T. Todesco

Bio: T. Todesco is an academic researcher from University of Verona. The author has contributed to research in topics: Adipose tissue & Body mass index. The author has an hindex of 14, co-authored 16 publications receiving 1160 citations.

The contribution of sonography to the measurement of intra-abdominal fat

Abstract: A study was conducted on a group of 50 obese females with a mean body mass index of 39 +/- 16, aged 19 years, in order to determine if sonography could be adopted as a direct means for measuring intra-abdominal fat deposits. Adipose tissue evaluation was performed by computed tomography (CT) and ultrasonography (using 3.5-MHz and 5-MHz probes) at the L4 level. CT intra-abdominal fat area (VAT) and ultrasonography visceral thickness from abdominal muscle to aorta were the values mainly considered. Ultrasonographic intra-abdominal thickness correlated well with VAT (r = 0.669, p less than 0.001), supporting the hypothesis that ultrasonography could be useful in the direct evaluation of intra-abdominal fat deposits.

Body fat distribution in pre- and post-menopausal women: metabolic and anthropometric variables and their inter-relationships.

Abstract: The aim of the study was to compare body fat distribution and metabolic variables in pre- and post-menopausal women. Body fat distribution was measured using abdominal circumference and computerized tomography. No significant differences were found between the two groups as regards body weight, body mass index, waist-hip ratio and total abdominal adipose tissue areas. Subcutaneous abdominal adipose tissue areas were significantly higher in premenopausal women whereas visceral abdominal adipose tissue areas and the subcutaneous to visceral abdominal adipose tissue area ratios were significantly higher in post-menopausal subjects. After adjusting for body mass index, no significant differences emerged between the two groups as regards total abdominal adipose tissue areas, waist circumference, hip circumference and waist-hip circumference ratio; subcutaneous abdominal adipose tissue areas were significantly lower and both visceral abdominal adipose tissue areas and visceral to subcutaneous abdominal adipose tissue area ratios significantly higher in post-menopausal women (P less than 0.01). Basal glucose, sum of blood glucose values during oral glucose tolerance test and blood cholesterol values were significantly higher in the post-menopausal group (P less than 0.05), while no significant difference was observed in sum of blood insulin values during oral glucose tolerance test. Basal plasma insulin values, systolic blood pressure and diastolic blood pressure were higher in post-menopausal women, though the differences were not significant. Only blood cholesterol was significantly higher in post-menopausal women after adjusting for visceral abdominal adipose tissue areas. Positive correlations emerged between age and waist-hip ratio (P less than 0.05), visceral abdominal adipose tissue areas and the visceral to subcutaneous abdominal adipose tissue area ratio (P less than 0.001). A negative correlation was established between age and subcutaneous abdominal adipose tissue areas (P less than 0.01). There was a significant correlation between visceral abdominal adipose tissue areas and metabolic and haemodynamic variables in both pre- and post-menopausal women. In pre-menopausal women, body mass index correlated with basal glucose, basal insulin, sum of glucose during oral glucose tolerance test and systolic and diastolic blood pressure (P less than 0.05). When stepwise multiple regression analysis was used to evaluate the joint effect of anthropometric variables on metabolic variables, visceral abdominal adipose tissue area proved to be the most powerful variable for predicting metabolic disorders. Our data suggest that visceral abdominal adipose tissue areas and visceral to subcutaneous abdominal adipose tissue area ratios increase with age. Obesity correlates directly with the amount of subcutaneous fat, but not with the distribution pattern.(ABSTRACT TRUNCATED AT 400 WORDS)

Total and intra-abdominal fat measurements by ultrasound and computerized tomography.

Abstract: Computerized tomography, a method of proven reliability for direct measurement of both total and visceral body fat, is not widely usable and alternative means of assessing body fat are required. Several anthropometric parameters, including ultrasound measurements of intra-abdominal and subcutaneous fat, were considered in 119 females (age 15-72 years, body mass index 24-51 kg/m2). Computerized tomography was also performed for total and visceral fat areas at the L4-L5 level. Reliability of each of these measurements in predicting total fat was assessed. Tertiles for visceral fat area were calculated ( 170 cm2). Only ultrasound intra-abdominal fat measurements were able to distinguish between all three VAT groups (16 +/- 10, 32 +/- 13, 50 +/- 22 mm); neither sagittal diameter nor waist/hip girth ratio were able to distinguish between the two > 114 cm2 groups. Predictive equations for total adipose tissue area confirmed weight/height ratio as the best predictor of total fat. Ultrasound intra-abdominal thickness was the 1 degree variable to enter the stepwise regression in predictive equations for visceral adipose tissue area. The 2 degrees was age, the 3 degrees sagittal diameter, the 4 degrees waist/hip girth ratio and the 5 degrees ultrasound subcutaneous abdominal thickness (adjusted r2 = 0.784; P < 0.001).

Relation of body fat distribution in men and degree of coronary narrowings in coronary artery disease.

Abstract: This study evaluates the relation between body fat distribution and severity of coronary artery disease (CAD). The study sample comprised 33 patients with angiographically demonstrated CAD and 10 angiographically normal control subjects. Body fat distribution was estimated by computed tomography and degree of coronary narrowings by angiographic score. Body weight, body mass index and total and subcutaneous abdominal adipose tissue areas showed no statistical differences in the 2 groups; visceral abdominal adipose tissue area and the visceral to subcutaneous abdominal adipose tissue area ratio were significantly higher in patients with CAD (p < 0.05). There was a significant correlation between visceral fat and triglycerides, apoprotein B and sum of glucose and insulin during glucose oral tolerance test. Sum of insulin during glucose oral tolerance test, visceral abdominal adipose tissue area and visceral/subcutaneous abdominal adipose tissue area ratio correlated significantly with severity of CAD, as evaluated by coronary score in all subjects and in CAD patients alone. Stepwise multiple regression analysis using the coronary score as the dependent variable and anthropometric and metabolic parameters as independent variables shows that in all subjects and in CAD patients alone, visceral/subcutaneous abdominal adipose-tissue area ratio entered the regression first and the sum of insulin during glucose oral tolerance test second. The results suggest that visceral abdominal adipose tissue area and visceral to subcutaneous abdominal adipose tissue area ratio may be cardiovascular risk factors.

European guidelines on cardiovascular disease prevention in clinical practice (version 2012) : the fifth joint task force of the European society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts).

Abstract: Guidelines and Expert Consensus Documents summarize and evaluate all currently available evidence on a particular issue with the aim to assist physicians in selecting the best management strategies for a typical patient, suffering from a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic or therapeutic means. Guidelines are not substitutes for textbooks. The legal implications of medical guidelines have been discussed previously. A great number of Guidelines and Expert Consensus Documents have been issued in recent years by the European Society of Cardiology (ESC) as well as by other societies and organizations. Because of the impact on clinical practice, quality criteria for development of guidelines have been established in order to make all decisions transparent to the user. The recommendations for formulating and issuing ESC Guidelines and Expert Consensus Documents can be found on the ESC web site (http://www.escardio.org/knowledge/guidelines/rules). In brief, experts in the field are selected and undertake a comprehensive review of the published evidence for management and/or prevention of a given condition. A critical evaluation of diagnostic and therapeutic procedures is performed, including assessment of the risk–benefit ratio. Estimates of expected health outcomes for larger societies are included, where data exist. The level of evidence and the strength of recommendation of particular treatment options are weighed and graded according to predefined scales, as outlined in the tables below. The experts of the writing panels have provided disclosure statements of all relationships they may have which might be perceived as real or potential sources of conflicts of interest. These disclosure forms are kept on file at the European Heart House, headquarters of the ESC. Any changes in conflict of interest that arise during the writing period must be notified to the ESC. The Task Force report was entirely …

Subcutaneous and visceral adipose tissue : Their relation to the metabolic syndrome

Abstract: Methods for assessment, e.g., anthropometric indicators and imaging techniques, of several phenotypes of human obesity, with special reference to abdominal fat content, have been evaluated. The correlation of fat distribution with age, gender, total body fat, energy balance, adipose tissue lipoprotein lipase and lipolytic activity, adipose tissue receptors, and genetic characteristics are discussed. Several secreted or expressed factors in the adipocyte are evaluated in the context of fat tissue localization. The body fat distribution and the metabolic profile in nonobese and obese individuals is discussed relative to lipolysis, antilypolysis and lipogenesis, insulin sensitivity, and glucose, lipid, and protein metabolism. Finally, the endocrine regulation of abdominal visceral fat in comparison with the adipose tissue localized in other areas is presented.

Colonic health: fermentation and short chain fatty acids.

Abstract: Interest has been recently rekindled in short chain fatty acids (SCFAs) with the emergence of prebiotics and probiotics aimed at improving colonic and systemic health Dietary carbohydrates, specifically resistant starches and dietary fiber, are substrates for fermentation that produce SCFAs, primarily acetate, propionate, and butyrate, as end products The rate and amount of SCFA production depends on the species and amounts of microflora present in the colon, the substrate source and gut transit time SCFAs are readily absorbed Butyrate is the major energy source for colonocytes Propionate is largely taken up by the liver Acetate enters the peripheral circulation to be metabolized by peripheral tissues Specific SCFA may reduce the risk of developing gastrointestinal disorders, cancer, and cardiovascular disease Acetate is the principal SCFA in the colon, and after absorption it has been shown to increase cholesterol synthesis However, propionate, a gluconeogenerator, has been shown to inhibit cholesterol synthesis Therefore, substrates that can decrease the acetate: propionate ratio may reduce serum lipids and possibly cardiovascular disease risk Butyrate has been studied for its role in nourishing the colonic mucosa and in the prevention of cancer of the colon, by promoting cell differentiation, cell-cycle arrest and apoptosis of transformed colonocytes; inhibiting the enzyme histone deacetylase and decreasing the transformation of primary to secondary bile acids as a result of colonic acidification Therefore, a greater increase in SCFA production and potentially a greater delivery of SCFA, specifically butyrate, to the distal colon may result in a protective effect Butyrate irrigation (enema) has also been suggested in the treatment of colitis More human studies are now needed, especially, given the diverse nature of carbohydrate substrates and the SCFA patterns resulting from their fermentation Short-term and long-term human studies are particularly required on SCFAs in relation to markers of cancer risk These studies will be key to the success of dietary recommendations to maximize colonic disease prevention

Pathophysiology of Human Visceral Obesity: An Update

Abstract: Excess intra-abdominal adipose tissue accumulation, often termed visceral obesity, is part of a phenotype including dysfunctional subcutaneous adipose tissue expansion and ectopic triglyceride storage closely related to clustering cardiometabolic risk factors. Hypertriglyceridemia; increased free fatty acid availability; adipose tissue release of proinflammatory cytokines; liver insulin resistance and inflammation; increased liver VLDL synthesis and secretion; reduced clearance of triglyceride-rich lipoproteins; presence of small, dense LDL particles; and reduced HDL cholesterol levels are among the many metabolic alterations closely related to this condition. Age, gender, genetics, and ethnicity are broad etiological factors contributing to variation in visceral adipose tissue accumulation. Specific mechanisms responsible for proportionally increased visceral fat storage when facing positive energy balance and weight gain may involve sex hormones, local cortisol production in abdominal adipose tissues, endocannabinoids, growth hormone, and dietary fructose. Physiological characteristics of abdominal adipose tissues such as adipocyte size and number, lipolytic responsiveness, lipid storage capacity, and inflammatory cytokine production are significant correlates and even possible determinants of the increased cardiometabolic risk associated with visceral obesity. Thiazolidinediones, estrogen replacement in postmenopausal women, and testosterone replacement in androgen-deficient men have been shown to favorably modulate body fat distribution and cardiometabolic risk to various degrees. However, some of these therapies must now be considered in the context of their serious side effects. Lifestyle interventions leading to weight loss generally induce preferential mobilization of visceral fat. In clinical practice, measuring waist circumference in addition to the body mass index could be helpful for the identification and management of a subgroup of overweight or obese patients at high cardiometabolic risk.