Association of Skeletal Muscle and Adipose Tissue Distribution with Histologic Severity of Non-Alcoholic Fatty Liver

Adipose tissue and skeletal muscle is associated with non-alcoholic fatty liver disease (NAFLD). This study evaluates the association between body composition and histologic severity in patients with NAFLD. Using the cross-sectional CT images at the level of L3 vertebra and the histologic findings of 178 patients with biopsy-proven NAFLD, we analyzed the correlation of the histologic findings to the skeletal muscle index (SMI), subcutaneous adipose tissue index (SATI), and visceral adipose tissue index (VATI), which is defined as the body composition area (cm2) by height squared (m2). The clinical and laboratory features with body composition were analyzed to determine the risk factors for advanced fibrosis. The VATI significantly increased in severe non-alcoholic steatohepatitis (NASH) or advanced fibrosis. In addition, the VATI was correlated with the NAFLD activity score (NAS) and the fibrosis stage. In multivariate analyses, age (odds ratio (OR), 1.09; 95% confidence interval (CI), 1.02–1.19; p = 0.025), severe NASH (OR, 8.66; 95% CI, 2.13–46.40; p = 0.005), and visceral adiposity (OR, 6.77; 95% CI, 1.81–29.90; p = 0.007) were independently associated with advanced fibrosis in patients with NAFLD. Visceral adiposity is correlated with the histologic severity of NAFLD, which is independently associated with advanced fibrosis.

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Body composition and its association with fatigue in the first 2 years after colorectal cancer diagnosis

Journal of Cancer Survivorship ◽

10.1007/s11764-020-00953-0 ◽

2020 ◽

Author(s):

H. van Baar ◽

M. J. L. Bours ◽

S. Beijer ◽

M. van Zutphen ◽

F. J. B. van Duijnhoven ◽

...

Keyword(s):

Colorectal Cancer ◽

Skeletal Muscle ◽

Body Composition ◽

Adipose Tissue ◽

The Body ◽

Life Questionnaire ◽

European Organization ◽

Skeletal Muscle Index ◽

Computed Tomography Images ◽

Pre Treatment

Abstract Purpose Persistent fatigue among colorectal cancer (CRC) patients might be associated with unfavorable body composition, but data are sparse and inconsistent. We studied how skeletal muscle index (SMI), skeletal muscle radiodensity (SMR), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) at diagnosis are associated with fatigue up to 24 months post-diagnosis in stage I–III CRC patients. Methods SMI, SMR, VAT, and SAT were assessed among 646 CRC patients using pre-treatment computed tomography images. Fatigue at diagnosis, at 6, and 24 months post-diagnosis was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. The association of SMI, SMR, VAT, and SAT with fatigue (yes/no) was assessed using confounder-adjusted restricted cubic spline analyses. Results Prevalence of fatigue at diagnosis was 18%, at 6 months 25%, and at 24 months 12%. At diagnosis, a significant (p = 0.01) non-linear association of higher levels of SAT with higher prevalence of fatigue was observed. Lower levels of SMR were linearly associated with higher prevalence of fatigue at 6 months post-diagnosis (overall association p = 0.02). None of the body composition parameters were significantly associated with fatigue at 24 months. Conclusion Having more SAT was associated with more fatigue at diagnosis, while low levels of SMR were associated with more fatigue at 6 months post-diagnosis. Implications for Cancer Survivors Our results suggest that it may be interesting to investigate whether interventions that aim to increase SMR around the time of diagnosis may help to lower fatigue. However, more knowledge is needed to understand the mechanisms behind the association of SMR with fatigue.

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Change in skeletal muscle index and its prognostic significance in patients who underwent successful conversion therapy for initially unresectable colorectal cancer: observational study

Therapeutic Advances in Gastroenterology ◽

10.1177/1756284820971197 ◽

2020 ◽

Vol 13 ◽

pp. 175628482097119

Author(s):

Hiroaki Nozawa ◽

Shigenobu Emoto ◽

Koji Murono ◽

Yasutaka Shuno ◽

Kazushige Kawai ◽

...

Keyword(s):

Colorectal Cancer ◽

Skeletal Muscle ◽

Systemic Therapy ◽

Skeletal Muscles ◽

Prognostic Significance ◽

Stage Iv ◽

The Body ◽

Conversion Therapy ◽

Cross Sectional ◽

Skeletal Muscle Index

Background: Systemic therapy can cause loss of skeletal muscle mass in colorectal cancer (CRC) patients in the neoadjuvant and palliative settings. However, it is unknown how the body composition is changed by chemotherapy rendering unresectable CRC to resectable disease or how it affects the prognosis. This study aimed at elucidating the effects of systemic therapy on skeletal muscles and survival in stage IV CRC patients who underwent conversion therapy. Methods: We reviewed 98 stage IV CRC patients who received systemic therapy in our hospital. According to the treatment setting, patients were divided into the conversion, neoadjuvant chemotherapy (NAC), and palliation groups. The cross-sectional area of skeletal muscles at the third lumbar level and changes in the skeletal muscle index (SMI), defined as the area divided by height squared, during systemic therapy were compared among patient groups. The effects of these parameters on prognosis were analyzed in the conversion group. Results: The mean SMI increased by 9.4% during systemic therapy in the conversion group ( n = 38), whereas it decreased by 5.9% in the NAC group ( n = 18) and 3.7% in the palliation group ( n = 42, p < 0.0001). Moreover, patients with increased SMI during systemic therapy had a better overall survival (OS) than those whose SMI decreased in the conversion group ( p = 0.025). The increase in SMI was an independent predictor of favorable OS on multivariate analysis (hazard ratio 0.25). Conclusions: Stage IV CRC patients who underwent conversion to resection often had an increased SMI. On the other hand, a decrease in the SMI during systemic therapy was a negative prognostic factor in such patients.

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A Multi-Center Study Exploring the Association of Metabolic Syndrome and Non-Alcoholic Fatty Liver Disease in Cuban Patients

Austin Journal of Obesity & Metabolic Syndromes ◽

10.26420/austinjobesmetabsynd.2021.1023 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Castellanos-Fernández MI ◽

◽

Stepanova M ◽

Infante-Velázquez ME ◽

Henry L ◽

...

Keyword(s):

Metabolic Syndrome ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Cross Sectional Study ◽

Advanced Fibrosis ◽

Cross Sectional ◽

Alcoholic Fatty Liver ◽

Rural Residency ◽

Alcoholic Fatty Liver Disease

Aim: There is a paucity of data on Non-Alcoholic Fatty Liver Disease (NAFLD) and Metabolic Syndrome (MetS) among native Cubans. We aimed to assess the prevalence of MetS in Cubans with NAFLD and the outcomes and predictors for advanced fibrosis. Methods: A multicenter (outpatient clinics of nine hospitals in seven Cuban provinces) cross-sectional study of adults with NAFLD between September 2018 and May 2019. MetS was defined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP: ATPIII) criteria. Advanced fibrosis was defined using AST to Platelet Ratio Index (APRI) ≥1 and Fibrosis-4 score (FIB-4) ≥2.67. Results: 819 patients enrolled, 563 (68.7%) had MetS; mean age 54.9 years, 60.3% female, 65.8% white, 95.1% from urban residency, mean BMI 30.7 kg/m². Fibrosis was present in 114 (13.9%); 94 (82.5%) had APRI ≥1; 77 (67.5%) had FIB-4 ≥ 2.67; 57 (50%) both scores were elevated. MetS group had significantly more fibrosis than no MetS, [17% vs. 7% (p=0.0001)]. Patients with fibrosis were older (57.7 vs. 54.5, P=0.0015), of Mestizos ethnicity (36.8% vs. 16.9%, P<0.0001), and from rural residency (17.5% vs. 2.8%, P<0.0001). MetS was independently associated with fibrosis: Odds Ratio (OR) = 2.05 (95% CI 1.10-3.81) (p=0.024), but, rural residency was the strongest fibrosis predictor [OR: 5.30 (95% CI 2.45-11.47, (P<0.0001)]. Other fibrosis predictors were male gender, sedentary life-style, NAFLD family history, and lower estimated glomerular filtration rate (p<0.05). Risk of fibrosis was not associated with age, ethnicity, or smoking (all p>0.05). Conclusion: Cuban NAFLD patients with MetS have substantial clinical impairment and a higher risk for fibrosis.

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Correlation of Body Mass Index, Skeletal Muscle, Subcutaneous and Visceral Adipose Tissue in Healthy Adults: A Cross Sectional Study

Studia Universitatis Babeş-Bolyai Educatio Artis Gymnasticae ◽

10.24193/subbeag.66(3).25 ◽

2021 ◽

Vol 66 (3) ◽

pp. 69-76

Author(s):

NORBERT CSABA LUKÁCS

Keyword(s):

Skeletal Muscle ◽

Body Mass Index ◽

Adipose Tissue ◽

Body Mass ◽

Visceral Adipose Tissue ◽

Negative Correlation ◽

Significant Negative Correlation ◽

The Body ◽

Cross Sectional ◽

Visceral Adipose

ABSTRACT. Introduction. Obesity is one of the 21st century major health challenges. Adipose tissue is distributed in different proportions in the human body depending on where it is located in the body. The purpose of the research. This study aims to determine the relationship between body mass index, skeletal muscle, subcutaneous and visceral adipose tissue in case of first year students of Partium Christian University from Oradea. Subjects and methods. The research included a sample group of 112 students. The analysis of the body composition was performed using the method of bioelectrical impedance. Results. The registered data reveal that 23% of the subjects were overweight or obese and 15% had a low percentage of skeletal muscle. Conclusions. In case of both genders there is a significant negative correlation between the percentage of skeletal muscle and subcutaneous adipose tissue and a significant negative correlation between the percentage of skeletal muscle and visceral adipose tissue.

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Volumetric body composition parameters in predicting survival outcomes of metastatic renal cell carcinoma patients treated with targeted therapy

10.22541/au.161987971.18594998/v1 ◽

2021 ◽

Author(s):

Oktay Aktepe ◽

Ahmet Gürkan Erdemir ◽

Gurkan Guner ◽

Deniz Can Güven ◽

Suayib Yalcin ◽

...

Keyword(s):

Skeletal Muscle ◽

Renal Cell Carcinoma ◽

Body Composition ◽

Adipose Tissue ◽

Targeted Therapy ◽

Cell Carcinoma ◽

Risk Score ◽

Renal Cell ◽

Survival Outcomes ◽

Skeletal Muscle Index

Background: To explore the clinical significance of baseline volumetric body composition parameters evaluated with computerized tomography (CT) and their changes after 3-4 months from treatment initiation of targeted therapy in patients with metastatic renal cell carcinoma (mRCC). Method: This study included 108 Caucasian mRCC patients (Male/Female: 77/31) treated with targeted therapy. Volumetric body composition parameters including total adipose tissue index (TATI), subcutaneous adipose tissue index (SATI), visceral adipose tissue index (VATI) and skeletal muscle index (SMI) values were depicted from CT images at third lumbar vertebra level through volumetric measurement software. Kaplan-Meier method and the long test were used for estimation of progression free survival (PFS) and overall survival (OS). Univariate and multivariate analyses were done to determine the associations between clinic-pathologic variables including VBC and survival outcomes. Results: The median PFS and OS of all patients were 11 months and 46 months in patients respectively. After adjustment for the variables including international mRCC database consortium (IMDC) risk score, only a high skeletal muscle index (SMI) was associated with better PFS (HR: 0.975, P=0.015). The independent predictors for OS were VATI (HR 1.005, P=0.024), SATI (HR: 0.976, P=0.019) and TATI (HR: 0.982, P=0.035) in addition to IMDC risk score. Conclusion: Our findings revealed that while SMI was the only significant determinant parameter for PFS among VBC parameters, TATI, VATI, and SATI were determined as independent predictors for OS in addition to IMDC risk score.

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PROTO-HORMONES LEVELS OF ADIPOSE TISSUE, INTERLEUKIN-6 AND INDICATORS OF DETOXIFYING FUNCTION OF THE LIVER IN PATIENTS WITH HYPERTENSION AND OBESITY COMBINED WITH NON-ALCOHOLIC FATTY LIVER DISEASE

Technology transfer innovative solutions in medicine ◽

10.21303/2585-663.2020.001469 ◽

2020 ◽

pp. 3-6

Author(s):

Olesia Bochar

Keyword(s):

Adipose Tissue ◽

Liver Disease ◽

Arterial Hypertension ◽

Fatty Liver ◽

Interleukin 6 ◽

Fatty Liver Disease ◽

Left Ventricular ◽

The Body ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

The research estimates the state of liver detoxifying function and analyzes the changes in the levels of leptin, adiponectin and interleukin-6 in patients with arterial hypertension in combination with obesity and non-alcoholic fatty liver disease. Aim. The aim of the study is to evaluate levels of proto-hormones adipose tissue, interleukin-6 and indicators of detoxifying function of the liver in patients with hypertension and obesity combined with non-alcoholic fatty liver disease (NAFLD). Materials and methods. The study involved patients with arterial hypertension combined with obesity and NAFLD. All patients underwent anthropometric, general clinical, laboratory (blood lipid profile) and instrumental diagnostics (electrocardiography, echocardiography, ultrasonography, 13C-metacetin breath test, ELISA (adiponectin, leptin, IL-6). The patients’ height and weight were measured, the body mass index was calculated according to standard formulas. Results. Patients with arterial hypertension combined with obesity and NAFLD at the stage of steatohepatitis showed an increase in the levels of leptin and IL-6 and a decrease in the level of adiponectin. This group also revealed a moderate decrease in liver detoxifying function, as indicated by the results of 13C- MBT due to a 46.7 % decrease in the metabolic rate and a decrease in cumulative doses of CUM40 by 40 % and CUM120 by 46.8 %, respectively. Conclusions. The elevated levels of leptin and IL-6 and lowered adiponectin levels can be used to determine the degree of activity of non-alcoholic steatohepatitis and predict the course of NAFLD in combination with hypertension and obesity. An increased level of leptin and IL-6 and a low level of adiponectin in patients with such a comorbid pathology lead to an increase in the left ventricular myocardial mass index and aggravate the course of arterial hypertension.

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Body composition and risk of non- alcoholic fatty liver disease; a case control study

Mediterranean Journal of Nutrition and Metabolism ◽

10.3233/mnm-210570 ◽

2021 ◽

pp. 1-9

Author(s):

Arash Tandoroost ◽

Sara Moradi ◽

Mehdi Moradinazar ◽

Shima Moradi ◽

Yahya Pasdar ◽

...

Keyword(s):

Body Composition ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Case Control Study ◽

Case Control ◽

The Body ◽

Alcoholic Fatty Liver ◽

Increased Risk ◽

Control Study

BACKGROUND: While evidence has been a highlight that obesity may be associated with the increased incidence of Nonalcoholic fatty liver disease (NAFLD), these data have depended on defective measures of obesity such as body mass index (BMI), and usually have not the well-known relationship between body composition with NAFLD. METHODS: In a case-control study of people aged 20– 65 years, we directly measured body composition (using bioelectrical impedance analysis), height, weight, and waist and hip circumferences who referred to radiology clinics in Kermanshah, Iran. Dietary intake was assessed by the food frequency questionnaire (FFQ). RESULTS: Among 221 people examined, 103 cases with NAFLD and 119 as control were established. The risk of NAFLD was positively associated with higher BMI and the components of the body composition. These associations were strengthened after adjusting for potential confounders including gender, age, marital status, education, smoking, alcohol consumption, and physical activity CONCLUSION: An increasing prevalence of obesity may be associated with the increasing incidence of NAFLD as observed in many populations. We observed an increased risk of NAFLD associated with increased BMI, central adiposity, and the fat component of weight, but found no association with nonfat mass.

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Assessment of the association between body composition and risk of non-alcoholic fatty liver

PLoS ONE ◽

10.1371/journal.pone.0249223 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0249223

Author(s):

Mohammad Ariya ◽

Farbod Koohpayeh ◽

Alireza Ghaemi ◽

Saeed Osati ◽

Sayed Hossain Davoodi ◽

...

Keyword(s):

Body Composition ◽

Fatty Liver ◽

Liver Steatosis ◽

Cross Sectional Study ◽

Abdominal Fat ◽

Cross Sectional ◽

Alcoholic Fatty Liver ◽

Total Fat ◽

Almost All ◽

The Relationship

Non-alcoholic fatty liver disease (NAFLD) is defined as the condition of fat accumulation in the liver. This cross-sectional study aimed to investigate the relationship between body composition and fatty liver and determine of cut-off point for predicting NAFLD. Samples were selected from the nutrition clinic from 2016 to 2017 in Tehran, Iran. The liver steatosis was calculated using the CAP score through the FiroScan™ and body composition was measured using the dual-energy X-ray absorptiometry scan method. A total of 2160 patients participated in this study, 745 (34.5%) subjects had NAFLD. We found that fat-free tissue was inversely and fat tissue was directly correlated with the risk of NAFLD in almost all factors and the risk of developing NAFLD increases if the total fat exceeds 32.23% and 26.73% in women and men and abdominal fat exceeds 21.42% and 13.76% in women and men, respectively. Finally, we realized that the total fat percent had the highest AUC (0.932 for men and 0.917 for women) to predict the risk of NAFLD. Overall, the likelihood of NAFLD development rose significantly with increasing the amount of total fat and abdominal fat from the cut-off point level.

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Impact of body composition on outcomes from anti-PD1 +/− anti-CTLA-4 treatment in melanoma

Journal for ImmunoTherapy of Cancer ◽

10.1136/jitc-2020-000821 ◽

2020 ◽

Vol 8 (2) ◽

pp. e000821

Author(s):

Arissa C Young ◽

Henry T Quach ◽

Haocan Song ◽

Elizabeth J Davis ◽

Javid J Moslehi ◽

...

Keyword(s):

Skeletal Muscle ◽

Body Composition ◽

Adipose Tissue ◽

Checkpoint Inhibitors ◽

Lumbar Vertebrae ◽

Composition Analysis ◽

Muscle Area ◽

Skeletal Muscle Index ◽

Body Composition Analysis ◽

Tissue Area

BackgroundImmune checkpoint inhibitors (ICIs) have transformed treatment for melanoma, but identifying reliable biomarkers of response and effective modifiable lifestyle factors has been challenging. Obesity has been correlated with improved responses to ICI, although the association of body composition measures (muscle, fat, etc) with outcomes remains unknown.MethodsWe performed body composition analysis using Slice-o-matic software on pretreatment CT scans to quantify skeletal muscle index (SMI=skeletal muscle area/height2), skeletal muscle density (SMD), skeletal muscle gauge (SMG=SMI × SMD), and total adipose tissue index (TATI=subcutaneous adipose tissue area + visceral adipose tissue area/height2) of each patient at the third lumbar vertebrae. We then correlated these measures to response, progression-free survival (PFS), overall survival (OS), and toxicity.ResultsAmong 287 patients treated with ICI, body mass index was not associated with clinical benefit or toxicity. In univariable analyses, patients with sarcopenic obesity had inferior PFS (HR 1.4, p=0.04). On multivariable analyses, high TATI was associated with inferior PFS (HR 1.7, p=0.04), which was particularly strong in women (HR 2.1, p=0.03). Patients with intermediate TATI and high SMG had the best outcomes, whereas those with low SMG/high TATI had inferior PFS and OS (p=0.02 for both PFS and OS).ConclusionsBody composition analysis identified several features that correlated with improved clinical outcomes, although the associations were modest. As with other studies, we identified sex-specific associations that warrant further study.

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Germinated Soybean Embryo Extract Ameliorates Fatty Liver Injury in High-Fat Diet-Fed Obese Mice

Pharmaceuticals ◽

10.3390/ph13110380 ◽

2020 ◽

Vol 13 (11) ◽

pp. 380

Author(s):

Doyoung Kwon ◽

Sou Hyun Kim ◽

Seung Won Son ◽

Jinuk Seo ◽

Tae Bin Jeong ◽

...

Keyword(s):

Adipose Tissue ◽

Fatty Liver ◽

High Fat Diet ◽

Ethanolic Extract ◽

The Body ◽

Acid Oxidation ◽

High Fat ◽

Alcoholic Fatty Liver ◽

Triglyceride Accumulation ◽

Germinated Soybean

Soybean is known to have diverse beneficial effects against human diseases, including obesity and its related metabolic disorders. Germinated soybean embryos are enriched with bioactive phytochemicals and known to inhibit diet-induced obesity in mice, but their effect on non-alcoholic fatty liver disease (NAFLD) remains unknown. Here, we germinated soybean embryos for 24 h, and their ethanolic extract (GSEE, 15 and 45 mg/kg) was administered daily to mice fed with a high-fat diet (HFD) for 10 weeks. HFD significantly increased the weight of the body, liver and adipose tissue, as well as serum lipid markers, but soyasaponin Ab-rich GSEE alleviated these changes. Hepatic injury and triglyceride accumulation in HFD-fed mice were attenuated by GSEE via decreased lipid synthesis (SREBP1c) and increased fatty acid oxidation (p-AMPKα, PPARα, PGC1α, and ACOX) and lipid export (MTTP and ApoB). HFD-induced inflammation (TNF-α, IL-6, IL-1β, CD14, F4/80, iNOS, and COX2) was normalized by GSEE in mice livers. In adipose tissue, GSEE downregulated white adipose tissue (WAT) differentiation and lipogenesis (PPARγ, C/EBPα, and FAS) and induced browning genes (PGC1α, PRDM16, CIDEA, and UCP1), which could also beneficially affect the liver via lowering adipose tissue-related circulating lipid levels. Thus, our results suggest that GSEE can prevent HFD-induced NAFLD via inhibition of hepatic inflammation and restoration of lipid metabolisms in both liver and adipose tissue.

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