Relationship between soluble receptor for advanced glycation end products (sRAGE), body composition and fat distribution in healthy women.

PURPOSE: Soluble receptor for advanced glycation end products (sRAGE) is a decoy receptor which sequesters RAGE ligands and acts as a cytoprotective agent. To date, it is unclear whether the lower sRAGE levels observed in obesity are a marker of increased overall adiposity or reflect increases in particular fat depots. Therefore, we evaluated in healthy women the relationship among sRAGE and indicators of adiposity, including abdominal visceral (VAT) and epicardial visceral (EAT) adipose tissues, to explore the potential role of sRAGE as an earlier biomarker of cardiometabolic risk. METHODS: Plasma sRAGE levels were quantified by an enzyme-linked immunosorbent assay in 47 healthy women. Total fat mass (FM) and fat-free mass were estimated with bioimpedance analysis. Anthropometric measures and biochemical data were recorded. Subcutaneous adipose tissue, VAT and EAT volumes were measured by magnetic resonance imaging. RESULTS: Obese women had lower sRAGE levels compared to normal-weight women. sRAGE levels were also lower in women with a waist circumference (WC) larger than 80 cm. Correlation analyses indicated an inverse association of sRAGE with body mass index and FM. Concerning adipose tissue distribution, sRAGE inversely correlated with WC, EAT and VAT depots. In a multiple stepwise regression analysis, performed to emphasize the role of fat distribution, EAT volume was the only predictor of sRAGE. CONCLUSIONS: Lower sRAGE levels reflect accumulation of visceral fat mainly at the epicardial level and are present in advance of metabolic complications in adult women. sRAGE quantification might be an early marker of cardiometabolic risk.

Peripheral artery disease: how much inter-leg symmetry? A contrast-enhanced magnetic resonance angiography study.

The aim of this observational retrospective study was to qualitatively and quantitatively evaluate the symmetry of atherosclerotic plaques in patients with peripheral artery disease (PAD) undergoing contrast-enhanced magnetic resonance angiography of lower limbs. We retrospectively evaluated the peripheral magnetic resonance angiography of 82 patients considering the iliac, femoral and tibial arteries. Stenosis was scored 0 (none), 1 (<50%), 2 (50%-74%), 3 (75%-99%), and 4 (occluded). Symmetry was quantified as the percentage of bilaterally-diseased arteries and using the inter-leg absolute score difference (0-4). Signs test and Cohen κ were also calculated. Seventy-one (87%) patients had ≥1 bilaterally-diseased artery, and 168 (20%) of 820 artery pairs were bilaterally affected. At least 1 bilateral stenosis was observed from 11% (right internal iliac) to 73% (right superficial femoral). All 10 arteries showed symmetry, none of the inter-leg comparisons being significantly different (P ≥ .100). Cohen κ ranged from 0.208 (common femoral) to 0.533 (internal iliac). This study showed that PAD was symmetrically distributed between the 2 legs, with the internal iliac artery being the most symmetric segment. Symmetry of PAD was quantified in 20%.

Bone marrow fat contributes to insulin sensitivity and adiponectin secretion in premenopausal women.

PURPOSE: Bone marrow fat is a functionally distinct adipose tissue that may contribute to systemic metabolism. This study aimed at evaluating a possible association between bone marrow fat and insulin sensitivity indices. METHODS: Fifty obese (n = 23) and non-obese (n = 27) premenopausal women underwent proton magnetic resonance spectroscopy to measure vertebral bone marrow fat content and unsaturation index at L4 level. Abdominal visceral, subcutaneous fat, and epicardial fat were also measured using magnetic resonance imaging. Bone mineral density was measured by dual-energy X-ray absorptiometry. Body composition was assessed by bioelectrical impedance analysis. Fasting serum glucose, insulin, lipids, adiponectin were measured; the insulin resistance index HOMA (HOMA-IR) was calculated. RESULTS: Bone marrow fat content and unsaturation index were similar in obese and non-obese women (38.5 ± 0.1 vs. 38.6 ± 0.1%, p = 0.994; 0.162 ± 0.065 vs. 0.175 ± 0.048, p = 0.473, respectively). Bone marrow fat content negatively correlated with insulin and HOMA-IR (r = -0.342, r = -0.352, respectively, p = 0.01) and positively with high density lipoprotein cholesterol (r = 0.270, p = 0.043). From a multivariate regression model including lnHOMA-IR as a dependent variable and visceral, subcutaneous, epicardial fat, and bone marrow fat as independent variables, lnHOMA-IR was significantly associated with bone marrow fat (ß = -0.008 ± 0.004, p = 0.04) and subcutaneous fat (ß = 0.003 ± 0.001, p = 0.04). Bone marrow fat, among the other adipose depots, was a significant predictor of circulating adiponectin (ß = 0.147 ± 0.060, p = 0.021). Bone marrow fat unsaturation index negatively correlated with visceral fat (r = -0.316, p = 0.026). CONCLUSIONS: There is a relationship between bone marrow fat content and insulin sensitivity in obese and non-obese premenopausal women, possibly mediated by adiponectin secretion. Visceral fat does not seem to regulate bone marrow fat content while it may affect bone marrow fat composition.

The use of bedside chest radiography at a university hospital. Data on a two-week period.

OBJECTIVE: To evaluate the requests for bedside chest radiography (BCR) by clinicians. MATERIALS AND METHODS: After IRB approval, we retrieved the patients' clinical records for demographics, unit, and duration for recovery in a two weeks period. For each BCR, exposure data and the reason for BCR were registered. The BCR results were categorized as one or more of the followings: negative, regular/irregular device position, known finding(s) unmodified/modified in respect with the previous BCR, new expected finding(s) (pleural effusion, low ventilation), or new unexpected findings (pulmonary edema, pneumothorax). As a utility indicator of BCR, we considered the rate of chest CT performed in these patients during the study period and the following week. We have estimated the effective radiation dose. RESULTS: A total of 337 BCRs (126 patients) entered the analysis, 74% of them being performed in post-surgery intensive care unit. Seventy-3 patients (58%) performed 1 or 2 BCRs, 53 (42%) 3 or more BCRs with a maximum of 13 BCRs performed on a newborn. The mean total effective dose was 0.2 mSv/patient (maximum 1 mSv). In post-surgery intensive care unit the mean daily BCR rate was 0.8/day (maximum 2/day). On 337 BCR requests, 49% showed no motivations at all, 42% reported the word "check" and in 9% a well-defined clinical query was specified. The rate of incorrect catheter position and new unexpected findings was 4%. One chest CT have been requested. CONCLUSION: BCR is often requested as a routine examination with a little rate of unexpected findings.