Sarcopenia could be linked to abdominal obesity through various mechanisms. The aim of the current study was to evaluate the association between sarcopenia and abdominal obesity among community-dwelling aged population.

Data were collected from 1356 eligible older adults (≥ 60 years) who participated in the baseline phase of Birjand Longitudinal Aging Study (BLAS) in 2019. Body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), a body shape index (ABSI), body roundness index (BRI), and body adiposity index (BAI) were measured. Sarcopenia was assessed based on hand grip strength, appendicular skeletal muscle mass (ASMM) and gait speed.

In the studied population, 834 individuals were sarcopenic. The best predictors of sarcopenia and low gait speed were BAI and WHtR (AUC = 0.61 to 0.65). All abdominal obesity indices were risk factors for sarcopenia, except for WHR. ABSI was significantly and directly associated with sarcopenia, only in the crude model (OR (95%CI): 1.14 (1.02; 1.28), P = 0.02). WHR, WHtR, BMI, and WC increased and ABSI decreased the odds of low handgrip strength.

Most abdominal obesity indices were identified as risk factors for sarcopenia except for WHR. Anthropometric indices can be considered for evaluating the risk of sarcopenia in the elderly.

The online version contains supplementary material available at 10.1007/s40200-025-01616-6.

Adipose tissue has varying distributions and metabolic properties between the sexes. Inherent sex-specific differences in adipocytes may heighten the risk of metabolic disease in males. Analysis of the adipocyte proteome can potentially provide important insight. To enable cell-type specific proteomic profiling in vivo, we genetically engineered a mouse line for cell-type specific production of a promiscuous biotin ligase (BirA*G3) facilitating the rapid isolation of biotinylated cell-type specific proteomes. Adipocyte-specific activation of cytoplasmic BirA*G3 led to robust biotinylation of adipocyte proteins across all major fat depots. Comparison of brown adipose tissue (BAT) and subcutaneous white adipose tissue (SAT) proteomes identified 229 brown adipose-enriched and 35 white adipose-enriched proteins. Regional comparison of white fat depots revealed additional differences across depots. Comparison of male and female depots identified sexually dimorphic adipose proteins: AHNAK predominating in the male and ACOT2 in the female. These findings validate the genetic model and highlight insights to be gained through targeted profiling of adipocytes. The genetic tool adds to existing approaches for in vivo proximity profiling of cell-type specific proteome programs.

To explore the relationship between quantitative CT histogram indices of abdominal muscles and coronary artery disease (CAD) severity.

CAD patients and controls who received chest CT covering the L1-L2 intervertebral disc were enrolled. Abdominal muscles at the L1-L2 level, including the abdominal wall muscles, the psoas major muscles and the paraspinal muscles, were segmented. Six histogram indices, covering area, average and median attenuation, skewness, kurtosis and standard deviation (SD) of attenuation, were measured and compared with controls. Associations between histogram indices and coronary artery calcium score (CACS) and total coronary plaque burden were then assessed using multivariate regression analysis.

Two hundred ninety male and 165 female CAD patients were enrolled. Compared with controls, both sexes of CAD patients had a broader, platykurtic and right-skewed distribution in the psoas major muscles and female CAD patients had a leptokurtic and left-skewed distribution in the abdominal wall muscles additionally. After adjusting for cardiovascular risk factors, BMI, liver fat fraction, visceral adipose tissue and subcutaneous adipose tissue, the SD in the psoas major muscles was positively associated with CACS in male CAD patients (β=0.13; 95% CI: 0.02 to 0.23; P=0.02), and kurtosis in the abdominal wall muscles was positively associated with total plaque burden in female CAD patients (β=0.15; 95% CI, 0.01 to 0.29; P=0.03).

The histogram indices for abdominal wall muscles were independently associated with CAD severity in CAD patients, and the relationships were different between the two sexes.

The burden of high high body mass index (BMI) in adolescent and young adults (AYA) is largely unknown. Therefore, we aim to assess this burden.

Data were extracted from GBD 2021. Age-standardized mortality, DALY rates (ASMR, ASDR) and estimated annual percentage change (EAPC) were used to describe the burden. Pearson's correlation coefficient was used to evaluate the correlation between the sociodemographic index (SDI) and ASMR/ASDR.

From 1990 to 2021, the death and DALY number attributable to high BMI in AYA had increased by 109 % and 141 % respectively. Low-middle SDI regions showed the most significant upward trend (EAPC = 1.37 for ASMR and 1.97 for ASDR). All diseases caused by high BMI showed a upward trend except for asthma and leukemia. ASMR of this burden was negatively correlated with the SDI (r = -0.13, p < 0.001), while the relationship between ASDR and SDI was opposite (r = 0.23, p < 0.001). The burden of osteoarthritis caused by high BMI (r = 0.68, p < 0.001), low back pain (r = 0.67, p < 0.001), gout (r = 0.62, p < 0.001) due to high BMI rose with SDI, which contributed to the severe DALY burden in high SDI regions.

The burden of high BMI is still rising in AYA. Targeted measures need to be taken in different regions.

Evidence links body composition and inflammatory markers with type 2 diabetes (T2D). However, the comparative analysis of body composition markers derived from different modalities and inflammatory markers in relation to T2D remains unexplored. This study aims to evaluate and compare the association of body composition and inflammatory markers with T2D.

We included 4043 participants (2081 female, 51.4%) aged 20-84 enrolled in the population-based Study of Health in Pomerania. Multivariable logistic regression models adjusted for confounding were used to analyse associations of standardized body composition markers derived from classic anthropometry, bioelectrical impedance analysis, magnetic resonance imaging as well as inflammatory markers C-reactive protein, white blood cell count, fibrinogen, ferritin and CRP-to-albumin ratio with prevalent T2D.

Body composition markers were more strongly associated with T2D than inflammatory markers. Waist circumference exhibited the strongest association with T2D (female: odds ratio (OR) = 2.55; 95% confidence interval [CI]: 2.17-3.00; male: OR = 2.20; 95% CI: 1.86-2.60). Similarly, body weight (female: 2.07; 1.78-2.41; male: OR = 1.99; 95% CI = 1.71-2.31), waist-to-height ratio (female: OR = 2.39; 95% CI = 2.05-2.77; male: 2.28; 1.92-2.70) and visceral adipose tissue (female: 3.02; 95% CI = 2.11-4.32; male: 1.50; 1.19-1.89) showed strong associations with T2D. Among inflammatory markers, white blood cell count in male and CRP-to-albumin ratio in female exhibit the strongest association with T2D.

Body composition markers seem to be more tightly associated with prevalent T2D compared to inflammatory markers.

Handgrip strength (HGS), cardiorespiratory fitness (CRF) and body size, shape, and composition are all related to cardiometabolic health and are associated in cross-sectional settings. Their longitudinal relationship is less clear. We used observational data from the Study of Health in Pomerania at baseline (SHIP-TREND-0; 2008-2012) and follow-up (SHIP-TREND-1; 2016-2019) with 1,214 men and 1,293 women. HGS was measured with a hand dynamometer. CRF was assessed using cardiopulmonary exercise testing. Linear regression models were adjusted appropriately. Several sensitivity analyses were performed. From baseline to follow-up (7 years) HGS decreased in men (3.5 kg) and women (0.8 kg). VO2peak lessened in men (36 ml/min) and increased in women (53 ml/min). We only found significant relations in men where a 1 l decline in VO2peak was associated with a 0.87 kg larger decrease in fat free mass and with a 1.15 kg stronger decline in body weight. All other analysis revealed non-significant findings. This longitudinal analysis suggests that age related changes in strength and CRF are not related to body size and shape but only composition (in men). A novelty of our findings are the sex-specific aspects given that strength decreased much stronger in men compared to women.

Barrett's esophagus (BE) is a known premalignant precursor to esophageal adenocarcinoma (EAC). The prevalence rates continue to rise in the United States, but many patients who are at risk of EAC are not screened. Current practice guidelines include male gender as a predisposing factor for BE and EAC. The population-based clinical evidence regarding female gender remains limited.

To study comparative trends of gender disparities in patients with BE in the United States.

A nationwide retrospective study was conducted using the 2009-2019 National Inpatient Sample (NIS) database. Patients with a primary or secondary diagnosis code of BE were identified. The major outcome of interest was determining the gender disparities in patients with BE. Trend analysis for respective outcomes for females was also reported to ascertain any time-based shifts.

We identified 1204190 patients with BE for the study period. Among the included patients, 717439 (59.6%) were men and 486751 (40.4%) were women. The mean age was higher in women than in men (67.1 ± 0.4 vs 66.6 ± 0.3 years, P < 0.001). The rate of BE per 100000 total NIS hospitalizations for males increased from 144.6 in 2009 to 213.4 in 2019 (P < 0.001). The rate for females increased from 96.8 in 2009 to 148.7 in 2019 (P < 0.001). There was a higher frequency of obesity among women compared to men (17.4% vs 12.6%, P < 0.001). Obesity prevalence among females increased from 12.3% in 2009 to 21.9% in 2019 (P < 0.001). A lower prevalence of smoking was noted in women than in men (20.8% vs 35.7%, P < 0.001). However, trend analysis showed an increasing prevalence of smoking among women, from 12.9% in 2009 to 30.7% in 2019 (P < 0.001). Additionally, there was a lower prevalence of alcohol abuse, Helicobacter pylori (H. pylori), and diabetes mellitus among females than males (P < 0.001). Trend analysis showed an increasing prevalence of alcohol use disorder and a decreasing prevalence of H. pylori and diabetes mellitus among women (P < 0.001).

The prevalence of BE among women has steadily increased from 2009 to 2019. The existing knowledge concerning BE development has historically focused on men, but our findings show that the risk in women is not insignificant.

With the rising global obesity rates, increasing research has been directed toward understanding how obesity affects cognitive ability in young adults. This study aims to explore the impact of body mass index (BMI) on general cognitive ability and how sleep quality and impulsive trait mediate this relationship.

A total of 1,205 young adults from Human Connectome Project(HCP) project were included, and questionnaires and cognitive assessment tools were conducted.

BMI was negatively correlated with general cognitive ability, with sleep quality and impulsive trait acting as chain mediators between BMI and general cognitive ability. Additionally, gender moderated the effect of BMI on sleep quality, with this effect being more pronounced in female young adults.

This study not only provided new insights into the impact of BMI on general cognitive ability in young adults but also offered an important perspective on how sleep quality and impulsive trait influenced this process. These findings provide a scientific basis for preventive measures against obesity and cognitive impairment in young adults.

We aimed to assess the changes in body fat distribution, intraorgan lipid accumulation, and cardiometabolic risk factors after 6 months of gender-affirming hormone therapy (GAHT) in transgender men (TM) and transgender women (TW).

Conducted at the Medical University of Vienna between 2019 and 2022, the study included 15 TW and 20 TM. We conducted magnetic resonance imaging and spectroscopy to determine the visceral (VAT) and subcutaneous adipose tissue (SAT) amounts, the VAT/SAT ratio, and the intraorgan lipid content (liver, pancreas, myocardium), bloodwork, and an oral glucose tolerance test at baseline and after 6 months of GAHT.

Pancreatic, hepatic, and intramyocardial lipid contents did not significantly change in either group after 6 months of GAHT. In TW, VAT/SAT ratio decreased significantly from baseline 0,930 (IQR 0,649-1,287) to 0,758 (IQR 0,424-0,900; p = 0,011) after 6 months of GAHT. The updated homeostatic model assessment for insulin sensitivity (HOMA2-%S) significantly decreased from 83,03 % (±31,11) to 64,27 % (±18,01; p = 0,047), indicating decreased insulin sensitivity, while the updated homeostatic model assessment for β-cell function (HOMA2-%β) increased (from 128,11 % (±35,80) to 156,80 % (±39,49); p = 0,020) in TW after 6 months of GAHT. In TM, there were no changes in glucose metabolism parameters except for an increase in HbA1c (5,1% (±0,3) vs 5,3% (±0,4), p = 0,001).

6 months of GAHT were not associated with statistically significant changes in myocardial, hepatic, or pancreatic lipid content. Short-term GAHT led to a marked body fat redistribution with a significant decrease in the VAT/SAT ratio in TW.

Muscle mass loss and fat mass increase are risk factors for cardiometabolic disease. We evaluated the effect of changes in body composition on the incidence of cardiometabolic diseases in older adults with or without sarcopenia, over two-year follow-up.

Changes in body composition and the development of cardiometabolic diseases over 2 years were measured in community-dwelling older adults recruited from the Korean Frailty Aging Cohort Study. Individuals with sarcopenia were 1:1 matched to those without sarcopenia via propensity score matching.

Among a total of 1634 eligible subjects, 353 were identified with sarcopenia. In men without sarcopenia, an increase in waist circumference by 1 cm was associated with a 32 % higher risk of the development of hypertension. Conversely, an increase in appendicular lean mass by 1 kg was associated with lower risks of the development of cardiovascular disease (41 % lower) and hyperlipidemia (28 % lower). However, there were no significant associations between changes in body composition and any incident cardiometabolic diseases in men with sarcopenia. Women without sarcopenia who experienced an increase in weight of 1 kg were 21 % less likely to develop hyperlipidemia. In women with sarcopenia, the risk of diabetes mellitus was reduced by 30 % with an incremental increase in weight by 1 kg, while the risk of hyperlipidemia increased almost threefold with an increase in appendicular lean mass by 1 kg.

In older adults without sarcopenia, a decrease in obesity-related indices and a gain in muscle gain are beneficial for men, but inverse relationships between weight and cardiometabolic diseases were reported in women. We found no cardiometabolic benefit of increasing lean mass in older adults with sarcopenia regardless of sex.

For characterizing health states, fat distribution is more informative than overall body size. We used population-based whole-body magnetic resonance imaging (MRI) to identify distinct body composition subphenotypes and characterize associations with cardiovascular disease (CVD) risk.

Bone marrow, visceral, subcutaneous, cardiac, renal, hepatic, skeletal muscle and pancreatic adipose tissue were measured by MRI in n = 299 individuals from the population-based KORA cohort. Body composition subphenotypes were identified by data-driven k-means clustering. CVD risk was calculated by established scores.

We identified five body composition subphenotypes, which differed substantially in CVD risk factor distribution and CVD risk. Compared to reference subphenotype I with favorable risk profile, two high-risk phenotypes, III&V, had a 3.8-fold increased CVD risk. High-risk subphenotype III had increased bone marrow and skeletal muscle fat (26.3 % vs 11.4 % in subphenotype I), indicating ageing effects, whereas subphenotype V showed overall high fat contents, and particularly elevated pancreatic fat (25.0 % vs 3.7 % in subphenotype I), indicating metabolic impairment. Subphenotype II had a 2.7-fold increased CVD risk, and an unfavorable fat distribution, probably smoking-related, while BMI was only slightly elevated. Subphenotype IV had a 2.8-fold increased CVD risk with comparably young individuals, who showed high blood pressure and hepatic fat (17.7 % vs 3.0 % in subphenotype I).

Whole-body MRI can identify distinct body composition subphenotypes associated with different degrees of cardiometabolic risk. Body composition profiling may enable a more comprehensive risk assessment than individual fat compartments, with potential benefits for individualized prevention.

Metabolic dysfunction-associated steatotic liver disease (MASLD) progression exhibits significant sex differences, with males generally developing more severe disease. This study used an endothelial nitric oxide synthase knockout (eNOS KO) murine model to investigate sex-specific MASLD progression under a Western diet intervention. Magnetic resonance imaging (MRI) assessed body composition and liver and skeletal muscle fat fraction, revealing greater visceral fat, liver volume, and liver-to-muscle fat ratios in males. Dimensionality reduction and clustering analyses identified distinct sex-specific MASLD phenotypes and progression patterns. Histological evaluations confirmed greater liver damage in males, evidenced by higher MAFLD Activity Scores. These findings highlight the critical role of sex as a biological variable in MASLD pathology and emphasize the influence of body composition and fat distribution on disease progression. The study underscores the utility of advanced imaging and analytical techniques for refining non-invasive diagnostics and guiding sex-specific interventions, paving the way for personalized MASLD management strategies.

Recent studies suggest that the metabolic score for insulin resistance (MetS-IR) is an effective indicator of metabolic disorders. However, evidence on the relationship between MetS-IR and metabolic syndrome (MetS) among the Chinese middle-aged and older adult population is limited.

This cohort study aims to assess the associations of MetS-IR levels with MetS risk and its components.

Data used in this study from the National Basic Public Health Service Project Management System (2020-2023). Multivariable Cox proportional hazards model and restricted cubic spline (RCS) were employed to evaluate the associations of baseline MetS-IR levels with MetS risk and its components, receiver operating characteristic (ROC) curves were further utilized to assess the efficacy of MetS-IR in predicting the risk of MetS and its component.

Of 1,498 subjects without MetS at baseline, 392 incident MetS cases were observed during a median of 27.70 months of follow-up. The adjusted multivariable Cox regression analysis indicated an elevated 15% risk of developing MetS for 1-SD increment of MetS-IR [hazard ratios (HRs) and 95% confidence intervals: 1.16 (1.13-1.18)]. Compared to the first tertile of MetS-IR, the HRs of the third tertile and second tertile were 6.31 (95% CI 4.55-8.76) and 2.72 (95% CI 1.92-3.85), respectively. Consistent findings were further detected across subgroups. Moreover, nonlinear associations were observed between MetS-IR and the risk of MetS, abdominal obesity, and reduced high-density lipoprotein concentration (HDL-C) (P nonlinear < 0.01), with the cutoff of MetS-IR was 32.89. The area under the curve for MetS-IR in predicting MetS was 0.740 (95% CI 0.713-0.768), which was better than those of other indicators.

Our cohort study indicates a positive nonlinear association between MetS-IR with incident MetS, abdominal obesity, and reduced HDL-C, but positive linear associations of MetS-IR and elevated blood pressure (BP), elevated fasting blood glucose (FBG), elevated triglycerides (TG) in middle-aged and older adult people, more studies are warranted to verify our findings.

Coronary artery calcification and cardiovascular disease are associated with elevated levels of atherogenic plasma index (AIP). However, the relationship with abdominal aortic calcification (AAC) remains unclear. This study aimed to explore the association between AIP and AAC using the National Health and Nutrition Examination Survey (NHANES) database.

A cross-sectional analysis was conducted on 2,811 individuals aged 40 years or older from the 2013-2014 NHANES dataset. Participants with missing AAC-24 scores, AIP data, or covariate information were excluded. AAC was quantified using the Kauppila score (AAC-24), with a score > 0 indicating the presence of AAC, and severe AAC (SAAC) being defined as an AAC-24 score ≥ 6. Multivariable regression models and restricted cubic spline analyses were employed to assess the associations between AIP and AAC. Sensitivity analysis was used to validate the robustness of the findings.

The study population had a mean age of 57.7 years, with 48.22% being male. A significant positive association was found between AIP and both the AAC score and the risk of AAC and SAAC, particularly in females. For the overall population, each unit increase in AIP was associated with an overall increase in AAC-24 score of 0.90 (95% CI: 0.22, 1.58; p = 0.009), and for women, the AAC risk and SAAC risk would be 4.01-fold higher (95% CI: 1.65, 9.74; p = 0.002) and 9.37-fold higher (95% CI: 2.37, 37.03; p = 0.001). No significant associations were found in males. Further analysis revealed a significant interaction between AIP and gender regarding both AAC scores and the risk of SAAC.

This study demonstrates a positive relationship between AIP and increased AAC scores, as well as a higher risk of AAC and SAAC in U.S. women. However, these findings require further investigation to confirm the observed gender-specific differences.

The associations of lean mass distribution with mortality risk are not fully elucidated. We aimed to evaluate the effects of a new lean mass distribution indicator-android/gynoid lean mass ratio (AGLR) evaluated by dual-energy x-ray absorptiometry (DXA) on the risk of all-cause and specific-cause mortality in a NHANES cohort.

This was a population-based cohort study, which included 18 542 subjects aged 20 years and older from the US National Health and Nutrition Examination Survey (US NHANES, 2003-2006 and 2011-2018). The primary outcomes of our study were all-cause mortality, cardiovascular (CVD) mortality and cancer mortality, which were obtained from the linkage to registries. Cox proportional hazard regression models were used to investigate the association between lean mass distribution and mortality risk among the US NHANES general population. Restricted cubic spline nested in Cox regression was also used to test whether there was a non-linear association of AGLR as a continuous variable with the risk of mortality.

During a median follow-up of 6.9 years, 1412 participants died, of whom 435 were due to CVD and 340 were due to cancer. The multivariable-adjusted (Model 4) hazard ratios (HRs) for each SD increase in AGLR were 1.53 (95% confidence interval [CI] 1.40-1.67) for all-cause mortality, 1.56 (95% CI 1.30-1.87) for cancer mortality and 1.64 (95% CI 1.47-1.84) for CVD mortality. The associations were robust in sensitivity analyses and present in most subgroups.

AGLR evaluated by DXA was associated with a higher risk of all-cause and specific-cause mortality among the general population from the US NHANES cohort.

Obesity is a significant modifiable risk factor for dementia. This study aims to quantify the global impact of obesity on dementia burden and examine how national strategies for managing overweight/obesity and dietary factors influence dementia prevalence and mortality, with a focus on sex-specific differences. We used data from the Global Burden of Disease (GBD) and World Health Organization (WHO) to evaluate the association between obesity age-standardized prevalence rate (ASPR) and dementia age-standardized mortality rate (ASMR) and ASPR across 161 countries. A two-step multivariate analysis adjusted for socioeconomic and lifestyle factors was performed. Temporal trends in dementia were analyzed based on the presence of national obesity management strategies and varying dietary scores. A 1% increase in national obesity prevalence was associated with a 0.36% increase in dementia mortality (OR: 1.0036; 95% CI: 1.0028-1.0045) in males and 0.12% in females (OR: 1.0012; 95% CI: 1.0007-1.0018). A 1% increase in national obesity ASPR was associated with an increase in ASPR of dementia by 0.26% for males (OR: 1.0026, 95% CI: 1.0024-1.0028) and 0.05% for females (OR: 1.0005, 95% CI: 1.0004-1.0006). Males exhibited a higher susceptibility to obesity-related dementia. Countries with national obesity management strategies showed a significantly greater reduction in dementia mortality, particularly among females (P = 0.025). Higher dietary scores were associated with a more significant decrease in dementia prevalence across both sexes. Rising obesity prevalence is linked to increased dementia burden globally, with males being more vulnerable to this relationship. National management of overweight/obesity and healthier dietary habits may help mitigate the dementia burden, emphasizing the need for integrated public health interventions.

Previous studies indicated that metabolic heterogeneity of obesity would affect the risk of cardiovascular disease (CVD). However, the alterations in CVD risk associated with transitions between various metabolic health statuses influenced by obesity status remain unclear.

We utilized data from the China Health and Retirement Longitudinal Study (CHARLS), a longitudinal cohort study involving Chinese residents aged 45 years and older. Baseline data were collected in 2011-2012, with follow-up surveys conducted up to 2020. Participants in the study were categorized into four body mass index-metabolic phenotypes: metabolically healthy normal weight (MHNW), metabolically healthy overweight/obesity (MHOO), metabolically unhealthy normal weight (MUNW) and metabolically unhealthy overweight/obesity (MUOO). Transitions in these phenotypes over 4 years were analysed. Cox regression models were used to assess the associations of these phenotypes and their transitions with CVD incidence.

Among 7721 participants, 1353 (17.5%) developed CVD during the follow-up period. Both overweight/obese and metabolically unhealthy statuses were associated with increased CVD risk. The highest risk was observed in the MUOO group (hazard ratio [HR]: 1.74, 95% confidence interval [CI]: 1.50-2.09, p < 0.0001), followed by the MUNW (HR 1.35, 95% CI: 1.13-1.66, p < 0.001) and MHOO (HR: 1.29, 95% CI: 1.08-1.56, p = 0.002) groups compared to the MHNW group. The deteriorations of obesity and metabolic health status elevated the incidence of CVD, whereas improvements in these statuses reduced the risk of CVD. Additionally, alterations in metabolic health status conferred greater benefits in overweight/obese individuals compared to those with normal weight.

The study highlights the importance of maintaining and promoting metabolic health, particularly in overweight/obese individuals, to reduce CVD risk. Metabolic health status plays a more crucial role than obesity status in predicting CVD incidence.

Although obesity is typically correlated with adverse outcomes in various diseases, certain acute critical illnesses exhibit a phenomenon known as the obesity paradox. This study evaluated sex-specific differences in the prognostic implications of the body mass index (BMI) of patients with severe acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT).

A multicenter retrospective cohort study.

Data from eight tertiary hospitals in Korea.

A total of 3805 critically ill patients receiving CRRT. Patients were categorized into four BMI groups: underweight, normal weight, overweight, and obese.

None.

There were 2308 male and 1497 female patients. The 90-day mortality risk significantly differed among BMI groups in the overall patient population and the male subpopulation but not the female subpopulation. Following adjustment for confounding variables, the 90-day mortality risk was higher in the underweight group than in the obese group (hazard ratio [HR], 1.20; 95% CI, 1.05-1.36; p = 0.006). Among male patients, the 90-day mortality risk was higher in both the underweight and normal weight groups than in the obese group (underweight: HR, 1.30; 95% CI, 1.10-1.53; p = 0.002 and normal weight: HR, 1.18; 95% CI, 1.04-1.35; p = 0.010); however, no such association was observed among female patients. Subgroup analysis demonstrated the obesity paradox in male patients of old age, with septic AKI, or with low albumin levels.

There were sex differences in the association between BMI and mortality in critically ill patients with severe AKI. Although the precise distribution of fat mass and muscle mass was not identified, obese male patients had a more favorable prognosis, which was not evident among female patients. These findings highlight the importance of considering sex-specific factors in understanding the complex relationship between obesity and mortality in critically ill patients with AKI.

Thyroid hormones (THs) are correlated with body composition regardless of the presence of thyroid dysfunctions, whereas little is known regarding THs' influence on muscular fitness components. This cross-sectional study investigated whether THs may affect muscular parameters in adults who are overweight and affected obesity.

One hundred and five volunteers (65 females and 40 males, BMI: 33.5 (8.0) kg/m2) in an euthyroid state were enrolled. Body composition was evaluated using bioelectrical impedance analysis. Muscular parameters of interest were grip strength-evaluated using the handgrip test (HG) and muscular performance -evaluated using the 10-repetition chair-stand test (CST). Free-triiodothyronine (FT3), free-thyroxine (FT4) and their ratio (FT3/FT4) were evaluated to assess thyroid function.

In the female group, the Pearson linear regression analysis revealed a positive correlation between FT3 and HG (R = 0.261, p = 0.036) and a negative correlation between FT3/FT4 and CST (R= -0.266, p= 0.032). In the male group, a positive correlation between FT3 and skeletal muscle mass was found (R = 0.354, p = 0.025). No correlations were found between THs of interest and adiposity indexes (BMI, fat mass) in either group (p > 0.05).

FT3 and FT3/FT4 ratio levels in euthyroidism may influence muscular parameters differently in females and males affected by an excess of fat mass. More research is needed to understand the mechanisms behind this correlation and whether THs could be a potential biomarker for muscle-related parameters.

Depression presents sexual dimorphism, and one important factor that increases the frequency of depression and contributes to sex-specific variations in its presentation is obesity. The conventional use of Body Mass Index (BMI) as an indicator of obesity is inherently limited due to its inability to distinguish between fat and lean mass, which limits its predictive utility for depression risk. Implementation of dual-energy X-ray absorptiometry (DXA) investigated sex-specific associations between body composition (fat mass, appendicular lean mass) and depression.

Data from the NHANES cycles between 2011 and 2018 were analyzed, including 3,637 participants (1,788 males and 1,849 females). Four body composition profiles were identified in the subjects: low adiposity-low muscle (LA-LM), low adiposity-high muscle (LA-HM), high adiposity-low muscle (HA-LM) and high adiposity-high muscle (HA-HM). After accounting for confounding variables, the associations between fat mass index (FMI), appendicular skeletal muscle mass index (ASMI), body fat percentage (BFP), body composition phenotypes, and depression risk were assessed using restricted cubic spline (RCS) curves and multivariable logistic regression models. We further conducted interaction analyses for ASMI and FMI in females.

RCS curves indicated a U-shaped relationship between ASMI and the risk of depression in males. Logistic regression analysis revealed that in males, the second (OR = 0.43, 95%CI:0.22-0.85) and third (OR = 0.35, 95%CI:0.14-0.86) quartile levels of ASMI were significantly negatively associated with depression risk. In females, increases in BFP (OR = 1.06, 95%CI:1.03-1.09) and FMI (OR = 1.08, 95% CI:1.04-1.12) were significantly associated with an increased risk of depression. Additionally, compared to females with a low-fat high-muscle phenotype, those with LA-LM (OR = 3.97, 95%CI:2.16-7.30), HA-LM (OR = 5.40, 95%CI:2.34-12.46), and HA-HM (OR = 6.36, 95%CI:3.26-12.37) phenotypes were more likely to develop depression. Interestingly, further interaction analysis of ASMI and FMI in females revealed an interplay between height-adjusted fat mass and muscle mass (OR = 4.67, 95%CI: 2.04-10.71).

The findings demonstrate how important it is to consider body composition when estimating the risk of depression, particularly in females. There is a substantial correlation between the LA-LM, HA-LM, and HA-HM phenotypes in females with a higher prevalence of depression. It is advised to use a preventative approach that involves gaining muscle mass and losing fat.

Normal weight obesity (NWO) is a body composition phenotype that is associated with increased cardiometabolic risk and is characterized by a normal weight body mass index but elevated body fat. The purpose of this study was to determine sex differences in aerobic capacity across body composition phenotypes, including normal weight lean (NWL), NWO, and traditional obesity (OB). We recruited 60 participants according to three body composition phenotypes: NWL (n = 10 females, n = 10 males), NWO (n = 10 females, n = 10 males), and OB (n = 10 females, n = 10 males). Measurements included fasting metabolic risk factors, body composition X-ray scan, and peak exercise test on a cycle ergometer to determine aerobic capacity (VO2peak). Across groups, males (34.5 ± 11.7 mL/kg/min) exhibited greater VO2peak than females (28.8 ± 8.8 mL/kg/min; p = 0.04). There were no differences in VO2peak between sexes within the same body composition phenotype, but NWL (42.7 ± 9.0 mL/kg/min) exhibited greater VO2peak than NWO (27.9 ± 4.4 mL/kg/min; p < 0.0001) and OB (24.4 ± 7.3 mL/kg/min; p < 0.0001). VO2peak was inversely correlated with relative body fat in the full sample (r = -0.67; p < 0.0001), but was stronger in males (r = -0.78; p < 0.0001) than females (r = -0.53; p = 0.0028). Visceral adipose tissue was not significantly correlated with VO2peak in the full sample (r = -0.25; p = 0.05) or in males (r = -0.23; p = 0.25), although they were inversely correlated in females (r = -0.36; p = 0.048). Our results suggest low aerobic capacity in both men and women with NWO, similar to men and women with OB. The relationship between body composition and aerobic capacity is strong across body composition phenotypes, but appears to be more consistent in females than males. For healthcare professionals aiming to lower cardiometabolic risk, attention should be given to improving aerobic fitness in both men and women with elevated body fat, including those with NWO.

The COVID-19 pandemic has led to significant lifestyle changes, including alterations in dietary habits and increases in sedentary behavior. The Mediterranean diet (MD) has been associated with various health benefits, which are especially important given the health challenges posed by the pandemic. During the pandemic, an overall shift towards consuming more highly processed foods has been observed.

This systematic review investigated adherence to MD during the COVID-19 pandemic, focusing on gender differences and factors influencing adherence to MD in the general public. The literature search focused on papers published between January 1, 2019, and July 8, 2024, across various databases such as Web of Science (WOS), Scopus, PubMed MEDLINE, and PsycINFO.

Following the PRISMA guidelines, this search identified 14,347 references, of which 5,734 were duplicates. After a thorough multi-level screening process, 29 studies, encompassing 55,242 participants, met the inclusion criteria. While seven studies reported that men adhered to a MD more than women during the COVID-19 pandemic, 12 studies also indicated that women had higher adherence to a MD compared to men. Nine studies, however, found no significant gender differences in MD adherence. Additionally, older age, higher education levels, higher socioeconomic status, and increased physical activity were linked to greater adherence to a MD in the pandemic context.

Gender-specific differences in dietary behavior are influenced by factors such as socioeconomic status, gender roles, and pandemic phases as well as biases in sample composition and methodological weaknesses. Significant gaps in the evidence, particularly concerning sexual and gender minorities, are highlighted.

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=421727.

Metabolic syndrome (MetS) is an indicator and diverse endocrine syndrome that combines different metabolic defects with clinical, physiological, biochemical, and metabolic factors. Obesity, visceral adiposity and abdominal obesity, dyslipidemia, insulin resistance (IR), elevated blood pressure, endothelial dysfunction, and acute or chronic inflammation are the risk factors associated with MetS. Abdominal obesity, a hallmark of MetS, highlights dysfunctional fat tissue and increased risk for cardiovascular disease and diabetes. Insulin, a vital peptide hormone, regulates glucose metabolism throughout the body. When cells become resistant to insulin's effects, it disrupts various molecular pathways, leading to IR. This condition is linked to a range of disorders, including obesity, diabetes, fatty liver disease, cardiovascular disease, and polycystic ovary syndrome. Atherogenic dyslipidemia is characterized by three key factors: high levels of small, low-dense lipoprotein (LDL) particles and triglycerides, alongside low levels of high-density lipoprotein (HDL), the "good" cholesterol. Such a combination is a major player in MetS, where IR is a driving force. Atherogenic dyslipidemia contributes significantly to the development of atherosclerosis, which can lead to cardiovascular disease. On top of that, genetic alteration and lifestyle factors such as diet and exercise influence the complexity and progression of MetS. To enhance our understanding and consciousness, it is essential to understand the fundamental pathogenesis of MetS. This review highlights current advancements in MetS research including the involvement of gut microbiome, epigenetic regulation, and metabolomic profiling for early detection of Mets. In addition, this review emphasized the epidemiology and fundamental pathogenesis of MetS, various risk factors, and their preventive measures. The goal of this effort is to deepen understanding of MetS and encourage further research to develop effective strategies for preventing and managing complex metabolic diseases.

Cold-induced vasodilation (CIVD) is a physiological response characterized by cyclic vasodilation occurring within 5-10 min of cold exposure, predominantly in the fingers and toes. This study aimed to determine the roles of body dimensions, specifically surface-to-mass (SM) ratio and sex in modulating CIVD responses. Thirty-nine participants (mean ± SD age: 24 ± 3 yr; height: 174 ± 28 cm; weight: 75.3 ± 15.2 kg; 20 males & 19 females) completed a 30-min immersion of the digits in ice water while sitting in a thermoneutral room (22 °C). Skin temperature was measured continuously on the anterior pads of the index, middle, ring, and little finger to assess CIVD parameters (onset time (tonset), minimum finger temperature (Tmin), maximum finger temperature (Tmax), mean finger temperature (Tmean), and CIVDwaves). A negative relationship was observed between Tmax and SM ratio (r =  - 0.39, p = 0.001) and Tmean and SM ratio (r =  - 0.32, p = 0.001), indicating that individuals with smaller SM ratios exhibited enhanced CIVD responses. A subgroup of 7 males and 7 females with identical anthropometrics from the original cohort showed no differences between any CIVD parameter: Tmean (Males: 8.0 ± 1.9 °C; Females: 8.9 ± 1.6 °C, p = 0.36), Tmax (Males: 11.2 ± 3.1 °C; Females: 13.1 ± 1.2 °C, p = 0.16), Tmin (Males: 5.9 ± 1.4 °C; Females: 5.0 ± 1.7 °C, p = 0.31), and tonset (Males: 12.0 ± 4.4 min; Females: 9.6 ± 3.6 min, p = 0.28). Therefore, body dimensions seem to play a crucial role in modulating CIVD responses, whereas sex does not.

Current measures of frailty often rely on subjective assessments or complex scoring systems. This study aims to investigate the utility of a novel anthropometric measure, the Weight-Adjusted Waist Index (WWI), as a simple and objective predictive marker for frailty in older adults.

This cross-sectional study included 847 patients aged 65 years and older. Comprehensive geriatric assessments and anthropometric measurements were conducted. Frailty was diagnosed using the Clinical Frailty Scale (CFS). The association between WWI and frailty was analyzed using multivariate logistic regression analysis.

The mean age of the participants was 74.9 ± 6 years, with 56.3% (n = 477) being women and 14.8% (n = 125) classified as frail. The frail group had a significantly higher WWI than the non-frail group (p < 0.001). In multivariate logistic regression analysis, WWI remained significantly associated with frailty, even after adjusting for other potential confounding factors (OR = 2.51, 95% CI 1.77-3.57, p < 0.001). The predictive ability of WWI for frailty was measured by the area under the receiver operating characteristic (ROC) curve, which was 0.705 (95% CI 0.67-0.73; p < 0.001). The optimal WWI threshold for predicting frailty was identified as > 12.

The Weight-Adjusted Waist Index shows significant potential as a simple and objective predictive marker for frailty in older adults.

There is general consensus that an improper diet negatively impacts health and that nutrition is a primary tool for the prevention of non-communicable diseases. Unfortunately, the importance of studying body composition, which can reveal early predictors of gender-related diseases, is still not well understood in this context. Currently, individuals are still classified as obese based solely on their body mass index, without considering the amount of fat, its distribution, and the quantity of muscle and bone mass. In this regard, the body composition phenotype defined as "osteosarcopenic obesity" affects approximately 6-41 % of postmenopausal women, with prevalence increasing with age due to the hormonal and metabolic changes that occur during this period. This particular phenotype arises from the strong relationship between visceral fat, muscle, bone, and gut microbiota and predispose postmenopausal women to frailty. Frailty is a complex clinical phenomenon with significant care and economic implications for our society. Recent studies suggest that women have a higher prevalence of frailty syndrome and its individual components, such as osteoporosis, fractures and sarcopenia, compared to men. Here, we provide a comprehensive overview of recent advances regarding the impact of gender on body composition and frailty. Furthermore, we reflect on the crucial importance of personalized nutritional interventions, with a focus on reducing visceral fat, increasing protein intake and optimizing vitamin D levels. A review of the scientific literature on this topic highlights the importance of studying body composition for a personalized and gender-specific approach to nutrition and dietetics, in order to identify frailty syndrome early and establish personalized treatments. This new method of researching disease predictors could likely help clarify the controversial results of studies on vitamin D, calcium and proteins, translate into practical wellness promotion across diverse elderly populations.

The prevalence of obesity and related complications is increasing relentlessly worldwide. The effect of intentional weight loss strategies for obese individuals on fat-free muscle mass (FFMM) and metabolic and general health is not well known. The aim of this research is to measure the effects of dietary intake and physical activity level on FFMM change during intentional weight loss in obese subjects.

Nine hundred and sixty-five overweight and obese community free-living subjects had the effects of physical activity level and dietary intake on FFMM change during intentional weight loss assessed in a prospective longitudinal study. Anthropometric, physical activity, dietary intake, inflammatory markers, and oxidative damage were assessed at baseline and follow-up. Validated questionnaires were used to measure dietary intake and physical activity. We compared FFMM loss or gain between subjects stratified by calorie, protein, and fruit and vegetable intake and physical activity levels. The Cox proportional hazards analysis was used to determine the independent effects of dietary intake and physical activity on FFMM changes.

A total of 965 subjects [(mean (SD) age 39 ± 12 years, 801 (83%)] females] were assessed at baseline with follow-up for a period of 427 ± 223 days. Using the WHO criteria for body mass index (BMI), 284 (30%) subjects were found to be overweight and 584 (62%) were obese. We found significant correlations between fat-muscle mass ratio (FMR) and inflammatory and oxidative damage markers. After adjusting for important prognostic indicators, age, gender, occupation, physical activity, and fruit and vegetable consumption were found to be significantly associated with FFMM at baseline (p < 0.05). We found no statistically significant difference in dietary protein or amino acids intake in subjects who gained FFMM compared to those who lost FFMM both at baseline and follow-up. By contrast, high consumption of fruits and vegetable and increased calorie intake were associated with increased odds of FFMM gain (p < 0.05). Increased physical activity was independently associated with significant FFMM gain after adjusting for other important indicators ([hazard ratio (95% CI): 0.49 (0.25, 0.97); p = 0.039].

Increased physical activity and high calorie, fruit and vegetable intake are associated with FFMM preservation or gains during intentional weight loss in obese subjects.

Given the fast-increasing prevalence of obesity and its comorbidities, it would be critical to improve our understanding of the cell-type level differences between the two key human adipose tissue depots, subcutaneous (SAT) and visceral adipose tissue (VAT), in their depot-specific contributions to cardiometabolic health. We integrated cell-type level RNA- and ATAC-seq data from human SAT and VAT biopsies and cell-lines to comprehensively elucidate transcriptomic, epigenetic, and genetic differences between the two fat depots. We identify cell-type marker genes for tissue specificity and functional enrichment, and show through genome-wide association study (GWAS) and partitioned polygenic risk score (PRS) enrichment analyses that the marker genes upregulated in SAT adipocytes have more prominent roles in abdominal obesity than those of VAT. We also identify SREBF1 , a master transcription factor (TF) of fatty acid synthesis and adipogenesis, as specifically upregulated in SAT adipocytes and present in numerous SAT functional pathways. By integrating multi-omics data from an independent human cohort, we further show that the risk allele carrier status of seven abdominal obesity GWAS variants in the cis region of SREBF1 affects the adipocyte expression of 146 SAT adipocyte marker genes in trans . We replicate this finding independently in the UK Biobank by showing that the partitioned abdominal obesity PRSs of the trans gene sets differ by the regional SREBF1 risk allele carrier status. In summary, we discover the master TF, SREBF1 , driving the SAT adipocyte expression profiles of more than a hundred of adipocyte marker genes in trans , a finding that indicates that human trans genes can be identified by integrating single cell omics with biobank data.

Mechanisms of abdominal obesity GWAS variants have remained largely unknown. To elucidate these mechanisms, we leveraged subcutaneous adipose tissue (SAT) single nucleus RNA-sequencing and genomics data. After discovering that heritability of abdominal obesity is enriched in adipocytes, we focused on a SAT unique adipocyte marker gene, the transcription factor TBX15, and its abdominal obesity-associated deleterious missense variant, rs10494217. The allele frequency of rs10494217 revealed a north-to-south decreasing gradient, with consistent significant FST values observed for 25 different populations when compared to Finns, a population with a history of genetic isolation. Given the role of Tbx15 in mouse thermogenesis, the frequency may have increased as an adaptation to cold in Finns. Our selection analysis provided significant evidence of selection for the abdominal obesity risk allele T of rs10494217 in Finns, with a north-to-south decreasing trend in other populations, and demonstrated that latitude significantly predicts the allele frequency. We also discovered that the risk allele status significantly affects SAT adipocyte expression of multiple adipocyte marker genes in trans in two cohorts. Two of these trans genes have been connected to thermogenesis, supporting the thermogenic effect of the TBX15 missense variant as a possible cause of its selection. Adipose expression of one trans gene, a lncRNA, AC002066.1, was strongly associated with adipocyte size, implicating it in metabolically unhealthy adipocyte hypertrophy. In summary, the abdominal obesity variant rs10494217 was selected in Finns, and individuals with the risk allele have trans effects on adipocyte expression of genes relating to thermogenesis and adipocyte hypertrophy.

In general abdominal surgery, the ratio of fat to muscle mass, or body composition measures, shows a stronger association with complications than body mass index. These studies include male and female patients. Women have a different body composition than men. Therefore, findings from general abdominal surgery cannot be extrapolated to women with cancer. The aim of this systematic review is to summarise the evidence on the association between body composition and peri- and postoperative complications in patients with gynaecological cancer.

Pubmed, Embase and the Cochrane Central databases were searched in June 2023. Studies were eligible if they included patients undergoing surgery for gynaecological cancer and reported on the association between body composition (muscle or fat mass) and surgical complications. The quality of the studies was assessed using the Newcastle-Ottawa quality assessment scale. A best-evidence synthesis was used to summarise the level of evidence.

Fifteen studies were included that assessed muscle mass (n = 9) or fat mass (n = 6). We found strong evidence that there was no association between visceral fat and length of hospital stay. We found moderate evidence that a higher amount of good quality muscle was associated with a lower risk of postoperative complications. We found moderate evidence that there was no association between muscle or fat mass (i.e., muscle- or subcutaneous fat) and postoperative complications or fat mass and intraoperative complications. There was insufficient evidence for an association between visceral fat and intraoperative or postoperative complications, and for an association between muscle mass or -quality and length of hospital stay. There was high heterogeneity in the methods used to measure body composition, hampering meta-analyses.

The association between body composition, particularly adipose tissue and muscle quality, and complications suggests that these measures may be of interest in determining postoperative risk in women undergoing surgery for gynaecological cancer.

Kicking is fundamental in many field-based sports. Most studies investigating kicking performance have been conducted with male athletes, resulting in a dearth of specific data to inform coaching of this skill in female players. This systematic review aimed to compare kicking biomechanics in male and female athletes in field-based sports. As per PRISMA guidelines, articles were retrieved from searches across five online databases. Studies investigating kicking biomechanics in field-based athletes of both sexes were eligible for inclusion. Articles were screened using Covidence and data extracted based on STROBE recommendations. The review included 23 studies, featuring 455 soccer players. Male athletes produced significantly greater ball velocities and linear velocities of the ankle, foot, and toe than females. Males had greater ankle plantarflexion angles than females at ball strike, while females used larger trunk flexion ranges than males. Hip and knee torques and ball-to-foot velocity ratios were greater in men than women. Skilled players generated power using tension arcs; a technique not seen in novices. Skill level within sex may have a greater influence on kicking performance than differences between the sexes. This review highlights the need for further research investigating kicking performance in both sexes across the spectrum of sports.

The aim was to investigate the mediating role of inflammatory biomarkers in the causal effect of body composition on glycaemic traits and type 2 diabetes.

A retrospective observational study and a Mendelian randomization (MR) study were used. Observational analyses were performed using data from 4717 Chinese children and adolescents aged 6-18 years who underwent dual-energy X-ray absorptiometry for body composition. MR analyses were based on summary statistics from UK Biobank, deCODE2021, Meta-Analysis of Glucose and Insulin-Related Traits Consortium (MAGIC) and other large consortiums. Inflammatory biomarkers included leptin, adiponectin, osteocalcin, fibroblast growth factor 23 (FGF23) and parathyroid hormone (PTH).

In a retrospective observational study, increased fat mass had a positive effect on homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment of pancreatic beta cell function (HOMA-β) through FGF23, whereas fat-free mass produced the opposite effects. PTH and osteocalcin played significant roles in the association of fat mass and fat-free mass with fasting glucose, fasting insulin and HOMA-IR (all p < 0.05). Mediation MR results indicated that childhood body mass index affected glycaemic traits through leptin and adiponectin. There existed a causal effect of fat-free mass on type 2 diabetes via FGF23 (indirect effect: OR [odds ratio]: 1.14 [95% CI, confidence interval: 1.01-1.28]) and adiponectin (OR: 0.85 [95% CI: 0.77-0.93]). Leptin mediated the causal association of fat mass (indirect effect: β: -0.05 [95% CI: -0.07, -0.02]) and fat-free mass (β: 0.03 [95% CI: 0.01, 0.04]) with fasting glucose.

Our findings suggest that different body compositions have differential influences on glycaemic traits and type 2 diabetes through distinct inflammatory biomarkers. The findings may be helpful in tailoring management of body composition based on inflammatory biomarkers with different glycaemic statuses.

To investigate the potential correlation between body mass index (BMI) and the 28-day mortality rate among sepsis patients and the gender difference in this association.

The current research was a retrospective cohort study.

A total of 14,883 male and female cohorts of sepsis patients were included in the Medical Information Mart for Intensive Care IV (MIMIC-IV V2.2) database. Patients in each gender cohort were further classified as underweight, normal weight, overweight, or obese according to BMI and the World Health Organization (WHO) BMI categories.

The 28-day mortality from the date of ICU hospitalization was the primary outcome measure.

The BMI and 28-day mortality exhibited an L-shaped relationship (p for nonlinearity <0.001) with significant gender-specific differences. Subgroup analysis revealed different association patterns between the male and female cohorts. Specifically, BMI and mortality exhibited a U-shaped curve relationship among the males (p for nonlinearity <0.001) and an L-shaped relationship among the females (p for nonlinearity = 0.045).

This study proposes a link between extreme BMI and 28-day mortality in patients with sepsis. Underweight patients have an increased risk of mortality; however, this risk decreases in overweight and obese patients. Upon stratifying by sex, a U-shaped pattern was observed, indicating an association between BMI and 28-day mortality in males, while an L-shaped pattern emerged in females.

This review discusses the quantitative assessment of tissue composition in the human body (body composition, BC) using radiological methods. Such analyses are gaining importance, in particular, for oncological and metabolic problems. The aim is to present the different methods and definitions in this field to a radiological readership in order to facilitate application and dissemination of BC methods. The main focus is on radiological cross-sectional imaging.

The review is based on a recent literature search in the US National Library of Medicine catalog (pubmed.gov) using appropriate search terms (body composition, obesity, sarcopenia, osteopenia in conjunction with imaging and radiology, respectively), as well as our own work and experience, particularly with MRI- and CT-based analyses of abdominal fat compartments and muscle groups.

Key post-processing methods such as segmentation of tomographic datasets are now well established and used in numerous clinical disciplines, including bariatric surgery. Validated reference values are required for a reliable assessment of radiological measures, such as fatty liver or muscle. Artificial intelligence approaches (deep learning) already enable the automated segmentation of different tissues and compartments so that the extensive datasets can be processed in a time-efficient manner - in the case of so-called opportunistic screening, even retrospectively from diagnostic examinations. The availability of analysis tools and suitable datasets for AI training is considered a limitation.

· Radiological imaging methods are increasingly used to determine body composition (BC).. · BC parameters are usually quantitative and well reproducible.. · CT image data from routine clinical examinations can be used retrospectively for BC analysis.. · Prospectively, MRI examinations can be used to determine organ-specific BC parameters.. · Automated and in-depth analysis methods (deep learning or radiomics) appear to become important in the future..

· Linder N, Denecke T, Busse H. Body composition analysis by radiological imaging - methods, applications, and prospects. Fortschr Röntgenstr 2024; 196: 1046 - 1054.

The fat-to-muscle mass ratio (FMR), integrating the antagonistic effects of fat and muscle mass, has been suggested as a valuable indicator to assess cardiometabolic health independent of overall adiposity. However, the specific associations of total and regional FMR with cardiometabolic risk are poorly understood. We aimed to examine sex-specific associations of total and regional FMR with single and clustered cardiometabolic risk factors (CRFs).

13,505 participants aged 20 years and above were included in the cross-sectional study. Fat mass and muscle mass were assessed using a bioelectrical impedance analysis device. FMR was estimated as fat mass divided by muscle mass in corresponding body parts (whole body, arm, leg, and trunk). Clustered CRFs was defined as the presence of two or more risk factors, including hypertension, elevated blood glucose, dyslipidemia, insulin resistance (IR), and hyperuricemia. IR was assessed by the triglyceride glucose (TyG) index. Multivariable logistic regression models were applied to explore the associations of FMR in the whole body and body parts with single and clustered CRFs.

The odds ratios (ORs) increased significantly for all single and clustered CRFs with the per quartile increase of total and regional FMR in both sexes (P for trend < 0.001), following adjustment for confounders. Among the regional parts, FMRs of the legs presented the strongest associations for clustered CRFs in both men and women, with adjusted OR of 8.54 (95% confidence interval (CI): 7.12-10.24) and 4.92 (95% CI: 4.24-5.71), respectively. Significant interactions (P for interaction < 0.05) were identified between age and FMRs across different body parts, as well as between BMI status and FMRs in different regions for clustered CRFs. Restricted cubic splines revealed significant non-linear relationships between FMRs of different body parts and clustered CRFs in both sexes (P for nonlinear < 0.05).

FMRs in the whole body and different regions were significantly associated with single and clustered CRFs in the general Chinese population. The association between FMR and clustered CRFs was more pronounced in youngers than in the elderly.

Myostatin inhibition improves insulin sensitivity in preclinical and clinical models; however, studies investigating the relationship between serum myostatin levels and insulin sensitivity are discrepant. Sensitive and specific myostatin LC-MS/MS assays are now available to accurately assess serum myostatin level in vivo. We sought to determine whether higher serum myostatin levels are independently associated with lower insulin sensitivity in adults with overweight/obesity. Participants included 74 adults, 20-65 years old, BMI ≥25 kg/m2 without type 2 diabetes. Appendicular lean mass (ALM) was measured by dual-energy x-ray absorptiometry; visceral adipose tissue (VAT) was measured by computed tomography. Main outcome measures were serum myostatin levels (LC-MS/MS) and insulin sensitivity (Matsuda index). Mean age was 48 ± 12 years, and BMI was 33.1 ± 5.6 kg/m2 (mean ± SD). Men had higher mean serum myostatin levels versus women (8.3 ± 1.9 vs. 7.2 ± 1.9 ng/mL, p = 0.01) and higher serum myostatin levels were associated with higher ALM (R = 0.34, p = 0.003). Higher serum myostatin levels were associated with lower Matsuda index (R = -0.44, p = 0.0004), which remained significant after controlling for BMI, VAT, ALM, and sex. In conclusion, higher serum myostatin levels are independently associated with lower insulin sensitivity in adults with overweight/obesity and may be a marker of or play a mechanistic role in the development of insulin resistance.