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Body composition and metabolic syndrome in patients with type 1 diabetes

World Journal of Diabetes 2024年第1期15卷 81-91页

作者： Qiong Zeng Xiao-Jing Chen Yi-Ting He Ze-Ming Ma Yi-Xi Wu Kun Lin Department of Neurology The First Affiliated Hospital of Shantou University Medical CollegeShantou 515041Guangdong ProvinceChina Medical College Shantou University Medical CollegeShantou 515041Guangdong ProvinceChina Department of Endocrinology The First Affiliated Hospital of Shantou University Medical CollegeShantou 515041Guangdong ProvinceChina

BACKGROUND In recent years,the prevalence of obesity and metabolic syndrome in type 1 diabetes(T1DM)patients has gradually increased.Insulin resistance in T1DM deserves attention.It is necessary to clarify the relationship between body composition,metabolic syndrome and insulin resistance in T1DM to guide clinical treatment and intervention.AIM To assess body composition(BC)in T1DM patients and evaluate the relationship between BC,metabolic syndrome(MS),and insulin resistance in these indi-viduals.METHODS A total of 101 subjects with T1DM,aged 10 years or older,and with a disease duration of over 1 year were included.Bioelectrical impedance analysis using the Tsinghua-Tongfang BC Analyzer BCA-1B was employed to measure various BC parameters.Clinical and laboratory data were collected,and insulin resistance was calculated using the estimated glucose disposal rate(eGDR).RESULTS MS was diagnosed in 16/101 patients(15.84%),overweight in 16/101 patients(15.84%),obesity in 4/101(3.96%),hypertension in 34/101(33.66%%)and dyslip-idemia in 16/101 patients(15.84%).visceral fat index(VFI)and trunk fat mass were significantly and negatively correlated with eGDR(both Pfat percentage and visceral fat ratio compared to male patients.Binary logistic regression analysis revealed that significant factors for MS included eGDR[P=0.017,odds ratio(OR)=0.109],VFI(P=0.030,OR=3.529),and a family history of diabetes(P=0.004,OR=0.228).Significant factors for hypertension included eGDR(Pfat mass(P=0.033,OR=1.202)and eGDR(P=0.037,OR=0.708).CONCLUSION visceral fat was found to be a superior predictor of MS compared to conventional measures such as body mass index and waist-to-hip ratio in Chinese individuals with T1DM.BC analysis,specifically identifying visceral fat(trunk fat),may play an important role in identifying the increased risk of MS in non-obese patients with T1DM.

关键词： Body composition Metabolic syndrome Insulin resistance visceral fat Estimated glucose disposal rate

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Can visceral fat parameters based on computed tomography be used to predict occult peritoneal metastasis in gastric cancer?

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World Journal of Gastroenterology 2023年第15期29卷 2310-2321页

作者： Li-Ming Li Lei-Yu Feng Chen-Chen Liu Wen-Peng Huang Yang Yu Peng-Yun Cheng Jian-Bo Gao Department of Radiology Henan Key Laboratory of Imaging Diagnosis and Treatment for Digestive system TumorThe First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052Henan ProvinceChina Department of Cardiology The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052Henan ProvinceChina Department of Radiology The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052Henan ProvinceChina Department of Nuclear Medicine Peking University First HospitalBeijing 100034China Beijing Branch Siemens Healthineers Ltd.Shenyang 110011Liaoning ProvinceChina

BACKGROUND The preoperative prediction of peritoneal metastasis(PM)in gastric cancer would prevent unnecessary surgery and promptly indicate an appropriate treatment plan.AIM To explore the predictive value of visceral fat(VF)parameters obtained from preoperative computed tomography(CT)images for occult PM and to develop an individualized model for predicting occult PM in patients with gastric carcinoma(GC).METHODS A total of 128 confirmed GC cases(84 male and 44 female patients)that underwent CT scans were analyzed and categorized into PM-positive(n=43)and PM-negative(n=85)groups.The clinical characteristics and VF parameters of two regions of interest(ROIs)were collected.Univariate and stratified analyses based on VF volume were performed to screen for predictive characteristics for occult PM.Prediction models with and without VF parameters were established by multivariable logistic regression analysis.RESULTS The mean attenuations of VF_(ROI 1)and VF_(ROI 2)varied significantly between the PM-positive and PMnegative groups(P=0.044 and 0.001,respectively).The areas under the receiver operating characteristic curves(AUCs)of VF_(ROI 1)and VF_(ROI 2)were 0.599 and 0.657,respectively.The mean attenuation of VF_(ROI 2)was included in the final prediction combined model,but not an independent risk factor of PM(P=0.068).No significant difference was observed between the models with and without mean attenuation of VF(AUC:0.749 vs 0.730,P=0.339).CONCLUSION The mean attenuation of VF is a potential auxiliary parameter for predicting occult PM in patients with GC.

关键词： Gastric carcinoma Peritoneal metastasis visceral fat Tomography X-ray computed Prediction Individualized model

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Estimation of visceral fat is useful for the diagnosis of significant fibrosis in patients with non-alcoholic fatty liver disease

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World Journal of Gastroenterology 2020年第42期26卷 6658-6668页

作者： Marta Hernández-Conde Elba Llop Carlos Fernández Carrillo Beatriz Tormo Javier Abad Luis Rodriguez Christie Perelló Marta López Gomez JoséLuis Martínez-Porras Natalia Fernández Puga Maria Trapero-Marugan Enrique Fraga Carlos Ferre Aracil JoséLuis Calleja Panero Gastroenterology and Hepatology Department IDIPHISAHospital Universitario Puerta de Hierro-MajadahondaMadrid 28222Spain Centro de Investigación Biomédica en Red en elÁrea temática de Enfermedades Hepáticas Instituto de Salud Carlos IIIMadrid 28029Spain

BACKGROUND Obesity is a risk factor for non-alcoholic fatty liver disease(NAFLD),although obese patients with NAFLD do not always develop significant fibrosis.The distribution of body fat could predict the risk of NAFLD progression.AIM To investigate the role of bioelectrical impedance-estimated visceral fat(VF)in assessing NAFLD severity.METHODS In this cross-sectional study,patients with biopsy-proven NAFLD were prospectively included.All patients underwent anthropometric evaluation,blood tests and bioelectrical impedance analysis.RESULTS Between 2017 and 2020,119 patients were included[66.4%male,56 years(SD 10.7),62.2%obese,61.3%with metabolic syndrome].Sixty of them(50.4%)showed significant fibrosis(≥F2)in liver biopsy.Age,VF and metabolic syndrome were associated with significant fibrosis(61 years vs 52 years,16.4 vs 13.1,73.3%vs 49.2%,respectively;P<0.001 for all).In the multivariate analysis,VF and age were independently associated with significant fibrosis(VF,OR:1.11,95%CI:1.02-1.22,P=0.02;age,OR:1.08,95%CI:1.03-1.12,P<0.01).A model including these variables showed and area under the receiver operating characteristic curve(AUROC)of 0.75,which was not inferior to transient elastography or NAFLD fibrosis score AUROCs.We developed a nomogram including age and VF for assessing significant fibrosis in routine practice.CONCLUSION VF is a surrogate marker of liver fibrosis in patients with NAFLD.Bioelectrical impedance analysis is an inexpensive and simple method that can be combined with age to guide patient referral when other resources may be unavailable.

关键词： Non-alcoholic fatty liver disease visceral fat Liver fibrosis Bioimpedanciometry Metabolic syndrome Obesity

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Effect of Ovariectomy on Serum Adiponectin Levels and visceral fat in Rats

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2014年第6期34卷 825-829页

作者： Camara Ce 周林远马炎朱琳于东赵要武杨年红 Department of Nutrition and Food Hygiene Hubei Key Laboratory of Food Nutrition and Safety Huazhong University of Science and Technology Department of Nutrition and Food Hygiene Hubei Key Laboratory of Food Nutrition and SafetyHuazhong University of Science and Technology Key Lab of Environment and Health of the Ministry of Education School of Public Health Tongji Medical College Huazhong University of Science and Technology

This study was aimed to examine the effect of ovariectomy on visceral fat, serum adi- ponectin levels and lipid profile. Forty-five female Sprague DawIey rats were divided into three groups （n=15 each）： ovariectomized group （OVX）, ovariectomized plus estrogen-treated group （OVX＋E2）, and sham-operated group （SHAM）. Body weight, abdominal adipose tissues, serum adiponectin and lipid profile were measured and compared among the groups after three-month feeding post-surgery. Signifi- cant increases in body weight and visceral fat were found in ovariectomized rats when compared with sham-operated ones and significant increases were also observed in serum adiponectin, triglyceride and very low density lipoprotein cholesterol levels in ovariectomized rats. Body weight, visceral fat and se- rum adiponectin levels were profoundly reduced in OVX＋E2 group as compared with OVX group. It was concluded that ovarian hormone deficiency induced by ovariectomy leads to significant increases in body weight and visceral fat, along with increased serum adiponectin, triglyceride and very low density lipoprotein cholesterol levels in rats. Attenuation in these changes can be achieved by estrogen supple- mentation.

关键词： ovariectomy estrogen post menopause serum adiponectin visceral fat

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The Accumulation of visceral fat and Preventive Measures among the Elderly

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Cardiovascular Innovations and Applications 2020年第2期4卷 279-285页

作者： Israel Oluwasegun Ayenigbara School Health and Community Health Unit Department of Health EducationUniversity of IbadanIbadanNigeria

visceral fat is a specifi c fat that is produced in the body,transformed into cholesterol,and circulated in the blood to other parts of the body.The circulated cholesterol usually in the form of low-density lipoproteins forms plaque on the walls of the arteries,thereby constricting and blocking them and preventing the free fl ow of nutrients to various vital organs in the body.visceral fat is deleterious to the health of elderly people because it is mostly found in the region of the abdomen that houses vital organs such as the pancreas,liver,and digestive tract,and it further affects the normal functioning of hormones in the body.Globally,15 million people die of a noncommunicable disease(NCD)annually between the age of 30 years and the age of 69 years,and there is an increase in NCD morbidity among people older than 70 years.Accumulated visceral fat in elderly people could have deleterious health consequences,as it is a predisposing factor for many other NCDs and chronic health conditions.Sedentary lifestyle,unhealthy eating,stress,and inactivity are the major causes of excessive visceral fat.However,measures to prevent the accumulation of visceral fat are straightforward,and impressive results are achieved with regular physical exercise,healthy diet choices,and proper stress management.

关键词： visceral fat prevention healthy diet exercise stress management

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visceral adipose volume is correlated with surgical tissue fibrosis in Crohn’s disease of the small bowel

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Gastroenterology Report 2022年第1期10卷 451-459页

作者： Gang Yuan Yao He Qing-Hua Cao Mi-Mi Tang Zong-Lin Xie Yun Qiu Zhi-Rong Zeng Sui Peng Min-Hu Chen Department of Gastroenterology The First Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongP.R.China Department of Pathology The First Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongP.R.China Department of Radiology The First Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongP.R.China Clinical Trial Unit The First Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongP.R.China Institute of Precision Medicine The First Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongP.R.China

Background This study explored the diagnostic performance of visceral adiposity to predict the degree of intestinal inflammation and fibrosis.Methods The patients with Crohn’s disease(CD)who underwent surgical small bowel resection at the First Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)between January 2007 and December 2017 were enrolled.We evaluated the intestinal imaging features of computed tomography enterography(CTE),including mesenteric inflammatory fat stranding,the target sign,mesenteric hypervascularity,bowel wall thickening,lymphadenopathy,stricture diameter,and maximal upstream diameter.We used A.K.software(Artificial Intelligence Kit,version 1.1)to calculate the visceral fat(VF)and subcutaneous fat(SF)volumes at the third lumbar vertebra level.Pathological tissue information was recorded.Diagnostic models were established based on the multivariate regression analysis results,and their effectiveness was evaluated by area under the curve(AUC)and decision curve analyses.Results Overall,48 patients with CD were included in this study.The abdominal VF/SF volume ratio(odds ratio,1.20;95%confidence interval,1.05–1.38;P=0.009)and the stenosis diameter/upstream intestinal dilatation diameter(ND)ratio(odds ratio,0.90;95%confidence interval,0.82–0.99;P=0.034)were independent risk factors for the severe fibrosis of the small intestine.The AUC values of the VF/SF ratio,the ND ratio,and their combination were 0.760,0.673,and 0.804,respectively.The combination of the VS/SF volume ratio and ND ratio achieved the highest net benefit on the decision curve.Conclusion The VF volume on CTE can reflect intestinal fibrosis.The combination of the VF/SF volume ratio and ND ratio of CD patients assessed using CTE can help predict severe fibrosis stenosis of the small intestine.

关键词： Crohn’s disease intestinal fibrosis visceral fat computed tomography enterography

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Pancreatic enzymes and abdominal adipose tissue distribution in new-onset prediabetes/diabetes after acute pancreatitis

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World Journal of Gastroenterology 2021年第23期27卷 3357-3371页

作者： Juyeon Ko Loren Skudder-Hill Jaelim Cho Sakina H Bharmal Maxim S Petrov School of Medicine University of AucklandAuckland 1142New Zealand

BACKGROUND New-onset prediabetes/diabetes after acute pancreatitis(NODAP)is the most common sequela of pancreatitis,and it differs from type 2 prediabetes/diabetes mellitus(T2DM).AIM To study the associations between circulating levels of pancreatic amylase,pancreatic lipase,chymotrypsin and fat phenotypes in NODAP,T2DM,and health.METHODS Individuals with NODAP(n=30),T2DM(n=30),and sex-matched healthy individuals(n=30)were included.Five fat phenotypes(intra-pancreatic fat,liver fat,skeletal muscle fat,visceral fat,and subcutaneous fat)were determined using the same magnetic resonance imaging protocol and scanner magnet strength for all participants.One-way analysis of covariance,linear regression analysis,and relative importance analysis were conducted.RESULTS Intra-pancreatic fat deposition(IPFD)was higher in NODAP(9.4%±1.8%)and T2DM(9.8%±1.1%)compared with healthy controls(7.8%±1.9%)after adjusting for covariates(P=0.003).Similar findings were observed in regards to visceral fat volume(P=0.005),but not subcutaneous fat volume,liver fat,or skeletal muscle fat.Both IPFD(β=-2.201,P=0.023)and visceral fat volume(β=-0.004,P=0.028)were significantly associated with circulating levels of pancreatic amylase in NODAP,but not in T2DM or healthy individuals.Of the five fat phenotypes,IPFD explained the highest amount of variance in pancreatic amylase concentration(R2=15.3%out of 41.2%).None of the phenotypes contributed meaningfully to the variance in pancreatic lipase or chymotrypsin.CONCLUSION Both NODAP and T2DM are characterized by increased IPFD and visceral fat volume.However,only NODAP is characterized by significant inverse associations between the two fat phenotypes and pancreatic amylase.

关键词： Amylase Lipase Chymotrypsin Pancreatitis Diabetes Intra-pancreatic fat visceral fat Liver fat

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Obesity in China： its characteristics, diagnostic criteria, and implications

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Frontiers of Medicine 2015年第2期9卷 129-133页

作者： Weiping Jia Department of Endocrinology and Metabolism Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai Clinical Centerfor Diabetes Shanghai Diabetes Institute Shanghai Key Laboratory of Diabetes Mellitus Shanghai Key Clinical Center for MetabolicDisease Shanghai 200233 China

The rising prevalence of overweight and obesity in several countries has been described as a global pandemic. Obesity and obesity-related diseases are increasing dramatically and have become a massive burden on world economy and global health. In 2010, overweight and obesity were estimated to cause 3.4 million deaths, with 4% of years of life lost and 4% of disability-adjusted life-years worldwide [1]. Abdominal obesity, also known as central obesity, refers to the presence of excess fat in the abdominal area. Epidemiological studies have demonstrated that obesity, especially central obesity,

关键词： INTIMA-MEDIA THICKNESS BODY-MASS INDEX WAIST CIRCUMFERENCE CUTOFFS CORONARY-ARTERY-DISEASE METABOLIC RISK-FACTORS ABDOMINAL OBESITY visceral fat CARDIOVASCULAR-DISEASE ADULT OVERWEIGHT ADIPOSE-TISSUE

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Chronic stress directly induces steatohepatitis while decreases visceral fat mass in mice

Chronic stress directly induces steatohepatitis while decrea...

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中国神经科学学会第十届全国学术会议

作者： Yun-Zi LIU Ji-Kuai CHEN Yi ZHANG Xia WANG Chun-Lei JIANG Laboratory of Stress Medicine Faculty of Psychology and Mental HealthSecond Military Medical University Department of Nautical Medicine Second Military Medical University Department of Pharmacology School of PharmacySecond Military Medical University

Objective Chronic stress disrupts body’s homeostasis and markedly increases vulnerability to various health problems.Long-term of stress exposure is a risk factor of metabolism-related diseases such as obesity and type 2diabetes.However,a relationship between chronic stress and non-alcoholic fatty hver disease（NAFLD） is unknown.Methods C57/bl6 mice were randomly assigned to the control or stress group（n = 10,respectively）.The stressed mice were received electronic foot shock and restraint stress every day.After 12 weeks,all mice were anesthetized using isoflurane.Blood was collected by orbital puncture,followed by sacrifice via cervical dislocation.Then the whole hver and intra-abdominal adipose were removed and weighed.Hematoxylin-Eosin（HE） and Oil Red O staining of hver sections and serum biochemical analysis were measured.Serum,adipose and hver cytokines were measured by Bio-Plex Suspension Array System.Results When compared to non-stressed control mice,chronically stressed mice had less food intake and decreased visceral fat mass.In addition,mice in the stress group had markedly increased hepatic triglyceride and cholesterol.HE and oil red O staining showed chronically stressed mice had microvesicular steatosis,lobular inflammation and ballooning degeneration.The levels of serum triglyceride and cholesterol were similar between the chronic stress and control groups.Pro-inflammatory factors and chemokines were measured in serum,hver and visceral fat tissue.Levels of hepatic TNF-α,IL-6 and plasminogen activator inhibitor-1（PAI-1） were elevated in stress group.Levels of serum TNF-α,IL-6,IL-1β and monocyte chemoattractant protein-1（MCP-1） were significantly increased.Although the amount of visceral fat was decreased in stress group,various adipocytokines such as IL-6,IL-1β,macrophage inflammatory protein 2（MIP-2）,MCP-1 and PAI-1 were elevated.Conclusion Chronic stress could directly induce NAFLD.

关键词： chronic stress NAFLD steatosis visceral fat inflammation

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SARS-CoV-2-the Unforeseen Peril of David Winning Against Goliath:the Immune Giant Collapsing Under Its Own Rampaging Cytokine Storm

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Journal of Endocrinology Research 2020年第1期2卷 26-43页

作者： Xanya Sofra City University London New School for Social Research New York

We examined SARS-CoV-2(Covid-19)available treatments and prophylactic methods that included interventions associated with inhibiting the“type II transmembrane serine protease”(TMPRSS2)to limit the fusion between the Covid-19 Spike proteins and ACE2 receptors,or newly developed therapeutics like Remdesivir that interferes with the viral RNA replication.We explored the dilemma of ACE2 receptors that have a protective function against high blood pressure associated disorders,yet,they serve as the viral points of entry,elevating the probability of infection.Human tissues’analysis reveals a higher ACE2 expression in adipose tissue,placing obesity-related conditions in the eye of the pandemic storm.It primarily exposes males due to the surge of ACE2 receptors in the testes along with other tissues.Males manifest a relatively higher positive ACE2 correlations with certain immune cells in the lungs,thyroid,adrenals,liver and colon,while females evidence higher ACE2 correlations with immune cells in the heart.The remaining tissues’ACE2/immunity expressions are equivalent in both sexes,indicating that despite its preference for males,the threat of Covid-19 can easily target females.Recent reports indicate that Covid-19 is empowered by hindering the critical process of viral recognition during the adaptive immune response leading to the“cytokine storm”,the aggravated immune response that indiscriminately perseveres,rampaging the host’s vital organs.Sedentary lifestyle,age-related hormonal imbalance,and adiposity induced inflammation predispose the body to the immune collapse following Covid-19 invasion,spotlighting the detrimental aftermath of metabolic dysfunction,and excess food consumption provoked by elevated cortisol and dysregulated appetite hormones.ACE 2 expression is suppressed in the skeletal muscle,rendering fitness and weight management an effective Covid-19 preventive intervention,along with social distancing,hygiene,and facial coverings.Physical activity,or exercise alternative methods have recently demonstrat

关键词： SARS-CoV-2 Covid-19 Cytokine Storm ACE2 Skeletal Muscle Mass visceral fat Triglycerides CRP Cortisol Remdesivir Leptin Ghrelin Free T3 IGF-1 HDL TMPRSS2 ADAM17 Angiotensin nsp12

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