Improved Psychological Well-Being,Quality of Life,and Health Practices in Moderately Overweight Women Participating in a 12-Week Structured Weight Loss Program

Objective : To study the effects of a 12-week weight loss strategy involving increased physical activity, self-selected hypocaloric diet, and group support on psychological well-being, quality of life, and health practices in moderately obese women. Methods; Eighty women aged 20–49 years weighing between 20–50% above 1983 Metropolitan Life Insurance Tables were randomly assigned to a weight loss intervention (6279 kJ/week of physical activity, 33,258-41,462 kJ/week diet and weekly meetings) or served as controls. Subjects were tested pre and post 12-weeks. Results : The intervention group lost significant (p<0.001) body weight (kg) and body fat (%) compared to controls (-6.07 ± 4.01 kg vs. 1.31 ± 1.28 kg; 36.8%-32.5% vs. 36.2%-36.0%). Intervention subjects vs. controls achieved significant improvements (p<0.001) in body cathexis (X Change 18.6 ± 16.7 vs. 0.7 ± 8.6) and estimation of ability to achieve physical fitness (X Change 8.1 ± 7.1 vs. 0.9 ± 5.9). Various quality of life indices also improved (p<0.01) in the intervention group compared to controls (physical function: X Change 13.5.2 ± 16.7 vs. 1.4 ± 9.5; vitality: X change 21.7 ± 17.9 vs. 2.9 20.8; mental health: X change 10.4 ± 16.0 vs. 2.3 ± 10.1). Similarly, physical activity levels also improved significantly (p<0.0001) in the intervention group (4.4 ± 2.3 vs. 0.6 ± 1.3; on NASA 0–7 scale). Conclusions : Practical weight loss practices such as increased activity, self-selected hypocaloric diet, and group support are effective for weight loss and yield significant health and psychological benefits in moderately obese females.     

Long-term survival of patients with prostate cancer in Martinique: Results of a population-based study

BackgroundMartinique has one of the highest incidences of prostate cancer (PCa) worldwide. We analysed overall survival (OS) among patients with PCa in Martinique, using data from a population-based cancer registry between 2005 and 2014.MethodsThe log-rank test was used to assess the statistical differences between survival curves according to age at diagnosis, risk of disease progression including Gleason score, stage at diagnosis and Prostate Specific Antigen (PSA). A multivariable Cox model was constructed to identify independent prognostic factors for OS.ResultsA total of 5045 patients were included with a mean age at diagnosis of 68.1±9.0 years [36.0 – 98.0 years]. Clinical stage was analysed in 4999 (99.1% of overall), 19.5% were at low risk, 34.7% intermediate and 36.9% at high risk. In our study, 8.9% of patients with available stage at diagnosis, were regional/metastatic cancers. Median PSA level at diagnosis was 10.4 ng/mL. High-risk PCa was more frequent in patients aged 65-74 and ≥75 years as compared to those aged <65 years (36.6% and 48.8% versus 28.7% respectively; p<0.0001). One-year OS was 96.3%, 5-year OS was 83.4 and 10-year OS was 65.0%. Median survival was not reached in the whole cohort. High-risk PCa (HR=2.32; p<0.0001), regional/metastatic stage (HR= 9.51; p<0.0001) and older age (65-74 and ≥75 years - respectively HR=1.70; and HR=3.38), were independent prognostic factors for OS (p<0.0001).ConclusionThis study provides long term data that may be useful in making cancer management decisions for patients with PCa in Martinique.     

Is dynamic thiol/disulfide homeostasis associated with the prognosis of myelodysplastic syndrome?

BackgroundThis study planned to investigate the relationship of dynamic thiol/disulfide homeostasis with the prognosis of myelodysplastic syndrome (MDS).Methods80 patients who had been diagnosed with MDS between 2012 and 2017 and who were older than 18 were included in the study together with 80 healthy control subjects. The MDS diagnosis was confirmed using bone marrow aspiration-biopsy immunostaining. Dynamic thiol/disulfide homeostasis and ischemia-modified albumin (IMA) levels were examined.ResultsThe average IMA (0.71±0.08 vs. 0.67±0.09; p=0.002), median disulfide (18.0 vs. 11.6; p<0.001), median disulfide/native thiol (6 vs. 3; p<0.001), and median disulfide/total thiol (5.4 vs. 2.9; p<0.001) were found higher in the MDS patients compared to control group, and the median hemoglobin, median white blood cell count, median neutrophil count, median lymphocyte count, average native thiol (290.7±48.5 vs. 371.5±103.8; p<0.001), average total thiol (328.2±48.9 vs. 393±105.5; p<0.001), and average native thiol/total thiol (%) (88.3±4.3 vs. 94.2±2.1; p<0.001) were found to below. Risk factors such as collagen tissue disease (HR:9.17; p=0.005), MDS-EB-1 (HR:10.14; p=0.032), MDS-EB-2 (HR:18.2; p=0.043), and disulfide/native thiol (HR:1.17; p=0.023) were found as the independent predictors anticipating progression to acute myeloid leukemia. In the Cox regression model, risk factors such as age (HR:1.05; p=0.002), MDS-EB-1 (HR:12.58; p<0.001), MDS-EB-2 (HR:5.75; p=0.033), disulfide/native thiol (HR:1.14; p=0.040), and hemoglobin (HR:0.64; p=0.007) were found as predictors anticipating for mortality.ConclusionsWe can argue that dynamic thiol/disulfide homeostasis could have significant effects on both the etiopathogenesis and the survival of patients with MDS, and it could be included in new prognostic scoring systems.     

Differential Metabolic Effects of Energy Restriction in Dogs Using Diets Varying in Fat and Fiber Content

The role of dietary fat and fiber in energy restriction for the management of obesity was examined. Twelve male castrated dogs were energy restricted for 7 weeks by feeding 60% of their calculated maintenance energy requirements (MER = 1500 kcal/m²/d) for ideal body weight. Six dogs were restricted on a high-fat (35.4 kcal% from fat), low-fiber (2.9% dry matter basis [DMB]) diet while the other six dogs were restricted on a low-fat (24.5 kcal% from fat), high-fiber (27% DMB) diet. Compared with the high-fat, low-fiber diet, energy restriction on the low-fat, high-fiber diet resulted in significantly greater decreases in body fat (1472 ± 166 vs. 853 ± 176 g; p < 0.05) and total serum cholesterol concentrations (108.7 ± 11.3 vs. 51.5 ± 13.9 mg/dL; p< 0.005). Reductions in body weight (2.86 ± 0.3 vs. 2.14 ± 0.3 kg; p< 0.09), and mean arterial blood pressure (17.4 ± 6.1 vs. 6.7 ± 2.9 mmHg; p < 0.12) were also greater on the low-fat diet; however, these diet effects did not reach statistical significance. These data suggest that the fat and fiber content of the diet during energy restriction are important factors in the management of obesity.     

Efficacy of choline and DHA supplements or enriched environment exposure during early adult obesity in mitigating its adverse impact through aging in rats

IntroductionThe aim of this study was to assess the efficacy of choline and DHA or exposure to environmental enrichment in obese adult and aging rats on alterations in body mass index, serum lipid profile and arterial wall changes, despite stopping high fat diet consumption and interventions during adulthood.Methods21 day old male Sprague Dawley rats were assigned as Experiment-1 & 2 - PND rats were divided into 4 groups with interventions for 7 months (n = 8/group). NC– Normal control fed normal chow diet; OB- Obese group, fed high fat diet; OB + CHO + DHA- fed high fat diet and oral supplementation of choline, DHA. OB + EE- fed high fat diet along with exposure to enriched environment .Experiment-2 had similar groups and interventions as experiment 1 but for next 5 months were fed normal chow diet without any interventions. Body mass index was assessed and blood was analyzed for serum lipid profile. Common Carotid Artery (CCA) was processed for Haematoxylin and eosin, Verhoff Vangeison stains. Images of tissue sections were analyzed and quantified using image J and tissue quant software.ResultsIn experiment.1, mean body mass index (p < 0.001), serum lipid profile (p < 0.01), thickness of tunica intima (p < 0.05), tunica media (p < 0.01) and percentage of collagen fibers (p < 0.01) of CCA were significantly increased in OB compared to NC. These were significantly attenuated in OB + CHO + DHA and OB + EE compared to OB. In experiment.2, mean body mass index (p < 0.01), serum lipid profile (p < 0.05) and thickness of tunica media of CCA (p < 0.01) were significantly increased in OB compared to NC. In OB + CHO + DHA and OB + EE, significant attenuation was observed in mean body mass index and mean thickness of tunica media compared to same in OB.ConclusionAdult obesity has negative impact on body mass index, serum lipid profile and arterial wall structure that persists through aging. Supplementation of choline and DHA or exposure to enriched environment during obesity attenuates these negative impacts through aging.     

Gender Differences in the Response of Plasma Leptin Concentrations to Weight Loss in Obese Older Individuals

Plasma leptin concentration is directly related to the degree of obesity and is higher in women than in men of the same body mass index (BMI). We hypothesized that fasting plasma leptin concentrations and the response of leptin to weight loss would differ in older men and women of a similar fat mass. Plasma leptin concentrations (radioimmunoassay) and fat mass (DXA) were measured in 47 older, obese (BMI=30 ± 4 kg/m²) women and 23 older, obese (BMI=31 ± 3 kg/m²) men after a 2 to 4 week period of weight and dietary stabilization, and then in 22 of the women and 18 of the men after a 6-month weight loss intervention (250–350 kcal/d deficit). Leptin correlated with fat mass in men and women (r=0.75 and r=0.77, respectively; p values<0.0001), but women had 3-fold higher leptin levels for a given fat mass than men (p=0.01). In response to the 6-month hypocaloric diet, men and women lost a similar percentage of fat mass (?13% and ?16%, respectively), but the relative decline in circulating leptin was greater in women than men (-45% and ?21%, respectively; p<0.0001). In addition, when leptin was normalized for fat mass using the ratio method, the decrease in leptin per kilogram of fat mass was greater in women than men (-0.37 ± 0.34 vs. ?0.04 ± 0.06 ng/mL/kg; p<0.01). After weight loss, the change in leptin concentrations correlated positively with the change in fat mass in men (r=0.60; p<0.01), but not in women (r=0.31; p=0.17). Furthermore, the loss in fat mass correlated negatively with baseline leptin levels in women (r=-0.47; p<0.05), but not in men (r=0.03, p=NS). These results indicate that the decline in leptin concentration with weight loss correlates with the loss in fat mass in men; but, in women, other factors affect the decrease in leptin concentration. This suggests that the role of leptin in the regulation of obesity is gender-specific and may account for gender differences in response to hypocaloric treatment and maintenance of lost weight.     

Coronary flow reserve in hypertrophic cardiomyopathy: relation with microvascular dysfunction and pathophysiological characteristics

Background. The decrease in coronary flow reserve (CFR) in hypertrophic cardiomyopathy (HCM) predisposes to myocardial ischaemia, systolic dysfunction and cardiac death. In this study we investigate to which extent haemodynamic, echocardiographic, and histological parameters contribute to the reduction of CFR. Methods. In ten HCM patients (mean age 44±14 years) and eight heart transplant (HTX) patients (mean age 51±6 years) CFR was calculated in the left anterior descending coronary artery. In all subjects haemodynamic, echocardiographic and histological parameters were assessed. The relationship between these variables and CFR was determined using linear regression analysis. Results. CFR was reduced in HCM compared with HTX patients (1.6±0.7 vs. 2.7±0.8, p<0.01). An increase in septal thickness (p<0.005), indexed left ventricular (LV) mass (p<0.005), LV end-diastolic pressure (p<0.001), LV outflow tract gradient (p<0.05) and a decrease in arteriolar lumen size (p<0.05) were all related to a reduction in CFR. Conclusion: In HCM patients haemodynamic (LV end-diastolic pressure, LV outflow tract gradient), echocardiographic (indexed LV mass) and histological (% luminal area of the arterioles) changes are responsible for a decrease in CFR. (Neth Heart J 2007;15:209-15.)     

DNA Polymorphisms in the α2- and β2 Adrenoceptor Genes and Regional Fat Distribution in Humans: Association and Linkage Studies

The aim of this study was to investigate the relationships between DNA restriction fragment length polymorphisms (RFLP) in the α₂- and β₂-adrenoceptor genes and body fat distribution in humans. Skinfold thickness measurements and genetic analyses (Southern blot) were performed on 280 individuals (142 parents and 138 offsprings) from the Québec Family Study. Using the association study design in unrelated adults, women but not men carrying the 6.3-kb allele of an α_2A-adrenoceptor/DraI RFLP had a significantly higher trunk to extremity skinfold ratio (= sum of subscapular + suprailiac + abdominal skinfolddsum of biceps + triceps + medial calf skinfolds) compared to women without the allele (1.44 ± 0.52 vs. 1.12 ± 0.33; p<0.005 after adjustment for age, p<0.002 after adjustment for age and body mass index or for age and subcutaneous fat). Using the sib-pair linkage procedure, a significant inverse relationship was found between the proportion of alleles identical by descent shared by sibs at the α2A RFLP marker locus and the squared differences of thetrunk to extremity skinfold ratio (p = 0.02 after adjustment for age or for age and body mass index or for age and subcutaneous fat). For a β-adrenoceptor/ BanI RFLP, no significant association or linkage was found between fat distribution indicators and the marker. These results suggest that α_2A-adrenoceptor gene variability detected with DraI is associated with a relative subcutaneous fat pattern favoring accumulation of truncal-abdominal fat in women, and that the α_2A-adrenoceptogr ene, or a locus in close proximity, may be linked to body fat distribution in humans independently of the overall level of fatness.     

Body fat responses to a 1‐year combined exercise training program in male coronary artery disease patients

Objective:

To analyze the body fat (BF) content and distribution modifications in coronary artery disease (CAD) patients in response to a 1‐year combined aerobic and resistance exercise training (CET) program.

Design and Methods:

We followed two groups of CAD male patients for 12 months. One group consisted of 17 subjects (57 ± 12 years) who engaged in a CET program (CET group) and the other was a age‐matched control group of 10 subjects (58 ± 11 years). BF content and distribution were measured through dual energy X‐ray absorptiometry (DXA) at baseline and follow‐up.

Results:

We found no differences on body mass and BMI between baseline and end of follow‐up in both groups but, in CET group, we found significant reductions in all analyzed BF depots, including total BF (21.60 ± 6.00 vs. 20.32 ± 5.89 kg, P < 0.01), % total BF (27.8 ± 5.5 vs. 26.4 ± 5.4%, P < 0.05), trunk fat (12.54 ± 3.99 vs. 11.77 ± 4.01 kg, P < 0.05), % trunk fat (31.1 ± 6.9 and 29.2 ± 7.1%, P < 0.05), appendicular fat (8.22 ± 2.08 vs. 7.72 ± 2.037 kg, P < 0.01), % appendicular fat (25.7 ± 4.9 and 24.5 ± 4.9%, P < 0.05), and abdominal fat (2.95 ± 1.06 vs. 2.75 ± 1.10 kg, P < 0.05). Control group showed significant increase in appendicular fat (7.63 ± 1.92 vs. 8.10 ± 2.12 kg, P < 0.05).

Conclusions:

These results confirm the positive effect of CET on body composition of CAD patients, despite no changes in body mass or BMI. In this study, we observed no alterations on BF distribution meaning similar rate of fat loss in all analyzed BF depots. These results also alert for the limitations of BMI for tracking body composition changes.     

Visceral Fat Accumulation as a Risk Factor for Prostate Cancer

Objective: No clear association between obesity or body fat distribution and prostate cancer has been shown. We investigated the relation between visceral fat accumulation as measured by computed tomography (CT) and the occurrence of prostate cancer. Research Methods and Procedures: We compared body fat distribution assessed by a direct method (CT) in 63 prostate cancer cases with 63 age‐matched healthy community controls. A CT scan at the level of the fourth lumbar vertebra was performed in all participants. Results: Patients presented a significantly higher mean total abdominal fat area (509.2 ± 226.1 vs. 334.3 ± 132.9 cm², p < 0.001), mostly because of a higher mean visceral fat area (VF; 324.7 ± 145.6 vs. 177.4 ± 88.4 cm², p < 0.001) and a significantly higher mean ratio between visceral and subcutaneous fat areas (V/S ratio; 1.8 ± 0.4 vs. 1.2 ± 0.4, p < 0.001). A significantly higher risk of prostate cancer was found for participants with higher VF (odds ratio = 4.6; 95% confidence interval = 2.6 to 8.2 per SD increase) and V/S ratio (odds ratio = 6.0; 95% confidence interval = 2.3 to 11.0 per SD increase). Discussion: These results suggest a role for visceral obesity, quantified by CT, as a risk factor for prostate cancer. The action of the adipocytokines secreted by visceral fat cells, steroid hormone disturbances, and increased levels of insulin or other hormones noted in visceral obesity may explain this association.     

The individual age at menopause — An appropriate indicator of postmenopausal body composition?

The interaction between age at menopause and postmenopausal body composition development was tested with in 178 Viennese women aged 47 to 68 years (x=55.4 yr). Postmenopausal body composition was described using dual energy x-ray absorptiometry by absolute fat and lean mass and bone mineral content of the whole body, the arms, legs, the trunk and the head. Upper and lower amount of body fat, the fat percentages of the individual body compartments and the fat distribution index were calculated. Postmenopausal body fat and lean soft tissue mass and postmenopausal bone mineral content were significantly associated with the age at menopause. Women whose menopause occurred late showed the highest amount of body fat (31.2+/−7.7kg) and lean body mass (41.2+/−4.4 kg) postmenopausally, while women with an early menopause exhibited the lowest amount of body fat (27.5+/−8.9kg) and lean body mass (38.4+/−5.4 kg) during the postreproductive phase of life (p<0.05). Women whose menopause occurred later than 51 had a significant higher postmenopausal bone mass (2.26+/−0.9kg versus 2.09+/−0.3 kg; p<0.05). A late menopause was associated with a significantly higher value in fat mass, lean body mass and in bone mineral content. Therefore age at menopause may be assumed as an indicator for body fat and bone mineral content during postmenopause and postmenopausal fat distribution patterns.     

Body Composition at 6 months of Life: Comparison Of Air Displacement Plethysmography and Dual‐Energy X‐Ray Absorptiometry

Body composition assessment during infancy is important because it is a critical period for obesity risk development, thus valid tools are needed to accurately, precisely, and quickly determine both fat and fat‐free mass. The purpose of this study was to compare body composition estimates using dual‐energy x‐ray absorptiometry (DXA) and air displacement plethysmography (ADP) at 6 months old. We assessed the agreement between whole body composition using DXA and ADP in 84 full‐term average‐for‐gestational‐age boys and girls using DXA (Lunar iDXA v11–30.062; Infant whole body analysis enCore 2007 software, GE, Fairfield, CT) and ADP (Infant Body Composition System v3.1.0, COSMED USA, Concord, CA). Although the correlations between DXA and ADP for %fat (r = 0.925), absolute fat mass (r = 0.969), and absolute fat‐free mass (r = 0.945) were all significant, body composition estimates by DXA were greater for both %fat (31.1 ± 3.6% vs. 26.7 ± 4.7%; P < 0.001) and absolute fat mass (2,284 ± 449 vs. 1,921 ± 492 g; P < 0.001), and lower for fat‐free mass (5,022 ± 532 vs. 5,188 ± 508 g; P < 0.001) vs. ADP. Inter‐method differences in %fat decreased with increasing adiposity and differences in fat‐free mass decreased with increasing infant age. Estimates of body composition determined by DXA and ADP at 6 months of age were highly correlated, but did differ significantly. Additional work is required to identify the technical basis for these rather large inter‐method differences in infant body composition.     

Collection and Interpretation of Plasma Leptin Concentration Data in Humans

JENSEN, MICHAEL D, DONALD HENSRUD, PETER C. O'BRIEN, AND SØREN NIELSEN. Collection and interpretation of plasma leptin concentration data in humans. Obes Res. Objective: To reassess the relationship between body fat and plasma leptin concentrations when a) replicate measures of leptin are made; b) energy intake is controlled at isoenergetic levels before the study; and c) body fat and percent body fat are measured with dual energy X-ray absorptiometry (DXA). Research Methods and Procedures: Two separate studies were conducted. In the first study, four plasma samples were collected for measurement of leptin over 30 minutes on a single day in 43 lean and obese men and women. For the second study, plasma samples were collected on four consecutive days from a group of 50 lean and obese men and women. Percent body fat (and body fat mass) was related to log-transformed mean plasma leptin concentrations using linear regression analysis; multiple linear regression analysis was used to determine whether there was an effect of gender on this relationship, and the analysis of Choi was used to examine whether percent body fat or body fat mass better predicts plasma leptin concentrations. Results: For the first study, percent body fat was highly correlated (r = 0. 96, p<O. OOOl) with log-transformed mean leptin concentrations. No difference in the relationship between leptin and percent body fat in men and women was detected. The second study confirmed this observation; the relationship between In leptin and percent body fat was virtually identical (r = 0. 93, p<0. 001). Analysis of the pooled data suggests that percent body fat is a better predictor of plasma leptin concentration than body fat mass. The use of multiple (as opposed to a single) leptin measurements did not significantly improve the leptinhody fat relationship. Discussion: When robust body composition techniques and diet control measures are taken into consideration, the relationship between In plasma leptin concentrations and percent body fat is not different in men and women.     

Total and Regional Fat and Serum Cardiovascular Disease Risk Factors in Lean and Obese Children and Adolescents

Objective: This study was conducted to evaluate the association of total and central adiposity with serum cardiovascular disease (CVD) risk factors in lean and obese Portuguese children and adolescents. Research Methods and Procedures: A total of 87 girls (13.2 ± 1.6 years old, 29.9 ± 6.4% body fat [mean ± SD]) and 72 boys (13.2 ± 1.6 years old, 20.8 ± 9.9% body fat) volunteered for the study. Whole‐body composition and fat distribution, from DXA and anthropometry, and serum lipids, lipoproteins, and apolipoproteins were evaluated. Results: The sum of three trunk skinfolds (STS) was highly correlated with total trunk fat mass measured by DXA (p < 0.001). Body mass index, DXA‐measured percentage of body fat, trunk fat mass, STS, and the waist‐to‐height ratio were generally found to be associated with triacylglycerol, the ratio of total cholesterol (TC) to high density lipoprotein‐cholesterol (HDL‐C), low density lipoprotein‐cholesterol (LDL‐C), and apolipoprotein B levels, (significant age‐adjusted r between 0.16 and 0.27, p < 0.05). Body mass index, STS, and the waist circumference were also associated with HDL‐C (p < 0.05), whereas no body composition variable significantly correlated with TC or apolipoproteins A‐I. The STS was significantly correlated with HDL‐C (p < 0.01), TC/HDL‐C (p < 0.05), and apolipoproteins A‐I (p < 0.05) independently of whole‐body fatness. Obese subjects (n = 73) had higher TC, LDL‐C, TC/HDL‐C, and apolipoprotein B than did non‐obese subjects (n = 86), and significant associations between central adiposity and some lipid variables (triacylglycerol and HDL‐C) were found in obese children and adolescents that were not present in leaner individuals. Discussion: DXA‐ and anthropometry‐based whole‐body and central fat measures are associated with serum CVD risk factors in Portuguese boys and girls. Obese children and adolescents have a poorer lipid profile than do their leaner counterparts. Trunk skinfolds, which are easy to obtain even in large samples, predict CVD risk factors to the same extent as DXA‐based variables, in some cases, independently of total fatness.     

Birth Weight and Its Relationship to Size Attained and Relative Fat Distribution at 7 to 12 Years of Age

The relationship between birth weight and relative subcutaneous fat distribution at school age was considered in 131 boys and 106 girls 7 to 12 years of age. Relative fat distribution at school age was estimated with the ratio of the subscapular to triceps skinfolds (S/T) for the total sample, and with the ratio of the sum of two trunk (subscapular, midaxillary) to the sum of two extremity (triceps, medial calf) skinfolds (T/E) for subsamples of 102 boys and 63 girls. There were no sex differences in the S/T ratio (mm/mm), boys 0.62 ± 0.15, girls 0.63 ± 0.18; T/E ratio (mm/mm), boys 0.58 ± 0.13, girls 0.59 ± 0.16; and BMI (kg/m²), boys 17.1 ± 2.4, girls 16.9 ± 2.2. Second order partial correlations, controlling for age and the BMI or age and sum of skinfolds, between birth weight and the skinfold ratios are, respectively, ?0.22 and ?0.20 (p<0.01) for S/T and ?0.29 and ?032 (p<0.01) for T/E in girls, and ?0.18 and ?0.17 (p<0.05) for S/T and ?0.06 and ?0.6 for T/E in boys. Though low, the correlations suggest that as birth weight decreases proportionally more subcutaneous fat is accumulated on the trunk than on the extremities, more so in females than in males. Results of stepwise multiple regression analyses indicate that birth weight accounts for from 2% to 8% of the variance in relative subcutaneous fat distribution at school age.     

Serum Leptin Concentrations and Weight Gain in Postobese,Postmenopausal Women

Objective : This study was designed to determine if serum leptin concentrations (adjusted for fat mass) after weight loss on a low-calorie diet predict subsequent weight gain. Research Methods and Procedures : Body composition and serum leptin concentrations were determined on 14 moderately obese, postmenopausal, nondiabetic women with a familial predisposition to obesity. Assessments were obtained under tightly controlled metabolic ward conditions of macronutrient intake and weight maintenance both before (obese state) and after a mean weight loss of 12.0 kg to normal body weight (postobese state). Four years later, without intervention, body weight and body composition were reassessed. Results : Weight loss resulted in significant decreases in fat mass (29.7 ± 5.4 vs. 20.3 ± 4.7; kg), body mass index (27.7 ± 1.6 vs. 23.0 ± 1.5; kg/m2), percent body fat (40.7 ± 4.3 vs. 33.1 ± 5.0), and serum leptin concentrations (31.8 ± 16.0 vs. 11.5 ± 5.4; ng/mL). Serum leptin concentrations were positively correlated (p<<0.05) with fat mass in both the obese and postobese states (r = 0.67 and r = 0.56, respectively). However, residual serum leptin concentrations (adjusted for fat mass) in the obese and postobese states were not related to changes in body weight (p<= 0.61 and 0.52), fat mass (p = 0.72 and 0.42), body mass index (p = 0.59 and 0.33), or percent body fat (p = 0.84 and 0.46) over the follow-up period. Discussion : These finding do not support the hypothesis that relatively low concentrations of leptin predict weight regain after weight loss. However, because the number of subjects in this study was limited, further studies are warranted.     

Effect of High Sucrose Feeding on Fat Accumulation in the Male Wistar Rat

High sucrose intake is generally thought to be a risk factor for obesity and insulin resistance. We examined the effects of feeding sucrose on fat accumulation and insulin release in male rats. Six-week-old male Wistar rats were maintained on a high sucrose diet for 4 or 12 weeks. Control rats were fed a diet based on starch. No significant difference in daily caloric intake or weight gain existed between the two dietary groups. There was no difference between the two dietary groups in the gain of abdominal subcutaneous fat (SC) at 4-week. In contrast, rats fed the high sucrose diet had significantly more mesenteric fat (MES) than controls (p<0.01). At 12 weeks, rats fed the high sucrose diet had significantly more SC and MES than controls (SC:p<0.05, MES:p<0.01). Basal immunoreactive insulin (IRI) concentrations in the portal vein (PV) of rats fed the high sucrose diet was significantly higher compared to those of controls (4 wk: p<0.05, 12 wk: p<0.05). No difference between the two dietary groups in basal IRI concentrations in the inferior vena cava (TVC) existed at 4 weeks; whereas at 12 weeks, the basal IRI concentrations in the IV C in rats fed the high sucrose diet were significantly higher than in controls (p<0.05). The mesenteric and subcutaneous fat accumulations were closely related to hyperinsulinemia in the portal vein and inferior vena cava, respectively. Twelve weeks of high sucrose feeding caused accumulation of abdominal adipose tissue with marked hyperinsulinemia and hyperlipidemia. Our study is the first to demonstrate that abdominal fat induced by high sucrose intake in male rats is accompanied by an abnormal metabolic state similar to an insulin-resistant state.     

Association between circulating irisin levels and epicardial fat in patients with treatment-naïve overt hyperthyroidism

Abstract

Background: Hyperthyroidism is associated with increased metabolic activity and thermogenesis. Irisin is a key molecule in thermogenesis and energy expenditure via adipose tissue browning. Epicardial fat was previously defined as brown-like fat. Thus, here we aimed to evaluate the association between serum irisin level and epicardial fat thickness (EFT) in patients with hyperthyroidism.

Methods: A total of 25 hyperthyroid patients and 24 age-, sex- and BMI-matched healthy controls were enrolled. Serum irisin levels, thyroid hormone levels, and body compositions were compared. EFT was measured via transthoracic echocardiography.

Results: Serum irisin level and EFT were significantly higher in the hyperthyroid group (p?<?0.001 and p?=?0.001, respectively). The distributions of fat-free mass, muscle mass and fat mass were similar between the study groups. Serum irisin level was negatively correlated with TSH (p?<?0.001) and positively correlated with fT3 (p?<?0.001), fT4 (p?<?0.001) and TSH receptor antibody (p?=?0.002) levels and EFT (p?=?0.001). In multivariate linear regression analysis, TSH (β?=??0.475, p?<?0.001) and EFT (β?=?0.290, p?=?0.023) levels were significantly associated with serum irisin levels.

Conclusions: An increased serum irisin level associated with EFT might contribute to metabolic derangement in hyperthyroidism. Further studies are needed to elucidate whether irisin levels and EFT are affected by hyperthyroidism or vice versa.     

Skeletal Muscle Metabolism and Body Fat Content in Men and Women

The purpose of the present study was to verify the relationships between indicators of body Eat content and specific characteristics of skeletal muscle in a large sample of men and women. Six skinfold thicknesses (σ6S) and maximal oxygen uptake (VO₂ max) were measured in 348 Caucasian subjects (149 women and 199 men). Fiber type proportions (type I, type IIA, and type IIB) and activity levels of marker enzymes for the Krebs cycle (malate dehydrogenase, MDH) and for the fatty acid oxidation (3-hydroxya-cyl CoA dehydrogenase, HADH) pathways were determined in vastus lateralis muscle samples. No significant correlation was found between fiber type proportions and σ6S. Significant and negative correlations were, however, obtained in both genders between the σ6S and MDH enzyme activity (r = ?0.23; p<0.01), but not between the σ6S and HADH enzyme activity. When individuals with low and high amount of subcutaneous fat but paired for VO₂max were compared, vastus lateralis of fat men exhibited the same proportion of type I fiber (38.6 ± 10.3 vs 38.5 ± 13.4 %) and HADH activity level (3.43 ± 1.05 vs. 334 ± 0.81 U/g), but had about 20% less MDH enzyme activity than vastus lateralis of leaner men (158 ± 35 vs. 198 ± 43 U/g;p<0.05). No difference was found in any of these muscle phenotypes when comparisons were made between women with low and high amount of subcutaneous fat but also paired for VO₂max. Moreover, no relations were observed between skeletal muscle fiber type proportion or metabolic markers with relative subcutaneous fat distribution. In conclusion, these results indicate that the proportion of fiber type of skeletal muscle is not a determinant of body fat content or fat distribution in men and women. However, the results of the present study suggest, at least in men, that a low oxidative capacity of skeletal muscle, undetected by muscle fiber typing, is associated with an augmented body fat content.     

Improved durable pulmonary vein isolation with shorter procedure times and lower energy levels using RF ablation with ablation index and a stringent lesion contiguity

BackgroundThe single procedure success rates of durable pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF) varies between 80 and 90%. Ablation index, incorporating contact force, stability, time and power is a more profound parameter of significant lesion size and has been established. Equally important is a stringent contiguity of the lesion set.Methods and resultsA total number of 100 consecutive patients undergoing de-novo catheter ablation for paroxysmal atrial fibrillation (PAF) were analyzed between 2016 and 2019. In the first 50 patients (group A) PVI was performed using a surround flow, contact force catheter (Biosense Webster Thermocool STSF, Biosense Webster, USA) with a drag-and-ablate technique to encircle the PVs. In the following 50 patients (group B), PVI was performed using ablation index and a stringent lesion contiguity with an interlesion distance (ILD) of <5 mm. The baseline characteristics showed no significant differences between both groups. During a mean follow-up of 18 ± 3 months after a single procedure, 36 (72%) patients of group A were free of arrhythmia recurrence versus 43 (86%) patients in group B (p = 0.047). A total of 14 patients (group A: 10 (20%), group B: 4 (8%); underwent a redo-procedure. 7 patients of group A (14%) and 2 patients of group B (4%) showed recovered veins. In 3 patients of group A and 2 patients of group B the PVs were durably isolated. In these patients persistent AF recurrence was caused by extra-PV AF sources. Four patients of group A and three patients of group B had continued paroxysmal or persistent AF but did not undergo redo-procedure. With regard to the procedural data, the procedure time, the total energy and the fluoroscopy time were significantly lower in group B (AI and ILD <5 mm) (128.86 ± 18.19 versus 115.35 ± 15.38; p < 0.05; 1619.16 ± 988.56 versus 1186.26 ± 756.34; p < 0.05; 11.49 ± 3.20 versus 9.66 ± 3.86; p = 0.04). Both procedures were performed with a low number of complications, no pericardial effusion was seen in either group.ConclusionsPVI using ablation index in combination with a stringent lesion contiguity improves clinical outcome after first-time PVI with lower PVI recovery, shorter procedure times, lower total energy and shorter fluoroscopy times and therefore, is more efficient.