Heterogeneity of abdominal obesity in patients with cardiovascular diseases

Aim: To assess the content of visceral adipose tissue (VAT) in patients with abdominal obesity and its relationship with metabolic disorders.Material and methods. Patients with abdominal obesity (n=107) were included in the study. All participants had an assessment of anthropometric parameters (height, weight), calculation of body mass index (BMI), proportion of total adipose tissue and VAT (bioimpedance analyzer), high-density lipoprotein cholesterol (HDL-c) levels, triglycerides, fasting blood glucose, epicardial thickness adipose tissue (two-dimensional echocardiography).Results. The median share of VAT (bioimpedance method) was 13%. Patients with abdominal obesity are divided by VAT into 2 groups: ≥14% or ≤13%. Patients with VAT≥14% had significantly higher levels of triglycerides (1.76 [1.27; 2.38] mmol / L) and glucose (6.33 [5.78; 7.87] mmol / L), and below HDL-c levels (0.95 [0.85; 1.21] mmol / L) compared with patients with VAT≤13% (1.32 [1.02; 1.50], 5.59 [5, 11; 6.16] and 1.31 [1.07; 1.58] mmol / L, respectively; p<0.001 for all three comparisons). A significant correlation was found between VAT and triglyceride, glucose and HDL-c levels (r=0.40; r=0.40; r=-0.31, respectively; p<0.001).Conclusion. Persons with abdominal obesity are heterogeneous in the proportion of VAT. The proportion of VAT above the median is associated with metabolic disorders that are significant for the development and progression of atherosclerosis. An increase in BMI in obese individuals is not associated with an increase in VAT and an increase in the severity of metabolic disorders.

Leptin and Beyond: Actors in Cancer

Leptin is a 16-kDa multifunctional, neuroendocrine peptide hormone secreted by adipocytes in proportion to total adipose tissue mass, known to control food intake, energy homeostasis, immune response, and reproductive processes [...]

Visceral Adiposity Associates With Malnutrition Risk Determined by Royal Free Hospital-Nutritional Prioritizing Tool in Cirrhosis

Mounting evidence has suggested the clinical significance of body composition abnormalities in the context of cirrhosis. Herein, we aimed to investigate the association between visceral adiposity and malnutrition risk in 176 hospitalized patients with cirrhosis. The adiposity parameters were obtained by computed tomography (CT) as follows: total adipose tissue index (TATI), visceral adipose tissue index (VATI), subcutaneous adipose tissue index (SATI), and visceral to subcutaneous adipose tissue area ratio (VSR). Malnutrition risk was screened using Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT). Visceral adiposity was determined given a higher VSR based on our previously established cutoffs. Multivariate analysis implicated that male gender (OR = 2.884, 95% CI: 1.360–6.115, p = 0.006), BMI (OR = 0.879, 95% CI: 0.812–0.951, P = 0.001), albumin (OR = 0.934, 95% CI: 0.882–0.989, P = 0.019), and visceral adiposity (OR = 3.413, 95% CI: 1.344–8.670, P = 0.010) were independent risk factors of malnutrition risk. No significant difference was observed regarding TATI, SATI, and VATI among patients with low or moderate and high risk of malnutrition. In contrast, the proportion of male patients embracing visceral adiposity was higher in high malnutrition risk group compared with that in low or moderate group (47.27 vs. 17.86%, p = 0.009). Moreover, this disparity was of borderline statistical significance in women (19.05 vs. 5.88%, p = 0.061). Assessing adipose tissue distribution might potentiate the estimation of malnutrition risk in cirrhotics. It is pivotal to recognize visceral adiposity and develop targeted therapeutic strategies.

Adipose Tissue is a Predictor of 30-days Mortality in Patients with Bloodstream Infection Caused by Carbapenem-Resistant Klebsiella Pneumoniae

Background: Prevalence of CRKP bloodstream infection with high mortality has attached physicians' attention. High-VAT and high-SAT were confirmed by previous studies that closely related to increased pneumonia severity, more complications, and higher mortality in COVID-19. Thus, we speculate that CT-quantified body composition may also be connected to all-cause mortality and bacterial clearance in patients with CRKP bloodstream infection. Methods: We investigated the associations of CT-quantified body composition with CRKP bloodstream infectious patients. All of the CT images were obtained at the level of the L3/4 spinal level. The prognostic value of the body composition was analyzed using the Cox regression model, and precise clinical nomograms were established. Results: Factors associated with 30-day all-in hospital mortality included TAT [adjusted odds ratio (OR)=1.028, 95% confidence interval (CI), 1.004–1.053; p = 0.028], age [OR=1.031, 95% CI, 1.001–1.062; p = 0.046] and SOFA score [OR=1.137, 95% CI 1.047–1.235; p = 0.002]. Compared with low-VAT, patients with high-VAT show a strikingly poor prognosis in both 30-day mortality (P=0.0449, Figure 2A) and all-cause mortality (P=0.0048, Figure 2C). The results of TAT were similar with VAT. Conclusions: Our study suggests that CT-derived composition could be a credible and effective alternative to assess the prognosis of patients with BSIs owing to CRKP. CT-quantified total adipose tissue, age and SOFA scores were independently associated with 30-day all-cause mortality in these severe infectious patients, while skeletal muscle did not have obvious statistical significance.

Adipose tissue is a predictor of 30-days mortality in patients with bloodstream infection caused by carbapenem-resistant Klebsiella pneumoniae

Background Prevalence of CRKP bloodstream infection with high mortality has attached physicians' attention. High-VAT and high-SAT were confirmed by previous studies that closely related to increased pneumonia severity, more complications, and higher mortality in COVID-19. Thus, we speculate that CT-quantified body composition may also be connected to all-cause mortality and bacterial clearance in patients with CRKP bloodstream infection. Methods We investigated the associations of CT-quantified body composition with CRKP bloodstream infectious patients. All of the CT images were obtained at the level of the L3/4 spinal level. The prognostic value of the body composition was analyzed using the Cox regression model, and precise clinical nomograms were established. Results Factors associated with 30-day all-in hospital mortality included TAT [adjusted odds ratio (OR) = 1.028, 95% confidence interval (CI), 1.004–1.053; p = 0.028], age [OR = 1.031, 95% CI, 1.001–1.062; p = 0.046] and SOFA score [OR = 1.137, 95% CI 1.047–1.235; p = 0.002]. Compared with low-VAT, patients with high-VAT show a strikingly poor prognosis in both 30-day mortality (P = 0.0449, Fig. 2A) and all-cause mortality (P = 0.0048, Fig. 2C). The results of TAT were similar with VAT. Conclusions Our study suggests that CT-derived composition could be a credible and effective alternative to assess the prognosis of patients with BSIs owing to CRKP. CT-quantified total adipose tissue, age and SOFA scores were independently associated with 30-day all-cause mortality in these severe infectious patients, while skeletal muscle did not have obvious statistical significance.

The correction of psychoemotional status in young people with overweight with increased consumption of mineral water

The aim. To study the influence of anthropometric indicators on the results of a drinking test with water of different temperatures, as well as on the psycho-emotional status.Materials and methods. The study involved 36 students. Conducted: measurement and calculation of basic anthropometric indicators, psychological testing using questionnaires, fasting drinking test with still water of different temperatures for four days with fixing the volume of liquids drunk. All examined students are divided into two groups according to the results of anthropometric examination.Results. The prevalence of overweight among students was 25,0%. Studies have shown the relationship between the main anthropometric indicators, the amount of fluid drunk and the temperature of the water taken, which indicate a violation of the relaxation accommodation of the stomach in individuals with a large amount of adipose tissue and% relative fat content. An increase in visceral hypersensitivity and a progressive deterioration of the relaxation accommodation of the stomach with an increase in the temperature of the received water were established. As a result of the work done, it was found that with an increase in BMI, a deterioration in well-being, an increase in depression, situational and personal anxiety and neurotization are observed. Overweight students with an increase in the volume and mass of total adipose tissue have a deterioration in mood and a greater tendency to depression. It was also proved the presence of a pronounced positive effect of drinking water on the human body with excess body weight, including its psychoemotional state.Conclusion. The results obtained make it possible to form anthropometric images of a person predisposed to disturbed accommodation of the stomach, taking into account gender, body weight and the nature of the distribution of adipose tissue. These studies confirmed a change in psychoemotional status depending on the main anthropometric indicators. The corrected effect of fasting drinking room-temperature water (30 °C) on the psycho-emotional state of overweight people is shown.

The Influences of Visceral Fat Area on the Sites of Esophageal Mucosal Breaks in Subjects with Gastroesophageal Reflux Diseases

Background. Central obesity is suggested as a risk factor for gastroesophageal reflux diseases. The aim of this study was to evaluate the influences of a visceral fat area on the site of mucosal breaks in the esophagogastric junction (EGJ). Methods. Subjects who underwent abdomen-computerized tomography and esophagogastroduodenoscopy for screening on the same day were evaluated between 2007 and 2016. We enrolled 178 subjects who had erosive esophagitis (LA classifications A-D). Abdominal obesity was evaluated by measuring visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), VAT-to-SAT ratio, total adipose tissue (TAT), body mass index (BMI), and waist circumference (WC). Results. The lesser curvature (LC) of EGJ was the most frequent site of mucosal breaks (104 cases, 58.4%). BMI, WC, VAT, the VAT-to-SAT ratio, and TAT were higher in the LC group. In multivariate analysis, higher VAT (odds ratio (OR) 2.90, 95% confidence interval (CI) 1.18 to 7.13, 3rd vs. 1st quartile, P=0.021; OR 3.63, 95% CI 1.44 to 9.10, 4th vs. 1st quartile, P=0.006) and the VAT/SAT ratio (OR 2.91, 95% CI 1.11 to 7.61, 3rd vs. 1st quartile, P=0.03; OR 3.02, 95% CI 1.17 to 7.83, 4th vs. 1st quartile, P=0.023) were significantly associated with mucosal breaks in the LC group. However, BMI, WC, and TAT were not significant in the multivariate analysis. Conclusion. The VAT and the VAT/SAT ratio were significantly associated with the mucosal breaks in the LC of EGJ. Visceral obesity could influence the location of the mucosal breaks on EGJ.

Obesity, Leptin and Breast Cancer: Epidemiological Evidence and Proposed Mechanisms

The prevalence of obesity has been steadily increasing over the past few decades in several developed and developing countries, with resultant hazardous health implications. Substantial epidemiological evidence has shown that excessive adiposity strongly influences risk, prognosis, and progression of various malignancies, including breast cancer. Indeed, it is now well recognized that obesity is a complex physiologic state associated with multiple molecular changes capable of modulating the behavior of breast tumor cells as well of the surrounding microenvironment. Particularly, insulin resistance, hyperactivation of insulin-like growth factor pathways, and increased levels of estrogen due to aromatization by the adipose tissue, inflammatory cytokines, and adipokines contribute to breast cancerogenesis. Among adipokines, leptin, whose circulating levels increase proportionally to total adipose tissue mass, has been identified as a key member of the molecular network in obesity. This review summarizes the current knowledge on the epidemiological link existing between obesity and breast cancer and outlines the molecular mechanisms underlying this connection. The multifaceted role of the obesity adipokine leptin in this respect is also discussed.