Analysis of indicators related to visceral fat index based on the random forest model / 中华健康管理学杂志

Objective:To explore indicators related to visceral fat index by constructing a random forest model.Methods:In this cross-sectional study, the laboratory measures and body composition analysis records of 617 hospital employees (in-service and retired) who underwent physical examination in Heilongjiang Provincial Hospital Health Management Center from March to September 2021 were selected. The subjects were divided into a training set ( n=411) and a test set ( n=206) with the ratio of 2∶1. A total of 110 predictors were included in the model. The model was constructed with the training set and was evaluated with the test set. The optimal number of nodes and decision trees were selected to evaluate the prediction performance of the optimal model. And the top 10 relatively important factors were selected for further investigation. The 617 participants were further divided in to groups according to the visceral fat index: the normal or high visceral fat index group, and the differences of the top 10 relatively important factors were further compared between the two groups. Results:The optimal number of nodes of the final random forest model was 39 and the number of decision trees was 300. The accuracy, precision, sensitivity and specificity of the model was 83.3%, 73.9%, 89.4% and 78.7%, respectively. The area under the receiver operating characteristic curve and 95% confidence interval of the model was 0.881 (0.832-0.931). The top 10 relatively important factors in the model were body mass index, gender, age, serum uric acid, red blood cell count, monocyte cell count, C-peptide, carcinoembryonic antigen, glycosylated hemoglobin and glutamyl transpeptidase. There were significant differences in the up-mentioned 10 indicators between the subjects with normal and high visceral fat index (all P<0.05). Conclusions:The random forest model built in this study has good performance in predicting visceral fat index, and visceral fat is related with changes in liver function, pancreas function and immune function.

Correlation between visceral adipose index and glomerular filtration rate in patients with type 2 diabetes mellitus / 中国基层医药

Objectives:To investigate the relationship between visceral adipose index and glomerular filtration rate in patients with type 2 diabetes mellitus.Methods:A total of 1 036 patients with type 2 diabetes mellitus who received treatment in The Second Affiliated Hospital of Xi'an Jiaotong University from May 2017 to May 2018 were included in this study. The visceral adipose index was detected using a bioresistance assay. These patients were divided into four groups using the quartile method: Visceral adipose index < 8.10 (q1 group, n = 246), 9.60 > visceral adipose index ≥ 8.10 (q2 group, n = 64), 11.10 > visceral adipose index ≥ 9.60 (q3 group, n = 423), visceral adipose index ≥ 11.10 (q4 group, n = 233). One-way analysis of variance was performed to compare the differences among groups. Partial correlation and multiple regression were used to analyze the correlation between body mass index, waist circumference, waist-to-height ratio, waist-to-hip ratio, body fat content, visceral adipose index, and urinary microalbumin and glomerular filtration rate. Results:With the increase in the visceral adipose index, the glomerular filtration rate gradually decreased. The glomerular filtration rate in the q1, q2, q3, q4 groups was (112.19 ± 31.74) mL·min -1·1.73 m -2, (106.14 ± 28.26) mL·min -1·1.73 m -2, (104.73 ± 23.63) mL·min -1·1.73 m -2, (103.40 ± 27.51) mL·min -1·1.73 m -2, respectively. In the female group, with the increase in visceral adipose index, the glomerular filtration rate decreased gradually. After controlling for age, sex, diabetes, and hypertension, the visceral adipose index was significantly correlated with the glomerular filtration rate ( r = -0.10, P < 0.001). Multiple regression analysis showed that visceral adipose index and waist-to-height ratio were closely related to glomerular filtration rate ( F = 6.00, P < 0.001). Conclusion:With the increase of visceral adipose index, body mass index, waist circumference, waist-to-height ratio, waist-to-hip ratio, body fat content, and urinary microalbumin increased gradually. When the visceral adipose index is greater than 9.60, the glomerular filtration rate is significantly decreased. Therefore, it is suggested to adopt various methods to evaluate obesity in clinical work, and visceral fat index should be paid more attention, especially when the visceral fat index is greater than 9.60.

Abdominal fat distribution and its relationship to sagittal abdominal diameter (SAD) and SAD-height ratio – An analytical cross-sectional study in the South Indian population

Background: The prevalence of obesity is increasing in developing countries like India. This will place a great burden on the health infrastructure of the country. Early identification and intervention are the keys to managing this important problem. Since Asians tend to have more visceral body fat for any given body mass index (BMI), lower cut-off values have been suggested for different anthropometric parameters. Studies determining the correlation of Sagittal abdominal diameter (SAD) and SAD-height ratio (SADHtR) with total visceral fat volumes measured by computed tomography (CT) scan abdomen quantification are limited in the South Indian population. Aims and Objectives: This study was conducted with the objectives of measuring BMI, SAD, SADHtR, and comparing the correlation of the measured anthropometric parameters with visceral and subcutaneous abdominal fat volumes measured using CT scan abdomen in both the genders in South Indian population. Materials and Methods: This analytical cross-sectional study was done in a hospital setting with a sample size of 566 (276 men and 290 women-aged 30–70 years). Weight, height, and BMI were measured. SAD was measured electronically from a CT image at the L4–L5 level. SADHtR was derived. Total abdominal fat volumes, subcutaneous abdominal fat volumes, and visceral abdominal fat volumes were measured in cm3 from the dome of the liver to the pubic symphysis using software for CT-based quantification of fat volumes between ?190 and ?30 Hounsfield units threshold limits. The data were tabulated and analyzed to compare mean values between men and women and to find the correlation between the anthropometric parameters and visceral fat volume using Pearson’s correlation test. Results: The difference in mean values of BMI, SAD, and SADHtR between the sexes was statistically significant. SAD showed the highest correlation with visceral fat volume in both genders. BMI showed a higher correlation with subcutaneous adipose tissue volume than with visceral adipose tissue volume. Conclusion: Both SAD and SADHtR can be used as simple and reproducible anthropometric tools to identify the presence of increased visceral fat volume in both genders in our population.

Exceso de grasa visceral asociado a severidad de COVID-19, cuantificado por bioimpedancia / Excess visceral fat associated with severity of COVID-19 quantified by bioimpedance

Hay dos tipos principales de tejido adiposo; el subcutáneo, que es menos activo metabólicamente, y el tejido adiposo visceral, que secreta constantemente citocinas inflamatorias y está relacionado a enfermedades metabólicas y cardiovasculares. Nuestro objetivo fue identificar la asociación entre el exceso de grasa visceral y la severidad de enfermedad en pacientes con COVID-19. Se realizó un estudio observacional analítico que incluyó a pacientes con COVID-19 admitidos al Hospital Carrión de Huancayo, Perú. Se utilizó la balanza de bioimpedancia para cuantificar la composición corporal, la variable dependiente fue la severidad de enfermedad. Se utilizó el análisis de regresión logística para determinar la asociación de la grasa visceral y otros parámetros antropométricos con severidad de enfermedad. Se analizaron a 120 personas con COVID-19, la edad promedio fue 50 años, el sexo masculino fue 60%. De acuerdo a los valores de la composición corporal emitidos por el equipo de bioimpedancia: La grasa visceral > 15Kg (OR 7,31; p = 0,001); la grasa corporal total > 35% (OR 5,58; p = 0,009) y el exceso de peso > 20Kg (OR 6,96; p = 0,011) fueron los parámetros asociados a enfermedad severa por COVID-19. La relación positiva entre el perímetro abdominal y la cantidad de grasa visceral fue significativo (p = 0,01). En la composición corporal, el exceso de grasa visceral es el mayor parámetro asociado a enfermedad severa por COVID-19(AU)

There are two main types of adipose tissue; the subcutaneous, which is less metabolically active, and the visceral adipose tissue, which constantly secretes inflammatory cytokines and is related to metabolic and cardiovascular diseases. Our objetive was to identify the association between the excess of visceral fat and disease severity in COVID-19 patients. An analytical observational study was carried out which included patients with COVID-19 admitted to the Carrión Hospital in Huancayo, Peru. The bioimpedance balance was used to quantify the body composition; the dependent variable was the severity of the disease. A logistic regression analysis was used to determine the association of visceral fat and other anthropometric parameters with the severity of the disease. Out of 120 people with COVID-19 were analyzed, the average age was 50 years, the male sex was 60%. According to the body composition values issued by the bioimpedance team: Visceral fat> 15Kg (OR 7.31; p = 0.001); Total body fat> 35% (OR 5.58; p = 0.009) and excess weight> 20Kg (OR 6.96; p = 0.011) were the parameters associated with severe disease due to COVID-19. The positive relationship between abdominal circumference and the amount of visceral fat was significant (p = 0.01). In body composition, excess visceral fat is the main parameter associated with severe COVID-19 disease(AU)

Association of serum uric acid with waist-hip ratio: A promising index for assessing cardiovascular disease risk profile

Background: Abdominal obesity is associated with insulin resistance, in turn, hyperinsulinemia and visceral adiposity lead to an increased uric acid (UA) absorption in renal tubules. Aim and Objectives: Accumulation of visceral fat is an underlying component of metabolic syndrome. Furthermore, the waist-hip ratio is an indirect tool for assessing visceral fat. The present study evaluates the association of UA levels with the waist-hip ratio. Materials and Methods: 160 subjects aged 18–60 years were enrolled in the study (those having any anatomical deformity, diabetes, and/or hypertension for more than 5 years were excluded from the study). Their anthropometric parameters, blood pressure, lipid profile, fasting plasma glucose, and serum UA levels were measured. Results: The study population was divided into three groups based on UA levels. The waist-hip ratio in a group of the hyperuricemic population was more as compared to groups of normal and below normal UA levels population and the association of UA level with waist-hip ratio was found to be significant (P = 0.045). Conclusion: The over-inflow of free fatty acid to the liver from accumulated visceral fat may be linked to the de novo purine synthesis through the pentose phosphate pathway, which may accelerate the production of UA.

Study on the relationship between serum Omentin-1 and metabolic parameters in patients with abdominal obesity / 中国综合临床

Objective:To investigate the level of serum Omentin-1 in subjects with abdominal obesity, and to analyze the influencing factors of Omentin-1 and its relationship with body fat distribution, insulin resistance and metabolic parameters.Methods:A retrospective case-control study was conducted to analyze the clinical data of one hundred and fifty adults with abdominal obesity (BMI≥28 kg/m 2) who were randomly selected from Obesity Multidisciplinary Diagnosis and Treatment Center, Subei People's Hospital from Januray 2018 to December 2021. Meanwhile, 150 healthy adults were enrolled as a normal control group. Fasting serum Omentin-1 and glucose metabolism were measured, and homeostasis model assessment of insulin resistance index (HOMA-IR) was calculated. Body fat composition was measured by bioelectrical impedance analysis. The relationship between Omentin-1 and other variables were presented by the Pearson correlation coefficients. Stepwise regression model was used to analyze the influencing factors of Omentin-1. Results:The serum omentin-1 level of patients with abdominal obesity was (36.97±6.99) μg/L, that of normal control group was (72.35±6.09) μg/L. The difference between the two groups was statistically significant ( t=46.69, P<0.001). The body fat level of patients with abdominal obesity was (43.40±14.59) kg, that of normal control group was (13.78±4.13) kg. The difference between the two groups was statistically significant ( t=23.93, P<0.001). The fasting insulin of patients with abdominal obesity was 29.05 (22.01,34.60) pmol/L, that of normal control group was 127.90 (84.08,201.45) pmol/L. The difference between the two groups was statistically significant( Z=14.75, P<0.001). The HOMA-IR of patients with abdominal obesity was 0.87 (0.68,1.05), that of normal control group was 4.19 (2.77,7.31). The difference between the two groups was statistically significant ( Z=14.75, P<0.001). Pearson linear correlation analysis showed that serum omentin-1 levels were negatively correlated with BMI, waist circumference, waist-hip ratio (WHR), body fat, visceral Fat area (VFA), HOMA-IR, triglyceride, total cholesterol and low density lipoprotein cholesterol ( r=-0.825, -0.843, -0.756, -0.777, -0.835, -0.583, -0.429, -0.353, -0.503, -0.938, all P<0.001). Whereas, a significantly positive correlation was found between serum Omentin-1 levels and high density lipoprotein cholesterol ( r=0.528, P<0.001). Omentin-1 concentrations were not related to age or gender ( r=-0.093, -0.040; P=0.669, 0.489). In multiple linear stepwise regression analysis, only VFA remained significantly associated with Omentin-1 ( β=-0.026, t=-2.250, P=0.026). Conclusion:The level of serum omentin-1 in patients with abdominal obesity was significantly lower than that in normal subjects, and it was closely related to body fat distribution and insulin resistance. VFA is an independent influencing factor of serum omentin-1, which can be used as a biomarker of abdominal obesity related metabolic disorders.

Adiposidad abdominal y resistencia a la insulina al finalizar el primer trimestre de la gestación / Abdominal Adiposity and Insulin Resistance at the End of the First Trimester of Gestation

Introducción: La adiposidad central como factor desencadenante de resistencia a la insulina precoz constituye una amenaza potencial de riesgo metabólico y cardiovascular en el embarazo. Objetivo: Determinar la capacidad discriminante de las grasas abdominales sobre la resistencia a la insulina, diagnosticada por el índice triglicéridos/glucosa-IMC al finalizar el primer trimestre del embarazo. Métodos: Se realizó un estudio observacional analítico de 526 gestantes con embarazo simple y edad gestacional entre 12 y 13 semanas, entre los años 2016 y 2020. Se estudió el test de triglicéridos/glucosa-IMC y las grasas abdominales por ultrasonido. Se utilizaron las curvas ROC (Receiver operating characteristic Curve) para discriminar la resistencia a la insulina al finalizar el primer trimestre de la gestación, cuando aumentan las grasas abdominales. Resultados: La grasa subcutánea fue la que presentó mayor área bajo la curva en la discriminación de la resistencia a la insulina, con un nivel de sensibilidad y especificidad aceptable. Conclusiones: La grasa subcutánea, aunque con bajo valor discriminativo, puede considerarse como augurio de resistencia a la insulina y de diabetes gestacional. Se requiere profundizar en el estudio de las grasas abdominales dado el conocimiento de su impacto en los desórdenes metabólicos en el curso avanzado de la gestación(AU)

Introduction: Central adiposity as a triggering factor for early insulin resistance is a potential threat of metabolic and cardiovascular risk in pregnancy. Objective: To determine the discriminating capacity of abdominal fat over insulin resistance, diagnosed by the triglyceride/glucose-BMI index at the end of the first trimester of pregnancy. Methods: An analytical and observational study was carried out with 526 pregnant women of singleton pregnancy and gestational age between twelve and thirteen weeks, between 2016 and 2020. The triglyceride/glucose-BMI test was studied, together with abdominal fats by ultrasound. ROC (receiver operating characteristic) curves were used to discriminate insulin resistance at the end of the first trimester of gestation, when abdominal fats increase. Results: Subcutaneous fat presented the highest area under the curve in the discrimination of insulin resistance, with an acceptable level of sensitivity and specificity. Conclusions: Subcutaneous fat, although with low discriminative value, can be considered as a harbinger of insulin resistance and gestational diabetes. Further study of abdominal fat is required, given the knowledge of its impact on metabolic disorders in late gestation(AU)

Genetic, sociodemographic and lifestyle factors associated with serum 25-hydroxyvitamin D concentrations in Brazilian adults: the Pró-Saúde Study / Fatores genéticos, sociodemográficos e de estilo de vida nas concentrações séricas de 25-hidroxivitamina D em adultos brasileiros: o Estudo Pró-Saúde / Factores genéticos, sociodemográficos y estilo de vida asociados con la concentración sérica 25-hidroxivitamina D en adultos brasileños: Estudio Pro-Salud

This study aims to investigate factors associated with serum 25-hydroxyvitamin D [25(OH)D] concentration in Brazilian adults considering sociodemographic and lifestyle factors, as well as vitamin D-related single nucleotide polymorphisms (SNPs). This is a cross-sectional study (n = 491; 34-79y; 251 women), nested within a prospective cohort (Pró-Saúde Study). Associations between serum 25(OH)D and sociodemographic characteristics, diet, use of supplement, physical activity, season of blood collection, body fat, skin type, sun exposure index, and SNPs CYP2R1-rs10741657 and GC-rs2282679 were explored by multiple linear regression. The prevalence of serum 25(OH)D < 50nmol/L was 55%. Serum 25(OH)D was lower among women (β = -4.38; 95%CI: -8.02; -0.74), those with higher visceral fat (β = -4.02; 95%CI: -5.92; -2.12), and those with AC and CC genotypes for GC-rs2282679 (β = -6.84; 95%CI: -10.09; -3.59; β = -10.63; 95%CI: -17.52; -3.74, respectively). Factors directly associated with serum 25(OH)D included summer (β = 20.14; 95%CI: 14.38; 25.90), intermediate skin type (β = 6.16; 95%CI: 2.52; 9.80), higher sun exposure (β = 0.49; 95%CI: 0.22; 0.75), vitamin D intake (β = 0.48; 95%CI: 0.03; 0.93), and physical activity (β = 4.65; 95%CI: 1.54; 7.76). Besides physical activity, diet, and sun exposure, non-modifiable factors, such as GC genotypes must be considered when evaluating vitamin D insufficiency in mixed-race populations. Moreover, high visceral fat in association with poorer vitamin D status deserve attention given that both conditions are unfavorably related with chronic and acute health outcomes.

Este estudo teve como objetivo investigar fatores associados com as concentrações séricas de 25-hidroxivitamina [25(OH)D] em adultos brasileiros de acordo com fatores sociodemográficos e de estilo de vida, assim como de polimorfismos de nucleotídeo único (SNPs) relacionados à vitamina D. Este é um estudo transversal (n = 491; 34-79 anos; 251 mulheres) aninhado em uma coorte prospectiva (Estudo Pró-Saúde). Associações entre a 25(OH)D sérica e características sociodemográficas, consumo alimentar, uso de suplementos, atividade física, estação do ano na coleta da amostra de sangue, gordura corporal, fototipo de pele, índice de exposição solar e SNPs CYP2R1-rs10741657 e GC-rs2282679, explorados por regressão multilinear. A prevalência de 25(OH)D sérica < 50nmol/L foi 55%. A concentração sérica de 25(OH)D foi menor entre mulheres (β = -4,38; IC95%: -8,02; -0,74), indivíduos com mais gordura visceral (β = -4,02; IC95%: -5,92; -2,12) e genótipos AC e CC para GC-rs2282679 (β = -6,84; IC95%: -10,09; -3,59 e β = -10,63; IC95%: -17,52; -3,74, respectivamente). Os fatores associados diretamente à 25(OH)D sérica incluíram os meses de verão (β = 20,14; IC95%: 14,38; 25,90), fototipo intermediário (β = 6,16; IC95%: 2,52; 9,80), maior exposição solar (β = 0,49; IC95%: 0,22; 0,75), ingestão de vitamina D (β = 0,48; IC95%: 0,03; 0,93) e atividade física (β = 4,65; IC95%: 1,54; 7,76). Além de atividade física, dieta e exposição solar, fatores não modificáveis, tais como variantes do gene GC devem ser considerados na avaliação da deficiência de vitamina D em populações miscigenadas. Além disso, merece atenção a associação entre a gordura visceral elevada e o pior estado de vitamina D, uma vez que ambas as condições implicam em desfechos de saúde desfavoráveis, tanto crônicos quanto agudos.

Nuestro objetivo fue investigar factores asociados con la concentración sérica 25-hidroxivitamina D [25(OH)D] en adultos brasileños, considerando factores sociodemográficos y de vida, así como también los polimorfismos de nucleótido único relacionados con la vitamina D (SNPs). Se trata de un estudio transversal (n = 491; 34-79 años; 251 mujeres), anidado dentro de una cohorte prospectiva (Estudio Pro-Salud). Se investigaron las asociaciones entre concentración sérica 25(OH)D y características sociodemográficas, ingesta alimentaria, uso de suplementos, actividad física, estación del año de recogida de muestras de sangre, grasa corporal, tipo de piel, índice de exposición al sol, y SNPs CYP2R1-rs10741657 y GC-rs2282679 mediante una regresión múltiple lineal. La prevalencia sérica 25(OH)D < 50nmol/L fue 55%. La 25(OH)D sérica fue menor entre las mujeres (β = -4,38; IC95%: -8,02; -0,74), quienes tenían alta grasa visceral (β = -4,02; IC95%: -5,92; -2,12), genotipos AC y CC para GC-rs2282679 (β = -6,84; IC95%: -10,09; -3,59 y β = -10,63; IC95%: -17,52; -3,74, respectivamente). Los factores directamente asociados con la concentración sérica 25(OH)D incluyeron verano (β = 20,14; IC95%: 14,38; 25,90), tipo de piel intermedia (β = 6,16; IC95%: 2,52; 9,80), más alta exposición al sol (β = 0,49; IC95%: 0,22; 0,75), toma de vitamina D (β = 0,48; IC95%: 0,03; 0,93) y actividad física (β = 4,65; IC95%: 1,54; 7,76). Además de la actividad física, dieta y exposición al sol, los factores no modificables, tales como genotipos GC, necesitan tenerse en cuenta cuando se está evaluando la insuficiencia de vitamina D en poblaciones mestizas. Asimismo, las implicaciones de la asociación de una alta grasa visceral con un estatus más pobre de vitamina D merece que se le preste atención, puesto que ambas condiciones de salud están relacionadas desfavorablemente con resultados de salud graves y crónicos.

Value of lipid accumulation product and visceral fat index in predicting nonalcoholic fatty liver disease / 临床肝胆病杂志

Objective To investigate the association of lipid accumulation product (LAP) and visceral fat index (VAI) with nonalcoholic fatty liver disease (NAFLD) and the value of LAP and VAI in predicting the risk of NAFLD. Methods A total of 708 subjects who underwent physical examination in China-Japan Friendship Hospital from September 2018 to May 2019 were enrolled and divided into NAFLD group ( n =426) and non-NAFLD group ( n =282), and the two groups were compared in terms of LAP, VAI, and related biochemical parameters. The independent samples t -test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups.The chi-square test was used for comparison of categorical data between groups. The Spearman test was used for correlation analysis. The subjects were divided into L1-L4 groups based on LAP and V1-V4 groups based on VAI, and the distribution of NAFLD was compared between groups; a logistic regression analysis was used to calculate the risk of NAFLD at different levels of LAP and VAI, and the receiver operating characteristic (ROC) curves were plotted for LAP, VAI, waist circumference (WC), and body mass index (BMI) in predicting NAFLD in different sex and body weight subgroups, so as to evaluate the value of each index in the prediction and diagnosis of NAFLD. Results Compared with the non-NAFLD group, the NAFLD group had significantly higher age, proportion of male subjects, proportion of subjects with a smoking history, and levels of LAP, VAI, WC, BMI, systolic blood pressure, diastolic blood pressure, alanine aminotransferase, aspartate aminotransferase, total cholesterol, triglyceride, low-density lipoprotein cholesterol, fasting blood glucose, and serum uric acid, as well as a significantly lower level of high-density lipoprotein cholesterol (all P 0.7 in predicting the onset of NAFLD in different sex and body weight subgroups; the AUCs of LAP and VAI in the female subgroup were significantly higher than those in the male subgroup (LAP: 0.886 vs 0.785, P < 0.05; VAI: 0.824 vs 0.748, P < 0.05), and the corresponding sensitivities and specificities of LAP and VAI in the female subgroup were also higher than those in the male subgroup (sensitivity: LAP: 79.8% vs 63.7%; VAI: 77.9% vs 77.0%; specificity: LAP: 85.0% vs 81.1%; VAI: 77.6% vs 62.3%). Conclusion The risk of NAFLD increases with the increase in the levels of LAP and VAI. Both LAP and VAI have a good value in predicting NAFLD in different sex and body weight subgroups, especially in predicting NAFLD in the female population.

Visceral fat area and diabetic peripheral neuropathy in patients with type 2 diabetes / 中华内分泌代谢杂志

Objective:To assess the relationship between visceral fat area(VFA) and diabetic peripheral neuropathy (DPN) in type 2 diabets mellitues(T2DM) patients.Methods:A total of 2 615 patients with T2DM were enrolled from the National Metabolic Management Center at Ningbo First Hospital between March 2018 and February 2021. The medical history, questionnaire survey, and laboratory parameters were collected, VFA was measured using bioelectrical impedance analysis, DPN was diagnosed based on neurophysiological examination. Patients were divided into four groups by VFA and body mass index as the following: VFA<100 cm 2 and body mass index<24 kg/m 2 group [VA(-)OB(-) group], VFA<100 cm 2 and body mass index≥24 kg/m 2 group [VA(-)OB(+ ) group], VFA≥100 cm 2 and body mass index<24 kg/m 2 group [VA(+ )OB(-) group], and VFA≥100 cm 2 and body mass index≥24 kg/m 2 group [VA(+ )OB(+ ) group]. Multivariable logistic regression analysis was done to determine the relationship between body mass index, VFA and DPN in patients with T2DM. Results:The proportion of DPN in this study was 46.96%. DPN group featured with older age, higher proportion of men, longer duration of disease, higher proportion of smoking, lower diastolic blood pressure, higher HbA 1C level, lower total cholesterol, lower high density lipoprotein-cholesterol, lower low density lipoprotein-cholesterol, higher blood creatinine levels, higher urinary albumin-to-creatinine ratio, higher VFA level (all P<0.01). Grouping according to VFA and body mass index, 68.1% in the VA(+ )OB(-) group had DPN, which was highest among the four groups. In multivariable logistic regression analysis, compared with VA(-)OB(-) group, VA(+ )OB(-) group had a significantly higher risk of DPN ( OR=2.234, 95% CI 1.339-3.728, P =0.002), VA(+ )OB(+ ) group took second place ( OR=1.281, 95% CI 1.030-1.592, P =0.026). Conclusions:VFA was associated with DPN in T2DM regardless of body mass index. The VA(+ )OB(-) group has the highest risk of DPN. Therefore, evaluation of visceral adiposity may have important clinical significance for the early screening and prevention of DPN in T2DM.

Eating speed and obesity: A correlation analysis of cross-sectional data / 中华内分泌代谢杂志

Objective:To analysis the correlation of eating speed with obesity.Methods:A total of 644 people aged 40-65 from Caihe Community in Hangzhou were enrolled to collect clinical and demographic data, undergo extensive physical examination and laboratory tests. Participants were divided into two groups according to their eating speed (non-fast and fast). Obesity-related parameters were compared between two groups. Multivariable logistic regression was conducted to explore the relationship between eating speed and obesity after adjusting confounders.Results:Body mass index, waist circumference, and visceral fat area were greater in the fast eating group than non-fast eating group(all P<0.01). After adjusting for age, gender, smoking, alcohol drinking, physical activity level per week, and principal food intake, logistic regression analysis showed that eating fast was correlated with abdominal obesity( OR=1.66, 95% CI 1.11-2.48, P=0.014) and visceral obesity( OR=1.65, 95% CI 1.14-2.39, P=0.007). After stratified by gender, in the group of men, eating fast was correlated with abdominal obesity( OR=2.04, 95% CI 1.07-4.04, P=0.032) and visceral obesity( OR=1.85, 95% CI 1.04-3.31, P=0.037); In the group of women, eating fast was correlated with overweight and obesity( OR=1.59, 95% CI 1.04-2.42, P=0.031). Conclusion:Eating fast is positively associated with obesity. Interventions for reducing eating speed may be effective for weight control.

Predictive value of lipid accumulation product and visceral fat index for metabolic syndrome among middle-aged and elderly populations / 预防医学

Objective@#To investigate the value of lipid accumulation product (LAP) and visceral fat index (VAI) for prediction of metabolic syndrome (MS). @*Methods@#Based on the 2018 Survey on Chronic Diseases and Risk Factors in Yantai City of Shandong Province, residents at ages of 45 years and older were sampled, and subjects' age, disease history, waist circumstance (WC), body mass index (BMI), blood pressure and blood lipid were collected to calculate LAP and VAI. MS was diagnosed with the a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity (JIS definition) and the recommended criteria proposed by the Chinese Diabetes Society (CDS) of Chinese Medical Association (CDS criteria), and the values of LAP and VAI for MS screening were evaluated using the receiver operating characteristic (ROC) curve analysis.@*Results@#Totally 9 366 subjects were enrolled, including 4 340 men (46.34%) and 5 026 women (53.66%), and had a mean age of (54.49±9.73) years. According to the CDS criteria, the prevalence of MS was 24.58%, and LAP and VAI showed areas under the ROC curve (AUC) of 0.837 (95%CI: 0.828-0.846) and 0.751 (95%CI: 0.739-0.762), sensitivities of 78.82% and 63.31% and optimal cut-off values of 44.64 and 1.86 for screening of MS. According to the JIS definition, the prevalence of MS was 35.26%, and LAP and VAI showed AUC values of 0.842 (95%CI: 0.834-0.850) and 0.790 (95%CI: 0.780-0.800), sensitivities of 75.73% and 68.42% and optimal cut-off values of 42.01 and 1.67 for screening of MS.@*Conclusions@#Both LAP and VAI are effective for screening MS among middle-aged and elderly residents, and LAP presents a higher accuracy than VAI.

Effect of Jinlida Granules on Visceral Fat Accumulation in Prediabetic Rats / 中国实验方剂学杂志

ObjectiveTo study the effect of Jinlida granules on visceral fat accumulation and its induced inflammatory response in prediabetic rats. MethodMale SD rats were randomly divided into normal group， model group， Jinlida low-dose group （1.5 g·kg-1）， Jinlida high-dose group （3.0 g·kg-1） and atorvastatin group （10 mg·kg-1）. Prediabetic rat model was established using high-carbohydrate， high-fat diet combined with low-dose streptozotocin （STZ） by multiple small-dose intraperitoneal injections. After 8 weeks of modeling and drug intervention for 13 consecutive weeks， body weight， oral glucose tolerance test（OGTT）， fasting blood glucose （FBG）， fasting insulin （FINS）， insulin resistance index （HOMA-IR）， total cholesterol （TC）， low-density lipoprotein cholesterol （LDL-C） and high-density lipoprotein cholesterol （HDL-C） were measured in each group of rats. The content of visceral fat was quantified by micro-computed tomography （Micro-CT）. Hematoxylin-eosin staining （HE） was used to observe the pathological changes of fat cells. The levels of tumor necrosis factor-α （TNF-α） and interleukin- 6 （IL-6） in rat visceral fat and serum were determined by enzyme linked immunosorbent assay （ELISA）. The expression of macrophage marker CD68 in visceral fat was detected by immunofluorescence and Western blot. ResultCompared with normal group， model group had increased oral glucose tolerance， FBG， FINS， HOMA-IR， TC， LDL-C （P<0.01）， elevated body weight and visceral fat accumulation （P<0.05， P<0.01）， enhanced CD68 protein expression and TNF-α and IL-6 levels （P<0.01）， decreased HDL-C （P<0.01）， and abnormal hypertrophy of adipocytes. Compared with model group， Jinlida high- and low-dose groups lowered oral glucose tolerance， HOMA-IR， TC and LDL-C （P<0.05， P<0.01）， body weight and visceral fat accumulation （P<0.05）， and CD68 protein expression and TNF-α and IL-6 levels （P<0.05， P<0.01） and lessened hypertrophy of fat cells. ConclusionJinlida can improve the insulin resistance in prediabetic rats by reducing visceral fat accumulation and its induced inflammatory response， which provides a new pharmacological basis for clinical treatment of prediabetes by Jinlida granules.

Correlation between body composition and cardiorespiratory fitness decline in physical examination population of different genders / 中华健康管理学杂志

Objective:To analyze the correlation between the body composition and cardiorespiratory fitness (CRF) decline in physical examination population of different genders.Methods:Clinical data of the cardiopulmonary exercise testing (CPET) and body composition analysis of 439 people who received physical examination in the Medical Examination Center of Peking University Third Hospital from May 2021 to September 2021 were retrospectively analyzed. The general data, physical examination, biochemical parameters, body composition and CPET results were collected. The subjects were divided into normal group and decline group according to the percentage of peak oxygen uptake (VO 2peak) levels ≥ 85% or<85%. Multivariate logistic regression was applied to investigate the influencing factors of CRF decline in subjects of different genders. Results:Among men, total cholesterol and triglyceride in the decline group were significantly higher than those in the normal group [(5.097±0.890) vs (4.865±0.856) mmol/L, (1.778±1.200) vs (1.485±0.709) mmol/L], and the blood homocysteine (Hcy) and skeletal muscle index were significantly lower than those in the normal group [13.00 (11.30, 15.90) vs 13.80 (12.05, 17.10) μmol/L, (7.89±0.65) vs (8.08±0.64) kg/m 2] (all P<0.05). Among women, skeletal muscle index in the decline group was significantly lower than that in the normal group [(6.21±0.52) vs (6.53±0.56)kg/m 2], and percent body fat was significantly higher than that in the normal group [(32.83±4.92)% vs (31.21±4.55)%] (all P<0.05). The elevation of triglyceride level ( OR=1.487, 95% CI: 1.042-2.121) and visceral fat area ( OR=1.032, 95% CI: 1.014-1.051) were positively correlated with the decline of CRF in man, the decrease of skeletal muscle index ( OR=0.215, 95% CI: 0.106-0.435) and the increase of percent body fat ( OR=1.149, 95% CI: 1.060-1.245) were positively correlated with the decrease of CRF in women (all P<0.05). Conclusions:There is a correlation between body composition and CRF decline in physical examination population of different genders. Men should control visceral fat more effectively, and women should pay attention to increase muscle mass while reducing body fat, in order to improve CRF.

Inverse association of plasma hydrogen sulfide levels with visceral fat area among Chinese young men: a cross-sectional study

ABSTRACT Objective: To investigate the association between plasma Hydrogen Sulfide (H2S) levels and visceral fat area (VFA) among Chinese young men. Subjects and methods: This cross-sectional study involved 156 Chinese male subjects, aged 18-45 years, who visited the First Hospital of Qinhuangdao (Hebei, China) in 2014 for annual health check-up. Participants were categorized into: low (VFA < 75.57 cm2), medium (75.57 cm2 ≤ VFA<100.37 cm2), and high (VFA ≥ 100.37 cm2) (n = 52/group). We estimated VFA and plasma H2S levels by using bioelectrical impedance analysis and a fluorescence probe-based approach, respectively. The associations of H2S with VFA and obesity anthropometric measures were assessed. Results: In the high VFA group, the body mass index (BMI, 30.4 ± 2.45 kg/m2), total body fat (TBF, 27.9 ± 3.23 kg), plasma H2S (3.5 μmol/L), free fatty acid (FFA, 0.6 ± 0.24 mmol/L), triglyceride (TG, 2.0 mmol/L), and total cholesterol (TC, 5.5 ± 1.02 mmol/L) levels were significantly higher than that of those of the low and medium VFA groups, respectively (P < 0.05). Plasma H2S levels were found to be inversely correlated with VFA, TBF, waist circumference, BMI, FFA, LnFINS, LnHOMA-IR, LnTG, TC, and LDL-C (P < 0.05). Multiple backward stepwise regression analysis revealed an inverse correlation of plasma H2S levels with FFA (β = −0.214, P = 0.005) and VFA (β = −0.429, P < 0.001), independent of adiposity measures and other confounding factors. Conclusion: VFA was independently and inversely associated with plasma H2S levels among Chinese young men. Therefore, determining plasma H2S levels could aid in the assessment of abnormal VAT distribution.

Associations of circulating irisin with 24-h blood pressure, total and visceral fat, and metabolic parameters in young adult hypertensives

ABSTRACT Objective: Some experimental and clinical studies suggest a possible role of irisin in central and peripheral regulation of blood pressure. The purpose of the study was to assess the associations between serum irisin levels, total and visceral fat, metabolic parameters, and blood pressure pattern during 24-h monitoring (ABPM). Materials and methods: In 206 patients with essential hypertension receiving standard antihypertensive treatments, we assessed anthropometric indices; serum irisin, blood lipids (total cholesterol, LDL-C, HDL-C, and triglycerides), glucose and insulin; body composition including lean mass and total, visceral, android and gynoid fat using a dual-energy x-ray absorptiometry; ABPM; and Homeostasis Model Assessment-Insulin Resistance (HOMA-IR). Results: Baseline irisin levels were within normal reference ranges and comparable between the genders. There were no significant correlations of irisin with age, anthropometric variables, lipids, HOMA-IR, body composition, as well as 24-h blood pressure and dipping status. In univariate analysis, age, fat mass and distribution, lipids and glucose, HOMA-IR, and nocturnal blood pressure fall were poor predictors of irisin levels. These neutral associations were not affected by age, gender, and treatment modality. Conclusions: In young adult hypertensives, serum concentration of irisin was within a normal range and not associated with total and regional fat, blood lipids, insulin resistance, as well as 24-h blood pressure and the magnitude of its nocturnal fall.

Helical computerized tomography can measure subcutaneous, visceral and total fat areas? / A tomografia helicoidal pode mensurar as áreas de gordura subcutânea, visceral e total?

ABSTRACT Background: Abdominal obesity or android obesity, that is, the increase in adipose tissue in the abdominal region, is considered a risk factor for several morbidities. Different ways of quantifying it have been proposed, one method is the measurement of the abdominal fat area by computed tomography. Aim: To establish correspondence between the groups defined by degree of obesity in relation to the total, subcutaneous and visceral fat area. Methods: Cross-sectional observational study carried out through the analysis of tomographic examinations. Horos v3.3.5 medical image visualization software was used, with abdominal tomography in a single cut including the L4 vertebral body and the umbilical scar, to obtain the areas of total, visceral and subcutaneous fat. Results: Of the 40 patients, 10 had grade II obesity, 23 grade III and 7 superobese. The amount of total fat showed an increase in relation to the degree of obesity. Visceral fat did not show significant differences between the degrees of obesity, but the data showed a lower average in the group of obesity grade II. The area of subcutaneous fat, as well as total fat, showed an increase in its measurements, according to the progression of the patients' BMI, but there was no statistical significance in this difference between the groups of grade II and super-obese individuals. Conclusion: The area of total and subcutaneous fat showed an increase in its measurements according to the progression of the BMI groups, which did not happen with visceral fat.

RESUMO Racional: A obesidade abdominal ou a obesidade androide, isto é, o aumento de tecido adiposo na região abdominal, é considerada fator de risco para diversas morbidades. Diferentes formas de quantificá-la foram propostas, sendo um dos métodos a medida da área da gordura abdominal pela tomografia computadorizada. Objetivo: Estabelecer correspondência entre os grupos definidos por grau de obesidade em relação a área de gordura total, subcutânea e visceral. Métodos: Estudo observacional analítico transversal realizado através da análise de exames tomográficos. Utilizou-se software de visualização de imagens médicas Horos v3.3.5, com tomografia abdominal em um único corte incluindo corpo vertebral de L4 e a cicatriz umbilical, para obter as áreas de gordura total, visceral e subcutânea. Resultados: Dos 40 pacientes 10 apresentavam obesidade grau II, 23 grau III e 7 superobesos. A quantidade de gordura total demonstrou aumento com relação ao grau de obesidade. A gordura visceral não apresentou diferenças significativas entre os graus de obesidade, porém os dados demonstraram média menor no grupo de obesidade grau II. A área de gordura subcutânea, assim como a gordura total, apresentou aumento de suas medidas, conforme a progressão do IMC dos pacientes, porém não houve significância estatística nesta diferença entre os grupos de obesos grau II e superobesos. Conclusão: A área de gordura total e subcutânea apresentaram aumento de suas medidas conforme a progressão dos grupos de IMC, o que não aconteceu com a gordura visceral.

Correlación de parámetros antropométricos predictores del riesgo de aparición de diabetes mellitus / Correlation of the anthropometric parameters predictors of emerging risk for diabetes mellitus

Introducción: Existen parámetros antropométricos predictivos del riesgo de padecer diabetes mellitus que pueden correlacionarse, tal como el índice de masa corporal, el porcentaje de grasa corporal, el perímetro de la cintura y el porcentaje de grasa visceral. Objetivo: Establecer el riesgo potencial de padecer diabetes mellitus de tipo 2 mediante la correlación de indicadores y medidas antropométricas aplicables a la población local. Métodos: Se realizó un estudio epidemiológico, transversal, observacional y analítico de 118 individuos jóvenes, en la Universidad Católica de Córdoba, en Córdoba, Argentina, durante el mes de septiembre de 2019, en el cual se aplicó el FINnish Diabetes Risk Score, tomando además como indicadores los porcentajes de grasa corporal y de grasa visceral. En el análisis estadístico de las variables cuantitativas y cualitativas se utilizaron el promedio y la desviación estándar como medidas descriptivas; asimismo, se aplicaron las pruebas de normalidad de Shapiro-Wilk y de Kolmogorow-Smirnov y el coeficiente de correlación de Spearman para probar las hipótesis estadísticas planteadas. Resultados: Se encontró que la mayoría de la población era de bajo riesgo y la correlación entre el índice de masa corporal y la grasa corporal que se ajustaba era Y=1,18X+4,06; donde Y fue el porcentaje de grasa corporal y X el índice de masa corporal. Para correlacionar el perímetro de la cintura y el porcentaje de grasa visceral se ajustaban Y=0,21X-10,21 para hombres y Y=0,17X-7,84 para mujeres, donde Y fue el porcentaje de grasa visceral y X el perímetro de la cintura. Conclusiones: El conocimiento del estado de salud de una población lleva a la capacitación y asistencia para el autocuidado y la adquisición de hábitos saludables, que contribuyan a una adultez con calidad de vida.

Introduction: There are risk anthropometric predictors parameters of suffering from diabetes mellitus that can be correlated, such as the body mass index, body fat percentage, waist perimeter and visceral fat percentage. Objective: To establish the potential risk of suffering from type2 diabetes mellitus by means of the correlation of indicators and anthropometric measures applicable to a local population. Methods: An epidemiological, cross-sectional, observational and analytic study of 118 young individuals was carried out in the Catholic University of Córdoba, in Córdoba, Argentina, during the month of September, 2019, in which the FINnish Diabetes Risk Score was implemented, the body fat and visceral fat percentages were also taken as warning signs. In the statistical analysis of the quantitative and qualitative variables the average and the standard deviation were used as descriptive measures; also, the Shapiro-Wilks and Kolmogorow-Smirnov normality tests and the Spearman correlation test were implemented to prove the outlined statistical hypotheses. Results: It was found that it was a low risk population and the correlation between the body mass index and the body fat that was adjusted was Y=1.18X+4.06; where Y was the body fat percentage and X the body mass index. To correlate the waist perimeter and the visceral fat percentage Y=0,21X-10,21 for men and Y=0,17X-7,84 for women were adjusted, where Y was the visceral fat percentage and X the waist perimeter. Conclusions: The knowledge of the population health condition leads to the training and assistance for the selfcare and to the acquisition of healthy habits that contribute to an adulthood with life quality.

Glomerular filtration rate and its relationship with visceral and subcutaneous adiposity: a study with patients from Northeast Brazil / Tasa de filtración glomerular y su relación con la adiposidad visceral y subcutánea: un estudio con pacientes del noreste brasileño

ABSTRACT Objective: evaluate the relationship between visceral/subcutaneous adipose tissue (VAT/SAT) and glomerular filtration rate (GFR). Methods: A case series study was conducted with 146 male and female adult outpatients at a hospital in Northeast Brazil. VAT and SAT were quantified using computed tomography and GFR was estimated using the formula proposed by the CKD Epidemiology Collaboration. The conceptual model also considered socio-demographic, clinical, anthropometric and lifestyle variables. Results: Females accounted for 71.9% of the sample and mean age was 52.5±13.2 years. Mean body mass index indicated obesity in both sexes (men:30.4±5.9 kg/m2; women: 31.6±6.1 kg/m2). For the same mean age and BMI, men had more VAT and a higher VAT/SAT ratio. Mean GFR was similar between sexes and within the normal range. Simple linear regression analysis revealed that 21.8% of the reduction in GFR in males could be explained by the VAT/SAT ratio (p=0.002). Among females, both VAT alone and the VAT/SAT ratio were predictors of GFR reduction (r2=4.8%, p=0.025 and r2=5.3%, p=0.019, respectively). Conclusion: Mean VAT and VAT/SAT ratio were compatible with abdominal obesity in both sexes and were related to a reduction in GFR.

RESUMEN Objetivo: Evaluar la relación entre el tejido adiposo visceral (TAV) y subcutáneo (TAS) con la tasa de filtración glomerular. Métodos: Estudio tipo serie de casos, en 146 pacientes adultos de ambos sexos, atendidos en un ambulatorio de un hospital de referencia en el Nordeste brasileño. El TAV y el TAS se cuantificaron por tomografía computadorizada y la tasa de filtración glomerular (TFG) estimada por la fórmula del grupo Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). El modelo conceptual también consideró variables sociodemográficas, clínicas, antropométricas y de estilo de vida. Resultados: Pacientes con edad promedio de 52,5 ± 13,2 años y el 71,9% de sexo femenino. El promedio del IMC en ambos sexos se encuentra en el rango de obesidad (hombres= 30,4 ± 5,9 kg/m2 vs mujeres= 31,6 ± 6,1 kg/m2). Para un mismo promedio de edad e IMC, los hombres presentaron mayor TAV y mayor razón TAV/TAS que las mujeres. El promedio de la TFG fue similar entre los sexos y se encuentra en el rango normal. A través de regresión lineal simple, se evidenció que, en el sexo masculino, la disminución de la TFG puede explicarse en el 21,8% por la razón TAV/TAS (p=0,002). En el sexo femenino, tanto el TAV aislado como la razón TAV/TAS fueron predictores de disminución de la TFG (r2= 4,8%; p=0,025 e r2= 5,3%; p=0,019), respectivamente. Conclusión: Se evidenciaron valores muy elevados de los parámetros antropométricos de obesidad abdominal y promedio de TAV y de la razón TAV/TAS compatible con obesidad visceral en ambos sexos, siendo que estos dos últimos parámetros estuvieron relacionados al descenso de la TFG.

Agreement between software programmes of body composition analyses on abdominal computed tomography scans of obese adults

ABSTRACT Objective A large number of studies have used abdominal computed tomography (CT) to quantify body composition, and different software programmes have been used to perform these analyses. Thus, this comparison is important to enable researchers to know the performance of more accessible software. Subjects and methods Fifty-four abdominal CT scans of obese (BMI 30 to 39.9 kg/m2), sedentary adults (24-41 years) patients from a Brazilian single center were selected. Two software programs were compared: Slice-O-Matic (Tomovision, Canada) version 5.0 and OsiriX version 5.8.5. The body composition analysis were segmented using standard Hounsfield unit (HU) (adipose tissue: -190 to +30 and skeletal muscle: -29 to +150) and measured at the mid third lumbar vertebra (L3) level on a slice showing both transversal processes. Bland-Altman limits of agreement analyses were used to assess the level of agreement between Slice-O-Matic and OsiriX. Results A total of fifty-four participants were evaluated, with majority women (69%), mean of age 31.3 (SD 6.5) years and obesity grade I most prevalent (74.1%). The agreement, in Bland-Altman analysis, between Slice-O-Matic and OsiriX analisys for the muscle mass tissue, visceral adipose tissue and subcutaneous adipose tissue were excellent (≥ 0.954) with P-values < 0.001. Conclusion These findings show that Slice-O-Matic and OsiriX softwares agreement in measurements of skeletal muscle and adipose tissue and sarcopenia diagnosis in obese patients, suggesting good applicability in studies with body composition in this population and clinical practice.