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It has been suggested that beige fat thermogenesis is tightly controlled by epigenetic regulators that sense environmental cues such as temperature. Here, we report that subcutaneous adipose expression of the DNA demethylase TET1 is suppressed by cold and other stimulators of beige adipocyte thermogenesis. TET1 acts as an autonomous repressor of key thermogenic genes, including Ucp1 and Ppargc1a, in beige adipocytes. Adipose-selective Tet1 knockout mice generated by using Fabp4-Cre improves cold tolerance and increases energy expenditure and protects against diet-induced obesity and insulin resistance. Moreover, the suppressive role of TET1 in the thermogenic gene regulation of beige adipocytes is largely DNA demethylase-independent. Rather, TET1 coordinates with HDAC1 to mediate the epigenetic changes to suppress thermogenic gene transcription. Taken together, TET1 is a potent beige-selective epigenetic breaker of the thermogenic gene program. Our findings may lead to a therapeutic strategy to increase energy expenditure in obesity and related metabolic disorders.

Abstract Background The term “non-alcoholic fatty liver disease” (NAFLD) refers to a range of disorders caused by lipid accumulation in the liver. High abdominal fat levels can cause adipocytes to become more lipolytic, releasing free fatty acids into the portal venous system. In this study, we aimed to use the analysis of visceral fat, subcutaneous fat, muscle mass, and liver volume to evaluate the severity of fatty liver in NAFLD. Results This study enrolled 130 patients with non-alcoholic fatty liver disease. The mean age of studied patients was 51.38 ± 11.11 years, ranging between 25 and 65 years. Of the studied patients, 60 (46.2%) patients were males and 70 (53.8%) were females. The mean body mass index was 41.23 ± 7.83 (kg/m2). Based on the radiological assessment of those patients, patients with grade III fatty liver had significantly higher total fat volume, visceral fat volume, subcutaneous fat volume, fat rate in the body, visceral fat volume rate, psoas muscle volume, and psoas muscle ratio in comparison with those with grade I and grade II fatty liver. Liver enzymes significantly correlated with total fat volume, visceral fat volume rate, psoas muscle volume, psoas muscle ratio, and liver volume. Conclusions The degree of fatty liver severity among patients with NAFLD was positively correlated with the amount of subcutaneous, visceral fat, and muscle mass. Also, both liver transaminases had a significant positive correlation with the amount of total and visceral fat, psoas muscle mass, and liver volume.

Integration of genome-wide association study (GWAS) signals with expression quantitative trait loci (eQTL) studies enables identification of candidate genes. However, evaluating whether nearby signals may share causal variants, termed colocalization, is affected by the presence of allelic heterogeneity, different variants at the same locus impacting the same phenotype. We previously identified eQTL in subcutaneous adipose tissue from 770 participants in the Metabolic Syndrome in Men (METSIM) study and detected 15 eQTL signals that colocalized with GWAS signals for waist-hip ratio adjusted for body mass index (WHRadjBMI) from the Genetic Investigation of Anthropometric Traits consortium. Here, we reevaluated evidence of colocalization using two approaches, conditional analysis and the Bayesian test COLOC, and show that providing COLOC with approximate conditional summary statistics at multi-signal GWAS loci can reconcile disagreements in colocalization classification between the two tests. Next, we performed conditional analysis on the METSIM subcutaneous adipose tissue data to identify conditionally distinct or secondary eQTL signals. We used the two approaches to test for colocalization with WHRadjBMI GWAS signals and evaluated the differences in colocalization classification between the two tests. Through these analyses, we identified four GWAS signals colocalized with secondary eQTL signals for FAM13A, SSR3, GRB14 and FMO1. Thus, at loci with multiple eQTL and/or GWAS signals, analyzing each signal independently enabled additional candidate genes to be identified.

Introduction: The evolution of liposuction and fat graft technique with the oncologic safety allowed to use the fat as autologous filler in patients with breast cancer and submitted to breast reconstruction. The objective is to introduce an innovation in the instrument used to harvest fat grafts for breast reconstruction. Methods: Search of anteriority and trademarks were performed at international and national databases, and a prototype was built as a fat harvest instrument with 35cm in length, 4cm in diameter, with 10 holes at the distal extremity, with 2mm diameter each. It was experimented with a harvest of a viscous substance, comparing the prototype with two regular industry cannulas types: three holes Mercedes’ type and five roles Pitanguy’s type. Results: Four high-relevance patents and one medium-relevance patent were found, which differ from the proposed utility model when comparing the type of design of the distal end of the studied cannulas and the function of the instruments identified. When the prototype’s efficiency was compared with the other cannulas, the cannula with five holes in Pitanguy’s type was the most efficient, and it was no statistical difference between the prototype and the cannula with three roles in Mercedes’ type. Conclusion: The innovation presented to harvest fat graft for breast reconstruction had the same efficiency in harvesting the viscose substance as the cannula Mercedes type with three holes in this experimental model.

Background and aim: High hepcidin levels in obesity reduce iron absorption, leading to iron deficiency anemia. Visceral fat is metabolically more active than subcutaneous fat. We wanted to assess if hemoglobin (Hb), serum iron, and serum ferritin levels correlated with surrogate markers of visceral fat and subcutaneous fat, i.e., waist circumference (WC) and the sum of three skinfold thicknesses (SFT3), respectively.Material and methods: Thirty young women aged 17-20 years, BMI => 25.0 kg/m2, participated in the cross-sectional analytical study. Data collected: Anthropometry- weight and height for Body Mass Index (BMI) calculation, WC, and skinfold thickness at three sites – triceps, abdomen, and suprailiac regions for SFT3; Haematology parameters - Hb, serum ferritin, and serum iron levels. Data analysis: Pearson's Correlation coefficient (p< 0.05) was calculated for both WC and SFT3, with S. Iron, S. Ferritin, and Hemoglobin.Results: Thirty percentage of the participants were anemic (Hb < 12.0 mg/dl). Their Iron stores and serum levels were poor (Serum Ferritin < 15.0 ng/ml and S. Iron < 60.0 µ/dl): 67.0% and 70.0%, respectively. WC and SFT3 correlated negatively with hemoglobin. SFT3 and BMI correlated positively with serum ferritin, but WC correlated negatively. Serum iron levels correlated negatively with WC and BMI but positively with SFT3. However, any positive or negative correlation was not found to be significant.Conclusions: There was a positive association between obesity with iron deficiency anemia. However, whether visceral or subcutaneous fat is more associated with the same remained inconclusive.

Background: To evaluate the correlation between single- and multi-slice cross-sectional thoracolumbar and whole-body compositions. Methods: We retrospectively included patients who underwent whole-body PET–CT scans from January 2016 to December 2019 at multiple institutions. A priori-developed, deep learning-based commercially available 3D U-Net segmentation provided whole-body 3D reference volumes and 2D areas of muscle, visceral fat, and subcutaneous fat at the upper, middle, and lower endplate of the individual T1–L5 vertebrae. In the derivation set, we analyzed the Pearson correlation coefficients of single-slice and multi-slice averaged 2D areas (waist and T12–L1) with the reference values. We then built prediction models using the top three correlated levels and tested the models in the validation set. Results: The derivation and validation datasets included 203 (mean age 58.2 years; 101 men) and 239 patients (mean age 57.8 years; 80 men). The coefficients were distributed bimodally, with the first peak at T4 (coefficient, 0.78) and the second peak at L2-3 (coefficient 0.90). The top three correlations in the abdominal scan range were found for multi-slice waist averaging (0.92) and single-slice L3 and L2 (0.90, each), while those in the chest scan range were multi-slice T12–L1 averaging (0.89), single-slice L1 (0.89), and T12 (0.86). The model performance at the top three levels for estimating whole-body composition was similar in the derivation and validation datasets. Conclusions: Single-slice L2–3 (abdominal CT range) and L1 (chest CT range) analysis best correlated with whole-body composition around 0.90 (coefficient). Multi-slice waist averaging provided a slightly higher correlation of 0.92. Key points: In single-slice analysis, the L2–3 and L1 levels had the closest correlations with whole-body composition. Multi-slice waist averaging (0.92; correlation) showed a better correlation than the L2–3 single-slice analysis (0.90) in the abdomen. Multi-slice T12–L1 averaging (0.89) provided a comparable correlation to the L1 level in the chest (0.89). [ABSTRACT FROM AUTHOR]

Fat deposition is very important to the growth and reproduction of yaks. In this study, the effect of the feeding system on fat deposition in yaks was explored by transcriptomics and lipidomics. The thickness of the subcutaneous fat in yaks under stall (SF) and graze feeding (GF) was evaluated. The transcriptomes and lipidomes of the subcutaneous fat in yaks under different feeding systems were detected by RNA-sequencing (RNA-Seq) and non-targeted lipidomics based on ultrahigh-phase liquid chromatography tandem mass spectrometry (UHPLC-MS), respectively. The differences in lipid metabolism were explored, and the function of differentially expressed genes (DEGs) was evaluated by gene ontology (GO) and Kyoto encyclopedia of genes and genome (KEGG) analysis. Compared with GF yaks, SF yaks possessed stronger fat deposition capacity. The abundance of 12 triglycerides (TGs), 3 phosphatidylethanolamines (PEs), 3 diglycerides (DGs), 2 sphingomyelins (SMs) and 1 phosphatidylcholine (PC) in the subcutaneous fat of SF and GF yaks was significantly different. Under the mediation of the cGMP–PKG signaling pathway, the blood volume of SF and GF yaks may be different, which resulted in the different concentrations of precursors for fat deposition, including non-esterified fatty acid (NEFA), glucose (GLU), TG and cholesterol (CH). The metabolism of C16:0, C16:1, C17:0, C18:0, C18:1, C18:2 and C18:3 in yak subcutaneous fat was mainly realized under the regulation of the INSIG1, ACACA, FASN, ELOVL6 and SCD genes, and TG synthesis was regulated by the AGPAT2 and DGAT2 genes. This study will provide a theoretical basis for yak genetic breeding and healthy feeding. [ABSTRACT FROM AUTHOR]

Simple Summary: Gastric cancer has a different characteristic than other cancers in that it causes postoperative body weight loss associated with gastric volume loss. It has been reported that the greater the rate of body weight loss after gastrectomy, the poorer the long-term prognosis. Therefore, a higher preoperative fat content may be a nutritional advantage. However, it is controversial whether a higher fat mass is associated with a better prognosis. In obesity, men tend to have visceral fat and women tend to have subcutaneous fat. In order to clarify the prognostic impact of obesity, it is necessary to investigate the prognostic relevance of fat distribution by sex. This study revealed that a low visceral fat mass in men and a low subcutaneous fat mass in women were independent poor prognostic factors after radical gastrectomy for advanced gastric cancer. We investigated the impact of the difference in fat distribution between men and women on long-term prognosis after gastrectomy in patients with advanced gastric cancer. Patients with advanced gastric cancer deeper than p-T2 who underwent gastrectomy between April 2008 and June 2018 were included. Visceral fat mass index (VFI) and subcutaneous fat mass index (SFI) were calculated by dividing the cross-sectional area at the umbilical level by the height squared. The medians of VFI and SFI by sex were defined as cut-off values, below which values were defined as low VFI and low SFI. Of the 485 patients, 323 (66.6%) were men and 162 (33.4%) were women. Men with a low VFI had a significantly worse overall survival (OS) (p = 0.004) and women with a low SFI had a significantly worse OS (p = 0.007). Patients with a low VFI and low SFI had the worst prognosis. Multivariate analysis showed that a low VFI was an independent poor prognostic factor in men, while a low SFI was an independent poor prognostic factor in women. In conclusion, a low visceral fat mass in men and a low subcutaneous fat mass in women were independent poor prognostic factors after radical gastrectomy for advanced gastric cancer. [ABSTRACT FROM AUTHOR]

Computed tomography (CT) scans used in treatment response assessment in prostate cancer (PCa) patients are a useful tool for nutritional status evaluation. The aim of this study was to assess the nutritional status, including sarcopenia development based on CT scans, in PCa patients and its association with progression-free survival (PFS). Sixty-four PCa patients were included (group 1: 34 patients undergoing androgen deprivation therapy (ADT) with docetaxel due to newly diagnosed, hormone-sensitive, metastatic PCa and group 2: 30 patients with castration-resistant metastatic PCa continuing ADT therapy with enzalutamide or abiraterone acetate). Nutritional status was evaluated with anthropometrical parameters, Nutritional Risk Score (NRS), and CT scans at the L3 vertebrae. Survival analyses were performed. According to NRS, nutritional status was significantly related to PFS. In both groups, there was a significant reduction in muscle tissue (total muscle tissue and skeletal muscle index). A significant increase in the distribution of adipose tissue (subcutaneous fat, visceral fat, subcutaneous adipose tissue index, and visceral adipose tissue index) in group one was observed. Sarcopenia was diagnosed in patients but with no influence on PFS. Significant reduction in muscle mass and increase in fat mass was observed in patients treated for PCa with no impact on PFS. The NRS was related to PFS in PCa patients and associated with body composition, assessed by CT after the castration therapy. Long-term castration combined with abiraterone therapy with prednisone or enzalutamide significantly influenced muscle tissue and may lead to sarcopenia development. [ABSTRACT FROM AUTHOR]

Skin grafting is an important method of wound repair and reconstruction. Skin grafting can be classified using multiple classification criteria. We often perform full‐thickness skin grafting (FTSG) for small wound areas; however, the traditional FTSG technique frequently causes postoperative scar depression at the donor site, especially in the abdomen. This study aimed to determine whether preserving the subcutaneous fat when performing FTSG can improve donor site prognosis. We reviewed 25 patients who underwent autologous FTSG in the last 3 years. Among them, subcutaneous fat was preserved in 11 patients (experimental group), whereas it was not preserved in 14 patients (control group). Using a 3D camera and the Patient and Observer Scar Assessment Scale (POSAS), we evaluated the donor site postoperatively. According to POSAS, vascularization was significantly more severe in the experimental group. The Antera 3D camera revealed more severe scar depression at the donor site in the control group. The processing time for graft take, subcutaneous fat trimming and donor site closure was less in the experimental group than in the control group. Preserving subcutaneous fat at the donor site improved patient outcomes by reducing donor site depression after FTSG. [ABSTRACT FROM AUTHOR]

Background: Wrinkles appear with aging, producing an aged impression, but the mechanism of wrinkle formation has not yet been fully elucidated. We recently reported that subcutaneous fat infiltrates into the dermal layer with aging and impairs skin elasticity, but the contribution of this process to wrinkle formation is still unclear. Purpose: We aimed to clarify the contribution of dermal fat infiltration to wrinkle formation by analyzing the relationship between them in the forehead of female volunteers. Methods: We measured the severity of fat infiltration in the forehead of 29 middle‐aged female volunteers by means of ultrasonography. Fixed wrinkles present when the eyes were closed and wrinkles transiently formed when the eyes were open were evaluated using a photograph‐based 6‐grade evaluation system for each type of wrinkle. Results: Fat infiltration at the forehead area was observed similarly to that in the cheek area as we reported previously. We found that opening the eyes induced the formation of stable transient wrinkles, the grade of which was significantly related to fat infiltration severity. Furthermore, fat infiltration was also significantly related to the severity of fixed wrinkles. Moreover, the severity of transient wrinkles was significantly related to that of fixed wrinkles. Conclusions: Our results suggest that fat infiltration into the dermal layer enhances transient wrinkle formation during facial expression by impairing the ability of the skin to resist deformation, thereby promoting fixed wrinkle formation. Therefore, fat infiltration is a critical cause of wrinkle formation. [ABSTRACT FROM AUTHOR]

Introduction: Type 2 diabetes mellitus (T2DM) is a non-communicable disease with a high prevalence in Indonesia. T2DM is caused by insulin resistance and relative insulin deficiency. One of the therapy for T2DM is insulin administration which is injected into the subcutaneous tissue. The absorption of insulin in the subcutaneous tissue is influenced by many factors, one of which is the thickness of subcutaneous fat. This study aimed to determine the correlation between the skinfold thickness of T2DM patients with the total daily dose of insulin needed every day. Methods: This was an observational analytic study using a cross-sectional design to analyze the correlation between subcutaneous fat thickness represented by skinfold thickness and the total daily dose of insulin of T2DM patients. Measurement of skinfold thickness was carried out on the triceps using a skinfold caliper. Data on the patient's total daily dose of insulin were obtained from medical records. Results: A total of 53 patients were included in this study. The patient's mean triceps skinfold thickness was 26.29±8.72 mm. The mean total daily dose of insulin was 40.96±18.01 IU. The results of the Spearman Rank correlation test showed a significant correlation between skinfold thickness on the triceps and the patient's total daily dose of insulin (p

Quantitative diagnostic ultrasound has been proposed as a way to characterize muscle structure, but there is a lack of normative data for children. This study aims to establish age-specific normal ranges for echo-intensity (EI), cross-sectional area (CSA), muscular thickness (MT), and subcutaneous adipose thickness (SAT) values of the rectus femoris muscle in typically developing children. The study recruited 497 children (288 boys and 209 girls) aged 4–10.9 years (mean age 7.39 years), and muscle parameters were measured using 2D B-mode ultrasound. Percentile values and reference curves were calculated using the Lambda, Mu, and Sigma method (LMS). The results showed small variation between measurements for boys compared to girls, with the most significant difference in EI, CSA, and MT values. EI decreased with age, with the most pronounced curve in boys. SAT increased in both sexes, with a slightly higher increase in girls after the age of 9.0 years. This study provides the first age-specific reference norms for the rectus femoris muscle architecture in children, and further research is needed to validate these curves and determine their clinical utility.

Introduction: Necrotising fasciitis requires a high index of clinical suspicion in the early stages since it is difficult to distinguish it from common skin diseases like cellulitis or harmless wound infections. Despite improvements in antibiotic therapy and intensive care, Necrotising Soft Tissue Infections (NSTIs) still have a high mortality rate. Point-of-Care Ultrasound (POCUS) can increase the efficiency and precision of diagnostics. Magnetic Resonance Imaging (MRI) has a higher sensitivity and specificity in diagnosing the infection. However, Computed Tomography (CT) and MRI are not always readily available in clinical practice settings and can have other drawbacks, such as being a time-consuming and expensive method. Aim: To define how POCUS can be used as an initial and primary modality for diagnosis of NSTI. Materials and Methods: The present cross-sectional study was conducted in the Department of Radiodiagnosis, Stanley Medical College, Chennai, Tamil Nadu, India, from April 2021 to March 2022. A total number of 40 patients of any age group and sex, who were suspected to have soft tissue infections were included. After doing a bedside ultrasound in all 40 patients, in 36 MRI was performed. MRI was considered the gold standard technique in the diagnosis of NSTI. The Ultrasonography (USG) and MRI findings were compared. The imaging findings taken into consideration for predicting NSTI include subcutaneous thickening, subcutaneous fluid collection, muscular oedema, and subcutaneous air pockets. Sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) were calculated. Results: The mean age of study population was 52 years. The incidence in males was 62.5% (25 patients) and in females was 37.5% (15 patients). The lower limb was the most frequently affected site involving the 25 (62.5%) patients. Out of 40 patients, 38 patients had subcutaneous thickening, 28 patients had subcutaneous fluid collection, 20 patients had muscular oedema and 13 patients had subcutaneous air pockets. Out of 13 patients who had subcutaneous air pockets four people had extensive air pockets and the USG findings were obscured in that four cases due to reverberation artifacts caused by air pockets. In the current study, POCUS has a sensitivity of 93.5%, specificity of 80%, PPV of 96%, NPV of 66.67%, and accuracy of 91.67%. Conclusion: According to the observations, the present study concluded that POCUS has a higher sensitivity in diagnosing NSTI.

Adipose tissue is a crucial economically significant trait that significantly influences the meat quality and growth performance of domestic animals. To reveal the changes in adipose tissue metabolism during the growth of naturally grazing sheep, we evaluated the thickness, adipocyte morphology, fatty acid profile, and metabolite profile of subcutaneous adipose tissue (SAT) from naturally grazing Sunit sheep at 6, 18, and 30 months of age (referred to as Mth-6, Mth-18, and Mth-30, respectively). The fat thickness and adipocyte number were significantly increased with the growth of the sheep (p < 0.05), and the increase of which from Mth-18 to Mth-30 was less than that from Mth-6 to Mth-18. Additionally, the alpha-linolenic acid metabolism was enhanced and fatty acid (FA) elongation increased with growth. The metabolomic analysis revealed 76 differentially expressed metabolites (DEMs) in the SAT in different growth stages. Interestingly, we observed elongation of FAs in lipids correlated with sheep growth. Furthermore, the expression of acylcarnitines was downregulated, and fatty acid amides, aspartic acid, acetic acid and phosphocholine were upregulated in Mth-18 and Mth-30 compared to Mth-6. Altogether, the study found that the difference in SAT in Mth-6 was great compared to Mth-18 and Mth-30. An increase in fat deposition via adipocyte proliferation with the growth of the sheep in naturally grazing. The DEMs of acylcarnitines, fatty acid amides, aspartic acid, acetic acid, and phosphocholine emerged as potential key regulators of adipose tissue metabolism. These findings illustrate the variation in and metabolic mechanism of sheep adipose tissue development under natural grazing, thus providing valuable insights into improving the edible quality of sheep meat and developing the mutton sheep industry.

Subcutaneous fat deposition is an important index with which to evaluate meat-producing ducks, and affects their meat quality and feed conversion rate. Studying the differentially expressed genes in subcutaneous fat will help to comprehensively understand the potential mechanisms regulating fat deposition in ducks. In this study, 72 Nankou 1 Pekin Ducks and 72 Jingdian Pekin Ducks (half male and half female) at 42 days of age were selected for slaughter performance and transcriptome analysis. The results showed that the breast-muscle yield of Nankou 1 ducks was significantly higher than that of Jingdian ducks, but that the abdominal fat yield and subcutaneous fat yield were higher than that of Jingdian ducks. Thousands of DEGs, including many important genes involved in fat metabolism regulation, were detected by transcriptome. KEGG enrichment analysis showed that the DEGs were significantly enriched on pathways such as regulation of lipolysis in adipocytes, primary bile acid biosynthesis, and biosynthesis of unsaturated fatty acids. SCD, FGF7, LTBP1, PNPLA3, ADCY2, and ACOT8 were selected as candidate genes for regulating subcutaneous fat deposition. The results indicated that Nankou 1 had superior fat deposition ability compared to Jingdian ducks, and that the candidate genes regulated fat deposition by regulating fat synthesis and decomposition.

Frailty is a state of decreased physiologic reserve associated with poor outcomes before and after lung transplantation. Obesity, particularly central obesity characterized by excess proinflammatory visceral adipose tissue (VAT), is associated with incident frailty in middle-aged and older adults. The association between VAT and frailty in advanced lung disease, however, is unknown. In two, nonoverlapping multicenter cohorts of adults listed for lung transplantation, we measured VAT area on bioelectrical impedance assay (BIA) in one cohort and cross-sectional VAT and subcutaneous adipose tissue (SAT) areas on abdominal computed tomography (CT) in the other. We identified a nonlinear relationship between greater VAT by BIA and frailty. In fully adjusted piecewise regression models, every 20 cm2 increase in VAT area was associated with 50% increased odds of frailty in subjects with high VAT (95% CI 1.2-1.9, P

ObjectivesAdipose tissue (AT) density measurement may provide information about AT quality among people living with HIV. We assessed AT density and evaluated relationships between AT density and immunometabolic biomarker concentrations in men with HIV.DesignCross-sectional analysis of men enrolled in the Multicenter AIDS Cohort Study.MethodsAbdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) density (Hounsfield units, HU; less negative = more dense) were quantified from computed tomography (CT) scans. Multivariate linear regression models described relationships between abdominal AT density and circulating biomarker concentrations.ResultsHIV+ men had denser SAT (-95 vs -98 HU HIV-, P < 0.001), whereas VAT density was equivalent by HIV serostatus men (382 HIV-, 462 HIV+). Historical thymidine analog nucleoside reverse transcriptase inhibitor (tNRTI) use was associated with denser SAT but not VAT. In adjusted models, a 1 s.d. greater SAT or VAT density was associated with higher levels of adiponectin, leptin, HOMA-IR and triglyceride:HDL cholesterol ratio and lower hs-CRP concentrations in HIV- men. Conversely, in HIV+ men, each s.d. greater SAT density was not associated with metabolic parameter improvements and was significantly (P < 0.05) associated with higher systemic inflammation. Trends toward higher inflammatory biomarker concentrations per 1 s.d. greater VAT density were also observed among HIV+ men.ConclusionsAmong men living with HIV, greater SAT density was associated with greater systemic inflammation independent of SAT area. AT density measurement provides additional insight into AT density beyond measurement of AT quantity alone, and may have implications for metabolic disease risk.

ObjectivePrevious studies of breast cancer survival have not considered specific depots of adipose tissue such as subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT).MethodsThis study assessed these relationships among 3,235 women with stage II and III breast cancer diagnosed between 2005 and 2013 at Kaiser Permanente Northern California and between 2000 and 2012 at Dana Farber Cancer Institute. SAT and VAT areas (in centimeters squared) were calculated from routine computed tomography scans within 6 (median: 1.2) months of diagnosis, covariates were collected from electronic health records, and vital status was assessed by death records. Hazard ratios (HRs) and 95% CIs were estimated using Cox regression.ResultsSAT and VAT ranged from 19.0 to 891 cm2 and from 0.484 to 454 cm2 , respectively. SAT was related to increased risk of death (127-cm2 increase; HR [95% CI]: 1.13 [1.02-1.26]), but no relationship was found with VAT (78.18-cm2 increase; HR [95% CI]: 1.02 [0.91-1.14]). An association with VAT was noted among women with stage II cancer (stage II: HR: 1.17 [95% CI: 0.99-1.39]; stage III: HR: 0.90 [95% CI: 0.76-1.07]; P interaction

Non-surgical fat reduction procedures have gained in popularity over the past few years and remain in great demand. The process results in accumulation of breakdown products, lipid droplets, that are slowly absorbed over a period of months. This paper outlines the physiological process whereby lipid droplets are absorbed through a process of autophagy (lipophagy) involving a repackaging of these droplets to smaller sizes so that macrophages can then cope with digestion of these very large particles. Furthermore, a fat compartment is described within the dermis surrounding the tail of the hair follicle, which is attracting much attention due to its unique phenotype, function, and connection to the deeper subcutaneous fat compartment. This provides an entry route for direct signaling to the subcutaneous fat. Related to these novel concepts, peptides can be designed in liposomal delivery systems to target lipid droplet breakdown via the hair follicle entry route. This concept is elucidated in this paper.J Drugs Dermatol. 2019;18(4):375-380.

Dermal fibroblasts (dFBs) resist infection by locally differentiating into adipocytes and producing cathelicidin antimicrobial peptide in response to Staphylococcus aureus (S. aureus). Here, we show that neonatal skin was enriched with adipogenic dFBs and immature dermal fat that highly expressed cathelicidin. The pool of adipogenic and antimicrobial dFBs declined after birth, leading to an age-dependent loss of dermal fat and a decrease in adipogenesis and cathelidicin production in response to infection. Transforming growth factor beta (TGF-β), which acted on uncommitted embryonic and adult dFBs and inhibited their adipogenic and antimicrobial function, was identified as a key upstream regulator of this process. Furthermore, inhibition of the TGF-β receptor restored the adipogenic and antimicrobial function of dFBs in culture and increased resistance of adult mice to S. aureus infection. These results provide insight into changes that occur in the skin innate immune system between the perinatal and adult periods of life.

Background and Purpose: One of the most important methods to cope with obesity metabolic disorder is to do exercise activities that are both effective as a prevention and treatment. Since the expression of adipogenic genes such as Retinoblastoma-1 (RB1) and Retinoblastoma like-1 (RBL-1) proteins are effective in adipogenesis, the aim of this study was to investigate the influence of various intensities of aerobic training on the expression of RB1 and RBL-1 genes in the subcutaneous adipose tissue of male Wistar rats.Materials and Methods: In this experimental study, 32 male Wistar rats (eight weeks old and weight: 237 ± 33 grams) were randomly divided into four equal groups: control, high intensity training (HIT), Moderate-intensity training (MIT) and high-intensity interval training (HIIT). The treadmill training protocols consisted of eight weeks, so that the HIT training consisted of running at a speed of 20 meters per minute or with an intensity of 65% of maximum oxygen consumption (VO2max), with a gradual increasing slope for 30 minutes. MIT training consisted of running at 65% VO2max for 37 minutes and HIIT training consisting of four bouts of high-intensity intervals with four minutes running at 90 to 100% VO2max and four bouts of low-intensity intervals with three minutes running at 50 to 60% VO2max (28 minutes in total). 24 hours after the last training session, the animals were sacrificed and their subcutaneous fat tissue was removed and gene expression was measured by RT-PCR. The obtained data were analyzed due to lack of natural distribution using Kruskal-wallis test and Bonferoni post hoc test through SPSS statistical software version 24 And significance level was considered P < 0.05.Results: The results of the present study showed that the expression of RB1 gene was significantly reduced only in the MIT group compared to the control group (P = 0.027). Also, RBL-1 gene expression was significantly lower only in the HIT group than in the control group (P = 0.028).Conclusion: Since in this study only MIT and HIT aerobic exercises with 65% VO2max intensity could reduce the expression of RB1 and RBL-1 genes, the use of this type of exercise to improve metabolic disorders and inhibit adipogenesis is recommended.

Introduction: The concept of female aesthetics has been changing, strongly influenced by cultural and regional patterns. Buttocks and breasts are the main regions emphasized, especially in Latin America. Then, gluteal fat grafting becomes increasingly important. In this article, we aim to study the results of this procedure and its complications, suggest a classification of the shape of the buttocks and standardize areas to be treated with fat grafting. Methods: This is a prospective study realized from January 2018 to February 2020, and there was a follow-up of the patients for 6 months of postoperative. The surgical technique was tumescent to get fat, and decantation was the method to prepare the graft, which was injected through the intergluteal and subgluteal folds. Results: Of 146 patients, nine were excluded, remaining 137, of which 132 were women, and four were men. The mean age of patients was 34.1 years, and the mean body mass index was 27.2Kg/m2. The predominant gluteal shape was the trapezoid (52.5%), and the average volume of fat injected into the buttocks was 510.8ml on the right side and 580.5ml on the left, with the central and lateral gluteal areas being the most grafted. As for complications, asymmetry occurred in 3.65% of patients, skin blister in 2.9% and chronic pain in 2.2% of them. Conclusion: It is a safe procedure with a low incidence of complication when the fat grafting respects the subcutaneous plane, and this procedure has high patient satisfaction.

Chronic inflammation accompanies obesity and limits subcutaneous white adipose tissue (WAT) expandability, accelerating the development of insulin resistance and type 2 diabetes mellitus. MicroRNAs (miRNAs) influence expression of many metabolic genes in fat cells, but physiological roles in WAT remain poorly characterized. Here, we report that expression of the miRNA miR-30a in subcutaneous WAT corresponds with insulin sensitivity in obese mice and humans. To examine the hypothesis that restoration of miR-30a expression in WAT improves insulin sensitivity, we injected adenovirus (Adv) expressing miR-30a into the subcutaneous fat pad of diabetic mice. Exogenous miR-30a expression in the subcutaneous WAT depot of obese mice coupled improved insulin sensitivity and increased energy expenditure with decreased ectopic fat deposition in the liver and reduced WAT inflammation. High-throughput proteomic profiling and RNA-Seq suggested that miR-30a targets the transcription factor STAT1 to limit the actions of the proinflammatory cytokine interferon-γ (IFN-γ) that would otherwise restrict WAT expansion and decrease insulin sensitivity. We further demonstrated that miR-30a opposes the actions of IFN-γ, suggesting an important role for miR-30a in defending adipocytes against proinflammatory cytokines that reduce peripheral insulin sensitivity. Together, our data identify a critical molecular signaling axis, elements of which are involved in uncoupling obesity from metabolic dysfunction.

ObjectiveTo examine whether abnormal subcutaneous (SC) abdominal adipose stem cell (ASC) development to adipocytes in polycystic ovary syndrome (PCOS) correlates with hyperandrogenism.DesignProspective cohort study.SettingAcademic medical center.Patient(s)Eight normal-weight women with PCOS and eight normoandrogenic ovulatory (control) women matched for age and body mass index.Intervention(s)Circulating hormone and metabolic measurements, intravenous glucose tolerance testing, total body dual-energy X-ray absorptiometry, and SC abdominal fat biopsy.Main outcome measure(s)In vitro ASC commitment to preadipocytes (ZFP423 protein expression, day 0.5), preadipocyte differentiation to adipocytes (PPARγ gene expression, day 3) and adipocyte lipid content (Oil-Red-O fluorescence, day 12) comparisons correlated with clinical outcomes.Result(s)In women with PCOS, SC abdominal ASCs compared with those of control women showed exaggerated commitment to preadipocytes and had greater lipid content in newly formed adipocytes after in vitro maturation. In all women combined, ZFP423 protein expression negatively correlated with fasting plasma glucose levels whereas the lipid content of newly formed adipocytes positively correlated with both PPARγ gene expression and serum free testosterone levels.Conclusion(s)In normal-weight women with PCOS compared with the control group, exaggerated SC abdominal ASC commitment to preadipocytes and enhanced adipocyte lipid content during maturation in vitro negatively and positively correlate with circulating fasting glucose and androgen levels, respectively, as a possible mechanism to maintain glucose-insulin homeostasis when fat accretion is accelerated.

The paper covers the peculiarities of the degree of meat shapes in the bulls of the Ukrainian meat breed, depending on the adipose tissue content under the skin and between the muscles. They were evaluated according to their productivity from 8 to 18, 21, and 23 months. Bulls with better development of meat shapes are characterized by fat deposition in the carcass and between the muscles earlier and more intensively. They have from 15.1 to 44.7% more fatty tissue in the carcass, including under the skin – from 3.8 to 44.1%. With a different degree of meat shapes, subcutaneous fat is deposited more than between muscles. The content of adipose tissue under the skin relative to its total amount in the body of animals tends to decrease by 6.5 points with age for a better degree of meat shapes, and on the contrary, to increase by 2.6 points for a worse degree. If the fat under the bull skin at 18 months in the best shapes is 72.1% of the fat in the carcass, and in the worst – 72.3%, then at 23 months, its amount decreases by 13.6 and 4.4 points, respectively. The fat between the muscles, on the contrary, increases from 27.9 and 27.7% by the same amounts, respectively. With a greater degree of meat shapes and subcutaneous fat thickness on the carcasses of 18-month-old bulls, intramuscular fat (marbling) content is lower by 75.0%. 18-month-old bulls with better-developed meat shapes have fat cuts off from the carcass by 15.2% more than animals with less developed shapes, 23 – by 11.3%. A large amount of produced waste in the body of animals in the best meat shape leads to excessive (from 0.9 to 14.5%) feed consumption (feed unit) for the increase in live weight. The subcutaneous fat content and the number of cuts off from 16 to 24 months positively correlate with the degree of meat shapes in bulls at 15 months and have correlation coefficients of 0.26 and 0.17, respectively.

The incidence of obesity in pet population increased over the last decades. Cats have been suggested as model for human obesity because of similar co-morbidities as diabetes and dyslipidaemia. Aim of this study were to quantify the distribution of visceral and subcutaneous adipose tissue (VAT, SAT respectively) in healthy adult cats during feeding-induced body weight (BW) gain by MRI, and to correlate it to the increased hepatic fat fraction (HFF). Cats received a commercial dry food ad libitum for 40 weeks and were longitudinally scanned three times. VAT and SAT were determined from Dixon MRI data by a dedicated software solution (ATLAS, established in human and rodents). HFF was quantified from a commercially available sequence. At both individual and group level, normalized adipose tissue volumes significantly increased longitudinally, with median VAT/SAT ratio always < 1. With increased BW, more than proportional increased total adipose tissue was observed together with more than proportional increased HFF. HFF is disproportionately high in overweight cats compared to SAT and VAT accumulation in the 40 weeks observation period. Quantitative unbiased MRI examination of different body fat components is useful in longitudinal monitoring of obesity in cats.

The pharmacological inhibition of sodium-glucose cotransporter 2 (SGLT2) has emerged as a treatment for patients with type 2 diabetes mellitus (T2DM), cardiovascular disease and/or other metabolic disturbances, although some of the mechanisms implicated in their beneficial effects are unknown. The SGLT2 inhibitor (SGLT2i) empagliflozin has been suggested as a regulator of adiposity, energy metabolism, and systemic inflammation in adipose tissue. The aim of our study was to evaluate the impact of a 6-week-empagliflozin treatment on the lipidome of visceral (VAT) and subcutaneous adipose tissue (SAT) from diabetic obese Zucker Diabetic Fatty (ZDF) rats using an untargeted metabolomics approach. We found that empagliflozin increases the content of diglycerides and oxidized fatty acids (FA) in VAT, while in SAT, it decreases the levels of several lysophospholipids and increases 2 phosphatidylcholines. Empagliflozin also reduces the expression of the cytokines interleukin-1 beta (IL-1β), IL-6, tumor necrosis factor-alpha (TNFα), monocyte-chemotactic protein-1 (MCP-1) and IL-10, and of Cd86 and Cd163 M1 and M2 macrophage markers in VAT, with no changes in SAT, except for a decrease in IL-1β. Empagliflozin treatment also shows an effect on lipolysis increasing the expression of hormone-sensitive lipase (HSL) in SAT and VAT and of adipose triglyceride lipase (ATGL) in VAT, together with a decrease in the adipose content of the FA transporter cluster of differentiation 36 (CD36). In conclusion, our data highlighted differences in the VAT and SAT lipidomes, inflammatory profiles and lipolytic function, which suggest a distinct metabolism of these two white adipose tissue depots after the empagliflozin treatment.

Simple Summary: Maternal adipose tissue grows during pregnancy to secure the fetus's nutritional supply, and too much visceral adipose tissue at the start of pregnancy can increase metabolic risk and gestational problems. The distribution of fat, and more particularly the rise in visceral fat or central obesity, has been found to be more closely linked to the onset of cardiovascular disease and metabolic syndrome than obesity itself. Our goal is to examine the association between the thickness of the mother's visceral fat, as determined by a first trimester ultrasound exam, and the risk of poor pregnancy outcomes. We observed that women who experienced complications during pregnancy had greater levels of maternal visceral fat, especially gestational diabetes, which was linked to metabolic risk factors including insulin resistance and arterial blood pressure. This fact may imply that the risk of complications would increase more when the distribution of visceral fat (associated with metabolic risk) is greater than expected for a given degree of obesity/body mass index. Obese women are more likely to experience pregnancy complications. The distribution of fat, and more particularly the rise in visceral fat, is well established to be more closely linked to the onset of cardiovascular disease and metabolic syndrome than obesity itself. We aim to examine the relationship between maternal visceral fat assessment in the first trimester and the appearance of adverse pregnancy outcomes. A prospective cohort study including 416 pregnant women was conducted. During the first trimester scan (11–13 + 6 weeks), all individuals had their visceral fat and subcutaneous thicknesses measured by ultrasonography. Blood samples were obtained, and maternal demographics and clinical information were documented. After delivery, the obstetric outcomes were evaluated. We contrasted two groups: one with healthy pregnancies and the other with adverse pregnancy outcomes (APO), defined as the development of at least one of the following complications: gestational diabetes mellitus, hypertensive disorders of pregnancy, abnormal fetal growth, preterm delivery or preterm premature rupture of membranes. Median maternal age was 33 and 34 years old for the uncomplicated and adverse pregnancy outcomes groups, respectively. We found that women with adverse pregnancy outcomes had higher VFT (median 30 vs. 26.5 mm, p = 0.001) and SFT (median 18.9 vs. 17.1 mm, p = 0.03). However, the visceral/subcutaneous fat ratio was not statistically different between groups. Finally, we performed a subanalysis for metabolic and placental vascular dysfunction complications. After performing a multivariate logistic regression analysis adjusted for maternal age, smoking, and mean arterial pressure, both the VFT (aOR 1.03, p < 0.001) and the ratio of visceral/subcutaneous fat (aOR 1.37, p = 0.04) were significantly associated with the development of adverse pregnancy outcomes; however, the associations of VFT and the VFT-to-SFT ratio were higher for the occurrence of gestational diabetes (aOR 1.07, p < 0.001; aOR 2.09, p = 0.001; respectively) and showed no relationships with placental complications. When conducting a first-trimester ultrasound assessment, sonographers may measure VFT without additional time or cost involved. Identification of pregnant women with increased VFT (>37 mm) may benefit from a close follow-up, especially for the development of gestational diabetes, independent of BMI. [ABSTRACT FROM AUTHOR]

Purpose: To assess abdominal fat deposition and lumbar vertebra with iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL-IQ) and investigate their correlation with menopausal status. Materials and Methods: Two hundred forty women who underwent routine abdominal MRI and IDEAL-IQ between January 2016 and April 2021 were divided into two cohorts (first cohort: 120 pre- or postmenopausal women with severe fatty livers or without fatty livers; second cohort: 120 pre- or postmenopausal women who were obese or normal weight). The fat fraction (FF) values of the liver (FFliver) and lumbar vertebra (FFlumbar) in the first group and the FF values of subcutaneous adipose tissue (SAT) (FFSAT) and FFlumbar in the second group were measured and compared using IDEAL-IQ. Results: Two hundred forty women were evaluated. FFlumbar was significantly higher in both pre- and postmenopausal women with severe fatty liver than in patients without fatty livers (premenopausal women: p < 0.001, postmenopausal women: p < 0.001). No significant difference in the FFlumbar was observed between obese patients and normal-weight patients among pre-and postmenopausal women (premenopausal women: p = 0.113, postmenopausal women: p = 0.092). Significantly greater lumbar fat deposition was observed in postmenopausal women than in premenopausal women with or without fatty liver and obesity (p < 0.001 for each group). A high correlation was detected between FFliver and FFlumbar in women with severe fatty liver (premenopausal women: r=0.76, p<0.01; postmenopausal women: r=0.82, p<0.01). Conclusion: Fat deposition in the vertebral marrow was significantly associated with liver fat deposition in postmenopausal women. [ABSTRACT FROM AUTHOR]

Background: The term "non-alcoholic fatty liver disease" (NAFLD) refers to a range of disorders caused by lipid accumulation in the liver. High abdominal fat levels can cause adipocytes to become more lipolytic, releasing free fatty acids into the portal venous system. In this study, we aimed to use the analysis of visceral fat, subcutaneous fat, muscle mass, and liver volume to evaluate the severity of fatty liver in NAFLD. Results: This study enrolled 130 patients with non-alcoholic fatty liver disease. The mean age of studied patients was 51.38 ± 11.11 years, ranging between 25 and 65 years. Of the studied patients, 60 (46.2%) patients were males and 70 (53.8%) were females. The mean body mass index was 41.23 ± 7.83 (kg/m2). Based on the radiological assessment of those patients, patients with grade III fatty liver had significantly higher total fat volume, visceral fat volume, subcutaneous fat volume, fat rate in the body, visceral fat volume rate, psoas muscle volume, and psoas muscle ratio in comparison with those with grade I and grade II fatty liver. Liver enzymes significantly correlated with total fat volume, visceral fat volume rate, psoas muscle volume, psoas muscle ratio, and liver volume. Conclusions: The degree of fatty liver severity among patients with NAFLD was positively correlated with the amount of subcutaneous, visceral fat, and muscle mass. Also, both liver transaminases had a significant positive correlation with the amount of total and visceral fat, psoas muscle mass, and liver volume. [ABSTRACT FROM AUTHOR]

Background: Totally extraperitoneal (TEP) repair is a recommended procedure for inguinal hernia repair in European hernia guidelines. However, technical challenges have limited its uptake in Japan, where transabdominal preperitoneal (TAPP) repair is more common. We evaluated the association of preoperative subcutaneous fat area (preSFA) with surgical outcomes and identified factors associated with the difficulty of TEP repair. Methods: Clinical data from 62 patients undergoing TEP repair were collected retrospectively. Using the median for the preoperative subcutaneous fat index (preSFI; 45.9 cm2 /m2 ), we classified patients as having a high SFI (HSFI) (n=31) and low SFI (LSFI) (n=31). Surgical outcomes and perioperative complications were then compared between these groups. Additionally, TEP repair was divided into five phases (e.g., Phase 1: dissection of the caudal side of the preperitoneal space), and operative time was measured during each phase. Phase 1 was divided into two sub-phases (1A: insertion of the first port, 1B: reaching Cooper’s ligament). Results: Operative time was longer (133 min vs 111 min, P = 0.028) and the peritoneal injury rate was higher (35.5% vs 9.7%, P = 0.015) for the HSFI patients. Furthermore, operative time for HSFI patients was significantly longer during Phase 1 (P = 0.014) and Phase 1A (P = 0.022). Conclusions: preSFA was associated with a higher peritoneal injury rate and longer operative time in HSFI patients, suggesting that the presence of abundant subcutaneous fat increases the difficulty of TEP repair. [ABSTRACT FROM AUTHOR]

The paper covers the peculiarities of the degree of meat shapes in the bulls of the Ukrainian meat breed, depending on the adipose tissue content under the skin and between the muscles. They were evaluated according to their productivity from 8 to 18, 21, and 23 months. Bulls with better development of meat shapes are characterized by fat deposition in the carcass and between the muscles earlier and more intensively. They have from 15.1 to 44.7% more fatty tissue in the carcass, including under the skin - from 3.8 to 44.1%. With a different degree of meat shapes, subcutaneous fat is deposited more than between muscles. The content of adipose tissue under the skin relative to its total amount in the body of animals tends to decrease by 6.5 points with age for a better degree of meat shapes, and on the contrary, to increase by 2.6 points for a worse degree. If the fat under the bull skin at 18 months in the best shapes is 72.1% of the fat in the carcass, and in the worst - 72.3%, then at 23 months, its amount decreases by 13.6 and 4.4 points, respectively. The fat between the muscles, on the contrary, increases from 27.9 and 27.7% by the same amounts, respectively. With a greater degree of meat shapes and subcutaneous fat thickness on the carcasses of 18-month-old bulls, intramuscular fat (marbling) content is lower by 75.0%. 18-month-old bulls with better-developed meat shapes have fat cuts off from the carcass by 15.2% more than animals with less developed shapes, 23 - by 11.3%. A large amount of produced waste in the body of animals in the best meat shape leads to excessive (from 0.9 to 14.5%) feed consumption (feed unit) for the increase in live weight. The subcutaneous fat content and the number of cuts off from 16 to 24 months positively correlate with the degree of meat shapes in bulls at 15 months and have correlation coefficients of 0.26 and 0.17, respectively. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine whether ultrasound imaging is an efficient method to assess subcutaneous fat in cats, the anatomical sites where more significant fat deposition occurs, and if there is a correlation between subcutaneous fat thickness and serum levels of cholesterol, triglycerides, and fructosamine. A total of 30 healthy adult cats were used and divided into three groups of 10 animals each, based on the estimated body condition score (BCS). The ideal group (IG) included cats with BCS 3; the overweight group (OWG), with BCS 4; and the obese group (OG), with BCS 5. Ultrasonographic measurement of subcutaneous fat was conducted in five anatomical regions: lumbar, abdominal, thoracic, femoral, and pectoral. We observed that obese cats had greater fat deposition in the abdominal and thoracic regions when compared to those with ideal weight, and that cholesterol and triglyceride levels were higher with the increase in subcutaneous fat thickness in the thoracic region. Nonetheless, there were no differences in fat deposition in the OWG compared to cats from the IG and OG. Ultrasonography made it possible to associate cholesterol and triglyceride levels with local fat deposits and to differentiate obese cats from those with ideal weight by analyzing the thickness of subcutaneous fat in the abdominal and thoracic regions, making this method efficient and less subjective. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the study is to see if visceral fat volume (VFV), subcutaneous fat volume (SFV), and visceral-subcutaneous fat ratio (VSR) can be used to detect metabolically obese normal weight individuals in Asian Indian population. Methods: This is a single center prospective cross-sectional study and 80 cases having either hypertension, diabetes, or hyperlipidemia with normal waist circumference and 80 controls having normal metabolic parameters with normal waist circumference were evaluated. Visceral and subcutaneous fat volumes and visceral to subcutaneous fat ratios were determined by computed tomography (CT) at L4–L5 level with a slice thickness of 5 mm. Results: Visceral fat volume, subcutaneous fat volume, and VSR are significantly higher in patients with metabolic risk factors as compared to those without risk factors. Volume of subcutaneous fat is significantly higher in females as compared to males. VSR is higher in males in our study. The cutoff values for VFV, SFV, and VSR to predict at least one metabolic syndrome are 8.5 cm3, 15.7 cm3, and 0.61 in males and 7.0 cm3, 16.5 cm3, and 0.44 in females. Conclusions: For individuals with normal waist circumference, VFV, SFV, and VSR can effectively predict the presence of one metabolic risk factor. Key Points: • Visceral fat volume, subcutaneous fat volume, and visceral-subcutaneous fat ratio can predict individuals at risk of metabolic syndrome having normal waist circumference. • Higher VSR in Indian population is due to low reservoir of primary adipose tissue fat compartment which leads to diversion of adipocytes into the secondary adipose tissue fat compartment. • This data can be used as a screening tool in preventive radiology for identifying individuals at risk of developing metabolic syndrome. [ABSTRACT FROM AUTHOR]

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Simple Summary: Cryolipolysis is a technique based on reduction of skin temperature, leading to local or systemic exposure of subcutaneous adipose tissue to active cooling, which are able to cause possible inflammatory and oxidative stress repercussions. In the present study, cyolipolysis in adult women did not change body composition, lipid profile or inflammatory markers; when applied on the abdomen and flanks, this procedure led to an isolated increase in lipid peroxidation markers. Besides no cardiometabolic risk using this procedure was observed. In the present study, the effects of cryolipolysis on one and multiple body areas, assessing body composition, lipid profile and peroxidation and inflammatory markers were investigated. Twenty-four women aged between 20 and 59 years were randomly assigned to three groups: (1) control, (2) cryolipolysis on the abdomen and (3) cryolipolysis on the abdomen + flanks. Anthropometric measurements, bioimpedance and ultrasound were performed, as well serum lipid profile, lipid peroxidation markers (malondialdehyde and myeloperoxidase) and inflammatory markers (C-reactive protein and Interleukin-1β) were determined. In addition, food consumption and physical activity level were evaluated. Data were obtained at 0, 10 and 30 days (t0, t10 and t30) after cryolipolysis. Cryolipolysis did not change anthropometric measurements, body composition or lipid profile. Interestingly, the abdomen + flanks group had significantly increased plasma myeloperoxidase activity at t0, t10 and t30, and increased malondialdehyde levels at t0 and t10 when compared to the other groups. Furthermore, there were no differences between macronutrient intake and total energy value, physical activity level, malondialdehyde and interleukin-1β at t30. Cryolipolysis did not change body composition, lipid profile or inflammatory markers investigated. On the other hand, when used on the abdomen and flanks, it produced an increase in lipid peroxidation markers, malondialdehyde and myeloperoxidase. [ABSTRACT FROM AUTHOR]

Visceral adiposity has been established as a predictor of outcomes in various cancers. We aimed to determine the association of radiographic measurements of visceral fat with clinical outcomes in patients with endometrial cancer. A retrospective review of patients with stage III-IV endometrial cancer who underwent surgery between 2004 and 2014 was performed. Visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and total adipose tissue (TAT;VAT+SAT) were assessed on preoperative computed tomography (CT) scans. Exploratory analysis was performed to establish the optimal cut-off values for VAT, SAT, and TAT to identify patients with poor prognostic body composition. Survival rates were analyzed using Kaplan-Meier analysis, log-rank tests, and cox-regression. Eighty-three patients were included. Forty-two (51%) patients had a low VAT/SAT ratio (<0.45) and 41 (49.4%) had a high VAT/SAT ratio (>0.45). There were no significant differences in demographics between the groups. The mean VAT, SAT, and TAT were 176.3 cm2, 379.3 cm2, and 555.3 cm2 respectively. Compared to patients with low VAT/SAT ratios, patients with high VAT/SAT ratios had a shorter recurrence-free survival (median 29.6 vs 32.3 months, P = 0.01) and shorter overall survival (median 56 vs 93.7 months, P = 0.03). Visceral fat measurements are predictive of outcomes in patients with advanced stage endometrial cancer. Specifically, VAT to SAT ratios are predictive of overall survival. Future studies should be pursued to identify potential therapeutic targets and biological mechanisms that underlie obesity's relationship with endometrial cancer. • Advanced stage endometrial cancer can be difficult to treat as there is no definitive optimal treatment regimen. • Visceral and subcutaneous fat stores can be easily measured on preoperative CT scans. • High visceral to subcutaneous fat ratios were associated with poorer outcomes in this patient cohort. • Preoperative CT scans could be used as a screening tool to determine which patients may require more aggressive treatment. [ABSTRACT FROM AUTHOR]

Background This study aimed to determine the optimal cut-off values of visceral fat area (VFA) and visceral-to-subcutaneous fat ratio (VSR) for predicting incident type 2 diabetes mellitus (T2DM). Methods A total of 10,882 individuals (6,835 men; 4,047 women) free of T2DM at baseline aged between 30 and 79 years who underwent abdominal computed tomography scan between 2012 and 2013 as a part of routine health check-ups were included and followed. VFA, subcutaneous fat area, and VSR on L3 vertebral level were measured at baseline. Results During a median follow-up of 4.8 years, 730 (8.1% for men; 4.3% for women) incident cases of T2DM were identified. Receiver operating characteristic curve analysis showed that the optimal cut-off values of VFA and VSR for predicting incident T2DM were 130.03 cm2 and 1.08 in men, respectively, and 85.7 cm2 and 0.48 in women, respectively. Regardless of sex, higher VFA and VSR were significantly associated with a higher risk of incident T2DM. Compared with the lowest quartiles of VFA and VSR, the highest quartiles had adjusted odds ratios of 2.62 (95% confidence interval [CI], 1.73 to 3.97) and 1.55 (95% CI, 1.14 to 2.11) in men, respectively, and 32.49 (95% CI, 7.42 to 142.02) and 11.07 (95% CI, 3.89 to 31.50) in women, respectively. Conclusion Higher VFA and VSR at baseline were independent risk factors for the development of T2DM. Sex-specific reference values for visceral fat obesity (VFA ≥130 cm2 or VSR ≥1.0 in men; VFA ≥85 cm2 or VSR ≥0.5 in women) are proposed for the prediction of incident T2DM.

Summary: Background & Aims: Measuring the thickness of skinfolds using calipers is a frequently used method for determining body fat in clinical practice. It is inexpensive and time saving compared to other methods and can be learned quickly. The aim of this study is to compare skinfold measurements made using calipers against measurements obtained using high-resolution ultrasonography (USG). Methods: A monocentric cross-sectional observational pilot study with 69 normal-weight volunteer participants aged between 18 and 80 years (women: n = 36, men: n = 33). Subcutaneous fat thickness was measured at five different sites (chest, abdomen, thighs, triceps, and back) using calipers and via USG.The mean values from the calipers and the USG measurements were examined for statistical significance using the paired t-test, and the Bland–Altman plot was used to compare the two methods. We then performed an agreement analysis by calculating the percentage of the differences less than or equal to 1 mm between the measurements made using calipers and those obtained via USG. Results: From the Bland–Altman analysis, the best matches among measurements for the female subjects were the skinfolds on the triceps (ULoA: 4.6 mm, mean: −0.1 mm, LLoA: −4.8 mm), the back (ULoA: 3.9 mm, mean: −0.2 mm, LLoA: −4.4 mm), and on the chest (ULoA: 5.9 mm, mean: 0.6 mm, LLoA: −4.6 mm). In contrast, for the male subjects, the best matches were the skinfolds on the triceps (ULoA: 3.3 mm, mean: −0.3 mm, LLoA −4.0 mm), the back (ULoA 3.5 mm, mean −0.3 mm, LLoA −4.0 mm), and the thigh (ULoA 2.2 mm, mean −0.5 mm, LLoA −3.2 mm).The best agreement for women was obtained with the measurements of the chest fold (47.2%), followed by the measurements of the back fold (38.9%). For men, it was the measurements of the thigh fold (63.6%), followed by the measurements of the triceps (51.5%) and back fold (51.5%). Conclusion: The agreement between skinfold measurements made using calipers and ultrasonography depends on the skinfold thickness and the localization of the measurement, with gender-based differences.

PurposeSkeletal muscle is the largest regulator of glucose metabolism, but few population-based studies have examined the associations between muscle and inflammation. We studied the relationships between abdominal muscle area and density with selected adiposity-associated inflammatory mediators.MethodsNearly 2000 subjects underwent computed tomography of the abdomen and had venous fasting blood drawn concomitantly. The computed tomography scans were interrogated for visceral and subcutaneous fat, as well as abdominal lean muscle areas and densities. We then categorized the muscle into locomotion (psoas) and stabilization (rectus, obliques, and paraspinal) groups. Blood samples were assayed for interleukin-6 (IL-6), resistin, C-reactive protein, and TNF-α.ResultsThe mean age was 64.7 yr, and 49% were female. Forty percent were white, 26% Hispanic/Latino American, 21% African American, and 13% Chinese American. The mean body mass index was 28.0 kg·m, and 30% were obese (body mass index, >30 kg·m). Using multivariable linear regression models that included adjustment for abdominal muscle area, a 1-SD increment in the mean densities for total, stabilization, and locomotive abdominal muscle were each significantly associated with lower levels of IL-6 (β = -15%, -15%, and -9%, P < 0.01 for all) and resistin (β = -0.11, -0.11, and -0.07 ng·mL, P < 0.02 for all), but not C-reactive protein or TNF-α. Conversely, muscle area was not independently associated with any of the inflammatory mediators studied.ConclusionsHigher densities of several muscle groups in the abdomen are significantly associated with lower IL-6 and resistin levels, independent of the muscle area in these groups. Techniques that enhance muscle density may reduce levels of adiposity-associated inflammatory mediators.

AimsIncreased epicardial adipose tissue (EAT), pericardial adipose tissue (PAT), periaortic adipose tissue (PaAT), and subcutaneous adipose tissue (SAT) are mediators of metabolic risk, and are associated with the severity of coronary artery calcium (CAC). Aged garlic extract (AGE) has been shown to reduce the progression of coronary atherosclerosis. This study evaluates the effect of AGE with supplements (AGE+S) on EAT, PAT, SAT, and PaAT.MethodsSixty asymptomatic participants participated in a randomized trial evaluating the effect of AGE+S versus placebo on coronary atherosclerosis progression, and underwent CAC at baseline and after 12 months of treatment. EAT, PAT, PaAT, and SAT volumes were measured on CAC scans. PAT was calculated as: intrathoracic adipose tissue-EAT. SAT was defined as the volume of fat depot anterior to the sternum and posterior to the vertebra. PaAT was defined as fat depot around the descending aorta.ResultsAt 1 year, the increase in EAT, PAT, PaAT, and SAT was significantly lower in the AGE+S as compared with the placebo group (P

BackgroundComputed tomography (CT)-based fat and muscle measures are associated with outcome in large populations. We tested if muscle and fat characteristics are associated with long-term outcomes after TAVR.MethodsWe included 403 clinical CTs performed prior to TAVR at our center between 2008 and 2016, measuring area (cm2) and density (Hounsfield units, HU) of both psoas muscles (PM), subcutaneous adipose (SAT), and visceral adipose tissue (VAT). Area measures were indexed to height, log-transformed and both area and density were standardized for analysis. We assessed the association of each measure with all-cause mortality (adjusted for age, sex, body mass index (BMI), and the Society of Thoracic Surgeons (STS) risk score.ResultsOf the 403 individuals (83 ± 8 years; 52% female), 167 (41.4%) died during a median follow-up of 458 days (interquartile range IQR 297-840). Fat measures were feasible and rapid. Fat area was available in 242 (60%) patients with an adequate field of view. Individuals with the lowest PM area, SAT area or VAT area exhibited the highest hazard of mortality. In addition, greater SAT density was associated with a higher mortality hazard (adjusted HR per standard deviation increase in density = 1.35, 95%CI 1.10-1.67, P = 0.005).ConclusionRapid CT-based tissue characterization is feasible in patients referred for TAVR. Decreased PM area and increased SAT density are associated with long-term mortality after TAVR, even after accounting for age, sex, BMI, and STS score. Further studies are necessary to interrogate sex-specific relationships between CT tissue metrics and mortality and whether CT measures are incremental to well-established frailty metrics.

BackgroundData on associations between abdominal fat depot mass and subclinical atherosclerosis are limited, especially in women with HIV.MethodsWe assessed cross-sectional associations of dual X-ray absorptiometry scan-derived estimates of visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue (SAT) with 3 measures of subclinical carotid artery atherosclerosis-carotid artery stiffness (Young's modulus of elasticity), presence of carotid artery lesions, and carotid artery intima-media thickness-in a subsample of participants in the Women's Interagency HIV Study. Statistical models adjusted for demographic variables, HIV serostatus, behavioral variables, and cardiovascular risk factors.ResultsThere were 244 women with and 99 without HIV infection (median age 42, 62% black). VAT mass (but not SAT) was associated with greater carotid artery stiffness in a fully adjusted linear regression model, including adjustment for SAT (β = 11.3 log 10·N·m per kg VAT, 95% confidence interval: 1.0 to 21.7). Greater SAT mass was associated with lower odds of having a carotid artery lesion in a fully adjusted model, including adjustment for VAT [adjusted odds ratio, 0.49 per kg of SAT (0.25 to 0.94)]. Neither VAT nor SAT was associated with carotid artery intima-media thickness. The VAT/SAT ratio was not statistically associated with any of the outcomes after covariate adjustment.ConclusionsIn our cross-sectional study of women, the majority of whom had HIV, greater VAT mass was associated with increased carotid artery stiffness, whereas greater SAT mass was associated with a reduced odds of prevalent carotid artery lesions.

PURPOSE:Obesity is a leading modifiable contributor to breast cancer mortality due to its association with increased recurrence and decreased overall survival rate. Obesity stimulates cancer progression through chronic, low-grade inflammation in white adipose tissue, leading to accumulation of adipose tissue macrophages (ATMs), in particular, the pro-inflammatory M1 phenotype macrophage. Exercise has been shown to reduce M1 ATMs and increase the more anti-inflammatory M2 ATMs in obese adults. The purpose of this study was to determine whether a 16-week exercise intervention would positively alter ATM phenotype in obese postmenopausal breast cancer survivors. METHODS:Twenty obese postmenopausal breast cancer survivors were randomized to a 16-week aerobic and resistance exercise (EX) intervention or delayed intervention control (CON). The EX group participated in 16 weeks of supervised exercise sessions 3 times/week. Participants provided fasting blood, dual-energy X-ray absorptiometry (DXA), and superficial subcutaneous abdominal adipose tissue biopsies at baseline and following the 16-week study period. RESULTS:EX participants experienced significant improvements in body composition, cardiometabolic biomarkers, and systemic inflammation (all p