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1.
BMC Urol ; 24(1): 38, 2024 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-38347470

RESUMO

BACKGROUND: Prostatic fibrosis, characterized by the accumulation of myofibroblasts and collagen deposition, is closely associated with LUTS and may lead to mechanical obstruction of the urethra. Additionally, Metabolic Syndrome (MetS), characterized by central obesity, high blood sugar, lipid metabolism disorders, and hypertension, is increasingly recognized as a proinflammatory condition linked to prostate inflammation. METHODS: Clinical data from 108 subjects who underwent transurethral resection of the prostate or bipolar plasmakinetic enucleation of the prostate were prospectively collected between June 2021 and August 2022. Patients were divided in two groups according to whether or not they had a diagnosis of MetS. Specimens were stained with Masson trichrome and the periurethral prostatic fibrosis extent was evaluated using quantitative morphometry. RESULTS: Forty-three patients (39.8%) were diagnosed with MetS. Patients with MetS showed a significantly greater extent of prostatic fibrosis than the others (68.1 ± 17.1% vs. 42.5 ± 18.2%, P < 0.001), and there was a positive correlation between the number of positive MetS parameters and the extent of prostatic fibrosis (R2 = 0.4436, P < 0.001). Multivariate regression analysis revealed that central obesity (B = 2.941, 95% confidence interval, 1.700-3.283), elevated fasting glucose (B = 1.036, 95% confidence interval, 0.293-1.780), reduced HDL cholesterol (B = 0.910, 95% confidence interval, 0.183-1.636) and elevated triglycerides (B = 1.666, 95% confidence interval, 0.824-2.508) were positively correlated to prostatic fibrosis. Elevated blood pressure, however, was unrelated to prostatic fibrosis (B = 0.009, 95% confidence interval, -0.664-0.683). CONCLUSIONS: The present findings suggest that prostatic fibrosis is positively correlated with MetS and its components including central obesity, elevated fasting glucose, reduced high density lipoprotein cholesterol and elevated triglycerides.


Assuntos
Síndrome Metabólica , Hiperplasia Prostática , Ressecção Transuretral da Próstata , Masculino , Humanos , Próstata/patologia , Síndrome Metabólica/complicações , Estudos Prospectivos , Hiperplasia Prostática/cirurgia , Obesidade Abdominal/complicações , Obesidade Abdominal/patologia , Obesidade Abdominal/cirurgia , Fibrose , Triglicerídeos , Glucose
2.
J Obstet Gynaecol Res ; 49(3): 988-997, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36593218

RESUMO

AIM: To evaluate the reliability of sagittal abdominal diameter (SAD)-a surrogate of visceral obesity-in magnetic resonance imaging, and its accuracy to predict the surgical morbidity of aortic lymphadenectomy. METHODS: We conducted a multicenter reliability (phase 1) and accuracy (phase 2) cohort study in three Spanish referral hospitals. We retrospectively analyzed data from the STELLA-2 randomized controlled trial that included high-risk endometrial cancer patients undergoing minimally invasive surgical staging. Patients were classified into subgroups: conventional versus robotic-assisted laparoscopy, and transperitoneal versus extraperitoneal technique. In the first phase, we measured the agreement of three SAD measurements (at the umbilicus, renal vein, and inferior mesenteric artery) and selected the most reliable one. In phase 2, we evaluated the diagnostic accuracy of SAD to predict surgical morbidity. Surgical morbidity was the main outcome measure, it was defined by a core outcome set including variables related to blood loss, operative time, surgical complications, and para-aortic lymphadenectomy difficulty. RESULTS: In phase 1, all measurements showed good inter-rater and intra-rater agreement. Umbilical SAD (u-SAD) was the most reliable one. In phase 2, we included 136 patients. u-SAD had a good diagnostic accuracy to predict surgical morbidity in patients undergoing transperitoneal laparoscopic lymphadenectomy (0.73 in ROC curve). It performed better than body mass index and other anthropometric measurements. We calculated a cut-off point of 246 mm (sensitivity: 0.56, specificity: 0.80). CONCLUSIONS: u-SAD is a simple, reliable, and potentially useful measurement to predict surgical morbidity in endometrial cancer patients undergoing minimally invasive surgical staging, especially when facing transperitoneal aortic lymphadenectomy.


Assuntos
Neoplasias do Endométrio , Laparoscopia , Procedimentos Cirúrgicos Robóticos , Feminino , Humanos , Estudos de Coortes , Estudos Retrospectivos , Obesidade Abdominal/etiologia , Obesidade Abdominal/patologia , Obesidade Abdominal/cirurgia , Reprodutibilidade dos Testes , Procedimentos Cirúrgicos Robóticos/métodos , Excisão de Linfonodo/métodos , Laparoscopia/métodos , Neoplasias do Endométrio/patologia , Estadiamento de Neoplasias
3.
J Clin Endocrinol Metab ; 108(5): 1173-1180, 2023 04 13.
Artigo em Inglês | MEDLINE | ID: mdl-36394524

RESUMO

CONTEXT: Low skeletal muscle mass often accompanies abdominal obesity in the aging process. OBJECTIVE: We aimed to investigate the effect of reduced skeletal muscle mass and its interaction with abdominal obesity on incident type 2 diabetes. METHODS: This retrospective longitudinal study included 36 304 diabetes-free Koreans who underwent 2 or more health checkups annually or biannually. Appendicular skeletal muscle mass was measured by bioelectrical impedance analysis and was presented as a skeletal muscle mass index (SMI) adjusted for body weight. Presarcopenia was defined as an SMI less than 1 SD of the sex-specific mean for a healthy young reference group. Abdominal obesity was defined using waist circumference greater than or equal to 90 cm for men and greater than or equal to 85 cm for women. Participants were classified into 4 groups of normal, presarcopenia alone, abdominal obesity alone, and presarcopenic obesity according to initial body composition. RESULTS: The cumulative incidence of diabetes was 9.1% during the 7-year follow-up. Compared with the highest tertile, the lowest sex-specific SMI tertile was significantly associated with a greater risk of incident type 2 diabetes (adjusted hazard ratio [HR] = 1.31; 95% CI, 1.18-1.45) in a fully adjusted model. Presarcopenic obesity significantly increased incident diabetes risk (adjusted HR = 1.57; 95% CI, 1.42-1.73) compared with normal body composition, presarcopenia alone, or abdominal obesity alone. CONCLUSION: Low skeletal muscle mass and its coexistence with abdominal obesity additively increased the risk of incident type 2 diabetes independent of the glycometabolic parameters.


Assuntos
Diabetes Mellitus Tipo 2 , Sarcopenia , Masculino , Humanos , Feminino , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/patologia , Obesidade Abdominal/complicações , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/patologia , Sarcopenia/complicações , Sarcopenia/epidemiologia , Sarcopenia/patologia , Estudos Longitudinais , Músculo Esquelético/patologia , Estudos Retrospectivos , Obesidade/complicações , Obesidade/epidemiologia , Obesidade/patologia , Índice de Massa Corporal , Fatores de Risco
4.
Biomed Khim ; 68(5): 383-389, 2022 Nov.
Artigo em Russo | MEDLINE | ID: mdl-36373885

RESUMO

Trace elements are important factors in human health. Zinc, an essential trace element, is necessary for normal functioning of many body systems where it plays an important role in metabolism. Obesity is accompanied by various metabolic pathologies provoking the development of dyslipidaemia, metabolic syndrome, type 2 diabetes mellitus, arterial hypertension, cardiovascular diseases and cancer. Many studies demonstrate changes in zinc homeostasis in obese men, but the data are conflicting, and a relationship between serum zinc and anthropometric and metabolic indicators remains controversial. In this study we have investigate the relationship between serum zinc level and body mass index (BMI), waist circumference (WC), and some metabolic parameters in Russian men. In 260 young men from the general population (n=268, median age 22 years), serum zinc, triglycerides (TG), total cholesterol (TC), high and low density lipoprotein cholesterol (HDL and LDL), glucose and uric acid levels were determined, as well as body weight, height, waist circumference (WC), and BMI were evaluated. According to BMI, men were divided into four groups: deficient and normal body weight, overweight, obesity. According to WC men were subdivided into two groups: normal and abdominal-visceral type of obesity. The median serum zinc concentration in men of the entire studied population was 20.3 µmol/l, and in men with obesity (BMI≥30) the median serum zinc concentration was higher than in the corresponding value in men with normal weight (30.9 and 20.8 µmol/l, respectively, p<0.01). Serum levels of TG, TC and LDL in obese men were also significantly higher (p<0.01) as compared to men with normal weight. In men with abdominal-visceral obesity, the median serum zinc concentration was significantly higher in comparison with control (26.3 and 19.9 µmol/l, respectively, p<0.01). It is suggested that elevated serum zinc level in obese young men can counter chronic inflammation and oxidative stress caused by increased body fat.


Assuntos
Diabetes Mellitus Tipo 2 , Masculino , Humanos , Adulto Jovem , Adulto , Diabetes Mellitus Tipo 2/metabolismo , Zinco , Obesidade/metabolismo , Circunferência da Cintura , Índice de Massa Corporal , Obesidade Abdominal/patologia , Triglicerídeos
5.
Commun Biol ; 5(1): 553, 2022 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-35672444

RESUMO

Several studies highlighted the importance of platelets in the tumor microenvironment due to their ability to interact with other cell types such as leukocytes, endothelial, stromal and cancer cells. Platelets can influence tumor development and metastasis formation through several processes consisting of the secretion of growth factors and cytokines and/or via direct interaction with cancer cells and endothelium. Patients with visceral obesity (VO) are susceptible to pro-thrombotic and pro-inflammatory states and to development of cancer, especially colon cancer. These findings provide us with the impetus to analyze the role of platelets isolated from VO patients in tumor growth and progression with the aim to explore a possible link between platelet activation, obesity and colon cancer. Here, using xenograft colon cancer models, we prove that platelets from patients with visceral obesity are able to strongly promote colon cancer growth. Then, sequencing platelet miRNome, we identify miR-19a as the highest expressed miRNA in obese subjects and prove that miR-19a is induced in colon cancer. Last, administration of miR-19a per se in the xenograft colon cancer model is able to promote colon cancer growth. We thus elect platelets with their specific miRNA abundance as important factors in the tumor promoting microenvironment of patients with visceral obesity.


Assuntos
Neoplasias do Colo , MicroRNAs , Plaquetas/metabolismo , Neoplasias do Colo/metabolismo , Humanos , MicroRNAs/genética , Obesidade Abdominal/complicações , Obesidade Abdominal/metabolismo , Obesidade Abdominal/patologia , Microambiente Tumoral
6.
Eur J Surg Oncol ; 48(7): 1664-1670, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35339340

RESUMO

BACKGROUND: Sarcopenia, myosteatosis and visceral obesity (VO) are known to negatively impact on outcomes from colorectal cancer (CRC). Little is known about tumour factors associated with these body composition (BC) phenotypes. We aimed to identify whether histopathological tumour characteristics were associated with various BC phenotypes. METHODS: A prospectively collected database of patients undergoing surgery for primary CRC at a tertiary referral unit in the United Kingdom was analysed. Sarcopenia, myosteatosis and VO were identified on preoperative CT. Binary logistic regression modelling was performed to determine significant associations between tumour stage, grade and BC phenotype. RESULTS: Final analysis included 795 patients; median age 69, 56% male, 65% were sarcopenic, 72% myosteatotic, 52% VO and 20% had sarcopenic obesity (SO). VO patients were significantly less likely to have advanced T Stage (T3-4) OR0.62(95%CI 0.44-0.86, p = 0.005); nodal metastases OR0.60(95%CI 0.44-0.82, p = 0.001); vascular invasion OR0.63(95%CI 0.46-0.88, p = 0.006) and poor tumour differentiation OR0.49(95%CI 0.28-0.86, p = 0.012). Myosteatotic patients were more likely to have metastatic disease OR2.31(95%CI 1.15-4.63, p = 0.018) but less likely to have poorly differentiated tumours OR0.48(95%CI 0.27-0.86, p = 0.013). SO patients were significantly more likely to have poorly differentiated tumours OR2.01(95%CI 1.04-3.87, p = 0.037). CONCLUSION: VO predisposes to earlier stage tumours with a less aggressive tumour phenotype. The SO group have adverse tumour characteristics which may be explained by differences in fat distribution. Myosteatosis relates to increased likelihood of distant metastasis that may be related to a systemic inflammatory response, despite the association with better differentiated tumours.


Assuntos
Neoplasias Colorretais , Sarcopenia , Composição Corporal , Neoplasias Colorretais/patologia , Feminino , Humanos , Masculino , Músculo Esquelético/patologia , Obesidade/complicações , Obesidade Abdominal/complicações , Obesidade Abdominal/patologia , Fenótipo , Estudos Retrospectivos , Sarcopenia/complicações , Tomografia Computadorizada por Raios X
7.
Neurobiol Aging ; 113: 39-54, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35303671

RESUMO

Characterizing age- and risk-related hippocampal vulnerabilities may inform about the neural underpinnings of cognitive decline. We studied the impact of three risk-factors, Apolipoprotein (APOE)-ε4, a family history of dementia, and central obesity, on the CA1, CA2/3, dentate gyrus and subiculum of 158 cognitively healthy adults (38-71 years). Subfields were labelled with the Automatic Segmentation of Hippocampal Subfields and FreeSurfer (version 6) protocols. Volumetric and microstructural measurements from quantitative magnetization transfer and Neurite Orientation Density and Dispersion Imaging were extracted for each subfield and reduced to three principal components capturing apparent myelin/neurite packing, size/complexity, and metabolism. Aging was associated with an inverse U-shaped curve on myelin/neurite packing and affected all subfields. Obesity led to reductions in myelin/neurite packing and size/complexity regardless of APOE and family history of dementia status. However, amongst individuals with a healthy Waist-Hip-Ratio, APOE ε4 carriers showed lower size/complexity than non-carriers. Segmentation protocol type did not affect this risk pattern. These findings reveal interactive effects between APOE and central obesity on the hippocampal formation of cognitively healthy adults.


Assuntos
Demência , Obesidade Abdominal , Apolipoproteína E4/genética , Apolipoproteínas , Atrofia/patologia , Demência/patologia , Hipocampo/diagnóstico por imagem , Hipocampo/patologia , Humanos , Imageamento por Ressonância Magnética/métodos , Obesidade/complicações , Obesidade/genética , Obesidade/patologia , Obesidade Abdominal/patologia
8.
Int J Mol Sci ; 23(4)2022 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-35216509

RESUMO

The metabolic syndrome (MetS) is a cluster of the most dangerous heart attack risk factors: diabetes or raised fasting plasma glucose, abdominal obesity, high cholesterol and high blood pressure. The goal of this study is to compare the state of the main features of obesity-associated white adipose tissue (WAT) dysfunction in 66 women with severe obesity without (MetS-) or with MetS (MetS+). Fat cell area, adipocyte size distribution and histological fibrosis were analysed in visceral (VAT) and abdominal subcutaneous WAT (SAT) in 33 age- and BMI-matched pairs of MetS- and MetS+ subjects. The mRNA expression of 93 genes implicated in obesity-associated WAT dysfunction was analysed by RT-qPCR in both fat depots. MetS+ females showed higher adipocyte hypertrophy in both fat depots and increased fibrosis and expression of macrophage and hypoxia markers in SAT. Transcriptional data suggest increased fatty acid oxidation in SAT and impaired thermogenesis and extracellular matrix remodelling in VAT from MetS+ subjects. A sPLS-DA model, including SAT expression of PPARA and LEPR genes identified MetS with an AUC = 0.87. Despite equal age, BMI and body composition, MetS+ females display morphological and transcriptional differences in both WAT depots, especially in SAT. These factors may contribute to the transition to MetS.


Assuntos
Síndrome Metabólica/patologia , Obesidade Mórbida/patologia , Gordura Subcutânea Abdominal/patologia , Adipócitos/metabolismo , Adipócitos/patologia , Tecido Adiposo Branco/metabolismo , Tecido Adiposo Branco/patologia , Composição Corporal/fisiologia , Índice de Massa Corporal , Diabetes Mellitus/metabolismo , Diabetes Mellitus/patologia , Feminino , Humanos , Hipertensão/metabolismo , Hipertensão/patologia , Gordura Intra-Abdominal/metabolismo , Síndrome Metabólica/metabolismo , Pessoa de Meia-Idade , Obesidade Abdominal/metabolismo , Obesidade Abdominal/patologia , Obesidade Mórbida/metabolismo , Gordura Subcutânea Abdominal/metabolismo , Termogênese/fisiologia
9.
J Clin Endocrinol Metab ; 107(1): 150-166, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34487152

RESUMO

CONTEXT: Chronic glucocorticoid (GC) overexposure, resulting from endogenous Cushing's syndrome (CS) or exogenous GC therapy, causes several adverse outcomes, including persistent central fat accumulation associated with a low-grade inflammation. However, no previous multiomics studies in visceral adipose tissue (VAT) from patients exposed to high levels of unsuppressed GC during active CS or after remission are available yet. OBJECTIVE: To determine the persistent VAT transcriptomic alterations and epigenetic fingerprints induced by chronic hypercortisolism. METHODS: We employed a translational approach combining high-throughput data on endogenous CS patients and a reversible CS mouse model. We performed RNA sequencing and chromatin immunoprecipitation sequencing on histone modifications (H3K4me3, H3K27ac, and H3K27me3) to identify persistent transcriptional and epigenetic signatures in VAT produced during active CS and maintained after remission. RESULTS: VAT dysfunction was associated with low-grade proinflammatory status, macrophage infiltration, and extracellular matrix remodeling. Most notably, chronic hypercortisolism caused a persistent circadian rhythm disruption in VAT through core clock genes modulation. Importantly, changes in the levels of 2 histone modifications associated to gene transcriptional activation (H3K4me3 and H3K27ac) correlated with the observed differences in gene expression during active CS and after CS remission. CONCLUSION: We identified for the first time the persistent transcriptional and epigenetic signatures induced by hypercortisolism in VAT, providing a novel integrated view of molecular components driving the long-term VAT impairment associated with CS.


Assuntos
Neoplasias das Glândulas Suprarrenais/complicações , Síndrome de Cushing/metabolismo , Glucocorticoides/efeitos adversos , Gordura Intra-Abdominal/imunologia , Obesidade Abdominal/genética , Administração Oral , Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/imunologia , Neoplasias das Glândulas Suprarrenais/urina , Adulto , Animais , Biópsia , Sequenciamento de Cromatina por Imunoprecipitação , Corticosterona/administração & dosagem , Corticosterona/efeitos adversos , Estudos Transversais , Síndrome de Cushing/imunologia , Síndrome de Cushing/patologia , Modelos Animais de Doenças , Epigenoma/efeitos dos fármacos , Epigenoma/imunologia , Feminino , Glucocorticoides/administração & dosagem , Glucocorticoides/metabolismo , Humanos , Hidrocortisona/metabolismo , Hidrocortisona/urina , Inflamação/induzido quimicamente , Inflamação/imunologia , Inflamação/metabolismo , Gordura Intra-Abdominal/metabolismo , Gordura Intra-Abdominal/patologia , Masculino , Camundongos , Pessoa de Meia-Idade , Obesidade Abdominal/imunologia , Obesidade Abdominal/patologia , RNA-Seq , Transcriptoma/efeitos dos fármacos , Transcriptoma/imunologia
10.
Front Endocrinol (Lausanne) ; 12: 747646, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34745012

RESUMO

Obesity, especially central obesity, is a strong risk factor for developing type 2 diabetes (T2D). However, the mechanism underlying the progression from central obesity to T2D remains unknown. Therefore, we analyzed the gut microbial profiles of central obese individuals with or without T2D from a Chinese population. Here we reported both the microbial compositional and gene functional alterations during the progression from central obesity to T2D. Several opportunistic pathogens were enriched in obese T2D patients. We also characterized thousands of genes involved in sugar and amino acid metabolism whose abundance were significantly depleted in obese T2D group. Moreover, the abundance of those genes was negatively associated with plasma glycemia level and percentage of individuals with impaired plasma glucose status. Therefore, our study indicates that the abundance of those depleted genes can be used as a potential biomarker to identify central obese individuals with high risks of developing T2D.


Assuntos
Metabolismo dos Carboidratos/genética , Diabetes Mellitus Tipo 2/etiologia , Microbioma Gastrointestinal/genética , Obesidade Abdominal/microbiologia , Adulto , Biomarcadores/metabolismo , Estudos de Casos e Controles , China , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/microbiologia , Progressão da Doença , Suscetibilidade a Doenças , Feminino , Humanos , Masculino , Metagenoma/fisiologia , Obesidade Abdominal/genética , Obesidade Abdominal/metabolismo , Obesidade Abdominal/patologia , RNA Ribossômico 16S/análise , RNA Ribossômico 16S/genética , Fatores de Risco , Transcriptoma
11.
Front Endocrinol (Lausanne) ; 12: 722187, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34539575

RESUMO

Objective: Observational studies have demonstrated a close relationship between obesity and longevity. The aim of this Mendelian randomization (MR) study is to investigate whether genetic determinants of visceral adipose tissue (VAT) accumulation are causally associated with longevity. Methods: In this two-sample MR study, we used summary data of genetic determinants (single-nucleotide polymorphisms; p < 5 × 10-8) of VAT accumulation based on genome-wide association studies (GWASs). Longevity was defined as an age beyond the 90th or 99th survival percentile. The causal association of VAT accumulation with longevity was estimated with the inverse variance-weighted (IVW) method. Sensitivity analyses, including weighted median, MR-Egger, and MR-pleiotropy residual sum and outlier (PRESSO), were also employed to assess the stability of the IVW results. Results: Our MR analysis used 221 genetic variants as instrumental variables to explore the causal association between VAT accumulation and longevity. In the standard IVW methods, VAT accumulation (per 1-kg increase) was found to be significantly associated with lower odds of surviving to the 90th (odds ratio [OR] = 0.69; 95% confidence interval [CI] 0.55 to 0.86, p = 8.32 × 10-4) and 99th (OR = 0.67; 95% CI 0.49 to 0.91, p = 0.011) percentile ages. These findings remained stable in sensitivity analysis. Conclusion: This MR analysis identified a causal relationship between genetically determined VAT accumulation and longevity, suggesting that visceral adiposity may have a negative effect on longevity.


Assuntos
Gordura Intra-Abdominal/metabolismo , Longevidade/fisiologia , Obesidade Abdominal/genética , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Causalidade , Feminino , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Humanos , Gordura Intra-Abdominal/patologia , Longevidade/genética , Masculino , Análise da Randomização Mendeliana , Metanálise como Assunto , Pessoa de Meia-Idade , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/metabolismo , Obesidade Abdominal/patologia , Polimorfismo de Nucleotídeo Único
12.
PLoS One ; 16(8): e0256809, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34449806

RESUMO

BACKGROUND: At the population level we would expect that people with obesity undergo diabetes screening tests more often than people with overweight and much more often than people with normal weight. We described the trends of diabetes screening according to body mass index (BMI) and waist circumference (WC) in Peru. METHODS: Pooled analysis of health national surveys (2015-2019); men and women aged 35-70 years. We used relative frequencies to study: among those who have had a glucose test in the last year, how many there were in each BMI and WC category. We fitted a Poisson model to study whether people with high BMI or WC were more likely to have had a glucose test. RESULTS: People with overweight (PR = 1.34; 95% CI: 1.29-1.38), obesity (PR = 1.57; 95% CI: 1.51-1.63) and central obesity (PR = 1.63; 95% CI: 1.35-1.96) were more likely to have had a glucose test. At the sub-national level, there was one (of twenty-five) region in which men with obesity were more often screened for diabetes than men with overweight and much more than men with normal weight. There were seven regions in which women with obesity were the most often screened for diabetes. CONCLUSIONS: Consistent with a risk-based prevention approach, people with obesity would be screened for diabetes more often than those with overweight and those with normal weight. This ideal profile was only observed in few regions. Diabetes screening strategies should be strengthened and homogenised, so that they reach those at high risk of diabetes.


Assuntos
Diabetes Mellitus/diagnóstico , Hipertensão/diagnóstico , Obesidade Abdominal/diagnóstico , Sobrepeso/diagnóstico , Adulto , Índice de Massa Corporal , Diabetes Mellitus/sangue , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/patologia , Feminino , Inquéritos Epidemiológicos , Humanos , Hipertensão/sangue , Hipertensão/epidemiologia , Hipertensão/patologia , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Obesidade Abdominal/sangue , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/patologia , Sobrepeso/sangue , Sobrepeso/epidemiologia , Sobrepeso/patologia , Peru/epidemiologia , Fatores de Risco , Circunferência da Cintura/fisiologia
13.
Rev Invest Clin ; 73(6): 379-387, 2021 11 05.
Artigo em Inglês | MEDLINE | ID: mdl-34128945

RESUMO

BACKGROUND: Muscle mass and visceral fat may be assessed at the level of the third lumbar vertebra (L3) in computed tomography (CT). Both variables have been related with adverse surgical outcomes. OBJECTIVE: The objective of the study was to study the association of skeletal muscle index (SMI) and visceral fat area (VFA) with 30-day mortality in colorectal surgery. METHODS: This is a retrospective cohort study conducted at a tertiary referral hospital in Mexico City. Patients who underwent colorectal surgery with primary anastomosis from January 2007 to December 2018 were included in the study. Their preoperative CT scans were analyzed with the NIH ImageJ software at the level of the third lumbar vertebra to determine their SMI (L3-SMI) and the VFA. Logistic regression analysis (adjusted by surgery anatomical location) was used to determine the association between these variables and surgical 30-day mortality. RESULTS: A total of 548 patients were included; 30-day mortality was 4.18% (23 patients). On univariable analysis, L3-SMI, low SMI, anastomosis leak, pre-operative albumin, estimated blood loss, age, steroid use, Charlson comorbidity index score >2, and type of surgery were associated with 30-day mortality. On multivariable analysis, low SMI remained an independent risk factor with an odds ratio of 4.74, 95% confidence interval 1.22-18.36 (p = 0.02). CONCLUSION: Low SMI was found to be an independent risk factor for 30-day mortality in patients submitted to colorectal surgery with a primary anastomosis, whether for benign or malignant diagnosis. VFA was not associated with 30-day mortality.


Assuntos
Anastomose Cirúrgica , Cirurgia Colorretal , Obesidade Abdominal/cirurgia , Sarcopenia , Cirurgia Colorretal/mortalidade , Humanos , Músculo Esquelético , Obesidade Abdominal/patologia , Prognóstico , Estudos Retrospectivos , Fatores de Risco
14.
PLoS One ; 16(5): e0252525, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34048505

RESUMO

BACKGROUND: Weight loss after bariatric surgery varies widely between individuals, partly due to genetic differences. In addition, genetic determinants of abdominal obesity have been shown to attenuate weight loss after dietary intervention with special attention paid to the rs1358980-T risk allele in the VEGFA locus. Here we aimed to test if updated genetic risk scores (GRSs) for adiposity measures and the rs1358980-T risk allele are linked with weight loss following gastric bypass surgery. METHODS: Five hundred seventy six patients with morbid obesity underwent Roux-en-Y gastric bypass. A GRS for BMI and a GRS for waist-hip-ratio adjusted for BMI (proxy for abdominal obesity), respectively, were constructed. All patients were genotyped for the rs1358980-T risk allele. Associations between the genetic determinants and weight loss after bariatric surgery were evaluated. RESULTS: The GRS for BMI was not associated with weight loss (ß = -2.0 kg/100 risk alleles, 95% CI -7.5 to 3.3, p = 0.45). Even though the GRS for abdominal obesity was associated with an attenuated weight loss response adjusted for age, sex and center (ß = -14.6 kg/100 risk alleles, 95% CI -25.4 to -3.8, p = 0.008), it was not significantly associated with weight loss after adjustment for baseline BMI (ß = -7.9 kg/100 risk alleles, 95% CI -17.5 to 1.6, p = 0.11). Similarly, the rs1358980-T risk allele was not significantly associated with weight loss (ß = -0.8 kg/risk allele, 95% CI -2.2 to 0.6, p = 0.25). DISCUSSION: GRSs for adiposity derived from large meta-analyses and the rs1358980-T risk allele in the VEGFA locus did not predict weight loss after gastric bypass surgery. The association between a GRS for abdominal obesity and the response to bariatric surgery may be dependent on the association between the GRS and baseline BMI.


Assuntos
Obesidade Abdominal/genética , Redução de Peso/genética , Adulto , Alelos , Cirurgia Bariátrica , Índice de Massa Corporal , Feminino , Marcadores Genéticos , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/patologia , Fator A de Crescimento do Endotélio Vascular/genética , Relação Cintura-Quadril
15.
Am J Gastroenterol ; 116(7): 1537-1541, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33955725

RESUMO

INTRODUCTION: We assessed if obesity perturbs the esophageal epithelial barrier function independent of promotion of gastroesophageal reflux (GER). METHODS: Thirty-eight participants were divided into 4 groups: Obesity-/GER-, Obesity+/GER-, Obesity-/GER+, and Obesity+/GER+. Esophageal intercellular space and desmosome density (structural integrity) and fluorescein leak (functional integrity) were measured. RESULTS: The Obesity+/GER- group demonstrated increased intercellular space, reduced desmosome density, and increased fluorescein leak compared with control subjects. These changes were similar but not additive to findings seen in Obesity-/GER + and Obesity+/GER+ patients. DISCUSSION: Central obesity impairs structural and functional integrity of the esophageal barrier independent of GER, likely predisposing to esophageal injury.


Assuntos
Mucosa Esofágica/metabolismo , Espaço Extracelular , Refluxo Gastroesofágico/metabolismo , Obesidade Abdominal/metabolismo , Permeabilidade , Adulto , Idoso , Desmossomos/ultraestrutura , Mucosa Esofágica/patologia , Mucosa Esofágica/ultraestrutura , Feminino , Refluxo Gastroesofágico/complicações , Refluxo Gastroesofágico/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/complicações , Obesidade Abdominal/patologia
16.
Surg Oncol ; 37: 101606, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34044270

RESUMO

Visceral obesity and systemic inflammatory response (SIR) were suggested to be closely related to colon cancer (CC) oncological and surgical outcomes. The first by producing several soluble factors involved in carcinogenesis and the second for having a key role in the nutritional and functional decline of patients with cancer. Furthermore, gender differences in relative body composition and adipose tissue regional distribution have also been acknowledged to influence CC. The primary aim of this study was to determine whether visceral adiposity, stratified by gender, influenced CC staging and prognosis. As secondary aim, this study evaluated whether visceral adiposity and SIR markers were associated with CC pathological features so that these could be used in clinical practice to predict disease outcomes and potentially influence therapeutic decisions. Case records from patients (n = 300) submitted to CC surgical resection at a single tertiary hospital were retrospectively reviewed to retrieve clinical, laboratory, imaging and pathological data. Visceral fat area was quantified by computerized morphometric analysis in preoperative tomography scans. Visceral obesity was defined as visceral fat area ≥160 cm2 for men and ≥80 cm2 for women. Preoperative full blood count performed as part of the routine clinical assessment at the hospital laboratory was used to obtain C-reactive protein (CRP) levels and to calculate neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), which were used as SIR markers. One hundred and forty-three (n = 143) patients fulfilled eligibility criteria and were included in the analysis. Patients with high-visceral adipose tissue (vAT) had smaller size CC tumors (p < 0.001), earlier T-stage disease (p = 0.027) and lower nodal involvement (p = 0.039). In gender subgroup analysis, these findings were only confirmed in males. Moreover, male patients with high-vAT also had a lower proportion of metastatic nodes (p = 0.021) and metastatic to dissected lymph node ratio (p = 0.030). Additionally, patients with high-vAT also had lower PLR (p = 0.001). CC survival was not influenced by visceral obesity, gender nor SIR. In conclusion, our study shows that male patients with high visceral adiposity have lower PLR levels and earlier stage tumors. Furthermore, our data suggests that visceral obesity and SIR despite being associated with earlier stage CC tumors do not seem to present a survival advantage.


Assuntos
Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Neoplasias do Colo/mortalidade , Neoplasias do Colo/patologia , Obesidade Abdominal/complicações , Adenocarcinoma/complicações , Idoso , Idoso de 80 Anos ou mais , Proteína C-Reativa/metabolismo , Neoplasias do Colo/complicações , Feminino , Humanos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Obesidade Abdominal/mortalidade , Obesidade Abdominal/patologia , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Taxa de Sobrevida
17.
Sci Rep ; 11(1): 5175, 2021 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-33664334

RESUMO

The prevalence of metabolic syndrome (MS) is increasing among the elderly, and new lifestyle-based treatment strategies are warranted. We conducted a randomized, double-blind controlled trial of the effects of aquatic exercise (AE) and/or consumption of burdock root extract (BE) on body composition and serum sex hormones, i.e., testosterone, estradiol, sex hormone-binding globulin (SHBG), and dehydroepiandrosterone-sulfate (DHEA-S) in elderly women with MS. The percentage of abdominal fat was decreased in the AE group. Waist circumference was increased in the control (CON) group, but not in the other groups. SHBG and estradiol levels were enhanced by both AE and BE and correlated with changes in fat-related body composition. DHEA-S levels only increased in the BE group, which was consistent with changes in lean body mass. Testosterone levels decreased in the CON group, which correlated with changes in lean body mass, skeletal muscle mass, body fat, and waist circumference. Our findings suggested that the combined AE/BE intervention exerted no synergistic and/or additive effects on any sex-related outcome measures in elderly women with MS.


Assuntos
Exercício Físico , Síndrome Metabólica/terapia , Obesidade Abdominal/terapia , Globulina de Ligação a Hormônio Sexual/genética , Idoso , Arctium/química , Índice de Massa Corporal , Feminino , Hormônios Esteroides Gonadais/genética , Hormônios Esteroides Gonadais/metabolismo , Humanos , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/patologia , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/genética , Obesidade Abdominal/patologia , Extratos Vegetais/administração & dosagem , Extratos Vegetais/química , Raízes de Plantas/química
18.
PLoS One ; 16(3): e0248028, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33684155

RESUMO

The increasing prevalence of obesity among the institutionalised elderly population and its severe consequences on health requires an early and accurate diagnosis that can be easily achieved in any clinical setting. This study aimed to determine new cut-off values for anthropometric and bioelectrical impedance measures that are superior to body mass index criteria for overweight and obesity status in a sample of Spanish institutionalised elderly population. A total of 211 institutionalised older adults (132 women, aged 84.3±7.3 years; 79 men, aged 81.5±7.3 years) were enrolled in the current cross-sectional study. Anthropometric and bioelectrical impedance measures included the body mass index, waist circumference, gluteal circumference, waist-hip ratio, sagittal-abdominal diameter, trunk fat, and visceral-fat ratio. In women, the waist circumference, gluteal circumference, sagittal-abdominal diameter, trunk fat, and visceral-fat index presented strongly significant specificity and sensitivity (area under the curve [AUC], p<0.0001) and elevated discriminative values (receiver operating characteristic [ROC] curves: 0.827 to 0.867) for overweight and obesity status. In men, the waist-hip ratio, waist circumference, gluteal circumference, sagittal-abdominal diameter, trunk fat, and visceral-fat ratio were strongly significant AUC (p<0.0001), with moderate-to-high values (ROC curves: 0.757-0.871). In conclusion, our findings suggest that gluteal circumference, waist circumference, and sagittal-abdominal diameter in women and trunk fat, visceral-fat ratio, and waist circumference in men may represent more suitable cut-off values superior to body mass index criteria for overweight and obesity in the Spanish institutionalised elderly population.


Assuntos
Índice de Massa Corporal , Impedância Elétrica , Obesidade Abdominal , Diâmetro Abdominal Sagital , Relação Cintura-Quadril , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Gordura Intra-Abdominal/patologia , Masculino , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/patologia , Espanha/epidemiologia
19.
PLoS One ; 16(3): e0247960, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33684157

RESUMO

BACKGROUND: The prevalence of abdominal obesity has been dramatically increasing both in developed and developing countries, including Ethiopia. It is an independent risk factor for cardiovascular diseases, type-2 diabetes mellitus, high blood pressure, and cancer. However, there is inadequate data regarding the prevalence and associated factors of abdominal obesity among adult population in Ethiopia. OBJECTIVE: This study aimed to assess the prevalence and associated factors of abdominal obesity among the adult population in Woldia town, Northeast Ethiopia in 2020. METHOD: A community-based cross-sectional study was conducted in Woldia town from March 20 to April 20, 2020. Data on socio-demographic, dietary history, and anthropometric characteristics were collected from 802 adults using the World Health Organization stepwise technique. Multi-stage sampling was employed to select the study subjects. Data were cleaned, coded, and entered by EPI-info Version 7 and were exported to SPSS Version 20 for further analysis. To indicate the strength of association, odds ratios (OR) and 95% confidence intervals (95% CI) were used. RESULT: From a total of 823 respondents 802 were involved with a response rate of 97.4%. The overall prevalence of central obesity based on waist to hip ratio was 16.5% with 95% CI (14.2-19.2). Female sex [AOR = 13.3, 95% CI: 7.01-25.39), high wealth rank (AOR = 2.95, 95% CI: 1.21-7.17), single marital status (AOR = 0.16, 95%CI: 0.04-0.58), age from 35 to 55 years (AOR = 4.3, 95% CI: 2.22-7.99), age greater than 55 years (AOR = 3.8, 95%CI: 1.36-10.78), secondary educational level (AOR = 1.83, 95% CI: 1.05-3.18), eat more protein (AOR = 4.22, 95% CI: 1.26-14.22), and consumption of snacks (AOR = 2.78, 95% CI: 1.68-4.61) were significantly associated with abdominal obesity. CONCLUSION: The prevalence of abdominal obesity among adults in Woldia town is high, and has become an emerging nutrition-related problem. Being female, older age, being in a high wealth rank, consuming more meat, having secondary education level, and consuming snacks were the risk factors of abdominal obesity. Nutrition interventions should target adults mainly focusing on the alarmingly increase in nutrition problems, such as abdominal obesity, in Ethiopia with specific attention to females.


Assuntos
Obesidade Abdominal/epidemiologia , Adolescente , Adulto , Cidades/epidemiologia , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/patologia , Obesidade Abdominal/fisiopatologia , Prevalência , Fatores de Risco , Fatores Socioeconômicos
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