Search Results (42)

Background and Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease and frequently improves after bariatric surgery. Conventional postoperative follow-up is mainly based on weight-loss outcomes, such as Body Mass Index (BMI), excess weight loss (EWL), total weight loss (TWL), and routine biochemical parameters, which may not fully characterize hepatic fat response. Ultrasound-derived fat fraction (UDFF) provides a quantitative non-invasive assessment of hepatic steatosis, while DXA-derived visceral adipose tissue (VAT) reflects central adiposity and metabolic risk. This study aimed to evaluate whether combined UDFF and DXA-VAT assessment provides complementary information to conventional bariatric follow-up parameters after bariatric surgery. Methods: We conducted a prospective longitudinal cohort study on 41 patients with severe obesity who underwent bariatric surgery between July 2025 and May 2026. Anthropometric, body composition, metabolic, hepatic, and biochemical parameters were assessed at baseline (T0) and 6 months postoperatively (T1). UDFF, utilizing a DAX ultrasound transducer, was used for hepatic steatosis assessment, while DXA was performed for VAT, android fat mass, total body fat percentage, and lean mass quantification. Correlation analyses, multivariable linear regression, and an exploratory clinical discordance analysis were performed. Results: At 6 months after surgery, patients showed significant improvements in body weight, visceral adiposity, insulin resistance, biochemical parameters, and hepatic steatosis. VAT reduction showed the strongest association with UDFF reduction, whereas conventional weight-loss outcomes, anthropometric, and metabolic parameters did not fully identify patients with residual steatosis. These findings suggest that hepatic fat improvement after bariatric surgery is more closely related to changes in visceral adiposity than to weight loss alone. Conclusions: Combined UDFF and DXA-derived VAT assessment may provide a practical dual-compartment imaging framework for postoperative MASLD monitoring. This approach captures both hepatic fat response and visceral adiposity remodeling, offering information that complements conventional bariatric follow-up based on weight-loss outcomes. Full article

Objectives: Explore and compare the effects of 8-week time-restricted eating (TRE), walking exercise, and their combination on fat and lean muscle distribution in female college students with hidden obesity. Methods: A total of 68 participants were randomly assigned to four groups: Control (CON), TRE, Exercise (EXE), and TRE + EXE. An 8-week intervention was begun according to a predetermined experimental plan, comparing changes in body fat and lean tissue indices before and after the intervention. Results: Before and after the intervention, the TRE group showed a significant decrease in body mass, body mass index (BMI), and total lean mass (p < 0.05). The EXE group saw a significant reduction in visceral fat area, visceral fat mass, and visceral fat volume (p < 0.01). The TRE + EXE group experienced a significant decrease in android lean mass (p < 0.05); Comparing before and after the intervention, there were no statistically significant differences in the body fat percentage, total fat mass, fat and lean in the android and gynoid areas, and %fat in trunk/%fat in legs among the CON, TRE, EXE, and TRE + EXE groups (p > 0.05). After the intervention, there were no significant differences in the body fat percentage, total fat mass, total lean mass, fat and lean in the android and gynoid areas, %fat in trunk/%fat in legs, visceral fat area, visceral fat mass, visceral fat volume, subcutaneous fat area, subcutaneous fat mass, and subcutaneous fat volume among the four groups (p > 0.05). Conclusions: An 8-week TRE intervention in young women with hidden obesity reduced body mass and BMI but also decreased total lean mass, potentially compromising metabolic health, with no statistically significant changes in total body fat or regional fat distribution. Walking exercise showed significant reductions in visceral adiposity indicators (VFA, VFM, VFV), whereas the combined TRE + EXE group did not achieve comparable reductions. These findings suggest that while isolated TRE facilitates body mass loss, it carries a distinct risk of muscle tissue loss and may not confer comparable benefits on visceral fat reduction as walking exercise. However, the generalizability of these preliminary observations is constrained by methodological limitations including retrospective registration, participant attrition, and restricted statistical power. Consequently, these exploratory outcomes must be interpreted with caution, warranting future robust, large-scale trials with enhanced compliance monitoring to optimize prescriptive guidelines for this specific cohort. Full article

To date, neutrophil-derived myeloperoxidase (MPO), a key mediator of inflammation and oxidative stress, has predominantly been assessed in peripheral fluids by protein concentration rather than enzymatic activity, mainly due to methodological limitations. However, MPO activity directly reflects the enzyme’s cytotoxic potential and pathogenic role in inflammatory diseases. To address this gap, we employed an optimized immunocapture assay to evaluate MPO activity, specific activity, and protein concentration in females with type 2 diabetes mellitus (T2DM), a condition tightly linked to chronic low-grade inflammation and obesity. Our findings revealed that females with T2DM exhibited nearly three-fold higher serum MPO activity and more than two-fold greater specific activity compared to controls with no differences in MPO protein concentration. Notably, MPO-specific activity remained significantly associated with T2DM (p < 0.01 to p < 0.001 across multivariate models), even after adjusting for age and dual-energy X-ray absorptiometry-derived measures of total and regional fat mass. Only android/gynoid fat distribution retained marginal significance in these models. This study is the first demonstration that MPO enzymatic activity, rather than protein concentration, is independently linked to T2DM in females. These findings underscore the importance of assessing functional MPO activity in the context of metabolic disease and support its potential role as a pathophysiological marker. Full article

Background/Objectives: The location and distribution of excess fat, rather than overall adiposity, are stronger predictors of cardiometabolic risk and are commonly assessed using the waist-to-hip ratio (WHR). Fat distribution in women has a heritable component, yet the genetic factors that influence it remain poorly understood. We aim to assess the association between obesity-related polymorphisms with WHR and cardiometabolic risk in overweight and obese women. Methods: A cohort study was conducted in 512 women (56.1 ± 6.4 years; body mass index (BMI) ≥ 25 kg/m²). WHR was calculated, and participants were classified into android (WHR > 0.85) or gynoid (WHR ≤ 0.85) obesity groups. We genotyped 15 SNPs previously associated with obesity using TaqMan real-time PCR. Different genetic models (dominant, recessive, and allelic) were analysed, and bivariate and multivariate analyses were performed to compare the fat distribution groups. Results: Of the 15 SNPs studied, only 3 presented a significant association with WHR > 0.85. PSRC1 rs599839 in a dominant model (AA + GA vs. GG) with OR = 3.18 (p = 0.041), SLC30A8 rs1326634 in a recessive model (CC vs. TC + TT) (OR = 2.38; p = 0.004), both showing increased susceptibility to central obesity. KIF6 rs20455 offers protection in a recessive model (CC vs. TC + TT) with an OR of 0.47 (p = 0.043). After adjusted multivariate analysis, only SLC30A8 and diabetes remained independently associated with an increased risk of android obesity (OR = 2.50; p = 0.003 and OR = 3.63; p = 0.004, respectively). Conclusions: The SLC30A8 variant was significantly associated with android fat distribution and high cardiometabolic risk in overweight/obese women. Identifying genetic factors that influence fat distribution may help specify targeted lifestyle changes or pharmacological interventions to reduce risk. Full article

Background and Objectives: Body composition changes with aging and menopause, often leading to increased adiposity and a shift in fat distribution. While BMI is commonly used in clinical practice, it does not accurately reflect fat mass or distribution. This study aims to evaluate age-related changes in both total and regional adiposity using DXA-derived indices in Korean women aged ≥ 40 years and to assess the limitations of BMI-based obesity classification. Materials and Methods: This retrospective multicenter study analyzed the DXA scans and clinical records of 914 Korean women aged 40–80 years who attended menopause clinics across multiple institutions between 2018 and 2021. We analyzed five adiposity indices: body mass index (BMI), total body fat percentage (TB%F), fat mass index (FMI), visceral adipose tissue (VAT) area, and android-to-gynoid (A/G) fat ratio. Excess adiposity was defined as BMI ≥ 23 kg/m², TB%F ≥ 40%, FMI ≥ 9 kg/m², VAT > 100 cm², or A/G ratio > 1.0. Age group comparisons were made using ANOVA, and misclassification was assessed by comparing BMI with other indices. Results: Mean BMI increased with age, peaking in the 60s before declining in the 70s. TB%F and FMI peaked in the 50s, while VAT and A/G ratio increased continuously with age. Excess adiposity was found in 41.9% of women by TB%F, 40.5% by FMI, and 59.4% by VAT in the 70s. Notably, 22% of women with normal BMI (<23 kg/m²) had VAT > 100 cm², and 35.7% had A/G > 1.0, indicating central obesity. Conclusions: DXA-based indices provide a more accurate assessment of adiposity and associated cardiometabolic risks in aging women than BMI alone. Clinical screening strategies should consider incorporating regional fat distribution markers, particularly in midlife and postmenopausal populations, to better identify individuals at risk. Full article

Vitamin D deficiency is highly prevalent in individuals with overweight/obesity and this can be largely attributed to the entrapment of VitD in adipose tissue due to impaired lipolytic stimulation. Considering the well-described role of exercise in stimulating lipolysis, the present study investigated the efficacy of multicomponent-type high-intensity interval training (m-HIIT) in increasing 25-hydroxyvitamin D [25(OH)D] levels in males with overweight/obesity. Twenty middle-aged males (43.5 ± 5 years, BMI: 30.7 ± 3.3 kg/m²) participated in three weekly supervised m-HIIT sessions over a 12-week period and underwent assessments at baseline, 6, and 12 weeks. Primary outcomes were total body fat mass, android fat, hepatorenal index, and serum 25(OH)D. Participants’ daily physical activity and dietary intake habits remained unaltered throughout the 12-week training period. The m-HIIT intervention reduced fat mass (by 3% at 12 weeks), android fat (by 3.7% at 6 weeks and 4.4% at 12 weeks), and hepatorenal index (by 8% at 12 weeks). Serum 25(OH)D levels increased by ~14% (+3.21 ng/mL, p = 0.002) and ~31% (+7.24 ng/mL, p < 0.001) at 6 and 12 weeks, respectively. The elevation of 25(OH)D levels at 12 weeks was inversely related to fat mass loss (R = 0.53, p = 0.016). Plasma SGPT, SGOT, ALP, γ-GT, fetuin-A, and calcium levels remained unaltered after the 12-week training period. In conclusion, m-HIIT may be useful as a non-pharmacological intervention to increase circulating VitD levels in adults with overweight/obesity. 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

Background: There are different types of obesity, and the metabolic conditions associated with these phenotypes are also heterogeneous. Overweight and obesity are not only associated with pain but are also identified as risk factors for the development of pain. Objective: This study aimed to compare the levels of inflammatory biomarkers, counting of immune cells, and chronic pain between android and gynoid female patients with obesity. Method: Thirty (n = 30) women took part in this study (18 androids, age: 50.61 ± 9.41 and 12 gynoids, age: 50.67 ± 9.45). The participants underwent anamnesis, Visual Numeric Scale (VNS), dual-energy X-ray absorptiometry, and blood sampling for the analysis of leukocytes, C-reactive protein (CRP), and interleukin (IL)-6. Results: The number of total leukocytes in the blood was not different when comparing the android group (6045 µL) with the gynoid group (5230 µL). No differences were observed for neutrophils (3440 µL in android and 3017 µL in gynoid), lymphocytes (2208 µL in android and 2115 µL in gynoid), for monocytes (429.7 µL in android and 392.8 µL in gynoid), and basophils (17.27 µL in android and 15.41 µL in gynoid). However, there was a significant difference between the number of eosinophils when comparing the android group (137.6 µL) with the gynoid group (204.9 µL), p = 0.04. Although both groups presented CRP values above 0.3 mg/dL—indicative of low-grade inflammation—no statistically significant difference was observed. Similarly, no difference was found in pain intensity between groups, as measured by the Visual Numeric Scale (VNS). Conclusions: Although most inflammatory and pain markers did not differ between groups, the higher eosinophil count in the gynoid phenotype suggests immunological distinctions between obesity types. These findings underline the importance of considering body fat distribution in clinical assessments of inflammation and chronic pain in women with obesity. Full article

Menstrual bleeding disorders (MBDs) are multifaceted issues affecting women’s health. Understanding their causes and impacts is vital for management and treatment. MBDs can affect women’s self-esteem (SE), creating a cycle of physical and emotional challenges. Women may resort to unhealthy behaviours; therefore, we raised the question of whether MBD women’s self-esteem differs in dietary behaviours, consequently leading to obesity. This cross-sectional study investigated the relationship between SE, dietary behaviours and body fat (BF) distribution in 63 19–35 y MBD women. It was conducted on two BMI and age-matched groups that differ by android fat content. Rosenberg’s SE questionnaire and Food Frequency Questionnaire were used. BF distribution was measured by dual-energy-X-ray-absorptiometry (DXA), and the android-to-gynoid fat ratio was calculated. We revealed the following determinants of higher android-to-gynoid fat distribution: medium or high self-esteem (OR: 3.4, 95%CI: 1.0; 10.8), daily milk products frequency intake (OR: 3.3, 95%CI: 1.1; 10.3). The level of self-esteem could affect dietary behaviours. Women with higher android fat distribution tend to consume dairy products more frequently but with less meat. Women with lower android fat distribution had lower SE. The issues raised in this project affect a complex area that requires further research in a larger group of participants. Full article

Background/Objectives: Obesity is influenced by biological, hormonal, and social factors, contributing to chronic diseases and burdening the healthcare system. Chronic stress and emotional eating are linked to weight gain, affecting eating behaviors and metabolism. This study aimed to assess the association between stress, eating behavior, and adiposity in obese women. Methods: This cross-sectional study included 132 obese women from Viçosa, Minas Gerais, Brazil. The participants completed the Lipp Stress Symptoms Inventory and the Dutch Eating Behavior Questionnaire. Blood samples were collected to measure plasma cortisol, and Body Mass Index (BMI) was calculated from weight and height measurements. Body fat was assessed using dual-energy X-ray absorptiometry (DXA). Associations between stress, eating behavior, and adiposity were evaluated using linear regression models, and interactions between stress and eating behavior subscales were tested. Results: Positive associations were observed between Phases I (alert), II (resistance), and III (exhaustion) of stress with emotional and external eating. A negative association was identified between dietary restraint and body fat, especially in women with lower cortisol levels (<13.7 mg/dL). Additionally, the alert phase was associated with higher android fat in these women. Conclusions: The findings support the hypothesis that stress and eating behavior are associated with body adiposity and that stress is linked to emotional and external eating. An inverse association between restrained eating and body fat was observed in women with lower cortisol levels. These results highlight the importance of an interdisciplinary approach that incorporates emotional and stress conditions in obesity treatment. Full article

Background: With the improvement of healthcare, the number of elderly individuals, including those with obesity, is increasing. The accumulation of various ventilation problems associated with the use of face masks in both these patient groups can pose a challenge even for an experienced anesthesiologist. The main aim of this study was to evaluate the ventilation of elderly patients with obesity using face masks, uncuffed or cuffed, and compare it with values obtained among patients with obesity who are not elderly. The secondary aim of the study was to demonstrate which of the two masks tested is better for elderly patients with android and gynoid obesity. Methods: This study was conducted at University Clinical Hospital No. 1 in Lodz among 108 patients with obesity, 50 elderly and 58 non-elderly. Patients’ BMIs ranged from 35.0 to 59.0. For the study, the uncuffed Intersurgical Eco Mask II and cuffed Ambu Ultra Seal face masks were used. Expiratory tidal volume and leakage obtained during the use of both types of masks were examined. The obtained data were analyzed using the Kolmogorov–Smirnov test and supplemented with Wilcoxon test values. Results: In elderly patients with obesity, especially those with gynoid obesity, the use of the Intersurgical Eco Mask II is associated with better ventilation parameters than the Ambu Ultra Seal mask. Only in the case of elderly patients with android obesity did the use of the Ambu Ultra Seal mask yield similar results to the Intersurgical Eco Mask II. Conclusions: Uncuffed face masks provide better ventilation parameters during manual bag ventilation in elderly patients with obesity. Full article

The prevalence of overweight and obesity increases in people with type 1 diabetes (T1D). However, the impact of fat accumulation on glucose dynamics in T1D is poorly understood. We assessed continuous glucose monitoring (CGM) parameters in patients with T1D depending on their body weight, body composition, and insulin sensitivity. In 547 patients, including 238 overweight/obese individuals, CGM-derived time in range (TIR) and glucose variability (GV) were estimated. Body composition was assessed by DXA. Estimated glucose disposal rate (eGDR) was used as an indicator of insulin sensitivity. Overweight/obese patients, when compared to normal-weight ones, have a lower time below range (TBR) (<3 mmol/L), GV, and experienced fewer episodes of low glucose. In men, lower TIR, higher time above range (TAR), and GV reduction were associated with central adiposity assessed by total, trunk, and android fat mass. In women, gynoid fat mass only was associated with a lower TIR and higher TAR. The eGDR was a positive predictor of TIR and a negative predictor of TAR, TBR, and GV in men and women. In conclusion, adiposity in people with T1D is associated with a lower risk of CGM-confirmed hypoglycemia, higher TAR, and reduced GV. These features of daily glucose dynamics may be mediated by insulin resistance. Full article

Objective: To describe the prevalence of sarcopenia in rheumatoid arthritis (RA) patients aged ≥65 years and identify the risk factors associated with sarcopenia. Methods: This is a multicenter, controlled, cross-sectional study of 76 RA patients and 76 age- and sex-matched healthy controls. Sarcopenia was defined according to the revised criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). Whole-body dual-energy X-ray absorptiometry (DXA) was performed. Binary regression was used to assess the relationship between sarcopenia and sex, age, duration of RA, Mini Nutritional Assessment (MNA) score, and Short Physical Performance Battery (SPPB) score in patients with RA. Results: Nearly 80% of participants were female, and the average age was >70 years. Patients with RA had lower muscle mass and greater adiposity (fat-to-muscle ratio mean [SD] 0.9 [0.2] vs. 0.8 [0.2]; p = 0.017) than controls, mainly in the central area (android/gynoid ratio, median [p25–p75]: 1.0 [0.9–1.2] vs. 0.9 [0.8–1.1]; p < 0.001). Twelve patients (15.8%) and three controls (3.9%) had confirmed sarcopenia (p = 0.014). Sarcopenic obesity was observed in 8/76 patients with RA (10.5%) and in 1/76 controls (1.3%) (p = 0.016). The factors associated with sarcopenia were male sex (OR [95% CI]: 9.3 [1.1–80.4]; p = 0.042), disease duration (OR [95% CI]: 1.1 [1.0–1.2]; p = 0.012), and nutritional status according to the MNA (OR [95% CI]: 0.7 [0.5–0.9]; p = 0.042). Conclusions: Our results suggest that patients with RA aged ≥65 years may be at increased risk for sarcopenia, adiposity, and malnutrition (especially male patients with long-standing disease) and have poor nutritional status. Full article

Menopause-related decline in estrogen levels is accompanied by a change in adipose tissue distribution from a gynoid to an android and an increased prevalence of obesity in women. These unfavorable phenomena can be partially restored by hormone replacement therapy, suggesting a significant role for estrogen in the regulation of adipocytes’ function. Indeed, preclinical studies proved the involvement of these hormones in adipose tissue development, metabolism, and inflammatory activity. However, the relationship between estrogen and obesity is bidirectional. On the one hand-their deficiency leads to excessive fat accumulation and impairs adipocyte function, on the other-adipose tissue of obese individuals is characterized by altered expression of estrogen receptors and key enzymes involved in their synthesis. This narrative review aims to summarize the role of estrogen in adipose tissue development, physiology, and in obesity-related dysfunction. Firstly, the estrogen classification, synthesis, and modes of action are presented. Next, their role in regulating adipogenesis and adipose tissue activity in health and the course of obesity is described. Finally, the potential therapeutic applications of estrogen and its derivates in obesity treatment are discussed. Full article

Myostatin acts as a negative regulator of muscle growth. Its effect on fat mass is subject to debate. Among alcoholics, there is a high prevalence of muscle atrophy, and increased fat deposition has been also described in these patients. Myostatin could be involved in these alterations, but its relationships with body composition have been scarcely studied in alcoholic patients. To analyze the behavior of myostatin among alcoholics and its relationship with alcohol intake, liver function, and body composition. We investigated serum myostatin in 59 male patients and 18 controls. Patients were all heavy drinkers admitted with organic complications related to excessive ethanol ingestion. Densitometry analysis was used to assess body composition in 46 patients. Handgrip was assessed in 51 patients. Patients showed lower myostatin values than controls (Z = 3.80; p < 0.001). There was a significant relationship between myostatin and fat at the right leg (ρ = 0.32; p = 0.028), left leg (ρ = 0.32; p = 0.028), trunk (ρ = 0.31, p = 0.038), total fat proport ion (ρ = 0.33, p = 0.026), and gynecoid fat distribution (ρ = 0.40, p = 0.006) but not with lean mass (total lean ρ = 0.07; p = 0.63; trunk lean ρ = 0.03; p = 0.85; lower limbs ρ = 0.08; p = 0.58; upper limbs ρ = 0.04 p = 0.82; android ρ = 0.02; p = 0.88, or gynoid lean mass ρ = 0.20; p = 0.19). In total, 80.43% of patients showed at least one criterion of osteosarcopenic adiposity (OSA). Myostatin was related to OSA obesity. We also observed higher myostatin values among patients with body mass index > 30 kg/m². Serum myostatin was lower among excessive drinkers, and it was related to increased fat deposition among these patients but not to lean mass, handgrip, or bone mineral density. Full article