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

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.

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

Healthcare ◽  
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.

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.

scholarly journals Association between Serum Concentration of Carotenoid and Visceral Fat

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 912
Author(s):  
Mai Matsumoto ◽  
Hiroyuki Suganuma ◽  
Naoki Ozato ◽  
Sunao Shimizu ◽  
Mitsuhiro Katashima ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Visceral Fat ◽  
Fruits And Vegetables ◽  
Beta Carotene ◽  
The Body ◽  
Healthy Individuals ◽  
Health Checkup ◽  
Visceral Fat Area ◽  
The Relationship ◽  
Aomori Prefecture

Consumption of fruits and vegetables rich in carotenoids has been widely reported to prevent cardiovascular diseases. However, the relationship between serum carotenoid concentrations and visceral fat area (VFA), which is considered a better predictor of cardiovascular diseases than the body-mass index (BMI) and waist circumference, remains unclear. Therefore, we examined the relationship in healthy individuals in their 20s or older, stratified by sex and age, to compare the relationship between serum carotenoid concentrations and VFA and BMI. The study was conducted on 805 people, the residents in Hirosaki city, Aomori prefecture, who underwent a health checkup. An inverse relationship between serum carotenoid concentrations and VFA and BMI was observed only in women. In addition, the results were independent of the intake of dietary fiber, which is mainly supplied from vegetables as well as carotenoids. This suggests that consumption of a diet rich in carotenoids (especially lutein and beta-carotene) is associated with lower VFA, which is a good predictor of cardiovascular disease, especially in women. This study is the first to comprehensively evaluate the association between serum carotenoid levels and VFA in healthy individuals.

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.

The increase in abdominal subcutaneous fat depot is an independent factor to determine the glycemic control after rosiglitazone treatment

2007 ◽  
Vol 157 (2) ◽  
pp. 167-174 ◽  
Author(s):  
Soo-Kyung Kim ◽  
Kyu-Yeon Hur ◽  
Hae-Jin Kim ◽  
Wan-Sub Shim ◽  
Chul-Woo Ahn ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Visceral Fat ◽  
Subcutaneous Fat ◽  
Fat Distribution ◽  
The Body ◽  
Diabetic Patients ◽  
Independent Factor ◽  
Type 2 Diabetic Patients ◽  
Rosiglitazone Treatment ◽  
Fat Depot

Objective: The goal was to investigate the interrelationships between the hypoglycemic effects of rosiglitazone and the changes in the regional adiposity of type 2 diabetic patients. Design and methods: We added rosiglitazone (4 mg/day) to 173 diabetic patients (111 males and 62 females) already taking a stable dose of conventional antidiabetic medications except for thiazolidinediones. The abdominal fat distribution was assessed by ultrasonography at baseline and 12 weeks later. Using ultrasonographic images, the s.c. and visceral fat thickness (SFT and VFT respectively) were measured. Results: Rosiglitazone treatment for 3 months improved the glycemic control. However, the response to rosiglitazone was no more than 36.4%; the deterioration of the glycemic control was found in 16.8% of subjects. In addition, rosiglitazone treatment significantly increased the body fat mass, especially the s.c. fat. However that did not alter the visceral fat content. The percentage changes in fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) concentrations after treatment were inversely correlated with the increase in SFT (r=−0.327 and −0.353, P<0.001 respectively) and/or body weight (r=−0.316 and −0.327, P<0.001 respectively). Multiple regression analysis revealed that the improvement in the FPG after rosiglitazone treatment was correlated with the baseline FPG (P<0.001) and the change in the SFT (P=0.019), and the reduction in the HbA1c was related with the baseline FPG (P=0.003) and HbA1c (P<0.001) and the changes in the SFT (P=0.010) or VFT (P=0.013). Conclusions: The increase in the s.c. fat depot after rosiglitazone treatment may be an independent factor that determines the hypoglycemic efficacy.

Comparison of epidemiology and injury profile between vulnerable road users and motor vehicle occupants in road traffic fatalities

2019 ◽  
Vol 20 (6) ◽  
pp. 581-587 ◽  
Author(s):  
Sang-Chul Kim ◽  
Hae-Ju Lee ◽  
Ji-Min Kim ◽  
So-Yeon Kong ◽  
Jung-Soo Park ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Road Traffic ◽  
Traffic Fatalities ◽  
Road Users ◽  
Vulnerable Road Users

scholarly journals Relationships between Composition of Major Fatty Acids and Fat Distribution and Insulin Resistance in Japanese

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Chikako Fujii ◽  
Toshihide Kawai ◽  
Koichiro Azuma ◽  
Yuko Oguma ◽  
Fuminori Katsukawa ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Fatty Acids ◽  
Linoleic Acid ◽  
Glucose Tolerance ◽  
Visceral Fat ◽  
Subcutaneous Fat ◽  
Fat Distribution ◽  
Normal Subjects ◽  
Metabolic Parameters ◽  
Visceral Fat Area

Objective. The aim of this study was to evaluate the relationships between the composition of free fatty acids (FFAs) and metabolic parameters, including body fat distribution, in Japanese.Methods. The study subjects were 111 Japanese patients (54 males, 57 females). Metabolic parameters and visceral and subcutaneous fat areas as determined by CT scanning at the umbilical level were measured. Glucose tolerance test (GTT) was performed by administering 75 g glucose orally.Results. The percentage of linoleic acid (C18:2), the greatest constituent among FFAs, was negatively correlated with visceral fat area (r=−0.411,p<0.0001), fasting glucose (r=−0.330,p<0.0001), HbA1c (r=−0.231,p=0.0146), and systolic blood pressure (r=−0.224,p=0.0184). Linoleic acid percentage was also significantly negatively correlated with HOMA-IR (r=−0.416,p<0.0001) by simple correlation. Based on the findings of OGTT, the 111 subjects were classified into three groups: 33 with normal glucose tolerance, 71 with impaired glucose tolerance (IGT), and 7 diabetic subjects. The percentage of serum linoleic acid in diabetic subjects was significantly lower than that in normal subjects.Conclusion. We conclude that serum linoleic acid level is negatively correlated with the accumulation of visceral fat in relation to a reduction of insulin resistance in Japanese subjects.

scholarly journals Association Between Visceral Fat and Brain Cortical Thickness in the Elderly: A Neuroimaging Study

2021 ◽  
Vol 13 ◽  
Author(s):  
Jaelim Cho ◽  
Seongho Seo ◽  
Woo-Ram Kim ◽  
Changsoo Kim ◽  
Young Noh
Keyword(s):  
Cortical Thickness ◽  
Visceral Fat ◽  
Reference Group ◽  
Subcutaneous Fat ◽  
Additive Model ◽  
The Elderly ◽  
Brain Regions ◽  
Magnetic Resonance Images ◽  
Visceral Fat Area ◽  
Cross Sectional

BackgroundDespite emerging evidence suggesting that visceral fat may play a major role in obesity-induced neurodegeneration, little evidence exists on the association between visceral fat and brain cortical thickness in the elderly.PurposeWe aimed to examine the association between abdominal fat and brain cortical thickness in a Korean elderly population.MethodsThis cross-sectional study included elderly individuals without dementia (n = 316). Areas of visceral fat and subcutaneous fat (cm2) were estimated from computed tomography scans. Regional cortical thicknesses (mm) were obtained by analyzing brain magnetic resonance images. Given the inverted U-shaped relationship between visceral fat area and global cortical thickness (examined using a generalized additive model), visceral fat area was categorized into quintiles, with the middle quintile being the reference group. A generalized linear model was built to explore brain regions associated with visceral fat. The same approach was used for subcutaneous fat.ResultsThe mean (standard deviation) age was 67.6 (5.0) years. The highest quintile (vs. the middle quintile) group of visceral fat area had reduced cortical thicknesses in the global [β = –0.04 mm, standard error (SE) = 0.02 mm, p = 0.004], parietal (β = –0.04 mm, SE = 0.02 mm, p = 0.01), temporal (β = –0.05 mm, SE = 0.02 mm, p = 0.002), cingulate (β = –0.06 mm, SE = 0.02 mm, p = 0.01), and insula lobes (β = –0.06 mm, SE = 0.03 mm, p = 0.02). None of the regional cortical thicknesses significantly differed between the highest and the middle quintile groups of subcutaneous fat area.ConclusionThe findings suggest that a high level of visceral fat, but not subcutaneous fat, is associated with a reduced cortical thickness in the elderly.

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