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Abstract Objective To evaluate the association between inflammatory markers and abdominal fat assessed by ultrasound in prepubertal children with and without excess weight. Methods A cross-sectional study involving 241 prepubertal children, 156 with obesity, 37 with overweight, and 48 with normal weight, aged five to ten years, who were followed at a research unit on Childhood Obesity from a teaching hospital belonging to a public health system. The concentration of interleukin-6, tumor necrosis factor-α and C-reactive protein were assessed and regression analyses, considering outcome variables such as abdominal wall and intra-abdominal fat thickness measured by ultrasound, were performed. Results The findings highlighted an association between abdominal fat and inflammatory markers, even in children at this young age group. Subcutaneous fat showed a stronger association with inflammatory biomarkers compared to intra-abdominal fat when performing logistic regression, with a positive association between tumor necrosis factor-α and abdominal wall thickness equal to or greater than the 75th percentile in adjusted logistic regression (OR: 18.12; CI 95 %: 1.57: 209.55). Conclusions Abdominal wall fat, in contrast to what is often observed in adults, appears to have a greater impact on chronic inflammation related to excessive weight in very young children.
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OBJECTIVE: To examine the relationship between the age-adjusted Charlson comorbidity index (A-CCI) with body composition and overall survival in patients newly diagnosed with colorectal cancer (CRC). RESEARCH METHODS AND PROCEDURES: In this cohort study, patients (≥ 18 years old) with CRC were followed for 36 months. Computed tomography images of the third lumbar were analyzed to determine body composition, including skeletal muscle area (SMA), skeletal muscle index (SMI), skeletal muscle radiodensity (SMD), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). Phenotypes based on comorbidity burden assessed by A-CCI and body composition parameters were established. RESULTS: A total of 436 participants were included, 50% male, with a mean age of 61 ± 13.2 years. Approximately half of the patients (50.4%) had no comorbidity, and the A-CCI median score was 4 (interquartile range: 3-6). A higher A-CCI score was a risk factor for 36-month mortality (HR = 3.59, 95% CI = 2.17-5.95). Low SMA and low SMD were associated with a higher A-CCI. All abnormal phenotypes (high A-CCI and low SMA; high A-CCI and low SMD; high A-CCI and high VAT) were independently associated with higher 36-month mortality hazard (adjusted HR 5.12, 95% CI 2.73-9.57; adjusted HR 4.58, 95% CI 2.37-8.85; and adjusted HR 2.36, 95% CI 1.07-5.22, respectively). CONCLUSION: The coexistence of comorbidity burden and abnormal body composition phenotypes, such as alterations in muscle or fat compartments, may pose an additional risk of mortality in patients newly diagnosed with CRC. Early assessment and management of these phenotypes could be crucial in optimizing outcomes in such patients.
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Composición Corporal , Neoplasias Colorrectales , Comorbilidad , Humanos , Masculino , Neoplasias Colorrectales/mortalidad , Neoplasias Colorrectales/patología , Persona de Mediana Edad , Femenino , Anciano , Estudios de Cohortes , Factores de Riesgo , Tomografía Computarizada por Rayos X/métodos , Factores de EdadRESUMEN
OBJECTIVE: To evaluate the association between inflammatory markers and abdominal fat assessed by ultrasound in prepubertal children with and without excess weight. METHODS: A cross-sectional study involving 241 prepubertal children, 156 with obesity, 37 with overweight, and 48 with normal weight, aged five to ten years, who were followed at a research unit on Childhood Obesity from a teaching hospital belonging to a public health system. The concentration of interleukin-6, tumor necrosis factor-α and C-reactive protein were assessed and regression analyses, considering outcome variables such as abdominal wall and intra-abdominal fat thickness measured by ultrasound, were performed. RESULTS: The findings highlighted an association between abdominal fat and inflammatory markers, even in children at this young age group. Subcutaneous fat showed a stronger association with inflammatory biomarkers compared to intra-abdominal fat when performing logistic regression, with a positive association between tumor necrosis factor-α and abdominal wall thickness equal to or greater than the 75th percentile in adjusted logistic regression (OR: 18.12; CI 95 %: 1.57: 209.55). CONCLUSIONS: Abdominal wall fat, in contrast to what is often observed in adults, appears to have a greater impact on chronic inflammation related to excessive weight in very young children.
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Grasa Abdominal , Biomarcadores , Proteína C-Reactiva , Interleucina-6 , Factor de Necrosis Tumoral alfa , Ultrasonografía , Humanos , Niño , Masculino , Estudios Transversales , Femenino , Preescolar , Biomarcadores/sangre , Biomarcadores/análisis , Proteína C-Reactiva/análisis , Grasa Abdominal/diagnóstico por imagen , Factor de Necrosis Tumoral alfa/sangre , Factor de Necrosis Tumoral alfa/análisis , Interleucina-6/sangre , Interleucina-6/análisis , Obesidad Infantil , Inflamación/sangre , Índice de Masa Corporal , Grasa Intraabdominal/diagnóstico por imagen , SobrepesoRESUMEN
Resumo Fundamento O tecido adiposo visceral (TAV) pode ser um contribuinte modificável específico para o comprometimento autonômico relacionado à composição corporal. Objetivos Comparar a variabilidade da frequência cardíaca (VFC) entre grupos estratificados pela classificação de gordura visceral (CGC) e comparar associações entre VFC e métricas de composição corporal. Métodos Um estudo transversal foi realizado em homens saudáveis (n=99, idade=37,8±13,4 anos, índice de massa corporal [IMC]=26,9±4,6 kg/m2). A VFC foi derivada de registros eletrocardiográficos de 5 minutos. A composição corporal (percentual de gordura corporal, CGC e relação entre massa muscular e gordura visceral [RMMCGC]) foi estimada por meio de análise de impedância bioelétrica tetrapolar. Os participantes foram categorizados em grupos de acordo com a CGC: G1 (CGC=1-8); G2 (CGC=9-12); e G3 (CGC>12). Comparações ajustadas por idade foram feitas entre os grupos. Associações independentes foram quantificadas com regressões lineares múltiplas. P <0,05 foi significativo. Resultados Raiz quadrada média de diferenças sucessivas (RMSSD) e desvio padrão dos intervalos RR normais (SDNN) foram maiores para G1 vs. G2 e G3 (p<0,05). A potência de baixa frequência (BF) foi maior no G1 que no G2 (p<0,05). CGC e RMMCGC foram associados negativamente com SDNN, RMSSD, BF e AF (p<0,05). Depois de ajustar para idade, IMC e pressão arterial sistólica e diastólica, a CGC foi significativamente preditiva de RMSSD, SDNN e AF (p = 0,002, -0,027), e a RMMCGC foi significativamente preditiva de RMSSD e SDNN (p = 0,020, -0,023). Conclusões Os homens na categoria de CGC mais baixa tiveram a VFC mais alta. A CGC foi mais fortemente associada à VFC do que ao percentual de gordura corporal e à RMMCGC. Os parâmetros no domínio do tempo foram mais sensíveis ao TAV do que os parâmetros no domínio da frequência. Os parâmetros da VFC podem ser os principais parâmetros de interesse no rastreamento do estado autonômico cardíaco em resposta a intervenções que visam a redução do TAV.
Abstract Background Visceral adipose tissue (VAT) may be a specific modifiable contributor to body composition-related autonomic impairment. Objectives To compare heart rate variability (HRV) between groups stratified by visceral fat rating (VFR) and compare associations between HRV and body composition metrics. Methods A cross-sectional study was conducted on healthy men (n=99,age=37.8±13.4 years, body mass index [BMI]=26.9±4.6 kg/m2). HRV was derived from 5-minute electrocardiographic recordings. Body composition (body fat percentage, VFR, and muscle mass to visceral fat ratio [MMVFR]) was estimated using tetrapolar bioelectrical impedance analysis. Participants were categorized into groups according to VFR: G1 (VFR=1-8); G2(VFR=9-12); and G3(VFR>12). Age-adjusted comparisons were made between groups. Independent associations were quantified with multiple linear regressions. P <0.05 was significant. Results Root-mean square of successive differences (RMSSD) and standard deviation of normal RR intervals (SDNN) were higher for G1 vs. G2 and G3 (p<0.05). Low-frequency power (LF) was higher in G1 than in G2 (p<0.05). VFR and MMVFR were negatively associated with SDNN, RMSSD, LF, and HF (p<0.05). After adjusting for age, BMI, and systolic and diastolic blood pressure, VFR was significantly predictive of RMSSD, SDNN, and HF (p=0.002,-0.027), and MMVFR was significantly predictive of RMSSD and SDNN (p=0.020,-0.023). Conclusions Men in the lowest VFR category had the highest HRV. VFR was more strongly associated with HRV than body fat percentage and MMVR. Time domain parameters were more sensitive to VAT than frequency domain parameters. HRV parameters could be the primary parameters of interest in tracking cardiac-autonomic status in response to interventions targeting VAT reduction.
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ABSTRACT Objectives: Body composition changes are associated with adverse effects such as increased insulin resistance (IR) in individuals with diabetes mellitus. This study aims to evaluate the association between different body adiposity markers and IR in adults with type 1 diabetes (T1D). Subjects and methods: The cross-sectional study included outpatient adults with T1D from a university public hospital in southern Brazil. The body adiposity markers studied were waist circumference (WC), waist-height ratio (WHtR), body mass index (BMI), conicity index (CI), lipid accumulation product (LAP) and body adiposity index (BAI). IR was calculated using an Estimated Glucose Disposal Rate (EGDR) equation (analyzed in tertiles), considering an inverse relation between EGDR and IR. Poisson regression models were used to estimate the odds ratio (OR) and 95% CIs of association of adiposity markers with IR. Results: A total of 128 patients were enrolled (51% women), with a median EGDR of 7.2 (4.4-8.7) mg.kg−1.min−1. EGDR was negatively correlated with WC (r = −0.36, p < 0.01), WHtR (r = −0.39, p < 0.01), CI (r = −0.44, p < 0.01), LAP (r = −0.41, p < 0.01) and BMI (r = −0.24, p < 0.01). After regression analyses, WC (OR = 2.07; CIs: 1.12-3.337; p = 0.003), WHtR (OR = 2.77; CIs: 1.59-4.79; p < 0.001), CI (OR = 2.59; CIs: 1.43-4.66; p = 0.002), LAP (OR = 2.27; CIs: 1.25-4.11; p = 0.007) and BMI (OR = 1.78; CIs: 1.09-2.91; p = 0.019) remained associated with IR. Conclusions: The authors suggest using the studied adiposity markers as a routine since they were shown to be suitable parameters in association with IR.
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SUMMARY OBJECTIVE: The aim of this study was to compare the correlation of maternal visceral adiposity with sonographic variables related to fetal biometry in the second trimester of pregnancy in mothers who were previously obese versus nonobese and gestational diabetic versus nondiabetic. METHODS: This cross-sectional study included 583 pregnant women who received prenatal care between October 2011 and September 2013 at the Instituto de Medicina Integral Prof. Fernando Figueira, northeast of Brazil. Maternal visceral adiposity was measured by ultrasound examination at the same time as fetal biometry. Gestational age was 14.9±3.2 weeks. The correlation between maternal visceral adiposity and fetal biometric variables was evaluated using Pearson's correlation coefficient. Among the groups, the correlation coefficients were compared using Fisher's Z-test. This test was also used to evaluate the null hypothesis of correlation coefficients between pairs of variables. RESULTS: Maternal visceral adiposity positively correlated with fetal abdominal circumference, estimated fetal weight, head circumference, femur length, and biparietal diameter in pregnant women with obesity, nonobesity, gestational diabetes, and nondiabetes, but the correlation coefficients were statistically similar among the groups. CONCLUSION: Maternal visceral adiposity positively correlated with fetal biometry in the second trimester of pregnancy in the same manner in pregnant women previously obese and nonobese, as well as in pregnant women with gestational diabetes and nondiabetes.
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Objective: Body composition changes are associated with adverse effects such as increased insulin resistance (IR) in individuals with diabetes mellitus. This study aims to evaluate the association between different body adiposity markers and IR in adults with type 1 diabetes (T1D). Subjects and methods: The cross-sectional study included outpatient adults with T1D from a university public hospital in southern Brazil. The body adiposity markers studied were waist circumference (WC), waist-height ratio (WHtR), body mass index (BMI), conicity index (CI), lipid accumulation product (LAP) and body adiposity index (BAI). IR was calculated using an Estimated Glucose Disposal Rate (EGDR) equation (analyzed in tertiles), considering an inverse relation between EGDR and IR. Poisson regression models were used to estimate the odds ratio (OR) and 95% CIs of association of adiposity markers with IR. Results: A total of 128 patients were enrolled (51% women), with a median EGDR of 7.2 (4.4-8.7) mg.kg-1.min-1. EGDR was negatively correlated with WC (r = -0.36, p < 0.01), WHtR (r = -0.39, p < 0.01), CI (r = -0.44, p < 0.01), LAP (r = -0.41, p < 0.01) and BMI (r = -0.24, p < 0.01). After regression analyses, WC (OR = 2.07; CIs: 1.12-3.337; p = 0.003), WHtR (OR = 2.77; CIs: 1.59-4.79; p < 0.001), CI (OR = 2.59; CIs: 1.43-4.66; p = 0.002), LAP (OR = 2.27; CIs: 1.25-4.11; p = 0.007) and BMI (OR = 1.78; CIs: 1.09-2.91; p = 0.019) remained associated with IR. Conclusion: The authors suggest using the studied adiposity markers as a routine since they were shown to be suitable parameters in association with IR.
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Diabetes Mellitus Tipo 1 , Resistencia a la Insulina , Adulto , Humanos , Femenino , Masculino , Adiposidad , Estudios Transversales , Obesidad , Circunferencia de la Cintura , Índice de Masa Corporal , Glucosa , Factores de RiesgoRESUMEN
Introducción: La profundización de los surcos nasolabiales es uno de los signos más tempranos del envejecimiento natural del ser humano y puede ser atenuado con el empleo de materiales de relleno, entre ellos el injerto de grasa autóloga. Objetivo: Describir los resultados de la infiltración de grasa autóloga en el surco nasolabial para el rejuvenecimiento facial. Métodos: Se realizó un estudio observacional, descriptivo, de corte longitudinal y prospectivo, para describir la infiltración de grasa autóloga en el surco nasolabial para el rejuvenecimiento facial en 40 pacientes. Los pacientes se siguieron durante seis meses de forma trimestral (un mes, tres meses y seis meses) y se evaluaron las variables: tiempo de recuperación, aparición de complicaciones, grado de satisfacción de los pacientes y resultados estéticos. Resultados: La edad media fue de 47 años, con predominio del sexo femenino. El 92 % de los pacientes se recuperó en menos de 10 días, con la aparición de seis complicaciones. La disminución del defecto posterior al procedimiento fue significativa respecto al momento inicial; sin embargo, con el tiempo (tres a seis meses) el defecto en el surco nasolabial reapareció en algunos pacientes. El grado de satisfacción de los pacientes vario entre un 95 % (un mes) a un 90 % a los seis meses y los resultados estéticos catalogados como buenos disminuyeron de un 90 % (un mes) a un 65 % (seis meses). Conclusiones: Se demostró que el injerto de grasa autóloga en el surco nasolabial es un procedimiento con resultados estéticos buenos, sin embargo, este disminuye en los meses posteriores, lo que puede estar relacionado con la reabsorción del injerto graso.
Introduction: The deepening of the nasolabial folds is one of the earliest signs of natural aging in humans and can be mitigated with the use of filler materials, including autologous fat grafting. Objective: To describe the results of autologous fat infiltration in the nasolabial fold for facial rejuvenation. Methods: An observational, descriptive, longitudinal and prospective study to describe the infiltration of autologous fat in the nasolabial fold for facial rejuvenation was carried out in 40 patients. The patients were followed up for 6 months: one month (1M), three months (3M) and six months (6M) and the evaluated variables were: recovery time, appearance of complications, degree of patient satisfaction and aesthetic results. Results: The average age was 47 years, with a female prevalence. 92% of patients recovered in less than 10 days, with the only appearance of six complications. The decrease in the defect after the procedure was significant compared to the initial moment; however, over time (3-6M) the defect in the nasolabial fold reappeared in some patients. The degree of patient satisfaction varied between 95% (1M) to 90% at 6M and the aesthetic results classified as good decreased from 90% (1M) to 65% (6M). Conclusions: It was shown that autologous fat grafting in the nasolabial fold is a procedure with good aesthetic results, however it decreases in subsequent months, which may be related to the reabsorption of the fat graft.
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Resumo Fundamento O aumento no volume de gordura epicárdica (VGE) está relacionado com doença arterial coronariana (DAC), independentemente de gordura visceral ou subcutânea. O mecanismo dessa associação não é claro. O escore de cálcio coronariano (CC) e a disfunção endotelial estão relacionados com eventos coronarianos, mas não está bem esclarecido se o VGE está relacionado com esses marcadores. Objetivos Avaliar a associação entre VGE medido por método automatizado, fatores de risco cardiovasculares, escore de CC, e função endotelial. Métodos: Em 470 participantes do Estudo Longitudinal de Saúde do Adulto LSA-Brasil com medidas de VGE, escore de CC e função endotelial, realizamos modelos multivariados para avaliar a relação entre fatore de risco cardiovascular e VGE (variável resposta), e entre VGE (variável explicativa), e função endotelial ou escore de CC. Valor de p<0,05 bilateral foi considerado estatisticamente significativo. Resultados A idade média foi 55 ± 8 anos, e 52,3% dos pacientes eram homens. O VGE médio foi 111mL (86-144), e a prevalência de escore de CC igual a zero foi 55%. Nas análises multivariadas, um VGE mais alto relacionou-se com sexo feminino, idade mais avançada, circunferência da cintura, e triglicerídeos (p<0,001 para todos). Um VGE mais alto foi associado com pior função endotelial: em comparação ao primeiro quartil, os valores de odds ratio para a amplitude de pulso basal foram (q2=1,22; IC95% 1,07-1,40; q3=1,50, IC95% 1,30-1,74; q4=1,50, IC95% 1,28-1,79) e para a razão de tonometria arterial periférica foram (q2=0,87; IC95% 0,81-0,95; q3=0,86, IC95% 0,79-0,94; q4=0,80, IC95% 0,73-0,89), mas não com escore de CC maior que zero. Conclusão Um VGE mais alto associou-se com comprometimento da função endotelial, mas não com escore de CC. Os resultados sugerem que o VGE esteja relacionado ao desenvolvimento de DAC por uma via diferente da via do CC, possivelmente pela piora da disfunção endotelial e doença microvascular.
Abstract Background The increase in epicardial fat volume (EFV) is related to coronary artery disease (CAD), independent of visceral or subcutaneous fat. The mechanism underlying this association is unclear. Coronary artery calcium (CAC) score and endothelial dysfunction are related to coronary events, but whether EFV is related to these markers needs further clarification. Objectives To evaluate the association between automatically measured EFV, cardiovascular risk factors, CAC, and endothelial function. Methods In 470 participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) with measures of EFV, CAC score and endothelial function, we performed multivariable models to evaluate the relation between cardiovascular risk factors and EFV (response variable), and between EFV (explanatory variable) and endothelial function variables or CAC score. Two-sided p <0.05 was considered statistically significant. Results Mean age was 55 ± 8 years, 52.3% of patients were men. Mean EFV was 111mL (IQ 86-144), and the prevalence of CAC score=0 was 55%. In the multivariable analyses, increased EFV was related to female sex, older age, waist circumference, and triglycerides (p<0.001 for all). Higher EFV was associated with worse endothelial function: as compared with the first quartile, the odds ratio for basal pulse amplitude were (q2=1.22, 95%CI 1.07-1.40; q3=1.50, 95%CI 1.30-1.74; q4=1.50, 95%CI 1.28-1.79) and for peripheral arterial tonometry ratio were (q2=0.87, 95%CI 0.81-0.95; q3=0.86, 95%CI 0.79-0.94; q4=0.80, 95%CI 0.73-0.89), but not with CAC score>0. Conclusion Higher EFV was associated with impaired endothelial function, but not with CAC. The results suggest that EFV is related to the development of CAD through a pathway different from the CAC pathway, possibly through aggravation of endothelial dysfunction and microvascular disease.
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Background: High anthropometric indexes before sleeve gastrectomy (SG) are associated with an increased risk of erosive esophagitis (EE) in bariatric surgery candidates. Reasons that explain how these indexes influence the development of esophageal pathology after surgery remains unclear. Objectives: To assess the association between the body mass index (BMI), waist circumference (WC), and body fat percentage (BFP) with the development of EE in adults with obesity three months after SG. Setting: Clínica Avendaño, Lima, Peru. Methods: Retrospective cohort using a database including adults with obesity who underwent SG during 2017-2020. All the patients included had an endoscopy before and after the surgery. Sociodemographic, clinical and laboratory characteristics were compared according to BMI, WC and BFP, as well as by the development of de novo esophagitis. The association was evaluated by crude and adjusted generalized linear models with the log-Poisson family. Results: From a total of 106 patients, 23 (21.7%) developed EE. We did not find significant differences in sociodemographic, clinical and laboratory characteristics between patients with de novo EE compared to those who did not develop EE. After adjustment, BMI (aRR = 0.59, 95% CI = 0.18-1.40), BFP (aRR = 0.41, 95% CI = 0.15-1.19) and WC (aRR = 0.91, 95% CI = 0.69-1.16) were not associated with the development of EE three months post SG. Conclusions: We found no association between preoperative anthropometric indexes and the development of de novo EE; therefore, morbid obesity should not be a criterion to exclude the patients to undergo SG as primary surgery because of the risk of developing EE.
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Esofagitis , Obesidad Mórbida , Adulto , Humanos , Tejido Adiposo , Índice de Masa Corporal , Esofagitis/etiología , Esofagitis/cirugía , Gastrectomía/efectos adversos , Obesidad Mórbida/complicaciones , Obesidad Mórbida/cirugía , Estudios Retrospectivos , Circunferencia de la CinturaRESUMEN
BACKGROUND: Low bone mineral density (BMD) is common in patients with inflammatory bowel disease. However, nutritional risk factors for low BMD in the ulcerative colitis (UC) population are still poorly understood. AIM: To investigate the association of anthropometric indicators and body composition with BMD in patients with UC. METHODS: This is a cross-sectional study on adult UC patients of both genders who were followed on an outpatient basis. A control group consisting of healthy volunteers, family members, and close people was also included. The nutritional indicators evaluated were body mass index (BMI), total body mass (TBM), waist circumference (WC), body fat in kg (BFkg), body fat in percentage (BF%), trunk BF (TBF), and also lean mass. Body composition and BMD assessments were performed by dual-energy X-ray absorptiometry. RESULTS: The sociodemographic characteristics of patients with UC (n = 68) were similar to those of healthy volunteers (n = 66) (P > 0.05). Most patients (97.0%) were in remission of the disease, 58.8% were eutrophic, 33.8% were overweight, 39.0% had high WC, and 67.6% had excess BF%. However, mean BMI, WC, BFkg, and TBF of UC patients were lower when compared to those of the control group (P < 0.05). Reduced BMD was present in 41.2% of patients with UC (38.2% with osteopenia and 2.9% with osteoporosis) and 3.0% in the control group (P < 0.001). UC patients with low BMD had lower BMI, TBM, and BFkg values than those with normal BMD (P < 0.05). Male patients were more likely to have low BMD (prevalence ratio [PR] = 1.86; 95% confidence interval [CI]: 1.07-3.26). Those with excess weight (PR = 0.43; 95%CI: 0.19-0.97) and high WC (PR = 0.44; 95%CI: 0.21-0.94) were less likely to have low BMD. CONCLUSION: Patients with UC in remission have a high prevalence of metabolic bone diseases. Body fat appears to protect against the development of low BMD in these patients.
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Obesity is a risk factor for gastroesophageal reflux disease. Studies addressing the brain-esophagus axis in obese are lacking. In obese with and without heartburn, we assessed: (i) the brain responses to esophageal acid perfusion during functional brain imaging; (ii) esophageal impedance baseline before and after acid perfusion; and (iii) abdominal fat distribution. In this exploratory study, 26 obese underwent functional magnetic resonance imaging (fMRI) of the brain combined with esophageal acid perfusion. Esophageal impedance baseline was determined before and after fMRI, followed by tomographic quantification of the abdominal fat. Among 26 obese (54% men, 39.7 years old, 33.5 kg/m2), there were 17 with heartburn and 9 without heartburn. Before fMRI, the esophageal impedance baseline was lower in obese with heartburn than without heartburn (median 1187 vs. 1890 Ω; P = 0.025). After acid perfusion, impedance baseline decreased in obese with heartburn (from 1187 to 899 Ω; P = 0.011) and was lower in this group than in obese without heartburn (899 vs. 1614 Ω; P = 0.001). fMRI task-residual analysis showed that obese with heartburn presented higher functional connectivity in several brain regions than obese without heartburn. Abdominal fat area did not differ between obese with and without heartburn either for total (72.8 ± 4.4% vs. 70.3 ± 6.0%; P = 0.280), subcutaneous (42.2 ± 9.0% vs. 37.4 ± 9.0%; P = 0.226), or visceral (30.6 ± 7.9% vs. 33.0 ± 7.8%; P = 0.484). In subjects with obesity, the brain-esophagus axis is disrupted centrally with higher functional brain connectivity and peripherally with decreased esophageal mucosa integrity in the presence of heartburn.
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Monitorización del pH Esofágico , Pirosis , Humanos , Masculino , Adulto , Femenino , Esófago/patología , Impedancia Eléctrica , Ácidos , Obesidad/complicaciones , Encéfalo/diagnóstico por imagen , Encéfalo/patologíaRESUMEN
OBJECTIVE: Studies of subcutaneous and visceral abdominal fat thickness evaluated by ultrasound as a predictor of gestational diabetes mellitus (GDM) have been published, but the best technique and standardization are unknown. To identify, critically evaluate, and analyze studies using subcutaneous and visceral abdominal fat as a model for predicting GDM in the first and second trimesters of pregnancy and evaluate their methodological quality. METHODS: PubMed, Scopus, and Web of Science databases were searched from May to July 2019. We included studies of any sample size performed for any duration and in any configuration. Model development and validation studies were eligible for inclusion. Two authors independently performed the eligibility assessment of the studies by reviewing the titles and abstracts. Data on study design, gestational age, diagnostic criteria for GDM, device, ultrasound fat measurement technique, and cutoff point for GDM prediction were extracted. RESULTS: The electronic search resulted in 1331 articles, of which 14 were eligible for systematic review. Different criteria for diagnosing GDM and fat measurement techniques were used. The cutoff point for subcutaneous, visceral, and total abdominal fat for predicting GDM in the first and second trimesters varied between the studies. CONCLUSION: No study validated the model for predicting GDM using subcutaneous and visceral abdominal fat measurements. External validation studies are recommended to improve the generalization of this GDM predictor in clinical practice.
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Diabetes Gestacional/diagnóstico , Grasa Intraabdominal/diagnóstico por imagen , Grasa Subcutánea/diagnóstico por imagen , Diabetes Gestacional/diagnóstico por imagen , Femenino , Edad Gestacional , Humanos , Embarazo , Primer Trimestre del Embarazo , Segundo Trimestre del Embarazo , UltrasonografíaRESUMEN
Introducción: La adiposidad central como factor desencadenante de resistencia a la insulina precoz constituye una amenaza potencial de riesgo metabólico y cardiovascular en el embarazo. Objetivo: Determinar la capacidad discriminante de las grasas abdominales sobre la resistencia a la insulina, diagnosticada por el índice triglicéridos/glucosa-IMC al finalizar el primer trimestre del embarazo. Métodos: Se realizó un estudio observacional analítico de 526 gestantes con embarazo simple y edad gestacional entre 12 y 13 semanas, entre los años 2016 y 2020. Se estudió el test de triglicéridos/glucosa-IMC y las grasas abdominales por ultrasonido. Se utilizaron las curvas ROC (Receiver operating characteristic Curve) para discriminar la resistencia a la insulina al finalizar el primer trimestre de la gestación, cuando aumentan las grasas abdominales. Resultados: La grasa subcutánea fue la que presentó mayor área bajo la curva en la discriminación de la resistencia a la insulina, con un nivel de sensibilidad y especificidad aceptable. Conclusiones: La grasa subcutánea, aunque con bajo valor discriminativo, puede considerarse como augurio de resistencia a la insulina y de diabetes gestacional. Se requiere profundizar en el estudio de las grasas abdominales dado el conocimiento de su impacto en los desórdenes metabólicos en el curso avanzado de la gestación(AU)
Introduction: Central adiposity as a triggering factor for early insulin resistance is a potential threat of metabolic and cardiovascular risk in pregnancy. Objective: To determine the discriminating capacity of abdominal fat over insulin resistance, diagnosed by the triglyceride/glucose-BMI index at the end of the first trimester of pregnancy. Methods: An analytical and observational study was carried out with 526 pregnant women of singleton pregnancy and gestational age between twelve and thirteen weeks, between 2016 and 2020. The triglyceride/glucose-BMI test was studied, together with abdominal fats by ultrasound. ROC (receiver operating characteristic) curves were used to discriminate insulin resistance at the end of the first trimester of gestation, when abdominal fats increase. Results: Subcutaneous fat presented the highest area under the curve in the discrimination of insulin resistance, with an acceptable level of sensitivity and specificity. Conclusions: Subcutaneous fat, although with low discriminative value, can be considered as a harbinger of insulin resistance and gestational diabetes. Further study of abdominal fat is required, given the knowledge of its impact on metabolic disorders in late gestation(AU)
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Humanos , Femenino , Embarazo , Primer Trimestre del Embarazo , Resistencia a la Insulina/fisiología , Grasa Subcutánea Abdominal/metabolismo , Obesidad Abdominal/metabolismo , Triglicéridos/sangre , Glucemia/análisis , Índice de Masa Corporal , Estudios Transversales , Valor Predictivo de las Pruebas , Curva ROCRESUMEN
Fat deposition is higher in fast growing chickens than in slow growing chickens. The liver is the major organ for lipogenesis and fat deposition in chickens, although genetic background, age, and gender also influence fat deposition. In the present study, we aimed to explore the molecular mechanisms underlying fat deposition in liver and abdominal fat. We determined the expression abundances of the key genes regulating fat metabolism in fast-growing (FG) broilers (Cobb) and slow-growing (SG) broilers (HS1) and found that ACC, FAS, PGC-1α, PPARγ, SREBP-1c and PLIN1genes were expressed in the abdominal fat and liver tissues of FG and SG. ANOVA analysis showed that the breed, age, and tissue factors influenced the expressions of ACC, FAS, PGC-1α, PPARγ, SREBP-1c, and PLIN1 genes in the liver and abdominal fat of FG and SG. Also, the expressions of PPARγ and PLIN1 in the liver of SG were higher than that of FG. The results suggest that the differences in adipocyte development and adipose deposition between breeds are due to genetic factors.(AU)
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Animales , Pollos/metabolismo , Adipocitos , Grasa Abdominal , Genes , HígadoRESUMEN
Chicken abdominal fat (AF) is an economically important trait, and many studies have been conducted on genetic selection for AF. However, previous studies have focused on detecting functional chromosome mutations or regions using gene chips. The present study used the specific-locus amplified fragment sequencing (SLAF-seq) technology to perform a genome-wide association study (GWAS) on purebred Wengshang Barred chicken. A total of 1,286,715 single-nucleotide polymorphisms (SNPs) were detected, and 175,211 SNPs were selected as candidate SNPs for genome-wide association analysis using TASSEL general linear models. Two SNPs markers reached genome-wide significance. Of these, rs7943847, rs127627362 were significantly associated with AF at 120 days. These SNPs are close to eight genes (SLC16A6, ARSG, WIPI1, PRKAR1A, FAM20A, ABCA8, ABCA9, CPQ,). These results would enrich the studies on AF and promote the use of Chinese chicken, especially the Wenshang Barred chicken.(AU)
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Animales , Selección Genética/fisiología , Pollos/genética , Polimorfismo Genético , Grasa Abdominal/fisiologíaRESUMEN
Chicken is an important source of protein for human nutrition and a model system for growth and developmental biology. Although the genetic architecture of quantitative traits in meat-type chickens has been the subject of ongoing investigation, the identification of mutations associated with carcass traits of economic interest remains challenging. Therefore, our aim was to identify predicted deleterious mutation, which potentially affects protein function, and test if they were associated with carcass traits in chickens. For that, we performed a genome-wide association analysis (GWAS) for breast, thigh and drumstick traits in meat-type chickens and detected 19 unique quantitative trait loci (QTL). We then used: (1) the identified windows; (2) QTL for abdominal fat detected in a previous study with the same population and (3) previously obtained whole genome sequence data, to identify 18 predicted deleterious single nucleotide polymorphisms (SNPs) in those QTL for further association with breast, thigh, drumstick and abdominal fat traits. Using the additive model, a predicted deleterious SNP c.482C > T (SIFT score of 0.4) was associated (p-value < 0.05) with abdominal fat weight and percentage. This SNP is in the second exon of the MYBPH gene, and its allele frequency deviates from Hardy-Weinberg equilibrium. In conclusion, our study provides evidence that the c.482C > T SNP in the MYBPH gene is a putative causal mutation for fat deposition in meat-type chickens.
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The excessive accumulation of abdominal fat in broilers is an economic waste. Supplemental dietary L-arginine has been shown to reduce lipogenesis in broilers, but studies on this subject are still scarce. Two experiments were conducted in a 5×2 factorial design, with five L-arginine concentrations in diets (0, 3, 6, 9 and 12â¯g/kg) provided to male and female broilers, from 29 to 42â¯days of age, reared in boxes or cages, with six replicates of 23 broilers per box and six replicates of three broilers per cage, totalling 1560 broilers. Data on performance, carcass and cuts yield, abdominal fat deposition, chemical composition of the breast, lipid profile and liver enzyme activity were evaluated in experiment 1. In experiment 2, the balance and retention of nitrogen, metabolizability coefficients and metabolizable energy of feed were determined and the treatments were evaluated in six replicates of three broilers per cage, totalling 180 broilers. In both experiments, there was no interaction (P >â¯0.05) between L-arginine concentration in the diet and sex of the broilers for all parameters evaluated. Male broilers showed higher (P <â¯0.05) weight gain, noble cuts yield, levels of CP and mineral matter in the breast, better feed conversion (P <â¯0.05) and lower (P <â¯0.05) malic enzyme activity in the liver and abdominal fat deposition. On the other hand, regardless of sex, the increase in L-arginine concentration in the diet improved (Pâ¯<â¯0.05) the feed conversion in addition to reducing (P <â¯0.05) serum levels of total cholesterol and low-density lipoprotein cholesterol, the malic enzyme activity in the liver and abdominal fat deposition. In conclusion, male broilers had better productive results than females. However, supplementing the diet of male or female broilers from 29 to 42â¯days of age with L-arginine at a concentration of 6.87â¯g/kg represents a nutritional strategy to improve feed conversion and reduce circulating triacylglycerol and cholesterol levels, NADPH synthesis by liver malic enzyme and abdominal fat deposition, without negatively affecting the carcass and noble cuts yield, the amount of nitrogen excreted by the broilers and the energy value of the feed.
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Alimentación Animal , Pollos , Alimentación Animal/análisis , Fenómenos Fisiológicos Nutricionales de los Animales , Animales , Arginina , Dieta/veterinaria , Suplementos Dietéticos , Femenino , Metabolismo de los Lípidos , MasculinoRESUMEN
BACKGROUND: Labor activities are demanding for workers and can induce occupational stress. Primary health care (PHC) workers have faced problems that can lead to the development of stress and abdominal obesity. The aim of this study was to estimate the prevalence of abdominal adiposity among primary health care physicians in the metropolitan mesoregion of Salvador, Bahia. METHODS: This is a cross-sectional study conducted with physicians from the family health units (FHUs) of the metropolitan mesoregion of Salvador, Bahia, Brazil. The number of FHUs corresponded to 41 teams (52 physicians). Anamnesis was performed and a questionnaire was applied. The clinical examination consisted of measuring waist circumference (WC), blood pressure levels (BP), and body mass index (BMI), as well as examining for acanthosis nigricans. Blood samples were collected for biochemical dosages. The data obtained were analyzed by SPSS version 22.0. RESULTS: The sample included 41 physicians (response rate: 78.8%), of which 18 were women (44.0%). The percentage of overweight participants represented by BMI was 31.7%. The hypertriglyceridemia prevalence was 29.2%. HDL-c was low in 48.7% of the participants. The waist circumference measurement revealed a prevalence of abdominal adiposity of 38.8% (women) and 34.8% (men). CONCLUSIONS: Medical professionals in PHC are more susceptible to having higher abdominal adiposity, especially female physicians.
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Obesidad Abdominal , Adiposidad , Índice de Masa Corporal , Brasil/epidemiología , Estudios Transversales , Estudios Epidemiológicos , Femenino , Humanos , Masculino , Obesidad Abdominal/epidemiología , Prevalencia , Atención Primaria de Salud , Circunferencia de la CinturaRESUMEN
Coturniculture has been standing out as an industrial poultry activity in several countries around the world because of the several adaptive advantages of quails. Research that considers the analysis of gene expression can enhance this activity. This study aimed to analyze the stability of reference genes (RGs) in different tissues of quails (both males and females) for the recommendation of use in gene expression studies by the quantitative reverse transcription-polymerase chain reaction (RT-qPCR). The expression stability of ten RGs (ACTA1, ACTB, B2M, GAPDH, HMBS, SDHA, HPRT1, MRPS27, MRPS30, and RPL5) was analyzed in four tissues (breast muscle, abdominal fat, liver, and intestine), and assessed using the statistical tools geNorm, NormFinder, comparative ΔCq method, and BestKeeper. The HPRT1 gene was the most stable in all quail tissues tested, followed by MRPS27 and MRPS30 in breast muscle, B2M and RPL5 in abdominal fat, HMBS and B2M in the liver, and RPL5 and HMBS in the intestine. These results may help studies using RT-qPCR assays to assess quail tissues from both sexes because they provide data on the most stable genes, which should be tested as candidate RGs for other experimental conditions.