Postoperative Vision-Related Quality of Life in Macula-Off Rhegmatogenous Retinal Detachment Patients and Its Relation to Visual Function

Objective

To determine the vision-related quality of life (VR-QOL) after surgery for macula-off rhegmatogenous retinal detachment (RRD) in relation to visual acuity, contrast acuity, and color vision.

Methods

In a prospective observational study, we included 55 patients with a macula-off RRD. Best corrected visual acuity (BCVA), color vision (saturated and desaturated color confusion indices (CCI)) and contrast acuity were measured at 12 months postoperatively in both the RRD eye and the fellow control eye, and the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was filled out.

Results

Operated and fellow control eyes differed significantly in mean LogMAR BCVA (P<0.0001), median Log contrast acuity (P<0.0001), saturated CCI (P = 0.009), and desaturated CCI (P = 0.016). Significant correlations were observed between the NEI VFQ-25 overall composite score and postoperative LogMAR BCVA (R = −0.551, P<0.0001), contrast acuity (R = 0.472, P<0.0001), saturated CCI (R = −0.315, P = 0.023), and desaturated CCI (R = −0.283, P = 0.044).

Conclusions

A lower VR-QOL was highly correlated to a worse postoperative BCVA and contrast acuity and to a lesser extent to color vision disturbances.     

Postoperative Metamorphopsia in Macula-Off Rhegmatogenous Retinal Detachment: Associations with Visual Function,Vision Related Quality of Life,and Optical Coherence Tomography Findings

Purpose

To evaluate postoperative metamorphopsia in macula-off rhegmatogenous retinal detachment (RRD) and its association with visual function, vision related quality of life, and optical coherence tomography (OCT) findings.

Methods

45 patients with primary macula-off RRD were included. At 12 months postoperatively, data on metamorphopsia using sine amsler charts (SAC), best corrected visual acuity (BCVA), letter contrast sensitivity, color vision (saturated and desaturated color confusion indexes), critical print size, reading acuity, the 25-item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25), and OCT, were obtained.

Results

Metamorphopsia was present in 39 patients (88.6%), with most of them (n = 35, 77.8%) showing only mild metamorphopsia (SAC score = 1). Patients with metamorphopsia had significantly worse postoperative BCVA (p = 0.02), critical print size (p<0.0005), and reading acuity (p = 0.001) compared to patients without metamorphopsia. Other visual function outcomes and NEI-VFQ-25 overall composite score were all also somewhat lower in patients with metamorphopsia, but this did not reach statistical significance. No association with OCT findings was present.

Conclusion

The prevalence of postoperative metamorphopsia in macula-off RRD patients is high, however, the degree of metamorphopsia is relatively low. When metamorphopsia is present, visual functions seem to be compromised, while vision related quality of life is only mildly affected.     

Five Year Nationwide Incidence of Rhegmatogenous Retinal Detachment Requiring Surgery in Korea

Purpose

To define the incidence and demographic characteristics of rhegmatogenous retinal detachment (RRD) requiring surgery in Korea.

Design

Nationwide population-based retrospective study.

Methods

Patients who underwent surgery for RRD from 2007 to 2011 were retrospectively identified using the diagnostic code for RRD and the surgical codes for retinal detachment surgeries in the national claim database. The average incidence rate of RRD during the 5-year period was estimated using the population data of the 2010 Census in Korea.

Results

A total of 24,928 surgically treated RRD cases were identified. The average incidence of surgery requiring RRD was 10.39 cases per 100,000 person-years [95% confidence interval (CI), 10.26–10.52). The incidence in men (11.32 cases per 100,000 person-years; 95% CI: 11.13–11.51) was significantly higher than that in women (9.47 cases per 100,000 person-years; 95% CI: 9.29–9.64) (p<0.001). The incidence of surgery requiring RRD showed a bimodal distribution across age groups, with one peak (28.55 cases per 100,000 person-years; 95% CI: 27.46–29.67) representing patients between 65 and 69 years of age and the second peak (approximately 8.5 per 100,000 person-years) representing patients between 20 and 29 years of age. The male-to-female ratio was approximately 1.0 for the peak-incidence age groups, whereas the ratio was higher for the other age groups.

Conclusions

The incidence of RRD in the Korean population was similar to that reported previously, with the peak incidence being lower than that in the Caucasian population. The age-specific RRD incidence pattern in Korea followed a bimodal distribution.     

Changes of Vision-Related Quality of Life in Retinal Detachment Patients after Cataract Surgery

Rhegmatenous retinal detachment (RRD) is one of the most serious complications after phacoemulsification combined with intraocular lens implantation surgery. It has been reported that vision-related quality of life (VRQoL), as well as visual acuity rapidly decreased when RRD developed. However, little is known of the VRQoL in those RRD patients after anatomical retinal re-attachment, especially whether or not the VRQoL is higher than that before cataract surgery. In this prospective case series study, we use the Chinese-version low vision quality of life questionnaire (CLVQOL) to assess the changes of VRQoL in age-related cataract patients who suffered from RRD after phacoemulsification with intraocular lens (phaco-IOL) implantation. All participants were asked to complete questionnaires in face- to-face interviews one day before and two weeks after cataract surgery, as well as one day before and three months after RRD surgery. A total of 10,127 consecutive age-related cataract patients were followed up to one year after phaco-IOL implantation; among these patients, 17 were diagnosed as RRD. The total CLVQOL scores and subscale scores except “Mobility” decreased significantly when RRD developed. After retinal surgery, only the score of “General vision and lighting” in the CLVQOL questionnaires improved when compared to the scores two weeks after cataract surgery, although the best corrected visual acuity of all patients significantly raised up. However, the mean CLVQOL scores and subscale scores were still considerably higher than the level prior to cataract surgery. Our study suggests that cataract patients at high risk of postoperative RRD should not deny the opportunity to undergo phaco-IOL implantation, even though potential VRQoL impairment induced by RRD exists.     

兔眼孔源性视网膜脱离手术复位后视功能以及超微结构的变化

目的对比研究兔眼视网膜脱离后选择不同时期手术复位视功能的变化情况,为临床手术时机的选择及预测术后视功能的恢复情况提供理论与实验依据。方法利用家兔制备孔源性视网膜脱离模型,成模后1 d、7 d1、4 d时经手术达解剖复位,采用多焦视网膜电流图检测复位后视网膜的功能,数据处理应用SPSS软件。制备组织病理学切片。结果多焦视网膜电流图显示1 d、7 d、14 d的RRD手术复位后P1波平均象限反应密度(QAP1,nV/deg2),P1波幅值(AP1,μV),N1波幅值(AN1,μV),P1波潜伏期(TP1,ms),N1波潜伏期(TN1,ms)各项数值差异有显著性(P<0.05)。光镜电镜显示视网膜脱离复位后组织病理学改变。结论视网膜脱离手术复位后视网膜细胞功能的恢复与脱离时间有明显的负相关性;多焦视网膜电流图对于局部视网膜功能的评价有重要意义;组织病理学研究提供了解释视功能变化的重要依据。     

70 岁以上老年原发性肝癌患者临床特点

目的:探讨70岁以上高龄原发性肝癌患者临床表现、诊治方法和预后特点。方法:回顾性研究我院2000～2010年间70例原发性肝癌患者(PLC)临床资料,比较两组患者(≥70岁,高龄组;和<70岁,低龄组)的临床特点和预后。结果:≥70岁患者36例(51.4%),<70岁34例(48.6%)。与低龄组相比,高龄组心脏病(50.0%vs 17.6%)和糖尿病(41.7%vs 14.7%)显著增高(P=0.004-0.012);而乙型病毒性肝炎感染率低(50.0%vs 88.2%,P=0.016),发病时平均肿瘤直径小(3.4±2.3cm vs 5.8±4.4cm,P=0.02)。两组男性发病率、饮酒、脑血管病、首发症状和体征、肝硬化、肿瘤位置、肿瘤形态、AFP、发病时Child分级、组织学类型两组无显著差异(P>0.05)。总体(59,84.3%)以肝动脉化疗栓塞(TACE)治疗为主,平均治疗3.2±3.1次,两组接受TACE治疗患者和次数无差异。平均随访28.9月,生存分析显示两组死亡率(63.9%vs 58.8%,p=0.66)和中位生存时间(25.5月vs 20.5月,P=0.88)无显著差异。结论:≥70岁高龄PLC患者有较高的心脏病和糖尿病合并率,但多数可耐受系统性TACE治疗,从而有效延长老年患者的平均生存时间。     

Relationship between Functional Visual Acuity and Useful Field of View in Elderly Drivers

Purpose

To investigate the relationship between the functional visual acuity (FVA) and useful field of view (UFOV) in elderly drivers and assess the usefulness of the FVA test to screen driving aptitude in elderly drivers.

Methods

This study included 45 elderly drivers (31 men, 14 women; mean age, 68.1 years) and 30 younger drivers (26 men, 4 women; mean age, 34.2 years) who drive regularly. All participants underwent measurement of the binocular corrected distant visual acuity (CDVA), binocular corrected distant FVA (CDFVA), and Visual Field with Inhibitory Tasks Elderly Version (VFIT-EV) to measure UFOV. The tear function and cognitive status also were evaluated.

Results

The CDVA, the CDFVA, cognitive status, and the correct response rate (CAR) of the VFIT-EV were significantly worse in the elderly group than in the control group (P = 0.000 for all parameters). The cognitive status was correlated significantly with the CDVA (r = -0.301, P = 0.009), CDFVA (r = -0.402, P = 0.000), and the CAR of the VFIT-EV (r = 0.348, P = 0.002) in all subjects. The results of the tear function tests were not correlated with the CDVA, CDFVA, or VFIT-EV in any subjects. Stepwise regression analysis for all subjects in the elderly and control groups showed that the CDFVA predicted the CAR most significantly among the clinical factors evaluated.

Conclusion

The FVA test is a promising method to screen the driving aptitude, including both visual and cognitive functions, in a short time.     

Lrit1, a Retinal Transmembrane Protein,Regulates Selective Synapse Formation in Cone Photoreceptor Cells and Visual Acuity

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中老年黄斑变性患者跌倒风险与视力的关系及对生存质量的影响

摘要 目的：分析中老年黄斑变性患者跌倒风险与视力的关系及其影响因素,并分析其对生存质量的影响。方法：研究对象为我院2018年1月~2020年12月期间收治的中老年黄斑变性患者95例,采用修订版社区老年人跌倒危险评估工具（MFROP-COM）评估患者跌倒风险。采用世界卫生组织生存质量量表（WHOQOL-BREAF）评价患者的生存质量。采用本院自制的调查问卷获取患者的临床资料。中老年黄斑变性患者跌倒风险的影响因素采用单因素及多因素Logistic回归分析。结果：本次研究共发放调查问卷95份,回收有效问卷95份,回收率100.00%。其中存在跌倒风险的患者38例（40.00%）。无跌倒风险的患者视力、生存质量各领域评分均优于有跌倒风险的患者（P<0.05）。单因素分析显示：中老年黄斑变性患者跌倒风险与视力、文化程度、年龄、家中安全行走、婚姻状况、居住方式、日常生活能力、居家环境安全、足部疾病、社区安全行走有关（P<0.05）。多因素Logistic回归分析结果显示：日常生活能力、视力、家中安全行走、足部疾病、社区安全行走、居家环境安全是中老年黄斑变性患者跌倒风险的影响因素（P<0.05）。结论：中老年黄斑变性患者存在跌倒风险的人数占比较高,且跌倒风险受多种因素影响,有跌倒风险的患者生存质量更低,因此临床需积极评估并帮助此类患者建立科学防跌倒生活行为,对改善中老年黄斑变性患者生存质量具有重要意义。     

Development of the Japanese 15D Instrument of Health-Related Quality of Life: Verification of Reliability and Validity among Elderly People

Objective

The 15D is a self-administered questionnaire for assessment of health-related quality of life, which contains 15 questions with 5 response options each. This study was conducted to evaluate the reliability and validity of the Japanese 15D.

Methods

The subjects were 430 community-dwelling elderly people. Each item of the 15D was scored on a 5-point Likert scale, with level 1 being the best, score 1. Reliability was assessed by determination of the internal consistency and test-retest reliability. Criterion-based validity was assessed using the Japanese version of the Nottingham Health Profile (NHP) and Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG index). Acceptability was assessed by inquiring about the time required to complete the questionnaire and the burden felt in responding to it.

Results

The answers of 423 individuals who responded to all items were analyzed. The median time required to complete the questionnaire was 5.0 minutes, and the proportion of subjects who indicated that the questionnaire was easy to complete was 98.3%. The Cronbach’s alpha coefficients for all 15 items in the 2 surveys were 0.793 and 0.792, respectively. The intraclass correlation coefficients for the 15 items ranged from 0.44 to 0.72. In the relationship between the 15D and the NHP, the correlation coefficients between the corresponding domains were higher than those between non-corresponding domains. The prevalence of disability in higher-level functional capacity was higher in the “level 2 to 5” group than in the “level 1” group.

Conclusions

The Japanese version of the 15D showed sufficient internal consistency and moderate repeatability. Because of the short time required to complete the Japanese 15D and the significant relationships between the scores on the 15D and the NHP, and between the 15D and higher-level functional capacity, the acceptability and validity of the Japanese 15D were considered to be sufficient.     

不同类型弱视儿童视网膜神经纤维层与预后视力恢复的相关性

摘要 目的：探讨不同类型弱视儿童视网膜神经纤维层（RNFL）与预后视力恢复的相关性。方法：选择2017年6月至2020年6月在本院眼科就诊的80例弱视患儿作为研究对象,其中屈光参差性弱视32例（A组）、斜视性弱视28例（B组）、屈光不正性弱视20例（C组）。三组患儿都进行常规检查与光学相干断层成像（OCT）,调查随访患儿的预后视力恢复情况,并进行相关性分析。结果：三组的视盘面积、盘沿面积、校正视盘面积、校正盘沿面积、等效球镜绝对值、眼轴长度等数据对比无差异（P>0.05）。B组与C组的上方、鼻侧、下方、颞侧、全周的RNFL厚度都高于A组（P<0.05）,C组高于B组（P<0.05）。随访截止时间为2021年1月,A组、B组与C组的总有效率分别为87.5 %、85.7 %和85.0 %,对比无差异（P>0.05）。Pearson线性相关分析显示预后总有效率与上方、鼻侧、下方、颞侧、全周的RNFL厚度均存在相关性（P<0.05）。结论：不同类型弱视儿童的视网膜神经纤维层结构厚度存在差异,与患儿的预后视力恢复存在相关性。     

Isolated Aortocoronary Bypass Operations in Patients Over 70 Years of Age: A Comparison With Results in Patients 50 to 59 Years Old

The early and late morbidity, mortality and beneficial effects of isolated aortocoronary bypass operations in a group of 35 patients 70 years old or older were compared with those factors in patients 50 to 59 years old. The patients in both groups were matched according to the year in which the operation was done and the number of vessels bypassed. Left ventricular function, estimated by the angiographically calculated ejection fraction, was not statistically different in the two groups. Cardiac index, while adequate in both groups, was significantly lower in the older age group. Comparisons were made of “early” events, such as perioperative myocardial infarction, perioperative death and length of post-operative hospital stay; and of “late” events, including myocardial infarction, angina pectoris, congestive heart failure and death, which occurred after patients were discharged from the hospital. The mean length of follow-up of patients was similar in both groups.In comparing early events in the two groups, there was no statistically significant difference in the incidence of perioperative myocardial infarction, perioperative mortality or mean length of postoperative hospital stays. With regard to late events, there was no statistically significant difference in the incidences of myocardial infarction, angina pectoris or mortality.     

加速康复外科理论对老年股骨颈骨折患者髋关节功能、生活质量及术后认知功能的影响

摘要 目的：探讨加速康复外科理论（ERAS）对老年股骨颈骨折（FNF）患者髋关节功能、生活质量以及术后认知功能的影响。方法：选取2018年7月~2019年10月期间我院收治的80例老年FNF患者,按照随机数字表法分为对照组（n=40）和研究组（n=40）,对照组给予常规围术期处理,研究组围术期应用ERAS进行处理,比较两组患者围术期指标、髋关节功能、生活质量、术后认知功能及并发症发生情况。结果：研究组术中出血量少于对照组,手术时间、住院时间短于对照组（P<0.05）。研究组术后6个月髋关节功能的优良率为92.50%（37/40）,高于对照组的70.00%（28/40）（P<0.05）。两组术后6个月SF-36各维度评分均升高,且研究组高于对照组（P<0.05）。两组术后简易智力状态量表（MMSE）评分均较术前降低,但研究组高于对照组（P<0.05）;研究组的认知功能障碍（POCD）发生率低于对照组（P<0.05）。研究组的并发症总发生率为7.50%（3/40）,低于对照组的25.00%（10/40）（P<0.05）。结论：老年FNF患者应用ERAS进行围术期处理,可促进患者术后恢复,减轻认知功能损害及并发症发生率,同时还可有效改善髋关节功能及生活质量。     

Relative Contributions of Geographic,Socioeconomic, and Lifestyle Factors to Quality of Life,Frailty, and Mortality in Elderly

Background

To date, few studies address disparities in older populations specifically using frailty as one of the health outcomes and examining the relative contributions of individual and environmental factors to health outcomes.

Methodology/Principal Findings

Using a data set from a health survey of 4,000 people aged 65 years and over living in all regions of Hong Kong, we examined regional variations in self-rated health, frailty, and four-year mortality, and analyzed the relative contributions of lifestyle, socioeconomic status, and geographical location of residence to these outcomes using path analysis. We hypothesize that lifestyle, socioeconomic status, and regional characteristics directly and indirectly through interactions contribute to self-rated physical and psychological health, frailty, and four-year mortality.District variations directly affect self-rated physical health, and also exert an effect through socioeconomic position as well as lifestyle factors. Socioeconomic position in turn directly affects self-rated physical health, as well as indirectly through lifestyle factors. A similar pattern of interaction is observed for self-rated mental health, frailty, and mortality, although there are differences in different lifestyle factors and district associations. Lifestyle factors also directly affect physical and mental components of health, frailty, and mortality. The magnitude of direct district effect is comparable to those of lifestyle and socioeconomic position.

Conclusions/Significance

We conclude that district variations in health outcomes exist in the Hong Kong elderly population, and these variations result directly from district factors, and are also indirectly mediated through socioeconomic position as well as lifestyle. Provision and accessibility to health services are unlikely to play a significant role. Future studies on these district factors would be important in reducing health disparities in the older population.     

Quality of Life of People Living with HIV/AIDS: A Cross-Sectional Study in Zhejiang Province,China

Health-related quality of life (HRQOL) has become a concept commonly used in the related research. Using the World Health Organization Quality of Life Questionnaire for Brief Version (WHOQOL-BREF), this study evaluated the Quality of Life (QOL) of people living with HIV/AIDS (PLWHA) in Zhejiang province, China, and assessed the influences of demographic, laboratory and disease-related variables on QOL. This cross-sectional study was conducted among PLWHA aged ≥ 18 years in Taizhou municipality, Zhejiang province, China, between August 1 and October 31, 2014. A multiple linear regression model was used to analyze the influential factors. Of 403 subjects, 72.48% were male, 72.46% had received a high- school or above education, 94.79% were of Han ethnicity, and 65.51% were non farmers. The total score of QOL was 15.99±1.99. The scores of QOL in physiological, psychological, social relation, and environmental domains were 14.99 ±2.25, 14.25 ±2.12, 13.22 ±2.37, and 13.31 ±1.99 respectively. Except the total score of QOL and the score of environmental domain (p<0.05), the scores in other domains had no significant difference with the results of the national norm level. The multiple linear regression model identified the physical domain related factors to be age (β = -0.045), CD4 count (β = 0.002), and ART adherence(β = 1.231). And it also showed that psychological domain related factors included CD4 count (β = 0.002) and WHO clinical stage (β = -0.437); social domain related factors included WHO clinical stage (β = -0.704) and ART adherence (β = 1.177); while environmental domain related factors included WHO clinical stage (β = -0.538), educational status(β = 0.549) and ART adherence(β = 1.078).Those who are young, with higher level of education, higher CD4 count and good access and adherence of ART, are likely to have better QOL among PLWHA in Zhejiang province. This suggests that in addition to ART, many other factors should be taken into consideration to improve the QOL of PLWHA. The relatively lower scores the subjects received in social relation and environmental domains also suggest that social relation and environmental interventions need to be strengthened.     

Primate Community Dynamics in Old Growth Forest over 23.5 Years at Ngogo,Kibale National Park,Uganda: Implications for Conservation and Census Methods

Few data exist regarding long-term changes in primate populations in old-growth, tropical forests. In the absence of this information, it is unclear how to assess population trends efficiently and economically. We addressed these problems by conducting line-transect censuses 23.5 years apart at the Ngogo study area in Kibale National Park, Uganda. We conducted additional censuses over short time intervals to determine the degree to which the temporal distribution of censuses affected estimates of primate numbers. Results indicate that two species, blue monkeys and red colobus, may have experienced significant reductions over the past 23.5 years at Ngogo. In contrast, five other species, baboons, black-and-white colobus, chimpanzees, mangabeys, and red-tailed guenons, have not changed in relative abundance. Additional findings indicate that different observers may vary significantly in their estimates of sighting distances of animals during censuses, thus rendering the use of measures of absolute densities problematic. Moreover, censuses conducted over short periods produce biased estimates of primate numbers. These results provide guidelines for the use of line-transect censuses and underscore the importance of protecting large blocks of forests for primate conservation.     

BMI and Health‐Related Quality of Life in Adults 65 Years and Older

Objective: To examine relationships of BMI with health‐related quality of life in adults 65 years and older. Research Methods and Procedures: In 1996, a health survey was mailed to all surviving participants ≥ 65 years old from the Chicago Heart Association Detection Project in Industry Study (1967 to 1973). The response rate was 60%, and the sample included 3981 male and 3099 female respondents. BMI (kilograms per meter squared) was classified into four groups: underweight (<18.5), normal weight (18.5 to 24.9), overweight (25.0 to 29.9), and obese (≥30.0). Main outcome measures were Health Status Questionnaire‐12 scores (ranging from 0 to 100) assessing eight domains: health perception, physical functioning, role limitations‐physical, bodily pain, energy/fatigue, social functioning, role limitations‐mental, and mental health. The higher the score, the better the outcome. Results: With adjustment for age, race, education, smoking, and alcohol intake, obesity was associated with lower health perception and poorer physical and social functioning (women only) but not impaired mental health. Overweight was associated with impaired physical well‐being among women only. Both underweight men and women reported impairment in physical, social, and mental well‐being. For example, multivariable‐adjusted health perception domain scores for women were 50.8 (underweight), 62.7 (normal weight), 60.5 (overweight), and 52.1 (obese), respectively. Associations weakened but remained significant with further adjustment for comorbidities. Discussion: Compared with normal‐weight people, both underweight and obese older adults reported impaired quality of life, particularly worse physical functioning and physical well‐being. These results reinforce the importance of normal body weight in older age.     

Quality of Life, Physical Diseases, and Psychological Impairment among Survivors 3 Years after Wenchuan Earthquake: A Population Based Survey

Background

Few research studies have addressed the long-term effects caused by catastrophes, and no study has ever explored the life quality, physical diseases, and psychological impairment of earthquake survivors at the same time. This study seeks to reveal survivors'' quality of life, physical diseases, and mental health.

Methods

A cross-sectional survey was conducted through multi-stage sampling approach three years after the Wenchuan earthquake.

Results

A total of 2525 subjects were interviewed. Symptoms of PTSD were reported by 8.8% of the respondents from the seriously affected areas and 0.5%, the less hit areas. Prevalence of chronic diseases was 39.2% and 22.1% respectively, and two-week prevalence rate, 24.9% and 12.7% respectively. In the multivariate analysis, two-week prevalence, displacement, no regular income, receiving mental health support after the disaster, family members died or missing, injured due to the quake, and person who witnessed someone being killed or injured were independently associated with higher prevalence for symptoms of PTSD. Most subscales of SF-12 negatively correlated with age, chronic diseases, two-week prevalence, injured due to the disaster, home or property loss, and score of the 3-year PTSD symptoms, but positively correlated with higher education and higher household income.

Conclusions

The rates of physical diseases and symptoms of PTSD were relatively high, and the quality of life was poor among victims in the hard-hit areas 3 years after the earthquake. Physical impairment correlated with symptom of PTSD, and both were negatively associated with quality of life.     

Serum Leptin in Elderly People: Associations with Sex Hormones,Insulin, and Adipose Tissue Volumes

BAUMGARTNER, RICHARD N., ROBERT R. ROSS, DEBRA L. WATERS, WILLIAM M. BROOKS, JOHN E. MORLEY, GEORGE D. MONTOYA, AND PHILIP J. GARRY. Serum leptin in elderly people: associations with sex hormones, insulin, and adipose tissue volumes. Obes Res. Objective There are few data for associations of serum leptin with body fat, fat distribution, sex hormones, or fasting insulin in elderly adults. We hypothesized that the sex difference in serum leptin concentrations would disappear after adjustment for subcutaneous, but not visceral body fat. Serum leptin would not be associated with sex hormone concentrations or serum fasting insulin after adjusting for body fat and fat distribution. Research Methods and Procedures Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) volumes were measured using magnetic resonance imaging in a cross-sectional sample of 56 nondiabetic, elderly men and women aged 64 years to 94 years. Serum leptin, sex hormones (testosterone and estrone), sex hormone-binding globulin, and fasting insulin were also measured. Nine women were taking hormone replacement, and five men were clinically hypogonadal. Results Leptin was significantly associated with both SAT and VAT in each sex. Adjustment for SAT reduced the sex difference in leptin by 56%, but adjustment for VAT increased the difference by 25%. Leptin was not associated with serum estrone or hormone replacement therapy in the women, but had a significant, negative association with testosterone in the men that was independent of SAT, but not VAT. Leptin was significantly associated with fasting insulin in both sexes independent of age, sex hormones, sex hormone-binding globulin, VAT and SAT. Discussion Sex difference in serum leptin is partly explained by different amounts of SAT. Studies including both men and women should adjust for SAT rather than total body fat that includes VAT. The sex difference in serum leptin is not due to estrogen, but may be partly explained by testosterone. Testosterone is negatively associated with leptin in men, but the association is confounded with VAT. Leptin is associated with fasting insulin in non-diabetic elderly men and women independent of body fat, fat distribution. or sex hormones.