scholarly journals Prognostic Role of Subcutaneous and Visceral Adiposity in Hospitalized Octogenarians with COVID-19

2021 ◽  
Vol 10 (23) ◽  
pp. 5500
Author(s):  
Max Scheffler ◽  
Laurence Genton ◽  
Christophe E. Graf ◽  
Jorge Remuinan ◽  
Gabriel Gold ◽  
...  
Keyword(s):  
Visceral Fat ◽  
Prognostic Significance ◽  
Subcutaneous Fat ◽  
Chest Ct ◽  
Abdominal Circumference ◽  
Logistic Regression Models ◽  
Total Fat ◽  
Subcutaneous Adiposity ◽  
Chest Ct Scan

Background: We investigated the prognostic significance of visceral and subcutaneous adiposity in octogenarians with COVID-19. Methods: This paper presents a monocentric retrospective study that was conducted in acute geriatric wards with 64 hospitalized patients aged 80+ who had a diagnosis of COVID-19 and who underwent a chest CT scan. A quantification of the subcutaneous, visceral, and total fat areas was performed after segmentations on the first abdominal slice caudal to the deepest pleural recess on a soft-tissue window setting. Logistic regression models were applied to investigate the association with in-hospital mortality and the extent of COVID-19 pneumonia. Results: The patients had a mean age of 86.4 ± 6.0 years, and 46.9% were male, with a mean BMI of 24.1 ± 4.4Kg/m2 and mortality rate of 32.8%. A higher subcutaneous fat area had a protective effect against mortality (OR 0.416; 0.183–0.944 95% CI; p = 0.036), which remained significant after adjustments for age, sex, and BMI (OR 0.231; 0.071–0.751 95% CI; p = 0.015). Inversely, higher abdominal circumference, total fat area, subcutaneous fat area, and visceral fat were associated with worse COVID-19 pneumonia, with the latter presenting the strongest association after adjustments for age, sex, and BMI (OR 2.862; 1.523–5.379 95% CI; p = 0.001). Conclusion: Subcutaneous and visceral fat areas measured on chest CT scans were associated with prognosis in octogenarians with COVID-19.

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 Cut-Off Values of Visceral Adiposity to Predict NAFLD in Brazilian Obese Adolescents

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Ana Paula Grotti Clemente ◽  
Bárbara Dal Molin Netto ◽  
Aline di Piano Ganen ◽  
Lian Tock ◽  
Danielle Arisa Caranti ◽  
...  
Keyword(s):  
Visceral Fat ◽  
Subcutaneous Fat ◽  
Treatment Strategies ◽  
Roc Curves ◽  
Visceral Adiposity ◽  
Safe Alternative ◽  
Abdominal Ultrasonography ◽  
Cross Sectional ◽  
Obese Adolescents ◽  
Total Fat

Objectives.The present study aimed at determining cut-off points of visceral fat to predict NAFLD and analyzed metabolic disorders of obese adolescents.Methods.Cross-sectional study involved 165 obese adolescents ranged in age from 15 to 19 years. Glycemia, hepatic transaminases, lipid profile, and insulin resistance were analyzed. Visceral and subcutaneous fat were measured by ultrasound and body composition by plesthysmography.Results.The NAFLD adolescents had significantly higher values for body mass, BMI-for-age, BMI, total fat, waist circumference, and visceral fat when compared with non-NAFLD obese adolescents in both genders. Moreover, there were significant positive correlations between visceral fat with the variables BMI-for-age (r=0.325,), TG (r=0.277), AST (r=0.509), ALT (r=0.519), WC (r=0.390), and visceral/subcutaneous ratio (r=0.790) for NAFLD group. Total fat, triglycerides, and visceral fat were the independent predictors to NAFLD. Analysis of the ROC curves revealed cut-off points of visceral fat of 4.47 cm for girls and 4.21 cm for boys.Conclusions.The results may suggest that abdominal ultrasonography procedure may be a safe alternative method of assessing visceral adiposity aiming to be considered to the development of preventive and treatment strategies in obese individuals. This clinial trial is registered with ClinicalTrial.gov (NCT01358773).

scholarly journals Elderly COVID-19 Pneumonic Patient with both Graded and Movable-weaning off Phenomenon or Yasser's Phenomena in a Surgical Severe Aortic Stenosis; at-home Dilemma Management

2021 ◽  
Vol 4 (5) ◽  
pp. 01-05
Author(s):  
Yasser Elsayed
Keyword(s):  
Risk Factors ◽  
Aortic Stenosis ◽  
Severe Aortic Stenosis ◽  
Chest Ct ◽  
Dynamic Changes ◽  
Case Presentation ◽  
Elderly Female ◽  
Patient Concerns ◽  
Chest Ct Scan

Rationale: Coronavirus disease is a leading remarkable critical pandemic global infection. Graded phenomenon or Yasser's phenomenon is a novel electrocardiographic phenomenon that changes the arrhythmia didactic. It is decisive progress in understanding arrhythmia. The phenomenon is a contemporary vigorous instructor for monitoring and follows up the arrhythmic patients. Movable-weaning off phenomenon or Yasser's phenomenon is another novel electrocardiographic phenomenon characterized by serial dynamic changes in all cases of either Wavy triple or double electrocardiographic signs (Yasser signs) of hypocalcemia. Movable-weaning off phenomenon is a guide for both Wavy triple and double an electrocardiographic. Severe symptomatic aortic stenosis has a bad outcome after the evolution of symptoms, and prompt operative intervention is advisable. Patient concerns: An elderly female COVID-19 pneumonic patient presented to physician outpatient clinic with bilateral peripheral pneumonia and both Graded and Movable-weaning off phenomenon or Yasser's phenomena in severe aortic stenosis. Diagnosis: Elderly COVID-19 pneumonia with both Graded and Movable-weaning off phenomenon or Yasser's phenomena. Interventions: Oxygenation, electrocardiography, chest CT scan, and echocardiography. Outcomes: Gradual dramatic clinical, electrocardiographic, and radiological improvement had happened. Lessons: It denotes the role of the anticoagulants, the antiplatelets, steroids, and antimicrobial therapy in the management of COVID-19 pneumonia with Graded and Movable-weaning off phenomenon or Yasser's phenomena in severe aortic stenosis. The presence of Graded and Movable-weaning off phenomenon or Yasser's phenomena, elderly, and pneumonia, in the case presentation, represent new complicated risk factors especially, with an associated severe sclerotic aortic stenosis. Short title: A case report article in cardiology, critical care, emergency medicine, and infectious diseases

Transdifferentiation properties of adipocytes in the adipose organ

2009 ◽  
Vol 297 (5) ◽  
pp. E977-E986 ◽  
Author(s):  
Saverio Cinti
Keyword(s):  
Insulin Resistance ◽  
Visceral Fat ◽  
Metabolic Disorders ◽  
Subcutaneous Fat ◽  
Causative Factor ◽  
Brown Adipocytes ◽  
Anatomy And Physiology ◽  
White Adipocytes ◽  
Adipose Organ

Mammals have two types of adipocytes, white and brown, but their anatomy and physiology is different. White adipocytes store lipids, and brown adipocytes burn them to produce heat. Previous descriptions implied their localization in distinct sites, but we demonstrated that they are mixed in many depots, raising the concept of adipose organ. We explain the reason for their cohabitation with the hypothesis of reversible physiological transdifferentiation; they are able to convert one into each other. If needed, the brown component of the organ could increase at the expense of the white component and vice versa. This plasticity is important because the brown phenotype of the organ associates with resistance to obesity and related disorders. Another example of physiological transdifferetiation of adipocytes is offered by the mammary gland; the pregnancy hormonal stimuli seems to trigger a reversible transdifferentiation of adipocytes into milk-secreting epithelial glands. The obese adipose organ is infiltrated by macrophages inducing chronic inflamation that is widely considered as a causative factor for insulin resistance. We showed that the vast majority of macrophages infiltrating the obese organ are arranged around dead adipocytes, forming characteristic crown-like structures. We recently found that visceral fat is more infiltrated than the subcutaneous fat despite a smaller size of visceral adipocytes. This suggests a different susceptibility of visceral and subcutaneous adipocytes to death, raising the concept of smaller critical death size that could be important to explain the key role of visceral fat for the metabolic disorders associated with obesity.

scholarly journals Visceral Fat Area Evaluation by Computed Tomography Correlates with Visceral Fat Volume

2017 ◽  
Vol 9 (10) ◽  
pp. 78
Author(s):  
Masato Mizui ◽  
Yuji Mizoguchi ◽  
Yutaka Senda ◽  
Masayuki Yokoi ◽  
Takao Tashiro
Keyword(s):  
Computed Tomography ◽  
Visceral Fat ◽  
Subcutaneous Fat ◽  
Area Measurement ◽  
Abdominal Circumference ◽  
Ct Scans ◽  
Visceral Fat Area ◽  
Visceral Fat Accumulation ◽  
Fat Volume ◽  
Very High

In Japan, the measurement of abdominal circumference is commonly used in diagnosis of visceral fat accumulation. It is also recommended that visceral fat at the umbilical level be measured using CT scans. If CT is used to measure the visceral fat area, we do not have to consider the possibility of measurement error due to subcutaneous fat. However, it is unknown whether the visceral fat area measurement by CT reflects the visceral fat volume of the entire abdomen.We examined the correlation between the visceral fat area at the umbilical level and the visceral fat volume of the entire abdomen using CT images taken from the diaphragm to the pubic bone.The results showed that there was a very high correlation between the visceral fat area and the visceral fat volume. The correlation was not affected by gender differences, old age or whether visceral fat was accumulated or not.Therefore, we concluded that it is possible to estimate the visceral fat volume of the entire abdomen by measuring the visceral fat area at the umbilical level.

scholarly journals Association of maternal central adiposity measured by ultrasound in early mid pregnancy with infant birth size

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Emelie Lindberger ◽  
Anna-Karin Wikström ◽  
Eva Bergman ◽  
Karin Eurenius ◽  
Ajlana Mulic-Lutvica ◽  
...  
Keyword(s):  
Early Pregnancy ◽  
Visceral Fat ◽  
Standard Deviation Score ◽  
Subcutaneous Fat ◽  
University Hospital ◽  
Birth Size ◽  
Central Adiposity ◽  
Term Infants ◽  
Logistic Regression Models ◽  
Infant Birth

AbstractWe sought to investigate whether early mid pregnancy visceral and subcutaneous fat depths measured by ultrasound were associated with infant birth size, independent of early pregnancy BMI. A cohort study was performed at Uppsala University Hospital, Sweden, between 2015–2018. Visceral and subcutaneous fat depths were measured at the early second-trimester anomaly scan in 2498 women, giving birth to singleton, term infants. Primary outcomes were birthweight and LGA (birthweight standard deviation score > 90th percentile in the cohort). Linear and logistic regression models were used, adjusted for BMI, age, smoking, parity, maternal country of birth, gestational age and infant sex. A 5-mm increase in visceral fat depth was associated with an increase in birthweight of 8.3 g [95% confidence interval (CI) 2.5 − 14.1 g], after adjustments, and a 6% increase in the adjusted odds of having an infant born LGA (OR 1.06, CI 1.02–1.11). There was no association between subcutaneous fat depth and birthweight or LGA after covariate adjustments. Hence, visceral fat depth measured by ultrasound in early mid pregnancy was associated with excessive fetal growth, independent of early pregnancy BMI, and may be useful in models for predicting LGA infants.

scholarly journals Role of fatty liver in coronavirus disease 2019 patients’ disease severity and hospitalization length: a case–control study

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Arash Ziaee ◽  
Ghodsiyeh Azarkar ◽  
Masood Ziaee
Keyword(s):  
Fatty Liver ◽  
Ct Scan ◽  
Disease Severity ◽  
Severe Disease ◽  
Hounsfield Unit ◽  
Chest Ct ◽  
Control Group ◽  
Case Group ◽  
Chest Ct Scan

Abstract Background and purpose Fatty liver is one of the most common pre-existing illnesses; it can cause liver injury, leading to further complications in coronavirus disease 2019 patients. Our goal is to determine if pre-existing fatty liver is more prevalent in hospitalized COVID-19 patients compared to patients admitted before the SARS-CoV-2 pandemic and determine the disease severity among fatty liver patients. Experimental approach This retrospective study involves a case and a control group consisting of 1162 patients; the case group contains hospitalized COVID-19 patients with positive PCR tests and available chest CT-scan; the control group contains patients with available chest CT-scan previous to the COVID-19 pandemic. Patients’ data such as liver Hounsfield unit, hospitalization length, number of affected lobes, and total lungs involvement score were extracted and compared between the patients. Results The findings indicate that 37.9% of hospitalized COVID-19 patients have a pre-existing fatty liver, which is significantly higher (P < 0.001) than the prevalence of pre-existing fatty liver in control group patients (9.02%). In comparison to hospitalized non-fatty liver COVID-19 patients, data from hospitalized COVID-19 patients with fatty liver indicate a longer hospitalization length (6.81 ± 4.76 P = 0.02), a higher total lungs involvement score (8.73 ± 5.28 P < 0.001), and an increased number of affected lobes (4.42 ± 1.2 P < 0.001). Conclusion The statistical analysis shows fatty liver is significantly more prevalent among COVID-19 against non-COVID-19 patients, and they develop more severe disease and tend to be hospitalized for more extended periods.

scholarly journals The Role of Fever Clinic During the COVID-19 Pandemic: A case study of 1034 febrile patients

2020 ◽  
Author(s):  
Li Tang ◽  
Yanxia He ◽  
Fangjing Bai ◽  
Bin Luo
Keyword(s):  
Body Temperature ◽  
Ct Scan ◽  
Sore Throat ◽  
Chest Ct ◽  
Entire World ◽  
Isolation Ward ◽  
Chest Ct Scan ◽  
Clinic Visits

Abstract Background Since winter of 2019, when coronavirus disease 2019 (Covid-19) emerged in China and rapidly spread throughout the entire world, many fever clinics were rearranged and enlarged to triage febrile patients in China. Methods This study included fever clinic visits of Sichuan Provincial Peoples’ Hospital to summarize the characteristics of these febrile patients retrospectively. Results From 24th January to 31th March, 1034 fever clinic visits with 530 male and 504 female, were triaged, treated and recorded. About 64.9% of them were checked with body temperature higher than 37.3℃. Cough (25.0%) and sore throat (19.2%) were the most common symptoms in addition to fever. Chest CT scan was ordered for 900 patients, and 172 cases (16.6%) were found ground grass opacity, 134 (13.0%) found local patchy shadowing, and 26 (2.5%) found bilateral patchy shadowing. At last 851 patients (82.3%) were excluded for COVID-19 or other severe diseases. Eighty patients (7.7%) were admitted to hospitalization for other conditions. One hundred and three (9.9%) patients were suspected or confirmed of COVID-19 at fever clinic, and then admitted to isolation ward. Conclusions The result of this study again verified the extraordinary role of fever clinics in pandemics. When confronted with a mass of unknown febrile patients, a well organized fever clinic may avoid the frustration of all medical staffs.

scholarly journals Independent role of CT chest scan in COVID-19 prognosis: Evidence from the machine learning classification

2021 ◽  
Vol 52 (4) ◽  
pp. 273-278
Author(s):  
Sudhir Bhandari ◽  
Shaktawat Singh ◽  
Amit Tak ◽  
Bhoopendra Patel ◽  
Jitentdra Gupta ◽  
...  
Keyword(s):  
Support Vector Machine ◽  
Ct Scan ◽  
Principal Components ◽  
Severity Score ◽  
Feature Space ◽  
Chest Ct ◽  
Support Vector ◽  
Machine Learning Classification ◽  
Chest Ct Scan

Background: The current coronavirus disease-19 (COVID-19) pandemic call attention to the key role informatics play in healthcare. The present study discovers an independent role of computerised tomography chest (CT) scans in prognosis of COVID-19 using classification learning algorithms. Methods: In this retrospective study, 57 RT PCR positive COVID-19 patients were enrolled from SMS Medical College, Jaipur (Rajasthan, India) after approval from the Institutional Ethics Committee. A set of 21 features including clinical findings and laboratory parameters and chest CT severity score were recorded. The CT score with mild, moderate and severe categories was chosen as response variable. The dimensionality reduction of feature space was performed and classifiers including, decision trees, K-nearest neighbours, support vector machine and ensemble learning were trained with principal components. The model with highest accuracy and area under the ROC curve (AUC) was selected. Results: The median age of patients was 55 years (range: 20-99 years) with 37 males. The feature space was reduced from 21 to 7 predictors, that included fever, cough, fibrin degradation products, haemoglobin, neutrophil-lymphocyte ratio, ferritin and procalcitonin. The linear support vector machine was chosen as the best classifier with 73.7 % and 0.69 accuracy and AUC for severe CT chest score, respectively. The variance contributed by first three principal components were 97.5 %, 2.4 % and 0.0 %, respectively. Conclusion: In view of low degree of relationships between predictors and chest CT scan severity score category as interpreted from accuracy and AUC it can be concluded that chest CT scan has an independent role in the prognosis of COVID-19 patients.

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