Correlation between Abdominal Wall Subcutaneous Fat Thickness and Heart Weight in Southern Chinese Population / 法医学杂志

Objective To study the correlation between the abdominal wall subcutaneous fat thickness and heart weight, so as to provide reference for prediction methods of normal range of heart weight that is suitable for autopsy in China. Methods The forensic pathology autopsy cases accepted by Center for Medicolegal Expertise of Sun Yat-sen University from 1998 to 2017 were collected. Then the exclusion criteria were determined, and according to them the total case group was selected, and the 6 disease groups and the normal group were further selected from the total case group. The rank sum test was used to compare the heart weight of the normal group and the disease groups to determine the influence of diseases on heart weight. Then the Spearman rank correlation analysis of abdominal wall subcutaneous fat thickness and heart weight in different genders and different ages in the total case group and the normal group was conducted to get the correlation coefficient （rs）. Results In the total case group, correlation between abdominal wall subcutaneous fat thickness and heart weight was shown in males of all ages （P<0.05）; while in females, the correlation had no statistical significance （P>0.05） in 15-<20 age and 50-<60 age, but was statistically significant （P<0.05） in other age groups. For the males in the normal group, rs was respectively 0.411, 0.541 and 0.683 in the 15-<40 age, the 40-<60 age, and the ≥60 age. For the females, rs was respectively 0.249 and 0.317 in the 15-<40 age and the 40-<60 age. The correlation in the ≥60 age had no statistical significance（P>0.05）. Conclusion In the general population and the normal population, abdominal wall subcutaneous fat thickness is correlated with the heart weight of males. It is of significance to include the abdominal wall subcutaneous fat thickness in the prediction of normal range of heart weight for males in China.

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.

Uso da ultrassonografia para avaliar a espessura muscular e a gordura subcutânea em crianças e adolescentes com fibrose cística / The use of ultrasonography to evaluate muscle thickness and subcutaneous fat in children and adolescents with cystic fibrosis

RESUMO Objetivo: Comparar a espessura muscular e a gordura subcutânea entre pacientes com fibrose cística (FC) e controles saudáveis e correlacionar os achados ultrassonográficos com variáveis nutricionais, clínicas e de função pulmonar. Métodos: Foram incluídos sujeitos (6 a 18 anos) com o diagnóstico de FC e indivíduos saudáveis. Foram realizadas medidas antropométricas, avaliação ultrassonográfica da espessura muscular e da gordura subcutânea do tríceps, quadríceps e da região do gastrocnêmio, além da quantificação das pregas cutâneas. O percentual de gordura corporal foi estimado pelas pregas cutâneas. Osindivíduos com FC também tiveram a função pulmonar avaliada por espirometria. Resultados: Foram incluídos 39 pacientes com FC e 45 controles. Ossujeitos com FC apresentaram do índice de massa corporal menor (p=0,011). Acomposição corporal e a espessura muscular foram similares entre os grupos. Apenas a circunferência da panturrilha (p=0,023) e o diâmetro do fêmur (p<0,001) foram menores nos pacientes com FC. Embora sem diferença na comparação dos achados ultrassonográficos da gordura subcutânea, os pacientes com FC apresentaram redução das dobras cutâneas do tríceps (p=0,0031) e do quadríceps (p=0,019). Além disso, observaram-se correlações fracas e moderadas da espessura do quadríceps pelo ultrassom com a capacidade vital forçada (CVF) e massa magra, respectivamente. Também houve correlações moderadas das pregas cutâneas do tríceps, quadríceps e gastrocnêmio com a gordura subcutânea avaliada pela ultrassonografia. Conclusões: Pacientes com FC apresentaram menor espessura da gordura subcutânea. A espessura muscular se correlacionou com a CVF e os parâmetros nutricionais, e a ultrassonografia apresentou correlação positiva com as pregas cutâneas.

ABSTRACT Objective: To compare muscle thickness and subcutaneous fat in cystic fibrosis (CF) patients and healthy controls using ultrasonography (US), and to correlate US findings with nutritional, clinical and functional variables. Methods: Patients aged 6 to 18 years old with a diagnosis of CF and healthy controls were included. Participants underwent anthropometric measurements, an ultrasonographic evaluation of muscle thickness and subcutaneous fat in the triceps, quadriceps, and gastrocnemius regions, and skinfold thickness measurements. Body fat percentage was estimated using skinfold measurement. Subjects with CF also underwent a pulmonary function assessment using spirometry. Results: We studied 39 CF patients and 45 controls. Alower body mass index was observed in CF patients (p=0.011). Body composition and muscle thickness were similar between the groups. Only calf (p=0.023) circumference and femur diameter (p<0.001) were lower in CF patients. Although there were no significant between-group differences in the comparison of US measurements of subcutaneous fat, CF patients exhibited decreased skinfold thickness in the triceps (p=0.031) and quadriceps (p=0.019). Moreover, there were weak and moderate correlations of US quadricep thickness with forced vital capacity (FVC) and lean mass, respectively. Moderate correlations of the triceps, quadriceps and gastrocnemius between US subcutaneous fat and skinfold measurements were found. Conclusions: Patients with CF presented a reduction in subcutaneous fat content. Muscle thickness correlated with FVC and nutritional parameters. In addition, US findings correlated positively with skinfold measurements.

Waist circumference measurement sites and their association with visceral and subcutaneous fat and cardiometabolic abnormalities

ABSTRACT Objectives: To estimate the degree of variability of the waist circumference (WC) when obtained in different anatomical sites and compare the performance of the measurement sites as predictors of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) and cardiometabolic abnormalities. Subjects and methods: Cross-sectional study involving 119 individuals with overweight (50.3 ± 12.2 years), in which six WC measurement sites were evaluated (minimal waist, immediately below the lowest rib, midpoint between the lowest rib and the iliac crest, 2 cm above the umbilicus, immediately above the iliac crest, umbilicus level), in addition to the VAT and SAT (quantified by computed tomography) and cardiometabolic parameters. Results: The differences between the measurements ranged from 0.2 ± 2.7 cm to 6.9 ± 6.7 cm for men, and from 0.1 ± 3.7 cm to 10.1 ± 4.3 cm for women. The minimum waist showed significant correlation with VAT (r = 0.70) and with a higher number of cardiometabolic parameters among men. Regarding women, the WC measurement showed high correlation with SAT and moderate correlation with VAT, not being found superiority of one measurement protocol in relation to the others when assessed the correlation with VAT and with cardiometabolic parameters. Conclusions: Greater variability between the measuring sites was observed among women. With respect to men, the minimum waist performed better as a predictor of VAT and cardiometabolic alterations.

Prediction of Optimal Gluteal Intramuscular Needle Length by Skinfold Thickness Measurements in Korean Adults

PURPOSE: This study was conducted to assess optimal needle length for gluteal intramuscular injections (IM) via simple skinfold thickness (SFT). METHODS: For this study, 190 healthy adults were recruited and grouped into eight groups according to gender and body mass index (BMI) (kg/m2). The Korean Society for the Study of Obesity criteria defines a BMI under 20 as underweight, 20.1-22.9 as normal, 23-24.9 as overweight and over 25 as obese. For each participant, the SFT of dorsoguteal (DG) and ventrogluteal (VG) sites were measured using a caliper. Subcutaneous tissue thickness was acquired through ultrasonic images. RESULTS: For men in the overweight and obese groups at the DG site, for the obese group at the VG site, and for women in the normal weight, overweight and obese groups at both sites, the mean subcutaneous tissue thickness exceeded 1.84 cm, the minimal length for a 1 inch needle used for IM. At the DG site, optimal intramuscular needle length (OINL) was 1.4 times in women and 1.0 times in men compared to SFT. At the VG site, OINL was 1.3 times in women and 0.9 times in men compared to SFT. CONCLUSION: The results of this study suggest that SFT is a reliable index to determine optimal needle length with minimal effort prior to IM.

Gluteal Subcutaneous Fat Thickness Measured by Computed Tomography as an Estimate of Proper Gluteal Intramuscular Injections in Korean Adults

PURPOSE: To study the thickness of gluteal subcutaneous fat (SCF) and propose an adequate length for needle for gluteal intramuscular injections based on computed tomography (CT) measurements. METHODS: The thickness of gluteal SCF were measured and studied for 568 patients who visited a tertiary hospital in Seoul, Korea between January 2007 and February 2009 for routine health screening and who had abdominopelvic CT. RESULTS: The average thickness of gluteal SCF was 15.92+/-4.08 mm in males and 24.90+/-5.47 mm in females. The thickness of gluteal SCF differed significantly according to gender. The gluteal SCF thickness was greater than 20.4 mm for 54 (12.3%) of the 440 male patients and 99 (77.3%) of the 128 female patients. CONCLUSION: The most common syringe needle used for gluteal intramuscular injections in Korea is a 23 G, 25.4 mm-needle. The SCF thickness must be less than 20.4 mm in order to reach the dorsogluteal muscles to a depth of at least 5 mm if this 25.4 mm needle is used. In many patients, especially in female patients, the 25.4 mm needles will result in improper intramuscular injections with the injection being into the SCF. Therefore an appropriate needle should be selected by considering the gender and SCF thickness of patients receiving gluteal intramuscular injections.