Excessive abdominal fat content indicates poor prognosis in patients with newly diagnosed multiple myeloma

2020 ◽  
Author(s):  
Li Bao ◽  
Yutong Wang ◽  
Xiaoguang Cheng ◽  
Bin Chu ◽  
Minqiu Lu ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
High Risk ◽  
Body Fat ◽  
Visceral Fat ◽  
Subcutaneous Fat ◽  
Abdominal Fat ◽  
Fat Content ◽  
Healthy People ◽  
Newly Diagnosed ◽  
Visceral Fat Area

Abstract Introduction: Obesity has been identified as risk factor for multiple myeloma (MM). Various indexes of body fat compartment make it difficult to assess the value of body fat compartment in predicting prognosis in MM patients.Methods: 36 newly diagnosed MM (NDMM) patients underwent abdominal CT pre-chemotherapy, and 72 matched healthy people were included. Total fat area (TFA), visceral fat area (VFA) and subcutaneous fat area (SFA) were measured from T12 to S1 and analyzed at six slices of vertebral interfaces. The level of adiponectin was also detected.Results: NDMM patients had larger TFA, VFA and SFA while significantly lower plasma adiponectin than healthy people. The percentage of bone marrow plasma cells was significantly inversely correlated with SAT, but positively correlated with VFA/SFA. A significant inverse correlation was observed between the high-risk cytogenetic abnormality gain 1q21 and VFA. SFA and VFA/SFA had a significant effect on treatment responses.Conclusions: NDMM patients had higher abdominal fat content but lower adipokine levels than healthy people. Excessive subcutaneous fat might be a predictive factor for high tumor burden and poor treatment response. Visceral fat content may be correlated with high-risk cytogenetic abnormalities. However, further investigation in larger samples is necessary to verify this association.

scholarly journals Hepatic steatosis in Cushing's syndrome: a radiological assessment using computed tomography

2003 ◽  
Vol 149 (6) ◽  
pp. 543-548 ◽  
Author(s):  
AG Rockall ◽  
SA Sohaib ◽  
D Evans ◽  
G Kaltsas ◽  
AM Isidori ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hepatic Steatosis ◽  
Cushing’S Syndrome ◽  
Negative Correlation ◽  
Visceral Fat ◽  
Subcutaneous Fat ◽  
Significant Negative Correlation ◽  
Cushing's Syndrome ◽  
Abdominal Fat ◽  
Visceral Fat Area

OBJECTIVE: Hepatic steatosis may occur in association with insulin resistance and obesity, two features commonly seen in Cushing's syndrome (CS). The aim of this report is to assess the prevalence of hepatic steatosis in patients with active CS using computed tomography (CT) and to identify any associations between hepatic steatosis, endocrine and biochemical variables and body fat distribution. PATIENTS AND MEASUREMENTS: We identified 50 patients with active CS in whom appropriate CT was available to allow measurement of liver and spleen attenuation. In 26 patients, abdominal fat measurements were also available. Serum markers of CS and liver function tests were recorded. RESULTS: Ten of 50 patients had a liver-to-spleen CT attenuation ratio (L/S) of less than 1, indicating hepatic steatosis. There was a significant negative correlation between both liver attenuation and L/S ratio with total abdominal fat area, visceral fat area, the percentage of visceral fat and the visceral to subcutaneous fat ratio; the strongest negative correlation was found between visceral fat area and L/S ratio (r=-0.638, P<0.001, n=26). L/S ratio positively correlated with alkaline phosphatase levels (r=+0.423, P=0.044, n=23) but with no other serum marker of CS activity or liver enzyme. CONCLUSIONS: We have demonstrated hepatic steatosis on CT in 20% of patients with active CS. The presence of hepatic steatosis was significantly correlated with total abdominal fat area and visceral fat area.

scholarly journals MUKnine OPTIMUM protocol: a screening study to identify high-risk patients with multiple myeloma suitable for novel treatment approaches combined with a phase II study evaluating optimised combination of biological therapy in newly diagnosed high-risk multiple myeloma and plasma cell leukaemia

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e046225
Author(s):  
Sarah Brown ◽  
Debbie Sherratt ◽  
Samantha Hinsley ◽  
Louise Flanagan ◽  
Sadie Roberts ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
High Risk ◽  
Plasma Cell ◽  
Phase Ii ◽  
Whole Body ◽  
Cell Leukaemia ◽  
High Dose ◽  
Newly Diagnosed ◽  
Genetic Changes ◽  
Novel Treatment

IntroductionMultiple myeloma (MM) is a plasma cell tumour with over 5800 new cases each year in the UK. The introduction of biological therapies has improved outcomes for the majority of patients with MM, but in approximately 20% of patients the tumour is characterised by genetic changes which confer a significantly poorer prognosis, generally termed high-risk (HR) MM. It is important to diagnose these genetic changes early and identify more effective first-line treatment options for these patients.Methods and analysisThe Myeloma UK nine OPTIMUM trial (MUKnine) evaluates novel treatment strategies for patients with HRMM. Patients with suspected or newly diagnosed MM, fit for intensive therapy, are offered participation in a tumour genetic screening protocol (MUKnine a), with primary endpoint proportion of patients with molecular screening performed within 8 weeks. Patients identified as molecularly HR are invited into the phase II, single-arm, multicentre trial (MUKnine b) investigating an intensive treatment schedule comprising bortezomib, lenalidomide, daratumumab, low-dose cyclophosphamide and dexamethasone, with single high-dose melphalan and autologous stem cell transplantation (ASCT) followed by combination consolidation and maintenance therapy. MUKnine b primary endpoints are minimal residual disease (MRD) at day 100 post-ASCT and progression-free survival. Secondary endpoints include response, safety and quality of life. The trial uses a Bayesian decision rule to determine if this treatment strategy is sufficiently active for further study. Patients identified as not having HR disease receive standard treatment and are followed up in a cohort study. Exploratory studies include longitudinal whole-body diffusion-weighted MRI for imaging MRD testing.Ethics and disseminationEthics approval London South East Research Ethics Committee (Ref: 17/LO/0022, 17/LO/0023). Results of studies will be submitted for publication in a peer-reviewed journal.Trial registration numberISRCTN16847817, May 2017; Pre-results.

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

Esophagus ◽  
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.

Newly Diagnosed Multiple Myeloma is Associated with Hypercoagulability and High Risk of VTE The ROADMAP Study

2016 ◽  
Vol 16 ◽  
pp. S76-S77
Author(s):  
Despina Fotiou ◽  
Grigoris Gerotziafas ◽  
Flora Zagouri ◽  
Theodoros Sergentanis ◽  
Kimon Stamatelopoulos ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
High Risk ◽  
Newly Diagnosed

scholarly journals The key role of a glucagon-like peptide-1 receptor agonist in body fat redistribution

2019 ◽  
Vol 240 (2) ◽  
pp. 271-286 ◽  
Author(s):  
Li Zhao ◽  
Chunfang Zhu ◽  
Meng Lu ◽  
Chi Chen ◽  
Xiaomin Nie ◽  
...  
Keyword(s):  
Lipid Metabolism ◽  
Body Fat ◽  
Visceral Fat ◽  
Subcutaneous Fat ◽  
Control Group ◽  
Acid Oxidation ◽  
High Dose ◽  
Fat Depots ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are an ideal therapy for type 2 diabetes and, as of recently, for obesity. In contrast to visceral fat, subcutaneous fat appears to be protective against metabolic diseases. Here, we aimed to explore whether liraglutide, a GLP-1RA, could redistribute body fat via regulating lipid metabolism in different fat depots. After being fed a high-fat diet for 8 weeks, 50 male Wistar and Goto-Kakizaki rats were randomly divided into a normal control group, a diabetic control group, low- and high-dose liraglutide-treated groups and a diet-control group. Different doses of liraglutide (400 μg/kg/day or 1200 μg/kg/day) or an equal volume of normal saline were administered to the rats subcutaneously once a day for 12 weeks. Body composition and body fat deposition were measured by dual-energy X-ray absorptiometry and MRI. Isotope tracers were infused to explore lipid metabolism in different fat depots. Quantitative real-time PCR and Western blot analyses were conducted to evaluate the expression of adipose-related genes. The results showed that liraglutide decreased visceral fat and relatively increased subcutaneous fat. Lipogenesis was reduced in visceral white adipose tissue (WAT) but was elevated in subcutaneous WAT. Lipolysis was also attenuated, and fatty acid oxidation was enhanced. The mRNA expression levels of adipose-related genes in different tissues displayed similar trends after liraglutide treatment. In addition, the expression of browning-related genes was upregulated in subcutaneous WAT. Taken together, the results suggested that liraglutide potentially redistributes body fat and promotes browning remodeling in subcutaneous WAT to improve metabolic disorders.

The relationship between thyroid hormone and lipid metabolism/body fat content in euthyroid male patients with type 2 diabetes mellitus in China: A cross-sectional study

2020 ◽  
Author(s):  
Xia Sun ◽  
Liping Chen ◽  
Rongzhen Wu ◽  
Dan Zhang ◽  
Yinhui He
Keyword(s):  
Body Fat ◽  
Visceral Fat ◽  
Fat Content ◽  
Body Fat Percentage ◽  
Fat Percentage ◽  
Body Fat Content ◽  
Male Patients ◽  
The Relationship ◽  
Visceral Fat Content

Abstract Background: This study compared the relationship between thyroid hormones and lipid metabolism/body fat content in euthyroid male patients with type 2 diabetes mellitus (T2DM) in China. Methods: A total of 64 male patients who were diagnosed as T2DM and 64 non-diabetic males who underwent health examination were matched according to age at a 1:1 ratio. Results: The 32 subjects in each sub-group showed differences in age, body mass index (BMI), mean arterial pressure, waist circumference, visceral fat content, body fat percentage, HbA1c, HOMA-IR, FT3, TSH, HDL-c, adiponectin, leptin, visfatin and TNF-α (all P < 0.05). In the overall population, FT3 was positively correlated with body fat percentage (r=0.21, P=0.02), and negatively correlated with HOMA-IR (r=-0.18, P=0.04) and visfatin (r=-0.47, P <0.01); TSH was positively correlated with body fat percentage (r=0.23, P=0.01). In the T2DM-OB group FT3 was positively correlated with BMI (r=0.45, P <0.05), visceral fat content (r=0.50, P <0.05), and body fat percentage (r=0.44, P <0.05); FT4 was positively correlated with visceral fat content (r=0.38, P <0.05); and TSH was positively correlated with HOMA-IR (r=0.39, P <0.05). Conclusion: TSH increased in obese people and FT3 was lower in patients with T2DM.

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