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PubMed2003

Development of centrality indices of subcutaneous fat during growth.

Changes of fat distribution were followed up in Czech and Slovak children from 1.5 to 15 years of age, using centrality indices, which relate the values of skinfolds on the trunk to the skinfolds on the extremities, head and neck. Up to 5 years of age, subcutaneous fat was deposited relatively more on the extremities, head and neck than on the trunk, which was expressed by lower values of the centrality indices. After the age of 5 years, the accumulation of subcutaneous fat was greater on the trunk, which was also expressed by higher values of the centrality indices. The comparison of the individual indices revealed in both genders a relatively higher amount of subcutaneous fat on the trunk in boys until 12 years of age. During puberty subcutaneous fat over triceps and on the forearm was reduced. In girls the deposition of the subcutaneous fat was relatively greater at different sites of the trunk than in boys, with the exception of the age of 14-15 years. The deposition of subcutaneous fat was greater on the trunk than on the head (cheek) and on the extremities in Czech compared to Slovak children, except for 12-year-old girls. During the period between the fifties and the seventies of the last century, in Czech children, especially in girls, the deposition of subcutaneous fat on the trunk was relatively smaller than on other parts of the body surface, which was expressed by the reduction of the centrality indices. Index 12 was therefore considered as the most valuable for the characterization of fat distribution on the body surface.

Adipose Tissue↗

PubMed2000

[Subcutaneous fat necrosis of the newborn with hypercalcemia].

INTRODUCTION: Hypercalcemia associated with subcutaneous fat necrosis of the newborn is a well known but rare event. CASE REPORT: A newborn with a history of cesarean section, fetomaternal infection, neurological and respiratory distress was admitted with anorexia, adynamia, vomiting, polyuria and polydipsia at the age of 37 days. Physical examination showed red and violaceous infiltrated skin lesions. Skin biopsy revealed focal areas of fat necrosis with crystal-like structures. Calcium and 1,25 (OH(2) ) vitamin D serum levels were increased. Diagnostic of subcutaneous fat necrosis of the newborn with symptomatic hypercalcemia was made. Evolution was favorable after treatment including furosemide, prednisone and a diet low in calcium and vitamin D. DISCUSSION: Hypercalcemia must be detected in infants with subcutaneous fat necrosis. This major complication may have fatal outcome. Treatment of hypercalcemia includes dietary changes associated with classic treatment of hypercalcemia. Routine evaluation of serum calcium level is essential.

Fat Necrosis↗

PubMed1996

Body size and subcutaneous fat patterning in adolescence.

Factors that influence low birth weight at term may also be associated with subcutaneous fat patterning in later life. This hypothesis was investigated in a comparative (retrospective) cohort study. The subjects, born in Cardiff between 1975 and 1977, were of mean age 15.7 years. Cases (low birth weight (< 2500 g) at term) were matched with controls (normal birth weight (3000-3800 g) at term) for sex, parity, place of birth, date of birth, and gestation. Subscapular skinfold (an index of central subcutaneous fat) and triceps skinfold (an index of peripheral subcutaneous fat) were measured using a Holtain skinfold caliper. The differences (cases minus controls) (95% confidence interval) for subscapular and triceps skinfolds were respectively -0.3 mm (-1.74 to 1.14) and -0.48 mm (-1.75 to 0.79). These findings are inconsistent with the hypothesis that low birth weight at term is associated with subcutaneous fat patterning in adolescence.

Adipose Tissue↗

PubMed1999

Subcutaneous fat in the fetal abdomen as a predictor of growth restriction.

OBJECTIVE: To determine if measuring fetal abdominal fat antenatally using ultrasound can predict fetal growth restriction (FGR). METHODS: One hundred thirty-seven unselected women with singleton pregnancies had serial ultrasound scans at 20, 26, 31, and 38 weeks' gestation. Subcutaneous fat in the fetal abdomen was measured using the same section as the abdominal circumference (AC). Outcome measures were birth weight, neonatal morbidity, and ponderal index. RESULTS: Infants with subcutaneous fat less than 5 mm at 38 weeks (n = 51) were almost five times more likely to have a birth weight below the 10th centile than those with subcutaneous fat of 5 mm or more (n = 75). The incidence of neonatal morbidity was significantly higher in infants with subcutaneous fat less than 5 mm, compared with those with subcutaneous fat of 5 mm or more (20% versus 8%, P < .05). Decreased subcutaneous fat was also associated with a high prevalence of low ponderal index, regardless of birth weight category. CONCLUSION: Measurement of fat in the abdominal wall is a simple technique with a sensitivity for predicting low birth weight similar to that of conventional sonography and might potentially predict FGR irrespective of fetal weight.

Abdomen↗

PubMed1991

Precooling prevents overheating of subcutaneous fat in the use of RF capacitive heating.

The usefulness of precooling subcutaneous tissue in the hyperthermic treatment of deep-seated human tumors with capacitive application of radio-frequency (RF) was investigated. A capacitive hyperthermia unit operated at 8 MHz of radiofrequency was used to heat deep-seated human tumors. The electrode surfaces were covered with flexible vinyl sheets and the space between the electrode and the vinyl sheets perfused with 0.4% saline. The temperature of the saline was controlled by circulating the saline through built-in heat exchangers. The depth of heating was controlled by pairing electrodes of different diameters. When subcutaneous fat was less than 1 cm thick, various deep-seated tumors could be heated to a therapeutic temperature without significant discomfort in the subcutaneous tissue as long as the skin was properly cooled with the cold saline bolus. However, the same cooling method could not prevent the occurrence of pain in subcutaneous tissue in obese patients. The pain usually developed when the temperature of subcutaneous fat 1-2 cm below the skin surface exceeded 42 degrees C. We observed that cooling the human skin surface with 10 degrees C bolus for 20 min could substantially lower the temperature of fat as deep as 2.0-2.5 cm. Therefore, when the subcutaneous tissue was precooled with 10 degrees C saline for 20 min or longer before heating, it was possible to prevent successfully the overheating of subcutaneous fat as thick as 2.0-2.5 cm and to raise the temperature of deep-seated tumors to therapeutic levels.

Adipose Tissue↗

PubMed2003

Changes in abdominal subcutaneous fat water content with rapid weight loss and long-term weight maintenance in abdominally obese men and women.

OBJECTIVE: Insulin resistance decreases blood flow and volume in fat tissue. We hypothesised that fat tissue nutritive blood flow and volume, and thereby water content, would increase during weight loss and weight maintenance in obese persons. DESIGN: Longitudinal clinical intervention with a 9-week very-low-calorie diet (VLCD) followed by one year of weight maintenance. SUBJECTS: Obese men (n=13) and women (n=14) with the metabolic syndrome. MEASUREMENTS: Water content of abdominal subcutaneous fat tissue as estimated by a sensor on the skin surface measuring the dielectric constant at 300 MHz. Anthropometric measures of fatness and fat distribution. Biochemical measures related to insulin resistance. RESULTS: Subjects lost 14.5+/-3.4% of body weight during the VLCD, and generally sustained this weight loss during weight maintenance. Insulin sensitivity as estimated by an index (qualitative insulin sensitivity check index) increased during the VLCD, and remained increased throughout weight maintenance. The dielectric constant increased from 23.3+/-2.3 to 25.0+/-2.1 (P<0.001) during the VLCD, and further to 27.8+/-1.9 (P<0.001) during weight maintenance, indicating an increase in the water content of subcutaneous fat. The increase in subcutaneous fat water content did not correlate with weight loss and other measures of adiposity during the VLCD, but there was an inverse correlation that strengthened in significance from baseline to 6, 9 and 12 mo (r=-0.32 to -0.64, P=0.079-0.002). Increases in subcutaneous fat water content also correlated with improvements in insulin sensitivity at 6, 9 and 12 months of weight maintenance (r=0.34-0.54, P=0.094-0.006). CONCLUSIONS: Water content of abdominal subcutaneous adipose tissue increases with weight loss in obese persons with the metabolic syndrome, and may reflect increased subcutaneous fat tissue nutritive blood flow. The increase in water content correlates with the increase in insulin sensitivity, suggesting that weight loss and consequent improved insulin sensitivity could mediate the increase in abdominal subcutaneous fat hydration.

Abdomen↗

PubMed2006

Subcutaneous management of vertical incisions with 3 or more centimeters of subcutaneous fat.

OBJECTIVE: This study was undertaken to determine the most appropriate management of the subcutaneous tissue of midline vertical incisions with 3 cm or more of subcutaneous fat. STUDY DESIGN: Patients undergoing surgery within the Division of Gynecologic Oncology at University of South Florida and East Tennessee State University with 3 cm or more of subcutaneous fat were randomly assigned to 1 of 3 groups: suture approximation of Camper's fascia, closed suction drainage of the subcutaneous space, or no intervention as a control group. Participants were evaluated daily during postoperative hospitalization and at 2 and 6 weeks postoperatively as an outpatient. Demographic information, perioperative data, and wound complications were recorded and then analyzed with chi2, t test, analysis of variance, and logistic regression where appropriate. RESULTS: Two hundred twenty-five patients were enrolled with 222 eligible for evaluation. Wound complications were observed in 34 (15.3%) patients, and 25 of these women also had wound disruption. Overall wound complication and wound disruption rates were not significantly different between groups: suture (12.8%, 7.7%), drain (17.9%, 14.9%), control (15.6%, 11.7%); P = .70 and P = .39, respectively. CONCLUSION: Suture approximation or drainage of the subcutaneous tissues of women with 3 cm or more subcutaneous fat measured in midline vertical incisions resulted in no significant change in the incidence of overall wound complications or superficial wound disruption.

Antibiotic Prophylaxis↗

PubMedDate not supplied

Subcutaneous fat necrosis of the newborn: a case presentation.

Subcutaneous fat necrosis is normally a self-limiting condition. A complication of subcutaneous fat necrosis is hypercalcemia. If the infant is discharged from the hospital before the lesions are healed, the family should be instructed to monitor the infant for the signs and symptoms of hypercalcemia. The parents need to understand the importance of keeping follow-up appointments to monitor the calcium levels. It is important to reassure the family that the lesions will disappear with time. They need to be instructed to leave the lesions alone. The lesions should not be punctured, nor should the family apply hot or cold compresses to the sites. The family should be cautioned against exposing the baby to sunlight to lower endogenous vitamin D production.

Cesarean Section↗

PubMed2000

Ultrasonic assessment of variations in thickness of subcutaneous fat during the normal menstrual cycle.

OBJECTIVE: To verify the occurrence of natural variations in thigh and abdominal subcutaneous fat thickness related to the phases of the menstrual cycle, to assess the value of ultrasonography as a reliable method for monitoring subcutaneous fat thickness changes and to evaluate their amplitudes. METHODS: This study included 10 women (19-39 years) who menstruated regularly. None had used oral contraceptives or slimming products during the 3 months prior to the study. At cycle day 2 (CD2), CD6, CD14, CD22, CD27 and CD30 days (CD0: beginning of menstruation), the subjects were submitted to: (1) measurement of weight and thigh perimeters, (2) measurements of thigh and abdomen subcutaneous fatty tissue thickness on B-mode images acquired at 10 MHz. A protocol was designed to guarantee a reproducible repositioning during the whole time course of the study and ultrasound examinations (US) were always performed by the same trained person to avoid inter-examiner variability. RESULTS: Subcutaneous fat thicknesses decreased during the first half of the cycle and reached their lowest values at day 22 (-2.0% for the thighs; -3.3% for the abdominal region). Both thigh and abdomen subcutaneous fat reached their maximum thicknesses during menstruation with respective increases of +2.2 and +4.0%. The observed cyclic amplitude variations in the subcutaneous adipose tissue thickness accounted for 7.3% for the abdominal region and 4.1% for the thighs. CONCLUSION: Variations in adipose tissue thickness during the menstrual cycle could be quantified and monitored by US. The thickness of the thigh and abdominal hypodermis was more important during menstruation and decreased in mid-cycle with a minimum occurring 1 week after ovulation.

Abdominal Muscles↗

PubMed1975

Subcutaneous fat necrosis associated with pancreatic disease.

Subcutaneous fat necrosis, a type of panniculitis, is a rare entity that is manifested by painless or painful subcutaneous nodules on the legs, buttocks, or trunk and is associated with pancreatitis or carcinoma of the pancreas, either of which may be asymptomatic. The histopathological findings are pathognomonic and consist of subcutaneous focal fat necrosis and "ghost-like" cells with thick, shadowy walls and no nuclei. Arthritis, particularly of the ankles, is a commonly associated finding. Distant foci of fat necrosis in pancreatic disease are probably due to the local action of hematogenous-borne trypsin and lipase. Since the underlying pancreatic disease may be asymptomatic, histopathologic study of all cases of panniculitis should be considered.

Adipose Tissue↗

PubMed2006

The visceral and subcutaneous fat changes in type 1 diabetes: a pilot study.

OBJECTIVE: To evaluate the effects of improved glycaemic control on the abdominal visceral and subcutaneous fat in type 1 diabetes. RESEARCH DESIGN AND METHODS: Sixteen subjects were enrolled for this 6-month study. The goal was to achieve normal haemoglobin A1c (HbA1c <5.6% in our laboratory). T1-weighted magnetic resonance imaging was used to measure the abdominal subcutaneous and visceral fat areas at the L2-L3 disk level. Activity and energy intake were assessed using a weekly recall and food diary respectively. Plasma leptin, ghrelin and adiponectin levels were measured at baseline and at 6 months. RESULTS: Twelve subjects completed the study. HbA1c was 10.4 +/- 2.2% at baseline, and abdominal visceral to subcutaneous fat ratio was 0.29 +/- 0.15. HbA1c dropped to 8.0 +/- 1.4% at 6 months (p = 0.009). There was a +1.85 kg weight change in 6 months (p = 0.30), whereas the visceral to subcutaneous fat ratios changed to 0.36 +/- 0.18 (p = 0.22). Daily metabolic equivalents (METs) of activity at 6 months correlated with a decrease in the visceral to subcutaneous fat ratios (r = -0.80, p = 0.01). Ghrelin level changes correlated negatively with the changes in the visceral to subcutaneous fat ratio (p < 0.01). CONCLUSIONS: The visceral to subcutaneous fat changes had a negative correlation with the physical activity METs at 6 months but not with HbA1c changes in this study. The correlation between the changes in ghrelin and the visceral to subcutaneous fat ratios is intriguing, but a larger study may be needed to confirm this finding.

Adiponectin↗

PubMed2005

Merkel cell carcinoma arising from the subcutaneous fat of the arm with intact skin.

BACKGROUND: Merkel cell carcinoma is a rare malignant neuroendocrine neoplasm characteristically arising from the dermis of sunlight-exposed skin. It rarely arises outside the skin. OBJECTIVE: We present a patient with primary Merkel cell carcinoma arising from subcutaneous fat, with no involvement of the overlying skin. We describe the clinical manifestations and magnetic resonance imaging (MRI) findings. METHODS: We report a 63-year-old woman with a primary lesion of Merkel cell carcinoma that arose from the subcutaneous fat layer of the left arm. The lesion presented as a subcutaneous nodule with intact overlying skin. MRI showed that the nodular lesion was located entirely in the subcutaneous fat layer, with no involvement of the dermis. Peritumoral infiltration around the lesion and enlarged lymph nodes deep to the lesion were noted. The patient received wide excision of the lesion with dissection of the regional lymph nodes and adjuvant radiotherapy and chemotherapy. RESULTS: Histopathologic examination confirmed the diagnosis of Merkel cell carcinoma with local lymphatic metastasis, and the lesion was completely located in the subcutaneous fat, with no involvement of the dermis. These findings were well correlated with MRI findings. CONCLUSION: Primary Merkel cell carcinoma may arise from the subcutaneous fat and present as an entirely subcutaneous lesion with intact skin. MRI is helpful to evaluate the local extension of the lesion and regional lymphatic metastasis.

Arm↗

PubMed1988

Estimation of body fat from ultrasound measures of subcutaneous fat and circumferences in obese women.

Body density and body fat are commonly estimated from measures of subcutaneous adipose tissue taken with skinfold calipers at specific body sites. In obese individuals, factors such as compression and inability to palpate tissues hinder the accurate measurement of skinfolds. Thus, the use of skinfold caliper measurements may yield spurious body density values. Previous research indicated that in obese persons, subcutaneous adipose tissue thickness measured by ultrasound gave more accurate predictions of body density, determined by hydrostatic weighing, than did caliper measurements. The present study compared ultrasound with circumference readings in estimating the body density of 31 white, obese women. Subcutaneous adipose tissue was measured at six body sites with an ADR model 2130 ultrasound real-time scanner. A calibrated fiberglass tape was used to take circumferences at ten body sites. Body density was computed from hydrostatic weighing using the Goldman/Buskirk formula, and percentage body fat, from the Siri equation. Mean (+/- s.d.) body density was 1.002 (+/- 0.015) g/ml, percentage body fat, 44.0 (+/- 7.5) and body mass index, 32.3 (+/- 4.5). The best prediction of body density, as determined by hydrostatic weighing, was with biceps and mid-thigh sites for ultrasound (r2 = 0.569). The combination of age, wrist, waist and upper thigh sites gave the best prediction for circumferences (r2 = 0.752). For the obese women in this study, circumference measurements provided a better estimation of body density and hence, body fat, than did ultrasound measures. A possible explanation to account for the difference is that circumference measures reflect both internal and subcutaneous adipose tissue, while only subcutaneous adipose tissue is measured with ultrasound.

Adipose Tissue↗

PubMed1995

Validation of body condition scores with ultrasound measurements of subcutaneous fat of dairy cows.

This research validated body condition scores with ultrasound measurements of subcutaneous fat. Fifty Holstein cows were evaluated during three sessions in 1993. Cows scored during each session were divided into three groups of 15 or 20 cows. Body condition scores were assigned by one trained individual, utilizing a five-point (1 = thin to 5 = fat) visual scoring technique. Cows were scored to the nearest quarter point. Ultrasound measurements of subcutaneous fat were obtained by another individual at the lumbar, thurl, and tailhead areas of both sides of the cow. Body condition scores and ultrasound measurements were collected on the same day, but obtained independently. Correlations between ultrasound measurements ranged from .36 to .86. Regression models were developed to validate the body condition scoring technique across the three cow groups. Group number and different combinations of ultrasound measurements were independent variables, and body condition score was the dependent variable. Ultrasound measurements were significantly associated with body condition scores. The coefficients of determination for the models ranged from .36 to .65, depending on which ultrasound measurements were included in the model. These results suggest that the body condition scoring technique used in this study was as valid as ultrasound techniques for measurement of subcutaneous fat.

Adipose Tissue↗

PubMed2001

Is fetal abdominal subcutaneous fat comparable with established indices of growth restriction?

The purpose of this study was to determine if measurement of the abdominal subcutaneous fat antenatally using ultrasound is comparable to other established indices of fetal growth restriction (FGR). One hundred women with singleton pregnancies had an ultrasound scan within 1 week of delivery at term. Ultrasound measurements included abdominal circumference (AC), liquor assessment by amniotic fluid index (AFI) and abdominal subcutaneous fat thickness (FAB). After delivery,infants were weighed and skinfold thickness at triceps and subscapular sites measured. Ponderal index was also calculated. Infants with an abdominal subcutaneous fat measurement antenatally of 5 mm or less (n = 41) were more likely than those with a fat measurement of more than 5 mm (n = 59) to have an AFI < 8 cm (P < 0.001) and to have an AC < 10th centile (P < 0.001). Decreased antenatal fat thickness was associated postnatally with a lower mean ponderal index (24.2 kg/m3 vs. 25.5 kg/m3, P < 0.02) and a decreased skinfold thickness (4.84 vs. 5.55 mm, P < 0.003 and 3.88 vs. 4.37, P < 0.03 for triceps and subscapular, respectively). This study shows that fetal abdominal subcutaneous fat measurement correlates with established predictors of fetal nutrition such as liquor volume, abdominal circumference, ponderal index, triceps and subscapular skinfold thickness.

Journal Article↗

PubMed1995

[Subcutaneous fat necrosis of the newborn].

Subcutaneous fat necrosis (SFN) of the newborn is an uncommon disorder, which occurs during the first years of life, and has been attributed to perinatal stress. Two typical cases are presented. This inflammatory disorder of adipose tissue affects primarily the back, buttocks, arms and thighs, and consists of sharply circumscribed, subcutaneous nodules and plaques. The lesions are red or violaceous and initially tender. Usually they involute spontaneously within months. Hypercalcemia, hypotonia, poor feeding, vomiting and fever are associated with SFN. The aetiology is still incompletely understood. Therapy is not required, except when associated with hypercalcemia.

Adipose Tissue↗

PubMed1986

Absorption of bupivacaine, etidocaine, lignocaine and ropivacaine into n-heptane, rat sciatic nerve, and human extradural and subcutaneous fat.

Absorption of four amide local anaesthetics, including a new experimental agent, ropivacaine, in n-heptane, rat sciatic nerve and human extradural and subcutaneous fat was studied in vitro. The relative n-heptane/buffer (37 degrees C) partitioning of bupivacaine:etidocaine:lignocaine:ropivacaine was 10:39:1:2.9. The absorption of bupivacaine and etidocaine into nerve tissue was identified at steady state, but in extradural and subcutaneous fat etidocaine was taken up significantly more than bupivacaine. The lowest uptake was with lignocaine, and at steady state its mean concentrations were similar in all three tissues. There was a significantly higher concentration of ropivacaine than lignocaine in all tissues. Mean tissue concentrations of bupivacaine in sciatic nerve and subcutaneous fat, on the other hand, were significantly higher than those of ropivacaine. The ratios of relative mean uptake (mg g-1), at steady state, of bupivacaine, etidocaine, lignocaine and ropivacaine were: sciatic nerve 3.3:4:1:1.8, extradural fat 4.1:8.3:1:2.3 and subcutaneous fat 3.8:10.6:1:1.9, all of which were clearly lower than the theoretical n-heptane/buffer partitioning ratios.

Absorption↗

PubMed2004

Gender differences in newborn subcutaneous fat distribution.

UNLABELLED: The pattern and distribution of subcutaneous fat in term and preterm newborns has been assessed by skinfold thicknesses (ST), describing gender and gestational age variations. Weight, length and ST (triceps, biceps, subscapular and suprailiac) were measured in 4634 neonates (2445 males and 2189 females) aged from 32 to 41 gestational weeks. Central to total skinfold ratio (CTS), (suprailiac + subscapular)/sum of 4 ST, was calculated. Males were heavier and longer than females. The sum of 4 ST and CTS was higher in females at every gestational age (with significant differences from 35 weeks) and also the sum of 4 ST per kg body weight (P < 0.05 from 32-33 weeks). Throughout the gestational period, ST increased significantly (P < 0.0001) but CTS did not show variations, neither in males nor in females. CONCLUSION: term and preterm females have a more centralised pattern and more amount of subcutaneous fat than males. Central to total skinfold ratio must be considered as an index of centripetal fat store which is independant of gestational age.

Adipose Tissue↗