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Ectopic Fat: Clinical Implications in Obesity and Type 2 Diabetes
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Ectopic Fat: Clinical Implications in Obesity and Type 2 Diabetes

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Endocrinology & Metabolism".

Deadline for manuscript submissions: closed (30 September 2022) | Viewed by 7818

Special Issue Editors

Dr. Andreea Ciudin

E-Mail Website
Guest Editor
Morbid Obesity Unit Coordinator, Endocrinology and Nutrition Department, Vall Hebron Research Institut-VHIR, Vall Hebron University Hospital, Universitat Autonoma de Barcelona, CIBERDEM, 08193 Barcelona, Spain
Interests: complications of type 2 diabetes; neurodegeneration and cognitive impairment; obesity and insulin resistance
Special Issues, Collections and Topics in MDPI journals
Dr. Juan M. Pericàs

E-Mail Website
Guest Editor
Liver Unit, Internal Medicine Department, Vall d'Hebron University Hospital, Vall d’Hebron Institute for Research (VHIR), 08035 Barcelona, Spain
Interests: NASH; liver disease; infectious disease; public health; platform trials

Special Issue Information

Dear Colleagues, 

At present, the prevalence of both obesity and type 2 diabetes (T2D) has reached pandemic levels worldwide, coexisting in many cases in the form of Diabesity. Adipose tissue is a recognized endocrine organ that acts not only as fuel storage but also by secreting various hormones and cytokines with effects on glucose, lipid metabolism, and energy homeostasis. T2D and obesity are linked by various pathophysiological mechanisms, such as adipose tissue dysfunction and insulin resistance. Adipose tissue dysfunction is characterized by large adipocytes and secretion of adipokines with a proinflammatory profile, ultimately leading to ectopic fat deposition in organs such as the liver, skeletal muscle, heart, and pancreas. Ectopic fat can interfere with cellular functions and, hence, organ function. The clinical consequences of ectopic fat accumulation depend on the specific organ, increasing the risk of developing metabolic and cardiovascular diseases.

We invite investigators to contribute with either original research or review articles focusing on the molecular mechanisms and clinical implications of ectopic fat in obesity and T2D, as well as potential therapeutic approaches.

Dr. Andreea Ciudin
Dr. Juan M. Pericàs
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Obesity
  • Type 2 diabetes
  • Ectopic fat
  • Insulin resistance

Published Papers (4 papers)

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Research

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9 pages, 963 KiB  
Article
Obesity Surgery Improves Hypogonadism and Sexual Function in Men without Effects in Sperm Quality
by Inka Miñambres, Helena Sardà, Eulalia Urgell, Idoia Genua, Analía Ramos, Sonia Fernández-Ananin, Carmen Balagué, Jose Luis Sánchez-Quesada, Lluís Bassas and Antonio Pérez
J. Clin. Med. 2022, 11(17), 5126; https://doi.org/10.3390/jcm11175126 - 31 Aug 2022
Cited by 6 | Viewed by 1709
Abstract
(1) Background: Obesity is associated with hypogonadism, sexual dysfunction, and impaired fertility in men. However, its effects on semen parameters or sexual function remain debatable. (2) Methods: This paper involves a longitudinal study in men submitted for obesity surgery at a university tertiary [...] Read more.
(1) Background: Obesity is associated with hypogonadism, sexual dysfunction, and impaired fertility in men. However, its effects on semen parameters or sexual function remain debatable. (2) Methods: This paper involves a longitudinal study in men submitted for obesity surgery at a university tertiary hospital. Patients were studied at baseline and at 6, 12, and 18 months after obesity surgery. At each visit, anthropometry measures were collected and hormonal and semen parameters were studied. Sexual function was evaluated with the International Index of Erectile Function (IIEF). (3) Results: A total of 12 patients were included. The average body mass index of patients decreased from 42.37 ± 4.44 to 29.6 ± 3.77 kg/m2 at 18 months after surgery (p < 0.05). Hormonal parameters improved after obesity surgery. The proportion of sperm cells with normal morphology tended to decrease from baseline and became most significant at 18 months (5.83 ± 4.50 vs. 2.82 ± 2.08). No significant changes were found in the remaining semen parameters. Erectile function improved significantly at six months after surgery. (4) Conclusions: The authors believe that, in general, the effects of obesity surgery on fertility may be limited or even deleterious (at least in the short and midterm follow-up). Full article
(This article belongs to the Special Issue Ectopic Fat: Clinical Implications in Obesity and Type 2 Diabetes)
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10 pages, 1024 KiB  
Article
Usefulness of Muscle Ultrasound to Study Sarcopenic Obesity: A Pilot Case-Control Study
by Andreu Simó-Servat, Montse Ibarra, Mireia Libran, Silvia Rodríguez, Verónica Perea, Carmen Quirós, Aida Orois, Noelia Pérez, Rafael Simó and Maria-José Barahona
J. Clin. Med. 2022, 11(10), 2886; https://doi.org/10.3390/jcm11102886 - 19 May 2022
Cited by 5 | Viewed by 2102
Abstract
Background and objectives: Sarcopenic obesity (SO) is an emerging problem, especially in candidates for bariatric surgery (BS). We hypothesized that musculoskeletal ultrasound (MUS), a simple and accessible method, could be a reliable index of SO. Materials and Methods: A cross-sectional pilot study including [...] Read more.
Background and objectives: Sarcopenic obesity (SO) is an emerging problem, especially in candidates for bariatric surgery (BS). We hypothesized that musculoskeletal ultrasound (MUS), a simple and accessible method, could be a reliable index of SO. Materials and Methods: A cross-sectional pilot study including 122 subjects (90 cases and 32 controls, 73% female, mean age: 51.2 years) who underwent BS was conducted at University Hospital Mútua Terrassa. The lean mass (LM) was calculated by bioelectrical impedance analysis (BIA) and the thigh muscle thickness (TMT) by MUS. To identify the subjects with SO by BIA, we used skeletal muscle index (SMI). The validity of MUS was determined using the ROC curve. Results: The mean BMI in the obesity group was 44.22 kg/m2. We observed a correlation between the LM and SMI assessed by BIA and the TMT assessed by MUS (R = 0.46, p < 0.001). This correlation was maintained at significant levels in the SO group (n = 40): R = 0.79; p = 0.003). The TMT assessed by MUS was able to predict SMI using BIA (AUC 0.77; 95% CI: 0.68242 to 0.84281). The optimal cut-off point for maximum efficiency was 1.57 cm in TMT (sensitivity = 75.6% and specificity = 71.1%). Conclusions: The TMT of the quadriceps assessed by US is a useful tool for identifying subjects with SO. Larger studies to validate this simple low-cost screening strategy are warranted. Full article
(This article belongs to the Special Issue Ectopic Fat: Clinical Implications in Obesity and Type 2 Diabetes)
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13 pages, 1749 KiB  
Article
Obesity and Risk of Diabetes Mellitus by Menopausal Status: A Nationwide Cohort Study
by Han Rim Lee, Jungeun Shin, Kyungdo Han, Jiwon Chang, Su-Min Jeong, Seung Joo Chon, Soo Jung Choi and Dong Wook Shin
J. Clin. Med. 2021, 10(21), 5189; https://doi.org/10.3390/jcm10215189 - 06 Nov 2021
Cited by 3 | Viewed by 2165
Abstract
Although both obesity and menopause are associated with increased risk of diabetes mellitus (DM), the association between obesity and DM according to menopausal status remains uncertain. Therefore, we conducted a study to examine the relationship between obesity and incidence of diabetes mellitus (DM) [...] Read more.
Although both obesity and menopause are associated with increased risk of diabetes mellitus (DM), the association between obesity and DM according to menopausal status remains uncertain. Therefore, we conducted a study to examine the relationship between obesity and incidence of diabetes mellitus (DM) in premenopausal and postmenopausal women. Total of 926,196 premenopausal and 1,193,881 postmenopausal women who underwent health examinations from 2009 to 2014 were identified using the database of the Korean National Health Insurance Service. We compared the incidence and risk of DM according to body mass index (BMI) and waist circumference (WC) in the two groups of women. Cox proportional hazards analyses were performed to evaluate the association between the presence of obesity and risk of DM according to menopausal state. During the 7.8-year follow-up period, 37,736 (4.1%) premenopausal women and 121,102 (10.1%) postmenopausal women were diagnosed with DM. Compared to the reference group (BMI 18.5–23), a stronger association between obesity and risk of DM was observed in both pre- and postmenopausal women: multivariable-adjusted hazard ratios and 95% confidence intervals for BMI subgroups <18.5, 23–25, 25–30, and >30 were 0.62 (0.54, 0.70), 1.91 (1.85, 1.97), 3.38 (3.28, 3.47), and 6.25 (6.02, 6.48), respectively (p trend < 0.001) in premenopausal women and 0.87 (0.82, 0.92), 1.44 (1.41, 1.46), 2.00 (1.97, 2.03), and 2.96 (2.89, 3.02) in postmenopausal women (p trend < 0.001, p-interaction < 0.001). A similar trend was observed for WC. Subgroup analyses of women aged 45 to 55 also showed a stronger association with DM in premenopausal than in postmenopausal women. In conclusion, the association between obesity and DM was stronger in premenopausal women than in postmenopausal women. As estrogens are synthesized in adipose tissue by aromatization of androgens after menopause, increased estrogen levels in obese postmenopausal might have a protective effect against DM. Full article
(This article belongs to the Special Issue Ectopic Fat: Clinical Implications in Obesity and Type 2 Diabetes)
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Review

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21 pages, 1061 KiB  
Review
When Sugar Reaches the Liver: Phenotypes of Patients with Diabetes and NAFLD
by Alba Rojano-Toimil, Jesús Rivera-Esteban, Ramiro Manzano-Nuñez, Juan Bañares, David Martinez Selva, Pablo Gabriel-Medina, Roser Ferrer, Juan M Pericàs and Andreea Ciudin
J. Clin. Med. 2022, 11(12), 3286; https://doi.org/10.3390/jcm11123286 - 08 Jun 2022
Cited by 9 | Viewed by 3109
Abstract
Type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) have been traditionally linked to one another. Recent studies suggest that NAFLD may be increasingly common in other types of diabetes such as type 1 diabetes (T1DM) and less frequently ketone-prone and [...] Read more.
Type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) have been traditionally linked to one another. Recent studies suggest that NAFLD may be increasingly common in other types of diabetes such as type 1 diabetes (T1DM) and less frequently ketone-prone and Maturity-onset Diabetes of the Young (MODY) diabetes. In this review, we address the relationship between hyperglycemia and insulin resistance and the onset and progression of NAFLD. In addition, despite the high rate of patients with T2DM and other diabetes phenotypes that can alter liver metabolism and consequently develop steatosis, fibrosis, and cirrhosis, NALFD screening is not still implemented in the daily care routine. Incorporating a clinical algorithm created around a simple, non-invasive, cost-effective model would identify high-risk patients. The principle behind managing these patients is to improve insulin resistance and hyperglycemia states with lifestyle changes, weight loss, and new drug therapies. Full article
(This article belongs to the Special Issue Ectopic Fat: Clinical Implications in Obesity and Type 2 Diabetes)
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