Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 591
Filtrar
1.
Nutrients ; 13(8)2021 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-34444654

RESUMO

Visceral adipose tissue (VAT) accumulation, is a part of a polycystic ovary syndrome (PCOS) phenotype. Dual-energy x-ray absorptiometry (DXA) provides a gold standard measurement of VAT. This study aimed to compare ten different indirect methods of VAT estimation in PCOS women. The study included 154 PCOS and 68 age- and BMI-matched control women. Subjects were divided into age groups: 18-30 y.o. and 30-40 y.o. Analysis included: body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), waist/height 0.5 (WHT.5R), visceral adipose index (VAI), lipid accumulation product (LAP), and fat mass index (FMI). VAT accumulation, android-to-gynoid ratio (A/G), and total body fat (TBF) was measured by DXA. ROC analysis revealed that WHtR, WHT.5R, WC, BMI, and LAP demonstrated the highest predictive value in identifying VAT in the PCOS group. Lower cut-off values of BMI (23.43 kg/m2) and WHtR (0.45) were determined in the younger PCOS group and higher thresholds of WHtR (0.52) in the older PCOS group than commonly used. Measuring either: WHtR, WHT.5R, WC, BMI, or LAP, could help identify a subgroup of PCOS patients at high cardiometabolic risk. The current observations reinforce the importance of using special cut-offs to identify VAT, dependent on age and PCOS presence.


Assuntos
Absorciometria de Fóton , Adiposidade , Antropometria , Gordura Intra-Abdominal/fisiopatologia , Síndrome do Ovário Policístico/diagnóstico , Adolescente , Adulto , Biomarcadores/sangue , Estudos de Casos e Controles , Feminino , Humanos , Gordura Intra-Abdominal/metabolismo , Síndrome do Ovário Policístico/sangue , Síndrome do Ovário Policístico/fisiopatologia , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Adulto Jovem
2.
Nutrients ; 13(7)2021 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-34371863

RESUMO

Introduction: The accumulation of visceral abdominal tissue (VAT) seems to be a hallmark feature of abdominal obesity and substantially contributes to metabolic abnormalities. There are numerous factors that make the body-mass index (BMI) a suboptimal measure of adiposity. The visceral adiposity index (VAI) may be considered a simple surrogate marker of visceral adipose tissue dysfunction. However, the evidence comparing general to visceral adiposity in CAD is scarce. Therefore, we have set out to investigate visceral adiposity in relation to general adiposity in patients with stable CAD. Material and methods: A total of 204 patients with stable CAD hospitalized in the Department of Medicine and the Department of Geriatrics entered the study. Based on the VAI-defined adipose tissue dysfunction (ATD) types, the study population (N = 204) was divided into four groups: (1) no ATD (N = 66), (2) mild ATD (N = 50), (3) moderate ATD (N = 48), and (4) severe ATD (N = 40). Nutritional status was assessed using the Controlling Nutritional Status (CONUT) score. Results: Patients with moderate and severe ATD were the youngest (median 67 years), yet their metabolic age was the oldest (median 80 and 84 years, respectively). CONUT scores were similar across all four study groups. The VAI had only a modest positive correlation with BMI (r = 0.59 p < 0.01) and body adiposity index (BAI) (r = 0.40 p < 0.01). There was no correlation between VAI and CONUT scores. There was high variability in the distribution of BMI-defined weight categories across all four types of ATD. A total of 75% of patients with normal nutritional status had some form of ATD, and one-third of patients with moderate or severe malnutrition did not have any ATD (p = 0.008). In contrast, 55-60% of patients with mild, moderate, or severe ATD had normal nutritional status (p = 0.008). ROC analysis demonstrated that BMI and BAI have poor predictive value in determining no ATD. Both BMI (AUC 0.78 p < 0.0001) and BAI (AUC 0.66 p = 0.003) had strong predictive value for determining severe ATD (the difference between AUC 0.12 being p = 0.0002). However, BMI predicted mild ATD and severe ATD better than BAI. Conclusions: ATD and malnutrition were common in patients with CAD. Notably, this study has shown a high rate of misclassification of visceral ATD via BMI and BAI. In addition, we demonstrated that the majority of patients with normal nutritional status had some form of ATD and as much as one-third of patients with moderate or severe malnutrition did not have any ATD. These findings have important clinical ramifications for everyday practice regarding the line between health and disease in the context of malnutrition in terms of body composition and visceral ATD, which are significant for developing an accurate definition of the standards for the intensity of clinical interventions.


Assuntos
Adiposidade , Doença da Artéria Coronariana/fisiopatologia , Gordura Intra-Abdominal/fisiopatologia , Estado Nutricional , Obesidade Abdominal/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Antropometria , Biomarcadores/análise , Índice de Massa Corporal , Doença da Artéria Coronariana/etiologia , Impedância Elétrica , Feminino , Avaliação Geriátrica , Humanos , Pacientes Internados/estatística & dados numéricos , Masculino , Avaliação Nutricional , Obesidade Abdominal/complicações , Reprodutibilidade dos Testes
3.
Nutrients ; 13(7)2021 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-34208967

RESUMO

Evidence accumulated to date suggests that excess weight in the adult population is associated with a wide range of impairments in executive function. However, most studies have only examined the influence of body mass index (BMI) on the cognitive function of individuals with overweight and obesity. This study examined the potential associations of markers of adiposity (BMI, body fat, and visceral fat) with five domains of executive function including cognitive flexibility, inhibition, monitoring, planning, and working memory in a sample of 87 adult with overweight (n = 34) and obesity (n = 53). The results show that obese people had poorer working memory than those with overweight. After controlling for educational levels and physical activity, the results suggest that neither the waist-hip index not visceral fat were associated with cognitive function. In overweight, body fat was negatively associated with executive components of inhibition (p = 0.05) and monitoring (p = 0.02). In the obesity subgroup, body fat was negatively associated with inhibition (0.02) and working memory (0.04). The results provide evidence of the importance of adiposity for cognitive function. The implications for understanding the influence of markers of adiposity in adults with overweight and obesity are discussed.


Assuntos
Adiposidade , Índice de Massa Corporal , Função Executiva/fisiologia , Gordura Intra-Abdominal/fisiopatologia , Obesidade/fisiopatologia , Adulto , Composição Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
4.
Life Sci ; 283: 119841, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34298036

RESUMO

Sympathetic vasomotor overactivity is a major feature leading to the cardiovascular dysfunction related to obesity. Considering that the retroperitoneal white adipose tissue (rWAT) is an important fat visceral depot and receives intense sympathetic and afferent innervations, the present study aimed to evaluate the effects evoked by bilateral rWAT denervation in obese rats. Male Wistar rats were fed with HFD for 8 consecutive weeks and rWAT denervation was performed at the 6th week. Arterial pressure, splanchnic and renal sympathetic vasomotor nerve activities were assessed and inflammation and the components of the renin -angiotensin system were evaluated in different white adipose tissue depots. HFD animals presented higher serum levels of leptin and glucose, an increase in arterial pressure and splanchnic sympathetic nerve activity; rWAT denervation, normalized these parameters. Pro-inflammatory cytokines levels were significantly increased, as well as RAAS gene expression in WAT of HFD animals; rWAT denervation significantly attenuated these changes. In conclusion, HFD promotes vasomotor sympathetic overactivation and inflammation with repercussions on the cardiovascular system. In conclusion, the neural communication between WAT and the brain is fundamental to trigger sympathetic vasomotor activation and this pathway is a possible new therapeutic target to treat obesity-associated cardiovascular dysfunction.


Assuntos
Doenças Cardiovasculares , Denervação , Dieta Hiperlipídica/efeitos adversos , Gordura Intra-Abdominal , Obesidade , Nervos Esplâncnicos , Animais , Pressão Sanguínea , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/terapia , Sistema Cardiovascular/metabolismo , Sistema Cardiovascular/fisiopatologia , Gordura Intra-Abdominal/inervação , Gordura Intra-Abdominal/metabolismo , Gordura Intra-Abdominal/fisiopatologia , Masculino , Obesidade/induzido quimicamente , Obesidade/metabolismo , Obesidade/fisiopatologia , Obesidade/terapia , Ratos , Ratos Wistar , Sistema Renina-Angiotensina , Nervos Esplâncnicos/metabolismo , Nervos Esplâncnicos/patologia , Nervos Esplâncnicos/fisiopatologia
5.
Nutr Metab Cardiovasc Dis ; 31(7): 2156-2164, 2021 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-34059384

RESUMO

BACKGROUND AND AIMS: Obesity-related cardiometabolic risk factors associate with COVID-19 severity and outcomes. Epicardial adipose tissue (EAT) is associated with cardiometabolic disturbances, is a source of proinflammatory cytokines and a marker of visceral adiposity. We investigated the relation between EAT characteristics and outcomes in COVID-19 patients. METHODS AND RESULTS: This post-hoc analysis of a large prospective investigation included all adult patients (≥18 years) admitted to San Raffaele University Hospital in Milan, Italy, from February 25th to April 19th, 2020 with confirmed SARS-CoV-2 infection who underwent a chest computed tomography (CT) scan for COVID-19 pneumonia and had anthropometric data available for analyses. EAT volume and attenuation (EAT-At, a marker of EAT inflammation) were measured on CT scan. Primary outcome was critical illness, defined as admission to intensive care unit (ICU), invasive ventilation or death. Cox regression and regression tree analyses were used to assess the relationship between clinical variables, EAT characteristics and critical illness. One-hundred and ninety-two patients were included (median [25th-75th percentile] age 60 years [53-70], 76% men). Co-morbidities included overweight/obesity (70%), arterial hypertension (40%), and diabetes (16%). At multivariable Cox regression analysis, EAT-At (HR 1.12 [1.04-1.21]) independently predicted critical illness, while increasing PaO2/FiO2 was protective (HR 0.996 [95% CI 0.993; 1.00]). CRP, plasma glucose on admission, EAT-At and PaO2/FiO2 identified five risk groups that significantly differed with respect to time to death or admission to ICU (log-rank p < 0.0001). CONCLUSION: Increased EAT attenuation, a marker of EAT inflammation, but not obesity or EAT volume, predicts critical COVID-19. TRIAL REGISTRATION: NCT04318366.


Assuntos
Adiposidade , COVID-19/diagnóstico por imagem , Gordura Intra-Abdominal/diagnóstico por imagem , Obesidade/diagnóstico por imagem , Radiografia Torácica , Tomografia Computadorizada por Raios X , Idoso , COVID-19/mortalidade , COVID-19/fisiopatologia , COVID-19/terapia , Feminino , Mortalidade Hospitalar , Humanos , Gordura Intra-Abdominal/fisiopatologia , Itália , Masculino , Pessoa de Meia-Idade , Obesidade/mortalidade , Obesidade/fisiopatologia , Pericárdio , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Medição de Risco , Fatores de Risco
6.
Nutr Metab Cardiovasc Dis ; 31(8): 2358-2365, 2021 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-34090774

RESUMO

BACKGROUND AND AIMS: Visceral adipose index (VAI) had been widely used to predict the risks of several diseases. However, few studies have clarified the association between VAI and the risk of hypertension in Chinese population. Thus, we investigate the association between VAI and the increased risk of hypertension in a nationwide cohort of middle-aged and elderly adults in China. METHODS AND RESULTS: Data were obtained from the China Health and Retirement Longitudinal Study from 2011 to 2015. A total of 5200 Chinese participants aged 45 years and older were included. Multivariable Cox regression was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) of hypertension, with the lowest quartile of VAI score group as the reference. During the 4-years follow-up, 979 cases of hypertension were recorded. Compared with those in the lowest VAI score group, the participants with the highest quartile of VAI score were at a higher risk level of hypertension (HR: 1.454; 95% CI 1.204 to 1.755), especially subjects living in the urban area (2.142, 1.522 to 3.014). Furthermore, VAI can improve the ability of both BMI and WC in predicting the risk of hypertension by 12.72% (95% CI: 5.78%-19.67%) and 10.12% (95% CI: 3.17%-17.07%), respectively. CONCLUSION: In summary, VAI was positively associated with an increased risk of hypertension among a middle-aged and elderly Chinese population; VAI score can improve the ability of BMI and WC in predicting risk of hypertension.


Assuntos
Pressão Sanguínea , Hipertensão/epidemiologia , Gordura Intra-Abdominal/fisiopatologia , Obesidade/epidemiologia , Adiposidade , Fatores Etários , Idoso , China/epidemiologia , Comorbidade , Feminino , Inquéritos Epidemiológicos , Humanos , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Obesidade/diagnóstico , Obesidade/fisiopatologia , Prognóstico , Medição de Risco , Fatores de Risco , Fatores de Tempo , Saúde da População Urbana
7.
Nutr Metab Cardiovasc Dis ; 31(8): 2407-2415, 2021 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-34158242

RESUMO

BACKGROUND AND AIMS: The accumulation of fat increases the formation of lipid peroxides, which are partly scavenged by alpha-tocopherol (α-TOH). Here, we aimed to investigate the associations between different measures of (abdominal) fat and levels of urinary α-TOH metabolites in middle-aged individuals. METHODS AND RESULTS: In this cross-sectional analysis in the Netherlands Epidemiology of Obesity study (N = 511, 53% women; mean [SD] age of 55 [6.1] years), serum α-TOH and α-TOH metabolites from 24-h urine were measured as alpha-tocopheronolactone hydroquinone (α-TLHQ, oxidized) and alpha-carboxymethyl-hydroxychroman (α-CEHC, enzymatically converted) using liquid-chromatography-tandem mass spectrometry. Body mass index and total body fat were measured, and abdominal subcutaneous and visceral adipose tissue (aSAT and VAT) were assessed using magnetic resonance imaging. Using multivariable-adjusted linear regression analyses, we analysed the associations of BMI, TBF, aSAT and VAT with levels of urinary α-TOH metabolites, adjusted for confounders. We observed no evidence for associations between body fat measures and serum α-TOH. Higher BMI and TBF were associated with lower urinary levels of TLHQ (0.95 [95%CI: 0.90, 1.00] and 0.94 [0.88, 1.01] times per SD, respectively) and with lower TLHQ relative to CEHC (0.93 [0.90, 0.98] and 0.93 [0.87, 0.98] times per SD, respectively). We observed similar associations for VAT (TLHQ: 0.94 [0.89, 0.99] times per SD), but not for aSAT. CONCLUSIONS: Opposite to our research hypothesis, higher abdominal adiposity was moderately associated with lower levels of oxidized α-TOH metabolites, which might reflect lower vitamin E antioxidative activity in individuals with higher abdominal fat instead.


Assuntos
Adiposidade , Gordura Intra-Abdominal/fisiopatologia , Obesidade Abdominal/sangue , Obesidade Abdominal/fisiopatologia , alfa-Tocoferol/sangue , Fatores Etários , Biomarcadores/sangue , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Gordura Intra-Abdominal/metabolismo , Peroxidação de Lipídeos , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Obesidade Abdominal/diagnóstico , Obesidade Abdominal/epidemiologia
8.
BMC Cardiovasc Disord ; 21(1): 291, 2021 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-34116640

RESUMO

BACKGROUND: Few studies have compared bioelectrical body and visceral fat indices with anthropometric measures, or evaluated their optimal cutoffs in relation to hypertension among Asians. We compared the efficiencies of bioelectrical indices (percentage of body fat, PBF; visceral fat area, VFA) with anthropometric measures (body mass index, BMI; waist-hip ratio, WHR) for hypertension and re-evaluated the optimal cutoffs of each index by age and gender. METHODS: We conducted a cross-sectional survey among 8234 adults for health examination. PBF, VFA, BMI, WHR, and data on hypertension and behaviors were collected. Receiver operating characteristic (ROC) curve and areas under curves (AUCs) were used to analyze the efficiencies of the indices for hypertension, optimal cutoffs were estimated using the Youden index. RESULTS: A total of 8234 individuals aged 21-91 with median age 44 (interquartile range [IQR] 33-56) years were included and 40.56% were men. The overall prevalence of hypertension was 27.47%. The studied indices were all associated with hypertension in all age-specific groups both among men and women except for WHR in 21-29 years old men and PBF in in 21-29 years old women. Among males, there were no statistical differences in powers of four indices for hypertension in all age-specific groups, except for 40-49 years, in which WHR was better than VFA. Among females, no differences were found among the indices in 30-39 and 70-79 years groups, while WHR was the best in 21-29 years group, VFA was better than PBF in 30-39 and 50-59 years groups, BMI was better than PBF and WHR in 60-69 years group. The optimal cutoffs of PBF, VFA, BMI and WHR ranged from 23.9 to 28.7%, 86.4 to 106.9cm2, 23.5 to 27.1 kg/m2, 0.92 to 0.96 across the age categories in males, and 32.8 to 36.3%, 75.9 to 130.9cm2, 21.9 to 26.4 kg/m2, 0.84 to 0.95 across the age categories in females, respectively. CONCLUSIONS: The obesity indices' efficiencies for hypertension varied by age and gender, and their cutoff values varied across the age categories and gender. Specific indices and cutoffs based on person's age and gender should be used to identify individuals with hypertension.


Assuntos
Adiposidade , Antropometria , Hipertensão/diagnóstico , Gordura Intra-Abdominal/fisiopatologia , Obesidade/diagnóstico , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea , China/epidemiologia , Estudos Transversais , Impedância Elétrica , Feminino , Inquéritos Epidemiológicos , Humanos , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/fisiopatologia , Valor Preditivo dos Testes , Prevalência , Fatores de Risco , Distribuição por Sexo , Fatores Sexuais , Adulto Jovem
9.
Nutr Metab Cardiovasc Dis ; 31(6): 1774-1781, 2021 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-33975738

RESUMO

BACKGROUND AND AIMS: The new visceral adiposity index (NVAI) is an indirect marker of visceral adipose tissue recently developed using a Korean population. Here we examined the association of NVAI with coronary artery calcification and arterial stiffness in asymptomatic Korean patients. METHODS AND RESULTS: We analyzed data from 60,938 asymptomatic Korean adults. Odds ratios and 95% confidence intervals (CIs) for coronary artery calcification score (CACS) > 100 and brachial-ankle pulse wave velocity (baPWV) ≥14 m/s were calculated across NVAI tertiles using multiple logistic regression analysis. Receiver operating characteristic (ROC) and area under the curve (AUC) analyses were used to assess the ability of NVAI to predict moderate to high risk of cardiovascular disease. The prevalence of moderate and high risk of cardiovascular disease increased significantly as the NVAI tertile increased. The odds ratio (95% CI) of the highest NVAI tertile for CACS >100 was 5.840 (5.101-6.686) for men and 18.916 (11.232-31.855) for women, after adjusting for confounders. All NVAI AUC values were significantly higher than the AUC values for other visceral adiposity markers. CONCLUSIONS: This study provides the evidence that NVAI is independently and positively associated with coronary calcification and arterial stiffness in asymptomatic Korean adults.


Assuntos
Adiposidade , Doença da Artéria Coronariana/diagnóstico , Gordura Intra-Abdominal/fisiopatologia , Calcificação Vascular/diagnóstico , Rigidez Vascular , Adulto , Idoso , Índice Tornozelo-Braço , Angiografia por Tomografia Computadorizada , Angiografia Coronária , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/fisiopatologia , Estudos Transversais , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Gordura Intra-Abdominal/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , Valor Preditivo dos Testes , Prevalência , Prognóstico , Análise de Onda de Pulso , Sistema de Registros , República da Coreia/epidemiologia , Estudos Retrospectivos , Medição de Risco , Calcificação Vascular/epidemiologia , Calcificação Vascular/fisiopatologia
10.
Medicine (Baltimore) ; 100(21): e25947, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34032704

RESUMO

ABSTRACT: To compare the speed of propagation of ultrasound (US) waves (SoS) of the lower leg with the clinical reference standard computed tomography (CT) at the level of lumbar vertebra 3 (L3) for muscle loss assessment. Both calf muscles of 50 patients scheduled for an abdominal CT were prospectively examined with ultrasound. A plexiglas-reflector located on the opposite side of the probe with the calf in between was used as a timing reference for SoS (m/s). CT measurements were performed at the level of L3 and included area (cm2) and attenuation (HU) of the psoas muscle, abdominal muscles, subcutaneous fat, visceral fat and abdominal area. Correlations between SoS, body mass index (BMI) and CT were determined using Pearson's correlation coefficient. Based on reported CT sarcopenia threshold values, receiver operating characteristic (ROC) analysis was performed for SoS. Inter-examiner agreement was assessed with the median difference, inter-quartile range (IQR) and intraclass correlation coefficients. SoS of the calf correlated moderately with abdominal muscle attenuation (r = 0.48; P < .001), psoas muscle attenuation (r = 0.40; P < .01), abdominal area (r = -0.44; P < .01) and weakly with subcutaneous fat area (r = -0.37; P < .01). BMI correlated weakly with psoas attenuation (r = -0.28; P < .05) and non-significantly with abdominal muscle attenuation. Normalization with abdominal area resulted in moderate correlations with abdominal muscle area for SoS (r = 0.43; P < .01) and BMI (r = -0.46; P < .001). Based on sarcopenia threshold values for skeletal muscle attenuation (SMRA), area under curve (AUC) for SoS was 0.724. Median difference between both examiners was -3.4 m/s with IQR = 15.1 m/s and intraclass correlation coefficient = 0.794. SoS measurements of the calf are moderately accurate based on CT sarcopenia threshold values, thus showing potential for muscle loss quantification.


Assuntos
Perna (Membro)/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Sarcopenia/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Feminino , Humanos , Gordura Intra-Abdominal/diagnóstico por imagem , Gordura Intra-Abdominal/fisiopatologia , Perna (Membro)/fisiopatologia , Vértebras Lombares , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Estudos Prospectivos , Curva ROC , Valores de Referência , Sarcopenia/fisiopatologia , Gordura Subcutânea/diagnóstico por imagem , Gordura Subcutânea/fisiopatologia , Fatores de Tempo , Tomografia Computadorizada por Raios X , Ultrassonografia
11.
Cardiovasc Diabetol ; 20(1): 70, 2021 03 24.
Artigo em Inglês | MEDLINE | ID: mdl-33761942

RESUMO

BACKGROUND: The prevalence of hypertension and obesity has increased significantly in recent decades. Hypertension and obesity often coexist, and both are associated with increased cardiovascular mortality. Obese hypertensive patients usually require special anti-hypertensive treatment strategy due to the increased risk of treatment resistance. Molecules that can target both obesity and hypertension underlying pathologies should get more attention. Herein, we evaluated the therapeutic effects of telmisartan, with special interest in visceral adipose tissue dysfunction, in obesity-related hypertension rat model. METHODS: Thirty male Wistar rats weighing 150-200 g were equally divided into: 1-Control group (fed normal laboratory diet for 24 weeks), 2-Diet-induced obesity group (DIO, fed high fat diet for 24 weeks), and 3-Diet-induced obesity treated with telmisartan group (DIO + Tel, fed high fat diet and received telmisartan for 24 weeks). At the end of the study, anthropometrical parameters were evaluated. Systolic blood pressure and heart rate were measured. Blood samples were collected for the measurement of serum lipids, adipokines, cardiac, renal, inflammatory, and oxidative stress biomarkers. Kidneys were removed and used for histopathological studies, and visceral adipose tissue was utilized for histopathological, immunohistochemical and RT-PCR studies. RESULTS: High fat diet resulted in obesity-related changes in anthropometrical parameters, elevation of blood pressure, increase in heart rate, higher serum levels of cardiac, inflammatory and kidney function biomarkers, with altered serum lipids, adipokines and oxidative stress markers. Morphological changes (H&E and PAS-stained sections) were noticed in kidneys and visceral adipose tissue. Immunohistochemistry and RT-PCR studies confirmed adipose tissue dysfunction and over-expression of inflammatory and oxidative stress proteins. Telmisartan countered obesity-induced alterations in cardiovascular, renal, and adipose tissue functions. CONCLUSION: Adipose tissue dysfunction could be the core pathophysiology of obesity-related hypertension. Besides its anti-hypertensive effect, telmisartan had profound actions on visceral adipose tissue structure and function. Attention should be given to polymodal molecules targeting adipose tissue-related disorders.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacologia , Anti-Hipertensivos/farmacologia , Pressão Sanguínea/efeitos dos fármacos , Hipertensão/tratamento farmacológico , Gordura Intra-Abdominal/efeitos dos fármacos , Obesidade/complicações , Telmisartan/farmacologia , Adiposidade/efeitos dos fármacos , Animais , Biomarcadores/sangue , Modelos Animais de Doenças , Hipertensão/sangue , Hipertensão/etiologia , Hipertensão/fisiopatologia , Gordura Intra-Abdominal/metabolismo , Gordura Intra-Abdominal/fisiopatologia , Rim/efeitos dos fármacos , Rim/metabolismo , Rim/fisiopatologia , Masculino , Obesidade/sangue , Obesidade/fisiopatologia , Ratos Wistar
12.
Respir Res ; 22(1): 2, 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33407481

RESUMO

BACKGROUND: The effects of visceral adiposity on decreased lung function have drawn much attention. Recently, the visceral adiposity index (VAI) has been proposed as a visceral fat distribution and dysfunction marker. However, the relationship between the VAI and lung function has not been investigated. The objective of the study was to analyze the association between the VAI and lung function and evaluate the potential of VAI as a predictor of lung function. METHODS: We collected data from a population-based study of 1786 subjects aged 40 years or older. All subjects completed a questionnaire and underwent anthropometric measurements and laboratory tests. Linear and logistic regression models were developed to assess the association between the VAI and lung function. RESULTS: The VAI was inversely related to FVC%predicted in men and negatively associated with both FVC%predicted and FEV1%predicted in women. In the linear regression analysis, the decrease in FVC%predicted associated with each 10% increase in the VAI was 1.127% in men and 1.943% in women; the decrease in FEV1%predicted associated with each 10%increase in the VAI was 0.663% in men and 1.738% in women. Further regression analysis revealed that the VAI was positively correlated with FVC and FEV1 impairment in women. CONCLUSIONS: We were the first to show a clear correlation between the VAI and lung function impairment in the Chinese population. The VAI could be a simple and reliable approach in daily practice, and individuals, especially women with a high VAI, should receive additional screening and preventive interventions for respiratory disease.


Assuntos
Índice de Massa Corporal , Gordura Intra-Abdominal/fisiopatologia , Pneumopatias/fisiopatologia , Obesidade Abdominal/fisiopatologia , Vigilância da População , Idoso , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Pulmão/fisiopatologia , Pneumopatias/diagnóstico , Pneumopatias/etiologia , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/complicações , Obesidade Abdominal/diagnóstico , Vigilância da População/métodos , Testes de Função Respiratória/métodos , Fatores de Risco
13.
Abdom Radiol (NY) ; 46(2): 818-825, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32748252

RESUMO

PURPOSE: To assess visceral (VAT), subcutaneous (SAT), and total adipose tissue (TAT) estimates at abdominopelvic CT in COVID-19 patients with different severity, and analyze Body Mass Index (BMI) and CT estimates of fat content in patients requiring hospitalization. METHODS: In this retrospective IRB approved HIPPA compliant study, 51 patients with SARS-CoV-2 infection with abdominopelvic CT were included. Patients were stratified based on disease severity as outpatient (no hospital admission) and patients who were hospitalized. Subset of hospitalized patient required mechanical ventilation (MV). A radiologist blinded to the clinical outcome evaluated single axial slice on CT at L3 vertebral body for VATL3, SATL3, TATL3, and VAT/TATL3. These measures along with age, gender, and BMI were compared. A clinical model that included age, sex, and BMI was compared to clinical + CT model that also included VATL3 to discriminate hospitalized patients from outpatients. RESULTS: There were ten outpatients and 41 hospitalized patients. 11 hospitalized patients required MV. There were no significant differences in age and BMI between the hospitalized and outpatients (all p > 0.05). There was significantly higher VATL3 and VAT/TATL3 in hospitalized patients compared to the outpatients (all p < 0.05). Area under the curve (AUC) of the clinical + CT model was higher compared to the clinical model (AUC 0.847 versus 0.750) for identifying patients requiring hospitalization. CONCLUSION: Higher VATL3 was observed in COVID-19 patients that required hospitalization compared to the outpatients, and addition of VATL3 to the clinical model improved AUC in discriminating hospitalized from outpatients in this preliminary study.


Assuntos
COVID-19/fisiopatologia , Gordura Intra-Abdominal/diagnóstico por imagem , Gordura Intra-Abdominal/fisiopatologia , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco/métodos , SARS-CoV-2 , Índice de Gravidade de Doença , Adulto Jovem
14.
Nutr Metab Cardiovasc Dis ; 31(2): 506-517, 2021 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-33279372

RESUMO

BACKGROUND AND AIMS: Both insulin resistance (IR) and visceral adipose tissue (VAT) are related cardiometabolic risk factors; nevertheless, their joint effect on endothelial functionality is controversial. This study aims to evaluate the joint effect of IR and VAT on endothelial functionality using the pulse-waveform analysis and explore the mediating role of VAT on the effect of IR on arterial pressure, arterial stiffness and incident arterial hypertension. METHODS AND RESULTS: We measured VAT (n = 586) using two methods (dual-energy X-ray absorptiometry and a clinical surrogate), arterial stiffness (with pulse-waveform velocity), and IR (using three methods: HOMA2-IR (n = 586), a frequently sampled intravenous glucose tolerance test (n = 131) and euglycemic hyperinsulinemic clamping (n = 97)) to confirm the mediator effect of IR on VAT. The incidence of arterial hypertension attributable to the mediating effect of IR related to VAT was evaluated using a prospective cohort (n = 6850). Adjusted linear regression models, causal mediation analysis, and Cox-proportional hazard risk regression models were performed to test our objective. IR and VAT led to increased arterial stiffness and increased blood pressure; the combination of both further worsened vascular parameters. Nearly, 57% (ΔE→MY 95% CI: 31.7-100.0) of the effect of IR on altered pulse-wave velocity (PWV) analysis was mediated through VAT. Moreover, VAT acts as a mediator of the effect of IR on increased mean arterial pressure (ΔE→MY 35.7%, 95% CI: 23.8-59) and increased hypertension risk (ΔE→MY 69.1%, 95% CI: 46.1-78.8). CONCLUSION: VAT acts as a mediator of IR in promoting arterial stiffness and arterial hypertension. Both phenomena should be targeted to ameliorate the cardiometabolic risk.


Assuntos
Adiposidade , Pressão Arterial , Hipertensão/epidemiologia , Resistência à Insulina , Gordura Intra-Abdominal/fisiopatologia , Rigidez Vascular , Adulto , Biomarcadores/sangue , Glicemia/metabolismo , Fatores de Risco Cardiometabólico , Estudos Transversais , Feminino , Humanos , Hipertensão/sangue , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Incidência , Insulina/sangue , Gordura Intra-Abdominal/diagnóstico por imagem , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Estudos Prospectivos , Medição de Risco
15.
Clin Exp Hypertens ; 43(3): 203-210, 2021 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-33233955

RESUMO

Purpose: We sought to observe the effect of submaximal aerobic exercise on abdominal obesity in hypertension patients and to clarify a correlation between blood pressure improvement and visceral fat, along with arterial elasticity. Materials and Methods: According to the treatment plan, the patients were divided into two groups: the combined treatment group and the single drug group. During the training period, the subjects in the combined treatment group performed a 60 min treadmill exercise at 65% of Pmax. PWV was measured using blood pressure pulse-wave detectors before and after treatment. We assessed carotid stiffness and visceral fat area by B­mode ultrasonography. Results: The 24-h SBP and DBP changed significantly in the two groups in the pre- and post-treatment comparison. Significant statistical differences among SBP and DBP in the two groups of combination therapy and drug therapy after 12 months were demonstrated. Visceral fat area was significantly reduced in the combination therapy group compared to the drug therapy group at the last assessment. Compared with the drug group, arterial compliance in the combination therapy group was higher after treatment. Blood pressure showed significant positive correlation with visceral fat area, PWV, ß­stiffness, Ep, and PWVß in the combination therapy group. Conclusion: The combination of drug therapy and is more effective than just pursuing single drug treatment of hypertension in patients with abdominal obesity. Submaximal aerobic exercise contributes to anti-hypertension. The main mechanism of anti-hypertension in combination with drug therapy and submaximal aerobic exercise is the improvement of vascular elasticity and decreased central body-fat distribution.


Assuntos
Anti-Hipertensivos/farmacologia , Vasos Sanguíneos/fisiopatologia , Elasticidade , Exercício Físico/fisiologia , Hipertensão/fisiopatologia , Gordura Intra-Abdominal/fisiopatologia , Adulto , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Índice de Massa Corporal , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Obesidade Abdominal/fisiopatologia
16.
Ann N Y Acad Sci ; 1492(1): 11-26, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33340110

RESUMO

Brown adipose tissue (BAT) is an endocrine organ that contributes to thermogenesis and energy consumption. We investigated the effects of salt loading and surgical removal of whitened interscapular BAT (iBAT) on cardiac and adipose tissue pathology in DahlS.Z-Leprfa /Leprfa (DS/obese) rats, an animal model of metabolic syndrome (MetS). DS/obese rats were subjected to surgical removal of iBAT or sham surgery at 8 weeks of age and were provided with drinking water containing or not containing 0.3% NaCl for 4 weeks beginning at 9 weeks of age. Removal of iBAT suppressed the salt-induced exacerbation of left ventricular inflammation, fibrosis, and diastolic dysfunction, but not that of hypertension development, in DS/obese rats. Salt loading attenuated adipocyte hypertrophy but enhanced inflammation in both visceral white adipose tissue (WAT) and iBAT. Although iBAT removal did not affect visceral WAT pathology in salt-loaded DS/obese rats, it attenuated the elevation of circulating interleukin-6 levels in these animals. Downregulation of uncoupling protein-1 expression in iBAT of DS/obese rats was not affected by salt loading. Our results suggest that the conversion of iBAT to WAT-like tissue contributes to a salt-induced elevation of circulating proinflammatory cytokine levels that leads to exacerbation of cardiac pathology in this model of MetS.


Assuntos
Tecido Adiposo Marrom/fisiopatologia , Síndrome Metabólica/fisiopatologia , Miocárdio/patologia , Tecido Adiposo Marrom/patologia , Tecido Adiposo Marrom/cirurgia , Animais , Citocinas/sangue , Modelos Animais de Doenças , Hipertensão/etiologia , Mediadores da Inflamação/sangue , Gordura Intra-Abdominal/patologia , Gordura Intra-Abdominal/fisiopatologia , Gordura Intra-Abdominal/cirurgia , Masculino , Síndrome Metabólica/patologia , Síndrome Metabólica/cirurgia , Mutação , Obesidade/patologia , Obesidade/fisiopatologia , Obesidade/cirurgia , Ratos , Ratos Endogâmicos Dahl , Ratos Zucker , Receptores para Leptina/genética , Receptores para Leptina/fisiologia , Cloreto de Sódio na Dieta/administração & dosagem , Disfunção Ventricular Esquerda/fisiopatologia
17.
Hypertension ; 77(2): 729-738, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33356396

RESUMO

As novel drug treatments for diabetes have shown favorable cardiovascular effects, interest has mounted with regard to their possible vascular actions, particularly in relation to visceral adipose tissue perfusion and remodeling in obesity. The present study tested the vasorelaxing effect of the SGLT2 (sodium-glucose transporter type 2) inhibitor canagliflozin in arteries from visceral adipose tissue of either nonobese or obese humans and investigated the underlying mechanisms. Also, the vasorelaxing effect of canagliflozin and the GLP-1 (glucagon-like peptide 1) agonist liraglutide were compared in arteries from obese patients. To these purposes, small arteries (116-734 µm) isolated from visceral adipose tissue were studied ex vivo in a wire myograph. Canagliflozin elicited a higher concentration-dependent vasorelaxation in arterioles from obese than nonobese individuals (P=0.02). The vasorelaxing response to canagliflozin was not modified (P=0.93) by inhibition of nitric oxide synthase (L-NAME) or prostacyclin (indomethacin), or by H2O2 scavenging (catalase); also, canagliflozin-induced relaxation was similar (P=0.23) in endothelium-intact or -denuded arteries precontracted with high potassium concentration, thereby excluding an involvement of endothelium-derived hyperpolarizing factors. The vasorelaxing response to canagliflozin was similar to that elicited by the Na+/H+ exchanger 1 inhibitor BIX (P=0.67), but greater than that to the Na+/Ca++ exchanger inhibitor SEA 0400 (P=0.001), hinting a role of Na+/H+ exchanger inhibition in canagliflozin-induced relaxation. In arterioles from obese patients, the vasorelaxing response to canagliflozin was greater than that to liraglutide (P=0.004). These findings demonstrate that canagliflozin induces endothelium-independent vasorelaxation in arterioles from human visceral adipose tissue, thereby suggesting that SGLT2 inhibition might favorably impact the processes linking visceral adipose burden to vascular disease in obesity.


Assuntos
Arteríolas/efeitos dos fármacos , Canagliflozina/farmacologia , Gordura Intra-Abdominal/efeitos dos fármacos , Obesidade/fisiopatologia , Inibidores do Transportador 2 de Sódio-Glicose/farmacologia , Vasodilatação/efeitos dos fármacos , Endotélio Vascular/efeitos dos fármacos , Inibidores Enzimáticos/farmacologia , Humanos , Hipoglicemiantes/farmacologia , Gordura Intra-Abdominal/fisiopatologia , Liraglutida/farmacologia , NG-Nitroarginina Metil Éster/farmacologia , Óxido Nítrico Sintase/antagonistas & inibidores , Vasodilatação/fisiologia
18.
J Urol ; 205(1): 122-128, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32718204

RESUMO

PURPOSE: Evidence suggests that visceral fat quantity may be associated with post-prostatectomy outcomes and risk of prostate cancer related death. We evaluated whether increased fat volume, normalized to prostate size, is associated with decreased risk of disease progression. MATERIALS AND METHODS: Patients enrolled on a prospective active surveillance trial for at least 6 months who had magnetic resonance imaging within 2 years of enrollment were eligible. The surveillance protocol included a standardized followup regimen consisting of biennial prostate specific antigen and examination and yearly biopsy. Clinicopathological characteristics were collected at baseline. Three fat measurements were taken using prostate magnetic resonance imaging, including subcutaneous, linear periprostatic (pubic symphysis to prostate) and volumetrically defined periprostatic. Progression was defined as increase in Gleason grade group. Multivariable Cox proportional hazards models were used to evaluate fat volumes normalized by prostate size (stratified into tertiles). RESULTS: A total of 175 patients were included in the study. Average age was 62.5 years (SD 7.4) and average prostate specific antigen was 5.4 ng/dl (SD 3.9). Median followup was 42 months (IQR 18-60) and 50 patients (28.6%) had progression. Compared to the lowest tertile, the highest tertile of volumetric periprostatic fat measurement (HR 2.63, 95% CI 1.23-5.60, p=0.01) and linear periprostatic fat measurement (HR 2.30, 95% CI 1.01-5.22, p=0.05) were associated with worsened progression-free survival, while subcutaneous fat measurement (p=0.97) was not. Importantly, the model did not substantively change when accounting for patient body mass index and other factors. CONCLUSIONS: Increased periprostatic fat volume, normalized to prostate size, may be associated with shortened progression-free survival in men with prostate cancer on active surveillance.


Assuntos
Adiposidade/fisiologia , Gordura Intra-Abdominal/fisiopatologia , Próstata/patologia , Neoplasias da Próstata/mortalidade , Conduta Expectante/estatística & dados numéricos , Idoso , Biópsia/estatística & dados numéricos , Progressão da Doença , Seguimentos , Humanos , Gordura Intra-Abdominal/diagnóstico por imagem , Calicreínas/sangue , Imageamento por Ressonância Magnética/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Tamanho do Órgão , Intervalo Livre de Progressão , Estudos Prospectivos , Próstata/diagnóstico por imagem , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/patologia , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Gordura Subcutânea/diagnóstico por imagem , Gordura Subcutânea/fisiopatologia
19.
Nutrients ; 12(11)2020 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-33266499

RESUMO

There is growing evidence of the dietary impact on obesity-induced low-grade chronic inflammation and the associated chronic non-communicable diseases modification. We determined changes in body composition and cardiometabolic and inflammatory status of participants with obesity after 24 weeks of a dietary intervention based on an energy-reduced anti-inflammatory diet and examined the relationship of these changes with changes in the inflammatory potential of the diet. The anthropometric and body composition parameters of 81 participants (average age of 43 years, 74 women) were assessed. Metabolic status was determined using the glycemic and lipid statuses, and the cardiometabolic index and inflammatory status were determined using the concentration of high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and tumor necrosis factor α (TNF-α). The inflammatory potential of the diet was assessed using the Dietary Inflammatory Index (DII®). Intervention with an anti-inflammatory diet resulted in a significant reduction in body weight and visceral adipose tissue and caused improvements in the participants' cardiometabolic and inflammatory statuses. The anti-inflammatory diet was shown to be effective regarding obesity management. The study data could advance current scientific knowledge in the field of inflammation and diet, provide guidelines for obesity management, and find its application in routine clinical practice.


Assuntos
Anti-Inflamatórios/administração & dosagem , Restrição Calórica , Dieta Mediterrânea , Obesidade/dietoterapia , Adulto , Glicemia/análise , Composição Corporal , Proteína C-Reativa/análise , Fatores de Risco Cardiometabólico , Feminino , Humanos , Inflamação/fisiopatologia , Interleucina-6/sangue , Gordura Intra-Abdominal/fisiopatologia , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Fator de Necrose Tumoral alfa/sangue , Perda de Peso
20.
Obesity (Silver Spring) ; 28(12): 2424-2430, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33230966

RESUMO

OBJECTIVE: The aim of this study was to determine the relationship between telomere length (TL) in subcutaneous adipose tissue (SAT), visceral adipose tissues (VAT), and leukocytes, as well as to examine the associations of TL in these tissues with postsurgical weight loss in Asians with severe obesity. METHODS: Presurgery TL was measured in leukocytes, SAT, and VAT of 91 patients who underwent weight loss surgery. Correlation between TL in multiple tissues was assessed using Pearson correlation. The association of presurgery TL and postsurgical weight loss at 6 or 12 months, expressed as a percentage of weight loss, was determined using linear regression in 70 patients. RESULTS: Telomeres were longer in VAT compared with those in leukocytes and SAT (P < 0.001) but were highly correlated between tissues. The strongest correlation was observed between TL in VAT and leukocytes (r = 0.739, P = 6.22 × 10-17 ). Compared with individuals in the highest tertile, those in the lowest tertile of VAT TL showed greater weight loss (ß = 6.23, SE = 3.10, P = 0.044) independent of age, sex, ethnicity, types of surgery, diabetes condition, preoperative BMI, and follow-up period. CONCLUSIONS: Among patients with severe obesity, TL in leukocytes and adipose tissue was highly correlated. However, there was variability in the association of TL in these tissues with weight loss after surgery.


Assuntos
Cirurgia Bariátrica/métodos , Gordura Intra-Abdominal/fisiopatologia , Leucócitos/metabolismo , Obesidade Mórbida/cirurgia , Telômero/fisiologia , Perda de Peso/fisiologia , Adulto , Feminino , Humanos , Masculino
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...