Visceral Adiposity in Relation to Body Adiposity and Nutritional Status in Elderly Patients with Stable Coronary Artery Disease

Introduction: The accumulation of visceral abdominal tissue (VAT) seems to be a hallmark feature of abdominal obesity and substantially contributes to metabolic abnormalities. There are numerous factors that make the body-mass index (BMI) a suboptimal measure of adiposity. The visceral adiposity index (VAI) may be considered a simple surrogate marker of visceral adipose tissue dysfunction. However, the evidence comparing general to visceral adiposity in CAD is scarce. Therefore, we have set out to investigate visceral adiposity in relation to general adiposity in patients with stable CAD. Material and methods: A total of 204 patients with stable CAD hospitalized in the Department of Medicine and the Department of Geriatrics entered the study. Based on the VAI-defined adipose tissue dysfunction (ATD) types, the study population (N = 204) was divided into four groups: (1) no ATD (N = 66), (2) mild ATD (N = 50), (3) moderate ATD (N = 48), and (4) severe ATD (N = 40). Nutritional status was assessed using the Controlling Nutritional Status (CONUT) score. Results: Patients with moderate and severe ATD were the youngest (median 67 years), yet their metabolic age was the oldest (median 80 and 84 years, respectively). CONUT scores were similar across all four study groups. The VAI had only a modest positive correlation with BMI (r = 0.59 p < 0.01) and body adiposity index (BAI) (r = 0.40 p < 0.01). There was no correlation between VAI and CONUT scores. There was high variability in the distribution of BMI-defined weight categories across all four types of ATD. A total of 75% of patients with normal nutritional status had some form of ATD, and one-third of patients with moderate or severe malnutrition did not have any ATD (p = 0.008). In contrast, 55–60% of patients with mild, moderate, or severe ATD had normal nutritional status (p = 0.008). ROC analysis demonstrated that BMI and BAI have poor predictive value in determining no ATD. Both BMI (AUC 0.78 p < 0.0001) and BAI (AUC 0.66 p = 0.003) had strong predictive value for determining severe ATD (the difference between AUC 0.12 being p = 0.0002). However, BMI predicted mild ATD and severe ATD better than BAI. Conclusions: ATD and malnutrition were common in patients with CAD. Notably, this study has shown a high rate of misclassification of visceral ATD via BMI and BAI. In addition, we demonstrated that the majority of patients with normal nutritional status had some form of ATD and as much as one-third of patients with moderate or severe malnutrition did not have any ATD. These findings have important clinical ramifications for everyday practice regarding the line between health and disease in the context of malnutrition in terms of body composition and visceral ATD, which are significant for developing an accurate definition of the standards for the intensity of clinical interventions.

Download Full-text

Visceral Adiposity Index: An Indicator of Adipose Tissue Dysfunction

International Journal of Endocrinology ◽

10.1155/2014/730827 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 80

Author(s):

Marco Calogero Amato ◽

Carla Giordano

Keyword(s):

Adipose Tissue ◽

Cardiometabolic Risk ◽

Polycystic Ovary ◽

Visceral Adiposity ◽

Visceral Adiposity Index ◽

Adiposity Index ◽

Adipose Tissue Dysfunction ◽

Conflicting Evidence ◽

And Function

The Visceral Adiposity Index (VAI) has recently proven to be an indicator of adipose distribution and function that indirectly expresses cardiometabolic risk. In addition, VAI has been proposed as a useful tool for early detection of a condition of cardiometabolic risk before it develops into an overt metabolic syndrome. The application of the VAI in particular populations of patients (women with polycystic ovary syndrome, patients with acromegaly, patients with NAFLD/NASH, patients with HCV hepatitis, patients with type 2 diabetes, and general population) has produced interesting results, which have led to the hypothesis that the VAI could be considered a marker of adipose tissue dysfunction. Unfortunately, in some cases, on the same patient population, there is conflicting evidence. We think that this could be mainly due to a lack of knowledge of the application limits of the index, on the part of various authors, and to having applied the VAI in non-Caucasian populations. Future prospective studies could certainly better define the possible usefulness of the VAI as a predictor of cardiometabolic risk.

Download Full-text

Changes in the Visceral Adiposity Index (VAI) Among Obese Older Adults After a 12-Month Exercise and Diet Intervention

Current Developments in Nutrition ◽

10.1093/cdn/nzab055_057 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 1247-1247

Author(s):

Katelyn Senkus ◽

Kristi Crowe-White ◽

Julie Locher ◽

Jamy Ard

Keyword(s):

Older Adults ◽

Adipose Tissue ◽

Linear Models ◽

Density Lipoprotein ◽

Energy Restriction ◽

Visceral Adiposity ◽

Visceral Adiposity Index ◽

Necrosis Factor Alpha ◽

Adiposity Index ◽

Adipose Tissue Dysfunction

Abstract Objectives The Visceral Adiposity Index (VAI) was developed to estimate adipose tissue dysfunction as well as visceral fat distribution. In an ancillary analysis of the CROSSROADS Study (clinicaltrials.gov #NCT00955903), this study investigated the effects of exercise with and without intentional energy restriction on VAI changes among older adults with obesity. Methods Participants (n = 163, 37.4% male, 70.3 ± 4.7 years) were randomized to the following groups: exercise only, exercise + nutrient-dense weight maintenance diet, and exercise + nutrient-dense energy restriction of 500 kcal/d. Visceral adiposity determined by magnetic resonance imaging (MRI) and dual-energy X-ray absorptiometry (DXA), anthropometrics, and cardiometabolic biomarkers were assessed at baseline and 12 months. Waist circumference, body mass index, triglycerides, and high-density lipoprotein (HDL) cholesterol were used to compute VAI at both time points. Data were analyzed utilizing Spearman's correlations and general linear models to determine differences among groups following adjustment for covariates. Results Among all participants, significant correlations were observed between VAI and glucose, insulin, tumor necrosis factor-alpha (TNF-α), and the adiponectin: leptin ratio at baseline (r = 0.343, P < 0.001; r = 0.363, P < 0.001; r = 0.200, P = 0.011; r = −0.246, P = 0.002, respectively). DXA and MRI measures of visceral adiposity were not significantly correlated with VAI. Upon completion of the 12-month study period, there were significant differences in VAI among groups [F (2,137) = 5.957, P = 0.003)]. Post hoc analysis revealed that VAI was significantly lower in the exercise + nutrient-dense energy restriction group compared to the exercise only group (P = 0.002). Conclusions Results suggest that VAI may be an adequate measure of adipose tissue dysfunction, yet its ability to estimate levels of visceral adiposity warrants further investigation to determine clinical utility. Nonetheless, results suggest that an exercise + nutrient-dense energy restriction intervention may reduce VAI among older adults with obesity. Funding Sources NIH.

Download Full-text

Different Cabergoline Effect on Metabolic and Anthropometric Parameters in Female Prolactinoma Patients Versus Idiopathic Hyperprolactinemia Patients

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530319666190219103812 ◽

2019 ◽

Vol 19 (4) ◽

pp. 511-518

Author(s):

Mohamed M. Aboelnaga ◽

Eman H. Eladawy ◽

Maha M. Elshafei ◽

Nahed Abdullah ◽

Moustafa El. Shaer

Keyword(s):

Adipose Tissue ◽

Visceral Adiposity ◽

Visceral Adiposity Index ◽

Newly Diagnosed ◽

Anthropometric Parameters ◽

Adiposity Index ◽

Female Patients ◽

Adipose Tissue Dysfunction ◽

One Year ◽

Anthropometric Profile

Background: Hyperprolactinemia can lead to weight gain, insulin resistance, abnormal glucose homeostasis and dyslipidemia. Reversibility of these changes after normalization of prolactin with dopamine agonists is still controversial and needs more clarification. Objective: We aimed to: 1) evaluate and compare metabolic and anthropometric profile in female with newly diagnosed prolactin-secreting adenoma versus female idiopathic hyperprolactinemic patients; 2) compare the effects of one year cabergoline therapy on the metabolic profile and anthropometric parameters (by using visceral adiposity index as index for evaluation of adipose tissue dysfunction) in females with prolactinoma to female idiopathic hyperprolactinemic patients. Patients and Methods: We enrolled 40 female patients with newly diagnosed prolactinoma and 40 female patients with idiopathic hyperprolactinemia, who were matched according to: age; weight; BMI; waist; and prolactin levels. We enrolled the participants in this study at the time of diagnosis before therapy and they were followed up for 12 months. Results: Cabergoline therapy had significant favorable effects on metabolic and anthropometric parameters, visceral adiposity index and in all patients (apart from HDLc in prolactinoma patients). : Cabergoline therapy was significantly more effective in patient with idiopathic hyperprolactinemia than prolactinoma patients with regard to BMI, waist circumference, HDLc and visceral adiposity index despite normalization of prolactin levels in both groups. Conclusion: 12 months of Cabergoline treatment improved most of the anthropometric and metabolic parameters, and visceral adiposity index as a marker for adipose tissue dysfunction in both idiopathic hyperprolactinemia and prolactinoma patients. However, Cabergoline treatment was more effective in idiopathic hyperprolactinemic than prolactinoma patients.

Download Full-text

Agreement of body adiposity index (BAI) and paediatric body adiposity index (BAIp) in determining body fat in Brazilian children and adolescents

Public Health Nutrition ◽

10.1017/s1368980018002458 ◽

2018 ◽

Vol 22 (1) ◽

pp. 132-139

Author(s):

Mariana De Santis Filgueiras ◽

Roberta Stofeles Cecon ◽

Eliane Rodrigues de Faria ◽

Franciane Rocha de Faria ◽

Patrícia Feliciano Pereira ◽

...

Keyword(s):

Children And Adolescents ◽

Body Fat ◽

Operating Characteristic ◽

Characteristic Curve ◽

The Body ◽

Body Adiposity Index ◽

Adiposity Index ◽

Body Adiposity ◽

Operating Characteristic Curve ◽

Brazilian Children

AbstractObjectiveTo evaluate agreement of the body adiposity index (BAI) and paediatric body adiposity index (BAIp) in estimating body fat compared with dual-energy X-ray absorptiometry (DXA) and to propose cut-off points for these indices to classify excess adiposity in Brazilian children and adolescents.DesignCross-sectional study. Measures of weight, height, hip circumference, BMI and body fat percentage (%BF) assessed by DXA were taken, and BAI and BAIp were calculated. The Bland–Altman plot was used to estimate agreement between the methods, and the receiver-operating characteristic curve to determine the cut-off points for BAI and BAIp per age and sex in comparison with DXA.SettingViçosa, Minas Gerais, Brazil.SubjectsChildren and adolescents aged 8–19 years (n 1049).ResultsOf the children and adolescents, 52·4 % were girls. BAI and BAIp had satisfactory performance by the receiver-operating characteristic curve, except for the 18–19 years age group, whose BAIp had better predictive capacity than BAI. The agreement analysis showed that BAI overestimated %BF by 2·64 %, on average, using DXA; while BAIp underestimated %BF by 3·37 %.ConclusionsBAI and BAIp showed low agreement with the body fat obtained by DXA, requiring caution when interpreting body composition data in children and adolescents.

Download Full-text

The validity of the body adiposity index in predicting percentage body fat and cardiovascular risk factors among Chinese

Clinical Endocrinology ◽

10.1111/cen.12351 ◽

2013 ◽

Vol 81 (3) ◽

pp. 356-362 ◽

Cited By ~ 13

Author(s):

Zhe-Qing Zhang ◽

Yan-Hua Liu ◽

Ying Xu ◽

Xiao-Wei Dai ◽

Wen-hua Ling ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Body Fat ◽

The Body ◽

Body Adiposity Index ◽

Percentage Body Fat ◽

Adiposity Index ◽

Body Adiposity

Download Full-text

Adipose tissue in control of metabolism

Journal of Endocrinology ◽

10.1530/joe-16-0211 ◽

2016 ◽

Vol 231 (3) ◽

pp. R77-R99 ◽

Cited By ~ 188

Author(s):

Liping Luo ◽

Meilian Liu

Keyword(s):

Adipose Tissue ◽

Metabolic Pathways ◽

The Body ◽

The Other ◽

Whole Body ◽

Endocrine Organ ◽

Lipid Mobilization ◽

Adipose Tissue Dysfunction ◽

Body Energy ◽

Beige Adipose Tissue

Adipose tissue plays a central role in regulating whole-body energy and glucose homeostasis through its subtle functions at both organ and systemic levels. On one hand, adipose tissue stores energy in the form of lipid and controls the lipid mobilization and distribution in the body. On the other hand, adipose tissue acts as an endocrine organ and produces numerous bioactive factors such as adipokines that communicate with other organs and modulate a range of metabolic pathways. Moreover, brown and beige adipose tissue burn lipid by dissipating energy in the form of heat to maintain euthermia, and have been considered as a new way to counteract obesity. Therefore, adipose tissue dysfunction plays a prominent role in the development of obesity and its related disorders such as insulin resistance, cardiovascular disease, diabetes, depression and cancer. In this review, we will summarize the recent findings of adipose tissue in the control of metabolism, focusing on its endocrine and thermogenic function.

Download Full-text