Effect of weight loss on knee joint synovitis over 48 months and mediation by subcutaneous fat around the knee: data from the Osteoarthritis Initiative.

BACKGROUND: Obesity influences the development of osteoarthritis via low-grade inflammation. Progression of local inflammation (= synovitis) increased with weight gain in overweight and obese women compared to stable weight. Synovitis could be associated with subcutaneous fat (SCF) around the knee. Purpose of the study was to investigate the effect of weight loss on synovitis progression and to assess whether SCF around the knee mediates the relationship between weight loss and synovitis progression. METHODS: We included 234 overweight and obese participants (body mass index [BMI] ≥ 25 kg/m2) from the Osteoarthritis Initiative (OAI) with > 10% weight loss (n = 117) or stable overweight (< ± 3% change, n = 117) over 48 months matched for age and sex. In magnetic resonance imaging (MRI) at baseline and 48 months, effusion-synovitis and Hoffa-synovitis using the MRI Osteoarthritis Knee Score (MOAKS) and average joint-adjacent SCF (ajSCF) were assessed. Odds-ratios (ORs) for synovitis progression over 48 months (≥ 1 score increase) were calculated in logistic regression models adjusting for age, sex, baseline BMI, Physical Activity Scale for the Elderly (PASE), and baseline SCF measurements. Mediation of the effect of weight loss on synovitis progression by local SCF change was assessed. RESULTS: Odds for effusion-synovitis progression decreased with weight loss and ajSCF decrease (odds ratio [OR] = 0.61 and 0.56 per standard deviation [SD] change, 95% confidence interval [CI] 0.44, 0.83 and 0.40, 0.79, p = 0.002 and 0.001, respectively), whereas odds for Hoffa-synovitis progression increased with weight loss and ajSCF decrease (OR = 1.47 and 1.48, CI 1.05, 2.04 and 1.02, 2.13, p = 0.024 and 0.038, respectively). AjSCF decrease mediated 39% of the effect of weight loss on effusion-synovitis progression. CONCLUSIONS: Effusion-synovitis progression was slowed by weight loss and decrease in local subcutaneous fat. Hoffa-synovitis characterized by fluid in the infrapatellar fat pad increased at the same time, suggesting a decreasing fat pad rather than active synovitis. Decrease in local subcutaneous fat partially mediated the systemic effect of weight loss on synovitis.

Correlation between subcutaneous adipose tissue of the head and body mass index in children and young adults aged 8-19 years: implications for functional neuroimaging.

High body mass index (BMI) is presumed to signify high amounts of fat (subcutaneous adipose tissue) distributed across the body. High amounts of fat co-occurring with increased BMI has been cited as a potential neuroimaging barrier. Presence of increased fat may result in high electrical impedance and increased light diffusion-resulting in low signal to noise ratios during electroencepholography (EEG), functional near-infrared spectroscopy (fNIRS), and transcranial direct current stimulation (tDCS) measurements. Examining if subcutaneous fat in the head increases with respect to total body fat percentage and BMI in school-aged children and adolescents is an essential next step in developing possible mathematical corrections for neuroimaging modalities. We hypothesized that percentage of subcutaneous adipose tissue in the head region would increase with respect to both total body fat percentage and BMI. Increased subcutaneous head fat percentage was associated with a positive linear relationship with BMI and a quadratic relationship with total body fat. The data indicate that participant age, sex, and adiposity should be considered in the development of model corrections for neuroimaging signal processing in school-aged children and adolescents. Strength of regression coefficients in our models differed from those in adults, indicating that age-specific models should be utilized.

Altered extracellular matrix dynamics is associated with insulin resistance in adolescent children with obesity.

OBJECTIVE: The objective of this study was to examine the hypothesis that abdominal and gluteal adipocyte turnover, lipid dynamics, and fibrogenesis are dysregulated among insulin-resistant (IR) compared with insulin-sensitive (IS) adolescents with obesity. METHODS: Seven IS and seven IR adolescents with obesity participated in a 3-h oral glucose tolerance test and a multi-section magnetic resonance imaging scan of the abdominal region to examine body fat distribution patterns and liver fat content. An 8-week 70% deuterated water (2 H2 O) labeling protocol examined adipocyte turnover, lipid dynamics, and fibrogenesis in vivo from biopsied abdominal and gluteal fat. RESULTS: Abdominal and gluteal subcutaneous adipose tissue (SAT) turnover rates of lipid components were similar among IS and IR adolescents with obesity. However, the insoluble collagen (type I, subunit α2) isoform measured from abdominal, but not gluteal, SAT was elevated in IR compared with IS individuals. In addition, abdominal insoluble collagen Iα2 was associated with ratios of visceral-to-total (visceral adipose tissue + SAT) abdominal fat and whole-body and adipose tissue insulin signaling, and it trended toward a positive association with liver fat content. CONCLUSIONS: Altered extracellular matrix dynamics, but not expandability, potentially decreases abdominal SAT lipid storage capacity, contributing to the pathophysiological pathways linking adipose tissue and whole-body IR with altered ectopic storage of lipids within the liver among IR adolescents with obesity.

Association between the Thickness of Lumbar Subcutaneous Fat Tissue and the Presence of Hernias in Adults with Persistent, Non-Traumatic Low Back Pain.

We aimed to analyze the association between the average lumbar subcutaneous fat tissue thickness (LSFTT) at each intervertebral level and the presence of hernias in patients with low back pain from an insurance network hospital in Mexico. This observational prospective study included 174 patients with non-traumatic lumbago who underwent magnetic resonance imaging with a 1.5T resonator. Two independent radiologists made the diagnosis, and a third specialist provided a quality vote when needed. The sample size was calculated with a 95% confidence interval using random order selection. Anonymized secondary information was used. Percentages and means with confidence intervals were tabulated. The area under the curve, specificity, and sensitivity of LSFTT were calculated. A regression analysis was performed to analyze the presence of hernias with LSFTT using each intervertebral level as a predictor. The odds of herniation at any intervertebral level increased directly with LSFTT. The average LSFTT predicted the overall presence of hernias; however, the LSFTT at each intervertebral level better predicted hernias for each intervertebral space. The area under the curve for LSFTT in predicting hernias was 68%. In conclusion, the average LSFTT was associated with the overall presence of hernias; patients with more hernias had higher LSFTT values.

Predictors of visceral and subcutaneous adipose tissue and muscle density: The ShapeUp! Kids study.

BACKGROUND AND AIMS: Body fat distribution, i.e., visceral (VAT), subcutaneous adipose tissue (SAT) and intramuscular fat, is important for disease prevention, but sex and ethnic differences are not well understood. Our aim was to identify anthropometric, demographic, and lifestyle predictors for these outcomes. METHODS AND RESULTS: The cross-sectional ShapeUp!Kids study was conducted among five ethnic groups aged 5-18 years. All participants completed questionnaires, anthropometric measurements, and abdominal MRI scans. VAT and SAT areas at four lumbar levels and muscle density were assessed manually. General linear models were applied to estimate coefficients of determination (R2) and to compare the fit of VAT and SAT prediction models. After exclusions, the study population had 133 male and 170 female participants. Girls had higher BMI-z scores, waist circumference (WC), and SAT than boys but lower VAT/SAT and muscle density. SAT, VAT, and VAT/SAT but not muscle density differed significantly by ethnicity. R2 values were higher for SAT than VAT across groups and improved slightly after adding WC. For SAT, R2 increased from 0.85 to 0.88 (girls) and 0.62 to 0.71 (boys) when WC was added while VAT models improved from 0.62 to 0.65 (girls) and 0.57 to 0.62 (boys). VAT values were significantly lower among Blacks than Whites with little difference for the other groups. CONCLUSION: This analysis in a multiethnic population identified BMI-z scores and WC as the major predictors of MRI-derived SAT and VAT and highlights the important ethnic differences that need to be considered in diverse populations.

Association between increased Subcutaneous Adipose Tissue Radiodensity and cancer mortality: Automated computation, comparison of cancer types, gender, and scanner bias.

PURPOSE: Body composition analysis using computed tomography (CT) is proposed as a predictor of cancer mortality. An association between subcutaneous adipose tissue radiodensity (SATr) and cancer-specific mortality was established, while gender effects and equipment bias were estimated. METHODS: 7,475 CT studies were selected from 17 cohorts containing CT images of untreated cancer patients who underwent follow-up for a period of 2.1-118.8 months. SATr measures were collected from published data (n = 6,718) or calculated according to CT images using a deep-learning network (n = 757). The association between SATr and mortality was ascertained for each cohort and gender using the p-value from either logistic regression or ROC analysis. The Kruskal-Wallis test was used to analyze differences between gender distributions, and automatic segmentation was evaluated using the Dice score and five-point Likert quality scale. Gender effect, scanner bias and changes in the Hounsfield unit (HU) to detect hazards were also estimated. RESULTS: Higher SATr was associated with mortality in eight cancer types (p < 0.05). Automatic segmentation produced a score of 0.949 while the quality scale measurement was good to excellent. The extent of gender effect was 5.2 HU while the scanner bias was 10.3 HU. The minimum proposed HU change to detect a patient at risk of death was between 5.6 and 8.3 HU. CONCLUSIONS: CT imaging provides valuable assessments of body composition as part of the staging process for several cancer types, saving both time and cost. Gender specific scales and scanner bias adjustments should be carried out to successfully implement SATr measures in clinical practice.

Elevated 18F-FDG uptake in subcutaneous adipose tissue correlates negatively with nutritional status and prognostic survival in cachexia patients with gastric cancer.

BACKGROUND: Browning of white adipose tissue is a crucial factor contributing to adipose loss in cachexia patients, detectable via 18F-Fluorodeoxyglucose (18F-FDG) uptake. The present study elucidates the clinical relevance of 18F-FDG uptake in the subcutaneous adipose tissue of gastric cancer patients, specifically focusing on adipose browning and its implications on patient clinical parameters and prognosis. METHODS: This investigation encompassed 770 gastric cancer patients, with PET-CT imaging and clinical data meticulously combined. The 18F-FDG uptake in subcutaneous adipose tissue at the third lumbar layer was quantified, and its correlation with clinical parameters, particularly those related to nutritional status and fat metabolism, was examined. Kaplan-Meier curves were subsequently employed to probe the relationship between 18F-FDG uptake and overall survival. RESULTS: Of the 770 gastric cancer patients, 252 exhibited cancer-associated cachexia, while 518 did not. Cachectic patients demonstrated elevated 18F-FDG uptake in subcutaneous adipose tissue relative to non-cachectic patients (P < 0.001). Increased 18F-FDG uptake was also correlated with reduced plasma concentrations of albumin, prealbumin, hemoglobin, platelets, cholesterol, apolipoprotein A, low-density lipoprotein, and elevated IL-6 concentrations (all P < 0.05). A significant inverse correlation was observed between 18F-FDG uptake and BMI, albumin, low-density lipoprotein, cholesterol, and apolipoprotein A (all P < 0.05). Patients with higher 18F-FDG uptake exhibited diminished overall survival rates compared to those with lower 18F-FDG uptake (P = 0.0065). Furthermore, 18F-FDG uptake in subcutaneous adipose tissue was an independent prognostic indicator in gastric cancer patients (P = 0.028). CONCLUSIONS: Browning of subcutaneous adipose tissue was markedly elevated in cachectic gastric cancer patients compared to non-cachectic counterparts. Increased 18F-FDG uptake in subcutaneous adipose tissue in cachectic gastric cancer patients was inversely correlated with nutritional status and survival prognosis.

Influence of subcutaneous adipose tissue index on prognosis in cirrhotic patients following endoscopic therapy: a retrospective cohort study.

BACKGROUND: The relation of adipose tissue depletion with prognostic outcome of variceal bleeding among cirrhotic patients is still inconclusive. The present work explored whether adipose tissue, which was measured based on computed tomography (CT), was valuable for analyzing rebleeding and mortality among patients with variceal bleeding who had undergone endoscopic therapy. METHODS: The study encompassed cirrhotic patients who underwent endoscopic therapy to prevent variceal rebleeding between January 2016 and October 2022. The L3-level CT images were obtained. Besides, impacts of subcutaneous adipose tissue index (SATI), visceral adipose tissue index (VATI), as well as total adipose tissue index (TATI) on rebleeding and mortality among cirrhotic patients following endoscopic therapy were examined. RESULTS: In this work, our median follow-up period was 31 months. Among those adipose tissue indexes, only SATI exhibited an independent relation to higher rebleeding (HR 0.981, 95% CI, 0.971-0.991, p < 0.001) and mortality (HR 0.965, 95% CI, 0.944-0.986, p = 0.001) risks. Upon multivariate Cox regression, low SATI (male < 30.15 cm2/m2, female < 39.82 cm2/m2) was independently linked to higher rebleeding risk (HR 2.511, 95% CI, 1.604-3.932, p < 0.001) and increased mortality risk (HR 3.422, 95% CI, 1.489-7.864, p = 0.004) after adjusting for other predictors. Furthermore, subgroups were created based on using nonselective ß-blockers (NSBBs), demonstrating that quantitatively assessing SATI exerts a vital role in evaluating rebleeding incidence in patients with or without NSBB therapy. CONCLUSION: This study underscores the potential of quantifying SATI as a means for achieving a more accurate risk classification for individual patients and identifying patients that can gain more benefits from nutritional intervention.

Age-related changes in the fiber structure around adipocytes in the subcutaneous fat layer and their association with skin viscoelasticity.

OBJECTIVE: Age-related changes in the fiber structure around adipocytes were investigated via scanning electron microscopy (SEM) of excised skin tissues. In addition, the viscoelasticity of the subcutaneous fat layer was evaluated via elastography, and the association between the fiber structure and the viscoelastic properties was assessed. METHODS: Skin tissues excised from the facial cheek area were used. Then, SEM images of these tissues were obtained. The thickness and quantity of the fibers around adipocytes were assessed using a 5-point scale. The score was used to grade 18 tissue samples. Moreover, the viscoelasticity of the subcutaneous fat layer in the same samples was evaluated via ultrasound elastography. RESULTS: Based on the SEM image score, an association was observed between the fiber status score and age, thereby indicating a tendency toward age-related fibrosis. Fiber structures with high scores, which indicate fibrosis, had a significantly lower viscoelasticity based on ultrasound elastography. CONCLUSION: The thickness and quantity of fibrous structures around adipocytes in the subcutaneous fat layer increase with age, and these changes can be associated with decreased viscoelasticity in the subcutaneous fat layer.

Lumbar Disc Degeneration Is Linked to Dorsal Subcutaneous Fat Thickness at the L1-L2 Intervertebral Disc Level Measured by MRI.

BACKGROUND: Obese individuals have a higher risk of degenerative disc disease (DDD). Currently, body mass index is not sensitive enough to differentiate between muscle and fat distribution, and obesity-related health issues are linked to the way body fat is distributed. Therefore, this study aims to investigate the association between the dorsal subcutaneous fat thickness (DSFT) of the lumbar spine, an alternative measurement tool of body fat distribution, and DDD. METHODS: A total of 301 patients with DDD and 123 participants without the disease were recruited. Using length functions of magnetic resonance imaging (MRI) console, the DSFT of L1 to S1 intervertebral disc levels was measured in mid-sagittal spin-echo T2 weighted image. The Mann-Whitney U test and Chi-squared test (X2) were utilized to examine any variations between the case and control groups. Logistic regression models were built to explore the association of the DSFT with DDD. RESULTS: The logistical regression model showed a positive association between DDD and DSFT [OR: 1.30, 95% CI: 1.02-1.64, p = 0.03]. In the stratified logistic regression analysis, a positive association was found between DDD and DSFT among younger participants and females [OR young: 1.48; 95% CI (1.02-2.20); p = 0.04-OR female: 1.37; 95% CI (1-1.88); p = 0.05]. CONCLUSIONS: Younger females with thicker DSFT at the L1-L2 level are more likely to develop DDD. This suggests that increased DSFT may be a contributing factor to DDD.

Abdominal adipose tissue distribution assessed by computed tomography and mortality in hospitalised patients with COVID-19: a retrospective longitudinal cohort study.

BACKGROUND: Visceral adiposity has been associated with an increased risk of critical illness in COVID-19 patients. However, if it also associates to a poor survival is still not well established. The aim of the study was to assess the relationship between abdominal fat distribution and COVID-19 mortality. METHODS: In this six-month longitudinal cohort study, abdominal visceral (VAT) and subcutaneous adipose tissues (SAT) were measured by computed tomography in a cohort of 174 patients admitted to the emergency department with a diagnosis of COVID-19, during the first wave of pandemic. The primary exposure and outcome measures were VAT and SAT at hospital admission, and death at 30 and 180 days, respectively. RESULTS: Overall survival was not different according to VAT (p = 0.94), SAT (p = 0.32) and VAT/SAT ratio (p = 0.64). However, patients in the lowest SAT quartile (thickness ≤ 11.25 mm) had a significantly reduced survival compared to those with thicker SAT (77 vs. 94% at day 30; 74 vs. 91% at day 180, p = 0.01). Similarly, a thinner SAT was associated with lower survival in Intensive Care Unit (ICU) admitted patients, independently of sex or age (p = 0.02). The VAT/SAT ratio showed a non-linear increased risk of ICU admission, which plateaued out and tended for inversion at values greater than 1.9 (p = 0.001), although was not associated with increased mortality rate. CONCLUSIONS: In our cohort, visceral adiposity did not increase mortality in patients with COVID-19, but low SAT may be associated with poor survival.

Loss of subcutaneous fat in 20 patients, both sexes, using a second-generation TECAR device of 1.240 Watts and results analyzed with magnetic resonance.

BACKGROUND: Body contouring and abdominal fat loss without surgery are increasingly used technique. In a study in pigs, it is noted that both capacitive and resistive radiofrequency stimulation reduced subcutaneous fat. One human study demonstrated a loss of 2.90 cm in waist diameter. Second-generation TECAR (Acronym for Transfer Electric Capacitive and Resistive) device with 4 channels, 200 cm2 work area per channel, and high power (1240 W), regulates body energy input by measuring absorption in the body and adjusting the power for 80 min at 50°C. AIMS: To evaluate the loss of subcutaneous fat, this magnitude was measured in grams and centimeters throughout the abdomen by MRI before and after each treatment. SUBJECT AND METHODS: We have studied 25 patients, 13 women and 12 men with a mean age of 49 years. All patients had their waist diameter measured and an MRI performed before and after 10 continuous sessions except Saturday and Sunday, over 2 weeks. Additionally, a lipid profile was performed on the same day of the study and at the end of it. The study was approved by the Ethics Committee. RESULTS: Waist diameter decreased by 5.5 cm, these differences being statistically significant (p = 0.000). Subcutaneous fat measured by MRI in cm decreased by 784 cm (p = 0.000). In grams, it decreased 808.7 g (p = 0.000). In the lipid profile, all the values decreased, but they were not statistically significant. CONCLUSIONS: The use of this second generation of TECAR equipment at 1 MHz decreases the waist diameter by more than 5 cm and leads to the loss of more than 800 grams of subcutaneous fat in 12 days. It is a method without risks or side effects, well tolerated, and an alternative for those patients who do not want to go to the operating room.

Diagnostic imaging in lipedema: A systematic review.

BACKGROUND: Diagnosing lipedema remains a challenge due to its heterogeneous presentation, co-existing diseases, and the lack of objective diagnostic imaging. OBJECTIVE: This systematic review aims to outline the currently available diagnostic imaging methods to characterize lipedema in the legs along with their diagnostic performance. METHODS: PubMed, Embase, Google Scholar, Scopus, and Web of Science were searched. The quality assessment of diagnostic accuracy studies (QUADAS) tool was used for quality assessment. RESULTS: Thirty-two studies describing a total of 1154 patients with lipedema were included for final analysis. Features for lipedema have been defined using ultrasound (increased subcutaneous adipose tissue), lymphoscintigraphy (slowing of the lymphatic flow and a frequent asymmetry between the lower extremities), computed tomography (symmetrical bilateral soft tissue enlargement without either skin thickening or subcutaneous edema), magnetic resonance imaging (increased subcutaneous adipose tissue), MR lymphangiography (enlarged lymphatic vessels up to a diameter of 2 mm), and dual-energy X-ray absorptiometry (fat mass in the legs adjusted for body mass index (BMI) ≥ 0.46 or fat mass in the legs adjusted for total fat mass ≥ 0.384). CONCLUSION: The diagnostic performance of currently available imaging modalities for assessing lipedema is limited. Prospective studies are needed to evaluate and compare the diagnostic performance of each imaging modality. Imaging techniques focusing on the pathogenesis of the disease are needed.

Isthmin-1 (ISM1), a novel adipokine that reflects abdominal adipose tissue distribution in individuals with obesity.

BACKGROUND: The assessment of obesity-related health risks has traditionally relied on the Body Mass Index and waist circumference, but their limitations have propelled the need for a more comprehensive approach. The differentiation between visceral (VIS) and subcutaneous (SC) fat provides a finer-grained understanding of these risks, yet practical assessment methods are lacking. We hypothesized that combining the SC-VIS fat ratio with non-invasive biomarkers could create a valuable tool for obesity-related risk assessment. METHODS AND RESULTS: A clinical study of 125 individuals with obesity revealed significant differences in abdominal fat distribution measured by CT-scan among genders and distinct models of obesity, including visceral, subcutaneous, and the SC/VIS ratio. Stratification based on these models highlighted various metabolic changes. The SC/VIS ratio emerged as an excellent metric to differentiate metabolic status. Gene expression analysis identified candidate biomarkers, with ISM1 showing promise. Subsequent validation demonstrated a correlation between ISM1 levels in SC and plasma, reinforcing its potential as a non-invasive biomarker for fat distribution. Serum adipokine levels also correlated with the SC/VIS ratio. The Receiver Operating Characteristic analysis revealed ISM1's efficacy in discriminating individuals with favorable metabolic profiles based on adipose tissue distribution. Correlation analysis also suggested that ISM1 was involved in glucose regulation pathways. CONCLUSION: The study's results support the hypothesis that the SC-VIS fat ratio and its derived non-invasive biomarkers can comprehensively assess obesity-related health risks. ISM1 could predict abdominal fat partitioning and be a potential biomarker for evaluating obesity-related health risks.

Machine Learning-Based Prediction of Abdominal Subcutaneous Fat Thickness During Pregnancy.

Objective: Current evidence regarding the safety of abdominal subcutaneous injections in pregnant women is limited. In this study, we developed a predictive model for abdominal skin-subcutaneous fat thickness (S-ScFT) by gestational periods (GP) in pregnant women. Methods: A total of 354 cases were measured for S-ScFT. Three machine learning algorithms, namely deep learning, random forest, and support vector machine, were used for S-ScFT predictive modeling and factor analysis for each abdominal site. Data analysis was performed using SPSS and RapidMiner softwares. Results: The deep learning algorithm best predicted the abdominal S-ScFT. The common important variables in all three algorithms for the prediction of abdominal S-ScFT were menarcheal age, prepregnancy weight, prepregnancy body mass index (categorized), large fetus for gestational age, and alcohol consumption. Conclusion: Predicting the safety of subcutaneous injections during pregnancy could be beneficial for managing gestational diabetes mellitus in pregnant women.

Associations between weight change, knee subcutaneous fat and cartilage thickness in overweight and obese individuals: 4-Year data from the osteoarthritis initiative.

OBJECTIVE: To assess (i) the impact of changes in body weight on changes in joint-adjacent subcutaneous fat (SCF) and cartilage thickness over 4 years and (ii) the relation between changes in joint-adjacent SCF and knee cartilage thickness. DESIGN: Individuals from the Osteoarthritis Initiative (total=399) with > 10% weight gain (n=100) and > 10% weight loss (n=100) over 4 years were compared to a matched control cohort with less than 3% change in weight (n=199). 3.0T Magnetic Resonance Imaging (MRI) of the right knee was performed at baseline and after 4 years to quantify joint-adjacent SCF and cartilage thickness. Linear regression models were used to evaluate the associations between the (i) weight change group and 4-year changes in both knee SCF and cartilage thickness, and (ii) 4-year changes in knee SCF and in cartilage thickness. Analyses were adjusted for age, sex, baseline body mass index (BMI), tibial diameter (and weight change group in analysis (ii)). RESULTS: Individuals who lost weight over 4-years had significantly less joint-adjacent SCF (beta range, medial/lateral joint sides: 2.2-4.2 mm, p < 0.001) than controls; individuals who gained weight had significantly greater joint-adjacent SCF than controls (beta range: -1.4 to -3.9 mm, p < 0.001). No statistically significant associations were found between weight change and cartilage thickness change. However, increases in joint-adjacent SCF over 4 years were significantly associated with decreases in cartilage thickness (p = 0.04). CONCLUSIONS: Weight change was associated with joint-adjacent SCF, but not with change in cartilage thickness. However, 4-year increases in joint-adjacent SCF were associated with decreases in cartilage thickness independent of baseline BMI and weight change group.

Early Prediction of Gestational Diabetes Mellitus Using Placental Strain Elastography and Subcutaneous Adipose Tissue Thickness.

AIM: The aim of this study is to investigate the efficacy of placental strain ratio values measured by real-time sonoelastography and maternal subcutaneous adipose tissue thickness measured by two-dimensional ultrasonography in predicting gestational diabetes mellitus in the first trimester. MATERIALS AND METHODS: The population of the study consisted of the first 210 consecutive singleton pregnant women who applied for routine first-trimester screening between the 11th and 14th week of gestation.B-mode subcutaneous adipose tissue thickness sonography and real-time placental strain elastography scanning were performed.All patients underwent 75 g oral glucose tolerance test between the 24th and 28th week of gestation. American Diabetes Association criteria were used in the diagnosis of gestational diabetes mellitus. RESULTS: It was observed that body mass index (p<0.001), first-trimester fasting blood sugar (p<0.001), subcutaneous adipose tissue thickness (p<0.001), and placental strain ratio value (p<0.001) affected the development of gestational diabetes mellitus statistically. The multivariate analysis shown that subcutaneous adipose tissue thickness (odds ratio=1.271, 95% CI=1.142-1.416, p<0.001) and placental strain ratio value (odds ratio=3.664, 95% CI=1.927-6.969, p<0.001) were the independent risk factors affecting the development of gestational diabetes mellitus. CONCLUSIONS: The findings of this study indicated a positive correlation between 75 g oral glucose tolerance test application and first trimester subcutaneous adipose tissue thickness and placental strain ratio. Using the cut-off values of>11.5 mm for subcutaneous adipose tissue and>0.986 for placental strain ratio, the development of gestational diabetes mellitus may be predicted in the early weeks of pregnancy.