Search Results (271)

Background: The causation of type 2 diabetes remains under debate, but evidence supports both abdominal lipid and ectopic lipid overspill into tissues including muscle as key. How these depots differentially alter cardiometabolic profile and change during body weight and fat loss is not known. Methods: Women with obesity scheduled to undergo bariatric surgery were assessed at baseline (BL, n = 28) and at 6-month follow-up (6m_FU, n = 26) after weight loss. Fasting plasma (Pla), subcutaneous thigh adipose (STA), subcutaneous abdominal adipose, (SAA), and thigh vastus lateralis muscle (VLM) samples were collected at BL through surgery and at 6m_FU using needle biopsy. An untargeted liquid chromatography mass spectrometry metabolomics platform was used. Pla and tissue-specific lipid and polar metabolite profiles were modelled as changes from BL and 6m_FU. Results: There was significant body weight (−24.5 kg) loss at 6m_FU (p < 0.05). BL vs. 6m_FU tissue metabolomics profiles showed the largest difference in lipid profiles in SAA tissue in response to surgery. Conversely, polar metabolites were more susceptible to change in STA and VLM. In Pla samples, both lipid and polar metabolite profiles showed significant differences between timepoints. Jaccard–Tanimoto coefficient t-tests identified a sub-group of gut microbiome and dietary-derived omega-3-fatty-acid-containing lipid species and core energy metabolism and adipose catabolism-associated polar metabolites that are trafficked between sample types in response to bariatric surgery. Conclusions: In this first report on channelling of lipids and polar metabolites to alternative tissues in bariatric-induced weight loss, adaptive shuttling of small molecules was identified, further promoting adipose processing and highlighting the dynamic and coordinated nature of post-surgical metabolic regulation. Full article

Background: The waist–calf circumference ratio (WCR) is an index that combines waist and calf circumference measurements, offering a potentially effective method for evaluating the imbalance between abdominal fat and leg muscle mass in older adults. Objective: To assess the association between WCR and indicators of body composition, muscle strength, and physical performance in community-dwelling older women. Methods: This was a cross-sectional study involving 133 older women (≥65 years) from an urban-marginal community in Guayaquil, Ecuador. The WCR was categorized into quartiles (Q1: 2.07–2.57; Q2: 2.58–2.75; Q3: 2.76–3.05; Q4: 3.06–4.76). Body indicators included fat-free mass (FFM), skeletal muscle mass (SMM), appendicular muscle mass (ASM), appendicular muscle mass index (ASMI), visceral fat (VF), fat mass (FM), and fat mass index (FMI). Handgrip strength (HGS) and the Short Physical Performance Battery test (SPPB) score were used to assess muscle strength and function, respectively. Results: The median age of the participants was 75 [IQR: 65–82] years. The mean WCR was 2.92 ± 0.93. Statistically significant associations were found between WCR and VF (p < 0.001), WCR and SMM (p = 0.039), and WCR and ASM (p = 0.016). Regarding muscle function, WCR was associated with HGS (p = 0.025) and SPPB score (p = 0.029). Conclusions: A significant association was observed between WCR and body composition, and muscle strength and function in older women. Full article

Abdominal fat necrosis is a dystrophic–necrotic process that is relatively common in dairy cows. It is determined by productive strain (excess fat in the diet), negative energy balance after calving, a lack of physical activity, vitamin E and selenium deficiency, etc. Lipomatous masses are predominantly located in the omentum and mesentery in cattle, potentially causing intestinal obstruction. We report on an outbreak of abdominal fat necrosis that affected 135 of 220 cows and heifers (61.36%); this involved massive fat accumulation in the uterine and salpingian ligaments and severe reproductive disorders (reducing fertility to 20% in cows and 10% in heifers) caused by a hyperenergetic diet (supplementation with saturated fats). A transrectal ultrasound examination of the genital apparatus—both in heifers and in cows in the puerperium—revealed a diffuse pathological hyperechogenicity of the cervical folds, suggesting lipid infiltration, proliferation of the endocervical folds and hyperechogenic lipogranulomas located paracervically or in the uterine ligaments. An ultrasound examination of the ovaries showed the presence of parasalpingial lipogranulomas on the mesovarium, with a uniformly pixelated greasy appearance, that altered the topography of the salpinx, leading to the impossibility of oocyte retrieval. At the histopathological examination, in addition to the necrosis of adipocytes and the subacute–chronic inflammation of the abdominal and retroperitoneal adipose tissue, lipid infiltration of the uterine walls was also observed in the uterine ligaments and lymph nodes. Additionally, lipid infiltration was observed in the wall of the uterine artery. All muscular-type branches of the ovarian artery exhibited subendothelial (subintimal) amyloid deposits, severely reducing their lumen and leading to ischaemia. Amyloidosis was secondary to the systemic inflammatory process triggered by lipid deposition and necrosis. Fertility returned to normal 45–60 days after the exclusion of fat supplements from the diet and their replacement with a vitamin–mineral supplement rich in antioxidants. Full article

Background/Objectives: Obesity is associated with various skin complications, yet its impact on dermal elastic fibers—key components maintaining skin elasticity—remains unclear, particularly in cases of mild obesity prevalent in East Asian populations. The aim of this study was to investigate whether mild obesity is associated with the early structural deterioration of dermal elastic fibers and alterations in elastin-related gene expression in Japanese individuals. Methods: Abdominal skin samples from 31 Japanese women (the mean body mass index [BMI] 23.9 ± 3.2 kg/m², mean age 49.5 ± 4.8) undergoing breast reconstruction surgery were analyzed. Gene expression levels of elastin-regenerative and -degradative molecules were assessed by quantitative polymerase chain reaction in the epidermis, dermis, and subcutaneous fat. Dermal elastic fiber content was evaluated histologically using Elastica van Gieson staining. Results: No statistically significant correlations between the BMI and elastin-degrading gene expression (NE, MMP2, MMP9, and NEP) were observed. ELN expression in the dermis showed a significant positive correlation with the BMI (ρ = 0.517, p = 0.003), potentially reflecting a compensatory response. Histological analysis revealed a significant inverse correlation between dermal elastic fiber content and the BMI (r = −0.572, p = 0.001), independent of age or smoking history. Conclusions: Even mild obesity is associated with the early degradation of dermal elastic fibers despite limited transcriptional alterations. These findings underscore the need for early skin care interventions to mitigate obesity-related skin fragility, especially in populations with predominantly mild obesity. Full article

Small-for-gestational-age (SGA) infants who experience a marked postnatal catch-up, mainly in weight, are at risk for developing metabolic disorders; however, the underlying mechanisms are imprecise. Exosomes and their cargo (including miRNAs) mediate intercellular communication and may contribute to altered crosstalk among tissues. We assessed the miRNA profile in cord blood-derived exosomes from 10 appropriate-for-gestational-age (AGA) and 10 SGA infants by small RNA sequencing; differentially expressed miRNAs with a fold change ≥2.4 were validated by RT-qPCR in 40 AGA and 35 SGA infants and correlated with anthropometric, body composition (DXA) and endocrine–metabolic parameters at 4 and 12 mo. miR-1-3p, miR-133a-3p and miR-206 were down-regulated, whereas miR-372-3p, miR-519d-3p and miR-1299 were up-regulated in SGA infants. The target genes of these miRNAs related to insulin, RAP1, TGF beta and neurotrophin signaling. Receiver operating characteristic analysis disclosed that these miRNAs predicted with accuracy the 0–12 mo changes in body mass index and in total and abdominal fat and lean mass. In conclusion, the exosomal miRNA profile at birth differs between AGA and SGA infants and associates with measures of catch-up growth, insulin resistance and body composition through late infancy. Further follow-up of this population will disclose whether these associations persist into childhood, puberty and adolescence. Full article

Background/Objectives: Increasing evidence suggests that metabolic dysfunction-associated steatotic liver disease (MASLD) and hypertension (HTN), a well-established cardiometabolic risk factor, both negatively impact bone metabolism. This study aimed to investigate the associations between bone turnover markers (BTMs)—namely, osteopontin (OPN) and procollagen type 1 N-terminal propeptide (P1NP)—and metabolic health indicators, non-invasive measures of liver disease severity, as well as skeletal muscle mass (SMM), muscle strength, and bone mineral density (BMD) in patients with MASLD and HTN. Methods: We enrolled 117 patients diagnosed with MASLD and HTN and conducted anthropometric measurements, laboratory analyses, abdominal ultrasound, and point shear-wave elastography. Muscle strength was evaluated using grip strength measurements and the Five Times Sit-to-Stand Test (FTSST). SMM and BMD were quantified using dual-energy X-ray absorptiometry (DEXA). Serum OPN and P1NP concentrations were quantified using enzyme-linked immunosorbent assays (ELISAs). Results: Serum OPN concentrations below 2.89 ng/mL were associated with significantly elevated levels of AST (p = 0.001), ALT (p = 0.006), and GGT (p = 0.025), while serum P1NP concentrations above 47.5 pg/mL were associated only with significantly elevated GGT levels (p = 0.024). In addition, patients with MASLD and HTN with lower serum OPN levels had higher liver stiffness values (p = 0.003). Serum OPN concentrations were inversely associated with the following metabolic health indicators: waist circumference (WC, p < 0.001) and epicardial fat thickness (EFT, p = 0.001). In addition, they were significantly elevated in patients with MASLD and HTN who had decreased spinal BMD (p = 0.017). In turn, serum P1NP levels were reduced in patients with decreased SMM (p = 0.023). Conclusions: These findings in patients with MASLD and HTN suggest an association between serum P1NP levels and SMM, and between OPN levels and spinal BMD, indicating a potential interplay among liver function, muscle mass, and bone health. Furthermore, OPN appeared to be strongly associated with overall metabolic health indicators, such as WC and EFT, whereas P1NP exhibited a stronger association with muscle mass. Full article

Background: The Mediterranean diet is considered one of the healthiest and safest diets for preventing chronic diseases. The primary objective of this study was to assess the association between adherence to the Mediterranean diet and the occurrence of prediabetes in a representative population of Bialystok, Poland. Prediabetes is a condition characterized by elevated blood glucose levels that are higher than normal but not yet in the diabetic range, indicating an increased risk of developing type 2 diabetes. Methods: The study participants were selected into healthy control (HC) and prediabetic (PreD) groups based on age and gender. Biochemical measurements included total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), fasting glucose (FG), glycated hemoglobin (HbA1c), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6). Additionally, blood pressure, handgrip strength, anthropometric parameters, and body composition were measured. Information on patients’ social data, medical history, and lifestyle history was collected using questionnaires developed for this study. A standardized questionnaire, the Satisfaction with Life Scale (SWLS), was used to assess life satisfaction. Dietary total antioxidant capacity (DTAC) and dietary total polyphenol intake (DTPI) were determined using a 3-day nutritional interview and appropriate databases containing information on polyphenols and the antioxidant potential of food products. To assess adherence to the Mediterranean diet recommendations, a 9-item Mediterranean Diet Index (MDI) was used. Results: It was found that the mean MDI for the entire group was low (3.98 ± 1.74), and the HC was characterized by a significantly higher MDI compared to the PreD. A statistically significant positive correlation was found between MDI and HDL-C, whereas a negative correlation was found between MDI and FG, homeostatic model assessment for insulin resistance (HOMA-IR), diastolic blood pressure (DBP), IL-6, body mass index (BMI), waist-hip ratio (WHR), waist circumference, visceral fat mass, android/gynoid fat ratio. Conclusions: Abdominal obesity was shown to significantly reduce life satisfaction. In model 3, after adjusting for age, sex, dietary energy intake, alcohol consumption, and smoking, each additional MDI point indicated a 10% lower risk of prediabetes. Full article

Introduction: Adequate protein intake is essential for maintaining lean body mass during weight loss, particularly for patients undergoing bariatric surgery (BS). Whey protein supplementation may help meet daily protein requirements. This study aimed to assess the effects of whey protein supplementation on weight loss and body composition in women during the medium-term postoperative phase following BS. Methods: In a double-blind, controlled study over four weeks, 24 women received 30 g of whey protein (Whey group), while 19 received 30 g of maltodextrin (Malto group). Body composition, energy expenditure, muscle thickness, muscle strength, walking performance, and dietary intake were evaluated. Results: Compared to the Malto group, the Whey group showed greater reductions in body weight (median: −0.6 kg vs. −0.2 kg, respectively) and fat mass (median: −1.1 kg vs. −0.25 kg, respectively), along with an increase in fat-free mass (−0.7 kg vs. 0.6 kg, respectively). Muscle thickness improved in the Whey compared to the Malto group in the abdominal (0.07 mm vs. −0.04 mm, respectively) and thigh (0.4 mm vs. −0.15 mm, respectively) regions. Additionally, muscle mass reduction was less pronounced in the Whey group (−3 kg vs. −0.13 kg). No significant differences were observed in handgrip strength, gait speed, or nutrient intake. Conclusions: Whey protein supplementation may be beneficial, as it enhances weight loss and preserves fat-free and muscle mass more effectively than a diet without this supplementation in women during the stabilization phase or late postoperative period of BS. Full article

Background: Obesity is a global health concern linked to an elevated risk of chronic diseases. Abdominal subcutaneous fat (ASF) thickness serves as a key indicator for obesity assessment; however, existing measurement methods often lack simplicity and accessibility. Methods: We developed the ASFmeter, a portable, low-cost A-mode ultrasound device designed for rapid ASF thickness measurement. Forty participants underwent ASF thickness assessment using both the ASFmeter and a conventional B-mode ultrasound system, demonstrating strong agreement (R² = 0.94, SEE = 1.72 mm). Statistical analyses evaluated correlations between ASF thickness and body weight, abdominal circumference, and body mass index (BMI). Results: the ASFmeter exhibited high consistency with B-mode ultrasound measurements, confirming its accuracy. Significant variations in ASF thickness were observed across BMI groups, supporting its utility as a reliable obesity indicator. Conclusions: the ASFmeter offers a user-friendly, portable, and cost-effective solution for ASF measurement, facilitating personal health monitoring and obesity-related risk assessment. This innovation holds promise for widespread application in home-based health management. Full article

Background: The prevalence of malnutrition is high in post-intensive care unit (ICU) coronavirus disease 2019 (COVID-19) patients during hospitalization and after hospital discharge. This paper presents prospective results from the NutriEcoMuscle study, a multicenter observational study. The study aimed to evaluate changes in nutritional and functional status in post-ICU COVID-19 patients following nutritional and physical rehabilitation interventions. Secondary aims included assessing adherence to and tolerance of the oral nutritional supplement (ONS) used in the nutritional intervention. Methods: The study enrolled adults who had been admitted to the ICU due to severe COVID-19. At hospital discharge, the patients underwent a nutritional intervention based on oral nutritional supplements (ONSs) with 100% serum lactoprotein enriched with leucine and vitamin D and a physical rehabilitation program. They were followed up during three months. Performed assessments included Subjective Global Assessment (SGA), Global Leadership Initiative on Malnutrition (GLIM) criteria, Barthel index (BI), handgrip strength and Timed Up and Go test, bioelectrical impedance analysis (BIA), nutritional ultrasound (US), and tolerance and adherence to ONS. Sample size was calculated based on handgrip strength, and parametric and non-parametric tests were used to assess differences between the baseline and three-month outcomes. Results: The study included 96 patients (71.9% male, mean age 58.8 years, mean body mass index (BMI) of 28.8 kg/m², 36.5% obese). A total of 85 patients (62 men and 23 women) completed the 90-day follow-up. The mean weight gain after the intervention was 6.8 (SD 5.2) kg (similar in men and women; p = 0.263). The proportion of patients with malnutrition according to the SGA or GLIM criteria decreased from 100% to 11.8% and 36.4%, respectively (p < 0.00001 in both cases). The proportion of patients with functional limitations by BI decreased from 66.7% to 27.0% (p < 0.0001). Handgrip strength increased more than 40% in both men and women (p < 0.00001). The time to perform the Timed Up and Go (TUG) test decreased more than 40% in both men and women (p < 0.00001). According to BIA, the mean fat mass did not increase significantly in either men or women. The mean fat-free mass index (FFMI) increased significantly in both men and women. There were also significant increases in body cell mass, skeletal muscle mass index, and appendicular skeletal muscle mass index. The phase angle (PhA) increased significantly in both men (26.5%) and women (17.4%). In a multivariate analysis, age and baseline PhA were related to the PhA increase (adjusted R² = 0.5573). The US study showed a significant increase in the mean measurements of muscle area, muscle circumference, X-axis, and Y-axis in the rectus femoris. Regarding abdominal fat, there were no significant increases in total, superficial, or preperitoneal adipose tissue by US. Participants engaged in a median interquartile range (IQR) of 70 (0–120) min/week of strength exercise and 60 (0–120) min/week of moderate physical exercise. The supplement was well tolerated, and poor adherence (less than 50%) was low (4% of the participants). Conclusions: A three-month intervention, including ONS and physical rehabilitation, is associated with a significant improvement in nutritional and functional status. Patients gained weight primarily by increasing their muscle mass. There was no significant increase in fat mass, as measured by BIA or US. The intervention was well tolerated and had good adherence. Full article

Background/Objectives: Opinions concerning the role of obesity and changes in muscle mass in individuals with malignancies vary. It is believed that decreased fat tissue leads to a higher complication rate, while decreased muscle mass results in a poorer oncologic outcome. This study aimed to evaluate the impact of fat distribution and skeletal muscle mass on postoperative morbidity and long-term oncological outcomes in patients with non-metastatic colon cancer. Methods: Between 2012 and 2018, a total of 129 patients with stage I-III colon cancer were evaluated. Abdominal CT scans were used to assess muscle mass and fat tissue (subcutaneous and visceral). Differences in postoperative morbidity and long-term oncologic outcome were analyzed and compared. Results: No significant differences occurred concerning complication rate or anastomotic leakage. Individuals with altered body composition parameters had a shorter length of hospital stay (p = 0.046) and an increased duration of surgery (p = 0.029). In patients with an ASA III score, altered fat tissue distribution was associated with improvements in both overall and disease-free survival (p = 0.031 and p = 0.027, respectively) but also resulted in longer hospital stay. Conclusions: Changes in body composition parameters lead to alterations in economic factors as well as changes in oncologic survival, especially in patients with higher ASA scores. No differences in morbidity were observed. Full article

Amyotrophic lateral sclerosis (ALS) is a heterogeneous disease that involves progressive loss of voluntary muscle and ultimately, respiratory function, which is the primary cause of death in ALS patients. Respiratory vital capacity (VC) measurements are objective, reproducible, and directly related to survival. Respiratory function is known to be negatively affected in individuals with excess abdominal fat contributing to a chronic innate immune inflammatory state. To test whether ALS patients might have a body mass index (BMI) related VC response to the innate immune system regulator NP001, clinical results from two NP001 phase 2 trials were evaluated in an intent-to-treat manner, stratified by BMI measurements. Slowing of progressive VC loss and extension of overall survival (OS) occurred primarily in ALS patients who were overweight with a BMI ≥ 25 (70% of patients in the phase 2 trials). Innate immune dysfunction is a characteristic of ALS patients ≤ 65 years of age, and in this group both VC and OS changes in response to NP001 were most significant. This study represents a novel approach to ALS, wherein VC and OS were both significantly improved through immunologic, not neurologic modulation with NP001, a precursor to the dominant regulator of inflammation, taurine chloramine. Full article

Background/Objectives: Obesity and abdominal adiposity are associated with worse surgical and functional outcomes in prostate cancer (PCa) patients. This exploratory study assessed whether reductions in total body fat mass (TFM) among overweight and obese PCa patients enrolled in a diet and exercise weight loss intervention prior to robotic-assisted radical prostatectomy (RARP) improved outcomes. Methods: In this secondary analysis of an NIH-funded randomized controlled trial (NCT01886677) conducted 2012–2015, twenty-nine patients with newly diagnosed, pathology-confirmed PCa who participated and underwent RARP were evaluated for percent change in TFM and divided into High Fat Losers who lost ≥1% TFM per week and Low Fat Losers who lost <1% TFM per week. High versus Low Fat Losers were compared on operative time (OT), estimated blood loss (EBL), length of hospital stay (LOS), incidence of surgical or postoperative complications, and incontinence and impotence scores at first postoperative follow-up. Results: There was a statistically significant difference between High versus Low Fat Losers with respect to overall complications (p = 0.027); 28.6% of High Fat Losers experienced one or more complications by first postoperative follow-up, compared to 73.3% of Low Fat Losers. However, no differences were observed for each individual complication analyzed, or with respect to OT, EBL, LOS, or incontinence or impotence scores. Conclusions and Relevance: Findings implicate the potential benefit of healthy weight loss as an adjunct to surgery, and support the need for larger trials to elucidate a clearer relationship between improvements in body composition and effects on specific surgical complications and functional outcomes. Full article

Introduction: Lipomas are among the most encountered neoplasms in clinical practice, occurring mainly in adults between the fourth and sixth decades of life. Deep-seated lipomas in children are found in the thorax, chest wall, mediastinum, pleura, pelvis, retroperitoneum, and paratesticular area. Herein, we present a case of a three-year-old child with a giant mesenteric lipoma, along with a review of the literature on mesenteric lipomas in childhood. Case presentation: A three-year-old male toddler was referred to our hospital for severe, intermittent abdominal pain. Imaging studies at admission revealed a fat lesion occupying most of the peritoneal cavity and dislocating adjacent structures. An urgent laparotomy was performed. A giant lipoma arising from the mesentery and leading to the torsion of the mesenteric radix was confirmed and completely excised alongside an adherent small tract of jejunum. The child recovered uneventfully and is still being followed-up with no signs of recurrence. Discussion: Lipomas of the mesentery in children are very rare, and they are reported to be more common among children younger than three years of age. Mesenteric lipomas appeared to be more frequent in males than females. Even though they might be asymptomatic, voluminous lipomas can also create a lead point for intermittent torsion of the mass causing ischemia and infarction. Abdominal pain was the most frequent symptom, and the ileum was the tract of bowel more frequently involved by the tumor. Laparotomy was reported to be the preferable approach to safely remove this abdominal mass, especially in case of huge dimensions. Full article

Background: Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) is the accumulation of fat in the liver without excessive alcohol consumption or other known liver diseases. MASLD is the most common liver disease in adolescents with obesity. The aims of this study were as follows: (i) to determine which index (waist circumference BMI, WHtR, VAI, METS-IR, METS-VF, HSI, FLI, or MetS_zscore) best explains the prevalence of MASLD in adolescents with obesity; (ii) to determine whether there was a specific index that was most strongly associated with MASLD; (iii) to assess which liver function indexes were most strongly correlated with MASLD. Methods: A total of 758 adolescents with severe obesity (BMI z-score > 2) admitted at the Division of Auxology, Istituto Auxologico Italiano, IRCCS, Piancavallo-Verbania for a 3-week multidisciplinary body weight reduction program were selected. Anthropometric parameters (stature, body mass, BMI, and waist and hip circumference) were collected, and body composition (lean and fat mass) was determined using the tetrapolar bioimpedance analysis (BIA) technique. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (gamma GT), alkaline phosphatase (ALP), bilirubin, glucose, total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), triglycerides (TG), and C-reactive protein (CRP) were measured using standard techniques. MASLD was diagnosed based on abdominal ultrasound results. Results: WHtR (65.76%) was the most sensitive compared with other indexes. The HSI (AUC: 0.67 (0.63–0.71, 95% CI), p-value < 0.05) showed the best performance in predicting MASLD, with the threshold for having MASLD considered at 48.22. The indexes that showed the worst performance in predicting MASLD were the MetS z-score (AUC: 0.56 (0.52–0.60)) and the VAI (AUC: 0.57 (0.52–0.61)). ALT (OR: 2.92 (2.29–3.77); 95% CI) and AST (OR: 2.52 (2.03–3.20)) were the parameters with a stronger correlation with MASLD. Conclusions: The most sensitive index for diagnosing MASLD was the WHtR, based exclusively on anthropometric parameters. HSI was the index that correlated the most with MASLD, while the parameters of liver function (ALT and AST) were the most strongly correlated with the disease and its severity. Full article