Search

The role of obesity in the pathogenesis of heart failure (HF), and in particular HF with preserved ejection fraction (HFpEF), has drawn significant attention in recent years. The prevalence of both obesity and HFpEF has increased worldwide over the past decades and when present concomitantly suggests an obese‐HFpEF phenotype. Anthropometrics, including body mass index, waist circumference, and waist‐to‐hip ratio, are associated with incident HFpEF. However, the cardiovascular effects of obesity may actually be driven by the distribution of fat, which can accumulate in the epicardial, visceral, and subcutaneous compartments. Regional fat can be quantified using non‐invasive imaging techniques, including computed tomography, magnetic resonance imaging, and dual‐energy X‐ray absorptiometry. Regional variations in fat accumulation are associated with different HFpEF risk profiles, whereby higher epicardial and visceral fat have a much stronger association with HFpEF risk compared with elevated subcutaneous fat. Thus, regional adiposity may serve a pivotal role in the pathophysiology of HFpEF contributing to decreased cardiopulmonary fitness, impaired left ventricular compliance, upregulation of local and systemic inflammation, promotion of neurohormonal dysregulation, and increased intra‐abdominal pressure and vascular congestion. Strategies to reduce total and regional adiposity have shown promise, including intensive exercise, dieting, and bariatric surgery programmes, but few studies have focused on HFpEF‐related outcomes among obese. Further understanding the role these variable fat depots play in the progression of HFpEF and HFpEF‐related hospitalizations may provide therapeutic targets in treating the obese‐HFpEF phenotype. [ABSTRACT FROM AUTHOR]

Summary: Objective: Research findings on the relationship between serum androgens and adipose tissue in older females are inconsistent. We aimed to clarify the relationship using state‐of‐the‐art techniques to evaluate associations between body fat distribution and plasma testosterone (T) levels in older postmenopausal women. Design: Observational, cross‐sectional study of healthy, community dwelling postmenopausal women. Patients and Measurements: Postmenopausal women (60‐80 years old) were included in this study. Overall body composition was evaluated by dual‐energy X‐ray absorptiometry. Abdominal and thigh fat depots were measured by magnetic resonance imaging. Circulating T concentrations were analysed by liquid chromatography‐tandem mass spectrometry. Results: Thirty‐five women (66.6 ± 0.8 years) participated in this study. T levels were positively associated with clinical proxy measures of adiposity including weight (ρ = 0.39), BMI (ρ = 0.43) and waist circumference (ρ = 0.39) (all P < 0.05). Fat mass and % body fat were correlated with T levels (ρ = 0.42 and 0.38 respectively, both P < 0.05). T correlated with overall and superficial abdominal fat (ρ = 0.34 and 0.37 respectively, both P < 0.05) but not with visceral adipose tissue. T increased with greater thigh fat (ρ = 0.49, P < 0.05) in both superficial and deep depots (ρ = 0.50 and 0.35 respectively, both P < 0.05). Conclusion: Our results suggest that postmenopausal women with higher circulating T levels have both higher regional and overall body adiposity. These findings underscore the sexual dimorphism in the relationship between serum androgen levels and adiposity. [ABSTRACT FROM AUTHOR]

Objectives To study the relationships between muscle mass, regional adiposity, and adipokines and glucose disposal in an older population. Design Cross-sectional analysis. Setting Community-dwelling volunteers from the Baltimore Longitudinal Study of Aging. Participants Two hundred eighty men and 259 women with a mean age of 71.1 ± 0.4 (range 55-96) and complete data on fasting plasma adiponectin and leptin, oral glucose tolerance test ( OGTT) (plasma glucose available at 0, 20, 40, 60, 80, 100, and 120 minutes), thigh computed tomography ( CT), physical activity levels, and anthropometric measures. Measurements Participants were classified into eight groups according to the presence of global adiposity (body mass index > 27 kg/m2), central adiposity (waist circumference > 88 cm for women and > 102 cm for men), and low muscle mass ( CT thigh, lowest sex-specific tertile (93.8 cm2 in women and 110.7 cm2 in men) of adjusted thigh muscle area). Linear regression models were used to estimate the contribution of these eight groups to early glucose area under the curve ( AUC) ( t = 0-40 minutes), late glucose AUC ( t = 60-120 minutes), and total glucose AUC ( t = 0-120 minutes) from the OGTT. Results Regardless of muscle mass, individuals with a combination of central and global adiposity were more likely to have delayed glucose disposal rates ( P < .05). A strong negative association was also found between circulating adiponectin levels and glucose disposal rates (early AUC, β = −0.14; late AUC, β = −0.20; and total AUC, β = −0.20; P < .05 for all three AUCs) after adjusting for regional adiposity, muscle mass, circulating leptin levels, physical activity, age, and sex. Conclusion Older individuals with global and central adiposity may be at risk of glucose intolerance unrelated to low muscle mass. [ABSTRACT FROM AUTHOR]

The article presents a consensus statement on equine metabolic syndrome (EMS). Similar to the metabolic syndrome (MetS) in humans, the principal components of EMS include obesity, insulin resistance (IR) and laminitis in horses and ponies. To diagnose EMS, a complete history of the patient should be obtained, in addition to performing a physical examination, taking radiographs of the feet and conducting laboratory tests.

Discusses that obesity is a serious and rapidly increasing public health issue in many developed and developing countries. Risk factors associated with obesity; Effects of peroxisome proliferator- activated receptor gamma on body fat distribution; Impact of obesity on metabolism in man and women.

Background Visceral adipose tissue (VAT) is associated with incident heart failure (HF) and HF with preserved ejection fraction, yet it is unknown how pericardial and abdominal adiposity affect HF and mortality risks in Black individuals. We examined the associations of pericardial adipose tissue (PAT), VAT, and subcutaneous adipose tissue (SAT) with incident HF hospitalization and all-cause mortality in a large community cohort of Black participants. Methods and Results Among the 2882 Jackson Heart Study Exam 2 participants without prevalent HF who underwent body computed tomography, we used Cox proportional hazards models to examine associations between computed tomography-derived regional adiposity and incident HF hospitalization and all-cause mortality. Fully adjusted models included demographics and cardiovascular disease risk factors. Median follow-up was 10.6 years among participants with available VAT (n=2844), SAT (n=2843), and PAT (n=1386). Fully adjusted hazard ratios (95% CIs) of distinct computed tomography-derived adiposity measures (PAT per 10 cm 3 , VAT or SAT per 100 cm 3 ) were as follows: for incident HF, PAT 1.08 (95% CI, 1.02-1.14) and VAT 1.04 (95% CI, 1.01-1.08); for HF with preserved ejection fraction, PAT 1.13 (95% CI, 1.04-1.21) and VAT 1.07 (95% CI, 1.01-1.13); for mortality, PAT 1.07 (95% CI, 1.03-1.12) and VAT 1.01 (95% CI, 0.98-1.04). SAT was not associated with either outcome. Conclusions High PAT and VAT, but not SAT, were associated with incident HF and HF with preserved ejection fraction, and only PAT was associated with mortality in the fully adjusted models in a longitudinal community cohort of Black participants. Future studies may help understand whether changes in regional adiposity improves HF, particularly HF with preserved ejection fraction, risk predictions. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT00005485.