The Influences of Visceral Fat Area on the Sites of Esophageal Mucosal Breaks in Subjects with Gastroesophageal Reflux Diseases

Background. Central obesity is suggested as a risk factor for gastroesophageal reflux diseases. The aim of this study was to evaluate the influences of a visceral fat area on the site of mucosal breaks in the esophagogastric junction (EGJ). Methods. Subjects who underwent abdomen-computerized tomography and esophagogastroduodenoscopy for screening on the same day were evaluated between 2007 and 2016. We enrolled 178 subjects who had erosive esophagitis (LA classifications A-D). Abdominal obesity was evaluated by measuring visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), VAT-to-SAT ratio, total adipose tissue (TAT), body mass index (BMI), and waist circumference (WC). Results. The lesser curvature (LC) of EGJ was the most frequent site of mucosal breaks (104 cases, 58.4%). BMI, WC, VAT, the VAT-to-SAT ratio, and TAT were higher in the LC group. In multivariate analysis, higher VAT (odds ratio (OR) 2.90, 95% confidence interval (CI) 1.18 to 7.13, 3rd vs. 1st quartile, P=0.021; OR 3.63, 95% CI 1.44 to 9.10, 4th vs. 1st quartile, P=0.006) and the VAT/SAT ratio (OR 2.91, 95% CI 1.11 to 7.61, 3rd vs. 1st quartile, P=0.03; OR 3.02, 95% CI 1.17 to 7.83, 4th vs. 1st quartile, P=0.023) were significantly associated with mucosal breaks in the LC group. However, BMI, WC, and TAT were not significant in the multivariate analysis. Conclusion. The VAT and the VAT/SAT ratio were significantly associated with the mucosal breaks in the LC of EGJ. Visceral obesity could influence the location of the mucosal breaks on EGJ.

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Visceral fat obesity is the key risk factor for the development of reflux erosive esophagitis in 40–69-years subjects

Esophagus ◽

10.1007/s10388-021-00859-5 ◽

2021 ◽

Author(s):

Shinya Ohashi ◽

Takahisa Maruno ◽

Keita Fukuyama ◽

Osamu Kikuchi ◽

Tomohiko Sunami ◽

...

Keyword(s):

Risk Factor ◽

Visceral Fat ◽

Subcutaneous Fat ◽

Erosive Esophagitis ◽

Smoking History ◽

Related Factors ◽

Visceral Fat Area ◽

Daily Alcohol Intake ◽

Gastrointestinal Reflux ◽

Total Fat

Abstract Background Visceral fat obesity can be defined quantitatively by abdominal computed tomography, however, the usefulness of measuring visceral fat area to assess the etiology of gastrointestinal reflux disease has not been fully elucidated. Methods A total of 433 healthy subjects aged 40–69 years (234 men, 199 women) were included in the study. The relationship between obesity-related factors (total fat area, visceral fat area, subcutaneous fat area, waist circumference, and body mass index) and the incidence of reflux erosive esophagitis was investigated. Lifestyle factors and stomach conditions relevant to the onset of erosive esophagitis were also analyzed. Results The prevalence of reflux erosive esophagitis was 27.2% (118/433; 106 men, 12 women). Visceral fat area was higher in subjects with erosive esophagitis than in those without (116.6 cm2 vs. 64.9 cm2, respectively). The incidence of erosive esophagitis was higher in subjects with visceral fat obesity (visceral fat area ≥ 100 cm2) than in those without (61.2% vs. 12.8%, respectively). Visceral fat obesity had the highest odds ratio (OR) among obesity-related factors. Multivariate analysis showed that visceral fat area was associated with the incidence of erosive esophagitis (OR = 2.18), indicating that it is an independent risk factor for erosive esophagitis. In addition, daily alcohol intake (OR = 1.54), gastric atrophy open type (OR = 0.29), and never-smoking history (OR = 0.49) were also independently associated with the development of erosive esophagitis. Conclusions Visceral fat obesity is the key risk factor for the development of reflux erosive esophagitis in subjects aged 40–69 years.

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The Incidence of Postoperative Complications after Gastrectomy Increases in Proportion to the Amount of Preoperative Visceral Fat

Journal of Oncology ◽

10.1155/2019/8404383 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Kazuyuki Okada ◽

Tatsuto Nishigori ◽

Kazutaka Obama ◽

Shigeru Tsunoda ◽

Koya Hida ◽

...

Keyword(s):

Gastric Cancer ◽

Postoperative Complications ◽

Visceral Fat ◽

Visceral Obesity ◽

Continuous Variable ◽

University Hospital ◽

Curative Gastrectomy ◽

Visceral Fat Area ◽

The Impact ◽

The Relationship

Background. Visceral obesity is a risk factor for complications after gastrectomy in patients with gastric cancer. However, it is unclear whether postoperative complications decrease with preoperative reduction of visceral fat without the achievement of a nonobese state. This is because previous studies have performed categorical comparisons of obesity and nonobesity. The current study was performed to estimate the impact of the preoperative visceral fat area (VFA) as a continuous variable on postoperative complications after gastrectomy. Methods. Consecutive patients with gastric cancer who underwent curative gastrectomy between June 2006 and August 2017 at the Kyoto University Hospital were included in this retrospective study. The VFA at the level of the umbilicus was measured using preoperative computed tomography. The relationship between postoperative complications and VFA was investigated with univariate and multivariate analyses. Results. total of 566 patients were included in the study. Their mean VFA was 110 ± 58 cm2, and postoperative complications occurred in 121 patients (21.4%). The larger the VFA (<50, 50–99, 100–149, and ≥150 cm2), the higher the incidence of postoperative complications (11%, 14%, 21%, and 38%, respectively, P<0.001). Multivariate logistic regression analyses showed that the VFA was associated with postoperative complications (odds ratio: 1.009, 95% confidence interval (CI): 1.004–1.013, P<0.001), with an incidence of postoperative complications that was 9% (95% CI: 4%–12%) higher for every 10 cm2 increase in the VFA. Conclusion. The incidence of postoperative complications after gastrectomy increases in proportion to an increase in the preoperative VFA.

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Does a “Cushion Effect” Really Exist? A Morphomic Analysis of Vulnerable Road Users with Serious Blunt Abdominal Injury

Healthcare ◽

10.3390/healthcare9081006 ◽

2021 ◽

Vol 9 (8) ◽

pp. 1006

Author(s):

Yu-San Tee ◽

Chi-Tung Cheng ◽

Chi-Hsun Hsieh ◽

Shih-Ching Kang ◽

Chih-Yuan Fu ◽

...

Keyword(s):

Multivariate Analysis ◽

Visceral Fat ◽

Motor Vehicle ◽

Subcutaneous Fat ◽

Abdominal Injury ◽

Visceral Fat Area ◽

Cross Sectional ◽

Road Users ◽

Severity Of Injury ◽

Vulnerable Road Users

Introduction: The severity of injury from motor vehicle crashes (MVCs) depends on complex biomechanical factors, and the bodily features of the injured person account for some of these factors. By assuming that vulnerable road users (VRUs) have limited protection resulting from vehicles and safety equipment, the current study analyzed the characteristics of fat distribution measured by computed tomography (CT) imaging and investigated the existence of a “cushion effect” in VRUs. Materials and Methods: This retrospective study enrolled 592 VRUs involved in MVCs who underwent CT scans. Visceral fat area and subcutaneous fat cross-sectional area were measured and adjusted according to total body area (TBA) and are presented as the visceral fat ratio and the subQ fat ratio (subcutaneous fat ratio). Risk factors for serious abdominal injury (maximum abbreviated injury scale (MAISabd ≥ 3)) resulting from MVCs were determined by univariate and multivariate analysis. Results: MAISabd ≥ 3 was observed in 104 (17.6%) of the patients. The subQ fat ratio at the L4 vertebral level was significantly lower in the MAISabd ≥ 3 group than in the MAISabd < 3 group (24.9 ± 12.0 vs. 28.1 ± 11.9%; p = 0.015). A decreased L4 subQ fat ratio was associated with a higher risk for MAISabd ≥ 3 in multivariate analysis (odds ratio 0.063; 95% CI 0.008–0.509; p = 0.009). Conclusion: The current study supported the “cushion effect” theory, and protection was apparently provided by subcutaneous fat tissue. This concept may further improve vehicle and safety designation in the future.

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Does a “Cushion Effect” Really Exist? A Morphomic Analysis of Vulnerable Road Users with Serious Blunt Abdominal Injury

10.21203/rs.3.rs-354841/v1 ◽

2021 ◽

Author(s):

Yu-San Tee ◽

Chi-Tung Cheng ◽

Chi-Hsun Hsieh ◽

Shih-Ching Kang ◽

CHIH-YUAN FU ◽

...

Keyword(s):

Multivariate Analysis ◽

Visceral Fat ◽

Motor Vehicle ◽

Subcutaneous Fat ◽

The Body ◽

Abdominal Injury ◽

Visceral Fat Area ◽

Road Users ◽

Severity Of Injury ◽

Vulnerable Road Users

Abstract Background: The severity of injury from motor vehicle crashes (MVCs) depends on complex biomechanical factors, and the body features of the injured person account for some of these factors. By assuming that vulnerable road users (VRU) have limited protection resulting from vehicle and safety equipment, the current study analyzed the characteristics of fat distribution measured by computed tomography (CT) imaging and investigated the existence of a “Cushion effect” in VRU.Materials and Methods: This retrospective study enrolled 592 VRU involved in MVCs who underwent CT scans. Visceral fat area and subcutaneous fat cross-sectional area were measured and adjusted according to total body area (TBA) and are presented as the visceral fat ratio and the subQ fat ratio (subcutaneous fat ratio). Risk factors for serious abdominal injury [maximum abbreviated injury scale (MAISabd ≥ 3)] resulting from MVCs were determined by univariate and multivariate analysis.Results: MAISabd ≥ 3 was observed in 104 (17.6%) of the patients. The SubQ fat ratio at the L4 vertebral level was significantly lower in the MAISabd ≥ 3 group than in the MAISabd < 3 group (24.9 ± 12.0 vs 28.1 ± 11.9%; p=0.015). A decreased L4 subQ fat ratio was associated with a higher risk for MAISabd ≥ 3 in multivariate analysis (odds ratio 0.063; 95% CI 0.008-0.509; p = 0.009).Conclusion: The current study supported the “Cushion effect” theory, and protection was apparently provided by subcutaneous fat tissue. This concept may further improve vehicle and safety designation in the future.

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Mitochondrial DNA Copy Number in Peripheral Blood Is Independently Associated with Visceral Fat Accumulation in Healthy Young Adults

International Journal of Endocrinology ◽

10.1155/2014/586017 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 24

Author(s):

Jee-Yon Lee ◽

Duk-Chul Lee ◽

Jee-Aee Im ◽

Ji-Won Lee

Keyword(s):

Young Adults ◽

Mitochondrial Dna ◽

Visceral Fat ◽

Copy Number ◽

Visceral Obesity ◽

Mtdna Copy Number ◽

Metabolic Disturbances ◽

Visceral Fat Area ◽

Mitochondrial Dna Copy Number ◽

Increased Risk

Aims. Visceral obesity is associated with an increased risk of cardiometabolic diseases and it is important to identify the underlying mechanisms. There is growing evidence that mitochondrial dysfunction is associated with metabolic disturbances related to visceral obesity. In addition, maintaining mitochondrial DNA (mtDNA) copy number is important for preserving mitochondrial function. Therefore, we investigated the relationship between mtDNA copy number and visceral fat in healthy young adults.Methods. A total of 94 healthy young subjects were studied. Biomarkers of metabolic risk factors were assessed along with body composition by computed tomography. mtDNA copy number was measured in peripheral leukocytes using real-time polymerase chain reaction (PCR) methods.Results. The mtDNA copy number correlated with BMI (r=-0.22,P=0.04), waist circumference (r=-0.23,P=0.03), visceral fat area (r=-0.28,P=-0.01), HDL-cholesterol levels (r=0.25,P=0.02), and hs-CRP (r=0.32,P=0.02) after adjusting for age and sex. Both stepwise and nonstepwise multiple regression analyses confirmed that visceral fat area was independently associated with mtDNA copy number (β=-0.33,P<0.01,β=0.32, andP=0.03, resp.).Conclusions. An independent association between mtDNA content and visceral adiposity was identified. These data suggest that mtDNA copy number is a potential predictive marker for metabolic disturbances. Further studies are required to understand the causality and clinical significance of our findings.

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Bioimpedance analysis in determining body composition in women with systemic lupus erythematosus: a pilot study

Modern Rheumatology Journal ◽

10.14412/1996-7012-2020-1-20-25 ◽

2020 ◽

Vol 14 (1) ◽

pp. 20-25

Author(s):

L. V. Kondratyeva ◽

T. A. Panafidina ◽

T. V. Popkova ◽

Yu. R. Varaeva ◽

A. V. Starodubova

Keyword(s):

Systemic Lupus Erythematosus ◽

Adipose Tissue ◽

Body Mass ◽

Lupus Erythematosus ◽

Visceral Fat ◽

Inverse Correlation ◽

Systemic Lupus ◽

Tissue Mass ◽

Visceral Fat Area ◽

Complement Component C3

Objective: to determine body composition (BC) in women with systemic lupus erythematosus (SLE), by using bioimpedance analysis.Patients and methods. The investigation enrolled 12 women with a reliable diagnosis of SLE, who were followed up at the Clinic of the V.A. Nasonova Research Institute of Rheumatology. Their median age was 46.5 [38.5; 54.7] years. All the patients underwent estimation of waist circumference (WC) and body mass index (BMI). BC was analyzed using an InBody 770 multi-frequency bioimpedance analyzer (Biospace Co. Ltd, South Korea) at the Clinical Nutrition Clinic, Federal Research Institute of Nutrition and Biotechnology.Results and discussion. BMI corresponding to overweight or obesity was observed in 67% of patients; abdominal obesity (AO) was seen in 83%. BC study showed that in most patients, adipose tissue mass was greater than the normal values (75%), lean body mass, skeletal muscle mass, and the amount of body water were within normal limits (83%), and the basal metabolic rate was reduced (67%). There were positive correlations between the percentage of adipose tissue and BMI (r=0.9; p<0.01), WC (r=0.7; p<0.01), C-reactive protein (CRP) levels (r=0.6; p<0.05), and complement C3 concentrations (r=0.9; p<0.01). Similar results were obtained when assessing the relationship between visceral fat area and BMI (r=0.9; p<0.01), WC (r=0.78; p<0.01), CRP (r=0.6; p<0.05), complement component C3 (r=0.8; p<0.01). There was an inverse correlation between visceral fat area and the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) (r=-0.6; p<0.05).Conclusion. Most women with SLE have AO, increased adipose tissue mass, normal lean body mass, and decreased basal metabolism. There is a direct correlation of visceral fat content and inflammatory markers (CRP, complement component C3) and an inverse correlation of those with the SLEDAI-2K.

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Impact of precise quantitative assessment of visceral obesity on outcomes of patients with metastatic renal cell carcinoma treated with systemic therapy.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.2_suppl.597 ◽

2016 ◽

Vol 34 (2_suppl) ◽

pp. 597-597

Author(s):

Ryuichi Mizuno ◽

Akira Miyajima ◽

Nozomi Hayakawa ◽

Eiji Kikuchi ◽

Shuji Mikami ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Overall Survival ◽

Cell Carcinoma ◽

Metastatic Renal Cell Carcinoma ◽

Systemic Therapy ◽

Visceral Fat ◽

Renal Cell ◽

Visceral Obesity ◽

Cancer Center ◽

Visceral Fat Area

597 Background: With its excellent resolution of adipose tissue, CT presents precise quantitative assessment of visceral obesity. We assessed the impact of visceral obesity on progression free and overall survival in patients treated with systemic therapy for metastatic renal cell carcinoma. Methods: This retrospective cohort study included 114 patients treated with systemic therapy for metastatic renal cell carcinoma between 2007 and 2015 at Keio university hospital in Japan. The visceral fat area was measured at the level of umbilicus using CT. A visceral fat area ≥100cm2 was used as the definition of visceral obesity. Progression free and overall survival was compared according to visceral obesity. Results: In the whole cohort, the median progression free survival in first line treatment was 12.0 month. The median overall survival was 42.5 month. According to Memorial Sloan-Kettering Cancer Center classification, 31 patients were favorable risk, 61 were intermediate risk, and 22 were poor risk; median overall survival for these groups were 76.9, 40.8, and 23.7 months, respectively (P<0.0001). Visceral obesity correlated with improved progression free (P=0.0095) and overall survival (P=0.0002). On multivariate analysis, visceral obesity (HR 0.64, P=0.0393) and Memorial Sloan-Kettering Cancer Center classification (P=0.0037) were independent indices to predict progression free survival in first line treatment. In addition, visceral obesity (HR 0.42, P=0.0016) and Memorial Sloan-Kettering Cancer Center classification (P=0.0006) independently predicted overall survival. Conclusions: The precision of CT imaging for measuring visceral fat tissue provides useful clinical venue to predict prognosis for metastatic renal cell carcinoma. Visceral obesity may be a useful and independent indicator for a better prognosis in patients treated with systemic therapy for metastatic renal cell carcinoma.

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Fatty Liver Has Stronger Association With Insulin Resistance Than Visceral Fat Accumulation in Nonobese Japanese Men

Journal of the Endocrine Society ◽

10.1210/js.2019-00052 ◽

2019 ◽

Vol 3 (7) ◽

pp. 1409-1416 ◽

Cited By ~ 7

Author(s):

Satoshi Kadowaki ◽

Yoshifumi Tamura ◽

Yuki Someya ◽

Kageumi Takeno ◽

Hideyoshi Kaga ◽

...

Keyword(s):

Insulin Resistance ◽

Adipose Tissue ◽

Insulin Sensitivity ◽

Fatty Liver ◽

Visceral Fat ◽

Visceral Fat Area ◽

Japanese Men ◽

Fat Accumulation ◽

Visceral Fat Accumulation ◽

Intrahepatic Lipid

Abstract Context Asians have a high prevalence of insulin resistance, even in the nonobese state. Whereas both visceral fat accumulation (VFA) and fatty liver (FL) have been shown to be associated with insulin resistance, it is still unclear which is a better marker to predict insulin resistance in nonobese Asians. Objective The aim of this study was to investigate the relation between VFA or FL and insulin resistance in nondiabetic nonobese Japanese men who do not have diabetes. Design and Participants We studied 87 nonobese (body mass index <25 kg/m2) Japanese men without diabetes. Using a two-step hyperinsulinemic euglycemic clamp, we evaluated insulin sensitivity in adipose tissue, muscle, and liver. Intrahepatic lipid and abdominal visceral fat area were measured by 1H-magnetic resonance spectroscopy and MRI, respectively. Subjects were divided into four groups based on the presence or absence of VFA (visceral fat area ≥100 cm2) and FL (intrahepatic lipid ≥ 5%): control (non-VFA, non-FL; n = 54), VFA only (n = 18), FL only (n = 7), and VFA plus FL (n = 8). Results Subjects in the FL only and VFA plus FL groups had insulin resistance in adipose tissue and muscle, as well as relatively lower hepatic insulin sensitivity. The specific insulin sensitivities in these organs were comparable in the VFA only and control groups. Conclusions In nonobese Japanese men without diabetes, subjects with FL only or VFA plus FL but not VFA only had insulin resistance, suggesting that FL may be a more useful clinical marker than VFA to predict insulin resistance in nonobese Japanese men without diabetes.

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Impact of visceral fat volume and fat density on biochemical outcome after radical prostatectomy and postoperative radiotherapy

Hormone Molecular Biology and Clinical Investigation ◽

10.1515/hmbci-2015-0075 ◽

2016 ◽

Vol 26 (3) ◽

Cited By ~ 1

Author(s):

Michel Zimmermann ◽

Guila Delouya ◽

Maroie Barkati ◽

Shanie Campeau ◽

Denis Rompotinos ◽

...

Keyword(s):

Multivariate Analysis ◽

Adipose Tissue ◽

Radical Prostatectomy ◽

Seminal Vesicle ◽

Visceral Adipose Tissue ◽

Visceral Fat ◽

Cox Regression Analysis ◽

Seminal Vesicle Involvement ◽

Visceral Adipose ◽

Fat Volume

AbstractTo assess the predictive value of visceral adipose tissue (VAT) and adipose tissue density after both radical prostatectomy (RP) and adjuvant or salvage external beam radiotherapy (EBRT).We randomly selected 201 patients treated with RP and EBRT between 2005 and 2015. Visceral adipose tissue and subcutaneous adipose tissue volumes were manually contoured and corresponding tissue densities in Hounsfield units (HU) calculated. Time to biochemical recurrence (BCR) was calculated using the Kaplan-Meier method and comparisons were made using the log-rank test. Cox regression analysis was done for multivariate analysis.Median time to BCR or last follow-up was 32 months. In univariate analysis for BCR, VAT volume and fat density were both associated with a better outcome (p=0.025 and p=0.024, respectively) as well as seminal vesicle involvement (p=0.024). Body mass index (BMI) was not predictive of BCR (p=0.32). In a multivariate model including seminal vesicle involvement, both a VAT volume above the median (HR2.5, 95%CI 1.1–5.7, p=0.03) and a VAT density (HR 2.4, 95%CI 1.1–5.1, p=0.028) above the median remained predictive for a better biochemical outcome. Adjusting for BMI did not significantly change the model.In both univariate and multivariate analysis, patients with both a larger VAT volume and density had a better biochemical outcome. The interaction between prostate cancer aggressiveness and visceral fat volume and density needs to be further evaluated to provide a better understanding of this disease.

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Insulin-sensitive obesity

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00586.2009 ◽

2010 ◽

Vol 299 (3) ◽

pp. E506-E515 ◽

Cited By ~ 458

Author(s):

Nora Klöting ◽

Mathias Fasshauer ◽

Arne Dietrich ◽

Peter Kovacs ◽

Michael R. Schön ◽

...

Keyword(s):

Adipose Tissue ◽

Insulin Sensitivity ◽

Body Fat ◽

Visceral Fat ◽

Elective Surgery ◽

Fat Distribution ◽

Retinol Binding Protein ◽

Visceral Fat Area ◽

P Values ◽

Insulin Resistant

The association between obesity and impaired insulin sensitivity has long been recognized, although a subgroup of obese individuals seems to be protected from insulin resistance. In this study, we systematically studied differences in adipose tissue biology between insulin-sensitive (IS) and insulin-resistant (IR) individuals with morbid obesity. On the basis of glucose infusion rate during euglycemic hyperinsulinemic clamps, 60 individuals with a BMI of 45 ± 1.3 kg/m2 were divided into an IS and IR group matched for age, sex, and body fat prior to elective surgery. We measured fat distribution, circulating adipokines, and parameters of inflammation, glucose, and lipid metabolism and characterized adipose tissue morphology, function, and mRNA expression in abdominal subcutaneous (sc) and omental fat. IS compared with IR obese individuals have significantly lower visceral fat area (138 ± 27 vs. 316 ± 91 cm2), number of macrophages in omental adipose tissue (4.9 ± 0.8 vs. 13.2 ± 1.4%), mean omental adipocyte size (528 ± 76 vs. 715 ± 81 pl), circulating C-reactive protein, progranulin, chemerin, and retinol-binding protein-4 (all P values <0.05), and higher serum adiponectin (6.9 ± 3.4 vs. 3.4 ± 1.7 ng/ml) and omental adipocyte insulin sensitivity (all P values <0.01). The strongest predictors of insulin sensitivity by far were macrophage infiltration together with circulating adiponectin ( r2 = 0.98, P < 0.0001). In conclusion, independently of total body fat mass, increased visceral fat accumulation and adipose tissue dysfunction are associated with IR obesity. This suggests that mechanisms beyond a positive caloric balance such as inflammation and adipokine release determine the pathological metabolic consequences in patients with obesity.

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