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Mo1325 Analysis of Insulin Resistance, Body Composition, and Fat Distribution in Obese Children With Nonalcoholic Fatty Liver Disease
AGA Abstracts
A randomized double-blind controlled trial in obese men and women aged ≥30 yrs and a BMI of 27-40 kg/m2 were randomly assigned to 500 calorie deficit, iso-caloric very high protein diet(VHPD), high protein diet (HPD) or standard protein (SPD) diets (1.4 vs 1 vs 0.5 gm protein/lb lean body mass respectively). Body composition was analyzed by bioelectrical impedance at baseline and pre-specified follow up intervals. Satiety was measured by visual analogue scale and 3 day food questionnaires. Sprague-Dawley rats were fed ad libitum on high fat diet (HFD) for 10 weeks at which time half of them were switched to high protein diet (HPD) for 6 weeks. Control rats remained on normal diet (ND). Their food intake was measured daily and body composition was analyzed using nuclear magnetic resonance imaging at weekly intervals. All rats were euthanized at 6 weeks of the experimental period and their mesenteric and epididymal adipose tissue was quantified. Results: Interim analysis includes 18, 8, and 6 patients enrolled respectively in the SPD, HPD and VHPD. The mean follow up time was 5 months. The average percent total weight loss achieved in the HPD group was significantly higher than SPD and VHPD (7.2% vs 0.95%, and 1.2% respectively). Similar results were observed in the loss of percent body fat (2.6% vs 0.86% and 0.7% respectively) and gain in percent lean body mass (4.2% vs 0.9 and 0.4%). Satiety index scores showed a reduction in appetite with HPD compared with the VHPD or SPD. In accordance with human study, significant reduction in fat mass was seen in both diet induced obese (DIO/responders) and non-obese (non-responders) rats after switching to HPD at 10 weeks (Table). Significant reduction in mesenteric and epididymal fat was also seen in rats on HPD (Figure). Food intake in rats only decreased for one day after switching to HPD. Conclusions: These interim results in humans and the completed results in rats indicate that a high protein replacement diet results in a significant reduction of appetite, and results in a reduction in BMI and a preferential reduction in visceral adiposity. This suggests that this is an important strategy for treating metabolic syndrome and non-alcoholic steatohepatitis (NASH). Long term outcomes of the trial are awaited which may help establish the underlying mechanisms. Percentage change in body composition of rats at 6 weeks after switching to HPD from HFD
(*: p<0.05 vs HFD in respective phenotype; #: p<0.05 vs HPD in DIO rats; n=5-6/group) Mo1325 Analysis of Insulin Resistance, Body Composition, and Fat Distribution in Obese Children With Nonalcoholic Fatty Liver Disease Eunjae Chang, Hye Ran Yang Objectives: With the recent increase in the prevalence of pediatric obesity, nonalcoholic fatty liver disease (NAFLD) has become a major childhood health-related issue.The aim of this study was to evaluate the influence of body composition, especially the distribution of body fat, and insulin resistance, along with demographic, anthropometric, and biochemical factors on the development of NAFLD in obese children and adolescents. Methods: One hundred obese children (66 boys, 34 girls) with (n = 60) and without NAFLD (n = 40) were assessed. Anthropometry, laboratory tests, abdominal ultrasonography, and dual energy x-ray absorptiometry (DXA) were evaluated in all subjects. Results: Subject age and measurements of liver enzymes, γ-glutamyl transpeptidase (γGT), uric acid, high-density lipoprotein cholesterol, and insulin resistance were significantly different between the non-NAFLD group and NAFLD group. Body fat and trunk fat percentage were significantly different between the two groups (P < 0.001 and P = 0.003), whereas extremity fat percentage was not (P = 0.683). Insulin resistance correlated significantly with body fat and trunk fat percentages, age, liver enzymes, γGT, and uric acid in obese children. Multiple logistic regression analysis indicated that insulin resistance and trunk fat percentage significantly affected the development of NAFLD in obese children. Conclusions: Body fat, especially abdominal fat, influences the development of insulin resistance and subsequent NAFLD in obese children. Therefore, body composition measurement using DXA, in conjunction with biochemical tests, may be beneficial in evaluating obese children with NAFLD.
Fat tissue weights of rats at 6 weeks after switching to HPD from HFD Mo1324 Body Mass Index Association With Functional Gastrointestinal Disorders. Differences Between Genders Michel Bouchoucha, Marinos Fysekidis, Gheorges Airinei, Cyriaque Bon, Jean-marc Catheline, Regis Cohen, Robert Benamouzig Objective: Obesity is considered as a risk factor for many functional gastrointestinal disorders (FGIDs). The aim of the present study was to evaluate if FGIDs are associated with specific BMI groups according to gender. Design: prospective study Methods: 1074 FGID patients have filled a standard questionnaire for FGIDs according to the Rome III criteria. They were assigned to five groups according to their BMI: Underweight, Normal, Overweight, Obese, and Morbidly Obese. Data analysis was performed using multinomial logistic regression. Results: FGID patients presented specific demographic and clinical characteristics according to the BMI groups. Patients with normal BMI being the reference group. * Underweight FGID patients were younger (P<0.001), presented a female predominance (P=0.006), a high prevalence of dysphagia (P=0.013) and soiling (P=0.021). * Overweight patients were older (P=0.001), reported more frequently globus (P=0.001), regurgitation (P=0.004), postprandial distress syndrome (P=0.009). * Obese patients reported more frequently regurgitation (P<0.001). * Morbid obese patients reported dyspepsia (P=0.046). In FGID patients, the odds of regurgitation increased with BMI from underweight to obesity, but not to morbid obesity. The probability of globus and regurgitation increased with BMI, showed a steeper increase in females. Conclusion: In FGID patients, globus and regurgitation are associated to BMI, mainly in female patients.
AGA Abstracts
Mo1326 Increased Risk of Functional Gastrointestinal Disorders (FGIDs) in Obesity Patients Christian Avila, María Inés Pinto Sanchez, Alexander C. Ford, Elena F. Verdu, Paul Moayyedi, Margaret Hahn, Valerie H. Taylor, Premysl Bercik Background: Functional gastrointestinal disorders (FGIDs) are common clinical conditions of unknown etiology. Around 30% of North American adults are obese. Although some reports have suggested that obesity may be more prevalent in FGIDs, the data on adult patients are scarce and contradictory.Thus our objective was to evaluate the association between obesity and different FGID and to determine the factors contributing to this association. Methods: Observational study conducted between January 2008 and January 2013. New patients referred to the Gastroenterology outpatient clinic at McMaster University completed questionnaires evaluating FGIDs (Rome III) and their basic demographic data were collected. A chart review was then performed in a random sample of the total population to collect further clinical and demographic data, and to rule out organic diseases. Continuous variables were expressed as Mean ±SD and categorical variables as percentages. χ2, and logistic regression analyses were performed and adjusted by age, gender, lifestyle habits, psychiatric medication and mood. Results: Overall, 2400 patients were included in the analysis. 82% of patients fulfilled the Rome III criteria for FGIDs but only 57% were diagnosed with FGIDs after organic diseases were ruled out. Overall, 60% of all the patients were overweight or obese (BMI ≥25 and ≥30, respectively). Compared to patients who did not meet the Rome III criteria for FGIDs, a significantly increased risk for overweight and obesity (aOR 2.36; 95% CI 1.83 to 3.85) was observed in patients with FGIDs.The highest
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A randomized double-blind controlled trial in obese men and women aged ≥30 yrs and a BMI of 27-40 kg/m2 were randomly assigned to 500 calorie deficit, iso-caloric very high protein diet(VHPD), high protein diet (HPD) or standard protein (SPD) diets (1.4 vs 1 vs 0.5 gm protein/lb lean body mass respectively). Body composition was analyzed by bioelectrical impedance at baseline and pre-specified follow up intervals. Satiety was measured by visual analogue scale and 3 day food questionnaires. Sprague-Dawley rats were fed ad libitum on high fat diet (HFD) for 10 weeks at which time half of them were switched to high protein diet (HPD) for 6 weeks. Control rats remained on normal diet (ND). Their food intake was measured daily and body composition was analyzed using nuclear magnetic resonance imaging at weekly intervals. All rats were euthanized at 6 weeks of the experimental period and their mesenteric and epididymal adipose tissue was quantified. Results: Interim analysis includes 18, 8, and 6 patients enrolled respectively in the SPD, HPD and VHPD. The mean follow up time was 5 months. The average percent total weight loss achieved in the HPD group was significantly higher than SPD and VHPD (7.2% vs 0.95%, and 1.2% respectively). Similar results were observed in the loss of percent body fat (2.6% vs 0.86% and 0.7% respectively) and gain in percent lean body mass (4.2% vs 0.9 and 0.4%). Satiety index scores showed a reduction in appetite with HPD compared with the VHPD or SPD. In accordance with human study, significant reduction in fat mass was seen in both diet induced obese (DIO/responders) and non-obese (non-responders) rats after switching to HPD at 10 weeks (Table). Significant reduction in mesenteric and epididymal fat was also seen in rats on HPD (Figure). Food intake in rats only decreased for one day after switching to HPD. Conclusions: These interim results in humans and the completed results in rats indicate that a high protein replacement diet results in a significant reduction of appetite, and results in a reduction in BMI and a preferential reduction in visceral adiposity. This suggests that this is an important strategy for treating metabolic syndrome and non-alcoholic steatohepatitis (NASH). Long term outcomes of the trial are awaited which may help establish the underlying mechanisms. Percentage change in body composition of rats at 6 weeks after switching to HPD from HFD
(*: p<0.05 vs HFD in respective phenotype; #: p<0.05 vs HPD in DIO rats; n=5-6/group) Mo1325 Analysis of Insulin Resistance, Body Composition, and Fat Distribution in Obese Children With Nonalcoholic Fatty Liver Disease Eunjae Chang, Hye Ran Yang Objectives: With the recent increase in the prevalence of pediatric obesity, nonalcoholic fatty liver disease (NAFLD) has become a major childhood health-related issue.The aim of this study was to evaluate the influence of body composition, especially the distribution of body fat, and insulin resistance, along with demographic, anthropometric, and biochemical factors on the development of NAFLD in obese children and adolescents. Methods: One hundred obese children (66 boys, 34 girls) with (n = 60) and without NAFLD (n = 40) were assessed. Anthropometry, laboratory tests, abdominal ultrasonography, and dual energy x-ray absorptiometry (DXA) were evaluated in all subjects. Results: Subject age and measurements of liver enzymes, γ-glutamyl transpeptidase (γGT), uric acid, high-density lipoprotein cholesterol, and insulin resistance were significantly different between the non-NAFLD group and NAFLD group. Body fat and trunk fat percentage were significantly different between the two groups (P < 0.001 and P = 0.003), whereas extremity fat percentage was not (P = 0.683). Insulin resistance correlated significantly with body fat and trunk fat percentages, age, liver enzymes, γGT, and uric acid in obese children. Multiple logistic regression analysis indicated that insulin resistance and trunk fat percentage significantly affected the development of NAFLD in obese children. Conclusions: Body fat, especially abdominal fat, influences the development of insulin resistance and subsequent NAFLD in obese children. Therefore, body composition measurement using DXA, in conjunction with biochemical tests, may be beneficial in evaluating obese children with NAFLD.
Fat tissue weights of rats at 6 weeks after switching to HPD from HFD Mo1324 Body Mass Index Association With Functional Gastrointestinal Disorders. Differences Between Genders Michel Bouchoucha, Marinos Fysekidis, Gheorges Airinei, Cyriaque Bon, Jean-marc Catheline, Regis Cohen, Robert Benamouzig Objective: Obesity is considered as a risk factor for many functional gastrointestinal disorders (FGIDs). The aim of the present study was to evaluate if FGIDs are associated with specific BMI groups according to gender. Design: prospective study Methods: 1074 FGID patients have filled a standard questionnaire for FGIDs according to the Rome III criteria. They were assigned to five groups according to their BMI: Underweight, Normal, Overweight, Obese, and Morbidly Obese. Data analysis was performed using multinomial logistic regression. Results: FGID patients presented specific demographic and clinical characteristics according to the BMI groups. Patients with normal BMI being the reference group. * Underweight FGID patients were younger (P<0.001), presented a female predominance (P=0.006), a high prevalence of dysphagia (P=0.013) and soiling (P=0.021). * Overweight patients were older (P=0.001), reported more frequently globus (P=0.001), regurgitation (P=0.004), postprandial distress syndrome (P=0.009). * Obese patients reported more frequently regurgitation (P<0.001). * Morbid obese patients reported dyspepsia (P=0.046). In FGID patients, the odds of regurgitation increased with BMI from underweight to obesity, but not to morbid obesity. The probability of globus and regurgitation increased with BMI, showed a steeper increase in females. Conclusion: In FGID patients, globus and regurgitation are associated to BMI, mainly in female patients.
AGA Abstracts
Mo1326 Increased Risk of Functional Gastrointestinal Disorders (FGIDs) in Obesity Patients Christian Avila, María Inés Pinto Sanchez, Alexander C. Ford, Elena F. Verdu, Paul Moayyedi, Margaret Hahn, Valerie H. Taylor, Premysl Bercik Background: Functional gastrointestinal disorders (FGIDs) are common clinical conditions of unknown etiology. Around 30% of North American adults are obese. Although some reports have suggested that obesity may be more prevalent in FGIDs, the data on adult patients are scarce and contradictory.Thus our objective was to evaluate the association between obesity and different FGID and to determine the factors contributing to this association. Methods: Observational study conducted between January 2008 and January 2013. New patients referred to the Gastroenterology outpatient clinic at McMaster University completed questionnaires evaluating FGIDs (Rome III) and their basic demographic data were collected. A chart review was then performed in a random sample of the total population to collect further clinical and demographic data, and to rule out organic diseases. Continuous variables were expressed as Mean ±SD and categorical variables as percentages. χ2, and logistic regression analyses were performed and adjusted by age, gender, lifestyle habits, psychiatric medication and mood. Results: Overall, 2400 patients were included in the analysis. 82% of patients fulfilled the Rome III criteria for FGIDs but only 57% were diagnosed with FGIDs after organic diseases were ruled out. Overall, 60% of all the patients were overweight or obese (BMI ≥25 and ≥30, respectively). Compared to patients who did not meet the Rome III criteria for FGIDs, a significantly increased risk for overweight and obesity (aOR 2.36; 95% CI 1.83 to 3.85) was observed in patients with FGIDs.The highest
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