Visceral fat and cardiometabolic future in children and adolescents: a critical update.

Cardiovascular disease (CVD) is a process whose pathogenetic mechanisms start very early in life. Recently, the importance of visceral adipose tissue (VAT) has been highlighted in the development of CVD. VAT does not always depend on body mass index (BMI) and has been implicated in unfavorable metabolic activity and cardiovascular adverse events. Abnormally high deposition of VAT is associated with metabolic syndrome, obesity-associated phenotype, and cardiometabolic risk factors. Although the importance of visceral fat has not been studied broadly or extensively in long-term studies in children and adolescents, it appears that it does not have the same behavior as in adults, it is related to the appearance of cardiac risk factors. In adolescents, it plays a role in the pathogenesis of CVD that occur later in adulthood. Excess body weight and adiposity may lead to the development of early myocardial and pathological coronary changes in childhood. The purpose of this review is to summarize the risk factors, the clinical significance, and the prognostic role of visceral obesity in children and adolescents. In addition, extensive reference is made to the most commonly used techniques for the evaluation of VAT in clinical settings. IMPACT: Visceral obesity, plays an important role in cardiovascular health from very early in an individual's life. Visceral adipose tissue (VAT) distribution is not entirely related to body mass index (BMI) and provides additional prognostic information. There is a need to pay more attention to the assessment of VAT in young people, to develop methods that would go beyond the measurement of only BMI in clinical practice and to identify individuals with excess visceral adiposity and perhaps to monitor its changes.

Are obesity indices derived by dual-energy x-ray absorptiometry capable of identifying postmenopausal females with high risk for coronary heart disease?

OBJECTIVE: The aim of the study was to evaluate the predictive ability of obesity indices derived by dual-energy x-ray absorptiometry (DXA) regarding coronary heart disease (CHD). METHODS: DXA total body scans were performed on 71 consecutive postmenopausal women who were referred for myocardial perfusion imaging (MPI). Twenty-four women with CHD diagnosed by MPI were considered as cases, whereas the remaining 47 women with normal MPI results were considered as controls. Biochemical markers, body mass index (BMI) and waist circumference (WC) were also recorded for all women and correlated to DXA adiposity indices. Receiver operating characteristic curve analysis was performed to evaluate the ability of DXA and anthropometrically obtained obesity indices on predicting CHD. RESULTS: Participants with CHD were found to have increased fat mass in the trunk (P < 0.01), in the android area (P < 0.01), and in the total body (P < 0.05) in agreement with the anthropometric indices WC (P < 0.01) and BMI (P < 0.05). Strong correlation was observed between BMI and fat mass in total body (R = 0.835), trunk (R = 0.731), and android (R = 0.796) and between WC and fat mass in android (R = 0.713). DXA-derived central fat indices were found to have higher potential for identification of individuals at high risk for CHD than BMI and WC but differences were not statistically significant. CONCLUSIONS: DXA central fat indices were found to have the power to identify individuals with CHD; however, the superiority of DXA indices over the commonly used anthropometric indices (BMI, WC) in identifying women with CHD did not reach statistical significance.

The -938C>A Polymorphism in MYD88 Is Associated with Susceptibility to Tuberculosis: A Pilot Study.

Introduction. Tuberculosis (TB) is a major disease worldwide, caused by Mycobacterium tuberculosis (MTB) infection. The Toll-Like Receptor (TLR) pathway plays a crucial role in the recognition of MTB. Aim. The present study aimed to investigate the involvement of myeloid differentiation primary response protein 88 (MYD88) gene polymorphisms in TB. Materials and Methods. A total of 103 TB cases and 92 control subjects were genotyped for the MYD88 -938C>A (rs4988453) and 1944C>G (rs4988457) polymorphisms. Results. The MYD88 -938CA and -938AA genotypes were associated with an increased risk for tuberculosis with odds ratio (OR) of 5.71 (95% confidence intervals [CIs] 2.89-11.28, p = 0.01). Conclusions. The MYD88 -938C>A genetic polymorphism is associated with increased susceptibility to TB and may serve as a marker to screen individuals who are at risk.