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1.
PLoS One ; 15(1): e0228360, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31999771

RESUMO

BACKGROUND: Growing evidence indicates that measures of body composition may be related to clinical outcomes in patients with malignancies. The aim of this study was to investigate whether measures of regional adiposity-including subcutaneous adipose tissue index (SATI) and visceral adipose tissue index (VATI)-can be associated with overall survival (OS) in Taiwanese patients with bone metastases. METHODS: This is a retrospective analysis of prospectively collected data. We examined 1280 patients with bone metastases who had undergone radiotherapy (RT) between March 2005 and August 2013. Body composition (SATI, VATI, and muscle index) was assessed by computed tomography at the third lumbar vertebra and normalized for patient height. Patients were divided into low- and high-adiposity groups (for both SATI and VATI) according to sex-specific median values. RESULTS: Both SATI (hazard ratio [HR]: 0.696; P<0.001) and VATI (HR: 0.87; P = 0.037)-but not muscle index-were independently associated with a more favorable OS, with the former showing a stronger relationship. The most favorable OS was observed in women with high SATI (11.21 months; 95% confidence interval: 9.434-12.988; P<0.001). CONCLUSIONS: High SATI and VATI are associated with a more favorable OS in Taiwanese patients with bone metastases referred for RT. The question as to whether clinical measures aimed at improving adiposity may improve OS in this clinical population deserves further scrutiny.


Assuntos
Neoplasias Ósseas/radioterapia , Neoplasias Ósseas/secundário , Gordura Intra-Abdominal/diagnóstico por imagem , Gordura Subcutânea/diagnóstico por imagem , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/mortalidade , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida , Taiwan , Tomografia Computadorizada por Raios X , Resultado do Tratamento
2.
Int J Sports Med ; 41(1): 3-11, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31791089

RESUMO

This study evaluated the morphological changes of the lower limb and associated hemodynamic responses to different lower-body compression pressures (COMPs) in physically active, healthy individuals at rest. Each of the 32 participants underwent three trials with three different degrees of lower-body compression applied: "Low" (2.2±1.4 mmHg), "Medium" (12.9±3.9 mmHg), and "High" (28.8±8.3 mmHg). In each COMP, a cross-sectional area of leg muscles (CSAmuscle), subcutaneous fat (CSAfat), superficial vessels (SupV), deep arteries (DA), and deep veins (DV) at the calf, knee, and thigh levels were measured using magnetic resonance imaging (MRI). Additionally, blood pressure (BP), heart rate (HR), cardiac output (CO), stroke volume (SV), and systemic vascular resistance (SVR) were measured using Doppler ultrasound (USCOM®). With High COMP, calf CSAmuscle and SupV were smaller (p<0.01), whereas DA and DV were larger (p<0.05). Calf CSAfat, however, was similar among all COMPs. There were no major changes in CSAmuscle and CSAfat at knee and thigh levels. CO (3.2±0.9 L/min) and SV (51.9±16.4 mL) were higher (p<0.05) only with High COMP, but other hemodynamic variables showed no significant changes across different COMPs. The High COMP at the lower limb induces leg morphological changes and increases associated hemodynamic responses of physically active healthy individuals at rest.


Assuntos
Hemodinâmica/fisiologia , Extremidade Inferior/fisiologia , Meias de Compressão , Artérias/diagnóstico por imagem , Artérias/fisiologia , Pressão Sanguínea/fisiologia , Estudos Cross-Over , Feminino , Frequência Cardíaca/fisiologia , Humanos , Extremidade Inferior/irrigação sanguínea , Extremidade Inferior/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/fisiologia , Volume Sistólico/fisiologia , Gordura Subcutânea/irrigação sanguínea , Gordura Subcutânea/diagnóstico por imagem , Gordura Subcutânea/fisiologia , Ultrassonografia Doppler , Resistência Vascular/fisiologia , Veias/diagnóstico por imagem , Veias/fisiologia , Adulto Jovem
3.
BMC Med Imaging ; 19(1): 95, 2019 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-31847832

RESUMO

BACKGROUND: Excess abdominal adiposity cause metabolic disturbances, particularly in pregnancy. Methods of accurate measurement are limited in pregnancy due to risks associated with these procedures. This study outlines a non-invasive methodology for the measurement of adipose tissue in pregnancy and determines the intra- and inter-observer reliability of ultrasound (US) measurements of the two components of adipose tissue (subcutaneous (SAT) and visceral adipose tissue (VAT)) within a pregnant population. METHODS: Thirty pregnant women were recruited at the end of their first trimester, from routine antenatal clinic at the University Maternity Hospital Limerick, Ireland. Measurements of adipose tissue thickness were obtained using a GE Voluson E8 employing a 1-5 MHz curvilinear array transducer. Two observers, employing methodological rigour in US technique, measured thickness of adipose tissue three times, and segmented the US image systematically in order to define measurements of SAT and VAT using specifically pre-defined anatomical landmarks. RESULTS: Intra-observer and inter-observer precision was assessed using Coefficient of Variation (CV). Measurements of SAT and total adipose for both observers were < 5% CV and < 10% CV for VAT in measures by both observers. Inter-observer reliability was assessed by Limits of Agreement (LoA). LoA were determined to be - 0.45 to 0.46 cm for SAT and - 0.34 to 0.53 cm for VAT values. Systematic bias of SAT measurement was 0.01 cm and 0.10 cm for VAT. Inter-observer precision was also assessed by coefficient of variation (CV: SAT, 3.1%; VAT, 7.2%; Total adipose, 3.0%). CONCLUSION: Intra-observer precision was found to be acceptable for measures of SAT, VAT and total adipose according to anthropometric criterion, with higher precision reported in SAT values than in VAT. Inter-observer reliability assessed by Limits-Of-Agreement (LoA) confirm anthropometrically reliable to 0.5 cm. Systematic bias was minimal for both measures, falling within 95% confidence intervals. These results suggest that US can produce reliable, repeatable and accurate measures of SAT and VAT during pregnancy.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Gordura Intra-Abdominal/diagnóstico por imagem , Gordura Subcutânea/diagnóstico por imagem , Feminino , Idade Gestacional , Humanos , Variações Dependentes do Observador , Gravidez , Primeiro Trimestre da Gravidez , Estudos Prospectivos , Interpretação de Imagem Radiográfica Assistida por Computador , Reprodutibilidade dos Testes , Ultrassonografia
4.
BMC Surg ; 19(1): 181, 2019 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-31779610

RESUMO

BACKGROUND: Various body composition indices have been reported as prognostic factors for different cancers. However, whether body composition affects prognosis after lower gastrointestinal tract perforation requiring emergency surgery and multidisciplinary treatment has not been clarified. This study examined whether body composition evaluations that can be measured easily and quickly from computed tomography (CT) are useful for predicting prognosis. METHODS: Subjects comprised 64 patients diagnosed with perforation at final diagnosis after emergency surgery for a preoperative diagnosis of lower gastrointestinal tract perforation and penetration. They were divided into a survival group and a non-survival (in-hospital mortality) group and compared. Body composition indices (psoas muscle index (PMI); psoas muscle attenuation (PMA); subcutaneous adipose tissue index (SATI); visceral adipose tissue index (VATI); visceral-to-subcutaneous fat area ratio (VSR)) were measured from preoperative CT. Cross-sectional psoas muscle area at the level of the 3rd lumbar vertebra was quantified. Optimal cut-off values were calculated using receiver operating characteristic curve analysis. Poor prognostic factors were investigated from multivariate logistic regression analyses that included patient factors, perioperative factors, intraoperative factors, and body composition indices as explanatory variables. RESULTS: The cause of perforation was malignant disease in 12 cases (18.7%), and benign disease in 52 cases (81.2%). The most common cause was diverticulum of the large intestine. Emergency surgery for the 64 patients led to survival in 52 patients and death in 12 patients. On multivariate logistic regression analysis, independent predictors of poor prognosis were Sequential Organ Failure Assessment score (odds ratio 1.908; 95% confidence interval (CI) 1.235-3.681; P = 0.0020) and PMI (odds ratio 13.478; 95%CI 1.342-332.690; P = 0.0252). The cut-off PMI was 4.75 cm2/m2 for males and 2.89 cm2/m2 for females. Among survivors, duration of hospitalization was significantly longer in the low PMI group (29 days) than in the high PMI group (22 days, p = 0.0257). CONCLUSIONS: PMI is easily determined from CT and allows rapid evaluation of prognosis following lower gastrointestinal perforation.


Assuntos
Traumatismos Abdominais/diagnóstico por imagem , Gordura Intra-Abdominal/diagnóstico por imagem , Músculos Psoas/diagnóstico por imagem , Gordura Subcutânea/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Composição Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
5.
J Dairy Res ; 86(3): 296-302, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31409432

RESUMO

This research paper addresses the hypothesis that in times of negative energy balance around parturition in dairy cattle, lipids stored in adipocytes are mobilised in a more intensive manner out of the abdominal depots than out of the subcutaneous adipose tissues. Furthermore, the impact of niacin supplementation and energy density of the ration on adipose tissue mass gain and loss was assessed. Absolute masses of subcutaneous (SCAT), retroperitoneal (RPAT), omental (OMAT), mesenterial (MAT) and abdominal adipose tissue as a whole (AAT) were estimated by ultrasonography at -42, 3, 21 and 100 DIM. Absolute and relative daily gain during dry period (-42 to 3 DIM) and loss in fresh cow period (3 to 21 DIM) and early lactation period (22 to 100 DIM) were calculated. Feeding regime neither by niacin nor by energy density exerted any effect on adipose tissue masses. The AAT was always bigger than SCAT, but RPAT, OMAT and MAT did not differ amongst each other. All depot masses showed similar patterns with an increase during dry period and a decrease after calving. In fresh cow period AAT absolutely and relatively lost more mass than SCAT. This confirms that AAT is more intensively mobilised than SCAT during that time span. Further absolute daily gain during dry period was strongly negatively correlated with absolute daily loss during fresh cow period. This underlines the impact of individual body condition on adipose mobilisation in periparturient dairy cows. According to these results, it has to be taken into account that the largest amount of fat mobilised in the fresh cow period origins from AAT. This might impact the pattern of adipose derived metabolites and metabolic effectors interacting in physiological and deregulated adaptation to negative energy balance.


Assuntos
Gordura Abdominal/fisiologia , Bovinos/fisiologia , Metabolismo Energético/fisiologia , Gordura Subcutânea/fisiologia , Gordura Abdominal/diagnóstico por imagem , Gordura Abdominal/efeitos dos fármacos , Animais , Composição Corporal , Dieta/veterinária , Suplementos Nutricionais , Feminino , Alemanha , Lactação , Niacina/administração & dosagem , Parto , Período Pós-Parto , Gravidez , Reprodução , Gordura Subcutânea/diagnóstico por imagem , Gordura Subcutânea/efeitos dos fármacos , Ultrassonografia/veterinária
6.
Int J Sports Med ; 40(8): 544-550, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31288294

RESUMO

Circumference measurements have been used to estimate muscle cross-sectional area (CSA) in clinical settings. Measurements of thigh circumference are affected by muscle and subcutaneous fat (SF). In fact, SF could increase over a short period. Therefore, clarifying the relationship between thigh circumference and muscle and SF following ACL reconstruction is important. This study's primary purpose was to examine pre- and post-operative changes in thigh circumference, thigh muscles and SF CSAs in both legs. Secondary, the relationship between thigh circumference and muscle and SF CSAs was examined to demonstrate that circumference measurements could be used to detect atrophy. Quadriceps, hamstrings, and SF CSAs at 15, 10, and 5 cm proximal to the patella were measured by MRI pre- and 4 weeks postoperatively to examine how reconstruction affected those tissues in the thighs. The results showed increases in SF CSA (r=0.72 at 10 cm, r=0.67 at 15 cm) greatly affected thigh circumference in females on the surgical side. In males, increases in SF CSA (r=0.83) at 15- and 5-cm and decreases in quadriceps muscle CSA (r=0.73) at 5 cm affected thigh circumference on the surgical side. Thigh circumference measurements might not reflect actual muscle CSA in ACL patients.


Assuntos
Reconstrução do Ligamento Cruzado Anterior , Músculos Isquiossurais/anatomia & histologia , Atrofia Muscular/patologia , Músculo Quadríceps/anatomia & histologia , Gordura Subcutânea/anatomia & histologia , Coxa da Perna/anatomia & histologia , Adolescente , Adulto , Feminino , Músculos Isquiossurais/diagnóstico por imagem , Músculos Isquiossurais/patologia , Humanos , Imagem por Ressonância Magnética , Masculino , Atrofia Muscular/diagnóstico por imagem , Período Pós-Operatório , Músculo Quadríceps/diagnóstico por imagem , Músculo Quadríceps/patologia , Gordura Subcutânea/diagnóstico por imagem , Gordura Subcutânea/patologia , Coxa da Perna/diagnóstico por imagem , Coxa da Perna/patologia , Adulto Jovem
7.
Asia Pac J Clin Nutr ; 28(2): 300-309, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31192559

RESUMO

BACKGROUND AND OBJECTIVES: Types and amounts of nutrients may influence the volume of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT). This study targeted to investigate the relationship between SAT and VAT volumes and macro- and micronutrients intake among adults. METHODS AND STUDY DESIGN: Data were collected via a private face-to-face interview, in which diet history was obtained using validated quantitative food frequency questionnaire. The different fat volumes were assessed using magnetic resonance imaging (MRI) scanning. RESULTS: Participants with the lowest VAT volume had the highest intake of saturated fats, monounsaturated fatty acids and omega-3 and omega-6 fatty acids (p<0.05). VAT volume was significantly associated with the highest level of total energy and energy from carbohydrate consumption among participants while significantly associated with the lowest energy intake from fat among participants (p=0.013). There was a significant relationship with the highest consumption of total carbohydrate, soluble fiber, and insoluble fiber and VAT volume (p<0.05). Participants in the highest VAT volume had significantly the highest intake of vitamin A, ß- carotene, and copper. CONCLUSIONS: This study underscores the importance of quantifying depot-specific body fat and highlights the unique responsiveness of various fat depots to dietary intake.


Assuntos
Dieta/métodos , Gordura Intra-Abdominal/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Nutrientes , Inquéritos Nutricionais/estatística & dados numéricos , Gordura Subcutânea/diagnóstico por imagem , Adulto , Estudos Transversais , Feminino , Humanos , Jordânia , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais/métodos , Inquéritos e Questionários , Adulto Jovem
8.
BMC Gastroenterol ; 19(1): 87, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31195984

RESUMO

BACKGROUND: The relationship between visceral adiposity and acute pancreatitis (AP) has not been completely elucidated. This study evaluated the significance of visceral adipose tissue (VAT) and the ratio of VAT to skeletal muscle tissue (VAT/SMT) in the prognosis of AP patients. METHODS: Based on a 1:2 propensity score matching, 306 hospitalized patients were enrolled in the study analysis from 2010 to 2017. VAT, subcutaneous adipose tissue (SAT), and SMT were measured using unenhanced computed tomography (CT). Cox proportional hazards models were applied for the analysis. RESULTS: VAT and the VAT/SMT ratio were significantly higher in the severe AP (SAP) and moderately severe AP (MSAP) groups compared to the mild AP (MAP) group (both p < 0.001). Intensive care transfer, AP severity, systemic complications, and prognostic scores (Acute Physiology and Chronic Health Evaluation II [APACHE-II] score ≥ 8, Ranson's score ≥ 3, Bedside Index of Severity in Acute Pancreatitis [BISAP] score ≥ 3, and the systemic inflammatory response syndrome [SIRS] score ≥ 2) significantly correlated with VAT and the VAT/SMT ratio in AP patients. The multivariate adjusted hazard ratios (HRs) for VAT and the VAT/SMT ratio in the relationship of body parameters and AP mortality were 1.042 (95% confidence interval (CI), 1.019-1.066) and 7.820 (95% CI, 1.978-30.917), respectively. Compared with other prognostic scores, VAT had the highest area under the curve of receiver operating characteristics (ROC) (0.943, 95% CI, 0.909-0.976). CONCLUSION: High VAT and VAT/SMT ratio are independent negative prognostic indicators of AP. TRIAL REGISTRATION: Clinical study registration number: NCT03482921 . Date of registration: 03/23/2018.


Assuntos
Gordura Intra-Abdominal/patologia , Músculo Esquelético/patologia , Pancreatite/patologia , Gordura Subcutânea/patologia , Tomografia Computadorizada por Raios X/estatística & dados numéricos , APACHE , Doença Aguda , Adulto , Idoso , Feminino , Humanos , Gordura Intra-Abdominal/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/diagnóstico por imagem , Pancreatite/diagnóstico por imagem , Prognóstico , Pontuação de Propensão , Modelos de Riscos Proporcionais , Curva ROC , Gordura Subcutânea/diagnóstico por imagem , Síndrome de Resposta Inflamatória Sistêmica
9.
Obes Facts ; 12(3): 259-271, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31055588

RESUMO

PURPOSE: Obesity is associated with increased incidence and mortality in rectal cancer (RC). However, an obesity paradox in the sense of a protective effect of obesity is discussed controversially. We evaluated whether adipose tissue distribution has an impact on medical (MC) and surgical complications (SC) after RC surgery. METHODS: A total of 296 RC patients underwent oncological surgery and multidetector CT with quantification of total (TAT), visceral (VAT), and subcutaneous adipose tissue (SAT). Logistic regressions on SC (anastomotic leakage [n = 26], wound infection [n = 58], bleeding [n = 12], abscess [n = 32], bladder dysfunction [n = 24], burst abdomen [n = 10]), and MC (pulmonary [n = 22], cardiac [n = 18], urinary tract infection [n = 9], sepsis [n = 5]) were performed. RESULTS: High pelvicVAT was associated with reduced risk for overall SC (OR = 0.915, p = 0.012) and anastomotic leakage (OR = 0.587, p = 0.024, CI: 0.369/0.934). In contrast, CT-quantified obesity was associated with increased risk for wound infection, bladder dysfunction, burst abdomen, overall MC, and cardiac complications (ORs up to 1.423). BMI was not associated with any SC or MC. CONCLUSION: An obesity paradox with a protective effect of CT-quantified adipose tissue was confirmed for anastomotic leakage and overall SC. In contrast, high adipose tissue was associated with higher risk for other SC and MC. These results show a more complex influence of body composition on MC and SC. CT-quantified obesity is able to provide deeper insights to explain the obesity paradox beyond BMI.


Assuntos
Composição Corporal/fisiologia , Distribuição da Gordura Corporal/métodos , Neoplasias Retais/diagnóstico , Neoplasias Retais/cirurgia , Tomografia Computadorizada por Raios X , Abdome/diagnóstico por imagem , Tecido Adiposo/diagnóstico por imagem , Tecido Adiposo/metabolismo , Idoso , Índice de Massa Corporal , Feminino , Humanos , Gordura Intra-Abdominal/diagnóstico por imagem , Gordura Intra-Abdominal/metabolismo , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/diagnóstico , Obesidade/mortalidade , Obesidade/cirurgia , Prognóstico , Fatores de Proteção , Neoplasias Retais/complicações , Neoplasias Retais/mortalidade , Estudos Retrospectivos , Fatores de Risco , Gordura Subcutânea/diagnóstico por imagem , Gordura Subcutânea/metabolismo , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
10.
Medicine (Baltimore) ; 98(22): e15867, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31145342

RESUMO

The aim of the study was to introduce our in-house software to measure the muscle and adipose area on axial computed tomography (CT) scans and to compare with various quantification methods.Our institutional review board approved this retrospective study and informed consent was waived. We developed in-house software to identify body composition analysis on CT scan, which semiautomatically operates 3 image processing steps. Abdominal images were obtained using multidetector row CT (MDCT). Two radiologists analyzed the same cross-sectional areas of subcutaneous fat, muscle, and visceral fat using the following techniques: manual measurements, Aquarius, ImageJ, and our newly developed software. We calculated an intraclass correlation coefficient (ICC) for comparison of muscle and fat areas quantified by various measurement methods using a 2-way random model. Interobserver agreement between the radiologists was also evaluated.Agreements in the measurement of subcutaneous fat and muscle areas were excellent among the methods (ICC = 0.962 and 0.897, respectively), and that of the visceral fat area was good (ICC = 0.822). In the subgroup analysis, ICC of the visceral fat area in the female group and in subjects with ascites was slightly lower than the other group (ICC = 0.742 and 0.787, respectively). The correlation coefficients between our software and other methods were relatively high (r = 0.854-0.996). Additionally, ICCs between both observers of our program for quantification of subcutaneous fat, muscle, and visceral fat areas were 0.999, 0.980, and 0.999, respectively.In conclusion, our method showed be reliable in quantifying muscle and adipose tissue using cross-sectional areas of MDCT with high reproducibility.


Assuntos
Gordura Abdominal/diagnóstico por imagem , Músculos Abdominais/diagnóstico por imagem , Tecido Adiposo/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodos , Tomografia Computadorizada Multidetectores/métodos , Software , Adulto , Idoso , Feminino , Humanos , Gordura Intra-Abdominal/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Estudos Retrospectivos , Estatísticas não Paramétricas , Gordura Subcutânea/diagnóstico por imagem
11.
PLoS One ; 14(5): e0217644, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31145760

RESUMO

Waist-to-hip ratio (WHR) is a prominent cardiometabolic risk factor that increases cardio-metabolic disease risk independently of BMI and for which multiple genetic loci have been identified. However, WHR is a relatively crude proxy for fat distribution and it does not capture all variation in fat distribution. We here present a study of the role of coding genetic variants on fat mass in 6 distinct regions of the body, based on dual-energy X-ray absorptiometry imaging on more than 17k participants. We find that the missense variant CCDC92S70C, previously associated with WHR, is associated specifically increased leg fat mass and reduced visceral but not subcutaneous central fat. The minor allele-carrying transcript of CCDC92 is constitutively more highly expressed in adipose tissue samples. In addition, we identify two coding variants in SPATA20 and UQCC1 that are associated with arm fat mass. SPATA20K422R is a low-frequency variant with a large effect on arm fat only, and UQCC1R51Q is a common variant reaching significance for arm but showing similar trends in other subcutaneous fat depots. Our findings support the notion that different fat compartments are regulated by distinct genetic factors.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Obesidade/diagnóstico por imagem , Gordura Subcutânea/diagnóstico por imagem , Relação Cintura-Quadril/métodos , Absorciometria de Fóton , Tecido Adiposo/fisiopatologia , Adulto , Composição Corporal/fisiologia , Distribuição da Gordura Corporal , Índice de Massa Corporal , Doenças Cardiovasculares/diagnóstico por imagem , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/fisiopatologia , Humanos , Masculino , Doenças Metabólicas/diagnóstico por imagem , Doenças Metabólicas/etiologia , Doenças Metabólicas/fisiopatologia , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Fatores de Risco , Gordura Subcutânea/fisiopatologia
12.
Nutrients ; 11(5)2019 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-31126078

RESUMO

The present study investigated the association of carbohydrate intake and isocaloric substitution with different types of fat with visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and hepatic fat content as determined by magnetic resonance imaging (MRI). Data from 283 participants (mean age 56.1 ± 9.0 years) from the MRI sub study of the KORA FF4 study were included. VAT, SAT and total body fat were quantified by a volume-interpolated VIBE-T1w-Dixon MR sequence. Hepatic fat content was determined as the proton density fat-fraction (PDFF) derived from multiecho-T1w MR sequence. Dietary intake was estimated using information provided by two different instruments, that is, repeated 24-h food lists and a food frequency questionnaire. Replacing total carbohydrates with an isoenergetic amount of total fat was significantly positively associated with VAT and hepatic fat, while there was no significant association with SAT. The multivariable adjusted ß-coefficient for replacing 5% of total energy (5E%) carbohydrates with total fat was 0.42 L (95% CI: 0.04, 0.79) for VAT. A substitution in total fat intake by 5E% was associated with a significant increase in liver fat content by 23% (p-value 0.004). If reproduced in prospective studies, such findings would strongly argue for limiting dietary fat intake.


Assuntos
Adiposidade , Carboidratos da Dieta/administração & dosagem , Gorduras na Dieta/administração & dosagem , Ingestão de Energia , Gordura Intra-Abdominal/diagnóstico por imagem , Fígado/diagnóstico por imagem , Imagem por Ressonância Magnética , Gordura Subcutânea/diagnóstico por imagem , Idoso , Carboidratos da Dieta/metabolismo , Gorduras na Dieta/metabolismo , Feminino , Humanos , Gordura Intra-Abdominal/metabolismo , Fígado/metabolismo , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Gordura Subcutânea/metabolismo
13.
Ter Arkh ; 91(4): 62-66, 2019 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-31094478

RESUMO

AIM: To estimate clinical significance of lipohypertrophy (LH) without visual and palpable changes, detected by ultrasonography of subcutaneous fat. MATERIALS AND METHODS: This study included 140 diabetic patients who received insulin in basal-bolus regimen. Ultrasonography of subcutaneous fat was performed for LH diagnostics in these diabetic patients. Than clinical significance of LH without visual and palpable changes was estimated. HbA1c level, fasting and postprandial glucose, episodes of hypoglycemia, body mass index (BMI) and scheme of insulinotherapy were evaluated at the moment of LH, after 3 and 6 months in all patients. RESULTS: After changing injection sites, good results were demonstrated by measuring glucose and HbA1c level. Thus fasting glucose decreased from 9.03±1.98 mmol/l to 7.11±0.95 mmol/l (p=0.023). Postprandial glucose reduced from 10.27±2.72 mmol/l to 9.34±1.21 mmol/l (p=0.011). HbA1c level reduced from 9.27±1.75% to 7.43±1.02% (p=0.002). Also BMI decreased from 33.75±3.49 kg/m2 to 30.5±2.96 kg/m2 (p=0.018). CONCLUSION: LH without visual and palpable changes could worsen compensation of glycemic control and leads to hypoglycemia and chronic Somogyi rebound. So, LH without visual and palpable is as important and clinically significant as classic LH.


Assuntos
Glicemia/análise , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/efeitos adversos , Insulina/efeitos adversos , Lipodistrofia/induzido quimicamente , Gordura Subcutânea/diagnóstico por imagem , Ultrassonografia/métodos , Diabetes Mellitus Tipo 2/sangue , Hemoglobina A Glicada/análise , Humanos , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/uso terapêutico , Insulina/administração & dosagem , Insulina/uso terapêutico , Lipodistrofia/sangue
14.
Diabetes ; 68(6): 1168-1177, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30936147

RESUMO

Patterns of abdominal fat distribution (for example, a high vs. low visceral adipose tissue [VAT]/[VAT + subcutaneous adipose tissue (SAT)] ratio), independent of obesity, during adolescence carry a high risk for insulin resistance and type 2 diabetes. Longitudinal follow-up of a cohort of obese adolescents has recently revealed that a high ratio (high VAT/[VAT + SAT]) is a major determinant of fatty liver and metabolic impairment over time, with these effects being more pronounced in girls than in boys. To unravel the underlying metabolic alterations associated with the unfavorable VAT/(VAT + SAT) phenotype, we used the 2H2O labeling method to measure the turnover of adipose lipids and cells in the subcutaneous abdominal and gluteal/femoral adipose tissue (SAT) of weight-stable obese adolescent girls with a similar level of obesity but discordant VAT/(VAT + SAT) ratios. Girls with the unfavorable (high VAT/[VAT + SAT]) phenotype exhibited higher in vivo rates of triglyceride (TG) turnover (representing both lipolysis and synthesis at steady state), without significant differences in de novo lipogenesis in both abdominal and gluteal depots, compared with obese girls with the favorable phenotype. Moreover, mature adipocytes had higher turnover, with no difference in stromal vascular cell proliferation in both depots in the metabolically unfavorable phenotype. The higher TG turnover rates were significantly correlated with higher intrahepatic fat stores. These findings are contrary to the hypothesis that impaired capacity to deposit TGs or proliferation of new mature adipocytes are potential mechanisms for ectopic fat distribution in this setting. In summary, these results suggest that increased turnover of TGs (lipolysis) and of mature adipocytes in both abdominal and gluteal SAT may contribute to metabolic impairment and the development of fatty liver, even at this very early stage of disease.


Assuntos
Adipócitos/metabolismo , Distribuição da Gordura Corporal , Obesidade/metabolismo , Gordura Subcutânea/metabolismo , Triglicerídeos/metabolismo , Absorciometria de Fóton , Adolescente , Óxido de Deutério , Feminino , Humanos , Gordura Intra-Abdominal/diagnóstico por imagem , Metabolismo dos Lipídeos , Lipogênese , Imagem por Ressonância Magnética , Obesidade Abdominal/diagnóstico por imagem , Obesidade Abdominal/metabolismo , Gordura Subcutânea/diagnóstico por imagem , Adulto Jovem
16.
Dermatol Surg ; 45(12): 1531-1541, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-30998531

RESUMO

BACKGROUND: ATX-101 (deoxycholic acid injection) is approved for reduction of moderate or severe submental fat (SMF). OBJECTIVE: To evaluate the efficacy and safety of ATX-101 in subjects with mild or extreme SMF. PATIENTS AND METHODS: Adults with mild or extreme SMF (based on clinician assessment) were randomized to receive ≤6 treatments with ATX-101 or placebo. Efficacy end points, evaluated at 12 weeks after last treatment, included percentage of subjects who achieved ≥1-grade improvement in SMF from baseline based on both clinician and patient assessment (composite CR-1/PR-1 response) as well as multiple subject-reported outcomes. Safety end points included change in skin laxity and incidence of adverse events. RESULTS: Overall, 61.3% of ATX-101-treated subjects versus 6.7% of placebo-treated subjects with mild SMF and 89.3% versus 13.3% of subjects, respectively, with extreme SMF achieved a composite CR-1/PR-1 response (p < .001 for both). ATX-101-treated subjects also reported higher levels of satisfaction and greater reductions in the psychological impact of SMF versus placebo-treated subjects regardless of baseline SMF severity. Skin laxity was unchanged or improved in most of the subjects. Adverse events were mainly mild/moderate, transient, and associated with the injection site. CONCLUSION: ATX-101 was efficacious and well tolerated for reduction of mild or extreme SMF.


Assuntos
Ácido Desoxicólico/administração & dosagem , Satisfação do Paciente , Ritidoplastia/métodos , Gordura Subcutânea/diagnóstico por imagem , Adolescente , Adulto , Idoso , Queixo , Ácido Desoxicólico/efeitos adversos , Método Duplo-Cego , Estética , Feminino , Humanos , Injeções Subcutâneas/efeitos adversos , Lipólise/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Placebos/administração & dosagem , Placebos/efeitos adversos , Resultado do Tratamento , Adulto Jovem
17.
Am J Physiol Endocrinol Metab ; 317(2): E194-E199, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31013145

RESUMO

Positron emission tomography (PET) radiopharmaceuticals can noninvasively measure free fatty acid (FFA) uptake into adipose tissue. We studied 29 volunteers to test whether abdominal and femoral subcutaneous adipose tissue FFA uptake measured using [1-11C]palmitate PET agrees with FFA storage rates measured using an intravenous bolus of [1-14C]palmitate and adipose biopsies. The dynamic left ventricular cavity PET images combined with blood sample radioactivity corrected for the 11CO2 content were used to create the blood time activity curve (TAC), and the constant (Ki) was determined using Patlak analysis of the TACs generated for regions of interest in abdominal subcutaneous fat. These data were used to calculate palmitate uptake rates in abdominal subcutaneous adipose tissue (µmol·kg-1·min-1). Immediately after the dynamic imaging, a static image of the thigh was taken to measure the standardized uptake value (SUV) in thigh adipose tissue, which was scaled to each participant's abdominal adipose tissue SUV to calculate thigh adipose palmitate uptake rates. Abdominal adipose palmitate uptake using PET [1-11C]palmitate was correlated with, but significantly (P < 0.001) greater than, FFA storage measured using [1-14C]palmitate and adipose biopsy. Thigh adipose palmitate measured using PET calculation was positively correlated (R2 = 0.44, P < 0.0001) with and not different from the biopsy approach. The relative differences between PET measured abdominal subcutaneous adipose tissue palmitate uptake and biopsy-measured palmitate storage were positively correlated (P = 0.03) with abdominal subcutaneous fat. We conclude that abdominal adipose tissue FFA uptake measured using PET does not equate to adipose FFA storage measured using biopsy techniques.


Assuntos
Tecido Adiposo/patologia , Ácidos Graxos não Esterificados/farmacocinética , Tomografia por Emissão de Pósitrons , Gordura Subcutânea/diagnóstico por imagem , Gordura Subcutânea/metabolismo , Tecido Adiposo/diagnóstico por imagem , Adiposidade/fisiologia , Adulto , Biópsia , Distribuição da Gordura Corporal/métodos , Índice de Massa Corporal , Isótopos de Carbono/análise , Isótopos de Carbono/farmacocinética , Radioisótopos de Carbono/análise , Radioisótopos de Carbono/farmacocinética , Feminino , Humanos , Peso Corporal Ideal/fisiologia , Lipólise/fisiologia , Masculino , Obesidade/metabolismo , Obesidade/patologia , Sobrepeso/metabolismo , Sobrepeso/patologia , Ácido Palmítico/química , Ácido Palmítico/farmacocinética , Tomografia por Emissão de Pósitrons/métodos
18.
Endocr J ; 66(7): 605-613, 2019 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-31019152

RESUMO

In this study, we investigated the relationships between body weight (BW), computed tomography (CT)-assessed abdominal adipose tissue, and the glycemic metabolic profile in obese Japanese patients following laparoscopic sleeve gastrectomy (LSG). This study analyzed adipose tissue compartments using CT methods before and 1 year after LSG. Thirty obese patients were studied, and variables measured included visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), density of VAT (VAT-D), and density of SAT (SAT-D). We also examined the parameters in patients according to whether they had type-2 diabetes (T2DM). LSG induced significant losses in BW, SAT, and VAT after LSG. Additionally, SAT-D and VAT-D both increased and fasting plasma glucose (FPG) and HbA1c, but not C-peptide, decreased after surgery. ΔSAT and ΔVAT were positively related, and ΔSAT-D and ΔVAT-D were negatively related to ΔBW and/or FPG. Furthermore, a multivariate regression model showed that total BW loss (TBWL) was closely related to ΔSAT (ß = 0.84; p < 0.001) and ΔVAT-D (ß = -0.45; p < 0.05) and improvement of FPG was related to ΔVAT (ß = 0.61; p < 0.05) after LSG. Finally, ΔFPG was correlated with ΔVAT in 16 T2DM patients (r = 0.58; p < 0.05) but not in non-T2DM patients. TBWL was related to ΔSAT and ΔVAT-D, and improvement of FPG was related to ΔVAT in obese Japanese patients after LSG.


Assuntos
Gordura Abdominal/diagnóstico por imagem , Gordura Abdominal/patologia , Glicemia/metabolismo , Gordura Intra-Abdominal/diagnóstico por imagem , Gordura Intra-Abdominal/patologia , Obesidade Mórbida/cirurgia , Gordura Abdominal/metabolismo , Adulto , Metabolismo Energético/fisiologia , Feminino , Gastrectomia/métodos , Humanos , Gordura Intra-Abdominal/metabolismo , Japão , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/metabolismo , Obesidade Mórbida/patologia , Tamanho do Órgão , Estudos Retrospectivos , Gordura Subcutânea/diagnóstico por imagem , Gordura Subcutânea/metabolismo , Gordura Subcutânea/patologia , Tomografia Computadorizada por Raios X
19.
Plast Reconstr Surg ; 143(6): 1605-1613, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30907804

RESUMO

BACKGROUND: Soft-tissue filler injections for the treatment of facial aging can result in different skin surface effects depending on the targeted facial fat compartment and fascial plane. This work investigates the tissue response of defined amounts of soft-tissue filler material injected into superficial and deep facial fat compartments by means of the calculation of the surface-volume coefficient. METHODS: Four fresh frozen cephalic specimens obtained from human donors (three female and one male; mean age, 74.96 ± 22.6 years; mean body mass index, 21.82 ± 6.3 kg/m) were studied. The superficial and deep lateral forehead compartments, deep temporal fat pad, sub-orbicularis oculi fat compartment, and deep medial cheek fat compartment were injected with aliquots of 0.1 cc of contrast-enhanced material and scanned using three-dimensional surface imaging, resulting in a total of 226 injection and scanning procedures. RESULTS: The sub-orbicularis oculi fat compartment revealed the highest correlation coefficient (rp = 0.992; p < 0.001) and the highest surface-volume coefficient (0.94). The compartment with the lowest tissue response was the deep medial cheek fat compartment (rp = 0.745; p < 0.001; surface-volume coefficient = 0.29), followed by the deep lateral forehead compartment (rp = 0.814; p < 0.001; surface-volume coefficient = 0.68), superficial lateral forehead compartment (rp = 0.824; p < 0.001; surface-volume coefficient = 0.74), and deep temporal fat pad (rp = 0.947; p < 0.001; overall surface-volume coefficient = 0.64). CONCLUSIONS: These results, confirmatory in their nature to current injection strategies, provide evidence for the validity and reliability of the surface-volume coefficient. Injection procedures should be targeted in terms of facial fat compartments and fascial planes for a desired aesthetic outcome, as each fat compartment and fascial plane has unique tissue responses to injected soft-tissue fillers.


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Imageamento Tridimensional , Tecido Adiposo/anatomia & histologia , Tecido Adiposo/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Cadáver , Preenchedores Dérmicos , Dissecação , Face/anatomia & histologia , Face/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Envelhecimento da Pele , Gordura Subcutânea/anatomia & histologia , Gordura Subcutânea/diagnóstico por imagem
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