Search Results (214)

Insulin resistance is a fundamental pathophysiological mechanism contributing to the development of type 2 diabetes and metabolic syndrome. Recently, attention has focused on mitochondria’s role in glucose and lipid metabolism. Mitochondrial dysfunction is strongly associated with impaired energy metabolism and elevated oxidative stress. We investigated the mitochondrial DNA (mtDNA) copy number in subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) in insulin-sensitive (IS) and insulin-resistant (IR) individuals. Twenty-seven paired adipose tissue biopsies were obtained during elective abdominal surgery. DNA and RNA were extracted, and mtDNA copy number was quantified using Real-Time PCR. We found that mtDNA content in VAT was approximately two-fold lower than in SAT. Furthermore, in IR individuals, mtDNA copy number was significantly reduced in both SAT and VAT compared to IS subjects. A strong positive correlation was observed between mtDNA content in VAT and body mass index (BMI), and a negative correlation was found with the QUICKI index. Additionally, mtDNA copy number in VAT positively correlated with the expression of several genes involved in insulin signalling, lipid metabolism, and other metabolic pathways. These findings underscore the central role of mitochondrial function in VAT in the context of metabolic disorders and suggest that targeting mitochondrial regulation in this tissue may represent a promising therapeutic approach. Full article

Increased body mass index (BMI) and age are associated with COVID-19 severity. SARS-CoV-2 infection occurs through ACE2 binding, with TMPRSS2, ADAM17, and NRP1 facilitating this process. This study describes how adipose tissue (AT) location, BMI, age, and obesity affect these proteins’ expression. AT was collected from subcutaneous (abdominal superficial [AS], abdominal deep [AD], thigh [T]) and visceral (epiploon [E]) areas from middle-aged women without obesity (BMI 23.9 kg/m², age 48.3 years). Subcutaneous AT was also obtained from middle-aged women with previous obesity (BMI 24.8 kg/m², previously 41.7 kg/m², age 46.9 years), older women with obesity (BMI 32.3 kg/m², age 70.8 years), and older women without obesity (BMI 23.7 kg/m², age 70.6 years). ACE2, TMPRSS2, ADAM17, and NRP1 expression was evaluated by qPCR and Western blotting. All proteins were more expressed in visceral AT. ACE2, TMPRSS2, and NRP1 positively correlated with BMI in AS and/or E, while NRP1 correlated with age in T. In subcutaneous AT, ACE2 and NRP1 were more influenced by obesity while TMPRSS2 was more age-dependent. In women with previous obesity, ACE2 and NRP1 levels decreased, while TMPRSS2 and ADAM17 remained unchanged. These findings highlight the differential influence of visceral AT, obesity, and age on the expression of SARS-CoV-2 cell entry mediators, potentially contributing to COVID-19 severity. Full article

Background: Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder characterized by reproductive and metabolic abnormality disorders. Dietary factors influence the body composition and hydration status, which may exacerbate PCOS symptoms. The aim of this study was to assess the associations between the habitual nutrient intake and bioelectrical impedance analysis parameters in Polish women with PCOS and healthy controls, in order to identify potential nutritional targets for a non-pharmacological intervention. Methods: This study involved 50 women aged 18–45 years (25 with PCOS and 25 healthy). Participants kept 7-day food diaries and their body composition was assessed using the SECA mBCA 515 analyzer. The nutrient intake was compared with EFSA recommendations. Results: Women with PCOS had a higher body weight, waist circumference and body mass index, visceral adipose tissue, and fat mass index, despite no difference in their total energy intake. They consumed more omega-3 fatty acids (EPA + DHA) than the control group. Vitamin D deficiency and irregular supplementation were common in both groups. Body composition parameters such as the phase angle and ECW/TBW ratio correlated with the diet quality—especially with protein; fiber; and vitamin B2, B12, and folate levels. Conclusions: The obtained results showed significant differences in body compositions and the presence of a relationship between the nutrient intake and bioimpedance parameters in women with PCOS. These results emphasize the importance of a comprehensive nutritional and body composition assessment in planning dietary interventions in this group of patients. Full article

Obesity is currently one of the most critical public health problems. Although there is no doubt that obesity is a significant risk factor for developing metabolic disorders, this relationship is not completely straightforward. On the one hand, some patients affected by obesity are metabolically unhealthy, while others are metabolically healthy; on the other hand, metabolic syndrome (MetS) can also occur in people with a normal body weight. A commonly used tool for diagnosing obesity is the body mass index (BMI), but the search for better anthropometric measures is ongoing due to the significant limitations of this measure. Obesity can lead to MetS and cardiovascular diseases (CVDs). Adipose tissue dysfunction is the fundamental mechanism linking obesity and cardiometabolic diseases, which is rooted in the disturbed secretion of adipokines. The visceral adiposity index (VAI) is calculated based on the BMI, waist circumference (WC), blood triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) concentrations. It was proposed in 2010 by Amato et al. as a parameter indicating adipose tissue dysfunction and cardiometabolic risk. According to the research conducted so far, some data confirm a relationship between the VAI value and the risk of developing prediabetes, diabetes, insulin resistance, fatty liver disease, MetS, CVD, and chronic kidney disease. Further research is needed to support the implementation of VAI assessment in routine clinical practice. The purpose of this paper is to present the results of a narrative literature review summarizing current knowledge regarding the VAI and its usefulness in clinical practice for assessing cardiometabolic 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

Background/Objectives:Arterial hypertension, increased carotid intima-media thickness (cIMT), and arterial stiffness (AS) are recognized predictors of cardiovascular disease (CVD). Emerging evidence suggests that vascular remodeling may precede the full development of hypertension. Furthermore, body mass index (BMI), fat mass percentage (FM%), and visceral adipose tissue (VAT), are significant risk factors for cardiovascular events. Conversely, adherence to the Mediterranean diet is associated with reduced cardiovascular risk due to its beneficial effects on lipid metabolism, inflammation, and vascular health. Methods: This observational study explored the association between nutritional care and cardiovascular risk in 55 Italian adults (27 women, 28 men) consecutively evaluated at the Section of Clinical Nutrition and Nutrigenomics, University of Rome “Tor Vergata”, in 2024. Nutritional and vascular assessments, including BMI, waist-to-hip ratio (WHR), BIA, DXA, lab tests, blood pressure (BP), pulse wave velocity (PWV), and cIMT, were recorded. Spearman’s rank correlation coefficient was used to evaluate the relationship between vascular and nutritional parameters. Wilcoxon rank sum test; Fisher’s exact test; and Pearson’s Chi-squared test were performed for statistical analysis. Participants were divided into two groups based on cIMT > 0.90 mm and ≤0.90 mm. Results: Significant correlations emerged between higher MEDAS scores and BMI (r = −0.53, p < 0.01), FM% (r = −0.49, p < 0.01), VAT (r = −0.63, p < 0.01), and cIMT (r = −0.88, p < 0.01). Higher WHR and VAT were associated with increased brachial and central BP and PWV. Notable dietary differences were significantly higher between cIMT groups. Total cholesterol/C-HDL, C-LDL/C-HDL, the Atherogenic Index of Plasma, and the HOMA Index differed significantly between groups. Significant differences were also observed in the left ventricular diastolic function (p = 0.04), LVM/BSA, and LVM/h^2.7 in individuals with subclinical atherosclerosis (p < 0.05). Conclusions: These innovative findings underline the importance of multidisciplinary approaches to prevent CVD and suggest long-term benefits of Mediterranean diet adherence on vascular health. Full article

Background/Objectives: The clinical implications of sarcopenia and visceral obesity in patients with cardiovascular disease (CVD) are poorly understood. We evaluated the impact of sarcopenia and visceral obesity on clinical outcomes among older adults with CVD. Methods: This retrospective cohort study included patients aged 65 years and older who had cardiovascular disease and had undergone body composition analysis using dual-energy X-ray absorptiometry (DXA) between November 2021 and October 2022 and been followed through February 2024. Sarcopenia was defined using the 2019 Asian Working Group for Sarcopenia criteria, and visceral obesity was defined using Korean sex-specific visceral adipose tissue area. The primary outcome was a composite of all-cause mortality and major cardiovascular events, including myocardial infarction, stroke, hospitalization for heart failure, and coronary revascularization. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology reporting guidelines. Results: A total of 317 patients were included, of whom 118 patients (37.2%) had sarcopenia, 184 (58.0%) had visceral obesity, and 55 (17.4%) had sarcopenic obesity. The prevalence of sarcopenia or visceral obesity was 93.8% in patients with obesity and 69.3% in those without obesity. Sarcopenic obesity showed a mixture of characteristics of two metabolic conditions in terms of demographics and body mass index. Sarcopenia was associated with an increased risk of primary outcomes (hazard ratio [HR], 1.93; 95% CI, 1.02–3.66), with the highest risk observed in patients with sarcopenic obesity (HR, 6.74; 95% CI, 1.81–25.16). Conclusions: Sarcopenia was associated with 1.9-fold increased risk of cardiovascular events among older adults with CVD, with a greater than 6-fold increased risk when combined with visceral obesity. Full article

Background: Prior studies suggest that patients’ body composition changes following transjugular intrahepatic portosystemic shunt (TIPS) implantation, potentially influencing complications and survival. Method: A prototype artificial intelligence (AI)-based, automated computed tomography (CT) body composition analysis tool was used to assess body composition imaging parameters in pre- and postinterventional scans of TIPS patients: visceral (VAT) and subcutaneous adipose tissue (SAT) areas, psoas muscle area (PMA), and total abdominal muscle area (TAMA). Sarcopenia was defined as a lumbar skeletal muscle index (LSMI) ≤ 38.5 cm²/m² in women and ≤52.4 cm²/m² in men. We analyzed longitudinal changes in body composition and investigated the impact of sarcopenia at TIPS implantation on the risk of TIPS thrombosis, hepatic encephalopathy, complications, and death using Cox regression models. Results: No clear trend emerged regarding changes in body composition parameters during postinterventional follow-up. Sarcopenia at TIPS implantation increased the instantaneous risk of postinterventional complications (hazard ratio (HR) 1.67; 95% confidence interval (CI) 0.95–2.93), development of hepatic encephalopathy (HR 1.65; 0.81–3.33), as well as the risk of dying within one year (HR 1.39; 0.66–2.92). Conclusions: CT body composition analysis may help in identifying high-risk patients undergoing TIPS implantation. Sarcopenia was associated with increased mortality and a higher incidence of postinterventional complications, particularly hepatic encephalopathy. Full article

Background/Objectives: The precise role of volumetric body composition (VBC) parameters, visceral adipose tissue index (VATI), subcutaneous adipose tissue index (SATI), and skeletal muscle index (SMI) on the survival of metastatic renal cell carcinoma (mRCC) is not fully elucidated. Herein, the present study investigated the clinical significance of baseline VBC parameters and their changes after 3–4 months from treatment initiation in patients with mRCC treated with first-line targeted therapy. Methods: A total of 108 patients were enrolled. VBC parameters were depicted from computerized tomography (CT) images at the third lumbar vertebra level. Kaplan–Meier curves were used to estimate survival probability, and the differences between prognostic subgroups were compared with the log-rank test. The association of baseline VBC variables and their change values (First CT value minus baseline CT value) with progression-free survival (PFS) and overall survival (OS) was evaluated in univariate and multivariate analyses. Results: The median PFS and OS of the whole patients were 11 and 46 months, respectively. Patients with increased VATI and SATI change values had poorer OS than those with decreased values. However, patients with higher SMI change values had superior OS than those with lower values. Among VBC variables, the independent predictors of worse OS were high VATI change (HR 5.10, p = 0.001) and low SMI change values (HR 2.66, p = 0.007), in addition to International Metastatic Renal Cell Carcinoma Database Consortium prognostic stratification (p = 0.001). Conclusions: Our findings showed that high VATI and low SMI changes were associated with worse OS in mRCC patients treated with first-line targeted therapy. Full article

Background: Sarcopenic obesity, characterized by excess fat and reduced muscle mass/function, is linked to chronic inflammation and metabolic dysfunction. Methods: This study aimed to evaluate the efficacy of a 2-month multidisciplinary residential program (MRP) on the clinical and functional outcomes associated with the risk of sarcopenia in 61 institutionalized Italian adults with obesity (mean age of 60; 36 women and 25 men; BMI ≥ 30 with metabolic comorbidities). The MRP included personalized nutrition, physical activity, and psychological support. Outcomes included anthropometric, biochemical, body composition, and physical performance measures (via Short Physical Performance Battery [SPPB]), with sarcopenia risk evaluated using EWGSOP2 criteria. Results: Post-intervention, significant improvements were observed in SPPB scores (+0.93 units, p < 0.001), weight (−6.4 kg), BMI (−2.45 kg/m²), fat mass (−3.9 kg), visceral adipose tissue (−314.2 g), and fat-free mass index (−285.54 g; all p < 0.01). Glycemic control improved, with reductions in fasting glucose (−16.4 mg/dL), HbA1c (−0.81%), insulin (−2.77 mcU/mL), and HOMA-IR (−0.95; p < 0.05). Lipid profiles also improved, including total cholesterol (−21.32 mg/dL), LDL (−12.10 mg/dL), and triglycerides (−39.07 mg/dL; all p < 0.001). Conclusions: The MRP effectively enhanced body composition, metabolic health, and physical function, underscoring its potential as a preferred strategy for managing sarcopenic obesity in institutional settings. Full article

Background/Objectives: Osteoporosis is a major public health concern, due to its high risk of fractures and disability and associated medical costs. Romosozumab, an anabolic agent, has been approved for the treatment of osteoporosis in postmenopausal women at high risk of fractures. However, limited data exist on its long-term effects in the Korean population, particularly regarding its impact on bone mineral density (BMD), bone turnover markers, and body composition. This study aimed to evaluate the 12-month effects of romosozumab treatment on BMD, bone turnover markers, and body composition in postmenopausal Korean women with high-fracture-risk osteoporosis (T-scores ≤ −3.0). Additionally, the impact of concomitant postmenopausal hormone therapy (MHT) on BMD changes was assessed. Methods: This multicenter, retrospective observational study included 50 postmenopausal women diagnosed with osteoporosis (T-scores ≤ −3.0) who received 12 monthly doses of romosozumab (210 mg) at two hospitals in Korea. Changes in BMD in the lumbar spine, femoral neck, and total hip were assessed using dual-energy X-ray absorptiometry (DXA). Bone turnover markers, including procollagen type 1 N-terminal propeptide (P1NP) and C-terminal telopeptide of type 1 collagen (CTX), were measured at baseline and at 3, 6, and 12 months. Changes in body composition, including the skeletal muscle index (SMI), body mass index (BMI), and visceral adipose tissue (VAT), were also analyzed. Results: After 12 months of romosozumab treatment, BMD significantly increased at the lumbar spine (14.65%), femoral neck (6.58%), and total hip (4.19%) (p < 0.05). P1NP levels increased significantly at 3 months (+37.9%), but returned to baseline at 6 months, while CTX levels continuously decreased (−27.8%) over 12 months. No significant changes were observed in SMI or BMI, but the VAT showed a slight decreasing trend (p < 0.05). Additionally, patients receiving concomitant MHT demonstrated a significantly greater increase in lumbar spine BMD compared to those receiving romosozumab alone (p < 0.05), while no significant differences were observed in femoral neck and total hip BMD. Conclusions: This study demonstrated that 12 months of romosozumab treatment significantly improved BMD and bone turnover markers in postmenopausal Korean women with severe osteoporosis. The combination of romosozumab and MHT further enhanced lumbar spine BMD gains. These findings support the use of romosozumab as an effective treatment for high-risk osteoporotic fractures in postmenopausal Korean women, and suggest potential benefits of a combined therapeutic approach. Full article

Background: Left ventricular hypertrophy (LVH) is a key predictor of cardiovascular disease. This study aimed to investigate the correlation between LVH and regional adipose tissue deposits, including visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and epicardial adipose tissue (EAT), and sex-related differences in these correlations. Methods: A total of 416 individuals (median age 66 years, range 20–95), without structural heart disease or a history of hypertension and coronary artery disease, underwent echocardiography and abdominal computed tomography. Statistical analyses included logistic and linear regression to assess the associations between adipose tissue measures and LVH. Results: LVH was associated with older age, higher systolic blood pressure, and increased EAT thickness. EAT thickness was independently associated with LVH in women (OR 1.21, 95% CI 1.03–1.44, p = 0.024) but not in men. Scatter plot analysis revealed a positive correlation between EAT and left ventricular mass index (LVMI) in women (r = 0.366, p < 0.001) and a negative correlation in men (r = −0.153, p = 0.038). Conclusions: VAT and SAT showed no significant associations with LVMI or LVH in either sex. These findings suggest that EAT, but not VAT or SAT, is linked to cardiac remodeling in a sex-specific manner. Full article

Background and Objectives: Type 2 diabetes (T2D) and prediabetes represent major global health concerns, with obesity being a key risk factor. However, recent evidence suggests that the adipose tissue composition and distribution play a more critical role in metabolic dysfunction than the total body weight or body mass index (BMI). This study evaluates the predictive capacity of the Córdoba Equation for Estimating Body Fat (ECORE-BF) for identifying individuals at high risk of developing T2D and prediabetes. Materials and Methods: A cross-sectional study was carried out involving 418,343 Spanish workers. Body fat percentage was estimated using the ECORE-BF equation, and diabetes risk was assessed using validated predictive models, including the Finnish Diabetes Risk Score (FINDRISC), QDiabetes score (QD-score), and others. The discriminatory power of ECORE-BF in predicting T2D and prediabetes was assessed using receiver operating characteristic (ROC) curve analysis. Results: ECORE-BF showed a strong correlation with high-risk classifications across all diabetes risk scales. The area under the ROC curve (AUC) exceeded 0.95 for both men and women, demonstrating high predictive accuracy. Conclusions: Adipose tissue distribution, particularly visceral adiposity, is a central factor in metabolic dysfunction. ECORE-BF provides a cost-effective alternative for large-scale T2D and prediabetes risk assessment. Future research should explore the impact of visceral adipose tissue reduction on diabetes prevention and the integration of estimation scales into clinical and public health strategies. Full article

Background: Cardiovascular-kidney-metabolic (CKM) syndrome with high incidence and mortality rates is a prevalent health issue globally. The Metabolic Score for Visceral Fat (METS-VF), as a new index for valuating visceral adipose tissue, has been reported to be closely related to a variety of diseases. However, whether the METS-VF can be an indicator to predict the risk of CKM syndrome remains unclear. Methods: We selected National Health and Nutrition Examination Survey (NHANES) database data from the 2011–2020 year cycles and conducted analyses between the METS-VF and CKM syndrome utilizing weighted Cox regression models, subgroup and interaction analysis, and restricted cubic spline (RCS) analysis. We also used receiver operating characteristic (ROC) curves to analyze and compare the diagnostic predictive ability of the METS-VF, the BMI, and other indicators assessing adipose tissue, including the VAI, fat mass, and lean mass, in CKM syndrome. Results: In this study, the average age was 34.40 ± 0.61 years in the non-CKM patients, while the average age was over 40.38 ± 0.62 years in the CKM patients. Additionally, there was a greater proportion of male patients in the CKM patients (over 49.04%) in comparison with the non-CKM patients (37.94%). The average METS-VF was higher in the CKM patients (over 6.63 ± 0.02) compared with the non-CKM patients (5.62 ± 0.03). We found the METS-VF had a positive correlation with CKM syndrome and was hardly affected by other confounding factors. The METS-VF was more closely associated with CKM syndrome in the subgroup of age 20–59 and female patients. In addition, the METS-VF had better diagnostic ability for CKM syndrome than the body mass index (BMI) and other indicators. Conclusions: The METS-VF is a potentially actionable indicator that had a positive correlation with CKM risk. The METS-VF may be used as a possible reference in the management of CKM syndrome. Full article

Background/Objectives: An increase in body fat is linked to abnormalities in energy metabolism. We aimed at determining cardiometabolic risk in Algerian participants with obesity alone and with or without type 2 diabetes. The study measured the concentrations of circulating adipocytokines (leptin, adiponectin, resistin), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) to identify and examine how imbalances in adipocytokines may affect the parameters of cardiometabolic health. Methods: Algerian participants (n = 300) were recruited and divided into three groups: control, obese, and type 2 diabetics (with two sub-groups: with and without obesity). Insulin resistance was evaluated using HOMA-IR, while ELISA was used to measure adipocytokines. Atherogenic index in plasma (AIP), adiponectin-leptin ratio (ALR), and visceral adiposity index (VAI) were also assessed. One-way ANOVA was used to compare obesity and diabetes groups to the control one (p < 0.05). Logistic regression analysis was conducted to strengthen the robustness of statistical correlations. Results: Participants with reduced adiponectin-leptin ratio (ALR) and elevated levels of resistin, TNF-α, and IL-6 are found to be at higher risk of cardiovascular diseases. An imbalance in adipocytokine levels is caused by a decrease in adiponectin concentrations, and an increase in pro-inflammatory adipocytokines that maintain and exacerbate energy imbalance and induces hyperinsulinemia, exposing individuals to a high risk of cardiovascular diseases. Conclusions: Given that ALR is a functional biomarker of inflammation, insulin resistance, and adipose tissue dysfunction, targeting ALR could potentially be a therapeutic approach to coping with obesity-related cardiometabolic risks. Mediterranean diet, weight loss, and increased physical activity can be key components to promote healthy adipose tissue through the increase in ALR. Full article