Changes in Body Fat Mass in Patients after Starting Peritoneal Dialysis

2011 ◽  
Vol 31 (1) ◽  
pp. 67-73 ◽  
Author(s):  
Soo Jeong Choi ◽  
Na Ri Kim ◽  
Seong Ah Hong ◽  
Wan Bok Lee ◽  
Moo Yong Park ◽  
...  

BackgroundPeritoneal dialysis (PD) is characterized by gain in fat mass. Visceral fat mass is associated with metabolic syndrome and atherosclerosis rather than subcutaneous fat mass. In addition, the change in visceral fat mass is a more reliable predictor of survival in PD patients. In this study, we prospectively examined serial changes in fat composition and nutritional status and analyzed factors associated with gain in fat mass in patients undergoing PD.MethodsBody composition was assessed by bioelectric impedance analysis (BIA) and computed tomogram (CT). Nutrition status was assessed by Subjective Global Assessment (SGA), protein equivalent of nitrogen appearance (nPNA), serum albumin, C-reactive protein (CRP), and lipid profile. All measurements except BIA were performed on the seventh day and at 6 and 12 months after the start of PD.Results60 patients (30 men; mean age 55.0 ± 12.5 years) were enrolled. Increase in body weight continued during the 12 months but visceral and subcutaneous fat mass increased during the first 6 months and decreased during the second 6 months. While hematocrit and serum albumin decreased during the first 6 months, they did not change during the second 6 months. Serum creatinine, total cholesterol, and triglyceride increased similarly to the weight pattern. While nPNA decreased during the 12 months, Kt/V, SGA, and CRP did not change. Patients that had more visceral fat mass at the start of PD had less gain of visceral fat mass during the first 6 months ( r = –0.821, p = 0.002). Patients that had more subcutaneous fat mass at the start of PD had less gain of subcutaneous fat mass ( r = –0.709, p = 0.015). The change in weight was not associated with the change in visceral or subcutaneous fat during the first 6 months.ConclusionPatients starting PD experience weight gain, including visceral and subcutaneous fat, during the first 6 months of PD. Patients with high baseline fat mass had less increase in fat mass than those with low baseline fat mass, regardless of visceral or subcutaneous fat mass.

2017 ◽  
Vol 37 (3) ◽  
pp. 290-297 ◽  
Author(s):  
Soo Jeong Choi ◽  
Moo Yong Park ◽  
Jin Kuk Kim ◽  
Seung Duk Hwang

BackgroundPeritoneal dialysis (PD) is characterized by a gain in fat mass. The fat tissue is a complex endocrine organ that releases various adipokines. In this study, we prospectively examined serial changes of fat composition and adipokines in patients undergoing PD.MethodsBody composition was assessed by computed tomography (CT). Nutrition status and adipokines (leptin, adiponectin, interleukin [IL]-6, and tumor necrosis factor [TNF]-α) were assessed on the 7th day and 6 months, 12 months, and 24 months after the start of PD.ResultsFifty-four patients (28 men), with a mean age of 53.2 ± 13.2 years, were enrolled. Baseline fat mass, especially subcutaneous fat mass, was correlated with baseline leptin (ρ = 0.612), adiponetin (ρ = -0.477), and interleukin-6 (IL-6) (ρ = 0.391). Visceral fat mass was correlated with leptin (ρ = 0.545) and adiponectin (ρ = -0.514). Baseline adiponectin was negatively correlated with baseline leptin (ρ = -0.363). While body weight and leptin increased during the 24 months, serum adiponectin decreased in that period. The changes in visceral and subcutaneous fat mass were greater in the first 12 months and 6 months, respectively. There was no difference in IL-6 and TNF-α. Eight patients died during the follow-up period (mean 47.4 months). Twenty-seven patients continued PD. Increased baseline and serial change of IL-6 level were risk factors for mortality. After adjusting for age, sex, diabetes mellitus (DM), and coronary vascular disease (CVD), the significance of the IL-6 level disappeared.ConclusionsBaseline subcutaneous fat in patients starting PD is correlated with baseline adipokine levels rather than visceral fat. The increase in subcutaneous fat was greatest in the first 6 months. While leptin and adiponectin increased and decreased respectively, IL-6 did not change in the first 24 months.


2014 ◽  
Vol 34 (4) ◽  
pp. 376-382 ◽  
Author(s):  
Soo Jeong Choi ◽  
Eun Jung Kim ◽  
Moo Yong Park ◽  
Jin Kuk Kim ◽  
Seung Duk Hwang

Background and AimsPeritoneal dialysis (PD) is characterized by a gain in fat mass. Unlike subcutaneous fat, visceral fat is associated with metabolic syndrome and survival. We prospectively examined whether visceral or subcutaneous fat could predict outcome in patients undergoing PD.MethodsWe studied 117 new patients (57 men) undergoing PD between February 2006 and November 2011. Baseline body composition was measured on computed tomograms. Visceral obesity was defined as a visceral fat area exceeding 100 cm2, and subcutaneous obesity, as a subcutaneous fat area exceeding 130 cm2.ResultsAmong the 117 patients, 37 and 29 were diagnosed with visceral and subcutaneous obesity respectively. Visceral and subcutaneous obesity were both present in 21 patients. In the study population, the 1-year and 5-year survival rates were 94% and 59%. The rates of peritonitis and exit-infection were 0.31 and 0.14 episodes per patient–year. Mortality was greater in patients with visceral obesity than in those without visceral obesity ( p = 0.005). Visceral obesity had no influence on peritonitis and exit-infection rates. Subcutaneous obesity was associated neither with survival nor with peritonitis or exit-site infection. In a multivariate Cox regression analysis, visceral obesity was not a risk factor for poor outcome.ConclusionsIncreased visceral fat at PD initiation is not an independent predictor of poor survival. Any impact of visceral or subcutaneous fat mass on outcomes in patients undergoing PD would be better defined by larger, long-term studies.


2016 ◽  
Vol 7 (3) ◽  
pp. 89-93 ◽  
Author(s):  
Pratap Kumar ◽  
Praveena Joglekar Pai ◽  
G Pallavi ◽  
Arun G Maiya ◽  
Preetha Ramachandra

ABSTRACT Aims To determine the body fat distribution in 30 women with polycystic ovarian syndrome (PCOS) using bioelectric impedance analysis (BIA) and assess the effect of a 2-month structured exercise on body fat, menstrual function and fertility outcomes. Materials and methods Thirty women with PCOS underwent assessment of body composition with BIA. Their body mass index (BMI), total body fat (TBF), visceral fat (VF) and subcutaneous fat were analyzed. Two-month structured exercises were advised based on individual exercise tolerance. The postexercise parameters were reassessed. Outcome measures studied were improvement in BMI, TBF, VF, subcutaneous fat, menstrual functions, and fertility outcomes. Results A significant reduction in BMI, VF and subcutaneous fat was found in these women after exercise. Results were further analyzed after dividing them into three groups based on their BMI (normal, overweight, and obese). There was a significant reduction in all parameters (BMI, TBF, visceral and subcutaneous fat) in the overweight group. In the obese group, there was a significant drop in BMI and VF and to a lesser extent in the TBF. In women with normal BMI, a significant drop was noted in TBF only. On follow-up, five women reported regularization of their menstrual cycles and four others managed to conceive Conclusion Total body fat and VF can be cost-effectively measured by a simple tool called BIA. Tailor-made exercises based on individual tolerance are effective in improving these parameters even when done over a short duration. These improvements do positively impact the menstrual dysfunctions and subfertility. Clinical significance These findings will help in better management of women with PCOS and ensure optimal improvement in menstrual dysfunction and fertility outcomes How to cite this article Pallavi G, Pai P, Kumar P, Maiya AG, Ramachandra P. Bioelectric Impedance Analysis of Visceral Fat in Women with Polycystic Ovarian Syndrome and the Effect of Exercise: A Pilot Study. Int J Infertil Fetal Med 2016;7(3):89-93.


2019 ◽  
Vol 16 (1) ◽  
Author(s):  
James W. Daily ◽  
Hye Jeong Yang ◽  
Meiling Liu ◽  
Min Jung Kim ◽  
Sunmin Park

Abstract Background and aims Subcutaneous fat mass is negatively correlated with atherogenic risk factors, but its putative benefits remain controversial. We hypothesized that genetic variants that influence subcutaneous fat mass would modulate lipid and glucose metabolism and have interactions with lifestyles in Korean middle-aged adults with high visceral fat. Materials and methods Subcutaneous fat mass was categorized by dividing the average of subscapular skin-fold thickness by BMI and its cutoff point was 1.2. Waist circumferences were used for representing visceral fat mass with Asian cutoff points. GWAS of subjects aged 40–65 years with high visceral fat (n = 3303) were conducted and the best gene-gene interactions from the genetic variants related to subcutaneous fat were selected and explored using the generalized multifactor dimensionality reduction. Genetic risk scores (GRS) were calculated by weighted GRS that was divided into low, medium and high groups. Results Subjects with high subcutaneous fat did not have dyslipidemia compared with those with low subcutaneous fat, although both subject groups had similar amounts of total fat. The best model to influence subcutaneous fat included IL17A_rs4711998, ADCY2_rs326149, ESRRG_rs4846514, CYFIP2_rs733730, TCF7L2_rs7917983, ZNF766_rs41497444 and TGFBR3_rs7526590. The odds ratio (OR) for increasing subcutaneous fat was higher by 2.232 folds in the high-GRS group, after adjusting for covariates. However, total and LDL cholesterol, triglyceride and C-reactive protein concentrations in the circulation were not associated with GRS. Subjects with high-GRS had higher serum HDL cholesterol levels than those with low-GRS. Physical activity and GRS had an interaction with subcutaneous fat. In subjects with low physical activity, the odds ratio for high subcutaneous fat increased by 2.232, but subcutaneous fat deposition was not affected in the high-GRS group with high physical activity. Conclusion Obese adults with high-GRS had more subcutaneous fat, but they did not show more dyslipidemia and inflammation compared to low-GRS. High physical activity prevented subcutaneous fat deposition in subjects with high GRS for subcutaneous fat.


2003 ◽  
Vol 228 (10) ◽  
pp. 1118-1123 ◽  
Author(s):  
Yin Li ◽  
Hideaki Bujo ◽  
Kazuo Takahashi ◽  
Manabu Shibasaki ◽  
Yanjuan Zhu ◽  
...  

2011 ◽  
Vol 31 (2) ◽  
pp. 160-167 ◽  
Author(s):  
Wen Tang ◽  
Tian Xue ◽  
Xin-Hong Lu ◽  
Ya-Jun Luo ◽  
Tao Wang

BackgroundVolume control is critical for the success of peritoneal dialysis (PD) but dry weight in PD has been difficult to obtain. Edema free is, in general, accepted clinically as a target for volume control in PD patients. However, PD patients can be free of edema despite significant volume overload. The present study investigates the possible factors that influence the formation of pitting edema in volume-overloaded PD patients.MethodsIn this cross-sectional study, patients’ fluid status was evaluated by multifrequency bioelectrical impedance spectroscopy analysis. Values for overhydration were obtained. Patients with overhydration ≥ 2.0 kg were considered volume overloaded and were eligible for inclusion. From 1 March 2009 to 1 December 2009, a total of 96 patients on continuous ambulatory PD were included. Endothelial function was evaluated by flow-mediated dilatation (FMD). Other clinical indicators, such as blood pressure, dialysis adequacy, nutrition status, and biochemical parameters, were recorded. Patients were divided into 2 groups based on edema status: the edema group ( n = 35 volume-overloaded patients with bilateral pitting edema) and the non-edema group ( n = 61 volume-overloaded patients without bilateral pitting edema).ResultsOverhydration in the edema group was significantly higher than in the non-edema group (4.28 ± 1.75 kg vs 3.12 ± 0.81 kg, p < 0.001), whereas both FMD and serum albumin in the edema group were significantly lower than in the non-edema group (6.65% ± 5.2% vs 10.3% ± 5.1%, p = 0.001; 37.6 ± 4.2 g/L vs 39.3 ± 3.5 g/L, p = 0.047, respectively). Edema status (edema = 1, non-edema = 0) was positively correlated with overhydration ( r = 0.341, p < 0.001), gender (male = 1, female = 2: r = 0.184, p = 0.072), and total fluid removal ( r = 0.188, p = 0.074) and negatively correlated with endothelial function, as assessed by FMD ( r = -0.33, p = 0.001), and serum albumin ( r = -0.18, p = 0.055). Logistic regression analysis showed that FMD [odds ratio (OR) 0.90, 95% confidence interval (CI) 0.81 - 0.99; p = 0.036], gender (male = 1, female = 2: OR 4.06, 95% CI 1.23 - 13.35; p = 0.021), overhydration (OR 3.06, 95% CI 1.53 - 6.13; p = 0.002), and serum albumin (OR 0.86, 95% CI 0.75 - 0.99; p = 0.035) were independent factors affecting the edema status of the study population.ConclusionOur study showed that endothelial function (assessed by FMD), gender, serum albumin, and over hydration are independent determinants of edema status in PD patients. This may explain why some PD patients can maintain free of edema despite significant volume overload.


2019 ◽  
Vol 25 (3) ◽  
pp. 195-202 ◽  
Author(s):  
Matthew A Christensen ◽  
Peter Smoak ◽  
Jonathon K Lisano ◽  
Reid Hayward ◽  
Craig Coronado ◽  
...  

Background: The control of chronic inflammation has emerged as a target for improving the health of cancer survivors (CS). Aim: To examine differences in fitness and dietary characteristics of CS when grouped by low vs. moderate to high serum C-reactive protein (CRP). Methods: CS ( N = 26, mean age = 68 ± 12 years) were evaluated for body mass index (BMI), body composition, cardiorespiratory fitness, dietary intake, dietary inflammatory index (DII), and serum CRP. Participants were assigned to one of two groups based on serum CRP concentrations: low CRP (≤1 mg/L) (LWC; n = 13) or moderate to high (CRP > 1 mg/L) (MHC; n = 13) and t-tests compared them. Data are presented as mean ± SD. Results: LWC had higher VO2peak values (mL/kg/min) ( p = 0.0003), and lower visceral fat area (cm2) ( p = 0.02) and body fat mass (kg) ( p = 0.04). Secondary analysis using Pearson’s correlation coefficients, including all current study participant data, found significant negative relationships between CRP and total dietary fat intake ( p = 0.02), saturated fat ( p = 0.03), and polyunsaturated fat ( p = 0.03). Conclusion: CS with moderate to high serum CRP concentrations had higher fat mass, visceral fat mass, and lower cardiorespiratory fitness. There was a significant negative relationship between dietary, fat, polyunsaturated and saturated fat, and CRP. However, these dietary fat related findings warrant further investigation. To summarize, improving cardiorespiratory fitness, maintaining lower body fat, may be helpful in altering chronic inflammation in CS.


2017 ◽  
Vol 71 (3-4) ◽  
pp. 203-210 ◽  
Author(s):  
Laura M. Breij ◽  
Marieke Abrahamse-Berkeveld ◽  
Dennis Acton ◽  
Emanuella De Lucia Rolfe ◽  
Ken K. Ong ◽  
...  

Background: Accelerated gain in fat mass in the first months of life is considered to be a risk factor for adult diseases, given the tracking of infancy fat mass into adulthood. Our objective was to assess the influence of early growth, type of feeding and maternal variables on fat mass in early life. Methods: In 300 healthy term infants, we longitudinally measured fat mass percentage (FM%) by air-displacement-plethysmography at 1, 3, and 6 months and abdominal visceral and subcutaneous fat measured by ultrasound at 3 and 6 months. Results: Both gain in FM% and weight-for-length in the first 3 months were positively associated with FM% at 6 months of age and visceral fat at 3 months of age. Gain in FM% and weight-for-length between 3 and 6 months were both positively associated with visceral fat at 6 months. Breastfeeding duration associated positively with subcutaneous fat but not with visceral fat at 3 and 6 months. Maternal characteristics did not associate with FM% or visceral fat at 3 or 6 months. Conclusion: Higher gain in FM% or in weight-for-length in the first postnatal months leads not only to higher FM% but also more to accumulation of visceral fat. Exclusive breastfeeding appears to promote subcutaneous but not visceral fat in the first 6 months.


2021 ◽  
Vol 39 ◽  
Author(s):  
Estela Beatriz Behling ◽  
José Simon Camelo Júnior ◽  
Eduardo Ferriolli ◽  
Karina Pfrimer ◽  
Jacqueline Pontes Monteiro

ABSTRACT Objective: To explore changes in the nutritional status of pediatric cancer patients before and after chemotherapy and evaluate the correlation between deuterium oxide dilution, bioelectric impedance analysis, and anthropometry for assessment of body composition. Methods: This study included 14 children (aged 5.6 to 13.6 years) and classified them as having hematologic or solid tumors. They had their body composition analyzed according to deuterium oxide, bioelectric impedance, and anthropometric measurements before the first chemotherapy cycle and after three and six months of therapy. Results: The patients in the hematologic tumor group had an increase in weight, height, body mass index, waist, hip, and arm circumference, subscapular skinfold thickness, and fat mass with the isotope dilution technique during chemotherapy. In the solid tumor group, the children showed a reduction in fat-free mass when assessed by bioimpedance analysis. We found a positive correlation between the triceps skinfold thickness and fat mass determined by bioimpedance analysis and deuterium oxide. The arm muscle circumference correlated with the fat-free mass estimated by bioimpedance analysis and deuterium oxide. Conclusions: Patients with hematologic tumors had an increase in body weight, height, and fat mass, which was not identified in the solid tumor group. The positive correlation between anthropometry (triceps skinfold thickness and arm muscle circumference), deuterium oxide dilution, and bioelectric impedance analysis shows the applicability of anthropometry in clinical practice.


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