimed to investigate the correlation between body fat distribution and quality of life in menopausal women. Methods: The present descriptive study was conducted on 250 premenopausal and menopausal women aged 40-65 years. Samples were selected by a multi-stage random sampling method. Data were collected through a two-part questionnaire including demographic variables and a questionnaire on the postmenopausal women's life quality in health centers. The data were analyzed using Statistical tests, distribution, frequency percentage mean score, Standard deviation, and independent sample t-tests. Results: The mean age of participants was 55.17 years. There was a statistically significant difference between the two forms of body fat distribution in the vasomotor domain (p = 0.021), the physical domain (p = 0.044), and the sexual domain (p = 0.001), but no statistically significant difference was observed for the psychological domain (p = 0.148). Conclusion: The results of the present study showed a significant difference in some aspects of the postmenopausal women's life quality with pear-shaped and gynoid fat distribution. [ABSTRACT FROM AUTHOR]

The experiment was to study the effect of different levels of bile acids on growth performance, slaughter performance, body fat distribution and meat quality of Guangxi Sanhuang chickens in finishing period. A total of 1 200 80-day-old Guangxi Sanhuang chickens with body weight of nearly 990 g were randomly divided into four groups, with three replicates in each group and 100 chickens in each replicate. The chickens in control group were fed with a basal diet, and the experimental groups were supplemented with 200, 350 and 500 g/t bile acid premix in basal diet, respectively. The pre-test lasted for 4 d and the formal test lasted for 35 d. The results showed that compared with control group, the final weight and average daily gain of Guangxi Sanhuang chickens in each experimental group were extremely increased (P<0.01). There was no significant difference in apparent digestibility of dry matter, crude protein, crude fat, and crude fiber among each group (P>0.05). There was no significant difference in slaughter performance such as slaughter rate, half clean bore rate, chest muscle rate and leg muscle rate among each group (P>0.05). There was no significant difference in abdominal fat weight, intermuscular fat width, chest muscle fat content and leg muscle fat content among each group (P>0.05). The chest muscle color in group 1 was significantly lower than that in control group (P<0.05), and the hydraulic capacity of chest muscle system was extremely higher than that in control group (P<0.01). The loss of chest muscle dripping was significantly higher than that in group 3 (P<0.05). The leg muscle shear force in group 1 was significantly lower than that in group 3 (P<0.05). The hydraulic power of leg muscle system in group 3 was extremely higher than that in other groups (P<0.01). The leg muscle dripping loss in group 2 was significantly lower than that in control group (P<0.05), leg muscle steaming loss was significantly higher than that in group 3 (P<0.05). The study indicates that bile acids can improve the growth performance and body fat distribution of Guangxi Sanhuang chickens, which has a regulatory effect on meat quality traits, and the supplementation level of 350 g/t is better. [ABSTRACT FROM AUTHOR]

• The link between obesity and AES was validated. • We uncoupled the effect of adiposity from that of metabolic dysregulations using genomics. • AES profile was positively associated with GRS of metabolically unhealthy adiposity. • The link between adiposity and AES emerges in the presence of metabolic dysregulation. Adiposity has been shown to be linked with atypical energy-related symptoms (AES) of depression. We used genomics to separate the effect of adiposity from that of metabolic dysregulations to examine whether the link between obesity and AES is dependent on the presence of metabolic dysregulations. Data were from NEO (n = 5734 individuals) and NESDA (n = 2238 individuals) cohorts, in which the Inventory of Depressive Symptomatology (IDS-SR30) was assessed. AES profile was based on four symptoms: increased appetite, increased weight, low energy level, and leaden paralysis. We estimated associations between AES and two genetic risk scores (GRS) indexing increasing total body fat with (metabolically unhealthy adiposity, GRS-MUA) and without (metabolically healthy adiposity, GRS-MHA) metabolic dysregulations. We validated that both GRS-MUA and GRS-MHA were associated with higher total body fat in NEO study, but divergently associated with biomarkers of metabolic health (e.g., fasting glucose and HDL-cholesterol) in both cohorts. In the pooled results, per standard deviation, GRS-MUA was specifically associated with a higher AES score (β = 0.03, 95%CI: 0.01; 0.05), while there was no association between GRS-MHA and AES (β = −0.01, 95%CI: −0.03; 0.01). These results suggest that the established link between adiposity and AES profile emerges in the presence of metabolic dysregulations, which may represent the connecting substrate between the two conditions. [ABSTRACT FROM AUTHOR]

Background: A recent hypothesis postulates the existence of an 'immune-metabolic depression' (IMD) dimension characterized by metabolic dysregulations. Combining data on metabolomics and depressive symptoms, we aimed to identify depressions associated with an increased risk of adverse metabolic alterations. Method: Clustering data were from 1094 individuals with major depressive disorder in the last 6 months and measures of 149 metabolites from a 1H-NMR platform and 30 depressive symptoms (IDS-SR30). Canonical correlation analyses (CCA) were used to identify main independent metabolite-symptom axes of variance. Then, for the replication, we examined the association of the identified dimensions with metabolites from the same platform and cardiometabolic diseases in an independent population-based cohort (n = 6572). Results: CCA identified an overall depression dimension and a dimension resembling IMD, in which symptoms such as sleeping too much, increased appetite, and low energy level had higher relative loading. In the independent sample, the overall depression dimension was associated with lower cardiometabolic risk, such as (i.e. per s.d.) HOMA-1B −0.06 (95% CI −0.09 – −0.04), and visceral adipose tissue −0.10 cm2 (95% CI −0.14 – −0.07). In contrast, the IMD dimension was associated with well-known cardiometabolic diseases such as higher visceral adipose tissue 0.08 cm2 (95% CI 0.04–0.12), HOMA-1B 0.06 (95% CI 0.04–0.09), and lower HDL-cholesterol levels −0.03 mmol/L (95% CI −0.05 – −0.01). Conclusions: Combining metabolomics and clinical symptoms we identified a replicable depression dimension associated with adverse metabolic alterations, in line with the IMD hypothesis. Patients with IMD may be at higher cardiometabolic risk and may benefit from specific treatment targeting underlying metabolic dysregulations. [ABSTRACT FROM AUTHOR]

Objective: To examine whether low-dose flutamide administration to normal-weight women with polycystic ovary syndrome (PCOS) reduces abdominal fat deposition, attenuates accelerated lipid accumulation in newly formed adipocytes derived from subcutaneous (SC) abdominal adipose stem cells (ASCs), and/or alters glucose-lipid metabolism.Design: A double-blind, placebo-controlled randomized clinical trial.Setting: An academic medical center.Patient(s): Twelve normal-weight women with PCOS and 12 age- and body mass index-matched controls.Intervention(s): Women underwent circulating hormonal and metabolic determinations, intravenous glucose tolerance testing, total body dual-energy roentgenogram absorptiometry, and SC abdominal fat biopsy. Interventions were repeated in women with PCOS after 6-month administration of flutamide (125 mg orally daily) vs. placebo.Main Outcome Measure(s): Clinical parameters and lipid accumulation in newly formed adipocytes derived from SC abdominal ASCs in vitro were compared between controls and the women with PCOS receiving flutamide vs. placebo.Results: Serum luteinizing hormone and androgen levels as well as lipid accumulation in newly formed SC abdominal adipocytes were greater in the women with PCOS than controls. Flutamide vs. placebo reduced percent android fat, lowered serum log low-density lipoprotein and log non-high-density lipoprotein levels, and increased fasting circulating glucose levels. In all women with PCOS, changes in percent android fat positively correlated with serum log non-high-density lipoprotein and log low-density lipoprotein levels, with correlations influenced by serum free testosterone levels. Flutamide vs. placebo also attenuated lipid accumulation in newly-formed PCOS SC abdominal adipocytes in vitro relative to controls, which was unrelated to serum lipid levels.Conclusion: Low-dose flutamide administration to normal-weight PCOS women reduces preferential abdominal fat deposition, attenuates accelerated lipid accumulation in newly-formed adipocytes derived from SC abdominal ASCs in vitro, and alters glucose-lipid homeostasis.Clinical Trial Registration Number: NCT01889199 (URL, clinicaltrials.gov; date of registration, 6/28/2013; enrollment date of first subject, 6/28/2013). [ABSTRACT FROM AUTHOR]

Objective To systematically evaluate the effect of liraglutide on fat distribution in patients with type 2 diabetes mellitus. Methods Databases of PubMed, the Cochrane Library, Embase, CNKI, Wanfang and VIP were searched for randomized controlled trials (RCT) with therapy of liraglutide in type 2 diabetes mellitus from establishment of the database to December 2021, and the eligible studies were screened according to the inclusion and exclusion criteria, and the relevant data were extracted. The experimental group received liraglutide, and the control group received placebo, active drug, dietary intervention or basal drug control. The primary outcome measures were visceral and subcutaneous adipose tissue, as well as other anthropometric measures, including body weight, waist circumference and body mass index. The Review Manager 5.4.1 and STATA 16.0 for statistical analysis were performed. Egger′s test assessed publication bias. The Cochrane risk of bias tool assessed the risk of bias. Results A total of 8 articles including 10 RCT were included. The results of the meta-analysis showed that compared with the control group, the liraglutide group had a significant reduction in visceral adipose tissue [standardized mean difference (SMD) =-0.69 cm2, 95%CI -1.09--0.29 cm2, I2=78%, P<0.05] and subcutaneous adipose tissue (SMD=-0.48 cm2, 95%CI -0.77--0.19 cm2, I2=50%, P<0.05). In addition, it also significantly reduced body weight [weighted mean difference (WMD)=-3.65 kg, 95%CI -4.45--2.85 kg, I2=0, P< 0.05], waist circumference (WMD=-3.07 cm, 95%CI -4.63--1.51 cm, I2=75%, P<0.05) and body mass index (WMD=-1.23 kg/m2, 95%CI -1.62--0.84 kg/m2, I2=50%, P<0.05). Conclusion Liraglutide significantly reduced visceral and subcutaneous fat. [ABSTRACT FROM AUTHOR]

Adipose tissue (AT) inflammation may increase obesity-related cardiometabolic complications. Altered AT oxygen partial pressure (pO2) may impact the adipocyte inflammatory phenotype. Here, we investigated the effects of physiological pO2 levels on the inflammatory phenotype of abdominal (ABD) and femoral (FEM) adipocytes derived from postmenopausal women with normal weight (NW) or obesity (OB). Biopsies were collected from ABD and FEM subcutaneous AT in eighteen postmenopausal women (aged 50–65 years) with NW (BMI 18–25 kg/m2, n = 9) or OB (BMI 30–40 kg/m2, n = 9). We compared the effects of prolonged exposure to different physiological pO2 levels on adipokine expression and secretion in differentiated human multipotent adipose-derived stem cells. Low physiological pO2 (5% O2) significantly increased leptin gene expression/secretion in ABD and FEM adipocytes derived from individuals with NW and OB compared with high physiological pO2 (10% O2) and standard laboratory conditions (21% O2). Gene expression/secretion of IL-6, DPP-4, and MCP-1 was reduced in differentiated ABD and FEM adipocytes from individuals with OB but not NW following exposure to low compared with high physiological pO2 levels. Low physiological pO2 decreases gene expression and secretion of several proinflammatory factors in ABD and FEM adipocytes derived from individuals with OB but not NW. [ABSTRACT FROM AUTHOR]

Aim: Conventionally, the skeletal muscle area with computed tomography (CT) attenuation ranging from −29 to +150 Hounsfield unit (HU) divided by height squared (the conventional skeletal muscle index [SMI]) was used as an index of skeletal muscle mass. However, it includes fat‐infiltrated skeletal muscle, which is known to have poor function. This study aims to determine whether the low‐fat SMI, which uses skeletal muscle mass with CT attenuation ranging from +30 to +150 HU, or conventional SMI appropriately reflects the function of skeletal muscle. Methods: We retrospectively analyzed 120 patients with cirrhosis whose handgrip strength was measured. Among them, 48 patients underwent a physical performance assessment such as liver frailty index (LFI) and short physical performance battery (SPPB), and 80 underwent quality of life (QOL) assessment. The relationships between each SMI and handgrip strength, LFI, SPPB, and QOL were evaluated. Results: Low‐fat SMI was significantly correlated with handgrip strength (males, R = 0.393, p = 0.002; females, R = 0.423, p < 0.001) and LFI (males, R = −0.535, p = 0.035; females, R = −0.368, p = 0.039), whereas conventional SMI was not. When using low‐fat SMI, patients with low skeletal muscle mass had significantly low handgrip strength, LFI, SPPB, and physical and social‐related QOL score than those without. By contrast, no significant differences were found for any items when using conventional SMI. Conclusions: Low‐fat SMI is a good index of skeletal muscle mass that appropriately reflects skeletal muscle function. [ABSTRACT FROM AUTHOR]

The analysis of body composition is a fundamental part of a nutritional status assessment, and the use of diagnostic imaging methods has been increasingly required for an adequate characterization of the lean body mass and fat mass. Body composition measurements are useful in evaluating the effectiveness of nutritional interventions and monitoring changes associated with aging and chronic diseases. Whole-body densitometry using dual-energy X-ray absorptiometry (DEXA) is one of the most widely used methods in clinical practice, allowing highly accurate assessment of the bone mineral content, lean body mass, and fat mass. Although a DEXA examination provides a lot of information, there is still no universal standardization of the parameters to be included in radiology reports. The aim of this study was to review the most relevant information for assessing body composition by whole-body densitometry. [ABSTRACT FROM AUTHOR]

Body fat distribution is a well-established predictor of adverse medical outcomes, independent of overall adiposity. Studying body fat distribution sheds insights into the causes of obesity and provides valuable information about the development of various comorbidities. Compared to total adiposity, body fat distribution is more closely associated with risks of cardiovascular diseases. The present review specifically focuses on the sexual dimorphism in body fat distribution, the biological clues, as well as the genetic traits that are distinct from overall obesity. Understanding the sex determinations on body fat distribution and adiposity will aid in the improvement of the prevention and treatment of cardiovascular diseases (CVD). [ABSTRACT FROM AUTHOR]

Background: Polycyclic aromatic hydrocarbons (PAHs) are environmental pollutants that may contribute to the etiology of obesity. However, it is unclear whether PAHs from environmental sources are associated with regional body fat distribution, and whether the association varies across racial/ethnic groups who may have differential PAH exposure patterns. Objectives: To examine correlations between PAHs and body fat distribution, and potential racial/ethnic differences among U.S. adults. Methods: Ten PAHs were measured in spot urine samples from 2691 non-smoking adults (age ≥ 20 years) in the NHANES 2001–2016. Dual-energy X-ray absorptiometry was used to measure fat mass percent (FM%). Partial Pearson correlation coefficients (r) with multivariable adjustment were used to assess PAH-FM% associations. Results: In the total population, 1-naphthalene, 3-fluorene, and 1-pyrene were inversely correlated with total FM% or trunk FM% (adjusted r ranged: − 0.06 to − 0.08), while 2-naphthalene, 9-fluorene, and 4-phenanthrene were positively correlated with the FM% measurements (r: 0.07–0.11). PAH levels are highest among non-Hispanic Blacks, followed by Hispanics and Whites and some of the correlations were different by these races/ethnicities. Among non-Hispanic Whites, no PAH was correlated with FM%. In contrast, 9-fluorene was positively correlated with total FM% (r = 0.20) and trunk FM% (r = 0.22) among Blacks, and 4-phenanthrene was positively correlated with total FM% (r = 0.23) and trunk FM% (r = 0.24) among Hispanics (P-interaction: 0.010–0.025). Discussion: In this US adult population, certain PAHs are significantly associated with higher body fat contents among non-Hispanic Blacks and Hispanics but not non-Hispanic Whites, suggesting that minority groups might be particularly susceptible to PAH's obesogenic effects or the effects of other factors that determine the PAH exposure levels. Alternatively, differences in body composition may contribute to differential PAH metabolism in minority groups. Future studies are warranted to explore the racial/ethnic disparity in PAH exposures, drivers of these exposure differences, and mechanisms through which PAHs may influence body composition by races/ethnicities. [ABSTRACT FROM AUTHOR]

Background: Polycyclic aromatic hydrocarbons (PAHs) are environmental pollutants that may contribute to the etiology of obesity. However, it is unclear whether PAHs from environmental sources are associated with regional body fat distribution, and whether the association varies across racial/ethnic groups who may have differential PAH exposure patterns.Objectives: To examine correlations between PAHs and body fat distribution, and potential racial/ethnic differences among U.S. adults.Methods: Ten PAHs were measured in spot urine samples from 2691 non-smoking adults (age ≥ 20 years) in the NHANES 2001-2016. Dual-energy X-ray absorptiometry was used to measure fat mass percent (FM%). Partial Pearson correlation coefficients (r) with multivariable adjustment were used to assess PAH-FM% associations.Results: In the total population, 1-naphthalene, 3-fluorene, and 1-pyrene were inversely correlated with total FM% or trunk FM% (adjusted r ranged: - 0.06 to - 0.08), while 2-naphthalene, 9-fluorene, and 4-phenanthrene were positively correlated with the FM% measurements (r: 0.07-0.11). PAH levels are highest among non-Hispanic Blacks, followed by Hispanics and Whites and some of the correlations were different by these races/ethnicities. Among non-Hispanic Whites, no PAH was correlated with FM%. In contrast, 9-fluorene was positively correlated with total FM% (r = 0.20) and trunk FM% (r = 0.22) among Blacks, and 4-phenanthrene was positively correlated with total FM% (r = 0.23) and trunk FM% (r = 0.24) among Hispanics (P-interaction: 0.010-0.025).Discussion: In this US adult population, certain PAHs are significantly associated with higher body fat contents among non-Hispanic Blacks and Hispanics but not non-Hispanic Whites, suggesting that minority groups might be particularly susceptible to PAH's obesogenic effects or the effects of other factors that determine the PAH exposure levels. Alternatively, differences in body composition may contribute to differential PAH metabolism in minority groups. Future studies are warranted to explore the racial/ethnic disparity in PAH exposures, drivers of these exposure differences, and mechanisms through which PAHs may influence body composition by races/ethnicities. [ABSTRACT FROM AUTHOR]

The objective of this study was to examine the associations of early mid-pregnancy ultrasound measured visceral and subcutaneous fat depths with blood-based protein biomarkers. This was a cross-sectional study including 201 pregnant women at Uppsala University Hospital, Sweden. The mean age of the women was 31.0 years, and 57.7% were nulliparous. Maternal visceral and subcutaneous fat depths were measured by ultrasound at the early second-trimester anomaly scan. A non-fasting blood sample was collected in conjunction with the second-trimester anomaly scan, and the Olink cardiovascular II panel was used to measure 92 blood-based protein biomarkers in the sample. Cross-sectional associations of visceral and subcutaneous fat depths with blood-based protein biomarkers were examined using Mann–Whitney U tests with false discovery rate adjustments. In addition, linear regression analyses adjusting for maternal age, parity, and early pregnancy body mass index were performed. The results showed differences in one biomarker between women with elevated (≥ 52 mm) versus normal (< 52 mm) visceral fat depth, and in three biomarkers between women with elevated (≥ 22 mm) versus normal (< 22 mm) subcutaneous fat depth. Hence, levels of blood-based protein biomarkers differ between pregnant women with dissimilar body fat distributions, which might reflect disparities in biological pathways. [ABSTRACT FROM AUTHOR]

For women, menopausal transition is a time of significant hormonal changes, which may contribute to altered body composition and regional adipose tissue accumulation. Excess adiposity, and especially adipose tissue accumulation in the central body region, increases women's risk of cardiovascular and metabolic conditions and affects physical functioning. We investigated the associations between menopausal progression and total and regional body adiposity measured with dual‐energy X‐ray absorptiometry and computed tomography in two longitudinal cohort studies of women aged 47–55 (n = 230 and 148, mean follow‐up times 1.3 ± 0.7 and 3.9 ± 0.2 years, mean baseline BMI 25.5 kg/m2). We also examined associations between menopausal progression and skeletal muscle fiber characteristics, as well as adipose tissue‐derived adipokines. Relative increases of 2%–14% were observed in regional and total body adiposity measures, with a pronounced fat mass increase in the android area (4% and 14% during short‐ and long‐term follow‐ups). Muscle fiber oxidative and glycolytic capacities and intracellular adiposity were not affected by menopause, but were differentially correlated with total and regional body adiposity at different menopausal stages. Menopausal progression and regional adipose tissue masses were positively associated with serum adiponectin and leptin, and negatively associated with resistin levels. Higher diet quality and physical activity level were also inversely associated with several body adiposity measures. Therefore, healthy lifestyle habits before and during menopause might delay the onset of severe metabolic conditions in women. [ABSTRACT FROM AUTHOR]

Background: Beyond the degree of adiposity, the pattern of fat distribution has a profound influence on cardiometabolic risk. It is unclear if sex differences in body fat distribution can potentially explain any sex differences in the prevalence of the metabolic syndrome (MetS) and in individual cardiometabolic risk factors among obese men and women. Methods: In this cross-sectional analysis, 432 persons from the ongoing Obesity Weight Reduction Study (n = 356 obese, ØBMI 41 ± 8 kg/m2, and 76 non-obese, ØBMI 25 ± 3 kg/m2), were included. The relations of sex to MetS prevalence and selected cardiometabolic risk factors were assessed using univariate and multivariate adjusted regression models. Results: In crude analyses, %fat mass and the fat mass/lean mass ratio were significantly higher in women than in men, regardless of increasing obesity categories, from normal weight to grade-3-obesity. In contrast, markers of abdominal obesity, such as waist circumference and waist-to-hip ratio were higher in men than in women, despite similar BMI. The prevalence of the MetS was higher in obese men than in women (67.6 vs. 45.0%, p < 0.0001), particularly in younger individuals < 40 years (72.5 vs. 36.8%, p < 0.0001), but "metabolically healthy obesity" (BMI ≥ 30, no other NCEP ATPIII MetS component) was more common in women than in men (15.6 vs. 4.1%, p < 0.0001). After adjusting for age, %body fat and height, sex differences were observed for HDL-cholesterol (p < 0.001), triglycerides (p < 0.001), fasting glucose (p = 0.002), insulin and HOMA-IR levels (p < 0.001), ALAT (p < 0.001), adiponectin (p < 0.001), and sE-selectin (p = 0.005). In contrast, crude sex differences in other variables, such as leptin levels (68 ± 4 in obese women vs. 33 ± 2 µg/L in men, p < 0.0001), disappeared after accounting for differences in %body fat (least-squares means of leptin: 52 ± 4 vs. 55 ± 6 µg /L, p = 0.740). A logistic regression model adjusting for age and lifestyle factors revealed a lower risk of having MetS for women as compared to men (OR = 0.38[0.22–0.60]). That risk estimate did not materially alter after adding BMI to the model. In contrast, no statistically significant association between sex and MetS prevalence was observed after adding waist circumference and adiponectin to the model (OR = 1.41[0.59–3.36]). Conclusions: Different body fat distribution patterns, particularly abdominal adiposity, adiponectin, and related biomarkers, may contribute to sex differences in cardiometabolic risk factors and to the prevalence of the MetS. [ABSTRACT FROM AUTHOR]

As a common endocrinopathy of reproductive-aged women, polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism, oligo-anovulation and polycystic ovarian morphology. It is linked with insulin resistance through preferential abdominal fat accumulation that is worsened by obesity. Over the past two millennia, menstrual irregularity, male-type habitus and sub-infertility have been described in women and confirm that these clinical features of PCOS were common in antiquity. Recent findings in normal-weight hyperandrogenic PCOS women show that exaggerated lipid accumulation by subcutaneous (SC) abdominal stem cells during development to adipocytes in vitro occurs in combination with reduced insulin sensitivity and preferential accumulation of highly-lipolytic intra-abdominal fat in vivo. This PCOS phenotype may be an evolutionary metabolic adaptation to balance energy storage with glucose availability and fatty acid oxidation for optimal energy use during reproduction. This review integrates fundamental endocrine-metabolic changes in healthy, normal-weight PCOS women with similar PCOS-like traits present in animal models in which tissue differentiation is completed during fetal life as in humans to support the evolutionary concept that PCOS has common ancestral and developmental origins. [ABSTRACT FROM AUTHOR]

Purpose: Obesity and a high body mass index (BMI) are considered as risk factors for abdominal wall hernia (AWH). However, anthropometric measures of body fat distribution (BFD) seem to be better indicators in the hernia field. This Mendelian randomization analysis aimed to generate more robust evidence for the impact of waist circumstance (WC), body, trunk, arm, and leg fat percentages (BFP, TFP, AFP, LFP) on AWH.A univariable MR design was employed and the summary statistics allowing for assessment were obtained from the genome-wide association studies (GWASs). An inverse variance weighted (IVW) method was applied as the primary analysis, and the odds ratio value was used to evaluate the causal relationship between BFD and AWH.None of the MR-Egger regression intercepts deviated from null, indicating no evidence of horizontal pleiotropy (p > 0.05). The Cochran Q test showed heterogeneity between the genetic IVs for WC (p = 0.005; p = 0.005), TFP (p < 0.001; p < 0.001), AFP-L (p = 0.016; p = 0.015), LFP-R (p = 0.012; p = 0.009), and LFP-L (p < 0.001; p < 0.001). Taking the IVW random-effects model as gold standard, each standard deviation increment in genetically determined WC, BFP, TFP, AFP-R, AFP-L, LFP-R, and LFP-L raised the risk of AWH by 70.9%, 70.7%, 56.5%, 69.7%, 78.3%, 87.7%, and 72.5%, respectively.This study proves the causal relationship between AWH and BFD, attracting more attention from BMI to BFD. It provides evidence-based medical evidence that healthy figure management can prevent AWH.Methods: Obesity and a high body mass index (BMI) are considered as risk factors for abdominal wall hernia (AWH). However, anthropometric measures of body fat distribution (BFD) seem to be better indicators in the hernia field. This Mendelian randomization analysis aimed to generate more robust evidence for the impact of waist circumstance (WC), body, trunk, arm, and leg fat percentages (BFP, TFP, AFP, LFP) on AWH.A univariable MR design was employed and the summary statistics allowing for assessment were obtained from the genome-wide association studies (GWASs). An inverse variance weighted (IVW) method was applied as the primary analysis, and the odds ratio value was used to evaluate the causal relationship between BFD and AWH.None of the MR-Egger regression intercepts deviated from null, indicating no evidence of horizontal pleiotropy (p > 0.05). The Cochran Q test showed heterogeneity between the genetic IVs for WC (p = 0.005; p = 0.005), TFP (p < 0.001; p < 0.001), AFP-L (p = 0.016; p = 0.015), LFP-R (p = 0.012; p = 0.009), and LFP-L (p < 0.001; p < 0.001). Taking the IVW random-effects model as gold standard, each standard deviation increment in genetically determined WC, BFP, TFP, AFP-R, AFP-L, LFP-R, and LFP-L raised the risk of AWH by 70.9%, 70.7%, 56.5%, 69.7%, 78.3%, 87.7%, and 72.5%, respectively.This study proves the causal relationship between AWH and BFD, attracting more attention from BMI to BFD. It provides evidence-based medical evidence that healthy figure management can prevent AWH.Results: Obesity and a high body mass index (BMI) are considered as risk factors for abdominal wall hernia (AWH). However, anthropometric measures of body fat distribution (BFD) seem to be better indicators in the hernia field. This Mendelian randomization analysis aimed to generate more robust evidence for the impact of waist circumstance (WC), body, trunk, arm, and leg fat percentages (BFP, TFP, AFP, LFP) on AWH.A univariable MR design was employed and the summary statistics allowing for assessment were obtained from the genome-wide association studies (GWASs). An inverse variance weighted (IVW) method was applied as the primary analysis, and the odds ratio value was used to evaluate the causal relationship between BFD and AWH.None of the MR-Egger regression intercepts deviated from null, indicating no evidence of horizontal pleiotropy (p > 0.05). The Cochran Q test showed heterogeneity between the genetic IVs for WC (p = 0.005; p = 0.005), TFP (p < 0.001; p < 0.001), AFP-L (p = 0.016; p = 0.015), LFP-R (p = 0.012; p = 0.009), and LFP-L (p < 0.001; p < 0.001). Taking the IVW random-effects model as gold standard, each standard deviation increment in genetically determined WC, BFP, TFP, AFP-R, AFP-L, LFP-R, and LFP-L raised the risk of AWH by 70.9%, 70.7%, 56.5%, 69.7%, 78.3%, 87.7%, and 72.5%, respectively.This study proves the causal relationship between AWH and BFD, attracting more attention from BMI to BFD. It provides evidence-based medical evidence that healthy figure management can prevent AWH.Conclusions: Obesity and a high body mass index (BMI) are considered as risk factors for abdominal wall hernia (AWH). However, anthropometric measures of body fat distribution (BFD) seem to be better indicators in the hernia field. This Mendelian randomization analysis aimed to generate more robust evidence for the impact of waist circumstance (WC), body, trunk, arm, and leg fat percentages (BFP, TFP, AFP, LFP) on AWH.A univariable MR design was employed and the summary statistics allowing for assessment were obtained from the genome-wide association studies (GWASs). An inverse variance weighted (IVW) method was applied as the primary analysis, and the odds ratio value was used to evaluate the causal relationship between BFD and AWH.None of the MR-Egger regression intercepts deviated from null, indicating no evidence of horizontal pleiotropy (p > 0.05). The Cochran Q test showed heterogeneity between the genetic IVs for WC (p = 0.005; p = 0.005), TFP (p < 0.001; p < 0.001), AFP-L (p = 0.016; p = 0.015), LFP-R (p = 0.012; p = 0.009), and LFP-L (p < 0.001; p < 0.001). Taking the IVW random-effects model as gold standard, each standard deviation increment in genetically determined WC, BFP, TFP, AFP-R, AFP-L, LFP-R, and LFP-L raised the risk of AWH by 70.9%, 70.7%, 56.5%, 69.7%, 78.3%, 87.7%, and 72.5%, respectively.This study proves the causal relationship between AWH and BFD, attracting more attention from BMI to BFD. It provides evidence-based medical evidence that healthy figure management can prevent AWH. [ABSTRACT FROM AUTHOR]

Background: It has been observed that gluteal-femoral adipose tissue has a protective effect against risk factors for cardiovascular disease but has not yet been concluded how different evaluation methods of fat distribution affect the results. Methods: To test the hypothesis that B-mode ultrasound-measured subcutaneous adipose tissue distribution is associated with cardiovascular risk factors, 326 Japanese unmedicated postmenopausal women aged 50-70 years were analyzed. Subcutaneous adipose tissue thickness at 6 sites (anterior and posterior aspects of trunk, upper-arm, and thigh) and serum total (TC) and high-density lipoprotein cholesterol (HDLC) was measured, and a ratio of HDLC to TC (HDLC/TC) was calculated. We used Bayesian linear regression with 4 separate models with each model predicting HDLC/TC. Results: Our first model provided evidence for an inverse correlation (r = -0.23) between ultrasound measured body fat (6 site measurement) and HDLC/TC. The second model noted evidence for an inverse correlation between trunk fat and HDLC/TC and found evidence for the null with respect to the correlation between thigh fat and HDLC/TC. Therefore, we added thigh fat to the null model to produce Distribution Model 2. Within this model, we noted an inverse correlation (r = -0.353) between trunk fat and HDLC/TC. Our last model determined that within the trunk fatness, the abdominal area (anterior trunk) was a larger predictor than the subscapular site (posterior trunk). Conclusion: These results support the evidence that ultrasound-measured abdominal subcutaneous adipose tissue thickness is a non-invasive predictor for monitoring the risk for dyslipidemia in postmenopausal women. [ABSTRACT FROM AUTHOR]

Summary: Background: In the United States, the underlying reasons for racial/ethnic disparities in type 2 diabetes risk remain unclear. However, differences in genetic risk for insulin resistance and peripheral adipose tissue distribution may be contributing factors. Objective: To investigate racial/ethnic differences in associations of genetic risk for insulin resistance with leg fat and insulin sensitivity in a cohort of American children. Methods: Participants were healthy European–American (n = 83), African–American (n = 79) and Hispanic–American (n = 74) children aged 7–12 years. Genetic risk scores were derived from published variants associated with insulin resistance phenotypes in European adults. Body composition was assessed using dual‐energy X‐ray absorptiometry. Insulin sensitivity was determined from the frequently sampled intravenous glucose tolerance test and minimal modelling. Statistical models were adjusted for age, sex, pubertal stage and body composition. Results: In the combined cohort, risk score was inversely associated with insulin sensitivity (p = 0.033) but not leg fat (p = 0.170). Within Hispanic Americans, risk score was inversely associated with insulin sensitivity (p = 0.027) and leg fat (p = 0.005), while associations were non‐significant in European and African Americans (p > 0.200). Conclusions: The higher type 2 diabetes risk observed among Hispanic Americans may have a genetic basis related to an inability to store lipid in peripheral adipose tissue. [ABSTRACT FROM AUTHOR]

Background: The prevalence of non-alcoholic fatty liver disease (NAFLD) has rapidly increased worldwide. The aim of this study was to investigate whether there is an independent relationship between regional fat distribution, especially leg fat mass, and the presence of NAFLD using nationally representative data in Korea. Methods: This cross-sectional study analyzed data from 14,502 participants in the Korea National Health and Nutrition Examination Survey 2008 to 2011. Total fat mass, leg fat mass, and appendicular skeletal muscle mass were measured by dual-energy X-ray absorptiometry. Validated NAFLD prediction models and scoring systems for hepatic fibrosis were used. Results: The leg fat to total fat (LF/TF) ratio showed a negative relationship with many factors, including body mass index, waist circumference, blood pressure, fasting blood glucose, and liver enzyme levels. When the LF/TF ratio and indices of hepatic steatosis were stratified by quartiles, the LF/TF ratio showed a negative correlation with the scoring systems that were used. The LF/TF ratio showed better accuracy in predicting NAFLD than total fat mass or leg fat mass alone. After adjusting for various traditional and lifestyle factors, a low LF/TF ratio remained a risk factor for NAFLD. Among NAFLD subjects, the LF/TF ratio showed a negative relationship with hepatic fibrosis. Conclusion: A lower LF/TF ratio was markedly associated with a higher risk of hepatic steatosis and advanced hepatic fibrosis using various predictive models in a Korean population. Therefore, the LF/TF ratio could be a useful anthropometric parameter to predict NAFLD or advanced hepatic fibrosis. [ABSTRACT FROM AUTHOR]

Purpose: Visceral adipose tissue (VAT) may be more important than subcutaneous fat in type 2 diabetes (T2D) etiology. We examined a VAT score developed in reference to MRI measurement of VAT in the Multiethnic Cohort (MEC) as a risk factor for incident T2D.Methods: Two nested case-control studies of cancer allowed calculation of the VAT score based on anthropometric measures and 8 biomarkers among 2,556 participants without T2D. Incident cases were identified from Medicare linkages and self-reports after blood draws in 2001-2006. Cox regression with age as time metric was applied to estimate the association of the VAT score with T2D.Results: During 10.1 ± 2.4 years, 355 incident T2D cases were identified. VAT scores were higher in T2D cases than among those without disease (5.06±0.43 vs. 4.95±0.41; P<0.0001) and significantly associated with T2D (HR = 2.70; 95%CI 1.60, 4.58 per unit) with similar values in men (HR = 2.99; 95%CI 1.03, 8.73) and women (HR = 2.61; 95%CI 1.39, 4.91). A significant association was observed in all five ethnic groups but only statistically significant among Japanese Americans (HR = 6.24; 95%CI 2.34, 16.68).Conclusion: These findings support that VAT as estimated by a biomarker-based score predicts T2D incidence beyond BMI in particular among older adults of Japanese ancestry. [ABSTRACT FROM AUTHOR]

Objective: Although both obesity and body posture are important factors affecting end‐expiratory lung volume (EELV) and upper airway patency, the influence of those factors on EELV and the association between EELV and upper airway calibers are still unknown in mice. This study examined such interaction effects in obese mice to test the hypothesis that obese mice have decreased EELV accompanied by structural alterations of the upper airway. Methods: A high‐resolution in vivo micro‐computed tomography was utilized to scan anesthetized lean and diet‐induced obese mice in the prone and supine positions, followed by quantifying lung volume and analyzing upper airway morphology. Results: There was a statistically significant interaction between the effects of body weight and posture on both EELV (p = 0.0049, η2 = 0.1041) and upper airway calibers (p = 0.0215, η2 = 0.6304). In lean mice, EELV in the prone position was significantly larger than in the supine position (prone EELV = 193.22 ± 9.10 µl vs. supine EELV = 176.01 ± 10.91 µl; p = 0.0072), whereas obese mice did not have such an improvement in EELV in the prone position (prone EELV = 174.37 ± 20.23 µl vs. supine EELV = 183.39 ± 17.49 µl; p = 0.0981) and tended to have a smaller upper airway when EELV was low based on Spearman's correlation analysis. Conclusions: These data indicate that obesity is an important factor compromising both EELV and upper airway calibers in a posture‐dependent manner even in mice, which should be taken into consideration in future studies regarding upper airway collapse and lung mechanical properties using mice. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MetS) is associated with an increased risk of morbidity and mortality in almost all chronic diseases. The most frequent methods for the calculation of a continuous MetS (cMetS) score have used the standardized residuals in linear regression (z-score). Recently, emerging data suggest that one of the main genetic targets is the CAV1, which plays a crucial role in regulating body fat distribution. This study is designed to investigate the relationship between CAV1 rs3807992 genotypes and cMetS, and to determine whether body fat distribution plays a mediating role in this regard. Methods: The current cross-sectional study was conducted on 386 overweight and obese females. The CAV1 rs3807992 and body composition were measured by the PCR–RFLP method and bioelectrical impedance analysis, respectively. Serum profile of HDL-C, TGs, FPG, and Insulin were measured by standard protocols. Results: GG allele carriers had significantly lowered Z-MAP (p = 0.02), total cMetS (p = 0.03) and higher Z-HDL (p = 0.001) compared with (A) allele carriers. There was a significant specific indirect effect (standardized coefficient = 0.19; 95% CI 0.01–0.4) of Visceral fat level (VFL). Although, total body fat was significantly associated with CAV1 rs3807992 and cMetS, the specific indirect effect was not significant (standardized coefficient = 0.21; 95% CI − 0.006, 0.44). VFL contributed to significant indirect effects of 35% on the relationship between CAV1 and cMetS. Conclusion: Higher visceral adipose tissue may affect the relationship between CAV1 and cMetS. Although CAV1 rs3807992 is linked to VFL in our study, the influence of this polymorphism on MetS is not via total fat. [ABSTRACT FROM AUTHOR]

Background. The prevalence of childhood obesity is increasing worldwide and can affect their linear growth through various mechanisms. Objectives. We aimed to investigate the association between obesity-related traits and height in adolescents. Material and methods. This was a categorized cross-sectional study carried out on 186 students (93 case and 93 control) 15 to 18 years of age who were randomly selected from three schools in Shiraz, Iran. Anthropometric indices including height, weight, body mass index (BMI), body fat percentage (BF) and body muscle percentage (BM) were measured. Statistical analysis was done by SPSS software (Version 16). A significance level was considered as being less than 0.05. Results. We found an inverse association for waist circumference (WC) and fat mass with height. In addition, there was a direct relationship between fat-free mass and trunk fat with height. The mean height of participants in the obesity group was significantly lower than the control group (p = 0.04). Participants in the obesity group had significant higher FM percentage (p < 0.001) and WC (p < 0.001) than the control group. There was a significant correlation between height and WC (p = 0.003), as well as between height and fat percentage (p < 0.001). We also found a direct relationship between fast-free mass and height (p < 0.001), as well as between trunk fat percentage and height (p = 0.026). We have suggested an equation to estimate adolescents’ height based on the anthropometric indices. Conclusions. Adiposity, especially central adiposity, is adversely associated with height. However, muscle percentage might reinforce linear growth. Further studies are warranted to confirm this finding. [ABSTRACT FROM AUTHOR]

Objective: Rare co-existance of disease or pathology Background: Lipedema is a loose connective tissue disease that causes disproportionate subcutaneous fat accumulation on the extremities. As a result of the increased subcutaneous tissue accumulation, lipedema is often confused with obesity by both physicians and patients. Poor awareness and limited diagnosis of lipedema contribute to the confusion of lipedema with obesity and can lead to decreased body image acceptance. Patients with lipedema may have anorexia nervosa, an eating disorder characterized by a distortion of body image, incorrect self-identification of being overweight, restricted eating behavior, and a relentless pursuit of weight loss. Case Report: A young woman with disproportionate fat accumulation on the lower half of her body self-identified as having obesity. She developed restrictive eating behavior and became obsessed with weight loss, resulting in anorexia nervosa. Her disproportionate subcutaneous tissue persisted despite losing weight to reach a nadir BMI of 15 kg/m2. After a decade-long struggle, her eating disorder resolved, and she maintained a healthy weight and BMI of 21.5 kg/m2 but disproportionate fat remained in her lower body. She experienced increasing leg tenderness, pain, and easy bruising and was diagnosed with lipedema. Conclusions: Lack of recognition of lipedema by medical professionals and the public as a weight loss-resistant disease can affect body image acceptance. Lipedema was mistaken for obesity by the young woman in this case and likely played a role in her development of an eating disorder. Eating disorders, such as anorexia nervosa, are not rare and may be more common in women with lipedema. [ABSTRACT FROM AUTHOR]

Purpose: Digit ratio (2D:4D) is a sexually dimorphic trait, that may be a sign for prenatal testosterone level, which is significantly associated with handgrip strength (HGS) and sex-related body fat distribution. The aim of this study was to explore the association between the 2D:4D, HGS, and body fat distribution parameters in medical students. Materials and Methods: A total of 253 participants (112 males, 141 females) were involved in this cross-sectional study. Anthropometric parameters, including height and body weight, circumferences of arm, neck, waist, hip, HGS, the length of the second and fourth finger were measured. According to 2D:4D, the volunteers were divided into three groups (>1, =1, <1). Results: For both genders, 2D:4D>1 was associated with lower HGS, while larger arm, neck, and waist circumferences were associated with higher HGS. Pearson correlation analysis showed that 2D:4D of both hands had a strong negative correlation with height, circumferences of arm and neck, waist-to-hip ratio (WHR), and HGS, whereas it was only positively correlated with body mass index. Right and left HGS were positively correlated with WHR, height, weight, circumferences of arm, neck, and waist. Conclusion: 2D/4D makes a substantial contribution to our prediction of body fat distribution in terms of the relationship of 2D:4D <1 to an increased HGS, WHR, arm and neck circumference depending on testosterone hormone as in males. [ABSTRACT FROM AUTHOR]

Central obesity and body fat distribution measured by waist circumference (WC) and waist hip ratio (WHR) are good predictors of cardio metabolic adversities independent of overall adiposity. There are substantial evidence that body fat distribution is controlled by genetic factors. Even after accounting for body mass index (BMI), individual variation in body fat distribution is heritable, with estimates ranging from 31–76%. Individuals genetically predisposed to store more fat in visceral depots are at higher risk of developing metabolic complications. Several linkage and genomewide association studies (GWAS) for measures of body fat distribution uncovered numerous loci harbouring genes potentially regulating body fat distribution. Additionally, genes with fat depot specific expression patterns (especially, subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT)) have provided plausible candidate genes involved in body fat regulation. Further, sexual dimorphism have revealed a remarkable heterogeneity in the genetic regulation of body fat distribution. More than hundred loci have been identified through GWAS, displaying more pronounced effect in females than males, suggesting that both sexes share potentially different biological architecture in traits related to body fat distribution. Moreover, the handful of genes identified by GWAS have been validated in different population groups. This article aims at reviewing the current knowledge of genomic basis of body fat distribution. [ABSTRACT FROM AUTHOR]

Background: Although obesity differs according to ethnicity, it is globally established as a solid risk factor for cardiovascular disease. However, it is not fully understood how obesity parameters affect the progression of coronary artery calcification (CAC) in Korean population. We sought to evaluate the association of obesity-related parameters including visceral adipose tissue (VAT) measurement and CAC progression. Methods: This retrospective observational cohort study investigated 1,015 asymptomatic Korean subjects who underwent serial CAC scoring by computed tomography (CT) with at least 1-year interval and adipose tissue measurement using non-contrast CT at baseline for a routine checkup between 2003 and 2015. CAC progression, the main outcome, was defined as a difference of ≥2.5 between the square roots of the baseline and follow-up CAC scores using Agatston units. Results: During follow-up (median 39 months), 37.5% of subjects showed CAC progression of a total population (56.4 years, 80.6% male). Body mass index (BMI) ≥25 kg/m2, increasing waist circumferences (WC), and higher VAT/subcutaneous adipose tissue (SAT) area ratio were independently associated with CAC progression. Particularly, predominance of VAT over SAT at ≥30% showed the strongest prediction for CAC progression (adjusted hazard ratio, 2.20; P<0.001) and remained of prognostic value regardless of BMI or WC status. Further, it provided improved risk stratification of CAC progression beyond known prognosticators. Conclusion: Predominant VAT area on CT is the strongest predictor of CAC progression regardless of BMI or WC in apparently healthy Korean population. Assessment of body fat distribution may be helpful to identify subjects at higher risk. [ABSTRACT FROM AUTHOR]

Objectives: Obstructive sleep apnea (OSA) affects 10-50% of children with obesity, but its identification is challenging and wait times for testing are long. Previous studies suggest that neck circumference (NC) and neck-to-height ratio (NHR) may predict OSA. Our objectives were to 1) evaluate associations of NC and NHR with OSA; 2) model NHR as a predictor of OSA, adjusting for age, sex, and Tanner stage; and 3) identify thresholds of NHR associated with OSA, in children with obesity.Methods: Participants were aged 8-17 years, with obesity (BMI >95%ile), undergoing polysomnography. Associations between NC and NHR with OSA were evaluated. NHR, age, sex and self-reported Tanner stage (early/late) were included in a negative binomial multiple regression model to predict obstructive apnea hypopnea index (OAHI).Results: 71 children participated, with median age 14.8 years (IQR 12.6, 16.0), 54% male, median BMI z-score 2.5 (IQR 2.3, 2.7), and 77% late Tanner stage. OSA was severe in 18 children (25.4%), moderate in 12 (16.9%), and mild in 18 (25.4%). In the model, each 0.01 increase in NHR was associated with a 55% increase in OAHI (95% CI: 36%, 80%); boys had a 119% higher OAHI than girls (95% CI: 10%, 337%). Threshold NHR associated with moderate-severe OSA was 0.25 in females and 0.23 in males.Conclusions: NHR and male sex independently predict OSA severity in children with obesity, adjusting for age and Tanner stage. Children with obesity and NHR above identified thresholds are more likely to have moderate-severe OSA, and may benefit from earlier polysomnography. [ABSTRACT FROM AUTHOR]

Background: A high body mass index (BMI) has been associated with increased risk of several cancers; however, whether BMI is related to a larger number of cancers than currently recognized is unclear. Moreover, whether waist circumference (WC) is more strongly associated with specific cancers than BMI is not well established. We aimed to investigate the associations between BMI and 26 cancers accounting for non-linearity and residual confounding by smoking status as well as to compare cancer risk estimates between BMI and WC.Methods: Prospective cohort study with population-based electronic health records from Catalonia, Spain. We included 3,658,417 adults aged ≥ 18 years and free of cancer at baseline between 2006 and 2017. Our main outcome measures were cause-specific hazard ratios (HRs) with 99% confidence intervals (CIs) for incident cancer at 26 anatomical sites.Results: After a median follow-up time of 8.3 years, 202,837 participants were diagnosed with cancer. A higher BMI was positively associated with risk of nine cancers (corpus uteri, kidney, gallbladder, thyroid, colorectal, breast post-menopausal, multiple myeloma, leukemia, non-Hodgkin lymphoma) and was positively associated with three additional cancers among never smokers (head and neck, brain and central nervous system, Hodgkin lymphoma). The respective HRs (per 5 kg/m2 increment) ranged from 1.04 (99%CI 1.01 to 1.08) for non-Hodgkin lymphoma to 1.49 (1.45 to 1.53) for corpus uteri cancer. While BMI was negatively associated to five cancer types in the linear analyses of the overall population, accounting for non-linearity revealed that BMI was associated to prostate cancer in a U-shaped manner and to head and neck, esophagus, larynx, and trachea, bronchus and lung cancers in an L-shaped fashion, suggesting that low BMIs are an approximation of heavy smoking. Of the 291,305 participants with a WC measurement, 27,837 were diagnosed with cancer. The 99%CIs of the BMI and WC point estimates (per 1 standard deviation increment) overlapped for all cancers.Conclusions: In this large Southern European study, a higher BMI was associated with increased risk of twelve cancers, including four hematological and head and neck (only among never smokers) cancers. Furthermore, BMI and WC showed comparable estimates of cancer risk associated with adiposity. [ABSTRACT FROM AUTHOR]

Background: Obesity is an important risk factor for the development of endometrial cancer (EC). Recent data showed that body fat distribution might be more relevant than Body Mass Index (BMI). High visceral fat percentage was shown to be an independent predictor for survival in EC, but mainly included grade 1-2 EC.Objective: To evaluate body fat distribution and its relation to outcome in high-grade endometrial cancer.Methods: Retrospective study in women diagnosed with high-grade EC between February 2006 and August 2017 at the Royal Cornwall Hospital who had abdominal CT-scan as part of routine diagnostic work-up. Subcutaneous abdominal fat volumes and visceral abdominal fat volumes were quantified based on CT-scan measurements, and visceral fat percentage calculated.Results: A total of 176 patients with high-grade EC were included. The median age was 70 years and median BMI was 29.4 kg/m2. The majority of patients had non-endometrioid endometrial cancer (NEEC; 62 %). High visceral fat percentage was associated with poor overall- and disease-specific survival (p = 0.006 and p = 0.026 respectively) in NEEC patients, but not in high-grade endometrioid EC (EEC). The most frequent obesity comorbidities hypertension and diabetes mellitus were significantly associated with high BMI and high visceral fat percentage.Conclusion: In high-grade EC, high visceral fat percentage was an independent predictor of poor survival only in NEEC. The strong correlation between high visceral fat and obesity-related comorbidities might be reflective of an unhealthy macroenvironment. [ABSTRACT FROM AUTHOR]

• CT-based adipose distribution pattern has great predictive value for HCC prognosis. • Comprehensive analysis of diverse adipose depots affirmed VSR's prognostic value. • VSR exhibited consistency and no publication bias across relevant studies. The present meta-analysis aimed at identifying potential prognostic indicators associated with adipose distribution patterns for predicting the survival outcomes of patients diagnosed with hepatocellular carcinoma (HCC). A systematic retrieve was performed to identify studies investigating the association of adipose distribution patterns and the prognosis of HCC from the inception of PubMed, Embase, Cochrane Library, and Web of Science databases to May 25, 2023. The Newcastle–Ottawa scale was applied to assess the quality of included studies. The hazard ratios (HRs) and 95 % confidence intervals (CIs) of adipose distribution parameters of visceral, subcutaneous, and intermuscular adipose tissue were extracted. Univariate and multivariable meta-analyses were performed by Stata 12.0 to evaluate the relationship between these factors and overall survival (OS) and recurrence-free survival (RFS). A total of 31 studies, comprising 7021 patients, including 2456 patients with HCV and 1466 patients with HBV were included. The pooled results indicated that only high visceral to subcutaneous adipose area ratio (VSR) (univariate analysis of OS: HR = 1.42, 95 % CI = 1.28–1.58, P < 0.001; multivariate analysis of OS: HR = 1.45, 95 % CI = 1.27–1.65, P < 0.001; univariate analysis of RFS: HR = 1.30, 95 % CI = 1.08–1.56, P = 0.006; multivariate analysis of RFS: HR = 1.36, 95 % CI = 1.10–1.67, P = 0.004) was both related to worse OS and RFS, with no significant heterogeneity observed. Pretreatment VSR, as the sole parameter among adipose distribution-related factors exhibiting independent and stable associations with OS and RFS in patients with HCC, may hold promise as a potential prognostic factor for HCC. [ABSTRACT FROM AUTHOR]

Objective To investigate the correlation between body fat parameters and the severity of acute pancreatitis (AP) and the value of body fat parameters in predicting the severity of AP. Methods A retrospective analysis was performed for the clinical data of 229 patients with AP who were treated in Department of Gastroenterology in The Affiliated Hospital of Southwest Medical University from June 2016 to June 2019. According to the diagnostic criteria for AP, the patients were divided into mild acute pancreatitis (MAP) group, moderate - severe acute pancreatitis ( MSAP) group (all P < 0. 05), and severe acute pancreatitis (SAP) group, and CT images were used to calculate related body fat parameters [ visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT ), total adipose tissue (TAT), abdominal muscle area (AMA), VAT/TAT ratio (VTR), and visceral fat - to - muscle ratio (VMR)]. A one - way analysis of variance was used for comparison between multiple groups, and the least significant difference t -test was used for further comparison between two groups. A logistic regression analysis was used to investigate the correlation of the body fat parameters with AP severity. The receiver operating characteristic (ROC) curve was established for each body fat parameter and the area under the ROC curve (AUC) was calculated, and then the Youden index was calculated to determine the optimal cut - off value. Results There were significant differences in age, VAT, TAT, AMA, VTR, and VMR between the three groups (F = 4. 15, 35. 25, 73. 02, 7.09, 462.30, and 139.4, all P < 0. 05), and further comparison showed that compared with the MAP group, the MSAP group and the SAP group had significant increases in VAT, TAT, VTR, and VMR (all P < 0. 05) and a significant reduction in AMA (all P < 0. 05). The SAP group had significantly higher VAT, VTR, and VMR than the MSAP group ( all P < 0. 05). VMR had the largest AUC of 0. 84 (95% confidence interval: 0.76 - 0.92) in predicting MSAP and SAP, and had the cut - off value of 1. 38 in predicting the severity of AP, with a sensitivity of 67.5% and a specificity of 90.6%. Conclusion Body fat parameters are correlated the severity of AP. VMR has a unique value in predicting the severity of AP and can be included in the future scoring models for predicting AP severity. [ABSTRACT FROM AUTHOR]

Diabetes prevalence estimation and reduction of its risk factors remain the major goals of health services. While obesity is the major risk factor for diabetes, body fat distribution may be a better predictor. To estimate the prevalence of diabetes in an adult working population in Mexico City, and to evaluate the strength of association with different risk factors. A cross-sectional survey was conducted in two city halls of Mexico City. Anthropometrics, blood pressure, physical activity, diet, and biochemical parameters were assessed. Diabetes was defined as a fasting plasma glucose level ≥7.0 mmol/l or referred diabetes. The bioelectrical impedance analysis of body components was performed and weight, soft lean mass, body fat percentage and abdominal fat were obtained. Prevalence with 95% confidence intervals was estimated, as well as odds ratios derived from a logistic regression model. The prevalence of type 2 diabetes was 11.0% (95% CI 9.6–12.4%). The proportion of individuals with diabetes who were unaware of having the disease was higher in women (42.5 vs. 36.9%), and the degree of metabolic control was better in women (39.1 vs. 25.0%). Age, blood pressure, triglycerides and the percentage of body fat, were major risk factors related to the occurrence of type 2 diabetes. No relation was observed with physical activity and diet. The prevalence of type 2 diabetes in Mexico continues to be high and obesity measured by body fat percentage seems to be a better predictor of its occurrence than body mass index. [ABSTRACT FROM AUTHOR]

Background: The relationship between betatrophin/ANGPTL8 and obesity has been investigated using body mass index (BMI); however, since BMI reflects overall adiposity rather than body fat distribution, it remains unclear whether fat deposition in different areas of the body affects betatrophin expression. Here, we investigated the correlation between circulating betatrophin levels and body fat distribution in patients with different glucose tolerance. Methods: We performed a cross-sectional study in 128 participants with impaired glucose tolerance (IGT; n = 64) or normal glucose tolerance (NGT; n = 64). Circulating betatrophin levels were detected by enzyme-linked immunosorbent assay (ELISA). Body fat distribution (subcutaneous, visceral, and limb fat) was measured by magnetic resonance imaging (MRI) and a body fat meter. Results: After controlling for age, sex, and BMI, betatrophin was correlated positively with visceral adipose tissue-to-subcutaneous adipose tissue ratio (VAT/SAT ratio; r = 0.339, p = 0.009) and negatively with body fat ratio (BFR; r = − 0.275, p = 0.035), left lower limb fat ratio (LLR; r = − 0.330, p = 0.011), and right lower limb fat ratio (RLR; r = − 0.288, p = 0.027) in the NGT group, with these correlations remaining after controlling for triglycerides. VAT/SAT ratio (standardized β = 0.419, p = 0.001) was independently associated with serum betatrophin levels; however, betatrophin was not associated with body fat distribution variables in the IGT group. Conclusions: Circulating betatrophin levels correlated positively with VAT/SAT ratio and negatively with lower limb fat, but not with subcutaneous or upper limb fat, in individuals with normal glucose tolerance. Thus, betatrophin may be a potential biomarker for body fat distribution in individuals without glucose disorders. [ABSTRACT FROM AUTHOR]

Background: Sedentary behavior (SB) has emerged as a new risk factor for cardiovascular accidents. We investigated whether physical activity levels or SB were related to percent body fat (%BF) in type 2 diabetes mellitus (T2DM). Methods: In this cross sectional study, we measured the duration of SB, light physical activity (LPA), moderate to vigorous physical activity (MVPA), total energy expenditure, and step counts using a wireless activity tracker (Fitbit HR; FB) for 7 days in freeliving conditions, along with %BF using a bio impedance analyzer (Inbody; Biospace) in 120 smartphone users with T2DM. Subjects were divided into exercise (Exe, n=68) and non-exercise (nonExe, n=52) groups based on self-reports of whether the recommended exercises (30 min/day, 3 days/week for 3 months) were performed. SBt, LPAt, MVPAt were transformed from SB, LPA, MVPA for normally distributed variables. Results: Participants were: female, 59.2%; age, 59.3±8.4 years; body mass index, 25.5±3.4 kg/m2; glycosylated hemoglobin (HbA1c), 7.6%±1.2%; %BF, 30.4%±7.1%. They performed SB for 15.7±3.7 hr/day, LPA for 4.4±1.7 hr/day, and MVPA for 0.9±0.8 hr/day. The %BF was related to SBt and LPAt, but not to MVPA after adjustments for age, gender, and HbA1c. VPA was significantly higher in the Exe group than in the nonExe group, but SB, LPA, and moderate physical activity were not different. Predicted %BF was 89.494 to 0.105 (age), -13.047 (gender), -0.507 (HbA1c), -7.655 (LPAt) (F[4, 64]=62.929, P<0.001), with an R2 of 0.785 in multiple linear regression analysis. Conclusion: Reduced body fat in elderly diabetic patients might be associated with reduced inactivity and increased LPA. [ABSTRACT FROM AUTHOR]

Recent data suggest that subclinical atherosclerosis is more related to visceral adipose tissue distribution than to overall fat mass. Both perirenal fat and epicardial fat are visceral fat depots surrounding the kidneys and the myocardium, respectively, which can be easily assessed by ultrasound. Their clinical relevance in children is largely unknown. This review describes studies relating perirenal and epicardial fat to cardiovascular disease or carotid intima-media thickness (cIMT), a well-established surrogate for subclinical atherosclerosis, and discusses this in context with our own data from children. In adults, both perirenal and epicardial fat are useful biological markers of visceral obesity. The former has been related to hypertension in overweight subjects and with atherosclerosis in patients with human immunodeficiency virus. The latter was associated with several metabolic syndrome components and with calcification of the carotid artery. In healthy prepubertal children, both epicardial and perirenal fat thickness, rather than total body fat mass, were related to cIMT. Ultrasonography measures of perirenal and epicardial fat are related to atherosclerosis in adults and may be convenient tools for the assessment of cardiometabolic risk in children. [ABSTRACT FROM AUTHOR]

Objective: To determine whether preoperative anthropometric and computed tomography (CT) measurements of body composition can predict postoperative morbidity and mortality in patients with gastric or esophageal cancer. Materials and Methods: This was a retrospective study in which we reviewed the medical records and abdominal CT scans of patients with gastric or esophageal cancer who underwent surgery in 2015 at a cancer center. CT scans performed during routine preoperative evaluation were retrospectively assessed to measure the area of lean body mass at the level of the third lumbar vertebra, as well as the area of visceral and subcutaneous fat. Results: Seventy patients were included in the study. The mean age was 59.9 years (range, 33-82 years), and 47 patients (67.1%) were men. The mean postoperative follow-up period was 14.9 months. Neither postoperative morbidity nor postoperative mortality correlated significantly with gender, age, the type of primary tumor, the presence of comorbidities, smoking status, body mass index, nutritional status, or visceral fat area. The survival rate was higher for patients with normal lean body mass than for those with low lean body mass (hazard ratio = 0.116; 95% confidence interval: 0.015-0.906; p = 0.040). Conclusion: Our data suggest that lean body mass can be a relevant prognostic factor in patients with gastric or esophageal cancer, and that CT measurements should be included in the routine preoperative evaluation, because it may provide information that aids nutritional and clinical care for these patients. [ABSTRACT FROM AUTHOR]

Background Fried's frailty phenotype is defined by five criteria: exhaustion, unexplained weight loss, weakness, slowness and low physical activity. Frailty can also affect obese people. Little is known about how body mass index [BMI] or waist-hip ratio [WHR] are associated with frailty or pre-frailty in the face of confounding factors, including markers of allostatic load which are known to be involved in frailty biology. We cross-sectionally examined these associations in a population-based study. Methods A cross-sectional analysis of data collected at Wave 1 (2010) of TILDA was undertaken. Participants aged <50 and those who did not have measurements of their BMI, WHR, chronic disease status, HbA1c, CRP, sex and educational status were excluded. Two multivariate logistic regression models (one with BMI and another one with WHR as measure of obesity) were computed adjusting for these covariates, with frail/pre-frail versus non-frail as the outcome variable. Results 4,568 participants were included: 3,277 non-frail and 1,291 frail/pre-frail. The frail/pre-frail group had a mean BMI of 29.2 (versus 28.3) kg/m2 and a mean WHR of 0.912 (versus 0.899). In the adjusted regression model, BMI had a significant association with frailty/pre-frailty (OR 1.02, 95% CI: 1.01-1.04, p=0.001). However, in the model using WHR, the latter had a stronger association with frailty (OR 4.52, 95% CI: 1.60-12.72, p=0.004). In both models, age, education, chronic disease status, HbA1c and CRP had the expected associations with frailty/pre-frailty. Female sex was significantly associated with frailty/pre-frailty in the WHR model (OR 1.26, 95% CI 1.06-1.50, p=0.008). Conclusion While obesity is associated with frailty, the distribution of body fat may be more important as a marker of frailty. These physical traits should not be overlooked in the over 50 population. The association between frailty, obesity and markers of 'inflammaging' could be examined longitudinally to further understand their complex biology. [ABSTRACT FROM AUTHOR]