Association between visceral/subcutaneous adipose tissue ratio and plasma inflammatory markers and score for cardiovascular risk prediction in a Brazilian cohort: Pró-Saúde Study

Visceral adipose tissue (VAT) is associated with various metabolic disorders, and adipokines, secreted by adipose tissue, are involved in their pathogenesis. This study investigated associations between VAT/subcutaneous adipose tissue (SAT) ratio, inflammatory markers, and cardiovascular (CV) risk-score in adults. Plasma levels of adipokines, plasma lipid profile, blood pressure, and body composition (using dual-emission x-ray absorptiometry) were determined. CV risk-score based on the American College of Cardiology and the American Heart Association (ACC/AHA) score was calculated in a sample of 309 Brazilian civil servants aged <60 years. Participants' VAT/SAT ratio were categorized into quartiles. Among males, plasma leptin (2.8 ng/mL) and C reactive protein (CRP) (0.2 mg/dL) (P<0.05) levels were higher at P75 and P50 than P5, and the highest calculated CV risk-score was observed at P75 (7.1%). Among females, higher plasma adiponectin levels were observed at P25 (54.3 ng/mL) compared with P75 (36 ng/mL) (P<0.05). Higher plasma CRP levels were observed at P75 (0.4 mg/dL) compared with P5 (0.1 mg/dL) (P<0.05). Higher CV risk-score was observed at P75 (2.0%) compared with P5 (0.7%). In both sexes, VAT and VAT/SAT ratio were directly associated with plasma leptin, CRP, and CV risk-score, and inversely associated with adiponectin; SAT was directly associated with plasma leptin and CRP (P<0.01); interleukin (IL)-10 and CRP were directly associated with adiponectin and leptin, respectively (P<0.05). Among men only, IL-10 (inversely) and CRP (directly) were associated with CV risk-score (P=0.02). Our results strengthened the relevance of the VAT/SAT ratio in cardiovascular risk.

Hashtag bone: detrimental effects on bone contrast with metabolic benefits one and five years after Roux-en-Y gastric bypass

Bone loss is a potential adverse consequence of rapid and sustained weight loss after bariatric surgery. The aim of the present study was to evaluate the bone mass, body fat distribution, and metabolic parameters in women submitted to Roux-en-Y gastric bypass (RYGB). The study included the following three groups: one group of lean women (control [C] group) and two groups of obese women, one evaluated one year (B1) and the other five years (B5) after RYGB. Dual-energy X-ray absorptiometry and magnetic resonance imaging were used to determine bone mineral density (BMD; lumbar spine, total hip, and femoral neck) and abdominal fat content (subcutaneous [SAT] and visceral [VAT] adipose tissues, and intrahepatic lipids [IHL]). The BMD/body mass index ratio was lower in the B5 compared with the C group at all sites. Serum C-terminal telopeptide of type I collagen (CTX) levels were higher in the B1 and B5 groups compared with the C group. Individuals submitted to RYGB showed greater SAT but similar VAT and IHL values compared with those in the C group. However, the B5 group had higher mean parathyroid hormone levels compared with the other two groups. Individuals submitted to RYGB presented increased levels of CTX and low BMD for body weight than those in the C group, suggesting that bone catabolism is a persistent alteration associated with RYGB. In conclusion, the long-lasting metabolic benefits obtained with RYGB in obesity are counterbalanced by a persistent catabolic effect of the procedure on bone and mineral metabolism.

Agreement between software programmes of body composition analyses on abdominal computed tomography scans of obese adults

ABSTRACT Objective A large number of studies have used abdominal computed tomography (CT) to quantify body composition, and different software programmes have been used to perform these analyses. Thus, this comparison is important to enable researchers to know the performance of more accessible software. Subjects and methods Fifty-four abdominal CT scans of obese (BMI 30 to 39.9 kg/m2), sedentary adults (24-41 years) patients from a Brazilian single center were selected. Two software programs were compared: Slice-O-Matic (Tomovision, Canada) version 5.0 and OsiriX version 5.8.5. The body composition analysis were segmented using standard Hounsfield unit (HU) (adipose tissue: -190 to +30 and skeletal muscle: -29 to +150) and measured at the mid third lumbar vertebra (L3) level on a slice showing both transversal processes. Bland-Altman limits of agreement analyses were used to assess the level of agreement between Slice-O-Matic and OsiriX. Results A total of fifty-four participants were evaluated, with majority women (69%), mean of age 31.3 (SD 6.5) years and obesity grade I most prevalent (74.1%). The agreement, in Bland-Altman analysis, between Slice-O-Matic and OsiriX analisys for the muscle mass tissue, visceral adipose tissue and subcutaneous adipose tissue were excellent (≥ 0.954) with P-values < 0.001. Conclusion These findings show that Slice-O-Matic and OsiriX softwares agreement in measurements of skeletal muscle and adipose tissue and sarcopenia diagnosis in obese patients, suggesting good applicability in studies with body composition in this population and clinical practice.

Cambios en el perfil proteómico de preadipocitos con diferentes condiciones metabólicas / Changes in the proteomic pro/ile of preadipocytes with different metabolic status

Resumen Introducción y objetivos: El tejido adiposo subcutáneo se considera un depósito con un papel protector desde un punto de vista metabólico. El exceso de tejido adiposo desencadena en obesidad, la cual, está acompañada típicamente por resistencia a insulina, dislipidemia, e hipertensión arterial. No obstante, se conoce que existe un subgrupo de obesos que parecen estar protegidos de dichas complicaciones. Estos individuos son definidos como obesos sanos metabólicamente. A pesar de los avances en el conocimiento de las alteraciones que suceden en el tejido adiposo en obesidad, aún se desconocen los mecanismos que subyacen en el desarrollo de resistencia a insulina. Por lo tanto, en este trabajo, se estudió la asociación entre obesidad y desarrollo de enfermedad metabólica identificando factores y procesos que determinan la transición desde el fenotipo obeso sano y no sano, empleando preadipocitos provenientes de tejido adiposo subcutáneo. Metodología: Se emplearon datos de un estudio de proteómica comparada de preadipocitos de tejido subcutáneo obtenidos de pacientes obesos normoglucémicos no resistentes a insulina y de pacientes obesos con diabetes mellitus de tipo 2. El estudio proteómico, se llevó a cabo utilizando la técnica de iTRAQ combinada con LC-MSMS. Resultados y conclusiones: Las diferencias entre preadipocitos de tejido adiposo subcutáneo en sujetos normoglucémicos y con diabetes, afectan sobre todo a proteínas citosólicas y, en particular, a proteínas relacionadas con procesos metabólicos mientras que, las membranales no cambian entre fenotipos obesos. En el estudio se identificaron importantes diferencias en el perfil proteómico de los preadipocitos de tejido adiposo subcutáneo en obesidad, tanto en sujetos normoglucémicos como diabéticos, apoyando la importancia de estas células en el mantenimiento de la identidad del depósito graso. También se encontró que, la transición desde el fenotipo obeso sano hacia el no sano conlleva un mayor desarrollo de estrés oxidativo e inflamación en las células precursoras adipocitarias.

Abstract Introduction and objectives: The subcutaneous adipose tissue is considered as a depot with a protective role from a metabolic point of view. An excess of adipose tissue is triggered in obesity, which is accompanied by insulin resistance, dyslipidemia and arterial hypertension. However, it is known that, there is a subgroup of obese people who seem to be protected from obese complications. These individuals are defined as metabolically healthy obese. Despite the advances in the knowledge of the alterations that occur in adipose tissue during obesity, the mechanisms underlying the development of insulin resistance are still unknown. Therefore, in this work, we studied the association between obesity and the development of metabolic disease, we identified factors and processes that determined the transition of healthy and unhealthy obesity phenotype, using preadipocytes from subcutaneous adipose tissue. Methods: Data obtained from a comparative proteomics study of subcutaneous adipose tissue preadipocytes from normoglycemic obese patients-not resistant to insulin and from obese patients with type 2 diabetes mellitus were used. The proteomic study was carried out using the iTRAQ combined with LC -MSMS. Results and conclusions: The differences between pre-adipocytes of subcutaneous adipose tissue in normoglycemic subjects and with diabetes affect mainly cytosolic proteins and, in particular, proteins related to metabolic processes while, membrane proteins do not change between obese phenotypes. In this study, we identified significant differences in the proteomic profile of preadipocytes from subcutaneous adipose tissue in obesity in both, normoglycemic and diabetic subjects, supporting the importance of these cells in the maintenance of the fat depot identity. We also found that, the transition from unhealthy to healthy phenotype in obesity, leads to further development of oxidative stress and inflammation in adipocyte precursor cells.

Different gene expression profiles in subcutaneous & visceral adipose tissues from Mexican patients with obesity

Background & objectives: Obesity is a health problem that requires substantial efforts to understand the physiopathology of its various types and to determine therapeutic strategies for its treatment. The objective of this study was to characterize differences in the global gene expression profiles of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) between control patients (normal weight) and patients with obesity (IMC?30) using microarrays. Methods: Employing RNA isolated from SAT and VAT samples obtained from eight control and eight class I, II and III patients with obesity, the gene expression profiles were compared between SAT and VAT using microarrays and the findings were validated via real-time quantitative polymerase chain reaction. Results: A total of 327 and 488 genes were found to be differentially expressed in SAT and VAT, respectively (P?0.05). Upregulation of PPAP2C, CYP4A11 and CYP17A1 genes was seen in the VAT of obese individuals. Interpretation & conclusions: SAT and VAT exhibited significant differences in terms of the expression of specific genes. These genes might be related to obesity. These findings may be used to improve the clinical diagnosis of obesity and could be a tool leading to the proposal of new therapeutic strategies for the treatment of obesity.

Change of gene expressions in perirenal adipose tissues of overweight and obese subjects / 中华内分泌代谢杂志

Objective@#To determine the change of gene expressions in human perirenal adipose tissue (PAT) and oblique abdomen subcutaneous adipose tissue (SAT) of overweight and obese subjects.@*Methods@#Ninety-seven patients, including 35 overweight/obese patients and 62 non-obese patients, who underwent renal surgery were included. The clinical data and various gene expressions in PAT and SAT of two groups were analyzed.@*Results@#Body mass index, waist circumference, systolic blood pressure, resting heart rate, fasting blood glucose, and serum creatinine were significantly higher in overweight/obese patients than those in non-obese patients(P<0.05 or P<0.01). Compared with non-obese patients, PAT adipocytes showed bigger, and the expressions of uncoupling protein-1 (UCP1) mRNA and protein were markedly lower in overweight/obese patients. The mRNA expressions of CIDEA and adiponectin in PAT of overweight/obese patients were significantly lower, while leptin, monocyte chemotactic protein 1, interleukin (IL)-6, and IL-10 mRNA expressions were significantly higher. There were no significant differences in the related gene expressions of SAT between the two groups.@*Conclusions@#Different parts of adipose tissue reveal various characteristics, and play different roles in the occurrence and development of obesity. UCP1 expression is decreased in PAT of overweight/obese patients, with the changes of adipocytokine expressions. (Chin J Endocrinol Metab, 2018, 34: 567-572)

Study on heterogeneity between visceral adipose tissue and subcutaneous adipose tissue / 中国糖尿病杂志

[Summary] The increasing prevalence of obesity has led to extensive research on white adipose tissue. Currently ,functional differences among white adipose tissue depots have become clear ,especially between visceral adipose tissue (VAT ) and subcutaneous adipose tissue (SAT ). This article will review the heterogeneity of distribution ,structure ,function ,influence factors ,measurement methods and metabolic properties between VAT and SAT.

The production and distribution of IL-6 and TNF-alpha in subcutaneous adipose tissue and their correlation with serum concentrations in Welsh ponies with equine metabolic syndrome

A main symptom of equine metabolic syndrome (EMS) in ponies is pathological obesity characterized by abnormal accumulation of fat deposits and inflammation. In this study, we analyzed the expression of two pro-inflammatory cytokines, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha), in subcutaneous adipose tissue and the correlation with serum concentrations in peripheral blood of Welsh ponies. Based on clinical examination findings, the animals were divided into two groups: ponies affected with EMS (n = 8) and obese ponies (n = 8). The adipose tissue was examined using immunohistochemical analysis while concentrations IL-6 and TNF-alpha were measured using enzyme-linked immunosorbent assays (ELISAs). Additionally, histological characterization of the adipose tissue was performed. The results obtained showed that IL-6 expression in adipose tissue biopsies derived from animals with EMS was enhanced while TNF-alpha levels of both groups were comparable. Compared to the obese ponies, EMS animals also had significantly elevated levels of serum IL-6 and TNF-alpha. Histological analysis revealed macrophage infiltration and fibrosis in adipose tissue preparations from the EMS group. These data suggest that IL-6 may play a key role in the course of EMS in Welsh ponies. Our findings also demonstrated that analysis of pro-inflammatory cytokines levels in serum may serve as an additional tool for diagnosing EMS.

A Congenitally Inherited Case of Lipedematous Scalp Involving the Entire Scalp / 대한피부과학회지

Lipedematous scalp was first reported by Cornbleet in 1935, and is characterized by an increase in the thickness of scalp subcutaneous fat tissue without hair changes. We present a case of a 40-year-old female with a diffusely thickened scalp since birth. The lesion was soft, and movable without color changes or hair loss. Histopathologic features and magnetic resonance imaging findings were compatible with a diagnosis of lipedematous scalp involving almost the entire scalp.

Abdominal and Pericardial Fat in Patients with and without Coronary Artery Disease: Computed Tomography Study

OBJECTIVE: There has been a limited investigation looking into the correlation between pericardial fat and abdominal fat with coronary artery disease (CAD) as measured by coronary computed tomographic angiography (CCTA). We proposed that the volume of pericardial fat is larger in patients with CAD than in patients without CAD, and sought to determine which abdominal adiposity index best correlated with pericardial fat volume. METHODS: Participants were examined using CCTA between October 2007 and January 2008. All participants had no previous history of CAD. Pericardial adipose tissue (PAT) volume, abdominal total adipose tissue volume, abdominal subcutaneous adipose tissue volume, and abdominal visceral adipose tissue (AVAT) volume were measured using CCTA. RESULTS: Fifty patients (26.5%) demonstrated CAD, and 139 patients did not demonstrate CAD by CCTA. PAT volume in patients with CAD was larger than that of patients without CAD (173.2+/-64.2 cm3 vs. 147.6+/-50.4 cm3, p<0.01). However, indices of abdominal adiposity were not significantly different between the two groups. Using multivariable analysis, independent predictors of CAD were PAT volume (odds ratio [OR] 1.01, 95% confidence interval [CI] 1.00-1.02, p=0.04), coronary artery calcium score (OR 1.01, 95% CI 1.00-1.01, p<0.01), and typical chest pain (OR 4.88, 95% CI 1.47-16.21, p=0.01). AVAT volume showed a linear correlation with PAT volume. CONCLUSION: PAT volume was an independent predictor of CAD as measured by CCTA. PAT volume was also well correlated with the AVAT volume among the indices of abdominal adiposity.

Hepatogenic differentiation of human mesenchymal stem cells from peritoneal adipose tissue

BACKGROUNDS/AIMS: It has been reported that functional hepatogenic differentiation has the possibility to occur in subcutaneous adipose tissue-derived stem cells. However, no studies have investigated whether the adipose tissue-driven stem cells present in various body parts differ according to hepatogenic differentiations. In this study, stem cells were separated from body visceral fat and abdominal subcutaneous adipose tissue, and cultured, and then hepatogenic differentiation was induced. We aim to investigate the possibilities and aspects of hepatogenic differentiations within the two types of fat cells. METHODS: Omental fat tissues were obtained as visceral fat and abdominal subcutaneous adipose tissues were obtained from patients who had suction-assisted lipectomy. Stem cells were separated from the obtained fat tissues, and then, hepatogenic differentiation was carried out by utilizing 2-step differentiation protocols. RESULTS: After the differentiation, two types of cultured cells that showed the similar neuron-like shapes were changed to cuboidal shapes and included several binucleated cells which could be characteristics of mature hepatocytes. We confirmed that hepatocyte specific genes and proteins such as albumin and CYP3A4 were being expressed. By utilizing the ELISA test, we were able to observe that the albumin was secreted into the culture fluids in both cells. After completing the differentiation, we observed the presence of the hepatocyte specific properties by confirming glycogen storage within the cells and the ICG reagent uptake. CONCLUSIONS: We confirmed that hepatogenic differentiation was possible to occur in the omental fat as well as subcutaneous adipose tissue.

Adipose tissue at the crossroads in the development of the metabolic syndrome, inflammation and atherosclerosis / Tecido adiposo na encruzilhada no desenvolvimento da síndrome metabólica, inflamação e aterosclerose

The authors analyze insulin resistance, the metabolic syndrome and endothelial dysfunction as consequence of a common antecedent, a low grade inflammation, indicating that in obesity there is a chronically activated inflammatory state of the adipose tissue. Furthermore, the inflammatory signaling is discussed according to the adipose tissue depot, visceral or subcutaneous.

Os autores analisam a resistência à insulina, a síndrome metabólica e a disfunção endotelial como consequência de um antecedente comum, a inflamação de baixo nível, o que mostra que a obesidade é um estado inflamatório cronicamente ativado do tecido adiposo. Discute-se, aqui, a sinalização inflamatória de acordo com a localização do tecido adiposo subcutâneo ou visceral.

Clinical Significance of Abdominal Deep Subcutaneous Adipose Tissue in the Obese: Associations with Cardiovascular and Risk Factors

BACKGROUND: It is well known that the metabolic syndrome is associated with visceral adipose tissue (VAT), but several recent studies showed stronger association between the subcutaneous adipose tissue (SAT) and insulin resistance. The purpose of this study was to investigate the clinical significance of deep SAT as a cardiovascular and a metabolic risk factor. METHODS: A cross-sectional survey was conducted among fifty-one subjects (21 men and 30 women) who visited an obesity clinic in Yeungnam University Hospital. We performed cross-sectional abdominal CT, and undertook the novel approach of partitioning SAT into the plane superficial to the fascia within SAT (Superficial SAT) and within subcutaneous adipose tissue (deep SAT), as well as the measurement of VAT. Percent body fat was measured by bioimpedance analysis (Inbody 2.0, Biospace). Fasting blood samples were analyzed for total cholesterol, HDL-cholesterol, TG, LDL-cholesterol, FFA, insulin, uric acid and glucose. Resting blood pressure was measured. RESULTS: After adjustment for age, sex, smoking, alchol and exercise, deep SAT was proved to be significantly and positively correlated with fasting insulin, FFA, and uric acid (P<0.05). VAT was significantly correlated with unfavorable levels of FFA, insulin, HDL-cholesterol, TG and diastolic blood pressure (P<0.05). In stepwise multiple regression analysis, deep SAT was shown to be the most powerful of the adiposity measures for explaining the variance in fasting insulin and uric acid levels (r2=0.196 and 0.225, respectively; both P<0.001; including superficial SAT, deep SAT, VAT). CONCLUSION: Our results suggest that the association exists between deep SAT and fasting insulin, a finding which provides further support to the observation that deep SAT may be involved in insulin sensitivity.

Comparison of modifications of intra-abdominal fat between low calorie diet alon and low calorie diet with exercise in Korean women

BACKGROUND: Obesity and its complicatians are increasing as social ecanamic standard of living is improving and life style has been changing in Korea. There is growing evidence that the visceral/subcutaneous adipose tissue area ratio (VSR) on computed tomography (CI) is closely related to the obesity camplications. Therefore, it is important to determine whether the VSR reduction is praduced during weight loss. The purpose of this study was to observe and campare the amount of reduction of intraabdaminal fat between low calorie diet (LCD) alane and LCD with exercise. METHODS: Sixty obese females were randomly prescribed a LCD alone or a LCD with exercise. Thirty obese females were treated with a LCD of 1,000kcal/d for 8 weeks (group A). Another thirty obese females were treated with a LCD of 1,000kcal/d combined with supervised aerobic exercise for 8 weeks (group B). Weight, height, BMI, and body fat distribution were measured in all subjects immediately before and after 8 weeks of this study. The body fat distribution was assessed by CT, by which the total abdaminal adipose tissue area (AT), subcutaneous abdominal adipose tissue (SAT), intra-abdominal adipose tissue (VAT), and visceral/subcutaneous adipose tissue area ratio (VSR) were measured at the level of the umbilicus. A venous blood sample was taken after an overnight fast to determine lipid, glucose, and insulin concentrations in all subjects before and after 8 weeks of this study. RESULTS: Body weight, BMI, CI' measurement of total (AT), visceral (VAT), and subcutaneous (SAT) fat were found to be decreased significantly in the two groups. The VSR of the group A did not change after weight loss. In contrast, the VSR of the group B decreased significantly (P<0.05) during weight loss. Fasting plasma glucose and total cholesterol levels significantly decreased in the both groups (P<0.001). Fasting plasma insulin and triglyceride levels significantly decreased in the group B, but not in group A. CONCLUSIONS: This study shows that the VSR decreased significantly in group B, but not in group A. Fasting plasma insulin and triglyceride levels decreased significantly in group B, but not in group A. These results suggest that the LCD with exercise is more effective in reducing expected complications of obesity than LCD alone.

Human body composition determined by cadaver dissection / 体力科学

Sixty-two embalmed cadavers of elderly Japanese individuals, ranged in age from 44-98 years (48 males, 14 females), were completely dissected, and the weights of skin plus subcutaneous adipose tissue (SSATW) and Triceps Surae Muscle (TSMW) determined. Then subcutaneous adipose tissue free weight (SSATFW) was determined by subtracting SSATW from body weight (BW) .<BR>SSATW and percentage of SSATW relative to BW in females (8.9 kg, 19.8%) were larger than those in males (6.1 kg, 12.7%) . On the other hand, TSMW and percentage of TSMW relative to BW in males (313.6 g, 0.65%) were larger than those in females (210.6g, 0.49%) . BW, SSATFW, TSMW were highly correlated (p<0.01) with each other in males. However, in females, TSMW was not significantly correlated (p>0.05) with those variables. The slopes of regression lines for SSATW against BW and SSATFW for females were about twice as steep as those for males.<BR>From these results, it was suggested that females carried a higher proportion of their adipose tissue externally than males and relationship between muscle weight and inner adipose tissue weight in females was more variable than in males.