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1.
Epicardial adipose tissue thickness and type 2 diabetes risk according to the FINDRISC modified for Latin America.
Lima-Martínez, MM, Colmenares, L, Campanelli, Y, Paoli, M, Rodney, M, Santos, RD, Iacobellis, G
Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis. 2019;(1):15-22
Abstract
BACKGROUND The Finnish Diabetes Risk Score (FINDRISC) is a tool to predict 10-year risk of type 2 diabetes mellitus (T2DM), and visceral adiposity is associated with higher cardio-metabolic risk. The objective of the study was to assess the relationship of epicardial adipose tissue (EAT) thickness with T2DM risk according to the FINDRISC tool. METHODS The study was conducted in Ciudad Bolívar, Venezuela, and included 55 subjects of whom 37 (67.3%) were women and 18 (32.7%) men with ages between 18 and 75 years. A record was made of weight, height, body mass index (BMI), waist circumference (WC), fasting glucose, baseline insulin, plasma lipids, Homeostasis Model Assessment-Insulin Resistance (HOMA-IR), and EAT thickness. The FINDRISC tool, with WC cut-off points modified for Latin America (LA-FINDRISC) was used. RESULTS BMI, WC, plasma insulin concentration, HOMA-IR index, and EAT thickness were higher (P<0.0001) in the high-risk group compared to subjects in the low-moderate risk group according to the LA-FINDRISC. LA-FINDRISC was positively correlated with BMI (r=0.513; P=0.0001), WC (r=0.524; P=0.0001), fasting blood glucose (r=0.396; P=0.003); baseline plasma insulin (r=0.483; P=0.0001); HOMA-IR index (r=0.545; P=.0.0001); and EAT thickness (r=0.702; P=0.0001). The multivariate regression analysis showed that fasting blood glucose (P=0.023) and EAT thickness (P=0.007) remained independently associated with high T2DM risk. CONCLUSIONS LA-FINDRISC was associated with EAT thickness and insulin resistance markers. Both were independently and directly associated with high risk for diabetes in the LA-FINDRISC category.
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2.
Determinants of ectopic liver fat in metabolic disease.
Bosy-Westphal, A, Braun, W, Albrecht, V, Müller, MJ
European journal of clinical nutrition. 2019;(2):209-214
Abstract
Common obesity-associated hepatic steatosis (nonalcoholic fatty liver disease (NAFLD)) and insulin resistance are mainly caused by dysfunctional adipose tissue. This adipose tissue dysfunction leads to increased delivery of NEFA and glycerol to the liver that (i) drives hepatic gluconeogenesis and (ii) facilitates the accumulation of lipids and insulin signaling inhibiting lipid intermediates. Dysfunctional adipose tissue can be caused by impaired lipid storage (overflow hypothesis, characterized by large visceral adipocytes) or increased lipolysis (due to impaired postprandial suppression of lipolysis in inflamed, insulin-resistant adipocytes). In line with the adipose tissue expandability hypothesis the amount and distribution of adipose tissue correlate with its dysfunction and thus with liver fat. This relationship is however modified by endocrine effects on lipid storage and lipolysis as well as dietary effects on hepatic lipogenesis and lipid oxidation. The association between body composition characteristics like visceral obesity or fat cell size and ectopic liver fat is modified by these influences. Phenotyping obesity according to metabolic risk should integrate body composition characteristics, endocrine parameters and information on diet.
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Acute Ingestion of a Mixed Flavonoid and Caffeine Supplement Increases Energy Expenditure and Fat Oxidation in Adult Women: A Randomized, Crossover Clinical Trial.
Nieman, DC, Simonson, A, Sakaguchi, CA, Sha, W, Blevins, T, Hattabaugh, J, Kohlmeier, M
Nutrients. 2019;(11)
Abstract
This randomized, double-blinded, crossover study measured the acute effect of ingesting a mixed flavonoid-caffeine (MFC) supplement compared to placebo (PL) on energy expenditure (EE) and fat oxidation (FATox) in a metabolic chamber with premenopausal women (n = 19, mean ± SD, age 30.7 ± 8.0 year, BMI 25.7 ± 3.4 kg/m2). The MFC supplement (658 mg flavonoids, split dose 8:30, 13:00) contained quercetin, green tea catechins, and anthocyanins from bilberry extract, and 214 mg caffeine. Participants were measured twice in a metabolic chamber for a day, four weeks apart, with outcomes including 22 h EE (8:30-6:30), substrate utilization from the respiratory quotient (RQ), plasma caffeine levels (16:00), and genotyping for the single-nucleotide polymorphism (SNP) rs762551. Areas under the curve (AUC) for metabolic data from the MFC and PL trials were calculated using the trapezoid rule, with a mixed linear model (GLM) used to evaluate the overall treatment effect. The 22 h oxygen consumption and EE were significantly higher with MFC than PL (1582 ± 143, 1535 ± 154 kcal/day, respectively, p = 0.003, trial difference of 46.4 ± 57.8 kcal/day). FATox trended higher for MFC when evaluated using GLM (99.2 ± 14.0, 92.4 ± 14.4 g/22 h, p = 0.054). Plasma caffeine levels were significantly higher in the MFC versus PL trial (5031 ± 289, 276 ± 323 ng/mL, respectively, p < 0.001). Trial differences for 22 h EE and plasma caffeine were unrelated after controlling for age and body mass (r = -0.249, p = 0.139), and not different for participants with the homozygous allele 1, A/A, compared to C/A and C/C (p = 0.50 and 0.56, respectively). In conclusion, EE was higher for MFC compared to PL, and similar to effects estimated from previous trials using caffeine alone. A small effect of the MFC on FATox was measured, in contrast to inconsistent findings previously reported for this caffeine dose. The trial variance for 22 h EE was not significantly related to the variance in plasma caffeine levels or CYP1A2*1F allele carriers and non-carriers.
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A semi-automatic approach for epicardial adipose tissue segmentation and quantification on cardiac CT scans.
Militello, C, Rundo, L, Toia, P, Conti, V, Russo, G, Filorizzo, C, Maffei, E, Cademartiri, F, La Grutta, L, Midiri, M, et al
Computers in biology and medicine. 2019;:103424
Abstract
Many studies have shown that epicardial fat is associated with a higher risk of heart diseases. Accurate epicardial adipose tissue quantification is still an open research issue. Considering that manual approaches are generally user-dependent and time-consuming, computer-assisted tools can considerably improve the result repeatability as well as reduce the time required for performing an accurate segmentation. Unfortunately, fully automatic strategies might not always identify the Region of Interest (ROI) correctly. Moreover, they could require user interaction for handling unexpected events. This paper proposes a semi-automatic method for Epicardial Fat Volume (EFV) segmentation and quantification. Unlike supervised Machine Learning approaches, the method does not require any initial training or modeling phase to set up the system. As a further key novelty, the method also yields a subdivision into quartiles of the adipose tissue density. Quartile-based analysis conveys information about fat densities distribution, enabling an in-depth study towards a possible correlation between fat amounts, fat distribution, and heart diseases. Experimental tests were performed on 50 Calcium Score (CaSc) series and 95 Coronary Computed Tomography Angiography (CorCTA) series. Area-based and distance-based metrics were used to evaluate the segmentation accuracy, by obtaining Dice Similarity Coefficient (DSC) = 93.74% and Mean Absolute Distance (MAD) = 2.18 for CaSc, as well as DSC = 92.48% and MAD = 2.87 for CorCTA. Moreover, the Pearson and Spearman coefficients were computed for quantifying the correlation between the ground-truth EFV and the corresponding automated measurement, by obtaining 0.9591 and 0.9490 for CaSc, and 0.9513 and 0.9319 for CorCTA, respectively. In conclusion, the proposed EFV quantification and analysis method represents a clinically useable tool assisting the cardiologist to gain insights into a specific clinical scenario and leading towards personalized diagnosis and therapy.
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The implication of adipocyte ATP-binding cassette A1 and G1 transporters in metabolic complications of obesity.
Choromanska, B, Mysliwiec, P, Hady, HR, Dadan, J, Mysliwiec, H, Bonda, T, Chabowski, A, Miklosz, A
Journal of physiology and pharmacology : an official journal of the Polish Physiological Society. 2019;(1)
Abstract
Obesity is characterised by imbalance in lipid metabolism manifested by high concentrations of circulating triacylglycerols and total cholesterol as well as low high-density lipoprotein (HDL) levels. Abnormalities related to these lipids lead to metabolic complications such as type 2 diabetes, arterial hypertension and cardiovascular disease. Despite extensive research, it is still unclear why a subset of obese subjects develop metabolic syndrome, while others do not. The aim of our work was to assess total and plasma membrane expressions of cholesterol transport proteins: adipocyte ATP-binding cassette A1 (ABCA1), adipocyte ATP-binding cassette G1 (ABCG1), class B scavenger receptor (SR-BI) in visceral and subcutaneous adipose tissue of obese subjects with and without metabolic syndrome. To keep our preliminary study group uniform, we focused on women, who constitute the majority of bariatric patients. The study was performed on 34 patients: 24 morbidly obese women subjected to bariatric surgery, half of whom had metabolic syndrome; and 10 lean subjects undergoing elective laparoscopic cholecystectomy. Total and plasma membrane expressions of cholesterol transport proteins (SR-BI, ABCA1 and ABCG1) were assessed in samples of both visceral and subcutaneous adipose and analysed in relation to other clinical and laboratory parameters. We demonstrated lower plasma membrane expressions of ABCG1 in visceral adipose tissue of obese patients with metabolic syndrome as compared to lean ones. In addition, total ABCG1 expressions in both types of adipose tissue were lower in morbidly obese patients with metabolic syndrome compared to those without metabolic syndrome. Plasma membrane ABCA1 expressions in visceral adipose tissue were lower in the group of morbidly obese patients without metabolic syndrome, compared to lean patients. We did not find any significant differences in SR-BI expressions. Because of ABCG1 is responsible for cholesterol efflux to HDL, reduced plasma membrane expression of ABCG1 in VAT of morbidly obese women with metabolic syndrome may leads to a significantly decreased concentration of HDL in serum. This may be also confirmed by high positive correlation between both parameters.
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Associations of types of dairy consumption with adiposity: cross-sectional findings from over 12 000 adults in the Fenland Study, UK.
Trichia, E, Imamura, F, Brage, S, De Lucia Rolfe, E, Griffin, SJ, Wareham, NJ, Forouhi, NG
The British journal of nutrition. 2019;(8):928-935
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Abstract
Evidence from randomised controlled trials supports beneficial effects of total dairy products on body weight, fat and lean mass, but evidence on associations of dairy types with distributions of body fat and lean mass is limited. We aimed to investigate associations of total and different types of dairy products with markers of adiposity, and body fat and lean mass distribution. We evaluated cross-sectional data from 12 065 adults aged 30-65 years recruited to the Fenland Study between 2005 and 2015 in Cambridgeshire, UK. Diet was assessed with an FFQ. We estimated regression coefficients (or percentage differences) and their 95 % CI using multiple linear regression models. The medians of milk, yogurt and cheese consumption were 293 (interquartile range (IQR) 146-439), 35·3 (IQR 8·8-71·8) and 14·6 (IQR 4·8-26·9) g/d, respectively. Low-fat dairy consumption was inversely associated with visceral:subcutaneous fat ratio estimated with dual-energy X-ray absorptiometry (-2·58 % (95 % CI -3·91, -1·23 %) per serving/d). Habitual consumption per serving/d (200 g) of milk was associated with 0·33 (95 % CI 0·19, 0·46) kg higher lean mass. Other associations were not significant after false discovery correction. Our findings suggest that the influence of milk consumption on lean mass and of low-fat dairy consumption on fat mass distribution may be potential pathways for the link between dairy consumption and metabolic risk. Our cross-sectional findings warrant further research in prospective and experimental studies in diverse populations.
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Effects of Diets on Adipose Tissue.
Ezquerro, S, Rodríguez, A, Portincasa, P, Frühbeck, G
Current medicinal chemistry. 2019;(19):3593-3612
Abstract
BACKGROUND Obesity is a major health problem that has become a global epidemic. Overweight and obesity are commonly associated with the development of several pathologies, such as insulin resistance, cardiovascular diseases, sleep apnea and several types of cancer, which can lead to further morbidity and mortality. An increased abdominal adiposity renders overweight and obese individuals more prone to metabolic and cardiovascular problems. OBJECTIVE This Review aims to describe the dietary strategies to deal with excess adiposity given the medical, social and economic consequences of obesity. METHODS One hundred and eighty-five papers were included in the present Review. RESULTS Excess adiposity leads to several changes in the biology, morphology and function of the adipose tissue, such as adipocyte hypertrophy and hyperplasia, adipose tissue inflammation and fibrosis and an impaired secretion of adipokines, contributing to the onset of obesity- related comorbidities. The first approach for obesity management and prevention is the implementation of a diet combined with physical activity. The present review summarizes the compelling evidence showing body composition changes, impact on cardiometabolism and potential adverse effects of very-low calorie, low- and high-carbohydrate, high-protein or low-fat diets. The use of macronutrients during the preprandial and postprandial state has been also reviewed to better understand the metabolic changes induced by different dietary interventions. CONCLUSION Dietary changes should be individualised, tailored to food preferences and allow for flexible approaches to reducing calorie intake in order to increase the motivation and compliance of overweight and obese patients.
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Development of a bedside-applicable ultrasound protocol to estimate fat mass index derived from whole body dual-energy x-ray absorptiometry scans.
Paris, MT, Mourtzakis, M
Nutrition (Burbank, Los Angeles County, Calif.). 2019;:225-230
Abstract
OBJECTIVES Precise measures of adiposity are difficult to obtain in clinical settings due to a lack of access to accurate and reliable techniques. The aim of this study was to develop and internally validate a bedside-applicable ultrasound protocol to estimate fat mass index. METHODS We conducted an observational cross-sectional study of 94 university and community dwelling adults who attended a single data-collection session. Adipose tissue thickness was quantified in a supine or prone position using the four-site protocol (images two anterior sites on each thigh) and the nine-site protocol (images nine anterior and posterior sites). Adipose tissue thicknesses from the four-site protocol were compared against the fat mass index that was derived from dual-energy x-ray absorptiometry scans. Subsequently, we optimized the accuracy of the four-site protocol with the addition of bedside-accessible adipose tissue thicknesses from the nine-site protocol and easily obtained covariates. RESULTS The four-site protocol was strongly associated (R2 = 0.65) with fat mass index but wide limits of agreement (-3.53 kg/m2 and 3.50 kg/m2) were observed using the Bland-Altman analysis. With the addition of the anterior upper arm and abdomen adipose tissue thicknesses as well as the covariates age, sex, and body mass index, the model accuracy improved (R2 = 0.93) and the Bland-Altman analysis displayed narrower limits of agreement (-1.57 kg/m2 and 1.60 kg/m2). CONCLUSIONS This optimized protocol developed can be applied bedside and provide accurate assessments of fat mass index.
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Does caffeine ingestion before a short-term sprint interval training promote body fat loss?
Ferreira, GA, Felippe, LC, Bertuzzi, R, Bishop, DJ, Ramos, IS, De-Oliveira, FR, Lima-Silva, AE
Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas. 2019;(12):e9169
Abstract
We investigated the effect of caffeine ingestion combined with a 2-wk sprint interval training (SIT) on training-induced reductions in body adiposity. Twenty physically-active men ingested either 5 mg/kg of cellulose as a placebo (PLA, n=10) or 5 mg/kg of caffeine (CAF, n=10) 60 min before each SIT session (13×30 s sprint/15 s of rest). Body mass and skinfold thickness were measured pre- and post-training. Energy expenditure was measured at rest, during exercise, and 45 min after exercise in the first SIT session. Body fat was similar between PLA and CAF groups at pre-training (P>0.05). However, there was a significant decrease in body fat after training in the CAF group (-5.9±4.2%, P<0.05) but not in PLA (1.5±8.0%, P>0.05). There was no difference in energy expenditure at rest and during exercise between PLA and CAF groups (P>0.05), but the post-exercise energy expenditure was 18.3±21.4% greater in the CAF than in the PLA group (P<0.05). In conclusion, caffeine ingestion before SIT sessions induced a body fat loss that may be associated with higher post-exercise energy expenditure.
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miR-20b, miR-296, and Let-7f Expression in Human Adipose Tissue is Related to Obesity and Type 2 Diabetes.
Gentile, AM, Lhamyani, S, Coín-Aragüez, L, Clemente-Postigo, M, Oliva Olivera, W, Romero-Zerbo, SY, García-Serrano, S, García-Escobar, E, Zayed, H, Doblado, E, et al
Obesity (Silver Spring, Md.). 2019;(2):245-254
Abstract
OBJECTIVE This study aimed to analyze the potential association of different microRNA (miRNA) molecules with both type 2 diabetes (T2D) and obesity and determine their target genes. METHODS Quantitative PCR was used to analyze the miR-20b, miR-296, and Let-7f levels in human visceral and subcutaneous adipose tissues (ATs) in relation to obesity and T2D, miRTarBase 4.0 was used for validation of target genes, and the Protein Analysis Through Evolutionary Relationships (PANTHER) Classification System and the Database for Annotation, Visualization and Integrated Discovery (DAVID) were used to annotate the biological processes of the predicted targets. RESULTS In AT, miR-20b, miR-296, and Let-7f levels were significantly different between normoglycemic subjects and those with T2D. In visceral adipose tissue, miRNA levels were higher in normoglycemic/obesity samples than in T2D/obesity samples. miR-20b-miR-296 and Let-7f target genes that showed significant differences in both ATs in relation to obesity and T2D were CDKN1A, CX3CL1, HIF1A, PPP2R1B, STAT3, and VEGFA. These genes are known to be principally involved in the vascular endothelial growth factor (VEGF) and WNT pathways. CONCLUSIONS This study provides experimental evidence of the possible correlation between AT miR-20b-miR-296-Let-7f with obesity and T2D, which might involve vascular endothelial growth factor and WNT-dependent pathways that are regulated by six different genes, suggesting a novel signaling pathway that could be important for understanding the mechanisms underlying the AT dysfunction associated with obesity and T2D.