VAT=TAAT‐SAAT: Innovative anthropometric model to predict visceral adipose tissue without resort to CT‐Scan or DXA

Objective:

To investigate whether a combination of a selected but limited number of anthropometric measurements predicts visceral adipose tissue (VAT) better than other anthropometric measurements, without resort to medical imaging.

Hypothesis:

Abdominal anthropometric measurements are total abdominal adipose tissue indicators and global measures of VAT and SAAT (subcutaneous abdominal adipose tissue). Therefore, subtracting the anthropometric measurement the more correlated possible with SAAT while being the least correlated possible with VAT, from the most correlated abdominal anthropometric measurement with VAT while being highly correlated with TAAT, may better predict VAT.

Design and Methods:

BMI participants' range was from 16.3 to 52.9 kg m^?2. Anthropometric and abdominal adipose tissues data by computed tomography (CT‐Scan) were available in 253 patients (18‐78 years) (CHU Nord, Marseille) and used to develop the anthropometric VAT prediction models.

Results:

Subtraction of proximal thigh circumference from waist circumference, adjusted to age and/or BMI, predicts better VAT (Women: VAT = 2.15 × Waist C ? 3.63 × Proximal Thigh C + 1.46 × Age + 6.22 × BMI ? 92.713; R² = 0.836. Men: VAT = 6 × Waist C ? 4.41 × proximal thigh C + 1.19 × Age ? 213.65; R² = 0.803) than the best single anthropometric measurement or the association of two anthropometric measurements highly correlated with VAT. Both multivariate models showed no collinearity problem. Selected models demonstrate high sensitivity (97.7% in women, 100% in men). Similar predictive abilities were observed in the validation sample (Women: R² = 76%; Men: R² = 70%). Bland and Altman method showed no systematic estimation error of VAT.

Conclusion:

Validated in a large range of age and BMI, our results suggest the usefulness of the anthropometric selected models to predict VAT in Europides (South of France).

     

Prediction of Visceral Adipose Tissue from Simple Anthropometric Measurements in Youths with Obesity

OWENS, SCOTT, MARK LITAKER, JERRY ALLISON, SHARON RIGGS, MICHAEL FERGUSON, AND BERNARD GUTIN. Prediction of visceral adipose tissue from simple anthropometric measurements in youths with obesity. Obes Res. 1999;7:16–22. Objective : Although visceral adipose tissue (VAT) is the component of body composition most highly associated with cardiovascular risk factors, its measurement requires expensive procedures, such as magnetic resonance imaging. This study examined the ability of simple demographic and anthropometric measurements to predict magnetic resonance imaging-derived VAT in 76 apparently healthy, black and white youths with obesity who were 7 years to 16 years of age. Research Methods and Procedures : Stepwise multiple linear regression was used to develop a prediction equation for VAT based on 13 simple anthropometric variables (height, weight, body mass index, triceps skinfold, calf skinfold, sagittal diameter, waist circumference, hip circumference, thigh circumference, waist/hip ratio, waist/thigh ratio, sagittal diameter/thigh ratio, and percent body fat from the sum of calf and triceps skinfolds) and three demographic variables (age, gender and ethnicity). Results : The stepwise multiple regression procedure yielded a final model that included two anthropometric variables (sagittal diameter and waist/hip ratio) and one demographic variable (ethnicity). The prediction equation was: VAT = ?124.06+16.67 (ethnicity)+4.15 (sagittal diameter)-+17.89 (waist/hip ratio), where ethnicity was coded as 0 = black and 1 = white. The model explained 63% of the variance in VAT and was associated with a measurement error of 23.9%. Discussion : Although the model seems to lack sufficient explanatory power for routine use in clinical settings with individual patients, it may have some utility in epidemiological studies given its relatively small (<25%) standard error of estimate.     

Measuring leg muscle and fat mass in humans: comparison of CT and dual-energy X-ray absorptiometry.

Dual-energy X-ray absorptiometry (DEXA) is reported to be inferior to computed tomography (CT) to measure changes in appendicular soft tissue composition. We compared CT- and DEXA-measured thigh muscle and fat mass to evaluate the random and systematic discrepancies between these two methods. Thigh skeletal muscle area (single-slice CT) was suboptimally (r(2) = 0.74, P < 0.0001) related to DEXA-measured thigh fat-free mass (FFM). In contrast, thigh muscle and adipose tissue volumes (multislice CT) were highly related to DEXA-measured thigh FFM and fat (both r(2) = 0.96, P < 0.0001). DEXA-measured leg fat was significantly less than multislice-CT-measured leg adipose tissue volume, whereas multislice-CT-measured leg muscle mass was less (P < 0.0001) than DEXA-measured leg FFM. The systematic discrepancies between the two approaches were consistent with the 10-15% nonfat components of adipose tissue. In conclusion, CT and DEXA measures of appendicular soft tissue are highly related. Systematic differences between DEXA and CT likely relate to the underlying principles of the techniques.     

Inflammation Correlates With Markers of T‐Cell Subsets Including Regulatory T Cells in Adipose Tissue From Obese Patients

Accumulation of cytotoxic and T‐helper (T_h)1 cells together with a loss of regulatory T cells in gonadal adipose tissue was recently shown to contribute to obesity‐induced adipose tissue inflammation and insulin resistance in mice. Human data on T‐cell populations in obese adipose tissue and their potential functional relevance are very limited. We aimed to investigate abundance and proportion of T‐lymphocyte sub‐populations in human adipose tissue in obesity and potential correlations with anthropometric data, insulin resistance, and systemic and adipose tissue inflammation. Therefore, we analyzed expression of marker genes specific for pan‐T cells and T‐cell subsets in visceral and subcutaneous adipose tissue from highly obese patients (BMI >40 kg/m², n = 20) and lean to overweight control subjects matched for age and sex (BMI <30 kg/m²; n = 20). All T‐cell markers were significantly upregulated in obese adipose tissue and correlated with adipose tissue inflammation. Proportions of cytotoxic T cells and T_h1 cells were unchanged, whereas those of regulatory T cells and T_h2 were increased in visceral adipose tissue from obese compared to control subjects. Systemic and adipose tissue inflammation positively correlated with the visceral adipose abundance of cytotoxic T cells and T_h1 cells but also regulatory T cells within the obese group. Therefore, this study confirms a potential role of T cells in human obesity‐driven inflammation but does not support a loss of protective regulatory T cells to contribute to adipose tissue inflammation in obese patients as suggested by recent animal studies.     

Sagittal Diameter Minus Subcutaneous Thickness. An Easy-to-Obtain Parameter That Improves Visceral Fat Prediction

ARMELLINI FABIO, MAURO ZAMBONI, TAMARA HARRIS, ROCCO MICCIOLO, OTTAVIO BOSELLO. Sagittal diameter minus subcutaneous thickness. An easy-to-obtain parameter that improves visceral fat prediction. Two groups of 99 and 98 women were studied to test if correcting sagittal diameter by subtracting the thickness of subcutaneous abdominal adipose tissue improves its degree of association with visceral adipose tissue. The first group (age, 40 ± 14 years; body mass index [BMI], 36 ± 6 kg/m²) was used to calculate the predictive equations for visceral adipose tissue. The second group (age, 43 ± 14 years; BMI, 37 ± 6 kg/m²) was used for cross-validation. Various anthropometric parameters were measured by ultrasound and computed tomography. Correlation coefficients with single-slice visceral adipose tissue area, after sagittal diameter was corrected by subtracting subcutaneous thickness, rose from 0.63 to 0.72 in the first group and from 0.64 to 0.71 in the second group. The standard error of residuals of the regression formula for visceral adipose tissue area was 10% lower with modified sagittal diameter than with sagittal diameter alone. During cross-validation, the standard error of differences was 5% lower with modified sagittal diameter. The visceral adipose tissue estimate was also less biased by the size of the area when sagittal diameter minus subcutaneous thickness was used. Results show that subtracting the thickness of abdominal subcutaneous adipose tissue from sagittal diameter significantly improves the predictive power of sagittal diameter for visceral adipose tissue and could be a useful tool for epidemiological studies.     

Cloning and Expression of SFRP5 in Tibetan Chicken and its Relationship with IMF Deposition

Secreted frizzled related protein 5 (SFRP5), an anti-inflammatory adipokine, is relevant to the adipocyte differentiation. In order to clarify its role in regulating intramuscular fat (IMF) deposition in Tibetan chicken, the full-length sequence of the Tibetan chicken SFRP5 gene was cloned. The relative expression of SFRP5 gene was detected using quantitative RT-PCR in various tissues of 154 days old Tibetan chicken, as well as in breast muscle, thigh muscle, and adipose tissue at different growth stages. The results showed that SFRP5 gene was expressed in all examined tissues but highly enriched in adipose tissue. Temporal expression profile showed that the expression of SFRP5 was gradually decreased in breast muscle, but was fluctuated in thigh muscle and adipose tissue with the growth of Tibetan chicken. Furthermore, correlation analysis demonstrated that the expression of SFRP5 in breast muscle, thigh muscle and adipose tissue was correlated with IMF content at different levels. The results indicated that Tibetan chicken SFRP5 is involved in IMF deposition.     

Anatomical Cross-Sectional Areas and Volumes of the Muscles of the Lower Extremities

The maximum anatomical muscle cross-sectional areas and volumes of the muscles in the lower part of the body, thigh, and shank were measured by magnetic resonance imaging. The largest cross-sectional areas were 145.65 and 63 cm² in m. gluteus maximus and m. vastus, respectively, referred to as mm. adductors. In the thigh, m. vastus had the largest volume, 1505 ± 271 cm³, and in the shank, m. soleus had the largest volume, 552 ± 64 cm³. Close correlations (0.50 < R < 0.75) between the maximum areas of the lower extremity muscles were evidence for a certain relationship between the muscle cross-sections. A multiple regression equation was formulated to calculate the maximum anatomical cross-sectional areas and volumes in the muscles of the lower extremities with respect to some anthropometric parameters.     

Prediction of Visceral Adipose Tissue Using Air Displacement Plethysmography in Children

Objective: To determine the ability of air displacement plethysmography (ADP) to predict visceral adipose tissue (VAT) volume in children. Research Methods and Procedures: Fifty‐five (33 boys/22 girls) white children 13 to 14 years old were studied. Anthropometric measures were collected for body mass, stature, BMI, and waist‐to‐hip ratio (WHR), and body fat percentage was estimated from triceps and subscapular skinfolds, bioelectrical impedance analysis, and ADP. VAT volume was determined using magnetic resonance imaging, using a multiple slice protocol at levels L1 to L5. Results: Boys had significantly (p ≤ 0.05) less VAT volume than girls [645.1 (360.5) cm³ vs. 1035.8 (717.3) cm³]. ADP explained the greatest proportion of the variance in VAT volume compared with the other anthropometric measures. Multiple regression analysis indicated that VAT volume was best predicted by ADP body fat percentage in boys [r² = 0.81, SE of the estimate (SEE) = 160.1, SEE coefficient of variation = 25%] and by WHR and BMI in girls (r² = 0.80, SEE = 337.71, SEE coefficient of variation = 33%). Discussion: Compared with the other anthropometric measures, ADP explains the greatest proportion of the variance in VAT volume in children 13 to 14 years old. For boys, ADP is the tool of choice to predict VAT volume, yet using the more simply collected measures of BMI and WHR is recommended for girls. However, large SE of the estimates remained, suggesting that if precision is needed, there is no surrogate for direct imaging of VAT.     

Effect of tissue-harvesting site on yield of stem cells derived from adipose tissue: implications for cell-based therapies

The stromal vascular fraction (SVF) of adipose tissue contains an abundant population of multipotent adipose-tissue-derived stem cells (ASCs) that possess the capacity to differentiate into cells of the mesodermal lineage in vitro. For cell-based therapies, an advantageous approach would be to harvest these SVF cells and give them back to the patient within a single surgical procedure, thereby avoiding lengthy and costly in vitro culturing steps. However, this requires SVF-isolates to contain sufficient ASCs capable of differentiating into the desired cell lineage. We have investigated whether the yield and function of ASCs are affected by the anatomical sites most frequently used for harvesting adipose tissue: the abdomen and hip/thigh region. The frequency of ASCs in the SVF of adipose tissue from the abdomen and hip/thigh region was determined in limiting dilution and colony-forming unit (CFU) assays. The capacity of these ASCs to differentiate into the chondrogenic and osteogenic pathways was investigated by quantitative real-time polymerase chain reaction and (immuno)histochemistry. A significant difference (P = 0.0009) was seen in ASC frequency but not in the absolute number of nucleated cells between adipose tissue harvested from the abdomen (5.1 ± 1.1%, mean ± SEM) and hip/thigh region (1.2 ± 0.7%). However, within the CFUs derived from both tissues, the frequency of CFUs having osteogenic differentiation potential was the same. When cultured, homogeneous cell populations were obtained with similar growth kinetics and phenotype. No differences were detected in differentiation capacity between ASCs from both tissue-harvesting sites. We conclude that the yield of ASCs, but not the total amount of nucleated cells per volume or the ASC proliferation and differentiation capacities, are dependent on the tissue-harvesting site. The abdomen seems to be preferable to the hip/thigh region for harvesting adipose tissue, in particular when considering SVF cells for stem-cell-based therapies in one-step surgical procedures for skeletal tissue engineering.     

Characterization and comparison of adipose tissue‐derived cells from human subcutaneous and omental adipose tissues

Different fat depots contribute differently to disease and function. These differences may be due to the regional variation in cell types and inherent properties of fat cell progenitors. To address the differences of cell types in the adipose tissue from different depots, the phenotypes of freshly isolated adipose tissue‐derived cells (ATDCs) from subcutaneous (SC) and omental (OM) adipose tissues were compared using flow cytometry. Our results showed that CD31^?CD34⁺CD45^?CD90^‐CD105^?CD146⁺ population, containing vascular smooth muscle cells and pericytes, was specifically defined in the SC adipose tissue while no such population was observed in OM adipose tissue. On the other hand, CD31^?CD34⁺CD45^?CD90^?CD105^?CD146^? population, which is an undefined cell population, were found solely in OM adipose tissue. Overall, the SC adipose tissue contained more ATDCs than OM adipose tissue, while OM adipose tissue contained more blood‐derived cells. Regarding to the inherent properties of fat cell progenitors from the two depots, adipose‐derived stem cells (ADSCs) from SC had higher capacity to differentiate into both adipogenic and osteogenic lineages than those from OM, regardless of that the proliferation rates of ADSCs from both depots were similar. The higher differentiation capacity of ADSCs from SC adipose tissue suggests that SC tissue is more suitable cell source for regenerative medicine than OM adipose tissue. Copyright © 2009 John Wiley & Sons, Ltd.     

Body Compartment and Subcutaneous Adipose Tissue Distribution - Risk Factor Patterns in Obese Subjects

The purpose of this study was to investigate whether upper body obesity and/or visceral obesity are related to cardiovascular risk factors among severely obese subjects, phenomena that have previously been reported in more heterogeneous body weight distri -buttons. 2450 severely obese men and women aged 37 to 59 years, with a body mass index of 39 ± 4.5 kg/m² (mean ± SD) were examined cross-sectionally. Eight cardiovascular risk factors were studied in relation. to the following body composition indicators: four trunk and three limb circumferences, along with weight, height and sagittal trunk diameter. From the latter three measurements lean body mass (LBM, i.e., the non-adipose tissue mass) and the masses of subcutaneous and visceral adipose tissue were estimated by using sex-specific prediction equations previously calibrated by computed tomography. Two risk factor patterns could be distinguished: 1. One body compartment- risk factor pattern in which the subcutaneous adipose tissue (AT) mass and, in particular, the visceral AT mass were positively related to most risk factors while the lean body mass was negatively related to some risk factors. 2. One subcutaneous adipose tissue distribution- risk factor pattern in which the neck circumference was positively and the thigh circumference negatively related to several risk factors. It is concluded that lean body mass (LBM), visceral and subcutaneous adipose tissue masses as well as neck and thigh circumferences, used as indices of subcutaneous adipose tissue distribution, are independently related to cardiovascular risk factors in severely obese men and women.     

Leukocyte Migration in Adipose Tissue of Mice Null for ICAM‐1 and Mac‐1 Adhesion Receptors

Objective: To determine whether the leukocyte adhesion receptors ICAM‐1 and Mac‐1, regulators of immune cell migration, have an intrinsic role within adipose tissue by 1) analyzing the expression of ICAM‐1 in adipose tissue, 2) identifying leukocyte populations within adipose tissue, and 3) determining whether ICAM‐1 and Mac‐1 mutant mice exhibit abnormal numbers of adipose tissue leukocytes. Research Methods and Procedures: Wild‐type, ICAM‐1^?/?, and Mac‐1^?/? mice were fed a long‐term high‐fat diet. ICAM‐1 expression was analyzed by Northern blot and immunohistochemistry. Leukocytes within adipose tissue were identified by immunohistochemistry and flow cytometry. Results: ICAM‐1 was expressed in adipose tissue and localized to the vascular endothelium. Macrophages and lymphocytes were prevalent within the stromal‐vascular cell fraction of adipose tissue, and gender‐specific differences were observed, with adipose tissue from female mice containing significantly more macrophages than tissue from male mice. Numbers of leukocytes in ICAM‐1^?/? and Mac‐1^?/? mice were not different from wild‐types, however, indicating that these adhesion receptors are not required for leukocyte migration into adipose tissue. Discussion: Our results documented leukocyte populations within adipose tissue, which may be involved in the development of heightened inflammation that is characteristic of obesity.     

Fat Distribution and Insulin Sensitivity in Postmenopausal Women: Influence of Hormone Replacement

Objective: To examine cross‐sectionally the influence of hormone replacement therapy (HRT) on the relationship between body composition and insulin sensitivity (Si). Research Methods and Procedures: Subjects were 57 early postmenopausal white women, 33 receiving HRT and 24 controls. Body composition was estimated using DXA and computed tomography scans at the abdomen and mid‐thigh. Si was assessed by a frequently sampled intravenous glucose tolerance test with minimal model analysis. Results: Compared with nonusers, HRT users had lower visceral adipose tissue, fasting serum glucose, and fasting insulin. Total body fat and unadjusted Si did not differ between groups. Visceral adipose tissue mass (VATM) was the only body‐fat compartment significantly associated with Si (r² = 0.43, p < 0.0001) in a model including total‐body fat, upper‐trunk fat, subcutaneous abdominal fat mass, leg fat, and mid‐thigh low‐density lean tissue. Lean body mass was positively correlated with Si among HRT users and tended to be negatively correlated among nonusers. HRT status also affected the relationship between VATM and Si such that, relative to nonusers, HRT users had lower Si across lower VATM levels, but higher Si across higher VATM. Discussion: These results suggest that in postmenopausal women, VATM is uniquely related to Si. HRT affects the relationship between VATM and Si and between lean body mass and Si. These interactions should be considered in future studies.     

Predictive equations for body fat and abdominal fat with DXA and MRI as reference in Asian Indians

Objective: To develop accurate and reliable equations from simple anthropometric parameters that would predict percentage of total body fat (%BF), total abdominal fat (TAF), subcutaneous abdominal adipose tissue (SCAT), and intra‐abdominal adipose tissue (IAAT) with a fair degree of accuracy. Methods and Procedures: Anthropometry, %BF by dual‐energy X‐ray absorptiometry (DXA) in 171 healthy subjects (95 men and 76 women) and TAF, IAAT, and SCAT by single slice magnetic resonance imaging (MRI) at L3–4 intervertebral level in 100 healthy subjects were measured. Mean age and BMI were 32.2 years and 22.9 kg/m², respectively. Multiple regression analysis was used on the training data set (70%) to develop equations, by taking anthropometric and demographic variables as potential predictors. Predicted equations were applied on validation data set (30%). Results: Multiple regression analysis revealed the best equation for predicting %BF to be: %BF = 42.42 + 0.003 × age (years) + 7.04 × gender (M = 1, F = 2) + 0.42 × triceps skinfold (mm) + 0.29 × waist circumference (cm) ? 0.22 × weight (kg) ? 0.42 × height (cm) (R ² = 86.4%). The most precise predictive equation for estimating IAAT was: IAAT (mm²) = ?238.7 + 16.9 × age (years) + 934.18 × gender (M = 1, F = 2) + 578.09 × BMI (kg/m²) ? 441.06 × hip circumference (cm) + 434.2 × waist circumference (cm) (R ² = 52.1%). SCAT was best predicted by: SCAT (mm²) = ?49,376.4 ? 17.15 × age (years) + 1,016.5 × gender (M = 1, F = 2) +783.3 × BMI (kg/m²) + 466 × hip circumference (cm) (R ² = 67.1). Discussion: We present predictive equations to quantify body fat and abdominal adipose tissue sub‐compartments in healthy Asian Indians. These equations could be used for clinical and research purposes.     

Epicardial Fat from Echocardiography: A New Method for Visceral Adipose Tissue Prediction

Objective: To validate transthoracic echocardiography as an easy and reliable imaging method for visceral adipose tissue (VAT) prediction. VAT is recognized as an important indicator of high cardiovascular and metabolic risk. Several methods are applied to estimate VAT, with different results. Research Methods and Procedures: We selected 60 healthy subjects (29 women, 31 men, 49.5 ± 16.2 years) with a wide range of body mass indexes. Each subject underwent transthoracic echocardiogram and magnetic resonance imaging (MRI) to measure epicardial fat thickness on the right ventricle. Measurements of epicardial adipose tissue thickness were obtained from the same echocardiographic and MRI views and points. MRI was also used to measure VAT cross‐sectional areas at the level of L4 to L5. Anthropometric indexes were also measured. Results: Subjects with predominant visceral fat accumulation showed higher epicardial adipose tissue thickness than subjects with predominant peripheral fat distribution: 9.97 ± 2.88 vs. 4.34 ± 1.98 (p = 0.005) and 7.19 ± 2.74 vs. 3.43 ± 1.64 (p = 0.004) in men and women, respectively. Simple linear regression analysis showed an excellent correlation between epicardial adipose tissue and waist circumference (r = 0.895, p = 0.01) and MRI abdominal VAT (r = 0.864, p = 0.01). Multiple regression analysis showed that epicardial adipose tissue thickness (r² = 0.442, p = 0.02) was the strongest independent variable correlated to MRI VAT. Bland test confirmed the good agreement between the two methods. Discussion: Epicardial adipose tissue showed a strong correlation with anthropometric and imaging measurements of VAT. Hence, transthoracic echocardiography could be an easy and reliable imaging method for VAT prediction.     

Development and Validation of Computed Tomography Derived Anthropometric Regression Equations for Estimating Abdominal Adipose Tissue Distribution

The purpose of this study was twofold: (1) to develop multiple regression equations for predicting computed tomography (CT) derived intra-abdominal (IAF), subcutaneous (SCF), and total (TOTF= IAF+SCF) abdominal adipose tissue areas from anthropometric measures in adult white males with a large range of age (18–71 years) and percent body fat (2.0–40.6); and (2) to validate the new and existing equations that used similar Hounsfield Units (HU) for determining IAF for estimating these fat depots. One hundred fifty-one white male subjects had IAF, SCF, and TOTF determined by a single CT scan, skinfold and circumference measures taken and body density determined. Linear intra-correlations and factor analysis procedures were used to identify variables for inclusion in stepwise multiple regression solutions. IAF was estimated from age, waist circumference, the sum of mid-thigh and lower thigh circumferences, and vertical abdominal skinfold. SCF was estimated from age, umbilicus circumference, chest and suprailiac skinfolds. TOTF was estimated from age, body mass index (BMI), chest skinfold, and umbilicus circumference. R² for IAF, SCF, and TOTF was .73, .77, and .86 respectively. The existing and the new equations were validated on an independent sub-sample of 51 subjects. The only existing equation that met validation criteria had a validation R² = .67 for IAF. All three new equations met validation criteria with R ² validations of .75, .79, and .85 for IAF, SCF, and TOTF respectively. It is concluded that the new equations might be used as an inexpensive estimation of IAF, SCF, and TOTF in adult white males varying greatly in age and percent body fat.     

Epicardial adipose tissue extent: relationship with age, body fat distribution, and coronaropathy

Epicardial fat is a relatively neglected component of the heart and could be an important risk factor of cardiac disease. The objective of our study was to assess the relationship between epicardial adipose tissue (EAT) extent, fat distribution, and coronaropathy in a group of adult victims of accidental or suspicious sudden death. In 56 cadavers, we performed 34 measurements of EAT from five computerized photographs of the heart (anterior and posterior faces, and three ventricle transversal slices) and analyzed their relationship with anthropometric markers of adiposity (BMI, waist and leg circumference, thickness of abdominal and thigh subcutaneous adipose tissue (SAT)), with the presence and staging of coronary artery disease (CAD), and with markers of myocardial hypertrophy. Simple linear regressions showed that EAT measurements are highly intercorrelated (r from 0.4 to 0.6, P < 0.001), and correlate with age, waist circumference, and heart weight, and to a lesser extent, with BMI, abdominal SAT thickness, and leg SAT thickness. Multiple regression showed that age, waist circumference, and heart weight significantly and independently correlate with EAT (P < 0.0001). No other anthropometric measurement was found independently correlated with EAT. The EAT/myocardium ratios correlated positively with age and waist circumference. Anterior and posterior areas of EAT were found significantly increased in patients with CAD and correlated positively with CAD staging (P = 0.0034, r = 0.38). Anterior EAT surface was found positively associated with CAD (P = 0.01), independently of age and other adiposity measurements. Prospective studies are needed to assess the risk of occurrence/progression of CAD that relate to EAT excess.     

Validation of an Elliptical Anthropometric Model to Estimate Visceral Compartment Area

Objective: The visceral compartment is a surrogate for visceral adipose tissue. Cross‐sectional visceral compartment area (VCA) has been approximated from waist circumference using a circular model. However, the two‐dimensional shape of the abdomen is rarely circular. This study validated an elliptical model of cross‐sectional total abdominal area (TAA), subcutaneous adipose tissue (SAT) area, and VCA at the L₄–L₅ level. Research Methods and Procedures: We analyzed magnetic resonance images (MRIs) at the level of the L₄–L₅ intervertebral space from 35 subjects with a wide range of abdominal adiposity. Waist circumference, abdominal thickness (midline sagittal diameter), abdominal width (coronal diameter at one‐half of abdominal thickness), and abdominal SAT thickness at four sites (front, back, right, and left) were measured from MRI images using an image analysis software. The same anatomical regions were also estimated from anthropometrics purely by geometric formulae of circular and elliptical models. A simple linear regression model was used to interpret the association strength between anthropometric estimates and MRI measures. Results: Estimated TAA by either model was strongly related to MRI TAA (r² = 0.98, p < 0.0001). The SAT and VCA by MRI analysis showed a stronger association with calculation from an elliptical model (r² = 0.95 and 0.88, respectively; p < 0.001) than a circular model (r² = 0.69 and 0.25, respectively; p < 0.001). The absolute prediction residuals and variances were significantly smaller with an elliptical model than a circular model (p < 0.0001). Discussion: An elliptical anthropometric model might be superior to a circular model to estimate abdominal SAT and VCA.     

Childbearing may increase visceral adipose tissue independent of overall increase in body fat

Objective: To examine whether childbearing is associated with increased visceral adiposity and whether the increase is proportionally larger than other depots. Methods and Procedures: This prospective study examined changes in adiposity assessed via computed tomography (CT) and dual‐energy X‐ray absorptiometry among 122 premenopausal women (50 black, 72 white) examined in 1995–1996 and again in 2000–2001. During the 5‐year interval, 14 women had one interim birth and 108 had no interim births. Multiple linear regression models estimated mean (95% confidence interval (CI)) 5‐year changes in anthropometric and adiposity measures by interim births adjusted for age, race, and changes in total and subcutaneous adiposity. Results: We found no significant differences between one interim birth and no interim births for 5‐year changes in weight, BMI, total body fat, subcutaneous adipose tissue, or total abdominal adipose tissue. Visceral adipose tissue increased by 40 and 14% above initial levels for 1 birth and 0 birth groups, respectively. Having 1 birth vs. 0 births was associated with a greater increase in visceral adipose tissue of 18.0 cm² (4.8, 31.2), P < 0.01; gain of 27.1 cm² (14.5, 39.7) vs. 9.2 cm² (4.8, 13.6), and a borderline greater increase in waist girth of 2.3 cm (0, 4.5), P = 0.05; gain of 6.3 cm (4.1, 8.5) vs. 4.0 cm (3.2, 4.8), controlling for gain in total body fat and covariates. Discussion: Pregnancy may be associated with preferential accumulation of adipose tissue in the visceral compartment for similar gains in total body fat. Further investigation is needed to confirm these findings and determine whether excess visceral fat deposition with pregnancy adversely affects metabolic risk profiles among women.