scholarly journals Significance of Adipose Tissue Maintenance in Patients Undergoing Hemodialysis

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1895
Author(s):  
Senji Okuno
Keyword(s):  
Nutritional Status ◽  
Fat Mass ◽  
Visceral Fat ◽  
Subcutaneous Fat ◽  
High Body Mass Index ◽  
Obesity Paradox ◽  
Nutritional Intervention ◽  
Hemodialysis Patients ◽  
Adverse Outcomes ◽  
Body Distribution

In the general population, obesity is known to be associated with adverse outcomes, including mortality. In contrast, high body mass index (BMI) may provide a survival advantage for hemodialysis patients, which is known as the obesity paradox. Although BMI is the most commonly used measure for the assessment of obesity, it does not distinguish between fat and lean mass. Fat mass is considered to serve as an energy reserve against a catabolic condition, while the capacity to survive starvation is also thought to be dependent on its amount. Thus, fat mass is used as a nutritional marker. For example, improvement of nutritional status by nutritional intervention or initiation of hemodialysis is associated with an increase in fat mass. Several studies have shown that higher levels of fat mass were associated with better survival in hemodialysis patients. Based on body distribution, fat mass is classified into subcutaneous and visceral fat. Visceral fat is metabolically more active and associated with metabolic abnormalities and inflammation, and it is thus considered to be a risk factor for cardiovascular disease and mortality. On the other hand, subcutaneous fat has not been consistently linked to adverse phenomena and may reflect nutritional status as a type of energy storage. Visceral and subcutaneous adipose tissues have different metabolic and inflammatory characteristics and may have opposing influences on various outcomes, including mortality. Results showing an association between increased subcutaneous fat and better survival, along with other conditions, such as cancer or cirrhosis, in hemodialysis patients have been reported. This evidence suggests that fat mass distribution (i.e., visceral fat and subcutaneous fat) plays a more important role for these beneficial effects in hemodialysis patients.

scholarly journals The Impact of Serum Zinc Levels on Abdominal Fat Mass in Hemodialysis Patients

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 656 ◽  
Author(s):  
Hirotaka Fukasawa ◽  
Hiroki Niwa ◽  
Kento Ishibuchi ◽  
Mai Kaneko ◽  
Takamasa Iwakura ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Fat Mass ◽  
Visceral Fat ◽  
Serum Zinc ◽  
Hemodialysis Patients ◽  
Abdominal Muscle ◽  
Abdominal Fat ◽  
Zinc Levels ◽  
The Impact ◽  
Serum Zinc Levels

Background: Zinc deficiency is highly prevalent and is caused by inadequate dietary intake, malabsorption and removal by treatment in hemodialysis patients. This study investigated the relationship between serum zinc levels and nutritional status in hemodialysis patients. Methods: A cross-sectional study examining 87 hemodialysis patients was performed. The serum concentrations of zinc were studied to evaluate their association with nutritional status, which was assessed by measuring abdominal muscle and fat areas with computed tomography. Results: Serum zinc levels were significantly and positively correlated with subcutaneous and visceral fat areas (r = 0.299, p < 0.01, and r = 0.298, p < 0.01, respectively), but not abdominal muscle areas. Multiple regression analyses demonstrated that serum zinc levels were a significant independent predictor of visceral fat areas (p < 0.01), but not subcutaneous fat areas (p = 0.631). Conclusions: Our findings suggest that serum zinc levels could play a crucial role in determining abdominal fat mass in hemodialysis patients.

scholarly journals Comparison of Simplified Creatinine Index and Systemic Inflammatory Markers for Nutritional Evaluation of Hemodialysis Patients

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1870
Author(s):  
Ming-Tsun Tsai ◽  
Wei-Cheng Tseng ◽  
Shuo-Ming Ou ◽  
Kuo-Hua Lee ◽  
Chih-Yu Yang ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Body Mass ◽  
Inflammatory Markers ◽  
Risk Index ◽  
Hemodialysis Patients ◽  
Adverse Outcomes ◽  
Fat Free Mass ◽  
Screening Tools ◽  
Composition Analysis ◽  
Nutritional Risk Index

Protein-energy wasting (PEW) is associated with adverse outcomes in hemodialysis patients. This study compares the simplified creatinine index (SCI) and circulating inflammatory markers as nutritional screening tools for hemodialysis patients. Maintenance hemodialysis patients (230 total patients, 34.8% women, 64.0 ± 14.3 years old) from a tertiary medical center were assessed for demographic data, body composition analysis, biochemistry tests, and circulating inflammatory biomarkers. The SCI was calculated using Canaud’s formula. Reduced fat-free mass index (FFMI), a surrogate of lean body mass, was identified according to the European Society for Clinical Nutrition and Metabolism guidelines. Nutritional status was assessed by the geriatric nutritional risk index (GNRI) and International Society of Renal Nutrition and Metabolism (ISRNM) criteria. Multivariate logistic regression revealed independent risk factors for low FFMI and malnutrition. Of the patients, 47.4% had low FFMI. Patients with a reduction in FFMI tended to be older females with lower body mass index, SCI, and GNRI scores but significantly higher levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and IL-8. SCI was found to be an independent predictor for reduced FFMI (OR 0.57, 95% CI 0.40–0.81) and presence of PEW according to ISRNM criteria (OR 0.38, 95% CI 0.21–0.68). Although a positive association between systemic inflammatory markers and low FFMI was observed, this association disappeared in multivariate analysis. Moreover, the inflammatory markers examined in this study were not associated with malnutrition after adjusting for potential confounders. Compared with markers of systemic inflammation, SCI achieved better performance in assessing the nutritional status of hemodialysis patients.

scholarly journals Phenotypes of Sarcopenic Obesity: Exploring the Effects on Peri-Muscular Fat, the Obesity Paradox, Hormone-Related Responses and the Clinical Implications

Geriatrics ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 8 ◽  
Author(s):  
Tariq A. Alalwan
Keyword(s):  
Postoperative Complications ◽  
Visceral Fat ◽  
Polycystic Ovary ◽  
Subcutaneous Fat ◽  
Visceral Obesity ◽  
Obesity Paradox ◽  
Sarcopenic Obesity ◽  
Clinical Implications ◽  
Hormonal Responses ◽  
Definition Of

Sarcopenic obesity combines the words sarcopenia and obesity. This definition of obesity should be better differentiated between visceral and subcutaneous fat phenotypes. For this reason, this review lays the foundation for defining the subcutaneous and the visceral fat into the context of sarcopenia. Thus, the review aims to explore the missing links on pathogenesis of visceral fat and its relationship on age: defining the peri-muscular fat as a new entity and the subcutaneous fat as a first factor that leads to the obesity paradox. Last but not least, this review underlines and motivates the mechanisms of the hormonal responses and anti-inflammatory adipokines responsible for the clinical implications of sarcopenic visceral obesity, describing factor by factor the multiple axis between the visceral fat-sarcopenia and all mortality outcomes linked to cancer, diabetes, cardiovascular diseases, cirrhosis, polycystic ovary, disability and postoperative complications.

Association of subjective global assessment of nutritional status with gut microbiota in hemodialysis patients: a case–control study

2020 ◽  
Author(s):  
Ting-Yun Lin ◽  
Szu-Chun Hung
Keyword(s):  
Nutritional Status ◽  
Gut Microbiota ◽  
Global Assessment ◽  
Hemodialysis Patients ◽  
Adverse Outcomes ◽  
Subjective Global Assessment ◽  
Protein Energy Wasting ◽  
Β Diversity ◽  
Protein Energy ◽  
Α Diversity

Abstract Background Protein-energy wasting (PEW) is prevalent and associated with adverse outcomes in patients with chronic kidney disease (CKD). However, the pathogenesis of PEW in CKD patients has not been fully identified. The gut microbiota has been implicated in the regulation of host metabolism and energy balance. Therefore, we aimed to explore the association between nutritional status and the composition of the gut microbiota in hemodialysis patients. Methods Gut microbial diversity and taxonomy were examined in 88 hemodialysis patients with PEW (n = 22) and normal nutritional status (n = 66) who were matched 1:3 for age and sex. Nutritional status was assessed by using the 7-point subjective global assessment (SGA) score (1–3 = severe PEW; 4–5 = moderate PEW and 6–7 = normal nutrition). The gut microbiota was assessed by 16S ribosomal RNA gene sequencing. Results Patients with normal nutritional status had a significantly higher body mass index and physical activity and serum albumin levels, but significantly lower levels of inflammatory cytokines than patients with PEW. The most striking finding was that the α-diversity of the gut microbiota was significantly lower in patients with PEW. In a multivariate analysis, the SGA score was independently and positively associated with α-diversity (P = 0.049). Patients with or without PEW were different with respect to the principal coordinate analysis of β-diversity. Notably, the relative abundance of Faecalibacterium prausnitzii, a butyrate-producing bacteria, was markedly reduced in patients with PEW. Conclusion In hemodialysis patients, PEW assessed with the SGA was associated with gut dysbiosis.

scholarly journals Subcutaneous fat mass is associated with genetic risk scores related to proinflammatory cytokine signaling and interact with physical activity in middle-aged obese adults

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
James W. Daily ◽  
Hye Jeong Yang ◽  
Meiling Liu ◽  
Min Jung Kim ◽  
Sunmin Park
Keyword(s):  
Physical Activity ◽  
Fat Mass ◽  
Visceral Fat ◽  
Genetic Variants ◽  
Genetic Risk ◽  
Odds Ratio ◽  
Subcutaneous Fat ◽  
Risk Scores ◽  
Obese Adults ◽  
High Physical Activity

Abstract Background and aims Subcutaneous fat mass is negatively correlated with atherogenic risk factors, but its putative benefits remain controversial. We hypothesized that genetic variants that influence subcutaneous fat mass would modulate lipid and glucose metabolism and have interactions with lifestyles in Korean middle-aged adults with high visceral fat. Materials and methods Subcutaneous fat mass was categorized by dividing the average of subscapular skin-fold thickness by BMI and its cutoff point was 1.2. Waist circumferences were used for representing visceral fat mass with Asian cutoff points. GWAS of subjects aged 40–65 years with high visceral fat (n = 3303) were conducted and the best gene-gene interactions from the genetic variants related to subcutaneous fat were selected and explored using the generalized multifactor dimensionality reduction. Genetic risk scores (GRS) were calculated by weighted GRS that was divided into low, medium and high groups. Results Subjects with high subcutaneous fat did not have dyslipidemia compared with those with low subcutaneous fat, although both subject groups had similar amounts of total fat. The best model to influence subcutaneous fat included IL17A_rs4711998, ADCY2_rs326149, ESRRG_rs4846514, CYFIP2_rs733730, TCF7L2_rs7917983, ZNF766_rs41497444 and TGFBR3_rs7526590. The odds ratio (OR) for increasing subcutaneous fat was higher by 2.232 folds in the high-GRS group, after adjusting for covariates. However, total and LDL cholesterol, triglyceride and C-reactive protein concentrations in the circulation were not associated with GRS. Subjects with high-GRS had higher serum HDL cholesterol levels than those with low-GRS. Physical activity and GRS had an interaction with subcutaneous fat. In subjects with low physical activity, the odds ratio for high subcutaneous fat increased by 2.232, but subcutaneous fat deposition was not affected in the high-GRS group with high physical activity. Conclusion Obese adults with high-GRS had more subcutaneous fat, but they did not show more dyslipidemia and inflammation compared to low-GRS. High physical activity prevented subcutaneous fat deposition in subjects with high GRS for subcutaneous fat.

Visceral Fat: Higher Responsiveness of Fat Mass and Gene Expression to Calorie Restriction than Subcutaneous Fat

2003 ◽  
Vol 228 (10) ◽  
pp. 1118-1123 ◽  
Author(s):  
Yin Li ◽  
Hideaki Bujo ◽  
Kazuo Takahashi ◽  
Manabu Shibasaki ◽  
Yanjuan Zhu ◽  
...  
Keyword(s):  
Gene Expression ◽  
Calorie Restriction ◽  
Fat Mass ◽  
Visceral Fat ◽  
Subcutaneous Fat

scholarly journals Impact of Early Infant Growth, Duration of Breastfeeding and Maternal Factors on Total Body Fat Mass and Visceral Fat at 3 and 6 Months of Age

2017 ◽  
Vol 71 (3-4) ◽  
pp. 203-210 ◽  
Author(s):  
Laura M. Breij ◽  
Marieke Abrahamse-Berkeveld ◽  
Dennis Acton ◽  
Emanuella De Lucia Rolfe ◽  
Ken K. Ong ◽  
...  
Keyword(s):  
Fat Mass ◽  
Visceral Fat ◽  
Subcutaneous Fat ◽  
Breastfeeding Duration ◽  
Growth Duration ◽  
Term Infants ◽  
Maternal Characteristics ◽  
Air Displacement Plethysmography ◽  
Total Body ◽  
Duration Of Breastfeeding

Background: Accelerated gain in fat mass in the first months of life is considered to be a risk factor for adult diseases, given the tracking of infancy fat mass into adulthood. Our objective was to assess the influence of early growth, type of feeding and maternal variables on fat mass in early life. Methods: In 300 healthy term infants, we longitudinally measured fat mass percentage (FM%) by air-displacement-plethysmography at 1, 3, and 6 months and abdominal visceral and subcutaneous fat measured by ultrasound at 3 and 6 months. Results: Both gain in FM% and weight-for-length in the first 3 months were positively associated with FM% at 6 months of age and visceral fat at 3 months of age. Gain in FM% and weight-for-length between 3 and 6 months were both positively associated with visceral fat at 6 months. Breastfeeding duration associated positively with subcutaneous fat but not with visceral fat at 3 and 6 months. Maternal characteristics did not associate with FM% or visceral fat at 3 or 6 months. Conclusion: Higher gain in FM% or in weight-for-length in the first postnatal months leads not only to higher FM% but also more to accumulation of visceral fat. Exclusive breastfeeding appears to promote subcutaneous but not visceral fat in the first 6 months.

The 24-Month Changes in Body Fat Mass and Adipokines in Patients Starting Peritoneal Dialysis

2017 ◽  
Vol 37 (3) ◽  
pp. 290-297 ◽  
Author(s):  
Soo Jeong Choi ◽  
Moo Yong Park ◽  
Jin Kuk Kim ◽  
Seung Duk Hwang
Keyword(s):  
Peritoneal Dialysis ◽  
Fat Mass ◽  
Visceral Fat ◽  
Subcutaneous Fat ◽  
Nutrition Status ◽  
Endocrine Organ ◽  
Tnf Α ◽  
Fat Composition ◽  
Serial Change

BackgroundPeritoneal dialysis (PD) is characterized by a gain in fat mass. The fat tissue is a complex endocrine organ that releases various adipokines. In this study, we prospectively examined serial changes of fat composition and adipokines in patients undergoing PD.MethodsBody composition was assessed by computed tomography (CT). Nutrition status and adipokines (leptin, adiponectin, interleukin [IL]-6, and tumor necrosis factor [TNF]-α) were assessed on the 7th day and 6 months, 12 months, and 24 months after the start of PD.ResultsFifty-four patients (28 men), with a mean age of 53.2 ± 13.2 years, were enrolled. Baseline fat mass, especially subcutaneous fat mass, was correlated with baseline leptin (ρ = 0.612), adiponetin (ρ = -0.477), and interleukin-6 (IL-6) (ρ = 0.391). Visceral fat mass was correlated with leptin (ρ = 0.545) and adiponectin (ρ = -0.514). Baseline adiponectin was negatively correlated with baseline leptin (ρ = -0.363). While body weight and leptin increased during the 24 months, serum adiponectin decreased in that period. The changes in visceral and subcutaneous fat mass were greater in the first 12 months and 6 months, respectively. There was no difference in IL-6 and TNF-α. Eight patients died during the follow-up period (mean 47.4 months). Twenty-seven patients continued PD. Increased baseline and serial change of IL-6 level were risk factors for mortality. After adjusting for age, sex, diabetes mellitus (DM), and coronary vascular disease (CVD), the significance of the IL-6 level disappeared.ConclusionsBaseline subcutaneous fat in patients starting PD is correlated with baseline adipokine levels rather than visceral fat. The increase in subcutaneous fat was greatest in the first 6 months. While leptin and adiponectin increased and decreased respectively, IL-6 did not change in the first 24 months.

Hyperleptinemia: an early sign of juvenile obesity. Relations to body fat depots and insulin concentrations

1996 ◽  
Vol 271 (3) ◽  
pp. E626-E630 ◽  
Author(s):  
S. Caprio ◽  
W. V. Tamborlane ◽  
D. Silver ◽  
C. Robinson ◽  
R. Leibel ◽  
...  
Keyword(s):  
Body Fat ◽  
Fat Mass ◽  
Visceral Fat ◽  
Subcutaneous Fat ◽  
Ventromedial Hypothalamus ◽  
Strong Positive Correlation ◽  
Fat Depots ◽  
Hyperglycemic Clamp ◽  
Juvenile Obesity ◽  
Fat Depot

Leptin, the OB gene product, is an adipocyte-derived circulating protein. In several rodent models of obesity, such as the db/db mice, fa/fa rats, and ventromedial hypothalamus-lesioned mice, as well as adult obese subjects, leptin mRNA expression and the circulating levels are elevated, suggesting resistance to its action. However, it is unknown whether the rise in leptin concentration occurs early in the natural evolution of human obesity or is a chronic adaptation to the obese state. Moreover, whether the distribution of body fat (i.e., visceral vs. subcutaneous abdominal fat) influences circulating leptin levels has not been assessed. We have determined in a group of obese and nonobese children and young adults whether leptin levels 1) are increased early in the development of obesity, 2) are related to a specific fat depot measured by magnetic resonance imaging, 3) vary during hyperinsulinemic, euglycemic, and hyperglycemic clamp studies, and 4) are different in males vs. females. In the basal state, leptin levels were elevated in obese children. Children and adults demonstrated a strong positive correlation between leptin concentrations and the subcutaneous fat depot (r = 0.84, P < 0.001). Surprisingly, a weaker correlation was found with visceral fat mass (r = 0.59, P = 0.001). Leptin levels remained unchanged under both euglycemic and hyperglycemic hyperinsulinemic conditions in both obese and nonobese subjects. A pronounced effect of gender on leptin levels was also observed. We conclude that, early in the development of juvenile obesity, leptin concentrations are elevated and are more closely linked to subcutaneous than visceral fat mass. Acute increases in insulin concentrations do not affect circulating leptin levels.

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